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Alsnes, I. V., Vatten, L. J., Fraser, A., Bjorngaard, J. H., Rich-Edwards, J., Romundstad, P. R., et al. (2017). Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood: Prospective and Sibling Studies in the HUNT Study (Nord-Trondelag Health Study) in Norway (Vol. 69).
Abstract: Women with hypertensive disorders in pregnancy are at increased lifetime risk for cardiovascular disease. We examined the offspring's cardiovascular risk profile in young adulthood and their siblings' cardiovascular risk profile. From the HUNT study (Nord-Trondelag Health Study) in Norway, 15 778 participants (mean age: 29 years), including 210 sibling groups, were linked to information from the Medical Birth Registry of Norway. Blood pressure, anthropometry, serum lipids, and C-reactive protein were assessed. Seven hundred and six participants were born after exposure to maternal hypertension in pregnancy: 336 mothers had gestational hypertension, 343 had term preeclampsia, and 27 had preterm preeclampsia. Offspring whose mothers had hypertension in pregnancy had 2.7 (95% confidence interval, 1.8-3.5) mm Hg higher systolic blood pressure, 1.5 (0.9-2.1) mm Hg higher diastolic blood pressure, 0.66 (0.31-1.01) kg/m2 higher body mass index, and 1.49 (0.65-2.33) cm wider waist circumference, compared with offspring of normotensive pregnancies. Similar differences were observed for gestational hypertension and term preeclampsia. Term preeclampsia was also associated with higher concentrations of non-high-density lipoprotein cholesterol (0.14 mmol/L, 0.03-0.25) and triglycerides (0.13 mmol/L, 0.06-0.21). Siblings born after a normotensive pregnancy had nearly identical risk factor levels as siblings born after maternal hypertension. Offspring born after maternal hypertension in pregnancy have a more adverse cardiovascular risk profile in young adulthood than offspring of normotensive pregnancies. Their siblings, born after a normotensive pregnancy, have a similar risk profile, suggesting that shared genes or lifestyle may account for the association, rather than an intrauterine effect. All children of mothers who have experienced hypertension in pregnancy may be at increased lifetime risk of cardiovascular disease.
Keywords: Adult; Blood Pressure/*physiology; Cardiovascular Diseases/*epidemiology/etiology/physiopathology; Female; Follow-Up Studies; Humans; Hypertension, Pregnancy-Induced/*epidemiology/physiopathology; Incidence; Infant, Newborn; Norway/epidemiology; Pregnancy; *Pregnancy Complications, Cardiovascular; Prospective Studies; *Registries; Risk Factors; Siblings; adolescent; blood pressure; cardiovascular disease; mother; preeclampsia
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Iversen, J. M., Hoftun, G. B., Romundstad, P. R., & Rygg, M. (2015). Adolescent chronic pain and association to perinatal factors: linkage of Birth Registry data with the Young-HUNT Study. European journal of pain, 19(4), 567–575.
Abstract: BACKGROUND: The aim of this study was to examine the associations of birthweight, gestation and 5-min Apgar score with self-reported chronic nonspecific pain in a large, unselected adolescent population. METHODS: The third population-based Nord-Trondelag Health Study (HUNT) included 8200 adolescents aged 13-19 years, constituting 78.2% of adolescents in Nord-Trondelag County. In the target age group, 13-18 years, data on pain frequency from 10 localizations were available from 7373 adolescents. Chronic nonspecific pain was defined as pain at least once a week during the last 3 months, not related to any known disease or injury. Chronic multisite pain was defined as chronic pain in at least three localizations, and chronic daily pain was defined as chronic pain almost every day. Perinatal data were retrieved from the Medical Birth Registry of Norway, and data were available for 7120 of the 7373 adolescents. Covariates included adolescent and maternal general health measures from the HUNT study. RESULTS: We found no consistent association between preterm birth and chronic pain and no clear association between birthweight and chronic pain complaints in adolescence. Post-term birth in boys and a low 5-min Apgar score in both sexes tended to increase the reporting of chronic pain in adolescence. CONCLUSIONS: Perinatal factors, and especially preterm birth and low birthweight, did not seem to have a major impact on pain complaints in adolescence.
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Markaki, M., Tsamardinos, I., Langhammer, A., Lagani, V., Hveem, K., & Roe, O. D. (2018). A Validated Clinical Risk Prediction Model for Lung Cancer in Smokers of All Ages and Exposure Types: A HUNT Study. EBioMedicine, 31, 36–46.
Abstract: Lung cancer causes >1.6 million deaths annually, with early diagnosis being paramount to effective treatment. Here we present a validated risk assessment model for lung cancer screening. The prospective HUNT2 population study in Norway examined 65,237 people aged >20years in 1995-97. After a median of 15.2years, 583 lung cancer cases had been diagnosed; 552 (94.7%) ever-smokers and 31 (5.3%) never-smokers. We performed multivariable analyses of 36 candidate risk predictors, using multiple imputation of missing data and backwards feature selection with Cox regression. The resulting model was validated in an independent Norwegian prospective dataset of 45,341 ever-smokers, in which 675 lung cancers had been diagnosed after a median follow-up of 11.6years. Our final HUNT Lung Cancer Model included age, pack-years, smoking intensity, years since smoking cessation, body mass index, daily cough, and hours of daily indoors exposure to smoke. External validation showed a 0.879 concordance index (95% CI [0.866-0.891]) with an area under the curve of 0.87 (95% CI [0.85-0.89]) within 6years. Only 22% of ever-smokers would need screening to identify 81.85% of all lung cancers within 6years. Our model of seven variables is simple, accurate, and useful for screening selection.
Keywords: Adult; Aged; Aged, 80 and over; Databases, Factual; Female; Follow-Up Studies; Humans; Lung Neoplasms/*epidemiology; Male; Middle Aged; *Models, Biological; Norway; Predictive Value of Tests; Prospective Studies; *Registries; Risk Factors; *Smoking/adverse effects/epidemiology; All ages; All smokers; Data-driven; Early diagnosis; Ever-smokers; External validation; Feature selection; Lung cancer prediction
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Skogen, J. C., Bergh, S., Stewart, R., Knudsen, A. K., & Bjerkeset, O. (2015). Midlife mental distress and risk for dementia up to 27 years later: the Nord-Trondelag Health Study (HUNT) in linkage with a dementia registry in Norway. BMC geriatrics, 15, 23.
Abstract: BACKGROUND: Dementia is an increasing public health challenge, and the number of individuals affected is growing rapidly. Mental disorders and symptoms of mental distress have been reported to be risk factors for dementia. The aim of this study was to examine whether midlife mental distress is a predictor for onset of dementia later in life. METHODS: Using data from a large population-based study (The Nord-Trondelag Health Study; HUNT1) linked to a dementia registry (The Health and Memory study; HMS) enabling a maximum 27 years of follow-up, we ascertained mental distress and subsequent dementia status for 30,902 individuals aged 30-60 years at baseline. In HUNT1, self-reported mental distress was assessed using the four-item Anxiety and Depression Index (ADI-4). Dementia status was ascertained from HMS, which included patient and caregiver history, cognitive testing and clinical and physical examinations from the hospitals and nursing homes serving the catchment area of HUNT1. In the main analysis, unadjusted and adjusted logistic regression models were computed for the prospective association between mental distress and dementia. In secondary analyses, two-way age and gender interactions with mental distress on later dementia were examined. RESULTS: A 50% increased odds for dementia among HUNT1-participants reporting mental distress was found (crude odds ratio (OR): 1.52; 95% CI 1.15-2.01), and a 35% increase in the fully adjusted model (OR 1.35; 95% CI 1.01-1.80). In secondary analyses, we found evidence for a two-way interaction with age on the association between mental distress and dementia (p = 0.030): the age- and gender adjusted OR was 2.44 (95% CI 1.18-5.05) in those aged 30-44 years at baseline, and 1.24 (0.91-1.69) in 45-60 year olds. CONCLUSIONS: Our results indicate an association between midlife mental distress and increased risk of later dementia, an association that was stronger for distress measured in early compared to later midlife. Mental distress should be investigated further as a potentially modifiable risk factor for dementia.
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