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Author Carslake, D.; Davey Smith, G.; Gunnell, D.; Davies, N.; Nilsen, T.I.L.; Romundstad, P. url  doi
  Title Confounding by ill health in the observed association between BMI and mortality: evidence from the HUNT Study using offspring BMI as an instrument Type Journal Article
  Year 2017 Publication International Journal of Epidemiology Abbreviated Journal (up) Int J Epidemiol  
  Volume Issue Pages  
  Keywords Body mass index; cohort study; confounding; instrumental variables; mortality; reverse causation  
  Abstract Background: The observational association between mortality and body mass index (BMI) is U-shaped, leading to highly publicized suggestions that moderate overweight is beneficial to health. However, it is unclear whether elevated mortality is caused by low BMI or if the association is confounded, for example by concurrent ill health. Methods: Using HUNT, a Norwegian prospective study, 32 452 mother-offspring and 27 747 father-offspring pairs were followed up to 2009. Conventional hazard ratios for parental mortality per standard deviation of BMI were estimated using Cox regression adjusted for behavioural and socioeconomic factors. To estimate hazard ratios with reduced susceptibility to confounding, particularly from concurrent ill health, the BMI of parents' offspring was used as an instrumental variable for parents' own BMI. The shape of mortality-BMI associations was assessed using cubic splines. Results: There were 18 365 parental deaths during follow-up. Conventional associations of mortality from all-causes, cardiovascular disease and cancer with parents' own BMI were substantially nonlinear, with elevated mortality at both extremes and minima at 21-25 kg m-2. Equivalent associations with offspring BMI were positive and there was no evidence of elevated parental mortality at low offspring BMI. The linear instrumental variable hazard ratio for all-cause mortality per standard deviation increase in BMI was 1.18 (95% confidence interval: 1.10, 1.26), compared with 1.05 (1.03, 1.06) in the conventional analysis. Conclusions: Elevated mortality rates at high BMI appear causal, whereas excess mortality at low BMI is likely exaggerated by confounding by factors including concurrent ill health. Conventional studies probably underestimate the adverse population health consequences of overweight.  
  Address Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, 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 0300-5771 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29206928 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1896  
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Author Paulsen, J.; Askim, A.; Mohus, R.M.; Mehl, A.; Dewan, A.; Solligard, E.; Damas, J.K.; Asvold, B.O. url  doi
  Title Associations of obesity and lifestyle with the risk and mortality of bloodstream infection in a general population: a 15-year follow-up of 64 027 individuals in the HUNT Study Type Journal Article
  Year 2017 Publication International Journal of Epidemiology Abbreviated Journal (up) Int J Epidemiol  
  Volume 46 Issue 5 Pages 1573-1581  
  Keywords Bacteraemia; alcohol drinking; exercise; obesity; sepsis; smoking  
  Abstract Background: Bloodstream infections (BSI) cause considerable morbidity and mortality, and primary prevention should be a priority. Lifestyle factors are of particular interest since they represent a modifiable target. Methods: We conducted a prospective cohort study among participants in the population-based Norwegian HUNT2 Survey, where 64 027 participants were followed from 1995-97 through 2011 by linkage to prospectively recorded information on BSI at local and regional hospitals. The exposures were: baseline body mass index (BMI) measurements; and self-reported smoking habits, leisure time physical activity and alcohol intake. The outcomes were hazard ratios (HR) of BSI and BSI mortality. Results: During 810 453 person-years and median follow-up of 14.8 years, 1844 (2.9%) participants experienced at least one BSI and 396 (0.62%) died from BSI. Compared with normal weight participants (BMI 18.5-24.9 kg/m2), the age- and sex-adjusted risk of a first-time BSI was 31% [95% confidence interval (CI) 14-51%] higher at BMI 30.0-34.9 kg/m2, 87% (95% CI 50-135%) higher at BMI 35.0-39.9 kg/m2 and 210% (95% CI 117-341%) higher at BMI >/= 40.0 kg/m2. The risk of BSI mortality was similarly increased. Compared with never-smokers, current smokers had 51% (95% CI 34-70%) and 75% (95% CI 34-129%) higher risks of BSI and BSI mortality, respectively. Physically inactive participants had 71% (95% CI 42-107%) and 108% (95% CI 37-216%) higher risks of BSI and BSI mortality, respectively, compared with the most physically active. Conclusions: Obesity, smoking and physical inactivity carry increased risk of BSI and BSI mortality.  
  Address Department of Endocrinology, St Olavs Hospital, Trondheim University Hospital, Trondheim, 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 0300-5771 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28637260 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1969  
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Author Bosnes, I.; Almkvist, O.; Bosnes, O.; Stordal, E.; Romild, U.; Nordahl, H.M. url  doi
  Title Prevalence and correlates of successful aging in a population-based sample of older adults: the HUNT study Type Journal Article
  Year 2017 Publication International Psychogeriatrics Abbreviated Journal (up) Int Psychogeriatr  
  Volume 29 Issue 3 Pages 431-440  
  Keywords Hunt; components; correlates; prevalence; successful aging  
  Abstract BACKGROUND: The factors influencing successful aging (SA) are of great interest in an aging society. The aims of this study were to investigate the prevalence of SA, the relative importance across age of the three components used to define it (absence of disease and disability, high cognitive and physical function, and active engagement with life), and its correlates. METHODS: Data were extracted from the population-based cross-sectional Nord-Trondelag Health Study (HUNT3 2006-2008). Individuals aged 70-89 years with complete datasets for the three components were included (N = 5773 of 8,040, 71.8%). Of the respondents, 54.6% were women. Univariate and multivariate regression analyses were used to analyze possible correlates of SA. RESULTS: Overall, 35.6% of the sample met one of the three criteria, 34.1% met combinations, and 14.5% met all of the three criteria. The most demanding criterion was high function, closely followed by absence of disease, while approximately two-thirds were actively engaged in life. The relative change with age was largest for the high cognitive and physical function component and smallest for active engagement with life. The significant correlates of SA were younger age, female gender, higher education, weekly exercise, more satisfaction with life, non-smoking, and alcohol consumption, whereas marital status was not related to SA. CONCLUSIONS: The prevalence of SA in this study (14.5%) is comparable to previous studies. It may be possible to increase the prevalence by intervention directed toward more exercise, non-smoking, and better satisfaction with life.  
  Address Department of Psychology,Norwegian University of Science and Technology (NTNU),Trondheim,Norway  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1041-6102 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27852332 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1886  
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Author Mauseth, S.A.; Skurtveit, S.; Langhammer, A.; Spigset, O. url  doi
  Title Incidence of and factors associated with anticholinergic drug use among Norwegian women with urinary incontinence Type Journal Article
  Year 2017 Publication International Urogynecology Journal Abbreviated Journal (up) Int Urogynecol J  
  Volume Issue Pages  
  Keywords Anticholinergic drugs; Drug treatment; Epidemiology; Health survey; Prescription patterns; Urinary incontinence  
  Abstract INTRODUCTION AND HYPOTHESIS: The aims of this study were to investigate patterns of prescribing anticholinergic drugs among women with urinary incontinence (UI) and to identify factors associated with prescription of these drugs. METHODS: We analysed questionnaire data on UI from 21,735 women older than 20 years who participated in a cross-sectional population-based study in Nord-Trondelag county, Norway (the HUNT study). These data were linked at the individual level to a national prescription database, and analysed using a multivariate logistic regression model. RESULTS: Among the women with UI, 4.5% had been prescribed an anticholinergic drug during the previous 12 months. Prescription was most frequent in women with urge UI (10.5%) and mixed UI (7.0%). Of women with UI without treatment with an anticholinergic drug, 1.8% obtained such a prescription during the subsequent 12 months, corresponding to 3.1% of women with urge UI and 3.0% of women with mixed UI. Characteristics significantly associated with starting treatment were age above 50 years, urge or mixed UI, severe or very severe symptoms, consumption of four or more cups of coffee per day, and having visited a doctor for UI. No association was found with marital status, parity, smoking, alcohol, body mass index or anxiety/depression. CONCLUSIONS: In this population-based study, 4.5% of women with UI were prescribed an anticholinergic drug, and the 12-month incidence of starting treatment was 1.8%. Age above 50 years, urge or mixed UI, severe symptoms, high coffee consumption and having visited a doctor for UI were factors associated with first-time drug prescription.  
  Address Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, 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 0937-3462 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29103164 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1954  
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Author Webb, T.R.; Erdmann, J.; Stirrups, K.E.; Stitziel, N.O.; Masca, N.G.D.; Jansen, H.; Kanoni, S.; Nelson, C.P.; Ferrario, P.G.; Konig, I.R.; Eicher, J.D.; Johnson, A.D.; Hamby, S.E.; Betsholtz, C.; Ruusalepp, A.; Franzen, O.; Schadt, E.E.; Bjorkegren, J.L.M.; Weeke, P.E.; Auer, P.L.; Schick, U.M.; Lu, Y.; Zhang, H.; Dube, M.-P.; Goel, A.; Farrall, M.; Peloso, G.M.; Won, H.-H.; Do, R.; van Iperen, E.; Kruppa, J.; Mahajan, A.; Scott, R.A.; Willenborg, C.; Braund, P.S.; van Capelleveen, J.C.; Doney, A.S.F.; Donnelly, L.A.; Asselta, R.; Merlini, P.A.; Duga, S.; Marziliano, N.; Denny, J.C.; Shaffer, C.; El-Mokhtari, N.E.; Franke, A.; Heilmann, S.; Hengstenberg, C.; Hoffmann, P.; Holmen, O.L.; Hveem, K.; Jansson, J.-H.; Jockel, K.-H.; Kessler, T.; Kriebel, J.; Laugwitz, K.L.; Marouli, E.; Martinelli, N.; McCarthy, M.I.; Van Zuydam, N.R.; Meisinger, C.; Esko, T.; Mihailov, E.; Escher, S.A.; Alver, M.; Moebus, S.; Morris, A.D.; Virtamo, J.; Nikpay, M.; Olivieri, O.; Provost, S.; AlQarawi, A.; Robertson, N.R.; Akinsansya, K.O.; Reilly, D.F.; Vogt, T.F.; Yin, W.; Asselbergs, F.W.; Kooperberg, C.; Jackson, R.D.; Stahl, E.; Muller-Nurasyid, M.; Strauch, K.; Varga, T.V.; Waldenberger, M.; Zeng, L.; Chowdhury, R.; Salomaa, V.; Ford, I.; Jukema, J.W.; Amouyel, P.; Kontto, J.; Nordestgaard, B.G.; Ferrieres, J.; Saleheen, D.; Sattar, N.; Surendran, P.; Wagner, A.; Young, R.; Howson, J.M.M.; Butterworth, A.S.; Danesh, J.; Ardissino, D.; Bottinger, E.P.; Erbel, R.; Franks, P.W.; Girelli, D.; Hall, A.S.; Hovingh, G.K.; Kastrati, A.; Lieb, W.; Meitinger, T.; Kraus, W.E.; Shah, S.H.; McPherson, R.; Orho-Melander, M.; Melander, O.; Metspalu, A.; Palmer, C.N.A.; Peters, A.; Rader, D.J.; Reilly, M.P.; Loos, R.J.F.; Reiner, A.P.; Roden, D.M.; Tardif, J.-C.; Thompson, J.R.; Wareham, N.J.; Watkins, H.; Willer, C.J.; Samani, N.J.; Schunkert, H.; Deloukas, P.; Kathiresan, S. url  doi
  Title Systematic Evaluation of Pleiotropy Identifies 6 Further Loci Associated With Coronary Artery Disease Type Journal Article
  Year 2017 Publication Journal of the American College of Cardiology Abbreviated Journal (up) J Am Coll Cardiol  
  Volume 69 Issue 7 Pages 823-836  
  Keywords Case-Control Studies; Coronary Artery Disease/epidemiology/*genetics; Female; Gene Frequency; *Genetic Loci; *Genetic Pleiotropy; Genome-Wide Association Study; Humans; Male; Odds Ratio; Polymorphism, Single Nucleotide; cholesteryl ester transfer protein; expression quantitative trait loci; genetics; genome-wide association; single nucleotide polymorphism  
  Abstract BACKGROUND: Genome-wide association studies have so far identified 56 loci associated with risk of coronary artery disease (CAD). Many CAD loci show pleiotropy; that is, they are also associated with other diseases or traits. OBJECTIVES: This study sought to systematically test if genetic variants identified for non-CAD diseases/traits also associate with CAD and to undertake a comprehensive analysis of the extent of pleiotropy of all CAD loci. METHODS: In discovery analyses involving 42,335 CAD cases and 78,240 control subjects we tested the association of 29,383 common (minor allele frequency >5%) single nucleotide polymorphisms available on the exome array, which included a substantial proportion of known or suspected single nucleotide polymorphisms associated with common diseases or traits as of 2011. Suggestive association signals were replicated in an additional 30,533 cases and 42,530 control subjects. To evaluate pleiotropy, we tested CAD loci for association with cardiovascular risk factors (lipid traits, blood pressure phenotypes, body mass index, diabetes, and smoking behavior), as well as with other diseases/traits through interrogation of currently available genome-wide association study catalogs. RESULTS: We identified 6 new loci associated with CAD at genome-wide significance: on 2q37 (KCNJ13-GIGYF2), 6p21 (C2), 11p15 (MRVI1-CTR9), 12q13 (LRP1), 12q24 (SCARB1), and 16q13 (CETP). Risk allele frequencies ranged from 0.15 to 0.86, and odds ratio per copy of the risk allele ranged from 1.04 to 1.09. Of 62 new and known CAD loci, 24 (38.7%) showed statistical association with a traditional cardiovascular risk factor, with some showing multiple associations, and 29 (47%) showed associations at p < 1 x 10(-4) with a range of other diseases/traits. CONCLUSIONS: We identified 6 loci associated with CAD at genome-wide significance. Several CAD loci show substantial pleiotropy, which may help us understand the mechanisms by which these loci affect CAD risk.  
  Address Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts; Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts; Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts  
  Corporate Author Myocardial Infarction Genetics and CARDIoGRAM Exome Consortia Investigators 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 0735-1097 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28209224; PMCID:PMC5314135 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 2030  
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Author Gemes, K.; Malmo, V.; Laugsand, L.E.; Loennechen, J.P.; Ellekjaer, H.; Laszlo, K.D.; Ahnve, S.; Vatten, L.J.; Mukamal, K.J.; Janszky, I. url  doi
  Title Does Moderate Drinking Increase the Risk of Atrial Fibrillation? The Norwegian HUNT (Nord-Trondelag Health) Study Type Journal Article
  Year 2017 Publication Journal of the American Heart Association Abbreviated Journal (up) J Am Heart Assoc  
  Volume 6 Issue 10 Pages  
  Keywords Hunt; alcohol; atrial fibrillation; cohort study; epidemiology; moderate alcohol  
  Abstract BACKGROUND: Compelling evidence suggests that excessive alcohol consumption increases the risk of atrial fibrillation (AF), but the effect of light-moderate alcohol consumption is less certain. We investigated the association between alcohol consumption within recommended limits and AF risk in a light-drinking population. METHODS AND RESULTS: Among 47 002 participants with information on alcohol consumption in a population-based cohort study in Norway, conducted from October 2006 to June 2008, 1697 validated AF diagnoses were registered during the 8 years of follow-up. We used Cox proportional hazard models with fractional polynomials to analyze the association between alcohol intake and AF. Population attributable risk for drinking within the recommended limit (ie, at most 1 drink per day for women and 2 drinks per day for men without risky drinking) compared with nondrinking was also calculated. The average alcohol intake was 3.8+/-4.8 g/d. The adjusted hazard ratio for AF was 1.38 (95% confidence interval, 1.06-1.80) when we compared participants consuming >7 drinks per week with abstainers. When we modeled the quantity of alcohol intake as a continuous variable, the risk increased in a curvilinear manner. It was higher with heavier alcohol intake, but there was virtually no association at <1 drink per day for women and <2 drinks per day for men in the absence of risky drinking. The population attributable risk among nonrisky drinkers was 0.07% (95% confidence interval, -0.01% to 0.13%). CONCLUSIONS: Although alcohol consumption was associated with a curvilinearly increasing risk of AF in general, the attributable risk of alcohol consumption within recommended limits among participants without binge or problem drinking was negligible in this population.  
  Address Regional Center for Health Care Improvement, St Olav's Hospital, Trondheim, 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 2047-9980 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29054845; PMCID:PMC5721892 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1901  
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Author Evensen, M.; Lyngstad, T.H.; Melkevik, O.; Reneflot, A.; Mykletun, A. url  doi
  Title Adolescent mental health and earnings inequalities in adulthood: evidence from the Young-HUNT Study Type Journal Article
  Year 2017 Publication Journal of Epidemiology and Community Health Abbreviated Journal (up) J Epidemiol Community Health  
  Volume 71 Issue 2 Pages 201-206  
  Keywords Employment; Inequalities; Longitudinal Studies; Mental Health; Social and life-course epidemiology  
  Abstract BACKGROUND: Previous studies have shown that adolescent mental health problems are associated with lower employment probabilities and risk of unemployment. The evidence on how earnings are affected is much weaker, and few have addressed whether any association reflects unobserved characteristics and whether the consequences of mental health problems vary across the earnings distribution. METHODS: A population-based Norwegian health survey linked to administrative registry data (N=7885) was used to estimate how adolescents' mental health problems (separate indicators of internalising, conduct, and attention problems and total sum scores) affect earnings (>/=30 years) in young adulthood. We used linear regression with fixed-effects models comparing either students within schools or siblings within families. Unconditional quantile regressions were used to explore differentials across the earnings distribution. RESULTS: Mental health problems in adolescence reduce average earnings in adulthood, and associations are robust to control for observed family background and school fixed effects. For some, but not all mental health problems, associations are also robust in sibling fixed-effects models, where all stable family factors are controlled. Further, we found much larger earnings loss below the 25th centile. CONCLUSIONS: Adolescent mental health problems reduce adult earnings, especially among individuals in the lower tail of the earnings distribution. Preventing mental health problems in adolescence may increase future earnings.  
  Address Division of Mental Health, Norwegian Institute of Public Health, 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 0143-005X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27531845 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1905  
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Author Modalsli, E.H.; Asvold, B.O.; Snekvik, I.; Romundstad, P.R.; Naldi, L.; Saunes, M. url  doi
  Title The association between the clinical diversity of psoriasis and depressive symptoms: the HUNT Study, Norway Type Journal Article
  Year 2017 Publication Journal of the European Academy of Dermatology and Venereology : JEADV Abbreviated Journal (up) J Eur Acad Dermatol Venereol  
  Volume 31 Issue 12 Pages 2062-2068  
  Keywords  
  Abstract BACKGROUND: While a number of observational hospital-based studies have reported an association between psoriasis and depression, less is known about the clinical diversity of psoriasis and depressive symptoms. OBJECTIVE: To investigate the associations of inverse psoriasis, psoriasis severity and psoriasis duration with depressive symptoms in a general population. METHODS: We linked data from the population-based third Nord-Trondelag Health Study (HUNT3) to the Norwegian Prescription Database (NorPD) and Statistics Norway. Depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Associations between psoriasis and depressive symptoms (HADS >/= 8) were estimated using logistic regression. RESULTS: Among 37 833 participants in HUNT3, we found a weak association between any psoriasis and the prevalence of depressive symptoms [fully adjusted odds ratio (OR) 1.12, 95% confidence interval (CI) 0.97-1.28]. The association with depressive symptoms was stronger when psoriasis was characterized by inverse anatomical distribution (OR 1.32, 95% CI 1.02-1.70), requirement of systemic psoriasis medication (OR 1.47, 95% CI 1.00-2.17) or long disease duration (OR 1.33, 95% CI 1.09-1.64). Conversely, when there was no inverse psoriasis distribution, no requirement of systemic medication, or shorter disease duration, psoriasis was not meaningfully associated with depressive symptoms. CONCLUSION: Overall, depressive symptoms do not seem to be a major concern among subjects with psoriasis in a general Norwegian population. However, among subjects with inverse anatomical distribution, requirement of systemic psoriasis medication or long disease duration, depressive symptoms may be particularly important to address when evaluating the burden of psoriasis.  
  Address Department of Cancer Research and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway  
  Corporate Author Thesis  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0926-9959 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28662282 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1956  
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Author Grov, E.K.; Fossa, S.D.; Dahl, A.A. url  doi
  Title A controlled study of the influence of comorbidity on activities of daily living in elderly cancer survivors (the HUNT-3 survey) Type Journal Article
  Year 2017 Publication Journal of Geriatric Oncology Abbreviated Journal (up) J Geriatr Oncol  
  Volume 8 Issue 5 Pages 328-335  
  Keywords Adl; Activities of daily living; Cancer survivors; Comorbidity; Elderly; Home dwelling  
  Abstract OBJECTIVES: To examine the influence of somatic comorbidity on Activity of Daily Living (ADL) problems in cancer survivors >/=70years (ECSs) based on data from The Health Study of Nord-Trondelag County (HUNT-3) 2006-08. MATERIAL AND METHODS: Among participants of the HUNT-3 survey, 599 ECSs had a diagnosis of one invasive cancer according to both The Cancer Registry of Norway and self-report. Three controls without cancer aged >/=70years for each ECS were drawn from the HUNT-3 sample. We compared personal-ADL (P-ADL) and instrumental-ADL (I-ADL) problems for ECSs and differences between ADL problems for ECSs with and without comorbidity and controls with and without comorbidity. RESULTS: The prevalence of P-ADL problems was 3.5% among ECSs and 2.9% among controls (p=0.97) and for I-ADL 28.5% versus 21.4% (p=0.01), respectively. In bivariate analyses where ECSs versus controls was the dependent variable, presence of I-ADL problems, higher age, being female, paired relationship, poor self-rated health, hospitalization last year, and low level of neuroticism were associated being ECSs. In multivariate analyses, these variables, except I-ADL-problems and paired relationship, remained significantly associated being ECSs. No significant differences were shown for P-ADL problems when comparing ECSs and controls with comorbidity, and ECSs with and without comorbidity. ECSs with comorbidity reported significantly more I-ADL-problems than controls with comorbidity, and ECSs with comorbidity had significantly more I-ADL-problems than ECSs without comorbidity. CONCLUSION: Our results reflect common factors found in ADL studies in the elderly population. Health personnel have to be particularly observant on I-ADL problems among female ECSs, and those reporting poor self-rated health or comorbidity.  
  Address National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Norwegian Radium Hospital, 0424 Oslo, Norway; Faculty of Medicine, University of Oslo, 0316 Oslo, Norway  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1879-4068 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28629695 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1917  
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Author Daneshvar, F.; Weinreich, M.; Daneshvar, D.; Sperling, M.; Salmane, C.; Yacoub, H.; Gabriels, J.; McGinn, T.; Smith, M.C. url  doi
  Title Cardiorespiratory Fitness in Internal Medicine Residents: Are Future Physicians Becoming Deconditioned? Type Journal Article
  Year 2017 Publication Journal of Graduate Medical Education Abbreviated Journal (up) J Grad Med Educ  
  Volume 9 Issue 1 Pages 97-101  
  Keywords *Cardiorespiratory Fitness; Cross-Sectional Studies; Education, Medical, Graduate; Exercise/*psychology; Female; Habits; Humans; Internal Medicine/*education; *Internship and Residency; Male; New York; Surveys and Questionnaires; Time Factors  
  Abstract BACKGROUND : Previous studies have shown a falloff in physicians' physical activity from medical school to residency. Poor fitness may result in stress, increase resident burnout, and contribute to mortality from cardiovascular disease and other causes. Physicians with poor exercise habits are also less likely to counsel patients about exercise. Prior studies have reported resident physical activity but not cardiorespiratory fitness age. OBJECTIVE : The study was conducted in 2 residency programs (3 hospitals) to assess internal medicine residents' exercise habits as well as their cardiorespiratory fitness age. METHODS : Data regarding physical fitness levels and exercise habits were collected in an anonymous cross-sectional survey. Cardiopulmonary fitness age was determined using fitness calculator based on the Nord-Trondelag Health Study (HUNT). RESULTS : Of 199 eligible physicians, 125 (63%) responded to the survey. Of respondents, 11 (9%) reported never having exercised prior to residency and 45 (36%) reported not exercising during residency (P < .001). In addition, 42 (34%) reported exercising every day prior to residency, while only 5 (4%) reported exercising daily during residency (P < .001), with 99 (79%) participants indicating residency obligations as their main barrier to exercise. We found residents' calculated mean fitness age to be 5.6 years higher than their mean chronological age (P < .001). CONCLUSIONS : Internal medicine residents reported significant decreases in physical activity and fitness. Residents attributed time constraints due to training as a key barrier to physical activity.  
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  Corporate Author Thesis  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1949-8357 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28261402; PMCID:PMC5330203 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1904  
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Author Thomsen, L.C.V.; McCarthy, N.S.; Melton, P.E.; Cadby, G.; Austgulen, R.; Nygard, O.K.; Johnson, M.P.; Brennecke, S.; Moses, E.K.; Bjorge, L.; Iversen, A.-C. url  doi
  Title The antihypertensive MTHFR gene polymorphism rs17367504-G is a possible novel protective locus for preeclampsia Type Journal Article
  Year 2017 Publication Journal of Hypertension Abbreviated Journal (up) J Hypertens  
  Volume 35 Issue 1 Pages 132-139  
  Keywords Adolescent; Adult; Alleles; Australia; Case-Control Studies; Female; Gene Frequency; Genetic Pleiotropy; Genome-Wide Association Study; Genotype; Humans; Hypertension/genetics; Inflammation/genetics; Methylenetetrahydrofolate Reductase (NADPH2)/*genetics; Norway; Polymorphism, Single Nucleotide; Pre-Eclampsia/*genetics; Pregnancy; Protective Factors; Young Adult  
  Abstract OBJECTIVE: Preeclampsia is a complex heterogeneous disease commonly defined by new-onset hypertension and proteinuria in pregnancy. Women experiencing preeclampsia have increased risk for cardiovascular diseases (CVD) later in life. Preeclampsia and CVD share risk factors and pathophysiologic mechanisms, including dysregulated inflammation and raised blood pressure. Despite commonalities, little is known about the contribution of shared genes (pleiotropy) to these diseases. This study aimed to investigate whether genetic risk factors for hypertension or inflammation are pleiotropic by also being associated with preeclampsia. METHODS: We genotyped 122 single nucleotide polymorphisms (SNPs) in women with preeclampsia (n = 1006) and nonpreeclamptic controls (n = 816) from the Norwegian HUNT Study. SNPs were chosen on the basis of previously reported associations with either nongestational hypertension or inflammation in genome-wide association studies. The SNPs were tested for association with preeclampsia in a multiple logistic regression model. RESULTS: The minor (G) allele of the intronic SNP rs17367504 in the gene methylenetetrahydrofolate reductase (MTHFR) was associated with a protective effect on preeclampsia (odds ratio 0.65, 95% confidence interval 0.53-0.80) in the Norwegian cohort. This association did not replicate in an Australian preeclampsia case-control cohort (P = 0.68, odds ratio 1.05, 95% confidence interval 0.83-1.32, minor allele frequency = 0.15). CONCLUSION: MTHFR is important for regulating transmethylation processes and is involved in regulation of folate metabolism. The G allele of rs17367504 has previously been shown to protect against nongestational hypertension. Our study suggests a novel association between this allele and reduced risk for preeclampsia. This is the first study associating the minor (G) allele of a SNP within the MTHFR gene with a protective effect on preeclampsia, and in doing so identifying a possible pleiotropic protective effect on preeclampsia and hypertension.  
  Address aDepartment of Gynecology and Obstetrics, Haukeland University Hospital bDepartment of Clinical Science, University of Bergen, Bergen, Norway cCentre for Genetic Origins of Health and Disease, University of Western Australia, Perth, Australia dDepartment of Cancer Research and Molecular Medicine, Centre of Molecular Inflammation Research, Norwegian University of Science and Technology, Trondheim eDepartment of Heart Disease, Haukeland University Hospital, Bergen, Norway fSouth Texas Diabetes and Obesity Institute, School of Medicine, University of Texas Rio Grande Valley, Brownsville, Texas, USA gDepartment of Obstetrics and Gynaecology, University of Melbourne, Parkville hPregnancy Research Centre, Department of Maternal-Fetal Medicine, Royal Women's Hospital, Parkville, Victoria iFaculty of Health Sciences, Curtin University, Perth, Western Australia, Australia  
  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 0263-6352 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27755385; PMCID:PMC5131692 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1996  
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Author Snekvik, I.; Smith, C.H.; Nilsen, T.I.L.; Langan, S.M.; Modalsli, E.H.; Romundstad, P.R.; Saunes, M. url  doi
  Title Obesity, Waist Circumference, Weight Change, and Risk of Incident Psoriasis: Prospective Data from the HUNT Study Type Journal Article
  Year 2017 Publication The Journal of Investigative Dermatology Abbreviated Journal (up) J Invest Dermatol  
  Volume 137 Issue 12 Pages 2484-2490  
  Keywords Adult; Body Mass Index; Body Weight; Female; Humans; Male; Middle Aged; Norway; Obesity/*diagnosis/epidemiology; Proportional Hazards Models; Prospective Studies; Psoriasis/complications/*diagnosis/*epidemiology; Risk Factors; *Waist Circumference; Waist-Hip Ratio  
  Abstract Although psoriasis has been associated with obesity, there are few prospective studies with objective measures. We prospectively examined the effect of body mass index, waist circumference, waist-hip ratio, and 10-year weight change on the risk of developing psoriasis among 33,734 people in the population-based Nord-Trondelag Health Study (i.e., HUNT), Norway. During follow-up, 369 incident psoriasis cases occurred. Relative risk (RR) of psoriasis was estimated by Cox regression. One standard deviation higher body mass index, waist circumference, and waist-hip ratio gave RRs of 1.22 (95% confidence interval [CI] = 1.11-1.34), 1.26 (95% CI = 1.15-1.39), and 1.18 (95% CI = 1.07-1.31), respectively. Compared with normal weight participants, obese people had an RR of 1.87 (95% CI = 1.38-2.52), whereas comparing the fourth with the first quartile of waist circumference gave an RR of 1.95 (95% CI = 1.46-2.61). One standard deviation higher weight change gave an RR of 1.20 (95% CI = 1.07-1.35), and people who increased their body weight by 10 kg or more had an RR of 1.72 (95% CI = 1.15-2.58) compared with being weight stable. In conclusion, obesity and high abdominal fat mass doubles the risk of psoriasis, and long-term weight gain substantially increases psoriasis risk. Preventing weight gain and promoting maintenance of a normal body weight could reduce incidence of psoriasis.  
  Address Department of Dermatology, St. Olavs Hospital, Trondheim University Hospital, Norway; Department of Cancer Research and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, 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 0022-202X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28780086 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1988  
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Author Jaremko, J.L.; Azmat, O.; Lambert, R.G.; Bird, P.; Haugen, I.K.; Jans, L.; Weber, U.; Winn, N.; Zubler, V.; Maksymowych, W.P. url  doi
  Title Validation of a Knowledge Transfer Tool for the Knee Inflammation MRI Scoring System for Bone Marrow Lesions According to the OMERACT Filter: Data from the Osteoarthritis Initiative Type Journal Article
  Year 2017 Publication The Journal of Rheumatology Abbreviated Journal (up) J Rheumatol  
  Volume 44 Issue 11 Pages 1718-1722  
  Keywords Bone Marrow Lesion; Knee Joint; Mri; Omeract; Osteoarthritis; Scoring Methods  
  Abstract OBJECTIVE: To assess feasibility and reliability of scoring bone marrow lesions (BML) on knee magnetic resonance imaging (MRI) in osteoarthritis using the Outcome Measures in Rheumatology Knee Inflammation MRI Scoring System (KIMRISS), with a Web-based interface and online training with real-time iterative calibration. METHODS: Six readers new to the KIMRISS (3 radiologists, 3 rheumatologists) scored sagittal T2-weighted fat-saturated MRI in 20 subjects randomly selected from the Osteoarthritis Initiative data, at baseline and 1-year followup. In the KIMRISS, the reader moves a transparent overlay grid within a Web-based interface to fit bones, then clicks or touches each region containing BML per slice, to score 1 if BML is present. Regional and total scores are automatically calculated. Outcomes include the interreader intraclass correlation coefficients (ICC) and the smallest detectable change (SDC). RESULTS: Scoring took 3-12 min per scan and all readers rated the process as moderately to very user friendly. Despite a low BML burden (average score 2.8% of maximum possible) and small changes, interobserver reliability was moderate to high for BML status and change in the femur and tibia (ICC 0.78-0.88). Four readers also scored the patella reliably, whereas 2 readers were outliers, likely because of image artifacts. SDC of 1.5-5.6 represented 0.7% of the maximum possible score. CONCLUSION: We confirmed feasibility of knee BML scoring by new readers using interactive training and a Web-based touch-sensitive overlay system, finding high reliability and sensitivity to change. Further work will include adjustments to training materials regarding patellar scoring, and study in therapeutic trial datasets with higher burden of BML and larger changes.  
  Address J.L. Jaremko, MD, PhD, FRCPC, Department of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta; O. Azmat, MB, FRCP, Department of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta; R.G. Lambert, MB, FRCPC, Department of Radiology and Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta; P. Bird, MD, Division of Medicine, University of New South Wales; I.K. Haugen, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; L. Jans, MD, PhD, Department of Radiology and Medical Imaging, Ghent University Hospital; U. Weber, MD, King Christian 10th Hospital for Rheumatic Diseases, and Institute of Regional Health Research, University of Southern Denmark; N. Winn, MBBS, FRCR, Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital; V. Zubler, MD, Department of Radiology, Balgrist University Hospital; W.P. Maksymowych, MB ChB, FRCP(C), FACP, Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta  
  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 0315-162X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28365581 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1932  
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Author Videm, V.; Thomas, R.; Brown, M.A.; Hoff, M. url  doi
  Title Self-reported Diagnosis of Rheumatoid Arthritis or Ankylosing Spondylitis Has Low Accuracy: Data from the Nord-Trondelag Health Study Type Journal Article
  Year 2017 Publication The Journal of Rheumatology Abbreviated Journal (up) J Rheumatol  
  Volume 44 Issue 8 Pages 1134-1141  
  Keywords Ankylosing Spondylitis; Epidemiology; Rheumatoid Arthritis  
  Abstract OBJECTIVE: Self-reported diagnoses of inflammatory arthritis are not accurate. The primary study aim was to ascertain self-reported diagnoses of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) in the Norwegian population-based Nord-Trondelag Health Study (HUNT) using hospital case files. The secondary aim was to provide updated estimates of the prevalence and incidence of RA and AS. METHODS: All inhabitants >/= 20 years old from the county of Nord-Trondelag were invited. Data from 70,805 unique participants from HUNT2 (1995-1997) and HUNT3 (2006-2008) were included. For participants who self-reported RA or AS, case files from all 3 hospitals in the catchment area were evaluated using standardized diagnostic criteria. RESULTS: Of 2703 self-reported cases of RA, 19.1% were verified in hospital files. Of 1064 self-reported cases of AS, 15.8% were verified. Of 259 cases self-reporting both RA and AS, 8.1% had RA and 5.4% had AS. Overall, a self-report of 1 or both diagnoses could not be verified in 82.1%, including 22.8% with insufficient information or no case file. The prevalence of RA was 768 (95% CI 705-835) per 100,000. The incidence of RA from HUNT2 to HUNT3 was 0.48 (0.41-0.56) per 1000 per year. The prevalence of AS was 264 (228-305) per 100,000. The incidence of AS from HUNT2 to HUNT3 was 0.19 (0.15-0.24) per 1000 per year. CONCLUSION: Self-reported diagnoses of RA and AS are often false-positive. The prevalence and incidence of RA were comparable to reports from similar populations. The incidence of AS was higher than previously reported in a mixed population from Norway.  
  Address V. Videm, MD, PhD, Professor, Department of Laboratory Medicine, Children's and Women's Health, NTNU, and Senior Consultant, Department of Immunology and Transfusion Medicine, St. Olavs Hospital; R. Thomas, MBBS, FRACP, MD, Professor, Translational Research Institute, University of Queensland; M.A. Brown, MBBS, MD, Director of Genomics, Queensland University of Technology, Institute of Health and Biomedical Research, Princess Alexandra Hospital; M. Hoff, MD, PhD, Associate Professor, Department of Public Health and General Practice and Department of Neuroscience, NTNU, and Senior Consultant, Department of Rheumatology, St. Olavs Hospital  
  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 0315-162X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28412703 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 2001  
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Author Simic, A.; Hansen, A.F.; Asvold, B.O.; Romundstad, P.R.; Midthjell, K.; Syversen, T.; Flaten, T.P. url  doi
  Title Trace element status in patients with type 2 diabetes in Norway: The HUNT3 Survey Type Journal Article
  Year 2017 Publication Journal of Trace Elements in Medicine and Biology : Organ of the Society for Minerals and Trace Elements (GMS) Abbreviated Journal (up) J Trace Elem Med Biol  
  Volume 41 Issue Pages 91-98  
  Keywords Aged; Diabetes Mellitus, Type 2/*blood/diagnosis/epidemiology; Female; *Health Surveys; Humans; Male; Middle Aged; Norway/epidemiology; Trace Elements/*blood; Case-control study; Hunt3; Trace elements; Type 2 diabetes; Whole blood  
  Abstract Several epidemiological studies have indicated that a number of trace elements may play a role in type 2 diabetes (T2D). We investigated the association between prevalent T2D and the concentrations of 25 trace elements in whole blood, and the relationships between T2D duration and blood levels of the trace elements that we found to be related to T2D prevalence. In this population based case-control study, 267 patients with self-reported T2D and 609 controls (frequency matched), were selected from the third Nord-Trondelag Health Survey. Trace element blood levels were determined by high resolution inductively coupled plasma-mass spectrometry. Multivariable conditional logistic regression and multivariable linear regression were used to estimate associations. The prevalence of T2D was positively associated with boron, calcium and silver, and inversely associated with indium, lead and magnesium (Ptrend<0.05). We found no statistical evidence for associations between blood levels of arsenic, bromine, cadmium, cesium, chromium, copper, gallium, gold, manganese, mercury, molybdenum, nickel, rubidium, selenium, strontium, tantalum, thallium, tin and zinc and T2D prevalence. After corrections for multiple testing, associations remained significant for calcium and lead (Qtrend<0.05), and borderline significant for magnesium, silver and boron. With increasing disease duration, higher calcium levels were observed (P<0.05). This study suggests an association between prevalent T2D and blood levels of boron, calcium, indium, lead, magnesium and silver.  
  Address Department of Chemistry, NTNU, Norwegian University of Science and Technology, Trondheim, 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 0946-672X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28347468 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1979  
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Author Selmeryd, J.; Henriksen, E.; Dalen, H.; Hedberg, P. url  doi
  Title Derivation and Evaluation of Age-Specific Multivariate Reference Regions to Aid in Identification of Abnormal Filling Patterns: The HUNT and VaMIS Studies Type Journal Article
  Year 2017 Publication JACC. Cardiovascular Imaging Abbreviated Journal (up) JACC Cardiovasc Imaging  
  Volume Issue Pages  
  Keywords Doppler; diastolic dysfunction; echocardiography; heart failure; reference values  
  Abstract OBJECTIVES: This study aimed to derive age-specific multivariate reference regions (MVRs) able to classify subjects into those having normal or abnormal filling patterns and to evaluate the prognostic impact of this classification. BACKGROUND: The integration of several parameters is necessary to diagnose disorders of left ventricular (LV) filling because no single measurement accurately describes the complexity of diastolic function. However, no generally accepted validated multiparametric algorithm currently exists. METHODS: A cohort of 1,240 apparently healthy subjects from HUNT (the Nord-Trondelag Health Study) with measured early (E) and late (A) mitral inflow velocity and early mitral annular diastolic tissue velocity (e') were used to derive univariate 95% reference bands and age-specific MVRs. Subsequently, the prognostic impact of this MVR-based classification was evaluated by Cox regression in a community-based cohort (n = 726) and in a cohort of subjects with recent acute myocardial infarction (n = 551). Both evaluation cohorts were derived from VaMIS (the Vastmanland Myocardial Infarction Study). RESULTS: Univariate reference bands and MVRs are presented graphically and as regression equations. After adjustment for sex, age, hypertension, body mass index, diabetes, prior ischemic heart disease, LV mass, LV ejection fraction, and left atrial size, the hazard ratio associated with abnormal filling patterns in the community-based cohort was 3.5 (95% confidence interval: 1.7 to 7.0; p < 0.001) and that in the acute myocardial infarction cohort was 1.8 (95% confidence interval: 1.1 to 2.8; p = 0.011). CONCLUSIONS: This study derived age-specific MVRs for identification of abnormal LV filling patterns and showed, in a community-based cohort and in a cohort of patients with recent acute myocardial infarction, that these MVRs conveyed important prognostic information. An MVR-based classification of LV filling patterns could lead to more consistent diagnostic algorithms for identification of different filling disorders.  
  Address Department of Clinical Physiology, Vastmanland County Hospital, Vasteras, Sweden; Centre for Clinical Research, Uppsala University, Vastmanland County Hospital, Vasteras, Sweden  
  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 1876-7591 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28734926 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1977  
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Author url  doi
  Title Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants Type Comment
  Year 2017 Publication Lancet (London, England) Abbreviated Journal (up) Lancet  
  Volume 389 Issue 10064 Pages 37-55  
  Keywords Bayes Theorem; *Blood Pressure; *Global Health; Humans; Prevalence; Risk Factors  
  Abstract BACKGROUND: Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. METHODS: For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. FINDINGS: We pooled 1479 studies that had measured the blood pressures of 19.1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127.0 mm Hg (95% credible interval 125.7-128.3) in men and 122.3 mm Hg (121.0-123.6) in women; age-standardised mean diastolic blood pressure was 78.7 mm Hg (77.9-79.5) for men and 76.7 mm Hg (75.9-77.6) for women. Global age-standardised prevalence of raised blood pressure was 24.1% (21.4-27.1) in men and 20.1% (17.8-22.5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacific countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1.13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net effect of increase due to population growth and ageing, and decrease due to declining age-specific prevalence. INTERPRETATION: During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe. FUNDING: Wellcome Trust.  
  Address  
  Corporate Author NCD Risk Factor Collaboration (NCD-RisC) 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 0140-6736 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27863813; PMCID:PMC5220163 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1897  
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Author Lie, A.; Engdahl, B.; Hoffman, H.J.; Li, C.-M.; Tambs, K. url  doi
  Title Occupational noise exposure, hearing loss, and notched audiograms in the HUNT Nord-Trondelag hearing loss study, 1996-1998 Type Journal Article
  Year 2017 Publication The Laryngoscope Abbreviated Journal (up) Laryngoscope  
  Volume 127 Issue 6 Pages 1442-1450  
  Keywords Adult; Aged; Aged, 80 and over; Audiometry/*statistics & numerical data; Female; Hearing Loss, Noise-Induced/*epidemiology/etiology; Humans; Male; Middle Aged; Noise, Occupational/*adverse effects; Norway/epidemiology; Occupational Diseases/*epidemiology/etiology; Occupational Exposure/*adverse effects; Prevalence; Sex Distribution; Young Adult; Noise; noise-induced hearing loss; notched audiograms; occupation  
  Abstract OBJECTIVES/HYPOTHESIS: To study the prevalence and usefulness of audiometric notches in the diagnosis of noise-induced hearing loss (NIHL). STUDY DESIGN: Audiograms and data on noise exposure from 23,297 men and 26,477 women, aged 20 to 101 years, from the Nord-Trondelag Hearing Loss Study, 1996-1998. METHODS: The prevalence of four types of audiometric notches (Coles, Hoffman, Wilson) and 4 kHz notch were computed in relation to occupational noise exposure, age, sex, and report of recurrent ear infections. RESULTS: The prevalence of notches in the 3 to 6 kHz range (Wilson, Hoffman, and Coles) ranged from 50% to 60% in subjects without occupational noise exposure, and 60% to 70% in the most occupationally noise-exposed men. The differences were statistically significant only for bilateral notches. For 4 kHz notches, the prevalence varied from 25% in occupationally nonexposed to 35% in the most occupationally exposed men, and the differences were statistically significant for both bilateral and unilateral notches. For women, the prevalence of notches was lower than in men, especially for 4 kHz notches, and the differences between occupationally noise exposed and nonexposed were smaller. Recreational exposure to high music was not associated with notched audiograms. CONCLUSIONS: The detection of bilateral notches and unilateral 4 kHz notches is of some value in diagnosing NIHL, especially in men. LEVEL OF EVIDENCE: 4 Laryngoscope, 127:1442-1450, 2017.  
  Address Division of Mental Health, Norwegian Institute of Public Health, 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 0023-852X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27696439; PMCID:PMC5484347 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1948  
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Author Karlsen, T.; Nauman, J.; Dalen, H.; Langhammer, A.; Wisloff, U. url  doi
  Title The Combined Association of Skeletal Muscle Strength and Physical Activity on Mortality in Older Women: The HUNT2 Study Type Journal Article
  Year 2017 Publication Mayo Clinic Proceedings Abbreviated Journal (up) Mayo Clin Proc  
  Volume 92 Issue 5 Pages 710-718  
  Keywords Aged; Aged, 80 and over; Cardiovascular Diseases/*mortality; *Cause of Death; *Exercise; Female; Hand Strength; Humans; Leg/physiology; *Muscle Strength; Norway/epidemiology; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Prospective Studies  
  Abstract OBJECTIVE: To assess the isolated and combined associations of leg and arm strength with adherence to current physical activity guidelines with all-cause and cause-specific mortality in healthy elderly women. PATIENTS AND METHODS: This was a prospective cohort study of 2529 elderly women (72.6+/-4.8 years) from the Norwegian Healthy survey of Northern Trondelag (second wave) (HUNT2) between August 15, 1995, and June 18, 1997, with a median of 15.6 years (interquartile range, 10.4-16.3 years) of follow-up. Chair-rise test and handgrip strength performances were assessed, and divided into tertiles. The hazard ratio (HR) of all-cause and cause-specific mortality by tertiles of handgrip strength and chair-rise test performance, and combined associations with physical activity were estimated by using Cox proportional hazard regression models. RESULTS: We observed independent associations of physical activity and the chair-rise test performance with all-cause and cardiovascular mortality, and between handgrip strength and all-cause mortality. Despite following physical activity guidelines, women with low muscle strength had increased risk of all-cause mortality (HR chair test, 1.37; 95% CI, 1.07-1.76; HR handgrip strength, 1.39; 95% CI, 1.05-1.85) and cardiovascular disease mortality (HR chair test, 1.57; 95% CI, 1.01-2.42). Slow chair-test performance was associated with all-cause (HR, 1.32; 95% CI, 1.16-1.51) and cardiovascular disease (HR, 1.41; 95% CI, 1.14-1.76) mortality. The association between handgrip strength and all-cause mortality was dose dependent (P value for trend <.01). CONCLUSION: Handgrip strength and chair-rise test performance predicted the risk of all-cause and CVD mortality independent of physical activity. Clinically feasible tests of skeletal muscle strength could increase the precision of prognosis, even in elderly women following current physical activity guidelines.  
  Address Faculty of Medicine, K.G. Jebsen Center of Exercise in Medicine, Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; School of Human Movement & Nutrition Sciences, University of Queensland, Australia  
  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 0025-6196 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28473035 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1938  
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Author Nauman, J.; Nes, B.M.; Lavie, C.J.; Jackson, A.S.; Sui, X.; Coombes, J.S.; Blair, S.N.; Wisloff, U. url  doi
  Title Prediction of Cardiovascular Mortality by Estimated Cardiorespiratory Fitness Independent of Traditional Risk Factors: The HUNT Study Type Journal Article
  Year 2017 Publication Mayo Clinic Proceedings Abbreviated Journal (up) Mayo Clin Proc  
  Volume 92 Issue 2 Pages 218-227  
  Keywords Adult; Aged; *Cardiorespiratory Fitness; Cardiovascular Diseases/*mortality; Cause of Death; Female; Humans; Male; Middle Aged; Myocardial Ischemia/mortality; Norway/epidemiology; Predictive Value of Tests; Proportional Hazards Models; Prospective Studies; Registries; Risk Factors; Stroke/mortality  
  Abstract OBJECTIVE: To assess the predictive value of estimated cardiorespiratory fitness (eCRF) and evaluate the additional contribution of traditional risk factors in cardiovascular disease (CVD) mortality prediction. PARTICIPANTS AND METHODS: The study included healthy men (n=18,721) and women (n=19,759) aged 30 to 74 years. A nonexercise algorithm estimated cardiorespiratory fitness. Cox proportional hazards models evaluated the primary (CVD mortality) and secondary (all-cause, ischemic heart disease, and stroke mortality) end points. The added predictive value of traditional CVD risk factors was evaluated using the Harrell C statistic and net reclassification improvement. RESULTS: After a median follow-up of 16.3 years (range, 0.04-17.4 years), there were 3863 deaths, including 1133 deaths from CVD (734 men and 399 women). Low eCRF was a strong predictor of CVD and all-cause mortality after adjusting for established risk factors. The C statistics for eCRF and CVD mortality were 0.848 (95% CI, 0.836-0.861) and 0.878 (95% CI, 0.862-0.894) for men and women, respectively, increasing to 0.851 (95% CI, 0.839-0.863) and 0.881 (95% CI, 0.865-0.897), respectively, when adding clinical variables. By adding clinical variables to eCRF, the net reclassification improvement of CVD mortality was 0.014 (95% CI, -0.023 to 0.051) and 0.052 (95% CI, -0.023 to 0.127) in men and women, respectively. CONCLUSION: Low eCRF is independently associated with CVD and all-cause mortality. The inclusion of traditional clinical CVD risk factors added little to risk discrimination and did not improve the classification of risk beyond this simple eCRF measurement, which may be proposed as a practical and cost-effective first-line approach in primary prevention settings.  
  Address K.G. Jebsen Center for Exercise in Medicine, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, 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 0025-6196 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27866655 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1963  
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Author Justice, A.E.; Winkler, T.W.; Feitosa, M.F.; Graff, M.; Fisher, V.A.; Young, K.; Barata, L.; Deng, X.; Czajkowski, J.; Hadley, D.; Ngwa, J.S.; Ahluwalia, T.S.; Chu, A.Y.; Heard-Costa, N.L.; Lim, E.; Perez, J.; Eicher, J.D.; Kutalik, Z.; Xue, L.; Mahajan, A.; Renstrom, F.; Wu, J.; Qi, Q.; Ahmad, S.; Alfred, T.; Amin, N.; Bielak, L.F.; Bonnefond, A.; Bragg, J.; Cadby, G.; Chittani, M.; Coggeshall, S.; Corre, T.; Direk, N.; Eriksson, J.; Fischer, K.; Gorski, M.; Neergaard Harder, M.; Horikoshi, M.; Huang, T.; Huffman, J.E.; Jackson, A.U.; Justesen, J.M.; Kanoni, S.; Kinnunen, L.; Kleber, M.E.; Komulainen, P.; Kumari, M.; Lim, U.; Luan, J.'an; Lyytikainen, L.-P.; Mangino, M.; Manichaikul, A.; Marten, J.; Middelberg, R.P.S.; Muller-Nurasyid, M.; Navarro, P.; Perusse, L.; Pervjakova, N.; Sarti, C.; Smith, A.V.; Smith, J.A.; Stancakova, A.; Strawbridge, R.J.; Stringham, H.M.; Sung, Y.J.; Tanaka, T.; Teumer, A.; Trompet, S.; van der Laan, S.W.; van der Most, P.J.; Van Vliet-Ostaptchouk, J.V.; Vedantam, S.L.; Verweij, N.; Vink, J.M.; Vitart, V.; Wu, Y.; Yengo, L.; Zhang, W.; Hua Zhao, J.; Zimmermann, M.E.; Zubair, N.; Abecasis, G.R.; Adair, L.S.; Afaq, S.; Afzal, U.; Bakker, S.J.L.; Bartz, T.M.; Beilby, J.; Bergman, R.N.; Bergmann, S.; Biffar, R.; Blangero, J.; Boerwinkle, E.; Bonnycastle, L.L.; Bottinger, E.; Braga, D.; Buckley, B.M.; Buyske, S.; Campbell, H.; Chambers, J.C.; Collins, F.S.; Curran, J.E.; de Borst, G.J.; de Craen, A.J.M.; de Geus, E.J.C.; Dedoussis, G.; Delgado, G.E.; den Ruijter, H.M.; Eiriksdottir, G.; Eriksson, A.L.; Esko, T.; Faul, J.D.; Ford, I.; Forrester, T.; Gertow, K.; Gigante, B.; Glorioso, N.; Gong, J.; Grallert, H.; Grammer, T.B.; Grarup, N.; Haitjema, S.; Hallmans, G.; Hamsten, A.; Hansen, T.; Harris, T.B.; Hartman, C.A.; Hassinen, M.; Hastie, N.D.; Heath, A.C.; Hernandez, D.; Hindorff, L.; Hocking, L.J.; Hollensted, M.; Holmen, O.L.; Homuth, G.; Jan Hottenga, J.; Huang, J.; Hung, J.; Hutri-Kahonen, N.; Ingelsson, E.; James, A.L.; Jansson, J.-O.; Jarvelin, M.-R.; Jhun, M.A.; Jorgensen, M.E.; Juonala, M.; Kahonen, M.; Karlsson, M.; Koistinen, H.A.; Kolcic, I.; Kolovou, G.; Kooperberg, C.; Kramer, B.K.; Kuusisto, J.; Kvaloy, K.; Lakka, T.A.; Langenberg, C.; Launer, L.J.; Leander, K.; Lee, N.R.; Lind, L.; Lindgren, C.M.; Linneberg, A.; Lobbens, S.; Loh, M.; Lorentzon, M.; Luben, R.; Lubke, G.; Ludolph-Donislawski, A.; Lupoli, S.; Madden, P.A.F.; Mannikko, R.; Marques-Vidal, P.; Martin, N.G.; McKenzie, C.A.; McKnight, B.; Mellstrom, D.; Menni, C.; Montgomery, G.W.; Musk, A.B.; Narisu, N.; Nauck, M.; Nolte, I.M.; Oldehinkel, A.J.; Olden, M.; Ong, K.K.; Padmanabhan, S.; Peyser, P.A.; Pisinger, C.; Porteous, D.J.; Raitakari, O.T.; Rankinen, T.; Rao, D.C.; Rasmussen-Torvik, L.J.; Rawal, R.; Rice, T.; Ridker, P.M.; Rose, L.M.; Bien, S.A.; Rudan, I.; Sanna, S.; Sarzynski, M.A.; Sattar, N.; Savonen, K.; Schlessinger, D.; Scholtens, S.; Schurmann, C.; Scott, R.A.; Sennblad, B.; Siemelink, M.A.; Silbernagel, G.; Slagboom, P.E.; Snieder, H.; Staessen, J.A.; Stott, D.J.; Swertz, M.A.; Swift, A.J.; Taylor, K.D.; Tayo, B.O.; Thorand, B.; Thuillier, D.; Tuomilehto, J.; Uitterlinden, A.G.; Vandenput, L.; Vohl, M.-C.; Volzke, H.; Vonk, J.M.; Waeber, G.; Waldenberger, M.; Westendorp, R.G.J.; Wild, S.; Willemsen, G.; Wolffenbuttel, B.H.R.; Wong, A.; Wright, A.F.; Zhao, W.; Zillikens, M.C.; Baldassarre, D.; Balkau, B.; Bandinelli, S.; Boger, C.A.; Boomsma, D.I.; Bouchard, C.; Bruinenberg, M.; Chasman, D.I.; Chen, Y.-D.I.; Chines, P.S.; Cooper, R.S.; Cucca, F.; Cusi, D.; Faire, U. de; Ferrucci, L.; Franks, P.W.; Froguel, P.; Gordon-Larsen, P.; Grabe, H.-J.; Gudnason, V.; Haiman, C.A.; Hayward, C.; Hveem, K.; Johnson, A.D.; Wouter Jukema, J.; Kardia, S.L.R.; Kivimaki, M.; Kooner, J.S.; Kuh, D.; Laakso, M.; Lehtimaki, T.; Marchand, L.L.; Marz, W.; McCarthy, M.I.; Metspalu, A.; Morris, A.P.; Ohlsson, C.; Palmer, L.J.; Pasterkamp, G.; Pedersen, O.; Peters, A.; Peters, U.; Polasek, O.; Psaty, B.M.; Qi, L.; Rauramaa, R.; Smith, B.H.; Sorensen, T.I.A.; Strauch, K.; Tiemeier, H.; Tremoli, E.; van der Harst, P.; Vestergaard, H.; Vollenweider, P.; Wareham, N.J.; Weir, D.R.; Whitfield, J.B.; Wilson, J.F.; Tyrrell, J.; Frayling, T.M.; Barroso, I.; Boehnke, M.; Deloukas, P.; Fox, C.S.; Hirschhorn, J.N.; Hunter, D.J.; Spector, T.D.; Strachan, D.P.; van Duijn, C.M.; Heid, I.M.; Mohlke, K.L.; Marchini, J.; Loos, R.J.F.; Kilpelainen, T.O.; Liu, C.-T.; Borecki, I.B.; North, K.E.; Cupples, L.A. url  doi
  Title Genome-wide meta-analysis of 241,258 adults accounting for smoking behaviour identifies novel loci for obesity traits Type Journal Article
  Year 2017 Publication Nature Communications Abbreviated Journal (up) Nat Commun  
  Volume 8 Issue Pages 14977  
  Keywords  
  Abstract Few genome-wide association studies (GWAS) account for environmental exposures, like smoking, potentially impacting the overall trait variance when investigating the genetic contribution to obesity-related traits. Here, we use GWAS data from 51,080 current smokers and 190,178 nonsmokers (87% European descent) to identify loci influencing BMI and central adiposity, measured as waist circumference and waist-to-hip ratio both adjusted for BMI. We identify 23 novel genetic loci, and 9 loci with convincing evidence of gene-smoking interaction (GxSMK) on obesity-related traits. We show consistent direction of effect for all identified loci and significance for 18 novel and for 5 interaction loci in an independent study sample. These loci highlight novel biological functions, including response to oxidative stress, addictive behaviour, and regulatory functions emphasizing the importance of accounting for environment in genetic analyses. Our results suggest that tobacco smoking may alter the genetic susceptibility to overall adiposity and body fat distribution.  
  Address NHLBI Framingham Heart Study, Framingham, Massachusetts, 01702 USA  
  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 2041-1723 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28443625; PMCID:PMC5414044 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1937  
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Author Scelo, G.; Purdue, M.P.; Brown, K.M.; Johansson, M.; Wang, Z.; Eckel-Passow, J.E.; Ye, Y.; Hofmann, J.N.; Choi, J.; Foll, M.; Gaborieau, V.; Machiela, M.J.; Colli, L.M.; Li, P.; Sampson, J.N.; Abedi-Ardekani, B.; Besse, C.; Blanche, H.; Boland, A.; Burdette, L.; Chabrier, A.; Durand, G.; Le Calvez-Kelm, F.; Prokhortchouk, E.; Robinot, N.; Skryabin, K.G.; Wozniak, M.B.; Yeager, M.; Basta-Jovanovic, G.; Dzamic, Z.; Foretova, L.; Holcatova, I.; Janout, V.; Mates, D.; Mukeriya, A.; Rascu, S.; Zaridze, D.; Bencko, V.; Cybulski, C.; Fabianova, E.; Jinga, V.; Lissowska, J.; Lubinski, J.; Navratilova, M.; Rudnai, P.; Szeszenia-Dabrowska, N.; Benhamou, S.; Cancel-Tassin, G.; Cussenot, O.; Baglietto, L.; Boeing, H.; Khaw, K.-T.; Weiderpass, E.; Ljungberg, B.; Sitaram, R.T.; Bruinsma, F.; Jordan, S.J.; Severi, G.; Winship, I.; Hveem, K.; Vatten, L.J.; Fletcher, T.; Koppova, K.; Larsson, S.C.; Wolk, A.; Banks, R.E.; Selby, P.J.; Easton, D.F.; Pharoah, P.; Andreotti, G.; Freeman, L.E.B.; Koutros, S.; Albanes, D.; Mannisto, S.; Weinstein, S.; Clark, P.E.; Edwards, T.L.; Lipworth, L.; Gapstur, S.M.; Stevens, V.L.; Carol, H.; Freedman, M.L.; Pomerantz, M.M.; Cho, E.; Kraft, P.; Preston, M.A.; Wilson, K.M.; Michael Gaziano, J.; Sesso, H.D.; Black, A.; Freedman, N.D.; Huang, W.-Y.; Anema, J.G.; Kahnoski, R.J.; Lane, B.R.; Noyes, S.L.; Petillo, D.; Teh, B.T.; Peters, U.; White, E.; Anderson, G.L.; Johnson, L.; Luo, J.; Buring, J.; Lee, I.-M.; Chow, W.-H.; Moore, L.E.; Wood, C.; Eisen, T.; Henrion, M.; Larkin, J.; Barman, P.; Leibovich, B.C.; Choueiri, T.K.; Mark Lathrop, G.; Rothman, N.; Deleuze, J.-F.; McKay, J.D.; Parker, A.S.; Wu, X.; Houlston, R.S.; Brennan, P.; Chanock, S.J. url  doi
  Title Genome-wide association study identifies multiple risk loci for renal cell carcinoma Type Journal Article
  Year 2017 Publication Nature Communications Abbreviated Journal (up) Nat Commun  
  Volume 8 Issue Pages 15724  
  Keywords  
  Abstract Previous genome-wide association studies (GWAS) have identified six risk loci for renal cell carcinoma (RCC). We conducted a meta-analysis of two new scans of 5,198 cases and 7,331 controls together with four existing scans, totalling 10,784 cases and 20,406 controls of European ancestry. Twenty-four loci were tested in an additional 3,182 cases and 6,301 controls. We confirm the six known RCC risk loci and identify seven new loci at 1p32.3 (rs4381241, P=3.1 x 10(-10)), 3p22.1 (rs67311347, P=2.5 x 10(-8)), 3q26.2 (rs10936602, P=8.8 x 10(-9)), 8p21.3 (rs2241261, P=5.8 x 10(-9)), 10q24.33-q25.1 (rs11813268, P=3.9 x 10(-8)), 11q22.3 (rs74911261, P=2.1 x 10(-10)) and 14q24.2 (rs4903064, P=2.2 x 10(-24)). Expression quantitative trait analyses suggest plausible candidate genes at these regions that may contribute to RCC susceptibility.  
  Address Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department Health and Human Services, Bethesda, Maryland 20892, USA  
  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 2041-1723 ISBN