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1.
Sleep Med ; 64: 56-61, 2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31670162

RESUMO

OBJECTIVE: The aim of this study was to assess the trends and determinants of sleeping pill consumption in the general population. METHODS: This was a prospective study that included 4329 participants (2379 women, 51.9 ± 10.4 years) living in the city of Lausanne, Switzerland, followed up for an average of 10.9 years. Benzodiazepines and benzodiazepine receptor agonists were considered as sleeping pills. RESULTS: The prevalence (95% confidence interval [CI]) of sleeping pills use was 8.0% (7.2-8.9) at baseline and 8.4 (7.6-9.3) after 10.9 years. Overall, sleeping pills use was higher among women, elderly individuals, and individuals reporting a history of anxiety and depression. During the 10.9-year follow-up, 85.8% of participants never used sleeping pills, 2.7% used the sleeping pills at all assessments, and 11.5% shifted from using to quitting (and vice versa). On multivariate analysis, the factors associated with "always" sleeping pills use were as follows: female gender (relative risk ratio and [95% CI] = 1.80 [1.14-2.85]); older age (7.05 [3.56-14.0] for 65 + vs < 45 years); lower educational level (2.06 [1.06-3.99] for mandatory vs university); anxiety (5.61 [3.61-8.71] for yes/no); and depression (3.75 [2.47-5.69] for yes/no). The same factors were also associated with occasional sleeping pills use (ie, shifters): relative risk ratios and 95% CI = 1.56 (1.26-1.94), 2.37 (1.72-3.26), 1.35 (0.98-1.87), 3.40 (2.59-4.45), and 2.50 (1.99-3.15) for female gender, older age, lower educational level, and anxiety and depression, respectively. CONCLUSION: During a 10.9-year follow-up, one out of seven participants (14.2%) used sleeping pills at least once during the study period. Sleeping pills use is more frequent among individuals with anxiety or depression, elderly individuals, and women.

2.
PLoS One ; 14(10): e0218933, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31596852

RESUMO

BACKGROUND AND AIMS: Many countries lack resources to identify patients at risk of developing Type 2 diabetes mellitus (diabetes). We aimed to develop and validate a diabetes risk score based on easily accessible clinical data. METHODS: Prospective study including 5277 participants (55.0% women, 51.8±10.5 years) free of diabetes at baseline. Comparison with two other published diabetes risk scores (Balkau and Kahn clinical, respectively 5 and 8 variables) and validation on three cohorts (Europe, Iran and Mexico) was performed. RESULTS: After a mean follow-up of 10.9 years, 405 participants (7.7%) developed diabetes. Our score was based on age, gender, waist circumference, diabetes family history, hypertension and physical activity. The area under the curve (AUC) was 0.772 for our score, vs. 0.748 (p<0.001) and 0.774 (p = 0.668) for the other two. Using a 13-point threshold, sensitivity, specificity, positive and negative predictive values (95% CI) of our score were 60.5 (55.5-65.3), 77.1 (75.8-78.2), 18.0 (16.0-20.1) and 95.9 (95.2-96.5) percent, respectively. Our score performed equally well or better than the other two in the Iranian [AUC 0.542 vs. 0.564 (p = 0.476) and 0.513 (p = 0.300)] and Mexican [AUC 0.791 vs. 0.672 (p<0.001) and 0.778 (p = 0.575)] cohorts. In the European cohort, it performed similarly to the Balkau score but worse than the Kahn clinical [AUC 0.788 vs. 0.793 (p = 0.091) and 0.816 (p<0.001)]. Diagnostic capacity of our score was better than the Balkau score and comparable to the Kahn clinical one. CONCLUSION: Our clinically-based score shows encouraging results compared to other scores and can be used in populations with differing diabetes prevalence.

3.
Nutrients ; 11(8)2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31426347

RESUMO

Menopause alters body composition by increasing fat mass. Menopausal hormone therapy (MHT) is associated with decreased total and visceral adiposity. It is unclear whether MHT favorably affects energy intake. We aimed to assess in the OsteoLaus cohort whether total energy intake (TEI) and/or diet quality (macro- and micronutrients, dietary patterns, dietary scores, dietary recommendations)-evaluated by a validated food frequency questionnaire-differ in 839 postmenopausal women classified as current, past or never MHT users. There was no difference between groups regarding TEI or consumption of macronutrients. After multivariable adjustment, MHT users were less likely to adhere to the unhealthy pattern 'fat and sugar: Current vs. never users [OR (95% CI): 0.48 (0.28-0.82)]; past vs. never users [OR (95% CI): 0.47 (0.27-0.78)]. Past users exhibited a better performance in the revised score for Mediterranean diet than never users (5.00 ± 0.12 vs. 4.63 ± 0.08, p < 0.04). Differences regarding compliance with dietary recommendations were no longer significant after adjustment for covariates. Overall, these results argue against a major role of TEI and diet quality as possible mediators of the MHT metabolic benefits. Future research on this relationship should focus on other potential targets of MHT, such as resting energy expenditure and physical activity.

4.
BMJ Open ; 9(8): e027070, 2019 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-31446404

RESUMO

OBJECTIVE: To assess the prevalence and factors associated with fatigue in the general population. DESIGN: Population-based, cross-sectional survey performed between May 2014 and April 2017. SETTING: General population of the city of Lausanne, Switzerland. PARTICIPANTS: 2848 participants (53.2% women, age range 45-86 years). PRIMARY OUTCOME MEASURE: Prevalence of fatigue the previous week, defined as a score of ≥4 using the Fatigue Severity Scale. RESULTS: The prevalence of fatigue was 21.9% (95% CI 20.4% to 23.4%) in the total sample. On bivariate analysis, participants with fatigue were younger, had a higher body mass index, a lower handgrip strength and lower ferritin levels. Participants with fatigue were more frequently women, had a lower educational level, presented more frequently with clinical insomnia, diabetes, anaemia, depression and low thyroid stimulating hormone (TSH) values, had a higher consumption of antihistamines, antidepressants and hypnotics, and rated more frequently their health as bad or very bad. Multivariable analysis showed that obesity (OR 1.40 (95% CI 1.03 to 1.91)), insomnia categories (p value for trend <0.001), depression (OR 3.26 (95% CI 2.38 to 4.46)), anaemia (OR 1.70 (95% CI 1.00 to 2.89)) and low self-rated health status (p value for trend <0.001) were positively associated with fatigue, while older age (p value for trend 0.002) was negatively associated with fatigue. Conversely, no association was found for diabetes, TSH levels, antihistamines or hypnotics. CONCLUSION: In a population-based sample aged 45-86, fatigue was present in one out of five subjects. Regarding clinical factors, sleep disturbances such as insomnia and sleep apnoea should be assessed first, followed by depression. Regarding biological factors, anaemia should be ruled out, while screening for hypothyroidism is not recommended as a first step. Sleep complaints and fatigue in older subjects are not due to ageing and should prompt identification of the underlying cause.

5.
Sci Rep ; 9(1): 9439, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31263163

RESUMO

Type 2 diabetes (T2D) affects the health of millions of people worldwide. The identification of genetic determinants associated with changes in glycemia over time might illuminate biological features that precede the development of T2D. Here we conducted a genome-wide association study of longitudinal fasting glucose changes in up to 13,807 non-diabetic individuals of European descent from nine cohorts. Fasting glucose change over time was defined as the slope of the line defined by multiple fasting glucose measurements obtained over up to 14 years of observation. We tested for associations of genetic variants with inverse-normal transformed fasting glucose change over time adjusting for age at baseline, sex, and principal components of genetic variation. We found no genome-wide significant association (P < 5 × 10-8) with fasting glucose change over time. Seven loci previously associated with T2D, fasting glucose or HbA1c were nominally (P < 0.05) associated with fasting glucose change over time. Limited power influences unambiguous interpretation, but these data suggest that genetic effects on fasting glucose change over time are likely to be small. A public version of the data provides a genomic resource to combine with future studies to evaluate shared genetic links with T2D and other metabolic risk traits.

6.
Endocr Connect ; 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31176299

RESUMO

BACKGROUND: Excessive glucocorticoid secretion has been associated with type 2 diabetes mellitus (T2DM) and other features of the metabolic syndrome. We aimed to evaluate if basal salivary cortisol may predict occurrence of new insulin resistance (IR) or T2DM. METHOD: This was a prospective, population-based study derived from the CoLaus (Cohorte lausannoise) study including 1525 participants (aged 57.7 ± 10.3 y; 725 women). A total of 1149 individuals were free from diabetes at baseline. Fasting plasma glucose and insulin were measured after a follow-up of 5.3 y. Basal salivary cortisol was measured at baseline. The association between basal salivary cortisol level and incidence of IR or T2DM was analyzed by logistic regression, and the results were expressed for each independent variables as ORs and 95% CI. RESULTS: After a median follow-up of 5.3 y, a total of 376 subjects (24.7%) developed IR and 32 subjects (2.1%) developed T2DM. Basal salivary cortisol divided in quartiles was not associated with incidence of IR or T2DM. Multivariable analysis for age, gender, body mass index, physical activity and smoking status showed no association between basal and incidence of IR (quartile 2 (Q2) OR: 1.01 (0.70-1.45), quartile 3 (Q3) OR: 1.01 (0.70-1.45), quartile 4 (Q4) OR: 1.05 (0.73-1.52), p=0.805) or T2DM (Q2 OR: 1.00 (0.37 - 2.73), Q3 OR: 0.96 (0.35 - 2.61), Q4 OR: 1.08 (0.40 - 2.95)). CONCLUSION: In the CoLaus study of healthy adults, basal salivary cortisol was not associated with incident IR or T2DM.

7.
Environ Sci Pollut Res Int ; 26(19): 19697-19704, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31079306

RESUMO

The effect of particulate matter (PM) on health increases with exposure duration but the change from short to longer term is not well studied. We examined the exposure to PM smaller 10 µm (PM10) from short to longer duration and their associations with levels of inflammatory markers in the population-based CoLaus cohort in Lausanne, Switzerland. Baseline and follow-up CoLaus data were used to study the associations between PM10 exposure and inflammatory markers, including the high-sensitivity C-reactive protein (CRP), as well as interleukin 1-beta (IL-1ß), interleukin 6 (IL-6), and tumor-necrosis-factor alpha (TNF-α) using mixed models. Exposure was determined for each participant's home address from hourly air quality simulations at a 5-m resolution. Short-term exposure intervals were 1 day, 1 week, and 1 month prior to the hospital visit (blood withdrawal); long-term exposure intervals were 3 and 6 months prior to the visit. In most time windows, IL-6, IL-1ß, and TNF-α were positively associated with PM10. No significant associations were identified for CRP. Adjusted associations with long-term exposures were stronger and more significant than those for short-term exposures. In stratified models, gender, age, smoking status, and hypertension only led to small modifications in effect estimates, though a few of the estimates for IL-6 and TNF-α became non-significant. In this general adult cohort exposed to relatively low average PM10 levels, clear associations with markers of systemic inflammation were observed. Longer duration of elevated exposure was associated with an exacerbated inflammatory response. This may partially explain the elevated disease risk observed with chronic PM10 exposure. It also suggests that reducing prolonged episodes of high PM exposure may be a strategy to reduce inflammatory risk.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/análise , Exposição Ambiental/análise , Inflamação/sangue , Material Particulado/análise , Adulto , Idoso , Poluentes Atmosféricos/toxicidade , Biomarcadores/sangue , Proteína C-Reativa/análise , Estudos de Coortes , Exposição Ambiental/efeitos adversos , Feminino , Humanos , Inflamação/induzido quimicamente , Interleucina-6/sangue , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Material Particulado/toxicidade , Fatores de Risco , Suíça , Fatores de Tempo , Fator de Necrose Tumoral alfa/sangue
8.
J Hypertens ; 37(9): 1853-1860, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30964826

RESUMO

BACKGROUND: The prevalence of chronic kidney disease (CKD) is increasing worldwide in part due to population ageing. Identifying risk factors for age-related kidney function decline could help in understanding mechanisms for kidney ageing. Sodium and potassium intakes are associated with CKD progression in the renal population, but little is known on their role in renal function decline [mean estimated glomerular filtration rate variation (ΔeGFR)] in the general adult population. METHOD: We therefore explored the association of urinary sodium and potassium excretions with ΔeGFR in a longitudinal population-based cohort. We estimated 24-h urinary sodium (eUNa), potassium (eUK) and sodium-to-potassium ratio (eUNa/K) from spot urine using Kawasaki formulae. We performed multivariate linear regression models studying the association of eUNa, eUK and eUNa/K with yearly ΔeGFR, taking several covariates into account, including baseline eGFR and albuminuria. RESULTS: There were 4141 white participants from which 54.3% were women. Median age was 51.5 [43.6-60.6] years and mean baseline eGFR 88 (SD 15) ml/min per 1.73 m. During a median follow-up of 5.4 years, mean ΔeGFR was -0.59 (SD 1.68) ml/min per 1.73 m per year. In the fully adjusted model, high eUNa and eUNa/K were associated with faster renal function decline with standardized coefficients ß = -0.07 (95% confidence interval: -0.11 to -0.04) and ß = -0.05 (95% confidence interval: -0.08 to -0.02), respectively. By contrast, eUK, taken alone, showed no association. CONCLUSION: These results suggest that dietary sodium and potassium intakes may play a role in kidney function decline in the general adult population. Whether lowering sodium and increasing potassium in the diet may help in CKD prevention needs further exploration.

9.
BMC Med ; 17(1): 75, 2019 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-30961604

RESUMO

BACKGROUND: Comorbidity patterns of childhood infections, atopic diseases, and adverse childhood experiences (ACE) are related to immune system programming conditions. The aim of this study was to make a step beyond the hygiene hypothesis and to comprehensively classify these patterns with latent class analysis (LCA). A second aim was to characterize the classes by associations with immunological, clinical, and sociodemographic variables. METHODS: LCA was applied to data from the CoLaus|PsyCoLaus study (N = 4874, age range 35-82 years) separately for men and women. It was based on survey information on chickenpox, measles, mumps, rubella, herpes simplex, pertussis, scarlet fever, hay fever, asthma, eczema, urticaria, drug allergy, interparental violence, parental maltreatment, and trauma in early childhood. Subsequently, we examined how immune-mediated classes were reflected in leukocyte counts, inflammatory markers (IL-1ß, IL-6, TNF-α, hsCRP), chronic inflammatory diseases, and mental disorders, and how they differed across social classes and birth cohorts. RESULTS: LCA results with five classes were selected for further analysis. Latent classes were similar in both sexes and were labeled according to their associations as neutral, resilient, atopic, mixed (comprising infectious and atopic diseases), and ACE class. They came across with specific differences in biomarker levels. Mental disorders typically displayed increased lifetime prevalence rates in the atopic, the mixed, and the ACE classes, and decreased rates in the resilient class. The same patterns were apparent in chronic inflammatory diseases, except that the ACE class was relevant specifically in women but not in men. CONCLUSIONS: This is the first study to systematically determine immune-mediated classes that evolve early in life. They display characteristic associations with biomarker levels and somatic and psychiatric diseases occurring later in life. Moreover, they show different distributions across social classes and allow to better understand the mechanisms beyond the changes in the prevalence of chronic somatic and psychiatric diseases.


Assuntos
Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/imunologia , Hipótese da Higiene , Fenômenos do Sistema Imunológico/fisiologia , Análise de Classes Latentes , Adulto , Idoso , Idoso de 80 Anos ou mais , Asma/epidemiologia , Asma/imunologia , Criança , Comorbidade , Feminino , Humanos , Inflamação/complicações , Inflamação/epidemiologia , Inflamação/imunologia , Masculino , Pessoa de Meia-Idade , Múltiplas Afecções Crônicas/epidemiologia , Prevalência , Inquéritos e Questionários
10.
Rev Med Suisse ; 15(647): 836-839, 2019 Apr 17.
Artigo em Francês | MEDLINE | ID: mdl-30994987

RESUMO

Changes occurring at menopause can be mitigated by prescribing menopausal hormone replacement therapy (HRT). Recent publications from the CoLaus/OsteoLaus cohorts provide important insights into the effects of HRT and after its discontinuation on bone and body composition. HRT has a beneficial effect on bone mineral density, bone microarchitecture and fracture prevention. The benefits persist after treatment discontinuation, but not beyond 2 to 5 years. The effect of HRT on body composition is more controversial. HRT reduces the accumulation of fat mass, mainly abdominal and visceral fat mass. This is important from the perspective of diabetes and cardiovascular disease prevention. However, the benefits seem to disappear immediately after discontinuation.


Assuntos
Composição Corporal , Terapia de Reposição Hormonal , Menopausa , Composição Corporal/efeitos dos fármacos , Densidade Óssea , Osso e Ossos , Terapia de Reposição de Estrogênios , Feminino , Humanos
11.
J Clin Sleep Med ; 15(2): 183-194, 2019 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-30736872

RESUMO

STUDY OBJECTIVES: Apnea-hypopnea index (AHI) is the main polysomnographic measure to diagnose obstructive sleep apnea (OSA). We aimed to evaluate the effect of three standard hypopnea definitions on the prevalence of OSA and its association with cardiometabolic outcomes in the general population. METHODS: We analyzed data from the HypnoLaus study (Lausanne, Switzerland), in which 2,162 participants (51% women, 57 ± 19 years) underwent in-home full polysomnography. AHI was calculated using three hypopnea definitions: AASM1999 (≥ 50% decrease in airflow or lower airflow reduction associated with oxygen desaturation ≥ 3% or an arousal), AASM2007 (≥ 30% airflow reduction associated with ≥ 4% oxygen desaturation), and AASM2012 (≥ 30% airflow reduction associated with ≥ 3% oxygen desaturation or an arousal). Participants underwent clinical assessment for hypertension, diabetes, and metabolic syndrome. RESULTS: Median AHI of AASM1999, AASM2007 and AASM2012 criteria were 10.9, 4.4, and 10.1 events/h, respectively. OSA prevalence defined as AHI ≥ 5, ≥ 15, and ≥ 30 events/h was 74.5%, 39.3%, and 16.3% using AASM1999; 46.9%, 18.8%, and 6.8% using AASM2007; and 72.2%, 36.6%, and 14.9% using AASM2012. Different AHI thresholds derived from AASM1999, AASM2007, and AASM2012 criteria, respectively, were associated with hypertension (11.5, 4.8, 10.7 events/h), diabetes (15.7, 7.1, 14.4 events/h), and metabolic syndrome (12.8, 5.5, 11.8 events/h). CONCLUSIONS: Hypopnea definition has a major effect on AHI and on OSA prevalence in the general population and, hence, important implications for public health policies. There is a twofold difference in the threshold above which an association with diabetes, hypertension, and metabolic syndrome is observed using AASM2007 compared to AASM1999 or AASM2012 criteria.

13.
Respir Res ; 19(1): 250, 2018 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-30545344

RESUMO

BACKGROUND: Reduced lung function predicts increased mortality, but its prevalence may vary depending on definition considered, use of bronchodilation and applied reference values. We aimed to assess lung function abnormalities in Lausanne, Switzerland, and their association with clinical history. METHODS: In a general population sample, spirometry was performed and bronchodilation applied if the ratio forced expiratory volume in 1 s (FEV1) / forced vital capacity (FVC) or the FVC was below the lower limit of normal (LLN) according to Global Lung Function Initiative 2012 references. Results for FEV1/FVC according to the LLN were compared to the 0.7 fixed ratio. Respiratory risk factors, symptoms and self-reported respiratory diagnoses were recorded through a questionnaire. RESULTS: Out of the 3342 included subjects, 3.8% had chronic obstruction and 2.5% reversible obstruction when using the LLN; possible lung restriction alone was present in 1.8%, and associated with chronic obstruction in 0.4%. Ever smokers had a higher prevalence of abnormal spirometry, chronic obstruction and reversible obstruction; there was no difference with regard to possible restriction. Overall, chronic airway obstruction was found in 8.9% of current smokers, 4.6% of former smokers and 1.5% of never smokers. Only one third of participants with chronic obstruction were aware of a respiratory disease. CONCLUSION: Prevalence of abnormal lung function in the population of Lausanne is low. This may be due to a low rate of ever-smokers, the application of a full bronchodilation dose, but also to inherent characteristics of this population.


Assuntos
Pneumopatias Obstrutivas/epidemiologia , Pneumopatias Obstrutivas/fisiopatologia , Pulmão/fisiologia , Vigilância da População , Espirometria/métodos , Idoso , Estudos de Coortes , Feminino , Seguimentos , Volume Expiratório Forçado/fisiologia , Humanos , Pneumopatias Obstrutivas/diagnóstico , Masculino , Pessoa de Meia-Idade , Vigilância da População/métodos , Estudos Prospectivos , Valores de Referência , Espirometria/normas , Suíça/epidemiologia , Volume de Ventilação Pulmonar/fisiologia , Capacidade Vital
14.
Clin Nutr ESPEN ; 28: 208-213, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30390882

RESUMO

BACKGROUND/AIM: Many trials have shown that dietary interventions reduce the incidence of hypertension. Whether these findings also apply in the general population is debated. We assessed the association between dietary markers and incidence of hypertension. DESIGN: prospective observational study. METHODS: Population-based study conducted between April 2009 and April 2017 in Lausanne, Switzerland. 2079 participants (60.6% women, 53.9 ± 9.0 years, age range 40-80), devoid of hypertension at baseline, were followed for a median time of 63 months. Hypertension was defined as systolic BP ≥ 140 mm Hg or diastolic BP ≥ 90 mm Hg or anti-hypertensive medication. Self-reported dietary intake was assessed using a food frequency questionnaire. Analysis was conducted using logistic regression. RESULTS: 370 participants (17.8%) developed hypertension. On bivariate analysis, no association was found between all food items, dietary scores and compliance to dietary guidelines and incident hypertension. Similar findings were observed after multivariable analysis. CONCLUSION: Over a period of 5 years, one sixth of the Swiss population aged 40 to 80 developed hypertension. No association was found between dietary markers and incident hypertension. Current dietary behaviours are insufficient to prevent hypertension in the general population.

15.
J Sleep Res ; : e12799, 2018 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-30474290

RESUMO

Sleep-disordered breathing is a common condition, related to a higher cardiometabolic and neurocognitive risk. The main risk factors for sleep-disordered breathing include obesity, craniofacial characteristics, male sex and age. However, some studies have suggested that adverse socioeconomic circumstances and lifestyle-related behaviours such as smoking and alcohol use, may also be risk factors for sleep-disordered breathing. Here, we investigate the associations between socioeconomic status and sleep-disordered breathing, as measured by sleep apnea-hypopnea and oxygen desaturation indexes. Furthermore, we assess whether these associations are explained by lifestyle-related factors (smoking, sedentary behaviour, alcohol use and body mass index [BMI]). We used data from the CoLaus|HypnoLaus study, a population-based study including 2162 participants from Lausanne (Switzerland). Socioeconomic status was measured through occupation and education. Sleep-disordered breathing was assessed through polysomnography and measured using the apnea-hypopnea index (AHI: number of apnea/hypopnea events/hr: ≥15/≥30 events), and the ≥3% oxygen desaturation index (ODI: number of oxygen desaturation events/hr: ≥15/≥30 events). Lower occupation and education were associated with higher AHI and ODI (occupation: AHI30, odds ratio (OR) = 1.88, 95% confidence interval (CI) [1.07; 3.31]; ODI30, OR = 2.29, 95% CI [1.19; 4.39]; education: AHI30, OR = 1.21, 95% CI [0.85; 1.72]; ODI30, OR = 1.26, 95% CI [0.83; 1.91]). BMI was associated with socioeconomic status and AHI/ODI, and contributed to the socioeconomic gradient in SDB, with mediation estimates ranging between 43% and 78%. In this Swiss population-based study, we found that low socioeconomic status is a risk factor for sleep-disordered breathing, and that these associations are partly explained by BMI. These findings provide a better understanding of the mechanisms underlying social differences in sleep-disordered breathing and may help implement policies for identifying high-risk profiles for this disorder.

16.
Rev Med Suisse ; 14(628): 2095, 2018 Nov 21.
Artigo em Francês | MEDLINE | ID: mdl-30462395
17.
Public Health Nutr ; : 1-8, 2018 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-30333073

RESUMO

OBJECTIVE: To assess the associations between single foods, nutrients, dietary patterns and dietary scores, and inflammatory markers (C-reactive protein (CRP), IL-6, TNF-α and leucocyte count). DESIGN: Cross-sectional, population-based study. SETTING: City of Lausanne, Switzerland, years 2009-2012. SUBJECTS: Adults (n 4027; 46·5 % men), mean age 57·2 (sd 10·2) years. Dietary intake was collected using a semi-quantitative FFQ. Single foods and nutrients, three dietary patterns ('Meat & fries'; 'Fruits & vegetables'; 'Fatty & sugary') and three dietary scores (two Mediterranean; Alternative Healthy Eating Index (AHEI)) were used. Associations were assessed using correlation and multivariable linear regression. RESULTS: After adjusting for total energy intake, gender and other sociodemographic factors, no individual macro- or micronutrient was associated with inflammatory markers. Among single foods, only fruit intake was negatively associated with CRP levels (standardized regression score=-0·043, P<0·01). The 'Fruits & vegetables' pattern, the Mediterranean and the AHEI scores were negatively associated with CRP levels (standardized regression score=-0·079, -0·043 and -0·067, respectively, all P<0·01). When entered simultaneously with fruit intake, the 'Fruits & vegetables' pattern, the Mediterranean and the AHEI scores tended to remain significantly and negatively associated with CRP levels, while the association with fruit intake was no longer significant. No association between all dietary markers and IL-6, TNF-α or leucocyte count was found. CONCLUSIONS: Dietary scores, but not individual foods, are associated with inflammatory markers in the general population.

18.
J Hum Hypertens ; 2018 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-30283088

RESUMO

Few studies assessed incidence and determinants of hypertension. We assessed the incidence and determinants of hypertension in a cohort of healthy adults aged 35-75 years living in Lausanne, Switzerland. Baseline data were collected from 2003 to 2006. Follow-ups were conducted in 2009-2012 and 2014-2017. Incident hypertension, defined as a systolic BP ≥140 mm Hg or a diastolic BP ≥90 mm Hg or anti-hypertensive medication, was assessed at 1) second follow-up only; 2) first and/or second follow-up. After 10.9 years, incident hypertension was 26.8% (analysis 1, N = 3299) and 30.3% (analysis 2, N = 3728). After multivariate adjustment, the variables associated with increased hypertension incidence were male gender [incident-rate ratio (IRR) and (95% confidence interval)]: 1.20 (1.07-1.35) and 1.24 (1.13-1.37) for analyses 1 and 2, respectively; increasing age (p for trend < 0.001) and body mass index (p for trend < 0.001) and history of cardiovascular disease (CVD). Being physically active was negatively associated with incident hypertension: 0.88 (0.78-0.98) and 0.92 (0.83-1.01) for analyses 1 and 2, respectively. Except for male gender, these associations remained after adjusting for baseline BP levels, with incident rate ratios for physical activity of 0.86 (0.77-0.96) and 0.91 (0.83-0.99) for analyses 1 and 2, respectively. No association was found for education, alcohol consumption or smoking status. We conclude that over 10.9 years, between 1/4 and 1/3 of the Swiss population aged 35-75 developed hypertension. Male gender, history of CVD, increasing age and higher BMI increase the risk of hypertension, while being physically active reduces the risk.

19.
Eur Respir J ; 52(5)2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30287472

RESUMO

Cross-sectional studies have demonstrated that obstructive sleep apnoea (OSA) and metabolic syndrome (MetS) are often associated, but whether a temporal relationship exists is unknown. We aimed to investigate the effect of OSA on the risk of developing MetS in the general population.A prospective study was conducted combining two population-based samples: Episono (Brazil) and HypnoLaus (Switzerland). MetS was assessed according to unified criteria. Polysomnography (PSG) was performed at baseline and follow-up in Episono, and at baseline in HypnoLaus. OSA was defined according to the apnoea-hypopnoea index as mild (≥5- <15 events h-1) and moderate-to-severe (≥15 events·h-1). We included 1853 participants (mean±sd age 52±13 years, 56% female) without MetS at baseline.After mean±sd 6±1 years, 318 (17.2%) participants developed MetS. Moderate-to-severe OSA was independently associated with incident MetS (OR 2.58, 95% CI 1.61-4.11) and increased the number of MetS components from baseline to follow-up through mediation of the percentage of time with arterial oxygen saturation <90%. Subset analysis in Episono confirmed that the increase in this parameter between baseline and follow-up PSGs represented a risk factor for incident MetS (OR 1.42, 95% CI 1.04-1.95, for each 10% increase).OSA is independently associated with an increased risk of developing MetS through mediation of nocturnal hypoxaemia in the general population.

20.
Nat Commun ; 9(1): 4228, 2018 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-30315176

RESUMO

Elevated serum urate levels can cause gout, an excruciating disease with suboptimal treatment. Previous GWAS identified common variants with modest effects on serum urate. Here we report large-scale whole-exome sequencing association studies of serum urate and kidney function among ≤19,517 European ancestry and African-American individuals. We identify aggregate associations of low-frequency damaging variants in the urate transporters SLC22A12 (URAT1; p = 1.3 × 10-56) and SLC2A9 (p = 4.5 × 10-7). Gout risk in rare SLC22A12 variant carriers is halved (OR = 0.5, p = 4.9 × 10-3). Selected rare variants in SLC22A12 are validated in transport studies, confirming three as loss-of-function (R325W, R405C, and T467M) and illustrating the therapeutic potential of the new URAT1-blocker lesinurad. In SLC2A9, mapping of rare variants of large effects onto the predicted protein structure reveals new residues that may affect urate binding. These findings provide new insights into the genetic architecture of serum urate, and highlight molecular targets in SLC22A12 and SLC2A9 for lowering serum urate and preventing gout.

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