Publications by authors named "Pedro Marques-Vidal"

418 Publications

Do Weight trajectories influence diabetes control? A prospective study in Switzerland (CoLaus study).

Prev Med Rep 2021 Sep 27;23:101473. Epub 2021 Jun 27.

Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, 46 rue du Bugnon, 1011 Lausanne, Switzerland.

Objective: Identify anthropometric trajectories among subjects with type 2 diabetes mellitus (T2DM), and associate them with glycaemic control.

Methods: Prospective study including 268 community-dwelling participants with T2DM (34% women, mean age 68.7 ± 8.9 years) followed for 10.7 years (range: 8.8-13.6 years). T2DM control was considered for 1) fasting plasma glucose (FPG) < 7.0 mmol/L, or 2) HbAc < 7.0% (53 nmol/mol). Changes in weight or waist and weight variability were considered.

Results: One half (FPG) and one third (HbAc) of participants presented with uncontrolled T2DM. Half of the participants presented with obesity and 75% with abdominal obesity. During follow-up, half of the participants maintained their weight, 25% gained > 5 kg, and 25% lost < 5 kg; almost half increased their waist by > 5 cm. Using FPG as criterion, participants who lost > 5 cm waist were more likely to be controlled: multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI): 3.10 (1.23-7.78). Participants with controlled T2DM also presented with a higher weight variability: multivariable adjusted mean ± standard error 4.8 ± 0.3 vs. 3.9 ± 0.3 kg, p = 0.028. Using HbAc as criterion, participants who lost > 5 kg were less likely to be controlled: OR and (95% CI): 0.35 (0.18-0.66). Similar findings were obtained when restricting the analysis to participants who were diabetic throughout the whole study period.

Conclusion: In a Swiss community-based sample of participants with T2DM, T2DM control rates could be implemented. Neither weight nor waist variability was significantly and consistently associated with T2DM control.
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http://dx.doi.org/10.1016/j.pmedr.2021.101473DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259406PMC
September 2021

No changes in dietary intake after quitting smoking; a prospective study in Switzerland.

BMC Nutr 2021 Jul 14;7(1):34. Epub 2021 Jul 14.

Department of medicine, internal medicine, Lausanne university hospital (CHUV) and University of Lausanne, rue du Bugnon 46, 1011, Lausanne, Switzerland.

Background: After quitting smoking, quitters frequently increase their weight and change their dietary intake. Still, most studies on the topic are over 20 years old and focused on few dietary markers. We analysed the changes in weight and dietary intake after quitting smoking using a large panel of dietary markers.

Methods: Prospective study including 5064 participants, 169 of whom (3.3%) quitted during a median follow-up of 5 years. Dietary intake was assessed using a food frequency questionnaire. Participants were excluded if they lacked dietary data or reported extreme total energy intakes (TEI) < 850 or > 4000 kcal/day.

Results: Data from 128 participants (43.8% women, aged 56.0 ± 10.0 years) were used. After quitting smoking, mean weight increased 2.1 ± 0.7 kg; the majority (58%) of the participants gained over 1 kg, and only 7.1% were on a diet to reduce their weight. Total protein intake increased from (median [interquartile range]) 14.4 [12.9-16.4] to 15.1 [13.4-17.9] % of total energy intake (TEI), p = 0.008, while animal protein intake increased from 9.7 [8.0-12.1] to 10.8 [8.5-13.5] %TEI, p = 0.011. Fish intake increased from 27 [17-45] to 37 [19-55] g/day, p = 0.016 and dairy intake decreased from 177 [94-288] to 150 [77-243] g/day, p = 0.009. No other changes were found. Among the 68 (53%) participants who reported time since quitting, quitting for <=1 year led to a decreased consumption of fruits, while the opposite was found for participants who quit for longer than one year. No associations were found between weight or dietary changes and time since quitting.

Conclusions: People who quit smoking tend to gain weight, do not significantly change their dietary intake, and seem to make little effort to prevent weight gain. Systematic dietary support should be provided to all smokers wishing to quit.
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http://dx.doi.org/10.1186/s40795-021-00440-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278689PMC
July 2021

Spatial clusters of daily tobacco consumption before and after a smoke-free policy implementation.

Health Place 2021 Jul 3;70:102616. Epub 2021 Jul 3.

Unit of Population Epidemiology, Department of Primary Care, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Group of Geographic Information Research and Analysis in Population Health (GIRAPH), Geneva, Switzerland; Division of Primary Care, Department of Primary Care, Geneva University Hospitals, Geneva, Switzerland; Laboratory of Geographic Information Systems (LASIG), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland. Electronic address:

This study assessed the spatial dependence of daily tobacco consumption and how it is spatially impacted by individual and neighborhood socioeconomic determinants, and tobacco consumption facilities before and after a smoke-free implementation. Individual data was obtained from the Bus Santé, a cross-sectional survey in Geneva. Spatial clusters of high and low tobacco consumption were assessed using Getis-Ord Gi*. Daily tobacco consumption was not randomly clustered in Geneva and may be impacted by tobacco consumption facilities independently of socioeconomic factors and a smoking ban. Spatial analysis should be considered to highlight the impact of smoke-free policies and guide public health interventions.
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http://dx.doi.org/10.1016/j.healthplace.2021.102616DOI Listing
July 2021

Impact of smoking on sleep macro- and microstructure.

Sleep Med 2021 May 28;84:86-92. Epub 2021 May 28.

Department of Medicine, Service of Pulmonary Medicine, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland; Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland.

Objectives: Existing data suggest that smoking may be associated with sleep disturbances. This study aimed to determine the association between smoking and both subjective and objective sleep quality.

Methods: Cross-sectional analysis of sleep characteristics in 3233 participants from the population-based CoLaus-HypnoLaus cohort (52.2% women, mean age 56.6 ± 10.2 years) who completed questionnaires on sleep quality, of whom 1489 (46%) had a full polysomnography. Smoking data were self-reported; participants were classified by smoking status as current, former or never smokers. Primary outcomes were subjective sleep quality assessed by sleep questionnaires, and objective sleep quality based on polysomnography (sleep macrostructure), including power spectral analysis of the electroencephalogram on C4 electrode (sleep microstructure), quantifying the relative amount of delta power (1-4 Hz), a marker of sleep depth, and arousal-associated alpha power (8-12 Hz).

Results: Current smokers had a shift toward faster sleep electroencephalogram activity with lower delta power in non-REM sleep compared with former and never smokers (-2.8 ± 0.4% and -2.4 ± 0.4%, respectively; both p < 0.001) and higher alpha power (+0.8 ± 0.2%; p < 0.001) compared with never smokers. There was a dose-dependent negative association between electroencephalogram delta power and smoking intensity (r = -1.2 [-1.9, -0.5]; p = 0.001). Additionally, mean nocturnal oxygen saturation was lower in current smokers.

Conclusions: Current smokers had decreased objective sleep quality, with a dose-dependent association between smoking intensity and decrease in electroencephalogram delta power during non-REM sleep, in addition to an increase in alpha power. Considering the importance of sleep quality for wellbeing and health, these results provide further data to support smoking cessation.
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http://dx.doi.org/10.1016/j.sleep.2021.05.024DOI Listing
May 2021

Geospatial Analysis of Sodium and Potassium Intake: A Swiss Population-Based Study.

Nutrients 2021 May 25;13(6). Epub 2021 May 25.

Laboratory of Geographic Information Systems (LASIG), School of Architecture, Civil and Environmental Engineering (ENAC), École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.

Inadequate sodium and potassium dietary intakes are associated with major, yet preventable, health consequences. Local public health interventions can be facilitated and informed by fine-scale geospatial analyses. In this study, we assess the existence of spatial clustering (i.e., an unusual concentration of individuals with a specific outcome in space) of estimated sodium (Na), potassium (K) intakes, and Na:K ratio in the Bus Santé 1992-2018 annual population-based surveys, including 22,495 participants aged 20-74 years, residing in the canton of Geneva, using the local Moran's spatial statistics. We also investigate whether socio-demographic and food environment characteristics are associated with identified spatial clustering, using both global ordinary least squares (OLS) and local geographically weighted regression (GWR) modeling. We identified clear spatial clustering of Na:K ratio, Na, and K intakes. The GWR outperformed the OLS models and revealed spatial variations in the associations between explanatory and outcome variables. Older age, being a woman, higher education, and having a lower access to supermarkets were associated with higher Na:K ratio, while the opposite was seen for having the Swiss nationality. Socio-demographic characteristics explained a major part of the identified clusters. Socio-demographic and food environment characteristics significantly differed between individuals in spatial clusters of high and low Na:K ratio, Na, and K intakes. These findings could guide prioritized place-based interventions tailored to the characteristics of the identified populations.
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http://dx.doi.org/10.3390/nu13061798DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8229307PMC
May 2021

Diurnal Salivary Cortisol in Sarcopenic Postmenopausal Women: The OsteoLaus Cohort.

Calcif Tissue Int 2021 May 18. Epub 2021 May 18.

Interdisciplinary Center for Bone Diseases, Service of Rhumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Sarcopenia, similar to hypercortisolism, is characterized by loss of muscle mass and strength. Cortisol circadian rhythm changes with aging (blunted late-day nadir values) were suggested to contribute to this decline. We aimed to explore the relationship between diurnal salivary cortisol values and sarcopenia diagnosis and its components in postmenopausal women. This is a cross-sectional study within the OsteoLaus population-based cohort in Lausanne (Switzerland). Participants had a body composition assessment by dual X-ray absorptiometry (DXA), a grip strength (GS) measure, and salivary cortisol measures (at awakening, 30 min thereafter, 11 AM (sc-11AM) and 8 PM (sc-8PM)). Associations between salivary cortisol and sarcopenia diagnosed by six different criteria (based on appendicular lean mass (ALM) assessed by DXA, and muscle strength by GS), and its components, were analyzed. 471 women aged > 50 years (63.0 ± 7.5) were included. Various definitions identified different participants as sarcopenic, who consistently presented higher salivary cortisol at 11 AM and/or 8 PM. There were no associations between salivary cortisol levels and ALM measures, either absolute or after correction to height squared (ALM index) or body mass index. GS was inversely correlated to sc-11AM (r = - 0.153, p < 0.001) and sc-8PM (r = - 0.118, p = 0.002). Each 10 nmol/l increase of sc-11AM, respectively sc-8PM, was associated with a GS decrease of 1.758 (SE 0.472) kg, respectively 2.929 (SE 1.115) kg. In postmenopausal women, sarcopenia is associated with higher salivary cortisol levels at 11 AM and 8 PM. An increase of daily free cortisol levels in the physiological range could participate to sarcopenia development by decreasing muscle function in postmenopausal women.
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http://dx.doi.org/10.1007/s00223-021-00863-yDOI Listing
May 2021

Primary prevention efforts are poorly developed in people at high cardiovascular risk: A report from the European Society of Cardiology EURObservational Research Programme EUROASPIRE V survey in 16 European countries.

Eur J Prev Cardiol 2021 May;28(4):370-379

National Institute for Prevention and Cardiovascular Health, National University of Ireland-Galway, Republic of Ireland.

Background: European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V in primary care was carried out by the European Society of Cardiology EURObservational Research Programme in 2016-2018. The main objective was to determine whether the 2016 Joint European Societies' guidelines on cardiovascular disease prevention in people at high cardiovascular risk have been implemented in clinical practice.

Methods: The method used was a cross-stional survey in 78 centres from 16 European countries. Patients without a history of atherosclerotic cardiovascular disease either started on blood pressure and/or lipid and/or glucose lowering treatments were identified and interviewed ≥ 6 months after the start of medication.

Results: A total of 3562 medical records were reviewed and 2759 patients (57.6% women; mean age 59.0 ± 11.6 years) interviewed (interview rate 70.0%). The risk factor control was poor with 18.1% of patients being smokers, 43.5% obese (body mass index ≥30 kg/m2) and 63.8% centrally obese (waist circumference ≥88 cm for women, ≥102 cm for men). Of patients on blood pressure lowering medication 47.0% reached the target of <140/90 mm Hg (<140/85 mm Hg in people with diabetes). Among treated dyslipidaemic patients only 46.9% attained low density lipoprotein-cholesterol target of <2.6 mmol/l. Among people treated for type 2 diabetes mellitus, 65.2% achieved the HbA1c target of <7.0%.

Conclusion: The primary care arm of the EUROASPIRE V survey revealed that large proportions of people at high cardiovascular disease risk have unhealthy lifestyles and inadequate control of blood pressure, lipids and diabetes. Thus, the potential to reduce the risk of future cardiovascular disease throughout Europe by improved preventive cardiology programmes is substantial.
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http://dx.doi.org/10.1177/2047487320908698DOI Listing
May 2021

Comparison of Swiss and European risk algorithms for cardiovascular prevention in Switzerland.

Eur J Prev Cardiol 2021 04 23;28(2):204–210. Epub 2020 Feb 23.

Service of Internal Medicine, Lausanne University Hospital, Switzerland.

Background: In Switzerland, two distinct algorithms are recommended for cardiovascular prevention: (a) Arbeitsgruppe Lipide und Atherosklerose (AGLA); and (b) European Society of Cardiology (ESC). We validated and determined which algorithm better predicts incident atherosclerotic cardiovascular disease and assessed statin eligibility in Switzerland.

Design: A prospective population-based cohort.

Methods: We employed longitudinal data of the CoLaus study involving 6733 individuals, aged 35-75 years, with a 10-year follow-up. Using discrimination and calibration, we evaluated the predictive performance of the AGLA and ESC algorithms for the prediction of atherosclerotic cardiovascular disease.

Results: From the 6733 initial participants, 5529 were analysed with complete baseline and follow-up data. Mean age (SD) was 52.4 (10.6) years and 54% were women. During an average follow-up (SD) of 10.2 years (1.7), 370 (6.7%) participants developed an incident atherosclerotic cardiovascular disease. The sensitivity of AGLA and ESC algorithms to predict atherosclerotic cardiovascular disease was 51.6% (95% confidence interval (CI) 46.4-56.8) and 58.6% (53.4-63.7), respectively. Discrimination and calibration were similar between the AGLA and ESC algorithms, with area under the receiver operating characteristic curve values of 0.78 (95% CI 0.76-0.80) and 0.79 (0.76-0.81), and Brier scores of 0.059 and 0.041, respectively. Among 370 individuals developing incident atherosclerotic cardiovascular disease, only 278 (75%) were eligible for statin therapy at baseline, including 210 (57%) according to both algorithms, 4 (1%) to AGLA only and 64 (17%) to ESC only.

Conclusion: AGLA and ESC algorithms presented similar accuracy to predict atherosclerotic cardiovascular disease in Switzerland. A quarter of adults developing atherosclerotic cardiovascular disease were not identified by preventive algorithms to be eligible for statin therapy.
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http://dx.doi.org/10.1177/2047487320906305DOI Listing
April 2021

Impact of dietary and obesity genetic risk scores on weight gain.

Am J Clin Nutr 2021 Apr 8. Epub 2021 Apr 8.

Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Background: Whether genetic background and/or dietary behaviors influence weight gain in middle-aged subjects is debated.

Objective: To assess whether genetic background and/or dietary behaviors are associated with changes in obesity markers (BMI, weight, and waist and hip circumferences) in a Swiss population-based cohort.

Methods: Cross-sectional and prospective (follow-up of 5.3 y) study. Two obesity genetic risk scores (GRS) based on 31 or 68 single nucleotide polymorphisms were used. Dietary intake was assessed using a semiquantitative FFQ. Three dietary patterns "Meat & fries" (unhealthy), "Fruits & vegetables" (healthy), and "Fatty & sugary" (unhealthy), and 3 dietary scores (2 Mediterranean and the Alternative Healthy Eating Index [AHEI]) were computed.

Results: On cross-sectional analysis (N = 3033, 53.2% females, 58.4 ± 10.6 y), obesity markers were positively associated with unhealthy dietary patterns and GRS, and negatively associated with healthy dietary scores and patterns. On prospective analysis (N = 2542, 54.7% females, age at baseline 58.0 ± 10.4 y), the AHEI and the "Fruits & vegetables" pattern were negatively associated with waist circumference gain: multivariate-adjusted average ± SE 0.96 ± 0.25 compared with 0.11 ± 0.26 cm (P for trend 0.044), and 1.14 ± 0.26 compared with -0.05 ± 0.26 cm (P for trend 0.042) for the first and fourth quartiles of the AHEI and the "Fruits & vegetables" pattern, respectively. Similar inverse associations were obtained for changes in waist >5 cm: multivariate-adjusted OR (95% CI): 0.65 (0.50, 0.85) and 0.67 (0.51, 0.89) for the fourth versus the first quartile of the AHEI and the "Fruits & vegetables" dietary pattern, respectively. No associations were found between GRS and changes in obesity markers, and no significant gene-diet interactions were found.

Conclusion: Dietary intake, not GRS, are associated with waist circumference in middle-aged subjects living in Lausanne, Switzerland.
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http://dx.doi.org/10.1093/ajcn/nqab069DOI Listing
April 2021

EAPC Core Curriculum for Preventive Cardiology.

Eur J Prev Cardiol 2021 04 1. Epub 2021 Apr 1.

Department of Prevention and Sports Medicine, University Hospital rechts der Isar, Technical University Munich, German Centre for Cardiovascular Research, Georg-Brauchle-Ring 56, 80992 Munich, Germany.

Preventive cardiology encompasses the whole spectrum of cardiovascular disease (CVD) prevention, at individual and population level, through all stages of life. This includes promotion of cardiovascular (CV) health, management of individuals at risk of developing CVD, and management of patients with established CVD, through interdisciplinary care in different settings. Preventive cardiology addresses all aspects of CV health in the context of the social determinants of health, including physical activity, exercise, sports, nutrition, weight management, smoking cessation, psychosocial factors and behavioural change, environmental, genetic and biological risk factors, and CV protective medications. This is the first European Core Curriculum for Preventive Cardiology, which will help to standardize, structure, deliver, and evaluate training in preventive cardiology across Europe. It will be the basis for dedicated fellowship programmes and a European Society of Preventive Cardiology (EAPC) subspecialty certification for cardiologists, with the intention to improve quality and outcome in CVD prevention.
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http://dx.doi.org/10.1093/eurjpc/zwab017DOI Listing
April 2021

Polypill eligibility and equivalent intake in a Swiss population-based study.

Sci Rep 2021 Mar 25;11(1):6880. Epub 2021 Mar 25.

Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

The polypill has been advocated for cardiovascular disease (CVD) management. The fraction of the population who could benefit from the polypill in Switzerland is unknown. Assess (1) the prevalence of subjects (a) eligible for the polypill and (b) already taking a polypill equivalent; and (2) the determinants of polypill intake in the first (2009-2012) and second follow-ups (2014-2017) of a population-based prospective study conducted in Lausanne, Switzerland. The first and the second follow-ups included 5038 and 4596 participants aged 40-80 years, respectively. Polypill eligibility was defined as having a high CVD risk as assessed by an absolute CVD risk ≥ 5% with the SCORE equation for Switzerland and/or presenting with CVD. Four polypill equivalents were defined: statin + any antihypertensive with (A) or without (B) aspirin; statin + calcium channel blocker (CCB) (C); and statin + CCB + angiotensin-converting enzyme inhibitor (D). The prevalence of polypill eligibility was 20.6% (95% CI 19.5-21.8) and 27.7% (26.5-29.1) in the first and second follow-up, respectively. However, only around one-third of the eligible 29.5% (95% CI 26.7-32.3) and 30.4% (27.9-33.0) respectively, already took the polypill equivalents. All polypill equivalents were more prevalent among men, elderly and in presence of CVD. After multivariable adjustment, in both periods, male gender was associated with taking polypill equivalent A (OR: 1.93; 95% CI 1.45-2.55 and OR: 1.67; 95% CI 1.27-2.19, respectively) and polypill equivalent B (OR: 1.52; 95% CI 1.17-1.96 and OR: 1.41; 95% CI 1.07-1.85, respectively). Similarly, in both periods, age over 70 years, compared to middle-age, was associated with taking polypill equivalent A (OR: 11.71; CI 6.74-20.33 and OR: 9.56; CI 4.13-22.13, respectively) and equivalent B (OR: 13.22; CI 7.27-24.07 and OR: 20.63; CI 6.51-56.36, respectively). Former or current smoking was also associated with a higher likelihood of taking polypill equivalent A in both periods. A large fraction of the population is eligible for the polypill, but only one-third of them actually benefits from an equivalent, and this proportion did not change over time.
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http://dx.doi.org/10.1038/s41598-021-84455-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7994372PMC
March 2021

Brain tissue properties link cardio-vascular risk factors, mood and cognitive performance in the CoLaus|PsyCoLaus epidemiological cohort.

Neurobiol Aging 2021 Jun 16;102:50-63. Epub 2021 Feb 16.

Department of Clinical Neurosciences, Laboratory for Research in Neuroimaging LREN, Centre for Research in Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Neurology Department, Max-Planck-Institute for Human Cognitive and Brain Sciences, Leipzig, Germany. Electronic address:

Given the controversy about the impact of modifiable risk factors on mood and cognition in ageing, we sought to investigate the associations between cardio-vascular risk, mental health, cognitive performance and brain anatomy in mid- to old age. We analyzed a set of risk factors together with multi-parameter magnetic resonance imaging (MRI) in the CoLaus|PsyCoLaus cohort (n > 1200). Cardio-vascular risk was associated with differences in brain tissue properties - myelin, free tissue water, iron content - and regional brain volumes that we interpret in the context of micro-vascular hypoxic lesions and neurodegeneration. The interaction between clinical subtypes of major depressive disorder and cardio-vascular risk factors showed differential associations with brain structure depending on individuals' lifetime trajectory. There was a negative correlation between melancholic depression, anxiety and MRI markers of myelin and iron content in the hippocampus and anterior cingulate. Verbal memory and verbal fluency performance were positively correlated with left amygdala volumes. The concomitant analysis of brain morphometry and tissue properties allowed for a neuro-biological interpretation of the link between modifiable risk factors and brain health.
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http://dx.doi.org/10.1016/j.neurobiolaging.2021.02.002DOI Listing
June 2021

Triangulating evidence from longitudinal and Mendelian randomization studies of metabolomic biomarkers for type 2 diabetes.

Sci Rep 2021 Mar 18;11(1):6197. Epub 2021 Mar 18.

Swiss Institute of Bioinformatics, Lausanne, Switzerland.

The number of people affected by Type 2 diabetes mellitus (T2DM) is close to half a billion and is on a sharp rise, representing a major and growing public health burden. Given its mild initial symptoms, T2DM is often diagnosed several years after its onset, leaving half of diabetic individuals undiagnosed. While several classical clinical and genetic biomarkers have been identified, improving early diagnosis by exploring other kinds of omics data remains crucial. In this study, we have combined longitudinal data from two population-based cohorts CoLaus and DESIR (comprising in total 493 incident cases vs. 1360 controls) to identify new or confirm previously implicated metabolomic biomarkers predicting T2DM incidence more than 5 years ahead of clinical diagnosis. Our longitudinal data have shown robust evidence for valine, leucine, carnitine and glutamic acid being predictive of future conversion to T2DM. We confirmed the causality of such association for leucine by 2-sample Mendelian randomisation (MR) based on independent data. Our MR approach further identified new metabolites potentially playing a causal role on T2D, including betaine, lysine and mannose. Interestingly, for valine and leucine a strong reverse causal effect was detected, indicating that the genetic predisposition to T2DM may trigger early changes of these metabolites, which appear well-before any clinical symptoms. In addition, our study revealed a reverse causal effect of metabolites such as glutamic acid and alanine. Collectively, these findings indicate that molecular traits linked to the genetic basis of T2DM may be particularly promising early biomarkers.
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http://dx.doi.org/10.1038/s41598-021-85684-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7973501PMC
March 2021

Associations of Total Legume, Pulse, and Soy Consumption with Incident Type 2 Diabetes: Federated Meta-Analysis of 27 Studies from Diverse World Regions.

J Nutr 2021 May;151(5):1231-1240

School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland.

Background: The consumption of legumes is promoted as part of a healthy diet in many countries but associations of total and types of legume consumption with type 2 diabetes (T2D) are not well established. Analyses across diverse populations are lacking despite the availability of unpublished legume consumption data in prospective cohort studies.

Objective: To examine the prospective associations of total and types of legume intake with the risk of incident T2D.

Methods: Meta-analyses of associations between total legume, pulse, and soy consumption and T2D were conducted using a federated approach without physical data-pooling. Prospective cohorts were included if legume exposure and T2D outcome data were available and the cohort investigators agreed to participate. We estimated incidence rate ratios (IRRs) and CIs of associations using individual participant data including ≤42,473 incident cases among 807,785 adults without diabetes in 27 cohorts across the Americas, Eastern Mediterranean, Europe, and Western Pacific. Random-effects meta-analysis was used to combine effect estimates and estimate heterogeneity.

Results: Median total legume intake ranged from 0-140 g/d across cohorts. We observed a weak positive association between total legume consumption and T2D (IRR = 1.02, 95% CI: 1.01 to 1.04) per 20 g/d higher intake, with moderately high heterogeneity (I2 = 74%). Analysis by region showed no evidence of associations in the Americas, Eastern Mediterranean, and Western Pacific. The positive association in Europe (IRR = 1.05, 95% CI: 1.01 to 1.10, I2 = 82%) was mainly driven by studies from Germany, UK, and Sweden. No evidence of associations was observed for the consumption of pulses or soy.

Conclusions: These findings suggest no evidence of an association of legume intakes with T2D in several world regions. The positive association observed in some European studies warrants further investigation relating to overall dietary contexts in which legumes are consumed, including accompanying foods which may be positively associated with T2D.
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http://dx.doi.org/10.1093/jn/nxaa447DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8112771PMC
May 2021

Menopausal Transition Is Not Associated with Dietary Change in Swiss Women.

J Nutr 2021 May;151(5):1269-1276

Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.

Background: Adherence to a healthy diet could contribute to maintaining adequate health throughout the menopausal transition, but data are scarce.

Objective: We evaluated the association between menopausal status and changes in dietary intake in Swiss adult women.

Methods: Cross-sectional (n = 2439) and prospective analyses (n = 1656) were conducted between 2009 and 2012 (first follow-up) among women (mean age ± SD, 58.2 ± 10.5 y) living in Lausanne, Switzerland. In both visits, dietary intake was assessed using a validated FFQ, and menopausal status was classified based on the presence or absence of menstruations. Multivariable linear and logistic regression models were used to investigate the cross-sectional association of menopausal status (postmenopausal compared with premenopausal) at the first follow-up with food intake and dietary recommendations. To examine whether menopausal status (premenopausal as reference group, menopausal transition, and postmenopausal) during 5 y of follow-up was associated with longitudinal changes in diet, including adherence to dietary Swiss recommendations, we applied multivariable linear and logistic mixed models adjusted for several covariates.

Results: At the first follow-up, postmenopausal women consumed less (P < 0.002) meat [median (IQR) 57.2 (35-86.2) compared with 62.5 (41.2-95.2) g/d], pasta [61.8 (37.5-89.2) compared with 85 (57.8-128) g/d], and added sugar [0.1 (0-4) compared with 0.7 (0-8) g/d] and more dairy products [126 (65.4-214) compared with 109 (64.5-182) g/d] and fruit [217 (115-390) compared with 174 (83.2-319) g/d] than premenopausal women. However, linear regression analysis adjusted for potential confounding factors showed no independent (cross-sectional) associations of menopausal status with total energy intake (TEI) and individual macro- or micronutrient intakes. In the prospective analysis, compared with women who remained premenopausal during follow-up (n = 244), no differences were found in changes in TEI, dietary intakes, or adherence to the Swiss dietary recommendations in women transitioning from premenopausal to postmenopausal (n = 229) and who remained postmenopausal (n = 1168).

Conclusion: The menopausal transition is not associated with changes in dietary habits among Swiss women.
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http://dx.doi.org/10.1093/jn/nxab003DOI Listing
May 2021

I can't see your heart from here.

Eur J Prev Cardiol 2021 Mar 8. Epub 2021 Mar 8.

Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), University of Lausanne, Rue du Bugnon 46, CH-1011 Lausanne, Switzerland.

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http://dx.doi.org/10.1093/eurjpc/zwab039DOI Listing
March 2021

Assessing Overall Diet Quality: Development and Evaluation of the Performance of a Short Self-Administrated Questionnaire SCASA.

Nutrients 2021 Feb 20;13(2). Epub 2021 Feb 20.

Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland.

Several tools assessing diet quality have been developed over the last decades, but their use in public health and clinical practice is limited because they necessitate detailed quantitative assessment of food intake. Our goal was to develop and validate a score (Score d'Alimentation Saine, SCASA) based on a short self-administrated online questionnaire to assess overall diet quality. SCASA targets the adult population in French-speaking Switzerland, but it was designed in a way enabling its adaptation for other regions. The choice of the items involved experts and lay volunteers. Construct validation and inter-method reliability were assessed by screening meal plans and by comparing the self-rated scores with food-record derived scores (kappa and Bland-Altman). SCASA (17 components) discriminated adequately balanced from imbalanced meal plans (93-95% and 44-46% of maximal score). Agreement between self-assessed and food record-based scores ranged between >90% (3 items), 80-89% (3 items), 70-79% (4 items), and <70% (5 items). The Bland-Altman plot showed a mean difference of -1.60 (95% CI -2.36 to -0.84), indicating a slight overestimation of the self-assessed diet quality compared to the food record. SCASA offers a reliable way to assess overall diet quality without requiring burdensome data collection or nutrient calculations.
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http://dx.doi.org/10.3390/nu13020677DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924174PMC
February 2021

Dietary Patterns are Differentially Associated with Atypical and Melancholic Subtypes of Depression.

Nutrients 2021 Feb 26;13(3). Epub 2021 Feb 26.

Department of Psychiatry, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.

Diet has been associated with the risk of depression, whereas different subtypes of depression have been linked with different cardiovascular risk factors (CVRFs). In this study, our aims were to 1) identify dietary patterns with exploratory factor analysis, 2) assess cross-sectional associations between dietary patterns and depression subtypes, and 3) examine the potentially mediating effect of dietary patterns in the associations between CVRFs and depression subtypes. In the first follow-up of the population-based CoLaus|PsyCoLaus study (2009-2013, 3554 participants, 45.6% men, mean age 57.5 years), a food frequency questionnaire assessed dietary intake and a semi-structured interview allowed to characterize major depressive disorder into current or remitted atypical, melancholic, and unspecified subtypes. Three dietary patterns were identified: Western, Mediterranean, and Sweet-Dairy. Western diet was positively associated with current atypical depression, but negatively associated with current and remitted melancholic depression. Sweet-Dairy was positively associated with current melancholic depression. However, these dietary patterns did not mediate the associations between CVRFs and depression subtypes. Hence, although we could show that people with different subtypes of depression make different choices regarding their diet, it is unlikely that these differential dietary choices account for the well-established associations between depression subtypes and CVRFs.
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http://dx.doi.org/10.3390/nu13030768DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996872PMC
February 2021

Does Cognitive Functioning Predict Chronic Pain in Older Adult? Results From the CoLaus|PsyCoLaus Longitudinal Study.

J Pain 2021 Feb 25. Epub 2021 Feb 25.

Department of Psychiatry, Service of Old Age Psychiatry (SUPAA), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Chronic pain (CP) and cognitive impairment are common in older adults. CP was found to be associated with cognitive impairment in many cross-sectional studies. However, their cross-sectional design precluded inference on temporality. Accordingly, we aimed to prospectively assess the association between cognitive functioning and the occurrence of CP in older community dwellers. Analyses were based on data of the first (FU1) and the second follow-up (FU2) of CoLaus|PsyCoLaus, a prospective cohort study conducted in the general population of Lausanne (Switzerland) including the participants aged 65 and over. Neuropsychological functioning including memory, language, attention and executive function was measured at FU1. CP was assessed at FU1 and FU2 by self-rating questionnaire. The association between cognitive scores and subsequent CP was determined using multiple logistic regressions. Among the 337 participants without CP at FU1, 107 (31.8%) developed CP at FU2. A significant association was observed between higher Stroop color-time and interference index at FU1 and a higher risk of CP at FU2 (OR = 1.02; P = .03 and OR = 1.49; P = .03, respectively). Our results suggest that patients with inhibitory deficit may be at higher risk of developing CP in the presence of painful events. A cognitive assessment could be recommended to identify frail patients in these situations. Perspective: This study suggests that presence of inhibitory deficits is associated with a higher risk of developing subsequent CP in older adults. In the presence of painful events, a cognitive assessment should be recommended to identify frail patients and to manage them carefully.
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http://dx.doi.org/10.1016/j.jpain.2021.01.007DOI Listing
February 2021

Electronic cigarettes and health with special focus on cardiovascular effects: position paper of the European Association of Preventive Cardiology (EAPC).

Eur J Prev Cardiol 2020 Jul 17. Epub 2020 Jul 17.

Department of Community Medicine, The Arctic University of Norway, Norway.

Background: Tobacco use is the single largest preventable risk factor for premature death of non-communicable diseases and the second leading cause of cardiovascular disease. In response to the harmful effects of tobacco smoking, the use of electronic cigarettes (e-cigarettes) has emerged and gained significant popularity over the past 15 years. E-cigarettes are promoted as safe alternatives for traditional tobacco smoking and are often suggested as a way to reduce or quit smoking. However, evidence suggests they are not harmless.

Discussion: The rapid evolution of the e-cigarette market has outpaced the legislator's regulatory capacity, leading to mixed regulations. The increasing use of e-cigarettes in adolescents and young individuals is of concern. While the long-term direct cardiovascular effects of e-cigarettes remain largely unknown, the existing evidence suggests that the e-cigarette should not be regarded as a cardiovascular safe product. The contribution of e-cigarette use to reducing conventional cigarette use and smoking cessation is complex, and the impact of e-cigarette use on long-term cessation lacks sufficient evidence.

Conclusion: This position paper describes the evidence regarding the prevalence of e-cigarette smoking, uptake of e-cigarettes in the young, related legislations, cardiovascular effects of e-cigarettes and the impact of e-cigarettes on smoking cessation. Knowledge gaps in the field are also highlighted. The recommendations from the population science and public health section of the European Association of Preventive Cardiology are presented.
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http://dx.doi.org/10.1177/2047487320941993DOI Listing
July 2020

Cardiovascular disease in Italy: good news, bad news and interesting news.

Eur J Prev Cardiol 2020 Jul 29. Epub 2020 Jul 29.

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http://dx.doi.org/10.1177/2047487320940474DOI Listing
July 2020

Association of fatal myocardial infarction with past level of physical activity: a pooled analysis of cohort studies.

Eur J Prev Cardiol 2021 Feb 10. Epub 2021 Feb 10.

Department of Cardiology, Bispebjerg Frederiksberg University Hospital, Bispebjerg Bakke 23, Building 67, 1st floor, DK-2400 Copenhagen, Denmark.

Aims: To assess the association between past level of physical activity (PA) and risk for death during the acute phase of myocardial infarction (MI) in a pooled analysis of cohort studies.

Methods And Results: European cohorts including participants with a baseline assessment of PA, conventional cardiovascular (CV) risk factors, and available follow-up on MI and death were eligible. Patients with an incident MI were included. Leisure-time PA was grouped as sedentary (<7 MET-hours), low (7-16 MET-hours), moderate (16.1-32 MET-hours), or high (>32 MET-hours) based on calculated net weekly energy expenditure. The main outcome measures were instant and 28-day case fatality of MI. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using multivariate random-effects models. Adjustments for age, sex, CV risk factors, alcohol consumption, and socioeconomic status were made. From 10 cohorts including a total of 1 495 254 participants, 28 140 patients with an incident MI comprised the study population. A total of 4976 (17.7%) died within 28 days-of these 3101 (62.3%) were classified as instant fatal MI. Compared with sedentary individuals, those with a higher level of PA had lower adjusted odds of instant fatal MI: low PA [OR, 0.79 (95% CI, 0.60-1.04)], moderate PA [0.67 (0.51-0.89)], and high PA [0.55 (0.40-0.76)]. Similar results were found for 28-day fatal MI: low PA [0.85 (0.71-1.03)], moderate PA [0.64 (0.51-0.80)], and high PA [0.72 (0.51-1.00)]. A low-to-moderate degree of heterogeneity was detected in the analysis of instant fatal MI (I2 = 47.3%), but not in that of 28-day fatal MI (I2 = 0.0%).

Conclusion: A moderate-to-high level of PA was associated with a lower risk of instant and 28-day death in relation to a MI.
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http://dx.doi.org/10.1093/eurjpc/zwaa146DOI Listing
February 2021

Obesity and atypical depression symptoms: findings from Mendelian randomization in two European cohorts.

Transl Psychiatry 2021 02 4;11(1):96. Epub 2021 Feb 4.

Institute of Primary Care and Public Health (Unisante), University of Lausanne, Lausanne, Switzerland.

Studies considering the causal role of body mass index (BMI) for the predisposition of major depressive disorder (MDD) based on a Mendelian Randomization (MR) approach have shown contradictory results. These inconsistent findings may be attributable to the heterogeneity of MDD; in fact, several studies have documented associations between BMI and mainly the atypical subtype of MDD. Using a MR approach, we investigated the potential causal role of obesity in both the atypical subtype and its five specific symptoms assessed according to the Statistical Manual of Mental Disorders (DSM), in two large European cohorts, CoLaus|PsyCoLaus (n = 3350, 1461 cases and 1889 controls) and NESDA|NTR (n = 4139, 1182 cases and 2957 controls). We first tested general obesity measured by BMI and then the body fat distribution measured by waist-to-hip ratio (WHR). Results suggested that BMI is potentially causally related to the symptom increase in appetite, for which inverse variance weighted, simple median and weighted median MR regression estimated slopes were 0.68 (SE = 0.23, p = 0.004), 0.77 (SE = 0.37, p = 0.036), and 1.11 (SE = 0.39, p = 0.004). No causal effect of BMI or WHR was found on the risk of the atypical subtype or for any of the other atypical symptoms. Our findings show that higher obesity is likely causal for the specific symptom of increase in appetite in depressed participants and reiterate the need to study depression at the granular level of its symptoms to further elucidate potential causal relationships and gain additional insight into its biological underpinnings.
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http://dx.doi.org/10.1038/s41398-021-01236-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862438PMC
February 2021

Genome-wide association study of circulating interleukin 6 levels identifies novel loci.

Hum Mol Genet 2021 Apr;30(5):393-409

Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK.

Interleukin 6 (IL-6) is a multifunctional cytokine with both pro- and anti-inflammatory properties with a heritability estimate of up to 61%. The circulating levels of IL-6 in blood have been associated with an increased risk of complex disease pathogenesis. We conducted a two-staged, discovery and replication meta genome-wide association study (GWAS) of circulating serum IL-6 levels comprising up to 67 428 (ndiscovery = 52 654 and nreplication = 14 774) individuals of European ancestry. The inverse variance fixed effects based discovery meta-analysis, followed by replication led to the identification of two independent loci, IL1F10/IL1RN rs6734238 on chromosome (Chr) 2q14, (Pcombined = 1.8 × 10-11), HLA-DRB1/DRB5 rs660895 on Chr6p21 (Pcombined = 1.5 × 10-10) in the combined meta-analyses of all samples. We also replicated the IL6R rs4537545 locus on Chr1q21 (Pcombined = 1.2 × 10-122). Our study identifies novel loci for circulating IL-6 levels uncovering new immunological and inflammatory pathways that may influence IL-6 pathobiology.
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http://dx.doi.org/10.1093/hmg/ddab023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8098112PMC
April 2021

Trends in prevalence and outcomes of frailty in a Swiss university hospital: a retrospective observational study.

Age Ageing 2021 Jun;50(4):1306-1313

Department of Medicine and Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.

Background: Frailty complicates management and worsens outcomes. We assessed the prevalence, determinants and consequences of frailty among elderly patients in a hospital setting.

Design: Retrospective observational study in a Swiss university hospital.

Methods: 22,323 patients aged ≥65 years hospitalized between January 2009 and December 2017 at the internal medicine ward were included. Frailty was defined by the Hospital Frailty Risk Score (HFRS) and patients were categorized as low (HFRS<5), intermediate (HFRS 5-15) and high (HFRS>15) risk.

Results: Overall prevalence of intermediate and high risk of frailty was 43% and 20%, respectively; prevalence was higher in women and increased with age. Prevalence of high risk of frailty increased from 11.4% in 2009 to 31% in 2012, and decreased to 19.2% in 2017. After multivariable adjustment, frailty was associated with increased length of stay: average and (95% confidence interval) 11.9 (11.7-12.1), 15.6 (15.4-15.8) and 19.7 (19.3-20.1) days for low, intermediate and high risk, respectively, and increased likelihood of ICU stay: odds ratio (OR) and (95% CI) 1.57 (1.41-1.75) and 2.10 (1.82-2.42) for intermediate and high risk, respectively, p for trend <0.001. Frailty was associated with increased likelihood of hospital costs >70,000 CHF: OR and (95% CI) 3.46 (2.79-4.29) and 10.7 (8.47-13.6) for intermediate and high risk, respectively, p for trend <0.001, and with a lower likelihood of complete cost coverage: OR and (95% CI) 0.70 (0.65-0.76) and 0.52 (0.47-0.58) for intermediate and high risk, respectively, p for trend<0.001.

Conclusions: Frailty is a frequent condition among hospitalized patients and is associated with higher costs.
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http://dx.doi.org/10.1093/ageing/afaa278DOI Listing
June 2021

Clinical and biological determinants of P-wave duration: cross-sectional data from the population-based CoLaus|PsyCoLaus study.

BMJ Open 2020 11 19;10(11):e038828. Epub 2020 Nov 19.

Internal Medicine, CHUV, Lausanne, Switzerland.

Objectives: P-wave duration (PWD) is associated with the development of atrial arrhythmias, cardiovascular and all-cause mortality. With this study, we aimed to assess the distribution and determinants of PWD in the general population.

Design: Cross-sectional study using data collected between 2014 and 2016.

Setting: In the population-based cohort CoLaus|PsyCoLaus, Lausanne, Switzerland, we used 12-lead ECGs to measure PWD. Potential demographic, clinical and biological determinants of PWD were collected by questionnaire, anthropometry, blood pressure measurement and biological assays.

Participants: Data from 3459 participants (55% women, 62±10 years, 93% Caucasian) were included. Participants were excluded if they presented with (1) no sinus rhythm or paced rhythm on the study ECG or Wolff-Parkinson-White ECG pattern; (2) missing or non-interpretable ECG; and (3) missing phenotypic data.

Primary Outcome Measure: Determine (1) the PWD distribution and (2) the demographic, clinical and biological determinants of PWD in a large population-based cohort.

Results: Median and IQR of PWD was 112 (102-120) ms . In the multivariable analyses, PWD was significantly associated with age (p<0.001) and height (p<0.001), with an adjusted regression coefficient (95% CI) of 0.29 ms/years (0.23 to 0.36) and 0.32 ms/cm (0.28 to 0.37), respectively. PWD, given thereafter in ms with adjusted mean±SE, was significantly (p<0.05) associated with (a) gender (woman 110.0±0.4; man 112.1±0.4), (b) body mass index (normal 110.1±0.4; overweight 110.9±0.4; obese 113.0±0.5), (c) abdominal obesity (no 110.5±0.3; yes 111.7±0.4) and (d) hypertension (no 110.4±0.3; yes 111.7±0.4).

Conclusion: PWD is positively associated with age, height, male gender, obesity markers and hypertension. Clinical interpretation of PWD should take these factors into consideration.
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http://dx.doi.org/10.1136/bmjopen-2020-038828DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678386PMC
November 2020

School-based interventions modestly increase physical activity and cardiorespiratory fitness but are least effective for youth who need them most: an individual participant pooled analysis of 20 controlled trials.

Br J Sports Med 2021 Jan 13. Epub 2021 Jan 13.

Department of Sport Science, Nottingham Trent University, Nottingham, Nottinghamshire, UK.

Objectives: To determine if subpopulations of students benefit equally from school-based physical activity interventions in terms of cardiorespiratory fitness and physical activity. To examine if physical activity intensity mediates improvements in cardiorespiratory fitness.

Design: Pooled analysis of individual participant data from controlled trials that assessed the impact of school-based physical activity interventions on cardiorespiratory fitness and device-measured physical activity.

Participants: Data for 6621 children and adolescents aged 4-18 years from 20 trials were included.

Main Outcome Measures: Peak oxygen consumption (VO mL/kg/min) and minutes of moderate and vigorous physical activity.

Results: Interventions modestly improved students' cardiorespiratory fitness by 0.47 mL/kg/min (95% CI 0.33 to 0.61), but the effects were not distributed equally across subpopulations. Girls and older students benefited less than boys and younger students, respectively. Students with lower levels of initial fitness, and those with higher levels of baseline physical activity benefitted more than those who were initially fitter and less active, respectively. Interventions had a modest positive effect on physical activity with approximately one additional minute per day of both moderate and vigorous physical activity. Changes in vigorous, but not moderate intensity, physical activity explained a small amount (~5%) of the intervention effect on cardiorespiratory fitness.

Conclusions: Future interventions should include targeted strategies to address the needs of girls and older students. Interventions may also be improved by promoting more vigorous intensity physical activity. Interventions could mitigate declining youth cardiorespiratory fitness, increase physical activity and promote cardiovascular health if they can be delivered equitably and their effects sustained at the population level.
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http://dx.doi.org/10.1136/bjsports-2020-102740DOI Listing
January 2021

Prospective association between adherence to the Mediterranean diet and hepatic steatosis: the Swiss CoLaus cohort study.

BMJ Open 2020 12 22;10(12):e040959. Epub 2020 Dec 22.

Medical Research Council Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK

Objective: The Mediterranean diet has been promoted as a healthy dietary pattern, but whether the Mediterranean diet may help to prevent hepatic steatosis is not clear. This study aimed to evaluate the prospective association between adherence to the Mediterranean diet and risk of hepatic steatosis.

Design: Population-based prospective cohort study.

Setting: The Swiss CoLaus Study.

Participants: We evaluated 2288 adults (65.4% women, aged 55.8±10.0 years) without hepatic steatosis at first follow-up in 2009-2012. Adherence to the Mediterranean diet was scaled as the Mediterranean diet score (MDS) based on the Mediterranean diet pyramid ascertained with responses to Food Frequency Questionnaires.

Outcome Measures: New onset of hepatic steatosis was ascertained by two indices separately: the Fatty Liver Index (FLI, ≥60 points) and the non-alcoholic fatty liver disease (NAFLD) score (≥-0.640 points). Prospective associations between adherence to the Mediterranean diet and risk of hepatic steatosis were quantified using Poisson regression.

Results: During a mean 5.3 years of follow-up, hepatic steatosis was ascertained in 153 (6.7%) participants by FLI criteria and in 208 (9.1%) by NAFLD score. After multivariable adjustment, higher adherence to MDS was associated with lower risk of hepatic steatosis based on FLI: risk ratio 0.84 (95% CI 0.73 to 0.96) per 1 SD of MDS; 0.85 (0.73 to 0.99) adjusted for BMI; and 0.85 (0.71 to 1.02) adjusted for both BMI and waist circumference. When using NAFLD score, no significant association was found between MDS and risk of hepatic steatosis (0.95 (0.83 to 1.09)).

Conclusion: A potential role of the Mediterranean diet in the prevention of hepatic steatosis is suggested by the inverse association observed between adherence to the Mediterranean diet and incidence of hepatic steatosis based on the FLI. The inconsistency of this association when hepatic steatosis was assessed by NAFLD score points to the need for accurate population-level assessment of fatty liver and its physiological markers.
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http://dx.doi.org/10.1136/bmjopen-2020-040959DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7757450PMC
December 2020

Prognostic and therapeutic considerations of antibodies against c-ter apolipoprotein A-1 in the general population.

Clin Transl Immunology 2020 14;9(12):e1220. Epub 2020 Dec 14.

Department of Internal Medicine Lausanne University Hospital Lausanne Switzerland.

Objectives: Autoantibodies against apolipoprotein A1 (anti-apoA1 IgGs) and its C-terminal region (cter apoA1) have emerged as an independent biomarker for cardiovascular disease. Cter apoA1 mimetic peptides were shown to reverse the deleterious anti-apoA1 IgG effects . We evaluated the association of anti-cter apoA1 IgGs with overall mortality in the general population and tested the ability of a cter apoA1 mimetic peptide to reverse the anti-apoA1 IgG-induced inflammatory response and mortality and , respectively.

Methods: Anti-cter apoA1 IgGs were measured in serum samples of 6386 participants of the CoLaus study of which 5220 were followed for a median duration of 5.6 years. The primary outcome was overall mortality. The peptide inhibitory concentration 50% (IC) was determined on HEK-Blue-4 and RAW cells. ApoE mice were exposed to 16 weeks of anti-apoA1IgG passive immunisation with and without peptide co-incubation.

Results: Anti-cter apoA1 IgGs were associated with higher interleukin 6 levels and independently predicted overall mortality; an increase of one standard deviation of anti-cter apoA1 IgG level was associated with an 18% increase in mortality risk (hazard ratio: 1.18, 95% confidence interval: 1.04-1.33;  = 0.009). The cterApoA1 analogue reversed the antibody-mediated inflammatory response with an IC of 1 µm but did not rescue the significant anti-apoA1 IgG-induced mortality rate (69% vs. 23%, LogRank  = 0.02).

Conclusion: Anti-cter apoA1 IgG independently predicts overall mortality in the general population. Despite being effective , our cter apoA1 analogue did not reverse the anti-apoA1 IgG-induced mortality in mice. Our data suggest that these autoantibodies are not readily treatable through cognate peptide immunomodulation.
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http://dx.doi.org/10.1002/cti2.1220DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734471PMC
December 2020

Clinical factors associated with the intraventricular conduction disturbances in Swiss middle-aged adults: The CoLaus|PsyCoLaus study.

Int J Cardiol 2021 03 10;327:201-208. Epub 2020 Dec 10.

Department of Heart and Vessels, Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland.

Background: Intraventricular conduction disturbances are associated with an increased risk of adverse cardiovascular outcomes. However, data about factors associated with intraventricular conduction disturbances are sparse. We aimed to identify the clinical factors associated with intraventricular conduction disturbances in the general population.

Methods: Cross-sectional study in a sample of 3704 participants (age range 45-86 years, 55.2% women). Intraventricular conduction disturbances were defined as QRS > 110 ms on electrocardiograms, and classified into right bundle branch block (RBBB), left bundle branch block (LBBB), left anterior fascicular block (LAFB) and non-specific intraventricular conduction disturbances (NIVCD).

Results: The number of participants, the resulting prevalence (square brackets) and 95% CI (round brackets) of intraventricular conduction disturbances and subtypes (RBBB, LBBB, LAFB and NIVCD) were 187 [5.1% (4.4-5.8%)], 103 [2.9%, (2.3-3.4%)], 29 [0.8% (0.6-1.1%)], 31 (0.9% [0.6-1.2%]), and 47 [1.3% (0.9-1.7)], respectively. Multivariable logistic regression identified male sex [odds ratio and (95% CI): 2.55 (1.34-4.86)] and increasing age (p-value for trend <0.001) as being associated with RBBB; hypertension [3.08 (1.20-7.91)] and elevated NT-proBNP [3.26 (1.43-7.41)] as being associated with LBBB; elevated NT-proBNP [3.14 (1.32-7.46)] as being associated with LFAB; and male sex [5.97 (1.91-18.7)] and increased height [1.31 (1.06-1.63)] as being associated with NIVCD.

Conclusion: In a sample of the Swiss middle-aged population, the clinical factors associated with intraventricular conduction disturbances differed according to the intraventricular conduction disturbances subtype: male sex and ageing for RBBB; hypertension and elevated NT-proBNP for LBBB; elevated NT-proBNP for LAFB; and male sex and increased height for NIVCD.
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http://dx.doi.org/10.1016/j.ijcard.2020.12.012DOI Listing
March 2021