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1.
J Intern Med ; 290(3): 693-703, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33978283

RESUMO

OBJECTIVES: (i) To estimate the prevalence and severity of coronary artery disease and (ii) to assess the risk of cardiovascular events and mortality, in patients with psoriasis and psoriatic arthritis (PsA) in a large-scale cohort of patients referred to coronary computed tomography angiography (CTA). METHODS: This was a cross-sectional study with follow-up of 46,022 patients based on data from a Danish national CTA registry. Exposure was defined as psoriasis or PsA. A group of patients without psoriasis, PsA or any other inflammatory disease was used as reference. Cross-sectional primary outcomes were a coronary artery calcium score (CACS) >0 and CACS ≥400, and secondary outcome was obstructive CAD. At follow-up, the primary outcome was a composite endpoint of cardiovascular events and all-cause mortality. All outcomes were adjusted for traditional cardiovascular risk factors. RESULTS: We identified 1356 psoriasis and 370 PsA patients. The adjusted odds ratio (OR) for psoriasis patients for CACS >0, CACS ≥400 and obstructive CAD was 1.26 (1.10-1.46), 1.25 (1.04-1.50) and 1.14 (0.98-1.33), respectively. For PsA patients, OR for CACS >0 was 1.28 (1.00-1.64). We found a crude hazard ratio (HR) of 1.49 (1.21-1.85) and adjusted HR of 1.14 (0.92-1.41) for the primary outcome in psoriasis patients. CONCLUSIONS: In this population, both psoriasis and PsA were associated with an increased prevalence of coronary calcification. Psoriasis patients also showed an increased prevalence of severe calcification. Psoriasis patients were at increased risk for cardiovascular events and death, however not after adjusting for the effect of other predictors.


Assuntos
Artrite Psoriásica , Calcinose , Doença da Artéria Coronariana , Psoríase , Artrite Psoriásica/complicações , Artrite Psoriásica/epidemiologia , Estudos de Coortes , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/epidemiologia , Estudos Transversais , Progressão da Doença , Humanos , Valor Preditivo dos Testes , Prevalência , Prognóstico , Psoríase/complicações , Psoríase/epidemiologia , Medição de Risco , Fatores de Risco
2.
Psychol Med ; : 1-6, 2021 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-33722322

RESUMO

BACKGROUND: Males have a lower prevalence of depression than females and testosterone may be a contributing factor. A comparison of opposite-sex and same-sex twins can be used indirectly to establish the role of prenatal testosterone exposure and the risk of depression. We therefore aimed to explore differences in depression risk using opposite-sex and same-sex twins. METHODS: We included 126 087 opposite-sex and same-sex twins from the Danish Twin Registry followed in nationwide Danish registers. We compared sex-specific incidences of depression diagnosis and prescriptions of antidepressants between opposite-sex and same-sex twins using Cox proportional hazard regression. RESULTS: During follow-up, 2664 (2.1%) twins were diagnosed with depression and 19 514 (15.5%) twins had purchased at least one prescription of antidepressants. First, in male twins, we found that the opposite-sex male twins had the same risk of depression compared to the same-sex male twins {hazard ratio (HR) = 1.01 [95% confidence interval (CI) 0.88-1.17)]}. Revealing the risk of use of antidepressants, the opposite-sex male twins had a slightly higher risk of 4% (HR = 1.04 (95% CI 1.00-1.11)) compared with the same-sex male twins. Second, in the female opposite-sex twins, we revealed a slightly higher, however, not statistically significant risk of depression (HR = 1.08 (95% CI 0.97-1.29)) or purchase of antidepressants (HR = 1.01 (95% CI 0.96-1.05)) when compared to the same-sex female twins. CONCLUSIONS: We found limited support for the hypothesis that prenatal exposure to testosterone was associated with the risk of depression later in life.

3.
Community Dent Health ; 38(4): 241-245, 2021 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-34185443

RESUMO

OBJECTIVE: The aim of the study was to investigate the separate and joint effects of household income and dental visits on tooth loss. BASIC RESEARCH DESIGN: Participants from the Social Inequality in Cancer Cohort (SIC) were followed in registers for household income (2000), dental visits (2002-2009) and tooth loss (2010-2016). Logistic regression was used to assess the effect of household income and dental visits on tooth loss, and linear models were applied to assess the separate and joint effects of household income and dental visits. RESULTS: In total, 10.8% of the participants had tooth loss (⟨15 teeth present). Low household income and irregular dental visits showed significantly higher odds ratios for tooth loss. Compared to regular dental visits, irregular dental visits accounted for 923 (95% CI 840 - 1,005) extra cases of tooth loss per 10,000 persons, and compared to high household income, low household income accounted for 1,294 (95% CI 1,124 - 1,464) additional cases of tooth loss per 10,000 persons. Further, due to household income-dental visit interaction, we observed 581 (95% CI 233 - 928) extra cases of tooth loss per 10,000 persons. CONCLUSION: Low household income and irregular dental visits are important in relation to social inequality in tooth loss. Irregular dental visits are associated with higher risk of tooth loss among persons with low household income compared to persons with high household income. Such interaction may be explained by differences in susceptibility to tooth loss across household income groups.


Assuntos
Perda de Dente , Estudos de Coortes , Humanos , Renda , Fatores Socioeconômicos , Perda de Dente/epidemiologia
4.
Acta Psychiatr Scand ; 142(6): 446-455, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33010028

RESUMO

OBJECTIVE: Familial and genetic factors seem to contribute to the development of depression but whether this varies with age at diagnosis remains unclear. We examined the influence of familial factors on the risk of depression by age at first diagnosis. METHODS: We included 23 498 monozygotic and 39 540 same-sex dizygotic twins from the population-based Danish Twin Registry, followed from 1977 through 2011 in nationwide registers. We used time-to-event analyses accounting for censoring and competing risk of death to estimate cumulative incidence, casewise concordance, relative recurrence risk, and heritability of first depression by age using monozygotic and same-sex dizygotic twin pairs. RESULTS: During follow-up, a total of 1545 twins were diagnosed with depression. For twins at age 35 or younger at first depression, heritability was estimated to be 24.8% (95% confidence interval [CI], 4.6-43.1%), whereas at age 90 it was 14.7% (95% CI, 3.1-26.3%). The relative recurrence risk was higher at younger ages: At age 35, the risk was 27.7-fold (95% CI, 20.0-35.5) and 6.9-fold (95% CI, 3.9-9.8) higher than the population risk for monozygotic and same-sex dizygotic twins, respectively, while the corresponding numbers were 3.0 (95% CI, 2.3-3.6) and 1.8 (95% CI, 1.3-2.2) at age 90. Heritability seemed similar for male and female twins. CONCLUSION: Familial risk of depression, caused either by genes or shared environment, seemed to slightly decrease with age at diagnosis and an elevated concordance risk for monozygotic over same-sex dizygotic pairs suggested a genetic contribution to the development of depression.


Assuntos
Depressão/genética , Predisposição Genética para Doença/epidemiologia , Predisposição Genética para Doença/genética , Sistema de Registros/estatística & dados numéricos , Gêmeos Dizigóticos/genética , Adulto , Fatores Etários , Estudos de Coortes , Dinamarca/epidemiologia , Depressão/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Fatores de Risco , Gêmeos Dizigóticos/estatística & dados numéricos
5.
Acta Psychiatr Scand ; 140(3): 265-274, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31306494

RESUMO

OBJECTIVE: Individuals with mood disorders have increased risk of cardiovascular disease. The aims of this study were to evaluate if the risk of cardiovascular disease in individuals with mood disorder could be explained by shared genetic and early environmental factors. METHODS: We included 6714 Danish middle and old aged twins from two large population-based studies. Cox proportional hazards regression was used to perform individual-level and intra-pair analyses of the association between self-reported depression symptomatology scores and register-based diagnoses of ischemic heart disease. RESULTS: Higher depression symptomatology scores (both total, affective, and somatic) were associated with higher incidence of ischemic heart disease after multivariable adjustment in individual-level analyses. In intra-pair analyses, this association was similar but with slightly larger confidence intervals. There was no interaction with gender and no major differences between mono- or dizygotic twins. Within twin pairs, the twin scoring highest on depressive symptoms developed ischemic heart disease more often or earlier than the lower scoring twin. A sensitivity analysis including a 2-year time lag of depression symptomatology to limit the risk of reverse causality showed similar results. CONCLUSION: Genetic factors and early life environment do not seem to explain the association between depressive mood and ischemic heart disease.


Assuntos
Depressão , Transtornos do Humor , Isquemia Miocárdica , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Comorbidade , Dinamarca/epidemiologia , Depressão/epidemiologia , Depressão/etiologia , Depressão/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos do Humor/etiologia , Transtornos do Humor/genética , Isquemia Miocárdica/epidemiologia , Isquemia Miocárdica/etiologia , Isquemia Miocárdica/genética
6.
Acta Psychiatr Scand ; 140(6): 522-531, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31487044

RESUMO

OBJECTIVE: To examine the incidence of suicidal and violent behaviour following initiation of antidepressant medication. METHOD: Cohorts of 997 911 conscripts and 95 794 patients with a first-time affective disorder were followed for purchase of antidepressant medication, suicide, suicide attempts and conviction for violent crime in Danish registries between 1997 through 2015. Incidence of outcomes was estimated for the first 28 days, 28-365 days or later after initiation of antidepressants or study entry. RESULTS: Of 16.5% of conscripts and 73.7% of patients with affective disorders initiated antidepressant medication. Incidence of suicide was 3-4 times higher during the first 28 days after initiation compared to the rates in the following year in both cohorts. A similar trend was seen among the untreated patients with affective disorders, whereas suicide incidence was stable at a low level among conscripts not treated with antidepressants. Incidence of attempted suicide was highest during the 28 days before and after initiation of antidepressants, while rates of violent crime were similar before and after initiation. These trends in incidence were independent of class of antidepressant. CONCLUSION: Higher rates of suicidal behaviour in the weeks following initiation of antidepressant medication probably reflect disease severity and a delay in mood response.


Assuntos
Agressão , Antidepressivos/uso terapêutico , Transtornos do Humor/tratamento farmacológico , Abuso Físico/estatística & dados numéricos , Sistema de Registros , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
Acta Anaesthesiol Scand ; 62(3): 357-366, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29282713

RESUMO

BACKGROUND: Follow-up of intensive care unit (ICU) patients often includes health-related quality of life (HRQoL) surveying, but non-responders hamper the interpretation. Our aim was to assess factors for non-response to HRQoL survey in ICU patients with septic shock at follow-up in a clinical trial. METHODS: In a post hoc follow-up registry study, we assessed all the Danish survivors in the Transfusion-Requirements in Septic Shock trial patients, who were mailed the Short Form 36-item Survey (SF-36) 1-year after randomization. We used covariates from the trial database merged with covariates from nation-wide registries using the unique national identification number to explore possible factors for not responding. Five covariates were pre-specified to be included in the primary multivariate analysis: age, number of days in hospital from randomization to follow-up, level of education, cohabitation and employment status at follow-up. We compared the mortality from 1-year survival (2012-2014) till end of final follow-up (January 2016) between non-responders and responders. RESULTS: We assessed 308 survivors of whom 108 (35%) were non-responders. In the primary analysis lower age (odds ratio 1.03, 95% CI [1.01-1.05]), more admission days in hospital (1.006 [1.001-1.011]) and living alone (4.33 [2.46-7.63]) were associated with non-responding, whereas the level of education and employment status were not. Non-responders had a hazard ratio of 1.63 [0.97-2.72] for mortality from 1-year follow-up to final follow-up as compared to the responders. CONCLUSION: Being younger, spending more days in hospital and living alone were all associated with non-response at 1-year HRQoL follow-up among ICU patients with septic shock.


Assuntos
Qualidade de Vida , Choque Séptico/psicologia , Idoso , Escolaridade , Emprego , Transfusão de Eritrócitos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Choque Séptico/mortalidade , Choque Séptico/terapia , Sobreviventes
8.
Scand J Med Sci Sports ; 27(5): 474-481, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28207959

RESUMO

Exercise lowers plasma triglyceride levels, but the physiological mechanisms remain not fully elucidated. Lipoprotein lipase (LPL) is a key enzyme in facilitating fatty acid uptake from lipoproteins. As exercise increases the efficiency of very low-density lipoprotein-triglyceride (VLDL-TG) oxidation, we hypothesized that muscle LPL activity would be a rate-limiting step and predict VLDL-TG Fatty acids oxidation during exercise. Sixteen healthy, lean subjects (eight men and eight women) were examined before and during an acute exercise bout (90 minutes at 50% of VO2-max). Heparin-releasable LPL activity was measured in muscle and adipose tissue biopsies. Breath 14 CO2 was measured after a primed-constant infusion of ex vivo labeled [14 C]-triolein VLDL-TG. Fractional VLDL-TG storage was measured in adipose tissue biopsies. Exercise did not affect muscle LPL activity (P=.30). No association was observed between muscle LPL activity and VLDL-TG oxidation, neither in the basal state (P=.17) nor during exercise (P=.83). Exercise did not affect upper body or lower body adipose tissue LPL activity (both P=.92). The basal adipose tissue fractional VLDL-TG storage (abdominal.13%±9%; femoral 17%±10% (P=.18)) was not associated with upper body (P=.56) or lower body (P=.44) subcutaneous adipose tissue LPL activity. Muscle LPL activity does not predict VLDL-TG oxidation during rest or exercise. In addition, adipose tissue LPL activity was not associated with VLDL-TG storage during rest. This suggests that LPL activity is present in excess of what is required to facilitate lipid uptake for oxidation during both rest and exercise.


Assuntos
Tecido Adiposo/metabolismo , Lipase Lipoproteica/metabolismo , Lipoproteínas VLDL/metabolismo , Músculo Esquelético/metabolismo , Triglicerídeos/metabolismo , Adulto , Exercício Físico/fisiologia , Feminino , Humanos , Masculino , Oxirredução
11.
Animal ; 18(6): 101157, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38744228

RESUMO

The comb is an ornament involved in signalling condition in domestic fowl. We hypothesised that comb size, comb shape complexity (i.e., rugosity, the comb perimeter jaggedness), and comb laterality of laying hens would be influenced by the degree of environmental enrichment experienced during juvenile development in the form of resource choice. We conducted a 2 × 2 factorial crossover experiment with pullets reared in pens containing four perches of equal length and four litter areas of equal size. Pullets were exposed to a single choice vs multiple choices of perch and litter types (i.e., all the same vs all different) during Weeks 1-4 (Period 1) and/or Weeks 5-15 (Period 2) of rearing (n = 4 pens/treatment combination) prior to transfer to standard adult laying pens for Weeks 16-27 (Period 3). In Week 27, combs were photographed, and comb laterality (hanging on left or right side) was noted. Using a custom-made image analysis programme, we captured comb area (mm2), perimeter length (mm), and rugosity ((perimeter length - horizontal length) / horizontal length) from comb photographs of 6-7 randomly selected hens/pen. We predicted that hens reared in the multi-choice environment during Periods 1 and 2 would have larger, more complex, and left-side-biased combs than those in the other treatment groups, reflecting lower allostatic load. The predicted comb side bias was based on a possible bias in head posture/movements associated with greater right eye/ear use and left-brain hemispheric dominance. Contrary to our predictions, we detected an overall right-side bias in comb laterality, and no associations between resource choice treatment in Period 1 or Period 2 and comb area, perimeter length, rugosity, or laterality of the adult hens. Thus, variation in allostatic load resulting from the rearing treatments was insufficient to modify the trajectory of comb morphological development, possibly due to a ceiling effect when comparing environmental treatments on the positive end of the welfare spectrum. We found that left-lopping combs had shorter perimeters than right-lopping combs. However, among hens with left-lopping combs, those with larger combs were heavier and had less feather damage, while among hens with right-lopping combs, those with longer-perimeter combs were heavier and tended to have less comb damage. In conclusion, comb characteristics were related to physical condition at the individual level but did not serve as sensitive integrated indicators of hen welfare in response to basic vs enhanced resource choice during rearing.


Assuntos
Galinhas , Animais , Galinhas/fisiologia , Galinhas/anatomia & histologia , Galinhas/crescimento & desenvolvimento , Feminino , Crista e Barbelas/anatomia & histologia , Crista e Barbelas/fisiologia , Abrigo para Animais , Lateralidade Funcional/fisiologia , Meio Ambiente , Criação de Animais Domésticos/métodos , Estudos Cross-Over
12.
J Microsc ; 251(1): 68-76, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23573905

RESUMO

Cell counting in stereology is time-consuming. The proportionator is a new stereological sampling method combining automatic image analysis and non-uniform sampling. The autodisector on virtual slides combines automatic generation of disector pairs with the use of digital images. The aim of the study was to investigate the time efficiency of the proportionator and the autodisector on virtual slides compared with traditional methods in a practical application, namely the estimation of osteoclast numbers in paws from mice with experimental arthritis and control mice. Tissue slides were scanned in a digital slide scanner and the autodisector was applied on the obtained virtual tissue slides. Every slide was partitioned into fields of view, and cells were counted in all of them. Based on the original exhaustive data set comprising 100% of fields of view and covering the total section area, a proportionator sampling and a systematic, uniform random sampling were simulated. We found that the proportionator was 50% to 90% more time efficient than systematic, uniform random sampling. The time efficiency of the autodisector on virtual slides was 60% to 100% better than the disector on tissue slides. We conclude that both the proportionator and the autodisector on virtual slides may improve efficiency of cell counting in stereology.


Assuntos
Imageamento Tridimensional/métodos , Microscopia/métodos , Imagem Óptica/métodos , Animais , Artrite/patologia , Automação Laboratorial/métodos , Osso e Ossos/citologia , Contagem de Células/métodos , Extremidades , Camundongos , Osteoclastos/citologia , Fatores de Tempo
13.
Expert Rev Clin Immunol ; 18(1): 31-45, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34978241

RESUMO

INTRODUCTION: There is a wide spectrum of noninfectious gastrointestinal pathology, causing considerable morbidity and mortality in CVID, where both etiology and effective therapy are under debate. AREAS COVERED: This review will focus on the noninfectious inflammation in the GI tract in CVID patients, covering the both the upper and lower GI tract inflammation, including the liver. The controversy of the CVID enteropathy definition and that of gluten-free diet for celiac-like disease in CVID will be discussed. Furthermore, the review will cover the link between GI inflammation and GI cancer. Finally, the role of gut microbiota, IgA, and genetics and its relationship with CVID enteropathy is scrutinized. The authors reviewed literature from PubMed. EXPERT OPINION: The heterogeneity and the unknown mechanism behind CVID enteropathy, and thereby the lack of effective treatment, is one of the key challenges in the field of CVID. Celiac-like disease in CVID is due to immune dysregulation, and a gluten-free diet is therefore not indicated. Gut microbial dysbiosis and mucosal IgA can initiate systemic and local inflammation and is involved in the immune dysregulation in CVID. Considering the heterogeneity of CVID enteropathy, personalized medicine is probably the future for these patients.


Assuntos
Imunodeficiência de Variável Comum , Microbioma Gastrointestinal , Dieta Livre de Glúten , Disbiose , Humanos , Inflamação
14.
Eur J Ageing ; 19(2): 189-200, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35663918

RESUMO

Hospital discharge of older people in need of both medical and social care following their hospital stay requires extensive coordination. This study aims to examine and compare the views of nurses in three Nordic cities on the influence of sociodemographic factors and having close relatives, for the hospital discharge and post hospital care of older people with complex health and social care needs. Thirty-five semi-structured interviews (Copenhagen n = 11, Tampere n = 8, Stockholm n = 16) with nurses were conducted. The nurses were identified through the researchers' networks, invitation and snowball sampling, and recruited from hospitals, primary care practices, home care units, home nursing units, and geriatric departments. The interviews were transcribed and analysed using thematic analysis. Interpretations were discussed and agreed within the team. Four main themes and 13 sub-themes were identified. Across the cities, informants reported that the patient's health status, rather than their gender or ethnicity, steered the discharge date and further care. Care costs, commonly reported in Tampere but also in Copenhagen and Stockholm including costs for medications and home help, were considered barriers for disadvantaged older people. Home situation, local arrangements and differences in collaboration between healthcare professionals at different sites also influenced the hospital discharge. Generally, the patient's health status steered the hospital discharge and post-hospital care. Close relatives were regarded important and a potential advantage. Some informants tried to compensate for the absence of close relatives, highlighting the importance of care systems that can compensate for this to minimise avoidable inequity. Supplementary Information: The online version contains supplementary material available at 10.1007/s10433-022-00701-6.

15.
Indoor Air ; 21(3): 182-90, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21418109

RESUMO

UNLABELLED: Modern, holistic indoor climate research started with the formation of an interdisciplinary 'Indoor Climate Research Group' in 1962 at the Institute of Hygiene, University of Aarhus, Denmark. After some years, other groups started similar research in Denmark and Sweden, and later - after the First International Indoor Air Symposium in Copenhagen 1978--this research spread to many countries and today it is carried out globally by probably 2000 scientists. This paper recounts the history of Danish indoor climate research, focusing on the three decades from the early 1960s to the founding of the Indoor Air journal in 1991. The aim of this paper is to summarize what was learned in those earlier years and to call to the attention of researchers in this area the need of multidisciplinary research, mingling epidemiological fact-finding field studies with climate chamber studies and laboratory investigations. PRACTICAL IMPLICATIONS: The review may be of interest to indoor climate researchers who want to know more about the early development of research on this multidisciplinary subject, as it emerged in a small country that undertook pioneering studies.


Assuntos
Poluição do Ar em Ambientes Fechados/história , Pesquisa/história , Dinamarca , Engenharia/história , Estudos Epidemiológicos , Arquitetura de Instituições de Saúde/história , História do Século XX , Projetos de Pesquisa
16.
JDR Clin Trans Res ; 6(4): 448-457, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-32816616

RESUMO

INTRODUCTION: Social and family conditions are likely of great importance to dental health; however, limited evidence of familial aggregation of caries among adolescent siblings exists. Moreover, social and family-level factors have never been evaluated as isolated caries predictors at the individual level. OBJECTIVES: The objectives were to evaluate socioeconomic patterning of caries among siblings, assess sibling-specific aggregation of caries within families, and examine if such aggregation differed by parental socioeconomic position (SEP). We also evaluated the discriminant ability of sibling caries, SEP, and other social and familial factors in predicting caries in cosiblings. METHODS: This nationwide register-based study included all 15-y-olds in Denmark in 2003 (index siblings) and their biological siblings born within ±3 y (cosiblings). Clinical and sociodemographic data for each subject were compiled from Danish national dental, social, and population registers. Caries was measured by the decayed, missing, and filled tooth surfaces (DMFS) index. Predictors included SEP (parental education, income, and occupational social class), gender, birth order, immigration status, and household type. Adjusted SEP-caries associations were estimated using negative binomial regression. Familial aggregation was evaluated using adjusted pairwise odds ratios from alternating logistic regressions. Caries prediction was based on classification and regression tree (CART) analyses. RESULTS: The study included 23,847 sibling pairs (n = 47,694). Socioeconomic patterning of caries was similar among the index and cosiblings with significant graded SEP-caries associations. Significant sibling-specific aggregation of caries was observed; cosiblings of caries-affected index siblings had odds of having caries 3.9 times (95% confidence interval: 3.65-4.18) as high as that of cosiblings with caries-free index siblings. This sibling similarity was stronger in socioeconomically disadvantaged families (adjusted pairwise odds ratios: 3.08-5.47). CART revealed index sibling caries as the single most important caries predictor, with caries predicted in ≥84% of cosiblings of adolescents with ≥3 carious tooth surfaces. CONCLUSIONS: Caries in a sibling should prompt preventive family-based approaches targeting cosiblings. KNOWLEDGE TRANSFER STATEMENT: This study revealed significant socioeconomic patterning of caries in adolescent siblings. Prediction modeling indicated that the single most important caries predictor among cosiblings was index sibling caries. Information on sibling caries level should be routinely combined with clinical evaluation to identify children at risk. Moreover, information on social and family conditions should be used to target prevention and health promotion at the school or municipal level. These approaches could possibly contribute to reducing the existing caries inequalities.


Assuntos
Cárie Dentária , Irmãos , Adolescente , Criança , Índice CPO , Cárie Dentária/epidemiologia , Suscetibilidade à Cárie Dentária , Humanos , Classe Social
17.
J Diabetes Complications ; 35(8): 107946, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34053797

RESUMO

BACKGROUND: It has been suggested that long-term glycemic load as reflected in plasma levels of Glycosylated Hemoglobin, Type A1C (HbA1c) is associated with higher risk of depression, however results have been conflicting. We examined the potential association between HbA1c and risk of depression in a large population-based cohort without baseline diabetes (the Glostrup cohort) defined by either self-reported diabetes, registry diagnosis of diabetes or use of antidiabetic medication at baseline and in a national diabetes cohort (the Danish Adult Diabetes Database). METHODS: A total of 16,124 middle-aged individuals from the Glostrup cohort and 93,544 patients registered in the Danish Adult Diabetes Database were followed from the first registered HbA1c measurement (1999-2014) for subsequent diagnosis of depression or use of antidepressant medication in nation-wide Danish registers. The association was analyzed using a Cox proportional hazards regression model with HbA1c on both a continuous scale using restricted cubic splines and categorized based on the groups found in the spline model. We adjusted for relevant sociodemographic and clinical variables including previous depression and tested for interaction of both gender, insulin use and diabetes type. RESULTS: During follow-up, 2694 (17%) in the Glostrup cohort and 29,234 (31%) in the diabetes cohort developed depression. In the Glostrup cohort, we found an indication of a positive linear association between HbA1c and depression in women, while no clear association was found in men. In patients with diabetes, we found a U-shaped association between HbA1c and depression in both men and women with the lowest risk estimates for HbA1c levels of 58 mmol/mol (7.5%) in men and of 60 mmol/mol (7.6%) in women. When HbA1c was categorized, men with the highest HbA1c-levels had significantly elevated risk of depression (HRHbA1c>9.4 1.16 (95%CI 1.10-1.23)) after multifactorial adjustment compared to the reference group with HbA1c of 42.1-56.2 mmol/mol (6.0-7.3%). Women in the lowest and highest category of HbA1c had significantly higher risk of depression HRHbA1c<6.0 1.15 (95% CI 1.09-1.22) and HRHbA1c>9.3 1.10 (95% CI 1.04-1.16), respectively, compared to the reference group with HbA1c 42.1-55.0 mmol/mol (7.2-9.3%). There was a significant interaction with gender, but no interaction for insulin use or diabetes type. CONCLUSIONS: In a population without baseline diabetes, higher HbA1c levels seemed associated with higher depression risk in women, whereas a U-shaped association was found in patients with known diabetes.


Assuntos
Depressão , Diabetes Mellitus Tipo 2 , Hemoglobinas Glicadas , Adulto , Glicemia , Dinamarca , Depressão/complicações , Depressão/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Hemoglobinas Glicadas/análise , Humanos , Insulinas/uso terapêutico , Masculino , Pessoa de Meia-Idade , Fatores de Risco
18.
Acta Psychiatr Scand ; 119(4): 312-9, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19077132

RESUMO

OBJECTIVE: To study the degree to which depression indicators based on register data on hospital and antidepressant treatment suffer from differential misclassification with respect to gender, age and social group. METHOD: Data on 7378 persons were obtained by linking a cross-sectional survey of Danish adults aged 40 and 50 years with population-based registers. Misclassification was analysed by comparing survey data to register data on major depression using the method proposed by Rothman and Greenland. RESULTS: Differential misclassification was found. Adjustment for misclassification reduced women's odds ratios from 2.18 to 1.00 for hospital treatment and from 1.70 to 1.10 for antidepressants. For the lower social group, the corresponding odds ratios increased from 1.18 to 3.52, and from 1.35 to 2.32 respectively, whereas odds ratios with respect to age remained almost unchanged. CONCLUSION: Differential misclassification should be considered when register-based information about hospital and antidepressant treatment are used as depression indicators.


Assuntos
Transtorno Depressivo Maior/classificação , Transtorno Depressivo Maior/diagnóstico , Erros de Diagnóstico , Sistema de Registros , Adulto , Antidepressivos/uso terapêutico , Estudos Transversais , Transtorno Depressivo Maior/terapia , Diagnóstico Diferencial , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População
19.
Epidemiol Psychiatr Sci ; 29: e43, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31455437

RESUMO

AIMS: To determine the risk of dementia in patients with type 1 or type 2 diabetes and in individuals with glycosylated haemoglobin, type A1C (HbA1c) of ⩾48 mmol/mol, which is the diagnostic limit for diabetes. METHODS: We included the following cohorts: all incident diabetes cases aged 15 or above registered in the National Diabetes Registry (NDR) from January 2000 through December 2012 (n = 148 036) and a reference population, adult participants from the Glostrup cohort (n = 16 801), the ADDITION Study (n = 26 586) and Copenhagen Aging and Midlife Biobank (CAMB) (n = 5408). Using these cohorts, we analysed if a diagnosis of type 1 or type 2 diabetes in the NDR or HbA1c level of ⩾ 6.5% (48 mmol/mol) in the cohorts increased risk of dementia in the Danish National Patient Registry or cognitive performance assessed by the Intelligenz-Struktur-Test 2000R (IST2000R). RESULTS: A diagnosis of type 1 or type 2 diabetes in the NDR was associated with increased risk of dementia diagnosed both before or after age 65 as well as across different subtypes of dementia. Self-reported diabetes or high HbA1c levels were associated with lower cognitive performance (p = 0.004), while high HbA1c was associated with increased risk of dementia (HR 1.94 (1.10-3.44) in the Glostrup cohort but not in the ADDITION Study (HR 0.96 (0.57-1.61)). CONCLUSIONS: Both type 1 and type 2 diabetes are associated with an increased risk of dementia, while the importance of screening-detected elevated HbA1c remains less clear.


Assuntos
Disfunção Cognitiva/epidemiologia , Demência/epidemiologia , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Hiperglicemia/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Dinamarca/epidemiologia , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
20.
Clin Microbiol Infect ; 13(7): 725-7, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17403127
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