Publications by authors named "Guy Fagherazzi"

229 Publications

Advanced analytical methods to assess physical activity behaviour using accelerometer time series: A scoping review.

Scand J Med Sci Sports 2021 Oct 25. Epub 2021 Oct 25.

Physical Activity, Sport and Health Research Group, Department of Population Health, Luxembourg Institute of Health, Luxembourg.

Physical activity (PA) is a complex human behaviour, which implies that multiple dimensions need to be taken into account in order to reveal a complete picture of the PA behaviour profile of an individual. This scoping review aimed to map advanced analytical methods and their summary variables, hereinafter referred to as wearable-specific indicators of PA behaviour (WIPAB), used to assess PA behaviour. The strengths and limitations of those indicators as well as potential associations with certain health-related factors were also investigated. Three databases (MEDLINE, Embase and Web of Science) were screened for articles published in English between January 2010 and April 2020. Articles, which assessed the PA behaviour, gathered objective measures of PA using tri-axial accelerometers and investigated WIPAB were selected. All studies reporting WIPAB in the context of PA monitoring were synthesised and presented in four summary tables: study characteristics, details of the WIPAB, strengths and limitations, and measures of association between those indicators and health-related factors. In total, 7247 records were identified, of which 24 articles were included after assessing titles, abstracts and full-texts. Thirteen WIPAB were identified, which can be classified into three different categories specifically focussing on 1) the activity intensity distribution, 2) activity accumulation and 3) the temporal correlation and regularity of the acceleration signal. Only five of the thirteen WIPAB identified in this review have been used in the literature so far to investigate the relationship between PA behaviour and health, while they may provide useful additional information to the conventional PA variables.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/sms.14085DOI Listing
October 2021

Detection of COVID-19 from voice, cough and breathing patterns: Dataset and preliminary results.

Comput Biol Med 2021 Oct 13;138:104944. Epub 2021 Oct 13.

Luxembourg Institute of Health, Department of Population Health, Deep Digital Phenotyping Research Unit, Strassen, Luxembourg.

COVID-19 heavily affects breathing and voice and causes symptoms that make patients' voices distinctive, creating recognizable audio signatures. Initial studies have already suggested the potential of using voice as a screening solution. In this article we present a dataset of voice, cough and breathing audio recordings collected from individuals infected by SARS-CoV-2 virus, as well as non-infected subjects via large scale crowdsourced campaign. We describe preliminary results for detection of COVID-19 from cough patterns using standard acoustic features sets, wavelet scattering features and deep audio embeddings extracted from low-level feature representations (VGGish and OpenL3). Our models achieve accuracy of 88.52%, sensitivity of 88.75% and specificity of 90.87%, confirming the applicability of audio signatures to identify COVID-19 symptoms. We furthermore provide an in-depth analysis of the most informative acoustic features and try to elucidate the mechanisms that alter the acoustic characteristics of coughs of people with COVID-19.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.compbiomed.2021.104944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8513517PMC
October 2021

Associations between device-measured physical activity and glycemic control and variability indices under free-living condition.

Diabetes Technol Ther 2021 Oct 14. Epub 2021 Oct 14.

Luxembourg Institute of Health, 58942, Department of Population Health, Deep Digital Phenotyping Research Unit, Strassen, Luxembourg;

Background: Disturbances of glycemic control and large glycemic variability have been associated with increased risk of type 2 diabetes in the general population as well as complications in people with diabetes. Long-term health benefits of physical activity are well documented but less is known about the timing of potential short-term effects on glycemic control and variability in free-living conditions.

Methods: We analyzed data from 85 participants without diabetes from the Food & You digital cohort. During a 2-week follow-up, device-based daily step count was studied in relation to glycemic control and variability indices using generalized estimating equations. Glycemic indices, evaluated using flash glucose monitoring devices (FreeStyle Libre), included minimum, maximum, mean, standard deviation, and coefficient of variation of daily glucose values, the glucose management indicator, and the approximate area under the sensor glucose curve.

Results: We observed that every 1000 steps/day increase in daily step count was associated with a 0.3588 mg/dL (95% CI -0.6931,-0.0245), a 0.0917 mg/dL (95% CI -0.1793,-0.0042), and a 0.0022% (95% CI -0.0043,-0.0001) decrease in the maximum glucose values, mean glucose, and in the glucose management indicator of the following day, respectively. We did not find any association between daily step count and glycemic indices from the same day.

Conclusions: Increasing physical activity level was linked to blunted glycemic excursions during the next day. Because health-related benefits of physical activity can be long to observe, such short-term physiological benefits could serve as personalized feedback to motivate individuals to engage in healthy behaviors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1089/dia.2021.0294DOI Listing
October 2021

Unraveling the concepts of distress, burnout, and depression in type 1 diabetes: A scoping review.

EClinicalMedicine 2021 Oct 28;40:101118. Epub 2021 Aug 28.

Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg.

Background: Psychological complications are frequent in type 1 diabetes (T1D) but they might be difficult to distinguish one from the other in clinical practice. Our objective was to study the distinguishing characteristics, overlaps and their use in the literature between three concepts of T1D: depression, diabetes distress (DD) and diabetes burnout (DB).

Methods: A scoping review (PRISMA guidelines) performed in three databases (PubMed/MEDLINE, PsycInfo, Web of Science) with the keywords: T1D, depression, diabetes and burnout, from January 1990 to June 2021. We selected original studies with participants with T1D, which reported depression, DD, or DB. We extracted information about the concepts, their sub-concepts and screening tools.

Findings: Of the 4763 studies identified, 201 studies were included in the study. Seventy-three percent, 57% and 45% of sub-concepts do not overlap in depression, DD, and DB, respectively. We observed overlap between depression (27%)/DD (27%) and between DD (20%)/DB (50%).

Interpretation: A number of sub-concepts distinguish depression and DD. Overlaps between concepts suggest that a more precise definition is still lacking. DB is still a relatively new concept and more research is needed to better understand how it can present itself differently, in order to personalize care in comparison to those having DD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.eclinm.2021.101118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8408521PMC
October 2021

Dietary Copper/Zinc Ratio and Type 2 Diabetes Risk in Women: The E3N Cohort Study.

Nutrients 2021 Jul 22;13(8). Epub 2021 Jul 22.

Center for Research in Epidemiology and Population Health (CESP), Institut Gustave Roussy, U1018 Inserm, CEDEX, 94800 Villejuif, France.

The serum copper (Cu) to zinc (Zn) ratio could be an important determinant of Type 2 diabetes (T2D) risk, but prospective epidemiological data are scarce. We aimed to investigate the association between T2D incidence and the dietary Cu/Zn ratio. A total of 70,991 women from the E3N cohort study were followed for 20 years. The intakes of copper and zinc were estimated at baseline using a validated food frequency questionnaire. We identified and validated 3292 incident T2D cases. Spline analysis showed that a Cu/Zn ratio < 0.55 was associated with a lower risk of T2D. Subgroup analyses comparing women in the highest versus the lowest quintile of Cu/Zn ratio showed the same pattern of association for obese women and those with zinc intake ≥8 mg/day. However, for women with zinc intake <8 mg/day, higher Cu/Zn ratio appeared to be associated with higher T2D risk. Our findings suggest that a lower dietary Cu/Zn ratio is associated with a lower T2D risk, especially among obese women and women with zinc intake >8 mg/day. Further studies are warranted to validate our results.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu13082502DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8400926PMC
July 2021

Author Correction: Estimated visceral adiposity is associated with risk of cardiometabolic conditions in a population based study.

Sci Rep 2021 Aug 25;11(1):17434. Epub 2021 Aug 25.

Department of Population Health, Luxembourg Institute of Health, 1A‑B, rue Thomas Edison, 1445, Strassen, Luxembourg.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-96667-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8387435PMC
August 2021

Towards precision cardiometabolic prevention: results from a machine learning, semi-supervised clustering approach in the nationwide population-based ORISCAV-LUX 2 study.

Sci Rep 2021 08 6;11(1):16056. Epub 2021 Aug 6.

Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, 1445, Strassen, Luxembourg.

Given the rapid increase in the incidence of cardiometabolic conditions, there is an urgent need for better approaches to prevent as many cases as possible and move from a one-size-fits-all approach to a precision cardiometabolic prevention strategy in the general population. We used data from ORISCAV-LUX 2, a nationwide, cross-sectional, population-based study. On the 1356 participants, we used a machine learning semi-supervised cluster method guided by body mass index (BMI) and glycated hemoglobin (HbA1c), and a set of 29 cardiometabolic variables, to identify subgroups of interest for cardiometabolic health. Cluster stability was assessed with the Jaccard similarity index. We have observed 4 clusters with a very high stability (ranging between 92 and 100%). Based on distinctive features that deviate from the overall population distribution, we have labeled Cluster 1 (N = 729, 53.76%) as "Healthy", Cluster 2 (N = 508, 37.46%) as "Family history-Overweight-High Cholesterol ", Cluster 3 (N = 91, 6.71%) as "Severe Obesity-Prediabetes-Inflammation" and Cluster 4 (N = 28, 2.06%) as "Diabetes-Hypertension-Poor CV Health". Our work provides an in-depth characterization and thus, a better understanding of cardiometabolic health in the general population. Our data suggest that such a clustering approach could now be used to define more targeted and tailored strategies for the prevention of cardiometabolic diseases at a population level. This study provides a first step towards precision cardiometabolic prevention and should be externally validated in other contexts.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-95487-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8346462PMC
August 2021

BMI in the Associations of Plant-Based Diets with Type 2 Diabetes and Hypertension Risks in Women: The E3N Prospective Cohort Study.

J Nutr 2021 Sep;151(9):2731-2740

Paris-Saclay University, UVSQ, University Paris-Sud, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP, Villejuif, France.

Background: Few studies have evaluated the quality of plant-based diets in relation to chronic diseases, and the potential role of BMI is not clearly explored.

Objectives: To study the associations between plant-based diet indices and type 2 diabetes (T2D) and hypertension risks, as well as the extent to which the associations were modified and/or mediated by BMI.

Methods: The study included 74,522 women from the Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale prospective cohort [mean (SD): age, 52.94 (6.7) years; BMI, 22.970 (3.328) kg/m2]. Dietary data were collected at baseline (1993) via an FFQ. Overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI) were developed. Multivariable Cox regression models were used to derive HRs and 95% CIs. Effect modification and mediation by BMI were explored.

Results: There were 3292 (4.64%) incident cases of T2D and 12,504 (27.14%) incident cases of hypertension over ∼20 years of follow-up. In the multivariable model further adjusted for BMI, higher adherence to PDI and hPDI was associated with lower T2D and hypertension risks, with an HR per 1-SD increase (95% CI) of 0.88 (0.85, 0.91) and 0.96 (0.94, 0.98) for PDI and 0.88 (0.85, 0.92) and 0.94 (0.92, 0.95) for hPDI, respectively. uPDI was not associated with T2D [0.98 (0.94, 1.01)], whereas a positive association was observed with hypertension: 1.04 (1.02, 1.06). There was interaction between PDI and uPDI, as well as BMI, on T2D (P-interaction < 0.001) but not on hypertension (P-interaction > 0.05). In addition, BMI mediated 26-59% and 0.2-59% of diet-T2D and diet-hypertension associations, respectively.

Conclusions: Differential associations between plant-based diets and T2D and hypertension risks were observed among women in this large prospective study. Only healthier plant foods were associated with lower risks, partly through decreasing BMI. The protocol was registered at clinicaltrials.gov as NCT03285230.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/jn/nxab158DOI Listing
September 2021

Type 2 diabetes and its characteristics are associated with poor oral health: findings from 60,590 senior women from the E3N study.

BMC Oral Health 2021 06 23;21(1):315. Epub 2021 Jun 23.

Center for Research in Epidemiology and Population Health (CESP), Inserm (Institut National de la Santé Et de la Recherche Médicale) U1018, Generations and Health, Gustave Roussy Institute, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France.

Background: Type 2 diabetes (T2D) has been identified as a risk factor for poor oral health, however, a limited number of oral health and T2D characteristics have been studied so far. We sought to assess T2D status, age at diagnosis, duration since diagnosis and treatment in relation to a variety of oral diseases.

Methods: Cross-sectional data were analyzed from the E3N (Etude Epidémiologique auprès de femmes de l'Education Nationale) cohort study which enrolled 60,590 women. Participants self-reported oral health status, and T2D cases were identified using diabetes-specific questionnaires and drug reimbursement insurance databases. Multivariable-adjusted ORs and 95% CIs were estimated using logistic regression models.

Results: The mean age (SD) of the women was 70 years (7.2), and 4.7% (n = 2857) had T2D. Compared to women without T2D, women with T2D were more likely to report a poor perceived oral health (OR 1.37 [95% CI 1.18, 1.60]), wearing dental prostheses (1.26 [1.14, 1.39]) and having problems of biting and chewing food (1.19 [1.07, 1.33]). In addition, for women with T2D the age at diagnosis (inversely) and the duration (positively) were associated with the likelihood to report poor oral health.

Conclusions: For women with T2D, duration and age at diagnosis are associated with wearing prostheses, problems of biting and chewing, periodontitis and gingivitis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12903-021-01679-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8220760PMC
June 2021

Impact of intra-category food substitutions on the risk of type 2 diabetes: a modelling study on the pizza category.

Br J Nutr 2021 Jun 14:1-10. Epub 2021 Jun 14.

Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, Paris, 75005, France.

Advice on replacing unhealthy foods with healthier alternatives within the same food category may be more acceptable and might ease the transition towards a healthy diet. Here, we studied the potential impact of substitutions within the pizza category on the risk of type 2 diabetes (T2D). The study sample consisted of 2510 adults from the INCA2 French national survey. Based on their nutritional characteristics, the 353 pizzas marketed in France were grouped into 100 clusters that were used to run various scenarios of pizza substitutions, which were either isoenergetic (IE) or non-isoenergetic (NIE). We then used a model structurally similar to the Preventable Risk Integrated ModEl to assess the expected rate of change in risk of T2D. Pizzas characterised by a low energy, high vegetable content and whole grain dough were associated with a greater reduction in the risk of T2D. The rates of change in risk of T2D were markedly stronger in men and for NIE substitutions. When the rates of change were estimated in the subsample of pizza consumers, replacing the observed pizzas with the best pizza resulted in a T2D risk reduction of -6·7 % (-8·4 %; -4·9 %, IE) and -8·9 % (-11·2 %; -6·3 %, NIE), assuming that this is their usual diets. The greatest risk reduction induced by an IE substitution of the observed pizza with a mixed dish was similar to that observed with the best pizzas. Overall, this modelling study suggests that healthy swaps within a category can effectively supplement broader dietary changes towards a healthier diet.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S0007114521002130DOI Listing
June 2021

Is the Consensual Threshold for Defining High Glucose Variability Implementable in Clinical Practice?

Diabetes Care 2021 Jun 7. Epub 2021 Jun 7.

Department of Diabetology and Endocrinology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France

Objective: Estimating glycemic variability (GV) through within-day coefficient of variation (%CV) is recommended for patients with type 1 Diabetes (T1D). High GV (hGV) is defined as %CV > 36%. However, continuous glucose monitoring (CGM) devices provide exclusively total CV (%CV). We aimed to assess consequences of this disparity.

Research Design And Methods: We retrospectively calculated both %CV and %CV of consecutive T1D patients from their CGM raw data during 14 days. Patients with hGV with %CV >36% and %CV ≤36% were called the "inconsistent GV group".

Results: A total of 104 patients were included. Mean ± SD %CV and %CV were 42.4 ± 8% and 37.0 ± 7.4% respectively ( < 0.0001). Using %CV, 81 patients (73.6%) were classified as having hGV, whereas 59 (53.6%) using %CV ( < 0.0001) corresponding to 22 patients (21%) in the inconsistent GV population.

Conclusions: Evaluation of GV through %CV in patients with T1D is highly dependent on the calculation method and then must be standardized.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2337/dc20-1847DOI Listing
June 2021

Voice for Health: The Use of Vocal Biomarkers from Research to Clinical Practice.

Digit Biomark 2021 Jan-Apr;5(1):78-88. Epub 2021 Apr 16.

Department of Computer Science, Faculty of Science, Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg.

Diseases can affect organs such as the heart, lungs, brain, muscles, or vocal folds, which can then alter an individual's voice. Therefore, voice analysis using artificial intelligence opens new opportunities for healthcare. From using vocal biomarkers for diagnosis, risk prediction, and remote monitoring of various clinical outcomes and symptoms, we offer in this review an overview of the various applications of voice for health-related purposes. We discuss the potential of this rapidly evolving environment from a research, patient, and clinical perspective. We also discuss the key challenges to overcome in the near future for a substantial and efficient use of voice in healthcare.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000515346DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8138221PMC
April 2021

The Use of Social Media for Health Research Purposes: Scoping Review.

J Med Internet Res 2021 05 27;23(5):e25736. Epub 2021 May 27.

Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg.

Background: As social media are increasingly used worldwide, more and more scientists are relying on them for their health-related projects. However, social media features, methodologies, and ethical issues are unclear so far because, to our knowledge, there has been no overview of this relatively young field of research.

Objective: This scoping review aimed to provide an evidence map of the different uses of social media for health research purposes, their fields of application, and their analysis methods.

Methods: We followed the scoping review methodologies developed by Arksey and O'Malley and the Joanna Briggs Institute. After developing search strategies based on keywords (eg, social media, health research), comprehensive searches were conducted in the PubMed/MEDLINE and Web of Science databases. We limited the search strategies to documents written in English and published between January 1, 2005, and April 9, 2020. After removing duplicates, articles were screened at the title and abstract level and at the full text level by two independent reviewers. One reviewer extracted data, which were descriptively analyzed to map the available evidence.

Results: After screening 1237 titles and abstracts and 407 full texts, 268 unique papers were included, dating from 2009 to 2020 with an average annual growth rate of 32.71% for the 2009-2019 period. Studies mainly came from the Americas (173/268, 64.6%, including 151 from the United States). Articles used machine learning or data mining techniques (60/268) to analyze the data, discussed opportunities and limitations of the use of social media for research (59/268), assessed the feasibility of recruitment strategies (45/268), or discussed ethical issues (16/268). Communicable (eg, influenza, 40/268) and then chronic (eg, cancer, 24/268) diseases were the two main areas of interest.

Conclusions: Since their early days, social media have been recognized as resources with high potential for health research purposes, yet the field is still suffering from strong heterogeneity in the methodologies used, which prevents the research from being compared and generalized. For the field to be fully recognized as a valid, complementary approach to more traditional health research study designs, there is now a need for more guidance by types of applications of social media for health research, both from a methodological and an ethical perspective.

International Registered Report Identifier (irrid): RR2-10.1136/bmjopen-2020-040671.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/25736DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8193478PMC
May 2021

Objective and subjective sleep measures are associated with HbA1c and insulin sensitivity in the general population: Findings from the ORISCAV-LUX-2 study.

Diabetes Metab 2021 May 20:101263. Epub 2021 May 20.

Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg.

Aim: To analyze the association of objective and subjective sleep measures with HbA1c and insulin sensitivity in the general population.

Methods: Using a cross-sectional design, data from 1028 participants in the ORISCAV-LUX-2 study from the general population in Luxembourg were analyzed. Objective sleep measures were assessed using accelerometers whereas subjective measures were assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Sleep measures were defined as predictors, while HbA1c and quantitative insulin sensitivity check index (QUICKI) scores were considered outcomes. Linear and spline regression models were fitted by progressively adjusting for demographic and lifestyle variables in the total sample population as well as by stratified analyses using gender, obesity status, depressive symptoms and diabetes status.

Results: In fully adjusted models, total and deep sleep durations were associated with lower HbA1c (mmol/mol) levels, whereas sleep coefficients of variation (%) and poor sleep efficiency, as measured by PSQI scores (units), were associated with higher HbA1c levels. In stratified models, such associations were observed mainly in men, and in subjects who had depressive symptoms, were overweight and no diabetes. In addition, total sleep, deep sleep, coefficients of variation and poor sleep efficiency as measured by PSQI revealed non-linear associations. Similarly, greater insulin sensitivity was associated with longer total sleep time and with PSQI-6 (use of sleep medication).

Conclusion: Associations were more frequently observed between sleep characteristics and glycaemic control with the use of objective sleep measures. Also, such associations varied within subgroups of the population. Our results highlight the relevance of measuring sleep patterns as key factors in the prevention of diabetes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.diabet.2021.101263DOI Listing
May 2021

Digital Health Interventions among People Living with Frailty: A Scoping Review.

J Am Med Dir Assoc 2021 09 14;22(9):1802-1812.e21. Epub 2021 May 14.

Deep Digital Phenotyping Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg. Electronic address:

Objectives: Digital health interventions (DHIs) are interesting resources to improve various health conditions. However, their use in the older and frail population is still sparse. We aimed to give an overview of DHI used in the frail older population.

Design: Scoping review with PRISMA guidelines based on Population, Concept, and Context.

Setting And Participants: We included original studies in English with DHI (concept) on people described as frail (population) in the clinical or community setting (context) and no limitation on date of publication. We searched 3 online databases (PubMed, Scopus, and Web of Science).

Measures: We described DHI in terms of purpose, delivering, content and assessment. We also described frailty assessment and study design.

Results: We included 105 studies that fulfilled our eligibility criteria. The most frequently reported DHIs were with the purpose of monitoring (45; 43%), with a delivery method of sensor-based technologies (59; 56%), with a content of feedback to users (34; 32%), and for assessment of feasibility (57; 54%). Efficacy was reported in 31 (30%) studies and usability/feasibility in 57 (55%) studies. The most common study design was descriptive exploratory for new methodology or technology (24; 23%). There were 14 (13%) randomized controlled trials, with only 4 of 14 studies (29%) showing a low or moderate risk of bias. Frailty assessment using validated scales was reported in only 47 (45%) studies.

Conclusions And Implications: There was much heterogeneity among frailty assessments, study designs, and evaluations of DHIs. There is now a strong need for more standardized approaches to assess frailty, well-structured randomized controlled trials, and proper evaluation and report. This work will contribute to the development of better DHIs in this vulnerable population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jamda.2021.04.012DOI Listing
September 2021

SARS-CoV-2 transmission risk from asymptomatic carriers: Results from a mass screening programme in Luxembourg.

Lancet Reg Health Eur 2021 May 27;4:100056. Epub 2021 Feb 27.

Luxembourg Institute of Health (LIH), 1A-B rue Thomas Edison, L-1445 Strassen, Luxembourg.

Background: To accompany the lifting of COVID-19 lockdown measures, Luxembourg implemented a mass screening (MS) programme. The first phase coincided with an early summer epidemic wave in 2020.

Methods: rRT-PCR-based screening for SARS-CoV-2 was performed by pooling of samples. The infrastructure allowed the testing of the entire resident and cross-border worker populations. The strategy relied on social connectivity within different activity sectors. Invitation frequencies were tactically increased in sectors and regions with higher prevalence. The results were analysed alongside contact tracing data.

Findings: The voluntary programme covered 49% of the resident and 22% of the cross-border worker populations. It identified 850 index cases with an additional 249 cases from contact tracing. Over-representation was observed in the services, hospitality and construction sectors alongside regional differences. Asymptomatic cases had a significant but lower secondary attack rate when compared to symptomatic individuals. Based on simulations using an agent-based SEIR model, the total number of expected cases would have been 42·9% (90% CI [-0·3, 96·7]) higher without MS. Mandatory participation would have resulted in a further difference of 39·7% [19·6, 59·2].

Interpretation: Strategic and tactical MS allows the suppression of epidemic dynamics. Asymptomatic carriers represent a significant risk for transmission. Containment of future outbreaks will depend on early testing in sectors and regions. Higher participation rates must be assured through targeted incentivisation and recurrent invitation.

Funding: This project was funded by the Luxembourg Ministries of Higher Education and Research, and Health.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.lanepe.2021.100056DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7912359PMC
May 2021

The associations of the Palaeolithic diet alone and in combination with lifestyle factors with type 2 diabetes and hypertension risks in women in the E3N prospective cohort.

Eur J Nutr 2021 Oct 28;60(7):3935-3945. Epub 2021 Apr 28.

Paris-Saclay University, UVSQ, Univ. Paris-Sud, Inserm U1018, "Exposome, Heredity, Cancer, and Health" Team, CESP, Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France.

Purpose: Patterns of change from the traditional Palaeolithic lifestyle to the modern lifestyle may partly explain the epidemic proportions of non-communicable diseases (NCDs). We investigated to what extent adherence to the Palaeolithic diet (PD) and the Palaeolithic-like lifestyle was associated with type 2 diabetes (T2D) and hypertension risks.

Methods: A study of 70,991 women from the E3N (Etude Epidémiologique auprès de femmes de la Mutuelle Générale de l'Education Nationale) cohort, followed up for nearly 20 years. There were 3292 incident T2D and 12,504 incident hypertension cases that were validated. Dietary data were collected at baseline in 1993 via a food frequency questionnaire. The PD score and the Palaeolithic-like lifestyle score (PD, physical activity, smoking status, and body mass index [BMI]) were derived and considered in quintiles. Multivariable Cox regression models were employed to estimate hazard ratios (HR) and 95% confidence intervals (CI) for incident T2D and hypertension.

Results: In the fully adjusted models, a 1-SD increase of the PD score was associated with 4% and 3% lower risks of T2D and hypertension, respectively. Those in the highest versus the lowest quintile of the score had HR (95% CI) of 0.88 (0.79, 0.98) and 0.91 (0.86, 0.96) for T2D and hypertension, respectively (P-trend < 0.0001). Associations were stronger for the Palaeolithic-like lifestyle score; in the fully adjusted model, a 1-SD increase of the score was associated with 19% and 6% lower risks of T2D and hypertension, respectively. Risks lowered successively with each increase in quintile; those in the highest versus the lowest quintile had HR (95% CI) of 0.58 (0.52, 0.65) and 0.85 (0.80, 0.90) for T2D and hypertension, respectively (P-trend < 0.0001).

Conclusions: Our data suggest that adhering to a PD based on fruit, vegetables, lean meats, fish, and nuts, and incorporating a Palaeolithic-like lifestyle could be promising options to prevent T2D and hypertension.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00394-021-02565-5DOI Listing
October 2021

Estimated visceral adiposity is associated with risk of cardiometabolic conditions in a population based study.

Sci Rep 2021 04 27;11(1):9121. Epub 2021 Apr 27.

Department of Population Health, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, 1445, Strassen, Luxembourg.

Visceral adiposity is a major risk factor of cardiometabolic diseases. Visceral adipose tissue (VAT) is usually measured with expensive imaging techniques which present financial and practical challenges to population-based studies. We assessed whether cardiometabolic conditions were associated with VAT by using a new and easily measurable anthropometric index previously published and validated. Data (1529 participants) came from the European Health Examination Survey in Luxembourg (2013-2015). Logistic regressions were used to study associations between VAT and cardiometabolic conditions. We observed an increased risk of all conditions associated with VAT. The total adjusted odds ratio (AOR, [95% CI]) for hypertension, prediabetes/diabetes, hypercholesterolemia, and hypertriglyceridemia for the fourth quartile of VAT compared to the lowest were (10.67 [6.95, 16.39]), (6.14 [4.14, 9.10]), (6.03 [3.97, 9.16]) and (9.18 [5.97, 14.12]). We observed higher odds in women than in men for all outcomes with the exception of hypertension. Future studies should investigate the impact of VAT changes on cardiometabolic health and the use of anthropometrically predicted VAT as an accurate outcome when no biomedical imaging is available.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-88587-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079669PMC
April 2021

Association of Migraine With Incident Hypertension After Menopause: A Longitudinal Cohort Study.

Neurology 2021 07 21;97(1):e34-e41. Epub 2021 Apr 21.

From Center for Research in Epidemiology and Population Health (CESP) (C.J.M., D.E.F., A.-L.M., G.S., M.-C.B.-R.), Institut Gustave Roussy, INSERM (Institut National de la Santé et de la Recherche Médicale) U1018; Université Paris-Saclay (C.J.M., D.E.F., A.-L.M., G.S., M.-C.B.-R.), Université Paris-Sud, Villejuif; EA 2694-Santé Publique: Épidémiologie et Qualité des Soins (A.-L.M.), Université de Lille, CHU Lille, France; Deep Digital Phenotyping Research Unit, Department of Population Health (G.F.), Luxembourg Institute of Health, Strassen; Institute of Public Health Charité-Universitätsmedizin Berlin (T.K.), Germany; and Department of Statistics, Computer Science and Applications (DISIA) (G.S.), University of Florence, Italy.

Objective: Migraine has been identified as a potential risk factor for hypertension in prospective studies. In women, migraine prevalence decreases after menopause, but no studies have determined whether migraine is associated with hypertension after menopause. This study sought to determine whether history of migraine was associated with an increased risk of hypertension among menopausal women.

Methods: We assessed associations between migraine and hypertension in a longitudinal cohort study of 56,202 menopausal women participating in the French E3N cohort, with follow-up beginning in 1993. We included women who did not have hypertension or cardiovascular disease at the time of menopause. Migraine was classified as ever or never at each questionnaire cycle. Cox proportional hazards models were used to investigate relations between migraine and hypertension, controlling for potential confounding. A secondary analysis with baseline in 2011 considered aura status, grouping participants reporting migraine as migraine with aura, migraine without aura, or unknown migraine type.

Results: During 826,419 person-years, 12,501 cases of incident hypertension were identified, including 3,100 among women with migraine and 9,401 among women without migraine. Migraine was associated with an increased risk of hypertension in menopausal women (hazard ratio [HR] 1.29 [95% confidence interval 1.24, 1.35]) and was consistent in post hoc sensitivity analyses, such as when controlling for common migraine medications. Associations between migraine and hypertension were similar whether or not women reported aura (HR 1.54 [1.04, 2.30], HR 1.32 [0.87, 2.02], heterogeneity 0.60). Associations were slightly stronger among ever users of menopausal hormone therapy (HR 1.34 [1.27, 1.41]) than among never users (HR 1.19 [1.11, 1.28]).

Conclusions: Migraine was associated with an increased risk of hypertension among menopausal women. In secondary analysis, we did not observe a significant difference between migraine with aura and migraine without aura.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1212/WNL.0000000000011986DOI Listing
July 2021

Associations of Physical Activity Level and Variability With 6-Month Weight Change Among 26,935 Users of Connected Devices: Observational Real-Life Study.

JMIR Mhealth Uhealth 2021 04 15;9(4):e25385. Epub 2021 Apr 15.

Center of Research in Epidemiology and Population Health, UMR 1018 INSERM, Institut Gustave Roussy, Paris-Sud Paris-Saclay University, Villejuif, France.

Background: Physical activity (PA) is a modifiable lifestyle factor that can be targeted to increase energy expenditure and promote weight loss. However, the amount of PA required for weight loss remains inconsistent. Wearable activity trackers constitute a valuable opportunity to obtain objective measurements of PA and study large populations in real-life settings.

Objective: We aim to study the associations of initial device-assessed PA characteristics (average step counts and step count variability) and their evolution with 6-month weight change.

Methods: We analyzed data from 26,935 Withings-connected device users (wearable activity trackers and digital scales). To assess the initial PA characteristics and their 6-month changes, we used data recorded during the first and sixth 30-day periods of activity tracker use. For each of these periods, we used the monthly mean of daily step values as a proxy for PA level and derived the monthly coefficient of variation (CV) of daily step values to estimate PA level variability. Associations between initial PA characteristics and 6-month weight change were assessed using multivariable linear regression analyses controlled for age, sex, blood pressure, heart rate, and the predominant season. Restricted cubic spline regression was performed to better characterize the continuous shape of the associations between PA characteristics and weight change. Secondary analyses were performed by analyzing the 6-month evolution of PA characteristics in relation to weight change.

Results: Our results revealed that both a greater PA level and lower PA level variability were associated with weight loss. Compared with individuals who were initially in the sedentary category (<5000 steps/day), individuals who were low active (5000-7499 steps/day), somewhat active (7500-9999 steps/day), and active (≥10,000 steps/day) had a 0.21-kg, a 0.52-kg, and a 1.17-kg greater decrease in weight, respectively (95% CI -0.36 to -0.06, -0.70 to -0.33, and -1.42 to -0.93, respectively). Compared with users whose PA level CV was >63%, users whose PA level CV ranged from 51% to 63%, 40% to 51%, and was ≤40%, had a 0.19-kg, a 0.23-kg, and a 0.33-kg greater decrease in weight, respectively (95% CI -0.38 to -0.01, -0.41 to -0.04, and -0.53 to -0.13, respectively). We also observed that each 1000 steps/day increase in PA level over the 6-month follow-up was associated with a 0.26-kg (95% CI -0.29 to -0.23) decrease in weight. No association was found between the 6-month changes in PA level variability and weight change.

Conclusions: Our results add to the current body of knowledge that health benefits can be observed below the 10,000 steps/day threshold and suggest that not only increased mean PA level but also greater regularity of the PA level may play important roles in short-term weight loss.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/25385DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8085744PMC
April 2021

Patterns of Sequelae in Women with a History of Localized Breast Cancer: Results from the French VICAN Survey.

Cancers (Basel) 2021 Mar 8;13(5). Epub 2021 Mar 8.

Department Prevention, Cancer, Environment, Léon Bérard Cancer Center, 69008 Lyon, France.

Breast cancer (BC) remains complex for women both physically and psychologically. The objectives of this study were to (1) assess the evolution of the main sequelae and treatment two and five years after diagnosis in women with early-stage breast cancer, (2) explore patterns of sequelae associated with given sociodemographic, clinical, and lifestyle factors. The current analysis was based on 654 localized BC patients enrolled in the French nationwide longitudinal survey "vie après cancer" VICAN (January-June 2010). Information about study participants was collected at enrollment, two and five years after diagnosis. Changes over time of the main sequelae were analyzed and latent class analysis was performed to identify patterns of sequelae related to BC five years after diagnosis. The mean age (±SD) of study participants at inclusion was 49.7 (±10.5) years old. Six main classes of sequelae were identified two years and five years post-diagnosis (functional, pain, esthetic, fatigue, psychological, and gynecological). A significant decrease was observed for fatigue ( = 0.03) and an increase in cognitive sequelae was reported ( = 0.03). Two latent classes were identified-functional and esthetic patterns. Substantial sequelae remain up to five years after BC diagnosis. Changes in patient care pathways are needed to identify BC patients at a high risk.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/cancers13051161DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7962808PMC
March 2021

The long-run effects of war on health: Evidence from World War II in France.

Soc Sci Med 2021 05 9;276:113812. Epub 2021 Mar 9.

Université Paris-Saclay, INRAE, UR ALISS, 65 Boulevard de Brandebourg, 94205, Ivry-sur-Seine, France; Sciences Po Paris, 28 Rue des Saints-Pères, 75007, Paris, France. Electronic address:

We investigate the effects of early-life exposure to war on adult health outcomes including cancer, hypertension, angina, infarction, diabetes and obesity. We combine data from the French prospective cohort study E3N on women employed in the French National Education with historical data on World War II. To identify causal effects, we exploit exogenous spatial and temporal variation in war exposure related to the German invasion of France during the Battle of France. The number of French military casualties at the level of the postcode area serves as main measure of exposure. Our results suggest that exposure to the war during the first 5 years of life has significant adverse effects on health in adulthood. A 10 percent increase in the number of deaths per 100,000 inhabitants in the individual's postcode area of birth increases the probability of suffering from any of the health conditions considered in this study by 0.08 percentage points. This is relative to a mean of 49 percent for the sample as a whole.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.socscimed.2021.113812DOI Listing
May 2021

Identification of chemical mixtures to which women are exposed through the diet: Results from the French E3N cohort.

Environ Int 2021 07 9;152:106467. Epub 2021 Mar 9.

French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Risk Assessment Department, Methodology and Survey Unit, 94701 Maisons-Alfort, France.

Due to the large number of chemical food contaminants, consumers are exposed simultaneously to a wide range of chemicals which can interact and have a negative impact on health. Nevertheless, due to the multitude of possible chemical combinations it is unrealistic to test all combined toxicological effects. It is therefore essential to identify the most relevant mixtures to which the population is exposed through the diet and investigate their impact on heath. The present study aims to identify and describe the main chemical mixtures to which women enrolled in the E3N study, a large French prospective cohort, are chronically exposed through the diet. 74522 women who had answered a validated semi-quantitative food frequency questionnaire in 1993, were included in the present study. Dietary exposure to chemical contaminates was estimated based on the food contamination measured in 186 core food in France collected between 2007 and 2009 by the French agency for food, environment and occupational health, and safety (ANSES) in the framework of the second French total diet study (2TDS). The sparse non-negative matrix under-approximation (SNMU) was used to identify mixtures of chemical substances. A k-means clustering classification of the whole study population was then performed to define clusters with similar co-exposure profiles. Overall, 8 mixtures which explained 83% of the total variance, were retained. The first mixture, entitled "Minerals, inorganic contaminants, and furans", explained the highest proportion of the total variance (38%), and was correlated in particular with the consumption of "Offal" (rho = 0.22), "Vegetables except roots" (rho = 0.20), and "Eggs" (rho = 0.19). The other seven mixtures explained between 17% and 1% of the variance. Finally, 5 clusters were identified based on the adherence to the 8 mixtures. This study, being the largest ever conducted to identify dietary exposure to chemical mixtures, represents a concrete attempt to prioritize mixtures for which it is essential to investigate combined health effects based on exposure.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.envint.2021.106467DOI Listing
July 2021

Scoping review protocol on the use of social media for health research purposes.

BMJ Open 2021 02 11;11(2):e040671. Epub 2021 Feb 11.

Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg

Introduction: More than one-third of the world population uses at least one form of social media. Since their advent in 2005, health-oriented research based on social media data has largely increased as discussions about health issues are broadly shared online and generate a large amount of health-related data. The objective of this scoping review is to provide an evidence map of the various uses of social media for health research purposes, their fields of applications and their analysis methods.

Methods And Analysis: This scoping review will follow the Arksey and O'Malley methodological framework (2005) as well as the Joanna Briggs Institute Reviewer's manual. Relevant publications will be first searched on the PudMed/MEDLINE database and then on Web of Science. We will focus on literature published between January 2005 and April 2020. All articles related to the use of social media or networks for health-oriented research purposes will be included. A first search will be conducted with some keywords in order to identify relevant articles. After identifying the research strategy, a two-part study selection process will be systematically applied by two reviewers. The first part consists of screening titles and abstracts found, thanks to the search strategy, to define the eligibility of each article. In the second part, the full texts will be screened and only relevant articles will be kept. Data will finally be extracted, collated and charted to summarise all the relevant methods, outcomes and key findings in the articles.

Ethics And Dissemination: This scoping review will provide an extensive overview of the use of social media for health research purposes. Opportunities as well as future ethical, methodological and technical challenges will also be discussed based on our findings to define a new research agenda. Results will be disseminated through a peer-reviewed publication.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2020-040671DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7880087PMC
February 2021

Correction to: Beyond the map: evidencing the spatial dimension of health inequalities.

Int J Health Geogr 2021 Jan 4;20(1). Epub 2021 Jan 4.

Center of Epidemiology and Population Health, UMR 1018, Inserm, Paris South, Paris Saclay University, Villejuif, France.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12942-020-00255-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7780645PMC
January 2021

Micronutrients and Markers of Oxidative Stress and Inflammation Related to Cardiometabolic Health: Results from the EHES-LUX Study.

Nutrients 2020 Dec 22;13(1). Epub 2020 Dec 22.

Nutrition and Health Research Unit, Department of Population Health, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, L-1445 Strassen, Luxembourg.

Metabolic syndrome (MetS) characteristics include chronic inflammation and elevated oxidative stress. This study assessed associations between circulating concentrations of micronutrients/phytochemicals and inflammatory/oxidative stress markers with MetS and MetS components. Adults (N = 606) from the European Health Examination Survey in Luxembourg (2013-2015) were randomly selected. We performed a multivariable logistic regression model using the least absolute shrinkage and selection operator to identify MetS-associated variables. Participants with MetS had higher concentrations of C-reactive protein (CRP), 8-iso-prostaglandin F2α, leptin, insulin, and vitamins E/A, but lower concentrations of adiponectin, beta-carotene, and oxidized low-density lipoprotein. A one-unit increase in log-CRP was associated with 51% greater odds of MetS (OR = 1.51 (95% CI: 1.16, 1.98)). Adults with a one-unit increase in log-leptin were 3.1 times more likely to have MetS (3.10 (2.10, 4.72)). Women with a one-unit increase in vitamin A were associated with 3% increased odds of MetS (1.03 (1.01, 1.05)), while those with a one-unit increase in log-adiponectin were associated with 82% decreased odds (0.18 (0.07, 0.46)). Chronic inflammation best characterized adults with MetS, as CRP, adiponectin, and leptin were selected as the main MetS determinants. Micronutrients did not seem to affect MetS, except for vitamin A in women.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu13010005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7822009PMC
December 2020

Beyond the map: evidencing the spatial dimension of health inequalities.

Int J Health Geogr 2020 11 9;19(1):46. Epub 2020 Nov 9.

Center of Epidemiology and Population Health, UMR 1018, Inserm, Paris South, Paris Saclay University, Villejuif, France.

Background: Spatial inequalities in health result from different exposures to health risk factors according to the features of geographical contexts, in terms of physical environment, social deprivation, and health care accessibility. Using a common geographical referential, which combines indices measuring these contextual features, could improve the comparability of studies and the understanding of the spatial dimension of health inequalities.

Methods: We developed the Geographical Classification for Health studies (GeoClasH) to distinguish French municipalities according to their ability to influence health outcomes. Ten contextual scores measuring physical and social environment as well as spatial accessibility of health care have been computed and combined to classify French municipalities through a K-means clustering. Age-standardized mortality rates according to the clusters of this classification have been calculated to assess its effectiveness.

Results: Significant lower mortality rates compared to the mainland France population were found in the Wealthy Metropolitan Areas (SMR = 0.868, 95% CI 0.863-0.873) and in the Residential Outskirts (SMR = 0.971, 95% CI 0.964-0.978), while significant excess mortality were found for Precarious Population Districts (SMR = 1.037, 95% CI 1.035-1.039), Agricultural and Industrial Plains (SMR = 1.066, 95% CI 1.063-1.070) and Rural Margins (SMR = 1.042, 95% CI 1.037-1.047).

Conclusions: Our results evidence the comprehensive contribution of the geographical context in the constitution of health inequalities. To our knowledge, GeoClasH is the first nationwide classification that combines social, environmental and health care access scores at the municipality scale. It can therefore be used as a proxy to assess the geographical context of the individuals in public health studies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12942-020-00242-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7727185PMC
November 2020

Protocol for a prospective, longitudinal cohort of people with COVID-19 and their household members to study factors associated with disease severity: the Predi-COVID study.

BMJ Open 2020 11 23;10(11):e041834. Epub 2020 Nov 23.

Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg

Introduction: A few major clinical factors such as sex, obesity or comorbidities have already been associated with COVID-19 severity, but there is a need to identify new epidemiological, clinical, digital and biological characteristics associated with severity and perform deep phenotyping of patients according to severity. The objectives of the Predi-COVID study are (1) to identify new determinants of COVID-19 severity and (2) to conduct deep phenotyping of patients by stratifying them according to risk of complications, as well as risk factors for infection among household members of Predi-COVID participants (the Predi-COVID-H ancillary study).

Methods And Analysis: Predi-COVID is a prospective, hybrid cohort study composed of laboratory-confirmed COVID-19 cases in Luxembourg who will be followed up remotely for 1 year to monitor their health status and symptoms. Predi-COVID-H is an ancillary cohort study on household members of index cases included in Predi-COVID to monitor symptoms and household clusters in this high-risk population. A subcohort of up to 200 Predi-COVID and 300 Predi-COVID-H participants with biological samples will be included. Severity of infection will be evaluated by occurrence and duration of hospitalisation, admission and duration of stay in intensive care units or equivalent structures, provision of and duration of supplemental oxygen and ventilation therapy, transfer to another hospital, as well as the impact of infection on daily activities following hospital discharge.

Ethics And Dissemination: The study has been approved by the National Research Ethics Committee of Luxembourg (study number 202003/07) in April 2020. An informed consent is signed by study participants. Scientific articles will be submitted to international peer-reviewed journals, along with press releases for lay audience for major results.

Trial Registration Number: NCT04380987.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2020-041834DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7684799PMC
November 2020

Plasma Vitamin C and Type 2 Diabetes: Genome-Wide Association Study and Mendelian Randomization Analysis in European Populations.

Diabetes Care 2021 01 17;44(1):98-106. Epub 2020 Nov 17.

Unit of Nutrition and Cancer, Cancer Epidemiology Research Program and Translational Research Laboratory; Catalan Institute of Oncology - ICO, Group of Research on Nutrition and Cancer, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet of Llobregat, Barcelona, Spain.

Objective: Higher plasma vitamin C levels are associated with lower type 2 diabetes risk, but whether this association is causal is uncertain. To investigate this, we studied the association of genetically predicted plasma vitamin C with type 2 diabetes.

Research Design And Methods: We conducted genome-wide association studies of plasma vitamin C among 52,018 individuals of European ancestry to discover novel genetic variants. We performed Mendelian randomization analyses to estimate the association of genetically predicted differences in plasma vitamin C with type 2 diabetes in up to 80,983 case participants and 842,909 noncase participants. We compared this estimate with the observational association between plasma vitamin C and incident type 2 diabetes, including 8,133 case participants and 11,073 noncase participants.

Results: We identified 11 genomic regions associated with plasma vitamin C ( < 5 × 10), with the strongest signal at , and 10 novel genetic loci including , , , , , , , , , and . Plasma vitamin C was inversely associated with type 2 diabetes (hazard ratio per SD 0.88; 95% CI 0.82, 0.94), but there was no association between genetically predicted plasma vitamin C (excluding variant due to its apparent pleiotropic effect) and type 2 diabetes (1.03; 95% CI 0.96, 1.10).

Conclusions: These findings indicate discordance between biochemically measured and genetically predicted plasma vitamin C levels in the association with type 2 diabetes among European populations. The null Mendelian randomization findings provide no strong evidence to suggest the use of vitamin C supplementation for type 2 diabetes prevention.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2337/dc20-1328DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783939PMC
January 2021

Associations Between Physical Activity and Incident Hypertension Across Strata of Body Mass Index: A Prospective Investigation in a Large Cohort of French Women.

J Am Heart Assoc 2020 12 14;9(23):e015121. Epub 2020 Nov 14.

Institut National de la Santé et de la Recherche Médicale U1018 Center for Research in Epidemiology and Population Health Institut Gustave Roussy Villejuif France.

Background High body mass index (BMI) and low physical activity are associated with increased risk of hypertension. Few studies have assessed their joint impact or the relation of physical activity and hypertension among individuals within a healthy BMI range. The objective of this study was to investigate the associations between physical activity and hypertension across strata of BMI. Methods and Results We used data from the E3N (Etude Epidémiologique de femmes de la Mutuelle Générale de l´Education) cohort, a French prospective study of women aged 40 to 65 years. We included participants who completed a diet history questionnaire and who did not have prevalent hypertension at baseline, resulting in a total of 41 607 women. Questionnaires assessed time spent undertaking various types of physical activity. Hypertension cases were self-reported. Cox models were used to calculate hazard ratios (HRs) for physical activity. Associations were assessed over strata of BMI. Among the 41 607 included women, 10 182 cases of hypertension were identified in an average follow-up time of 14.5 years. Total physical activity was associated with a lower hypertension risk in women within the high-normal BMI range (BMI, 22.5-24.9) (HR , 0.89; 95% CI, 0.79-0.99). An inverse relationship was observed between sports (HR, 0.87; 95% CI, 0.83-0.93), walking (HR, 0.94; 95% CI, 0.90-1.00), and gardening (HR, 0.94; 95% CI, 0.89-0.99). Sports were associated with a reduced risk of hypertension in women with a healthy weight, but evidence was weaker in overweight/obese or underweight women. Conclusions Women with a healthy weight were those who could benefit most from practicing sports, and sports provided the largest risk reduction compared with other types of activity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1161/JAHA.119.015121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763781PMC
December 2020
-->