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Author (up) Hellevik, A.I.; Johnsen, M.B.; Langhammer, A.; Baste, V.; Furnes, O.; Storheim, K.; Zwart, J.A.; Flugsrud, G.B.; Nordsletten, L. url  doi
  Title Metabolic syndrome as a risk factor for total hip or knee replacement due to primary osteoarthritis: a prospective cohort study (the HUNT study and the Norwegian Arthroplasty Register) Type Journal Article
  Year 2018 Publication Clinical Epidemiology Abbreviated Journal Clin Epidemiol  
  Volume 10 Issue Pages 83-96  
  Keywords metabolic syndrome; osteoarthritis; total hip replacement; total knee replacement  
  Abstract Objective: Biochemical changes associated with obesity may accelerate osteoarthritis beyond the effect of mechanical factors. This study investigated whether metabolic syndrome and its components (visceral obesity, hypertension, dyslipidemia and insulin resistance) were risk factors for subsequent total hip replacement (THR) or total knee replacement (TKR) due to primary osteoarthritis. Design: In this prospective cohort study, data from the second survey of the Nord-Trondelag Health Study 2 (HUNT2) were linked to the Norwegian Arthroplasty Register for identification of the outcome of THR or TKR. The analyses were stratified by age (<50, 50-69.9 and >/=70 years) and adjusted for gender, body mass index, smoking, physical activity and education. Results: Of the 62,661 participants, 12,593 (20.1%) were identified as having metabolic syndrome, and we recorded 1,840 (2.9%) THRs and 1,111 (1.8%) TKRs during a mean follow-up time of 15.4 years. Cox regression analyses did not show any association between full metabolic syndrome and THR or TKR, except in persons <50 years with metabolic syndrome who had a decreased risk of THR (hazard ratio [HR] 0.58, 95% CI 0.40-0.83). However, when including only participants whose exposure status did not change during follow-up, this protective association was no longer significant. Increased waist circumference was associated with increased risk of TKR in participants <50 years (HR 1.62, 95% CI 1.10-2.39) and 50-69.9 years (HR 1.43, 95% CI 1.14-1.80). Hypertension significantly increased the risk of TKR in participants <50 years (HR 1.38, 95% CI 1.05-1.81), and this risk was greater for men. Conclusion: This study found an increased risk of TKR in men <50 years with hypertension and persons <70 years with increased waist circumference. Apart from this, neither metabolic syndrome nor its components were associated with increased risk of THR or TKR due to primary osteoarthritis.  
  Address Faculty of Medicine, University of Oslo, Oslo  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1179-1349 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29391831; PMCID:PMC5768432 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 2094  
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Author (up) Hellevik, A.I.; Johnsen, M.B.; Langhammer, A.; Fenstad, A.M.; Furnes, O.; Storheim, K.; Zwart, J.A.; Flugsrud, G.; Nordsletten, L. url  doi
  Title Incidence of total hip or knee replacement due to osteoarthritis in relation to thyroid function: a prospective cohort study (The Nord-Trondelag Health Study) Type Journal Article
  Year 2017 Publication BMC Musculoskeletal Disorders Abbreviated Journal BMC Musculoskelet Disord  
  Volume 18 Issue 1 Pages 201  
  Keywords Hip joint replacement; Knee joint replacement; Osteoarthritis; Thyroid function; Thyroid stimulating hormone  
  Abstract BACKGROUND: To study whether thyroid function was associated with risk of hip or knee replacement due to primary osteoarthritis. METHODS: In a prospective cohort study, data from the second and third survey of the Nord-Trondelag Health Study were linked to the Norwegian Arthroplasty Register in order to identify total hip or knee replacement as a result of primary osteoarthritis. RESULTS: Among 37 891 participants without previously known thyroid disease we recorded 978 total hip replacements (THRs) and 538 total knee replacements (TKRs) during a median follow-up time of 15.7 years. The analyses were adjusted for sex, age, BMI (body mass index), smoking, physical activity and diabetes. We did not find any association between TSH (thyroid stimulating hormone) and THR or TKR due to osteoarthritis. Neither were changes in TSH over time, or overt hypo- or hyperthyroidism, associated with incidence of THR or TKR. CONCLUSION: No association was found between thyroid function and hip or knee joint replacement due to osteoarthritis.  
  Address Faculty of Medicine, University of Oslo, Oslo, Norway  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1471-2474 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28521834; PMCID:PMC5437592 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1924  
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Author (up) Hellevik, A.I.; Nordsletten, L.; Johnsen, M.B.; Fenstad, A.M.; Furnes, O.; Storheim, K.; Zwart, J.A.; Flugsrud, G.; Langhammer, A. url  doi
  Title Age of menarche is associated with knee joint replacement due to primary osteoarthritis (The HUNT Study and the Norwegian Arthroplasty Register) Type Journal Article
  Year 2017 Publication Osteoarthritis and Cartilage Abbreviated Journal Osteoarthritis Cartilage  
  Volume 25 Issue 10 Pages 1654-1662  
  Keywords Hip joint replacement; Hormonal therapies; Knee joint replacement; Osteoarthritis; Reproductive history  
  Abstract OBJECTIVE: To investigate whether parity, age at menarche, menopausal status, age at menopause, use of oral contraceptives (OC) or use of hormone replacement therapy (HRT) were associated with total knee replacement (TKR) or total hip replacement (THR) due to primary osteoarthritis. METHOD: In a prospective cohort study of 30,289 women from the second and third surveys of the Nord-Trondelag Health Study, data were linked to the Norwegian Arthroplasty Register (NAR) in order to identify TKR or THR due to primary osteoarthritis. Cox proportional hazards models were used to estimate the hazard ratios (HRs). RESULTS: We observed 430 TKRs and 675 THRs during a mean follow-up time of 8.3 years. Increasing age at menarche was inversely associated with the risk of TKR (P-trend < 0.001). Past users and users of systemic HRT were at higher risk of TKR compared to never users (HR 1.42 (95% confidence interval (CI) 1.06-1.90) and HR 1.40 (95% CI 1.03-1.90), respectively). No association was found between parity, age at menarche, menopausal status, age at menopause, oral contraceptive use or HRT use and THR. CONCLUSION: We found that increasing age at menarche reduced the risk of TKR. Past users and users of systemic HRT were at higher risk of TKR compared to never users. Parity did not increase the risk of THR or TKR.  
  Address The HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Levanger, Norway. Electronic address: arnulf.langhammer@ntnu.no  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1063-4584 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28705605 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1925  
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Author (up) Hellevik, A.I.; Nordsletten, L.; Johnsen, M.B.; Fenstad, A.M.; Furnes, O.; Storheim, K.; Zwart, J.A.; Flugsrud, G.; Langhammer, A. url  doi
  Title Corrigendum to “Age of menarche is associated with knee joint replacement due to primary osteoarthritis (The HUNT Study and the Norwegian Arthroplasty Register)” [Osteoarthr Cartil 25 (2017) 1654-1662] Type Published Erratum
  Year 2017 Publication Osteoarthritis and Cartilage Abbreviated Journal Osteoarthritis Cartilage  
  Volume 25 Issue 12 Pages 2148-2149  
  Keywords  
  Abstract  
  Address The HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Levanger, Norway. Electronic address: arnulf.langhammer@ntnu.no  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1063-4584 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29066295 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1926  
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Author (up) Johnsen, M.B.; Guddal, M.H.; Smastuen, M.C.; Moksnes, H.; Engebretsen, L.; Storheim, K.; Zwart, J.A. url  doi
  Title Sport Participation and the Risk of Anterior Cruciate Ligament Reconstruction in Adolescents: A Population-based Prospective Cohort Study (The Young-HUNT Study) Type Journal Article
  Year 2016 Publication Am J Sports Med Abbreviated Journal The American journal of sports medicine  
  Volume Issue Pages  
  Keywords  
  Abstract BACKGROUND: An anterior cruciate ligament (ACL) injury is a severe injury that may require ACL reconstruction (ACLR) to enable the return to sport. Risk factors for ACLR have not firmly been established in the general adolescent population. PURPOSE: To investigate the incidence and risk factors for ACLR in a population-based cohort of adolescents. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We prospectively followed 7644 adolescents from the adolescent part of the Nord-Trondelag Health Study, included from 2006 to 2008. The main risk factors of interest were the level of sport participation (level I, II, or III) and sport competitions. The endpoint was primary ACLR recorded in the Norwegian National Knee Ligament Registry between January 2006 and December 2013. RESULTS: A total of 3808 boys and 3836 girls were included in the analyses. We identified 69 (0.9%) ACLRs with a median of 7.3 years of follow-up, providing an overall ACLR incidence of 38.9 (95% CI, 30.7-49.3) per 100,000 person-years. The hazard ratio (HR) for ACLR associated with level I sport participation was 3.93 (95% CI, 0.92-16.80) for boys and 3.31 (95% CI, 1.30-8.43) for girls. There was a stronger association related to participating in sport competitions. Girls had over 5 times a higher risk (HR, 5.42; 95% CI, 2.51-11.70) and boys over 4 times the risk (HR, 4.22; 95% CI, 1.58-11.30) of ACLR compared with those who did not compete. CONCLUSION: Participating in level I sports and sport competitions significantly increased the risk of undergoing primary ACLR. Preventive strategies should be implemented to reduce the incidence and future burden of ACLR.  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication Communication and Research Unit for Musculoskeletal Disorders, Oslo University Hospital, Oslo, Norwa Editor  
  Language Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN ISBN Medium  
  Area Expedition Conference  
  Notes Johnsen, Marianne BakkeGuddal, Maren HjelleSmastuen, Milada CvancarovaMoksnes, HavardEngebretsen, LarsStorheim, KjerstiZwart, John-AnkerENG2016/05/10 06:00Am J Sports Med. 2016 Apr 27. pii: 0363546516643807. Approved no  
  Call Number HUNT @ maria.stuifbergen @ Johnsen2016a Serial 1756  
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Author (up) Johnsen, M.B.; Hellevik, A.I.; Baste, V.; Furnes, O.; Langhammer, A.; Flugsrud, G.; Nordsletten, L.; Zwart, J.A.; Storheim, K.   
  Title Leisure time physical activity and the risk of hip or knee replacement due to primary osteoarthritis: a population based cohort study (The HUNT Study) Type Journal Article
  Year 2016 Publication BMC Musculoskelet Disord Abbreviated Journal BMC musculoskeletal disorders  
  Volume 17 Issue Pages 86  
  Keywords  
  Abstract BACKGROUND: The relationship between leisure time physical activity (LPA) and hip and knee OA and subsequent joint replacement has not yet been clearly defined. Some studies have found the risk of knee replacement (TKR) to increase with high levels of LPA, while others have found no overall relationship to either TKR or hip replacement (THR). The aim was to investigate the association between LPA and the risk of severe end-stage OA, defined as THR or TKR due to primary OA, in a large population-based cohort. METHODS: Participants in the Nord-Trondelag Health Study (HUNT) were followed prospectively to identify THR and TKR using the Norwegian Arthroplasty Register. Self-reported LPA was classified as inactive, low, moderate or high. The Cox proportional hazards model was used to calculate hazard ratios (HRs) according to levels of LPA with adjustments for confounding variables. Analyses were performed by age (  
  Address  
  Corporate Author Thesis  
  Publisher Place of Publication Communication and Research Unit for Musculoskeletal Disorders, Oslo University Hospital, Oslo, Norwa Editor  
  Language Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN ISBN Medium  
  Area Expedition Conference  
  Notes Approved no  
  Call Number HUNT @ maria.stuifbergen @ Johnsen2016b Serial 1757  
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Author (up) Johnsen, M.B.; Hellevik, A.I.; Smastuen, M.C.; Langhammer, A.; Furnes, O.; Flugsrud, G.B.; Nordsletten, L.; Zwart, J.A.; Storheim, K. url  doi
  Title The mediating effect of body mass index on the relationship between smoking and hip or knee replacement due to primary osteoarthritis. A population-based cohort study (the HUNT Study) Type Journal Article
  Year 2017 Publication PloS one Abbreviated Journal PLoS One  
  Volume 12 Issue 12 Pages e0190288  
  Keywords  
  Abstract To investigate the total effect of smoking on total hip or knee replacement (THR/TKR) due to primary osteoarthritis (OA) and to quantify the indirect effect of smoking through body mass index (BMI). Participants from the Nord-Trondelag Health Study (the HUNT Study) were linked to the Norwegian Arthroplasty Register to detect the first THR or TKR due to primary OA. A mediation analysis was used to decompose the total effect of smoking into a direct and indirect effect. BMI was considered a mediator in the analysis. All effects were estimated as hazard ratios (HRs) with 95% confidence intervals (CIs). The indirect effect of smoking mediated through BMI was expressed as a percentage (proportion*100). In total 55 188 participants were followed up during 17.2 years (median). We identified 1322 THRs and 754 TKRs. For men, the total effect of current vs. never smoking revealed a decreased risk of THR (HR 0.59, 95% CI 0.46-0.76) and TKR (HR 0.47, 95% CI 0.32-0.66). For women, current smoking increased the risk of THR (HR 1.34, 95% CI 1.11-1.60). For men, 6% and 7% of the risk reduction for THR and TKR, respectively, was mediated by BMI. We found a negative association between smoking and THR or TKR for men. On the contrary, smoking was associated with increased risk of THR for women. Most of the effect of smoking on joint replacement risk remained unexplained by BMI.  
  Address Faculty of Medicine, University of Oslo, Oslo, Norway  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1932-6203 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29284048; PMCID:PMC5746263 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1933  
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Author (up) Johnsen, M.B.; Vie, G.A.; Winsvold, B.S.; Bjorngaard, J.H.; Asvold, B.O.; Gabrielsen, M.E.; Pedersen, L.M.; Hellevik, A.I.; Langhammer, A.; Furnes, O.; Flugsrud, G.B.; Skorpen, F.; Romundstad, P.R.; Storheim, K.; Nordsletten, L.; Zwart, J.A. url  doi
  Title The causal role of smoking on the risk of hip or knee replacement due to primary osteoarthritis: a Mendelian randomisation analysis of the HUNT study Type Journal Article
  Year 2017 Publication Osteoarthritis and Cartilage Abbreviated Journal Osteoarthritis Cartilage  
  Volume 25 Issue 6 Pages 817-823  
  Keywords Epidemiology; Genetic variants; Osteoarthritis; Smoking  
  Abstract OBJECTIVE: Smoking has been associated with a reduced risk of hip and knee osteoarthritis (OA) and subsequent joint replacement. The aim of the present study was to assess whether the observed association is likely to be causal. METHOD: 55,745 participants of a population-based cohort were genotyped for the rs1051730 C > T single-nucleotide polymorphism (SNP), a proxy for smoking quantity among smokers. A Mendelian randomization analysis was performed using rs1051730 as an instrument to evaluate the causal role of smoking on the risk of hip or knee replacement (combined as total joint replacement (TJR)). Association between rs1051730 T alleles and TJR was estimated by hazard ratios (HRs) and 95% confidence intervals (CIs). All analyses were adjusted for age and sex. RESULTS: Smoking quantity (no. of cigarettes) was inversely associated with TJR (HR 0.97, 95% CI 0.97-0.98). In the Mendelian randomization analysis, rs1051730 T alleles were associated with reduced risk of TJR among current smokers (HR 0.84, 95% CI 0.76-0.98, per T allele), however we found no evidence of association among former (HR 0.97, 95% CI 0.88-1.07) and never smokers (HR 0.97, 95% CI 0.89-1.06). Neither adjusting for body mass index (BMI), cardiovascular disease (CVD) nor accounting for the competing risk of mortality substantially changed the results. CONCLUSION: This study suggests that smoking may be causally associated with the reduced risk of TJR. Our findings add support to the inverse association found in previous observational studies. More research is needed to further elucidate the underlying mechanisms of this causal association.  
  Address Communication and Research Unit for Musculoskeletal Disorders, Oslo University Hospital, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway. Electronic address: j.a.zwart@medisin.uio.no  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1063-4584 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28049019 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1934  
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Author (up) Johnsen, M.B.; Winsvold, B.S.; Borte, S.; Vie, G.A.; Pedersen, L.M.; Storheim, K.; Skorpen, F.; Hagen, K.; Bjorngaard, J.H.; Asvold, B.O.; Zwart, J.A. url  doi
  Title The causal role of smoking on the risk of headache. A Mendelian randomization analysis in the HUNT study Type Journal Article
  Year 2018 Publication European Journal of Neurology Abbreviated Journal Eur J Neurol  
  Volume 25 Issue 9 Pages 1148-e102  
  Keywords *epidemiology; *genetic variants; *headache; *migraine; *smoking  
  Abstract BACKGROUND AND PURPOSE: Headache has been associated with various lifestyle and psychosocial factors, one of which is smoking. The aim of the present study was to investigate whether the association between smoking intensity and headache is likely to be causal. METHOD: A total of 58 316 participants from the Nord-Trondelag Health (HUNT) study with information on headache status were genotyped for the rs1051730 C>T single-nucleotide polymorphism (SNP). The SNP was used as an instrument for smoking intensity in a Mendelian randomization analysis. The association between rs1051730 T alleles and headache was estimated by odds ratios with 95% confidence intervals. Additionally, the association between the SNP and migraine or non-migrainous headache versus no headache was investigated. All analyses were adjusted for age and sex. RESULTS: There was no strong evidence that the rs1051730 T allele was associated with headache in ever smokers (odds ratio 0.99, 95% confidence interval 0.95-1.02). Similarly, there was no association between the rs1051730 T allele and migraine or non-migrainous headache versus no headache. CONCLUSION: The findings from this study do not support that there is a strong causal relationship between smoking intensity and any type of headache. Larger Mendelian randomization studies are required to examine whether higher smoking quantity can lead to a moderate increase in the risk of headache subtypes.  
  Address Department of Neurology, Oslo University Hospital, Oslo, Norway  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1351-5101 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29747220 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 2106  
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