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Author Heuch, I.; Heuch, I.; Hagen, K.; Mai, X.-M.; Langhammer, A.; Zwart, J.-A. url  doi
  Title Is there an association between vitamin D status and risk of chronic low back pain? A nested case-control analysis in the Nord-Trondelag Health Study Type Journal Article
  Year 2017 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 7 Issue 11 Pages e018521  
  Keywords back pain; epidemiology; vitamin D and low back  
  Abstract OBJECTIVES: To explore potential associations between vitamin D status and risk of chronic low back pain (LBP) in a Norwegian cohort, and to investigate whether relationships depend on the season of blood sample collection. DESIGN: A nested case-control study in a prospective data set. SETTING: The Norwegian community-based Nord-Trondelag Health Study (HUNT). Data were collected in the HUNT2 (1995-1997) and HUNT3 (2006-2008) surveys. MAIN OUTCOME MEASURE: Chronic LBP, defined as LBP persisting at least 3 months continuously during the past year. PARTICIPANTS: Among individuals aged 19-55 years without LBP in HUNT2, a data set was generated including 1685 cases with LBP in HUNT3 and 3137 controls without LBP. METHODS: Blood samples from the participants collected in HUNT2 were analysed for serum 25-hydroxyvitamin D (25(OH)D) level. Associations with LBP in HUNT3 were evaluated by unconditional logistic regression analysis with adjustment for age, sex, work status, physical activity at work and in leisure time, education, smoking, and body mass index. RESULTS: No association between vitamin D status and risk of chronic LBP was found in the total data set (OR per 10 nmol/L 25(OH)D=1.01, 95% CI 0.97 to 1.06) or in individuals with blood samples collected in summer/autumn (OR per 10 nmol/L 25(OH)D=0.99, 95% CI 0.93 to 1.06). For blood samples drawn in winter/spring, associations differed significantly between women and men (p=0.004). Among women a positive association was seen (OR per 10 nmol/L 25(OH)D=1.11, 95% CI 1.02 to 1.20), but among men no significant association was observed (OR per 10 nmol/L 25(OH)D=0.90, 95% CI 0.81 to 1.01). CONCLUSIONS: Overall, no association between vitamin D status and risk of LBP was demonstrated. The association suggested in women for the winter/spring season cannot be regarded as established.  
  Address Faculty of Medicine, University of Oslo, Oslo, Norway  
  Corporate Author (up) 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 2044-6055 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29175890; PMCID:PMC5719329 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1928  
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Author Hjerkind, K.V.; Stenehjem, J.S.; Nilsen, T.I.L. url  doi
  Title Adiposity, physical activity and risk of diabetes mellitus: prospective data from the population-based HUNT study, Norway Type Journal Article
  Year 2017 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 7 Issue 1 Pages e013142  
  Keywords *Adiposity; Adult; Aged; Aged, 80 and over; Body Mass Index; Comorbidity; Diabetes Mellitus/*epidemiology; *Exercise; Female; Humans; Longitudinal Studies; Male; Middle Aged; Norway/epidemiology; Odds Ratio; Overweight/*epidemiology; Prospective Studies; Risk Factors; Young Adult; *Epidemiology; *Public Health  
  Abstract BACKGROUND: Physical activity may counteract the adverse effects of adiposity on cardiovascular mortality; however, the evidence of a similar effect on diabetes is sparse. This study examines whether physical activity may compensate for the adverse effect of adiposity on diabetes risk. METHODS: The study population consisted of 38 231 individuals aged 20 years or more who participated in two consecutive waves of the prospective longitudinal Nord-Trondelag Health Study in Norway: in 1984-1986 and in 1995-1997. A Poisson regression model with SEs derived from robust variance was used to estimate adjusted risk ratios of diabetes between categories of body mass index and physical activity. RESULTS: Risk of diabetes increased both with increasing body mass (Ptrend <0.001) and with decreasing physical activity level (Ptrend <0.001 in men and 0.01 in women). Combined analyses showed that men who were both obese and had low activity levels had a risk ratio of 17 (95% CI 9.52 to 30) compared to men who were normal weight and highly active, whereas obese men who reported high activity had a risk ratio of 13 (95% CI 6.92 to 26). Corresponding analysis in obese women produced risk ratios of 15 (95% CI 9.18 to 25) and 13 (95% CI 7.42 to 21) among women reporting low and high activity levels, respectively. CONCLUSIONS: This study shows that overweight and obesity are associated with a substantially increased risk of diabetes, particularly among those who also reported being physically inactive. High levels of physical activity were associated with a lower risk of diabetes within all categories of body mass index, but there was no clear evidence that being physically active could entirely compensate for the adverse effect of adiposity on diabetes risk.  
  Address Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway  
  Corporate Author (up) Thesis  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2044-6055 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28093432; PMCID:PMC5253523 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1929  
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Author Hoff, M.; Meyer, H.E.; Skurtveit, S.; Langhammer, A.; Sogaard, A.J.; Syversen, U.; Dhainaut, A.; Skovlund, E.; Abrahamsen, B.; Schei, B. url  doi
  Title Validation of FRAX and the impact of self-reported falls among elderly in a general population: the HUNT study, Norway Type Journal Article
  Year 2017 Publication Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA Abbreviated Journal Osteoporos Int  
  Volume 28 Issue 10 Pages 2935-2944  
  Keywords Fracture risk assessment; General population studies; Hunt; Osteoporosis  
  Abstract Fracture Risk Assessment Tool (FRAX) without bone mineral density (BMD) for hip fracture prediction was validated in a Norwegian population 50-90 years. Fracture risk increased with higher FRAX score, and the observed number of hip fractures agreed well with the predicted number, except for the youngest and oldest men. Self-reported fall was an independent risk factor for fracture in women. INTRODUCTION: The primary aim was to validate FRAX without BMD for hip fracture prediction in a Norwegian population of men and women 50-90 years. Secondary, to study whether information of falls could improve prediction of fractures in the subgroup aged 70-90 years. METHODS: Data were obtained from the third survey of the Nord-Trondelag Health Study (HUNT3), the fracture registry in Nord-Trondelag, and the Norwegian Prescription Database (NorPD), including 15,432 women and 13,585 men. FRAX hip without BMD was calculated, and hip fractures were registered for a median follow-up of 5.2 years. The number of estimated and observed fractures was assessed, ROC curves with area under the curve (AUC), and Cox regression analyses. For the group aged 70-90 years, self-reported falls the last year before HUNT3 were included in the Cox regression model. RESULTS: The risk of fracture increased with higher FRAX score. When FRAX groups were categorized in a 10-year percentage risk for hip fracture as follows, <4, 4-7.9, 8-11.9, and >/=12%, the hazard ratio (HR) for hip fracture between the lowest and the highest group was 17.80 (95% CI: 12.86-24.65) among women and 23.40 (13.93-39.30) in men. Observed number of hip fractures agreed quite well with the predicted number, except for the youngest and oldest men. AUC was 0.81 (0.78-0.83) for women and 0.79 (0.76-0.83) for men. Self-reported fall was an independent risk factor for fracture in women (HR 1.64, 1.20-2.24), and among men, this was not significant (1.09, 0.65-1.83). CONCLUSIONS: FRAX without BMD predicted hip fracture reasonably well. In the age group 70-90 years, falls seemed to imply an additional risk among women.  
  Address Department of Gynecology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway  
  Corporate Author (up) Thesis  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0937-941X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28668994 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1930  
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Author Islam, M.K.; Folland, S.; Kaarboe, O.M. url  doi
  Title Social capital and cigarette smoking: New empirics featuring the Norwegian HUNT data Type Journal Article
  Year 2017 Publication Economics and Human Biology Abbreviated Journal Econ Hum Biol  
  Volume 26 Issue Pages 174-185  
  Keywords *Cigarette smoking; *Instrumental variables; *Longitudinal data; *Social capital  
  Abstract Using a rich Norwegian longitudinal data set, this study explores the effects of different social capital variables on the probability of cigarette smoking. There are four social capital variables available in two waves of our data set. Our results based on probit (and OLS) analyses (with municipality fixed-effects) show that the likelihood of smoking participation is negatively and significantly associated with social capital attributes, namely, community trust (-0.017), participation in organizational activities (-0.032), and cohabitation (-0.045). Significant negative associations were also observed in panel data, pooled OLS, and random effects models for community trust (-0.024; -0.010) and cohabitation (-0.040; -0.032). Fixed-effects models also showed significant negative effects for cohabitation (-0.018). Estimates of alternative instrumental variables (IV) based on recursive bivariate probit and IV-GMM models also confirmed negative and significant effects for three of its characteristics: cohabitation (-0.030; -0.046), community trust (-0.065; -0.075), and participation in organizational activities (-0.035; -0.046). The limitations of our conclusions are discussed, and the significance of our study for the field of social capital and health is described, along with suggested avenues for future research.  
  Address Department of Health Management and Health Economics, University of Oslo, 0373 Oslo, Norway  
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  Language English Summary Language Original Title  
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  Series Volume Series Issue Edition  
  ISSN 1570-677X ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28448881 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1931  
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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 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 (up) 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 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 (up) Thesis  
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  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 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 (up) Thesis  
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  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 Jorgensen, P.; Langhammer, A.; Krokstad, S.; Forsmo, S. url  doi
  Title Mortality in persons with undetected and diagnosed hypertension, type 2 diabetes, and hypothyroidism, compared with persons without corresponding disease – a prospective cohort study; The HUNT Study, Norway Type Journal Article
  Year 2017 Publication BMC Family Practice Abbreviated Journal BMC Fam Pract  
  Volume 18 Issue 1 Pages 98  
  Keywords Chronic disease; Diabetes; Hypertension; Primary care; Public health; Thyroid disorders  
  Abstract BACKGROUND: Suggested strategies in reducing the impact of non-communicable diseases (NCD) are early diagnosing and screening. We have limited proof of benefit of population screening for NCD. Increased mortality in persons with diagnosed NCD has been shown for decades. However, mortality in undetected NCD has barely been studied. This paper explores whether all-cause mortality differed between persons with diagnosed hypothyroidism, type 2 diabetes (T2DM), and hypertension, compared with persons with undetected-, and with persons without the corresponding disease. METHODS: A prospective cohort study of the general population in Nord-Trondelag, Norway. Persons >/=20 years at baseline 1995-97 were followed until death or June 15, 2016. Cox proportional hazards models were used to compute age and multiple adjusted hazard ratios (HR) with 95% confidence intervals (CI) for the association between disease status and all-cause mortality. The number of participants in the hypothyroidism study was 31,960, in the T2DM study 37,957, and in the hypertension study 63,371. RESULTS: Mortality was increased in persons with diagnosed type 2 diabetes and hypertension, compared to persons without corresponding disease; HR 1.69 (95% CI 1.55-1.84) and HR 1.23 (95% CI 1.09-1.39), respectively. Among persons with undetected T2DM, the HR was 1.21 (95% CI 1.08-1.37), whilst among undetected hypothyroidism and hypertension, mortality was not increased compared with persons without the diseases. Further, the association with mortality was stronger in persons with long duration of T2DM (HR 1.96 (95% CI 1.57-2.44)) and hypertension (HR 1.32 (95% CI 1.17-1.49)), compared with persons with short duration (HR 1.29 (1.09-1.53) and HR 1.16 (1.03-1-30) respectively). CONCLUSIONS: Mortality was increased in persons with diagnosed T2DM and hypertension, and in undetected T2DM, compared with persons without the diseases. The strength of the association with mortality in undetected T2DM was however lower compared with persons with diagnosed T2DM, and mortality was not increased in persons with undetected hypothyroidism and hypertension, compared with persons without the diseases. Thus, future research needs to test more thoroughly if early diagnosing of these diseases, such as general population screening, is beneficial for health.  
  Address Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway  
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  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1471-2296 ISBN Medium  
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  Notes PMID:29212453; PMCID:PMC5719734 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1935  
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Author Junker, A.; Bjorngaard, J.H.; Bjerkeset, O. url  doi
  Title Adolescent health and subsequent risk of self-harm hospitalisation: a 15-year follow-up of the Young-HUNT cohort Type Journal Article
  Year 2017 Publication Child and Adolescent Psychiatry and Mental Health Abbreviated Journal Child Adolesc Psychiatry Ment Health  
  Volume 11 Issue Pages 25  
  Keywords Adolescence; Hospitalisation; Self-harm  
  Abstract BACKGROUND: Self-harm is associated with increased suicide risk, and constitutes a major challenge in adolescent mental healthcare. In the current study, we examined the association between different aspects of adolescent health and risk of later self-harm requiring hospital admission. METHODS: We linked baseline information from 13 to 19 year old participants (n = 8965) in the Norwegian Young-HUNT 1 study to patient records of self-harm hospitalisation during 15 years of follow-up. We used Cox regression to estimate risk factor hazard ratios (HR). RESULTS: Eighty-nine persons (71% female) were admitted to hospital because of self-harm. Intoxication/self-poisoning was the most frequent method (81%). Both mental (anxiety/depression, loneliness, being bullied) and somatic (epilepsy, migraine) health issues were associated with up to fourfold increased risk of self-harm-related hospital admission. CONCLUSIONS: Several health issues during adolescence markedly increased the risk of later self-harm hospitalisation. Current findings should be incorporated in the strive to reduce self-harming and attempted suicides among young people.  
  Address Faculty of Health Sciences, Nord University, Levanger, Norway.grid.465487.c  
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  ISSN 1753-2000 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28469702; PMCID:PMC5410696 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1936  
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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 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 (up) 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 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 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 (up) 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 Lie, T.M.; Bomme, M.; Hveem, K.; Hansen, J.M.; Ness-Jensen, E. url  doi
  Title Snus and risk of gastroesophageal reflux. A population-based case-control study: the HUNT study Type Journal Article
  Year 2017 Publication Scandinavian Journal of Gastroenterology Abbreviated Journal Scand J Gastroenterol  
  Volume 52 Issue 2 Pages 193-198  
  Keywords Adult; Aged; Aged, 80 and over; Case-Control Studies; Female; Gastroesophageal Reflux/*epidemiology; Heartburn/etiology; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Norway/epidemiology; Risk Factors; Tobacco Use/*epidemiology; Tobacco, Smokeless/*adverse effects; Young Adult; Health surveys; oral tobacco; smokeless tobacco; snuff  
  Abstract OBJECTIVE: Tobacco smoking is a risk factor for gastroesophageal reflux, but whether other tobacco products increase the risk is unclear. The aim of this study was to investigate if snus increases the risk of gastroesophageal reflux symptoms (GERS). MATERIAL AND METHODS: The study was based on the third Nord-Trondelag health study (HUNT3), a population-based study of all adult residents in Nord-Trondelag County, Norway, performed in 2006-2009. The association between self-reported severe heartburn/regurgitation and snus use was assessed by logistic regression. RESULTS: Compared to never snus users, daily snus users had a reduced risk of GERS (OR 0.77, 95% confidence interval [CI] 0.64-0.93), while previous snus users and those using <2 boxes of snus/month had an increased risk (OR 1.20, 95% CI 1.00-1.46 and OR 1.41, 95% CI 1.02-1.96, respectively). There was no association between age when starting using snus and GERS. Snus users who started using snus to quit or cut down on cigarette smoking, who started using both snus and cigarettes or cigarettes alone had an increased risk of GERS. Snus users <30 years of age had an increased risk of GERS (OR 1.49, 95% CI 1.02-2.16), while those aged between 50-60 and 60-70 years had a reduced risk (OR 0.67, 95% CI 0.49-0.93 and OR 0.51, 95% CI 0.28-0.94, respectively). CONCLUSIONS: Daily snus users had a reduced risk of GERS. However, previous snus users and subgroups of snus users had an increased risk of GERS indicating reverse causality, such that snus use could increase the risk of GERS.  
  Address d Department of Medicine , Levanger Hospital, Nord-Trondelag Hospital Trust , Levanger , Norway  
  Corporate Author (up) 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 0036-5521 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27797289 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1942  
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Author Krokstad, S.; Ding, D.; Grunseit, A.C.; Sund, E.R.; Holmen, T.L.; Rangul, V.; Bauman, A. url  doi
  Title Multiple lifestyle behaviours and mortality, findings from a large population-based Norwegian cohort study – The HUNT Study Type Journal Article
  Year 2017 Publication BMC Public Health Abbreviated Journal BMC Public Health  
  Volume 17 Issue 1 Pages 58  
  Keywords Adult; Aged; Alcohol Drinking/epidemiology; Cohort Studies; Diet/adverse effects; Female; Follow-Up Studies; Humans; *Life Style; Male; Middle Aged; Norway/epidemiology; Proportional Hazards Models; Risk Factors; *Risk-Taking; Sleep; Smoking/adverse effects; Social Behavior; Young Adult; *All-cause mortality; *Cardiovascular disease; *Cohort study; *Lifestyle behaviour; *Metabolic disease; *Risk factors  
  Abstract BACKGROUND: Lifestyle risk behaviours are responsible for a large proportion of disease burden and premature mortality worldwide. Risk behaviours tend to cluster in populations. We developed a new lifestyle risk index by including emerging risk factors (sleep, sitting time, and social participation) and examine unique risk combinations and their associations with all-cause and cardio-metabolic mortality. METHODS: Data are from a large population-based cohort study in a Norway, the Nord-Trondelag Health Study (HUNT), with an average follow-up time of 14.1 years. Baseline data from 1995-97 were linked to the Norwegian Causes of Death Registry. The analytic sample comprised 36 911 adults aged 20-69 years. Cox regression models were first fitted for seven risk factors (poor diet, excessive alcohol consumption, current smoking, physical inactivity, excessive sitting, too much/too little sleep, and poor social participation) separately and then adjusted for socio-demographic covariates. Based on these results, a lifestyle risk index was developed. Finally, we explored common combinations of the risk factors in relation to all-cause and cardio-metabolic mortality outcomes. RESULTS: All single risk factors, except for diet, were significantly associated with both mortality outcomes, and were therefore selected to form a lifestyle risk index. Risk of mortality increased as the index score increased. The hazard ratio for all-cause mortality increased from 1.37 (1.15-1.62) to 6.15 (3.56-10.63) as the number of index risk factors increased from one to six respectively. Among the most common risk factor combinations the association with mortality was particularly strong when smoking and/or social participation were included. CONCLUSIONS: This study adds to previous research on multiple risk behaviours by incorporating emerging risk factors. Findings regarding social participation and prolonged sitting suggest new components of healthy lifestyles and potential new directions for population health interventions.  
  Address Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia  
  Corporate Author (up) 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 1471-2458 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28068991; PMCID:PMC5223537 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1946  
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Author Li, J.; Wu, B.; Selbaek, G.; Krokstad, S.; Helvik, A.-S. url  doi
  Title Factors associated with consumption of alcohol in older adults – a comparison between two cultures, China and Norway: the CLHLS and the HUNT-study Type Journal Article
  Year 2017 Publication BMC Geriatrics Abbreviated Journal BMC Geriatr  
  Volume 17 Issue 1 Pages 172  
  Keywords Abstainers; Alcohol consumption; China; Elderly; Norway; Older adults  
  Abstract BACKGROUND: There is little knowledge about the consumption of alcohol among Chinese and Norwegian older adults aged 65 years and over. The aim of this study was to investigate the prevalence and factors related to alcohol consumption among older adults in China and Norway. METHODS: The Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2008-2009 conducted in China and The Nord-Trondelag Health Study data in 2006-2008 (HUNT3) conducted in Norway were used. Mulitvariable logistic regression was used to test the factors related to alcohol consumption. RESULTS: The prevalence of participants who drink alcohol in the Chinese and Norwegian sample were 19.88% and 46.2%, respectively. The weighted prevalence of participants with consumption of alcohol in the Chinese sample of women and men were 7.20% and 34.14%, respectively. In the Norwegian sample, the prevalence of consumption of alcohol were 43.31% and 65.35% for women and men, respectively. Factors such as younger age, higher level of education, living in urban areas, living with spouse or partner, and better health status were related to higher likelihood of alcohol consumption among Norwegian older women and men; while reported better health status and poorer life satisfaction were related to higher likelihood of alcohol consumption among Chinese. In addition, rural males and older females with higher level of education were more likely to consume alcohol. CONCLUSION: The alcohol consumption patterns were quite different between China and Norway. Besides economic development levels and cultures in the two different countries, demographic characteristics, socioeconomic status, overall health status, and life satisfaction were associated with alcohol consumption as well.  
  Address St. Olav's University Hospital, Trondheim, Norway  
  Corporate Author (up) 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 1471-2318 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28760157; PMCID:PMC5537928 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1947  
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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 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 (up) 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 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 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 (up) 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 Modalsli, E.H.; Asvold, B.O.; Romundstad, P.R.; Langhammer, A.; Hoff, M.; Forsmo, S.; Naldi, L.; Saunes, M. url  doi
  Title Psoriasis, fracture risk and bone mineral density: the HUNT Study, Norway Type Journal Article
  Year 2017 Publication The British Journal of Dermatology Abbreviated Journal Br J Dermatol  
  Volume 176 Issue 5 Pages 1162-1169  
  Keywords  
  Abstract BACKGROUND: An association between psoriasis and osteoporosis has been reported. OBJECTIVES: To investigate, in a large prospective population-based Norwegian study, whether psoriasis is associated with increased risk of forearm or hip fracture; to investigate the cross-sectional association between psoriasis and bone mineral density (BMD) T-score in a subpopulation. METHODS: Hospital-derived fracture data from Nord-Trondelag County (1995-2013) were linked to psoriasis information, BMD measurements and lifestyle factors from the third survey of the Nord-Trondelag Health Study 2006-08 (HUNT3); socioeconomic data from the National Education Database; and use of medication from the Norwegian Prescription Database. RESULTS: Among 48 194 participants in HUNT3, we found no increased risk of forearm or hip fracture in 2804 patients with self-reported psoriasis [overall age- and sex-adjusted hazard ratio 1.03, 95% confidence interval (CI) 0.82-1.31]. No clear association was found between psoriasis and mean BMD T-score; overall age- and sex-adjusted differences in total hip, femoral neck and lumbar spine BMD T-scores were 0.02 (95% CI -0.11 to 0.14), 0.05 (95% CI -0.06 to 0.17) and 0.07 (95% CI -0.09 to 0.24), respectively. No clear association was found between psoriasis and prevalent osteoporosis in either total hip, femoral neck or lumbar spine; overall age- and sex-adjusted odds ratio was 0.77 (95% CI 0.54-1.10). Associations did not change substantially after adjustment for education, smoking, systemic steroid use and body mass index. CONCLUSIONS: We found no association between psoriasis and risk of fracture. The study did not indicate reduced BMD T-score or higher prevalence of osteoporosis among patients with psoriasis.  
  Address Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway  
  Corporate Author (up) 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 0007-0963 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27718508 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1955  
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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 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 (up) 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 0926-9959 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28662282 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1956  
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Author Nordstoga, A.L.; Nilsen, T.I.L.; Vasseljen, O.; Unsgaard-Tondel, M.; Mork, P.J. url  doi
  Title The influence of multisite pain and psychological comorbidity on prognosis of chronic low back pain: longitudinal data from the Norwegian HUNT Study Type Journal Article
  Year 2017 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 7 Issue 5 Pages e015312  
  Keywords back pain; epidemiology; musculoskeletal disorders; spine  
  Abstract OBJECTIVES: This study aimed to investigate the prospective influence of multisite pain, depression, anxiety, self-rated health and pain-related disability on recovery from chronic low back pain (LBP). SETTING: The data is derived from the second (1995-1997) and third (2006-2008) wave of the Nord-Trondelag Health Study (HUNT) in Norway. PARTICIPANTS: The study population comprises 4484 women and 3039 men in the Norwegian HUNT Study who reported chronic LBP at baseline in 1995-1997. PRIMARY OUTCOME MEASURES: The primary outcome was recovery from chronic LBP at the 11-year follow-up. Persons not reporting pain and/or stiffness for at least three consecutive months during the last year were defined as recovered. A Poisson regression model was used to estimate adjusted risk ratios (RRs) with 95% CIs. RESULTS: At follow-up, 1822 (40.6%) women and 1578 (51.9%) men reported recovery from chronic LBP. The probability of recovery was inversely associated with number of pain sites (P-trend<0.001). Compared with reporting 2-3 pain sites, persons with only LBP had a slightly higher probability of recovery (RR 1.10, 95% CI 0.98 to 1.22 in women and RR 1.10, 95% CI 1.01 to 1.21 in men), whereas people reporting 6-9 pain sites had substantially lower probability of recovery (RR 0.58, 95% CI 0.52 to 0.63 in women and RR 0.70, 95% CI 0.63 to 0.79 in men). Poor/not so good self-rated general health, symptoms of anxiety and depression, and pain-related disability in work and leisure were all associated with reduced probability of recovery, but there was no statistical interaction between multisite pain and these comorbidities. CONCLUSIONS: Increasing number of pain sites was inversely associated with recovery from chronic LBP. In addition, factors such as poor self-rated health, psychological symptoms and pain-related disability may further reduce the probability of recovery from chronic LBP.  
  Address Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway  
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  Series Volume Series Issue Edition  
  ISSN 2044-6055 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28592580; PMCID:PMC5734202 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1967  
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Author Naicker, K.; Johnson, J.A.; Skogen, J.C.; Manuel, D.; Overland, S.; Sivertsen, B.; Colman, I. url  doi
  Title Type 2 Diabetes and Comorbid Symptoms of Depression and Anxiety: Longitudinal Associations With Mortality Risk Type Journal Article
  Year 2017 Publication Diabetes Care Abbreviated Journal Diabetes Care  
  Volume 40 Issue 3 Pages 352-358  
  Keywords Adult; Aged; Aged, 80 and over; Anxiety/*complications; Comorbidity; Depression/*complications; Diabetes Mellitus, Type 2/*complications; Female; Follow-Up Studies; Humans; Male; Middle Aged; Norway/epidemiology; Proportional Hazards Models; Risk Factors; Socioeconomic Factors; Surveys and Questionnaires; Young Adult  
  Abstract OBJECTIVE: Depression is strongly linked to increased mortality in individuals with type 2 diabetes. Despite high rates of co-occurring anxiety and depression, the risk of death associated with comorbid anxiety in individuals with type 2 diabetes is poorly understood. This study documented the excess mortality risk associated with symptoms of depression and/or anxiety comorbid with type 2 diabetes. RESEARCH DESIGN AND METHODS: Using data for 64,177 Norwegian adults from the second wave of the Nord-Trondelag Health Study (HUNT2), with linkage to the Norwegian Causes of Death Registry, we assessed all-cause mortality from survey participation in 1995 through to 2013. We used Cox proportional hazards models to examine mortality risk over 18 years associated with type 2 diabetes status and the presence of comorbid affective symptoms at baseline. RESULTS: Three clear patterns emerged from our findings. First, mortality risk in individuals with diabetes increased in the presence of depression or anxiety, or both. Second, mortality risk was lowest for symptoms of anxiety, higher for comorbid depression-anxiety, and highest for depression. Lastly, excess mortality risk associated with depression and anxiety was observed in men with diabetes but not in women. The highest risk of death was observed in men with diabetes and symptoms of depression only (hazard ratio 3.47, 95% CI 1.96, 6.14). CONCLUSIONS: This study provides evidence that symptoms of anxiety affect mortality risk in individuals with type 2 diabetes independently of symptoms of depression, in addition to attenuating the relationship between depressive symptoms and mortality in these individuals.  
  Address School of Public Health and Preventive Medicine, University of Ottawa, Ontario, Canada icolman@uottawa.ca  
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  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0149-5992 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28077458 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1961  
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Author Naicker, K.; Overland, S.; Johnson, J.A.; Manuel, D.; Skogen, J.C.; Sivertsen, B.; Colman, I. url  doi
  Title Symptoms of anxiety and depression in type 2 diabetes: Associations with clinical diabetes measures and self-management outcomes in the Norwegian HUNT study Type Journal Article
  Year 2017 Publication Psychoneuroendocrinology Abbreviated Journal Psychoneuroendocrinology  
  Volume 84 Issue Pages 116-123  
  Keywords Anxiety; Depression; Diabetes self-management; Metabolic control; Type 2 diabetes  
  Abstract OBJECTIVE: To determine if symptoms of depression and anxiety are differentially associated with clinical diabetes measures and self-management behaviours in individuals with Type 2 diabetes, and whether these associations vary by patient sex. RESEARCH DESIGN AND METHODS: A cross-sectional analysis using data from 2035 adults with Type 2 diabetes in the Nord-Trondelag Health Study. Multivariate logistic regression was used to explore associations between symptoms of depression and anxiety and waist girth, HDL cholesterol, systolic blood pressure, triglycerides, c-reactive protein, glycemic control, diet adherence, exercise, glucose monitoring, foot checks for ulcers, and the subjective patient experience. Analyses were stratified by sex. RESULTS: Depression was associated with a lower likelihood of avoiding saturated fats (OR=0.20 [95% CI: 0.06, 0.68]) and increased odds of physical inactivity (OR=1.69 [95% CI: 1.37, 2.72]). Anxiety was associated with increased odds of eating vegetables (OR=1.66 [95% CI: 1.02, 2.73]), and an over two-fold increase of feeling that having diabetes is difficult. In women, anxiety was associated with elevated c-reactive protein levels (OR=1.57 [95% CI: 1.05, 2.34]). In men, depressive symptoms were associated with elevated HbA1c (OR=5.00 [95% CI: 1.15, 8.23). CONCLUSIONS: Symptoms of depression and anxiety were differentially associated with some key diabetes-related measures. Our results suggest sex-specific differences with respect to two important clinical outcomes (i.e., anxiety and CRP in women and depression and glycemic control in men). These findings should alert practitioners to the importance of detection and management of psychological symptoms in individuals with Type 2 diabetes.  
  Address School of Public Health and Preventive Medicine, University of Ottawa, Ontario Canada. Electronic address: icolman@uottawa.ca  
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  Series Volume Series Issue Edition  
  ISSN 0306-4530 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28704763 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1962  
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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 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  
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  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 Nes, B.M.; Gutvik, C.R.; Lavie, C.J.; Nauman, J.; Wisloff, U. url  doi
  Title Personalized Activity Intelligence (PAI) for Prevention of Cardiovascular Disease and Promotion of Physical Activity Type Journal Article
  Year 2017 Publication The American Journal of Medicine Abbreviated Journal Am J Med  
  Volume 130 Issue 3 Pages 328-336  
  Keywords Adult; Age Factors; Aged; Algorithms; Cardiovascular Diseases/mortality/*prevention & control; *Exercise; Female; Health Promotion/*methods; Humans; Male; Middle Aged; Proportional Hazards Models; Risk Assessment/*methods; Risk Factors; Sex Factors; Young Adult; Activity tracking; Cardiovascular disease mortality; Physical activity; Prevention  
  Abstract PURPOSE: To derive and validate a single metric of activity tracking that associates with lower risk of cardiovascular disease mortality. METHODS: We derived an algorithm, Personalized Activity Intelligence (PAI), using the HUNT Fitness Study (n = 4631), and validated it in the general HUNT population (n = 39,298) aged 20-74 years. The PAI was divided into three sex-specific groups (</=50, 51-99, and >/=100), and the inactive group (0 PAI) was used as the referent. Hazard ratios for all-cause and cardiovascular disease mortality were estimated using Cox proportional hazard regressions. RESULTS: After >1 million person-years of observations during a mean follow-up time of 26.2 (SD 5.9) years, there were 10,062 deaths, including 3867 deaths (2207 men and 1660 women) from cardiovascular disease. Men and women with a PAI level >/=100 had 17% (95% confidence interval [CI], 7%-27%) and 23% (95% CI, 4%-38%) reduced risk of cardiovascular disease mortality, respectively, compared with the inactive groups. Obtaining >/=100 PAI was associated with significantly lower risk for cardiovascular disease mortality in all prespecified age groups, and in participants with known cardiovascular disease risk factors (all P-trends <.01). Participants who did not obtain >/=100 PAI had increased risk of dying regardless of meeting the physical activity recommendations. CONCLUSION: PAI may have a huge potential to motivate people to become and stay physically active, as it is an easily understandable and scientifically proven metric that could inform potential users of how much physical activity is needed to reduce the risk of premature cardiovascular disease death.  
  Address K.G. Jebsen Center of Exercise in Medicine at the Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Faculty of Medicine, Trondheim, Norway; School of Human Movement & Nutrition Sciences, University of Queensland, St. Lucia, QLD, Australia  
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  Language English Summary Language Original Title