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1.
Br J Dermatol ; 190(5): 680-688, 2024 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-38015798

RESUMO

BACKGROUND: Case-control studies indicate an association between lower serum 25-hydroxyvitamin D [25(OH)D] levels and psoriasis. Data from larger population-based cohorts including mild cases are sparse. OBJECTIVES: To investigate the association between 25(OH)D and psoriasis in a large population-based cohort, and assess possible effect modification by overweight. METHODS: Data from the Tromsø Study 2015-16 (Tromsø7), which included 19 520 participants from the general population aged 40-79 years, were subjected to a cross-sectional analysis. We assessed the shapes of the relationships between 25(OH)D and psoriasis using fractional polynomials. Odds ratios (ORs) for lifetime and active psoriasis were estimated using logistic regression. Adjusted models included month of blood sampling, body mass index (BMI), age and sex. Two-way and additive interaction between BMI and 25(OH)D were explored. RESULTS: From a total of 19 520 participants [10 203 women (52.3%); mean age 56.3 years (SD 10.4); mean 25[OH]D, 63.4 nmol L-1 (SD 21.9)], 2088 (10.7%) reported lifetime psoriasis and 1179 (6.0%) reported active psoriasis the past 12 months. There was no association between 25(OH)D and lifetime psoriasis [OR per 10 nmol L-1 increase in 25(OH)D 1.02, 95% confidence interval (CI) 0.99-1.04]. The relationship between 25(OH)D and active psoriasis was suggested to be nonlinear, but the model was not significant (P = 0.098). There was evidence for a superadditive effect (i.e. larger than the sum of the factors) of BMI > 27.5 kg m-2 and 25(OH)D < 25 nmol L-1 on the odds for active psoriasis (OR 1.92, 95% CI 1.18-3.12), but not for lifetime psoriasis (OR 1.41, 95% CI 0.93-2.15). There was no evidence for two-way interaction between BMI and 25(OH)D. CONCLUSIONS: This large population-based study found no significant relationship between 25(OH)D and psoriasis. The analysis may have been underpowered to detect a threshold effect in the lower 25(OH)D spectrum. Interaction analysis indicates that high BMI and vitamin D deficiency combined increase the odds of active psoriasis more than the sum of these factors, with an estimated 92% higher odds for active psoriasis in participants with BMI > 27.5 kg m-2 and 25(OH)D < 25 nmol L-1. Providing advice to prevent vitamin D deficiency may be considered in the follow-up of overweight patients with psoriasis.


Assuntos
Psoríase , Deficiência de Vitamina D , Vitamina D/análogos & derivados , Humanos , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Sobrepeso , Calcifediol , Deficiência de Vitamina D/epidemiologia
2.
Exp Dermatol ; 31(4): 535-547, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34748247

RESUMO

MicroRNAs (miRNAs) are small non-coding RNAs that have emerged as central regulators of gene expression and powerful biomarkers of disease. Much is yet unknown about their role in psoriasis pathology. To globally characterize the miRNAome of psoriatic skin, skin biopsies were collected from psoriatic cases (n = 75) and non-psoriatic controls (n = 46) and RNA sequenced. Count data were meta-analysed with a previously published dataset (cases, n = 24, controls, n = 20), increasing the number of psoriatic cases fourfold from previously published studies. Differential gene expression analyses were performed comparing lesional psoriatic (PP), non-lesional psoriatic (PN) and control (NN) skin. Further, functional enrichment and cell-specific analyses were performed. Across all contrasts, we identified 439 significantly differentially expressed miRNAs (DEMs), of which 85 were novel for psoriasis and 11 were related to disease severity. Meta-analyses identified 20 DEMs between PN and NN, suggesting an inherent change in the constitution of all skin in psoriasis. By integrating the miRNA transcriptome with mRNA target interactions, we identified several functionally enriched terms, including "thyroid hormone signalling," "insulin resistance" and various infectious diseases. Cell-specific expression analyses revealed that the upregulated DEMs were enriched in epithelial and immune cells. This study provides the most comprehensive overview of the miRNAome in psoriatic skin to date and identifies a miRNA signature related to psoriasis severity. Our results may represent molecular links between psoriasis and related comorbidities and have outlined potential directions for future functional studies to identify biomarkers and treatment targets.


Assuntos
MicroRNAs , Psoríase , Biomarcadores/metabolismo , Perfilação da Expressão Gênica , Humanos , MicroRNAs/genética , MicroRNAs/metabolismo , Psoríase/metabolismo , Índice de Gravidade de Doença , Pele/metabolismo
3.
Acta Derm Venereol ; 99(1): 18-25, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30085329

RESUMO

Optimal clinical management of psoriasis and psoriatic arthritis (PsA) Optimal clinical management of psoriasis and psoriatic arthritis (PsA) requires understanding of the impact on patients. The NORdic PAtient survey of Psoriasis and PsA (NORPAPP) aimed to obtain current data on disease prevalence and patient perceptions in Sweden, Denmark and Norway. Among 22,050 individuals questioned, the reported prevalence of psoriasis and/or PsA was 9.7% (5.7% physician-diagnosed plus 4.0% self-diagnosed only); prevalence was similar in Sweden (9.4%) and Denmark (9.2%) but significantly higher in Norway (11.9%). Of those reporting a physician's diagnosis, 74.6% reported psoriasis alone, 10.3% PsA alone and 15.1% both. Patients with PsA perceived their disease to be more severe than those with psoriasis; patients with PsA and psoriasis reported greater disease severity than those with each condition alone. Patient's perceptions of psoriasis severity correlated weakly (Spearman's rho 0.42) with clinical severity; both patient perceptions and clinical measures are important in the assessment and management of psoriasis.


Assuntos
Artrite Psoriásica/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Pacientes/psicologia , Percepção , Psoríase/epidemiologia , Adolescente , Adulto , Idoso , Artrite Psoriásica/diagnóstico , Artrite Psoriásica/psicologia , Efeitos Psicossociais da Doença , Dinamarca/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Prevalência , Psoríase/diagnóstico , Psoríase/psicologia , Qualidade de Vida , Índice de Gravidade de Doença , Suécia/epidemiologia , Adulto Jovem
4.
Tidsskr Nor Laegeforen ; 139(12)2019 09 10.
Artigo em Norueguês | MEDLINE | ID: mdl-31502795

RESUMO

Acne should not be perceived as a self-limiting affliction of adolescence. Due to the growing problem of antimicrobial-resistant bacteria, restrictive use of peroral and topical antibiotics is recommended. There are a number of effective agents for topical treatment of mild to moderate acne. In cases of severe, therapy-resistant acne, treatment with peroral isotretinoin is recommended.


Assuntos
Acne Vulgar/tratamento farmacológico , Antibacterianos/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Acne Vulgar/diagnóstico , Acne Vulgar/etiologia , Acne Vulgar/psicologia , Administração Oral , Administração Tópica , Adolescente , Algoritmos , Antibacterianos/administração & dosagem , Peróxido de Benzoíla/administração & dosagem , Peróxido de Benzoíla/uso terapêutico , Cicatriz/tratamento farmacológico , Fármacos Dermatológicos/administração & dosagem , Humanos , Isotretinoína/administração & dosagem , Isotretinoína/uso terapêutico , Qualidade de Vida
5.
Acta Derm Venereol ; 97(3): 332-339, 2017 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-27602427

RESUMO

Overweight is a proposed risk factor for psoriasis. How-ever, evidence from prospective studies is limited. The aim of this study was to investigate the association be-tween overweight, weight gain and risk of psoriasis, and potential synergism with smoking, within a population-based cohort including 8,752 individuals followed from 1994 up to 2008. There was a 32% increased odds of psoriasis from a body mass index (BMI) of 27 kg/m2, in multi-variable logistic regression analysis, further increasing to 43% at BMI 28 kg/m2, and to 71% at BMI ≥ 30 kg/m2 in non-smokers. There was a dose-response association between weight gain from age 25 years, with up to 90% higher odds of psoriasis from middle age, independent of weight category. There was no indication of a synergism between overweight and smoking, and no interaction with sex. Overweight and weight gain represent modifiable risk factors that may be targets for primary prevention of psoriasis.


Assuntos
Sobrepeso/complicações , Psoríase/etiologia , Aumento de Peso , Adulto , Idoso , Índice de Massa Corporal , Distribuição de Qui-Quadrado , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Noruega , Razão de Chances , Sobrepeso/diagnóstico , Sobrepeso/fisiopatologia , Sobrepeso/prevenção & controle , Estudos Prospectivos , Psoríase/diagnóstico , Psoríase/prevenção & controle , Medição de Risco , Fatores de Risco , Comportamento de Redução do Risco , Fatores Sexuais , Fumar/efeitos adversos , Prevenção do Hábito de Fumar , Fatores de Tempo
6.
Qual Health Res ; 26(5): 685-96, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26246522

RESUMO

Physical activity is considered fundamental in lifestyle interventions. We explore experiences of physical activity prior to, during, and following a 10- to 14-week inpatient lifestyle modification program, including high volume of physical activity, for the treatment of severe obesity. Eight participants from a prospective clinical trial were selected to participate in a complementary qualitative study. The participants' experiences with physical activity during and following the treatment program represented different opposites: "pain and pleasure," "desire and duty," and "bubble and battle." We summarized the findings into one overall theme: "the ambivalence of attending physical activity." The ambivalence is experienced as a shift in how participants experience physical activity during the intervention period and as an ongoing, dynamic, and constantly shifting experience during such activity. To address and reflect upon such experiences with the participants, and acknowledge ambivalence as a legitimate part of being physically active, might be important within obesity treatment.


Assuntos
Exercício Físico/psicologia , Estilo de Vida , Obesidade Mórbida/psicologia , Obesidade Mórbida/terapia , Adulto , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Obesidade/psicologia , Obesidade/terapia , Estudos Prospectivos , Pesquisa Qualitativa
8.
Artigo em Inglês | MEDLINE | ID: mdl-37681779

RESUMO

An increasing number of university students are facing mental health challenges. The primary aim of this study was to determine the feasibility of 10 weeks of supervised tailored group exercise for 60 min twice a week delivered by the student health service for students facing mental health challenges. Secondary aims were to explore changes in mental health and physical fitness from pre- to post-test. Feasibility was assessed in terms of recruitment, drop-outs, attendance, and adverse events. The secondary outcomes included symptoms of depression and anxiety, wellbeing, satisfaction with life, cardiorespiratory fitness, and muscular endurance/strength. A total of 13 university students with self-reported mental health challenges, aged 20-39 years, were recruited during a four-week period. Ten (77%) of these completed the intervention and post-test as planned, and no adverse events occurred. There was a significant average reduction of 20% in symptoms of depression and anxiety (p = 0.008), and non-significant improvements of 21% in well-being and 16% in satisfaction with life were found. On average, cardiorespiratory fitness (p = 0.01) and muscular strength (push-ups test, p = 0.01, and sit-ups test, p = 0.02) increased. In conclusion, a 10-week tailored exercise intervention delivered by the student mental health service was found to be feasible, and beneficial for mental health and physical fitness in students facing mental health challenges.


Assuntos
Exercício Físico , Saúde Mental , Humanos , Estudos de Viabilidade , Aptidão Física , Estudantes
9.
JAMA Dermatol ; 159(5): 518-525, 2023 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-36988936

RESUMO

Importance: Topical vitamin D analogues are routine treatment for psoriasis, but the effect of oral supplementation has not been established. Objective: To examine the effect of vitamin D supplementation on psoriasis severity throughout the winter. Design, Setting, and Participants: This randomized, double-blind placebo-controlled clinical trial with 2 parallel groups was performed through 2 winter seasons (2017 to 2018 and 2018 to 2019). Randomization was computer generated. All participants, health care clinicians, and outcome assessors were masked to group assignment. Each participant was followed for 4 months. The presented analyses were conducted in May 2022. The trial was conducted at the clinical research unit of the University Hospital of North Norway (Tromsø; Norway). Adults from the general population in Tromsø with active plaque psoriasis and 25-hydroxyvitamin D (25[OH]D) levels of less than 24 ng/mL (to convert to nmol/L, multiply by 2.496) were included. Intervention: Vitamin D (cholecalciferol, 100 000 IU, loading dose, followed by 20 000 IU/week) or placebo for 4 months. Main outcomes and Measures: Psoriasis Area Severity Index (PASI) (primary outcome), Physician Global Assessment, self-administered PASI, and Dermatology Life Quality Index scores (secondary outcomes). Results: A total of 122 participants (46 women [37.7%]; mean [SD] age, 53.6 [10.0] years; mean [SD] PASI score, 3.1 [2.0]; mean [SD] serum 25(OH)D, 14.9 [3.9] ng/mL) were included. Of these, 60 (49.2%) were randomized to the vitamin D group and 62 (50.8%) to the placebo group. A total of 120 participants (59 vitamin D [49.2%]/61 placebo [51.8%]) completed the study. By completion, mean (SD) 25(OH)D levels were 29.7 (5.2) ng/mL (vitamin D) and 12.0 (3.8) ng/mL (placebo). There was no significant difference in change in PASI score between the groups (adjusted difference, 0.11; 95% CI, -0.23 to 0.45). There was no significant difference in change in Physician Global Assessment score (adjusted odds ratio, 0.66; 95% CI, 0.27-1.63), self-administered PASI (adjusted difference, -0.60; 95% CI, -1.76 to 0.55) or Dermatology Life Quality Index (adjusted difference, -0.86; 95% CI, -1.9 to 0.19) between the groups. No adverse effects of the intervention were registered. Conclusion and Relevance: The results of this randomized clinical trial showed that vitamin D supplementation did not affect psoriasis severity. Low baseline severity scores may explain the lack of measurable effect. Levels of 25(OH)D in the intervention group increased to a less-than-expected degree based on previous experimental data from the same source population, and this may have affected the results. Trial Registration: ClinicalTrials.gov Identifier: NCT03334136.


Assuntos
Psoríase , Vitamina D , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Colecalciferol/efeitos adversos , Vitaminas/uso terapêutico , Psoríase/tratamento farmacológico , Psoríase/induzido quimicamente , Suplementos Nutricionais , Método Duplo-Cego
10.
Dermatol Ther (Heidelb) ; 13(8): 1873-1887, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37452929

RESUMO

INTRODUCTION: The purpose of this study is to explore treatment preferences and identify patient characteristics in young bio-naive adults with moderate to severe psoriasis in the Nordic countries (Norway, Finland, Sweden, and Denmark). METHODS: Patients were 18-45 years old and bio-naive but referred for biologic treatment of moderate to severe psoriasis. Patients were included at eight Nordic dermatology clinics. Patients with significant comorbidity or psoriatic arthritis were excluded. The Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) were assessed along with basic patient information. A semistructured interview guide was used in individual qualitative interviews, asking patients about their treatment preferences and reasons, disease journey, and disease management. The interviews were analyzed using thematic content analysis. Twenty-four patients sufficed to reach saturation in this qualitative study. RESULTS: The patient sample characteristics represented a qualitative variation in age, sex, symptoms, duration of disease, and country. We included a total of 12 male and 12 female patients. The mean age was 34 years (range 18-45 years), the mean age at diagnosis was 20 years (range 6-34 years), the mean ± standard deviation (SD) time since diagnosis was 13 ± 8 years, PASI was 9.5 ± 4.7, and DLQI was 15.2 ± 6.4. Interviews suggested that both the burden of disease as well as the burden of treatment influenced patient preferences regarding treatment attributes, hence getting alleviation from symptoms did not alone influence patient preferences. Time, effort, and inconvenience related to psoriasis treatments also influenced patient preferences. CONCLUSIONS: This first in-depth, qualitative study in young bio-naive adults with psoriasis suggests that patient preferences are focusing not only on symptom relief but also on alleviating the burden of psoriasis treatment. Understanding the reasons for patient preferences and the perspectives of young adults is needed to guide individual shared decision-making in psoriasis management.


Not much research has been done on understanding the disease burden and treatment needs of young adults suffering from psoriasis. This is an interview study with young adults from Nordic countries suffering from moderate to severe psoriasis with an active lifestyle. The adult patients were all referred for biologic treatment of psoriasis but had not yet started treatment when they were interviewed. The aim was to explore treatment preferences in this group.The study showed that treatment goals depended upon both alleviation of symptoms and obtaining a low treatment burden. The most influential symptoms were scaling, itching, and visible plaques. The most important treatment burden features were efficacy, durability, speed of response, safety, and convenience. Understanding the reasons behind these different treatment preferences is essential to help shared-decision psoriasis management that matches individual needs.

11.
Br J Sports Med ; 46(2): 91-4, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20460258

RESUMO

An inpatient programme for the treatment of morbidly obese patients is described. The programme targets physical training, nutrition and coping strategies for behaviour change management. The patients spend 14 weeks at the clinic followed by two 1-week visits 16 and 32 weeks postdischarge. Preliminary data from the 166 patients treated during 2006 are given.


Assuntos
Assistência Ambulatorial/métodos , Obesidade Mórbida/terapia , Adaptação Psicológica , Instituições de Assistência Ambulatorial , Terapia Comportamental/métodos , Terapia por Exercício/métodos , Feminino , Humanos , Masculino , Noruega , Terapia Nutricional/métodos , Avaliação de Programas e Projetos de Saúde , Resultado do Tratamento , Redução de Peso/fisiologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-34639815

RESUMO

Mental health care policies call for health-promoting and recovery-oriented interventions, as well as community-based programs supporting healthier habits. The purpose of this study was to explore how individuals facing mental health challenges experienced participating in tailored exercise at a community-based activity center, and what role tailored exercise could play in supporting an individual's process of recovery. Data were collected through in-depth interviews with nine adults experiencing poor mental health who engaged in exercise at the activity center. Interviews were audio-recorded, transcribed verbatim and analyzed using systematic text condensation. Participants spoke about the community-based program being a safe space where they could "come as they are" (Theme 1). Taking part in the program was "more than just exercise" and allowed them to connect with others (Theme 2). The experiences they gained from exercise also helped with other areas in life and provided them with a safe space to build their confidence towards the "transition back to the outside" (Theme 3). We summarized the findings into one overall theme: "inside vs. outside". In conclusion, a community-based activity center acted as a liminal space that aided mental health recovery by allowing participants to feel safe, accepted and supported, as well as experience citizenship. The findings highlight the need to treat mental health challenges as a contextual phenomenon and creating arenas for community and citizenship in society.


Assuntos
Recuperação da Saúde Mental , Adulto , Cognição , Participação da Comunidade , Emoções , Exercício Físico , Humanos
14.
Ann Med ; 46(5): 273-82, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24491067

RESUMO

INTRODUCTION: We examined the effects of 10-14 weeks of inpatient intensive lifestyle intervention (ILI), including a minimum of 90 minutes of adapted physical activity 5 days/week, with regard to changes in quality of life and associations with weight loss in subjects with severe obesity. METHODS: A total of 100 severely obese subjects (BMI 42.6 ± 5.3 kg/m(2); 42.7 ± 10.6 years) were included. Quality of life was assessed by Binge Eating Scale, Hospital Anxiety, and Depression Scale, and SF- 36. The ILI group completed the questionnaires at inclusion, after 10-14 weeks and 12 months, and controls at inclusion and after 10-14 weeks. RESULTS: Compared to controls, self-reported binge eating (-6.4, P < 0.0001), anxiety (-1.7, P = 0.005), and depression (-3.0, P < 0.0001) were reduced, and physical (8.0, P < 0.0001) and mental (7.6, P < 0.0001) health increased in the ILI group. After 12 months, reduction in self-reported binge eating (-7.2, P < 0.0001) and depression (-3.4, P < 0.0001) and increase in physical (8.9, P < 0.0001) and mental (3.6, P = 0.035) health were maintained. Decreased self-reported binge eating (ß = 0.555, P = 0.010) and increased physical health (ß = -0.554, P = 0.003) were associated with weight loss. CONCLUSION: ILI including a high volume of physical activity in subjects with severe obesity improved quality of life by favorable changes in self-reported binge eating, depression, and mental and physical health. Improvements in binge eating and physical health were associated with weight loss.


Assuntos
Estilo de Vida , Obesidade Mórbida/terapia , Obesidade/terapia , Qualidade de Vida , Adulto , Bulimia/epidemiologia , Depressão/epidemiologia , Depressão/etiologia , Feminino , Nível de Saúde , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Atividade Motora/fisiologia , Obesidade/psicologia , Obesidade Mórbida/psicologia , Estudos Prospectivos , Inquéritos e Questionários , Redução de Peso/fisiologia
15.
J Obes ; 2013: 325464, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23710347

RESUMO

We examined the effects of a 10-14-weeks inpatient lifestyle modification program, including minimum 90 min of physical activity (PA) five days/week, on body composition, CVD risk factors, and eating behavior in 139 obese subjects (BMI 42.6 ± 5.2 kg/m²). Completion rate was 71% (n = 71) in the intensive lifestyle intervention (ILI) group and 85% (n = 33) among waiting list controls. Compared to controls body weight (-17.0 (95% CI: -18.7, -15.3) kg, P < 0.0001), fat mass (-15.2 (95% CI: -17.4, -13.1) kg, P < 0.0001), fat free mass (-1.2 (95% CI: -2.2, -0.2) kg, P = 0.016) and visceral fat (-86.6(95% CI: -97.4, -75.7) cm², P < 0.0001) were reduced in the ILI-group after 10-14 weeks. Within the ILI-group weight loss was -23.8 (95% CI: -25.9, -21.7) kg, P < 0.0001 and -20.3 (95% CI: -23.3, -17.3) kg, P < 0.0001, after six and 12 months, respectively. Systolic BP, glucose, triglycerides, and LDL-C were reduced, and HDL-C was increased (all P ≤ 0.006) after 10-14 weeks within the ILI group. The reduction in glucose and increase in HDL-C were sustained after 12 months (all P < 0.0001). After one year, weight loss was related to increased cognitive restraint and decreased uncontrolled eating (all P < 0.05). Thus, ILI including high volume of PA resulted in weight loss with almost maintenance of fat-free mass, favorable changes in CVD risk factors, and eating behavior in subjects with severe obesity.


Assuntos
Composição Corporal , Restrição Calórica , Doenças Cardiovasculares/prevenção & controle , Terapia por Exercício , Comportamento Alimentar , Atividade Motora , Obesidade Mórbida/terapia , Comportamento de Redução do Risco , Adiposidade , Adulto , Regulação do Apetite , Doenças Cardiovasculares/etiologia , Distribuição de Qui-Quadrado , Terapia Combinada , Tolerância ao Exercício , Feminino , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pacientes Internados , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Noruega , Obesidade Mórbida/complicações , Obesidade Mórbida/diagnóstico , Obesidade Mórbida/dietoterapia , Obesidade Mórbida/fisiopatologia , Obesidade Mórbida/psicologia , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Redução de Peso
16.
PLoS One ; 8(5): e63716, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23667661

RESUMO

BACKGROUND: Obesity and diabetes mellitus (DM) have been linked to increased risk of infections, and Staphylococcus aureus nasal colonization is a major risk factor for developing infections with the microbe. We therefore sought to find whether body mass index (BMI) and waist circumference (WC) could be associated with S. aureus colonization independent of DM. METHODOLOGY: S. aureus colonization was assessed by nasal swab cultures among 2,169 women and 1,709 men, aged 30-87 years, in the population-based Tromsø Staph and Skin Study in 2007-08. Height (cm), weight (kg), WC (cm), and glycated haemoglobin (HbA1c,%) were measured. Multivariable logistic regression analyses including information on DM, HbA1c, hormonal contraceptive use and other potential confounders were used. RESULTS: In the female population, each 2.5 kg/m(2) increase in BMI was associated with a 7% higher odds of S. aureus nasal colonization (P = 0.01). When comparing obese and lean women aged 30-43 years, we observed that BMI ≥32.5 versus <22.5 kg/m(2) and WC ≥101 versus <80 cm was associated with a 2.60 and 2.12 times higher odds of S. aureus colonization, respectively (95% confidence intervals 1.35-4.98 and 1.17-3.85). Among men, high WC was also associated with S. aureus nasal colonization. The associations did not change significantly when the analysis was restricted to participants without signs of pre-diabetes (HbA1c <6.0%) among women and men, and to non-users of hormonal contraceptives among women. CONCLUSION: Our results support that obesity is a possible determinant for S. aureus nasal colonization independent of DM, in particular for premenopausal women. The role of obesity at different ages and by sex should be addressed in future prospective studies of S. aureus colonization.


Assuntos
Nariz/microbiologia , Obesidade/epidemiologia , Staphylococcus aureus/crescimento & desenvolvimento , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Contagem de Colônia Microbiana , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Obesidade/microbiologia , Razão de Chances , Probabilidade , Circunferência da Cintura
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