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Kaluza, J., Harris, H., Melhus, H., Michaëlsson, K. & Wolk, A. (2018). Questionnaire-Based Anti-Inflammatory Diet Index as a Predictor of Low-Grade Systemic Inflammation.. Antioxidants and Redox Signaling, 28(1), 78-84.
Open this publication in new window or tab >>Questionnaire-Based Anti-Inflammatory Diet Index as a Predictor of Low-Grade Systemic Inflammation.
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2018 (English)In: Antioxidants and Redox Signaling, ISSN 1523-0864, E-ISSN 1557-7716, Vol. 28, no 1, p. 78-84Article in journal (Refereed) Published
Abstract [en]

There is accumulating evidence that diet may be associated with markers of inflammation. We have evaluated if an empirically developed questionnaire-based Anti-Inflammatory Diet Index (AIDI) may predict low-grade systemic chronic inflammation in a Nordic population. The AIDI was developed using a 123-item food frequency questionnaire among 3503 women (56-74 years old) with high-sensitivity C-reactive protein (hsCRP) plasma concentration <20 mg/L. Using Spearman correlations, we identified 20 foods (AIDI-20) statistically significantly related to hsCRP. The median (range) of AIDI-20 was 8 (0-17) scores, and the median concentration of hsCRP in the lowest versus the highest quintile of AIDI-20 (≤6 vs. ≥11 scores) varied by 80% (1.8 vs. 1.0 mg/L, respectively). In a multivariable-adjusted linear regression model, women in the highest quintile of AIDI-20 compared with those in the lowest had a 26% (95% confidence interval [CI] 18-33%; p-trend <0.001) lower hsCRP concentration; each 1-score increment in the AIDI-20 was associated with a 0.06 (95% CI 0.04-0.08) mg/L lower hsCRP. The observed association between the AIDI-20 and hsCRP was robust by all hsCRP levels and in subgroups defined by inflammatory-related factors. Our results lead to the hypothesis that the empirically developed questionnaire-based dietary anti-inflammatory index may predict low-grade systemic inflammation. Antioxid. Redox Signal. 28, 78-84.

Keyword
C-reactive protein, anti-inflammatory index, diet, food, inflammation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-337200 (URN)10.1089/ars.2017.7330 (DOI)000415967200006 ()28877589 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00778Swedish Research Council, 2015-05997Swedish Research Council Formas, FR 2016/0004
Available from: 2017-12-21 Created: 2017-12-21 Last updated: 2018-01-17Bibliographically approved
Michaëlsson, K., Lohmander, L. S., Turkiewicz, A., Wolk, A., Nilsson, P. & Englund, M. (2017). Association between statin use and consultation or surgery for osteoarthritis of the hip or knee: a pooled analysis of four cohort studies.. Osteoarthritis and Cartilage, 25(11), 1804-1813, Article ID S1063-4584(17)31102-0.
Open this publication in new window or tab >>Association between statin use and consultation or surgery for osteoarthritis of the hip or knee: a pooled analysis of four cohort studies.
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2017 (English)In: Osteoarthritis and Cartilage, ISSN 1063-4584, E-ISSN 1522-9653, Vol. 25, no 11, p. 1804-1813, article id S1063-4584(17)31102-0Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Experimental findings and previous observational data have suggested lower risk of osteoarthritis (OA) with statin use but results are inconsistent. Large-scale studies with a clinically important outcome are needed. Thus, we aimed to determine whether statin use is associated with a reduced risk of developing clinically-defined hip or knee OA.

DESIGN: Pooled analysis based on time-to-event analysis of four population-based large cohorts, encompassing in total 132,607 persons aged 57-91 years resident in southern and central Sweden. We studied the association between statin use and time to consultation or surgery for OA of the hip or knee by time-dependent exposure analysis and Cox regression.

RESULTS: During 7.5 years of follow-up, we identified 7468 out- or inpatient treated cases of hip or knee OA. Compared with never use, current use of statins conferred no overall reduction in the risk of OA with an adjusted pooled hazard ratio (HR) of 1.04 (95% confidence intervals [95% CI] 0.99-1.10). We found no dose-response relation between duration of current statin use and the risk of OA, with similar HRs among patients with less than 1 year of use (HR 1.09; 95% CI 0.92-1.32) as in patients with use for 3 years or more (HR 1.05; 0.93-1.16). Results were comparable in those with low, medium and high dose of current statin use, without indications of heterogeneity of study results.

CONCLUSION: Statin use is not associated with reduced risk of consultation or surgery for OA of the hip or knee.

Keyword
Cohort, Meta-analysis, Osteoarthritis, Pooled analysis, Statin
National Category
Orthopaedics
Identifiers
urn:nbn:se:uu:diva-334461 (URN)10.1016/j.joca.2017.07.013 (DOI)000413267300009 ()28756279 (PubMedID)
Funder
Swedish Research Council
Available from: 2017-11-23 Created: 2017-11-23 Last updated: 2018-02-21Bibliographically approved
Larsson, S. C., Burgess, S. & Michaëlsson, K. (2017). Association of Genetic Variants Related to Serum Calcium Levels With Coronary Artery Disease and Myocardial Infarction. Journal of the American Medical Association (JAMA), 318(4), 371-380.
Open this publication in new window or tab >>Association of Genetic Variants Related to Serum Calcium Levels With Coronary Artery Disease and Myocardial Infarction
2017 (English)In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 318, no 4, p. 371-380Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE Serum calcium has been associated with cardiovascular disease in observational studies and evidence from randomized clinical trials indicates that calcium supplementation, which raises serum calcium levels, may increase the risk of cardiovascular events, particularly myocardial infarction.

OBJECTIVE To evaluate the potential causal association between genetic variants related to elevated serum calcium levels and risk of coronary artery disease (CAD) and myocardial infarction using mendelian randomization.

DESIGN, SETTING, AND PARTICIPANTS The analyses were performed using summary statistics obtained for single-nucleotide polymorphisms (SNPs) identified from a genome-wide association meta-analysis of serum calcium levels (N = up to 61 079 individuals) and from the Coronary Artery Disease Genome-wide Replication and Meta-analysis Plus the Coronary Artery Disease Genetics (CardiogramplusC4D) consortium's 1000 genomes-based genome-wide association meta-analysis (N = up to 184 305 individuals) that included cases (individuals with CAD andmyocardial infarction) and noncases, with baseline data collected from 1948 and populations derived from across the globe. The association of each SNP with CAD andmyocardial infarction was weighted by its association with serum calcium, and estimates were combined using an inverse-variance weighted meta-analysis.

EXPOSURES Genetic risk score based on genetic variants related to elevated serum calcium levels.

MAIN OUTCOMES AND MEASURES Co-primary outcomes were the odds of CAD and myocardial infarction.

RESULTS Among the mendelian randomized analytic sample of 184 305 individuals (60 801 CAD cases [approximately 70% with myocardial infarction] and 123 504 noncases), the 6 SNPs related to serum calcium levels and without pleiotropic associations with potential confounders were estimated to explain about 0.8% of the variation in serum calcium levels. In the inverse-variance weighted meta-analysis (combining the estimates of the 6 SNPs), the odds ratios per 0.5-mg/dL increase (about 1 SD) in genetically predicted serum calcium levels were 1.25 (95% CI, 1.08-1.45; P = .003) for CAD and 1.24 (95% CI, 1.05-1.46; P = .009) for myocardial infarction.

CONCLUSIONS AND RELEVANCE A genetic predisposition to higher serum calcium levels was associated with increased risk of CAD andmyocardial infarction. Whether the risk of CAD associated with lifelong genetic exposure to increased serum calcium levels can be translated to a risk associated with short-term to medium-term calcium supplementation is unknown.

Place, publisher, year, edition, pages
AMER MEDICAL ASSOC, 2017
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-332841 (URN)10.1001/jama.2017.8981 (DOI)000406296700017 ()28742912 (PubMedID)
Available from: 2017-11-09 Created: 2017-11-09 Last updated: 2017-11-09Bibliographically approved
Rosqvist, F., Bjermo, H., Kullberg, J., Johansson, L., Michaëlsson, K., Ahlström, H., . . . Risérus, U. (2017). Fatty acid composition in serum cholesterol esters and phospholipids is linked to visceral and subcutaneous adipose tissue content in elderly individuals: a cross-sectional study. Lipids in Health and Disease, 16, 1-10, Article ID 68.
Open this publication in new window or tab >>Fatty acid composition in serum cholesterol esters and phospholipids is linked to visceral and subcutaneous adipose tissue content in elderly individuals: a cross-sectional study
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2017 (English)In: Lipids in Health and Disease, ISSN 1476-511X, E-ISSN 1476-511X, Vol. 16, p. 1-10, article id 68Article in journal (Refereed) Published
Abstract [en]

Background: Visceral adipose tissue (VAT) and truncal fat predict cardiometabolic disease. Intervention trials suggest that saturated fatty acids (SFA), e. g. palmitic acid, promote abdominal and liver fat storage whereas polyunsaturated fatty acids (PUFA), e. g. linoleic acid, prevent fat accumulation. Such findings require investigation in population-based studies of older individuals. We aimed to investigate the relationships of serum biomarkers of PUFA intake as well as serum levels of palmitic acid, with abdominal and total adipose tissue content.

Methods: In a population-based sample of 287 elderly subjects in the PIVUS cohort, we assessed fatty acid composition in serum cholesterol esters (CE) and phospholipids (PL) by gas chromatography and the amount of VAT and abdominal subcutaneous (SAT) adipose tissue by magnetic resonance imaging (MRI), liver fat by MR spectroscopy (MRS), and total body fat, trunk fat and leg fat by dual-energy X-ray absorptiometry (DXA). Insulin resistance was estimated by HOMA-IR.

Results: VAT and trunk fat showed the strongest correlation with insulin resistance (r = 0.49, P < 0.001). Linoleic acid in both CE and PL was inversely related to all body fat depots (r = -0.24 to -0.33, P < 0.001) including liver fat measured in a sub-group (r = -0.26, P < 0.05, n = 73), whereas n-3 PUFA showed weak inverse (18: 3n-3) or positive (20: 5n-3) associations. Palmitic acid in CE, but not in PL, was directly correlated with VAT (r = 0.19, P < 0.001) and trunk fat (r = 0.18, P = 0.003). Overall, the significant associations remained after adjusting for energy intake, height, alcohol, sex, smoking, education and physical activity. The inverse correlation between linoleic acid and VAT remained significant after further adjustment for total body fat.

Conclusions: Serum linoleic acid is inversely related to body fat storage including VAT and trunk fat whereas palmitic acid was less consistently but directly associated, in line with recent feeding studies. Considering the close link between VAT and insulin resistance, a potential preventive role of plant-based PUFA in VAT accumulation warrants further study.

Keyword
Adipose tissue distribution, Body fat, Fatty acid, Linoleic acid, Palmitic acid, Polyunsaturated fat, Saturated fat, Visceral adipose tissue
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-319605 (URN)10.1186/s12944-017-0445-2 (DOI)000398222200001 ()28372558 (PubMedID)
Funder
Swedish Research Council, K2015-54X-22081-04-3EXODIAB - Excellence of Diabetes Research in SwedenSwedish Diabetes Association
Available from: 2017-04-06 Created: 2017-04-06 Last updated: 2017-11-29Bibliographically approved
Stilling, F., Wallenius, S., Michaëlsson, K., Dalgård, C., Brismar, K. & Wolk, A. (2017). High insulin-like growth factor-binding protein-1 (IGFBP-1) is associated with low relative muscle mass in older women. Metabolism: Clinical and Experimental, 73, 36-42.
Open this publication in new window or tab >>High insulin-like growth factor-binding protein-1 (IGFBP-1) is associated with low relative muscle mass in older women
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2017 (English)In: Metabolism: Clinical and Experimental, ISSN 0026-0495, E-ISSN 1532-8600, Vol. 73, p. 36-42Article in journal (Refereed) Published
Abstract [en]

Objective: Skeletal muscles serve several important roles in maintaining good health. Insulin like growth factor-1 (IGF-1) is a promoter of protein synthesis in skeletal muscle. Its binding protein, Insulin-like growth factor-binding protein-1 (IGFBP-1) can be one determinant of IGF-1 activity. In the present study we investigate the association between serum IGFBP-1 and muscle mass.

Design: Cross-sectional analysis of 4908 women, between 55 and 85 years old, participating in the Swedish Mammography Cohort-Clinical.

Methods: We defined low relative muscle mass (LRMM) as an appendicular lean mass divided by height squared of less than 5.45 (kg/m(2)), assessed by dual energy x-ray absorptiometry. IGFBP-1 was measured by radioimmunoassay. Logistic regression was used to calculate odds-ratios of LRMM across quartiles of IGFBP-1.

Results: The odds of LRMM increased across quartiles of IGFBP-1. In the age-adjusted model the odds-ratio (OR) of LRMM was 3.41 (95% CI: 2.55-4.56), comparing the highest to the lowest quartile. This estimate was attenuated in multivariate models (OR: 1.84, 95% CI: 1.34-2.53), mainly due to inclusion of fat mass index.

Conclusion: Women with higher IGFBP-1 were more likely to have a low relative muscle mass. High IGFBP-1 may be a marker of a catabolic state.

Place, publisher, year, edition, pages
W B SAUNDERS CO-ELSEVIER INC, 2017
Keyword
Insulin-like growth factor binding, protein 1, Body composition, Muscle, skeletal, Aged
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-333700 (URN)10.1016/j.metabol.2017.04.013 (DOI)000406984200004 ()28732569 (PubMedID)
Funder
Swedish Research CouncilForte, Swedish Research Council for Health, Working Life and WelfareEU, Horizon 2020, 633589
Available from: 2017-11-21 Created: 2017-11-21 Last updated: 2017-12-21Bibliographically approved
Zillikens, M. C., Demissie, S., Hsu, Y.-H., Yerges-Armstrong, L. M., Chou, W.-C., Stolk, L., . . . Kiel, D. P. (2017). Large meta-analysis of genome-wide association studies identifies five loci for lean body mass. Nature Communications, 8, Article ID 80.
Open this publication in new window or tab >>Large meta-analysis of genome-wide association studies identifies five loci for lean body mass
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2017 (English)In: Nature Communications, ISSN 2041-1723, E-ISSN 2041-1723, Vol. 8, article id 80Article in journal (Refereed) Published
Abstract [en]

Lean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray absorptiometry or bioelectrical impedance analysis, adjusted for sex, age, height, and fat mass. Twenty-one single-nucleotide polymorphisms were significantly associated with lean body mass either genome wide (p < 5 x 10(-8)) or suggestively genome wide (p < 2.3 x 10(-6)). Replication in 63,475 (47,227 of European ancestry) individuals from 33 cohorts for whole body lean body mass and in 45,090 (42,360 of European ancestry) subjects from 25 cohorts for appendicular lean body mass was successful for five single-nucleotide polymorphisms in/ near HSD17B11, VCAN, ADAMTSL3, IRS1, and FTO for total lean body mass and for three single-nucleotide polymorphisms in/ near VCAN, ADAMTSL3, and IRS1 for appendicular lean body mass. Our findings provide new insight into the genetics of lean body mass.

Place, publisher, year, edition, pages
NATURE PUBLISHING GROUP, 2017
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-332854 (URN)10.1038/s41467-017-00031-7 (DOI)000405818900003 ()28724990 (PubMedID)
Funder
Swedish Research CouncilSwedish Foundation for Strategic Research Torsten Söderbergs stiftelseRagnar Söderbergs stiftelse
Available from: 2017-11-08 Created: 2017-11-08 Last updated: 2018-02-22Bibliographically approved
Warensjö Lemming, E., Byberg, L., Melhus, H., Wolk, A. & Michaëlsson, K. (2017). Long-term a posteriori dietary patterns and risk of hip fractures in a cohort of women. European Journal of Epidemiology, 32(7), 605-616.
Open this publication in new window or tab >>Long-term a posteriori dietary patterns and risk of hip fractures in a cohort of women
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2017 (English)In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 32, no 7, p. 605-616Article in journal (Refereed) Published
Abstract [en]

Dietary pattern analysis is a useful tool to study the importance of food components in the context of a diet and how they relate to health and disease. The association between dietary patterns and fractures is at present uncertain. We aimed to study associations between dietary patterns and risk of hip fracture in the Swedish Mammography Cohort, including 56,736 women (median baseline age 52 years). Diet data was collected in food frequency questionnaires at two investigations and dietary patterns were defined by principal component analysis using 31 food groups. Information on hip fractures was collected from the Swedish National Patient Register. Multivariable adjusted hazard ratios (HR) with 95% confidence intervals (CI) were estimated in Cox proportional hazards regression analysis. The two patterns identified-the healthy and Western/convenience dietary patterns-were time-updated and analysed. During a median follow-up time of 25.5 years, 4997 women experienced a hip fracture. Hip fracture rate was 31% lower in the highest compared to the lowest quartile of the healthy dietary pattern [HR (95% CI) 0.69 (0.64; 0.75)]. In contrast, women in the highest compared to the lowest quartile of the Western/convenience dietary pattern had a 50% higher [HR (95% CI) 1.50 (1.38; 1.62)] hip fracture rate. Further, in each stratum of a Western/convenience dietary pattern a higher adherence to a healthy dietary pattern was associated with less hip fractures. The present results suggest that a varied healthy diet may be beneficial for the prevention of fragility fractures in women.

Keyword
Dietary pattern, Healthy dietary pattern, Western dietary pattern, Principal component analysis, Hip fractures, Food frequency questionnaire
National Category
Orthopaedics Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-334099 (URN)10.1007/s10654-017-0267-6 (DOI)000408307500008 ()
Available from: 2017-11-21 Created: 2017-11-21 Last updated: 2018-02-22Bibliographically approved
Manousaki, D., Dudding, T., Haworth, S., Hsu, Y.-H., Liu, C.-T., Medina-Gomez, C., . . . Richards, J. B. (2017). Low-Frequency Synonymous Coding Variation in CYP2R1 Has Large Effects on Vitamin D Levels and Risk of Multiple Sclerosis. American Journal of Human Genetics, 101(2), 227-238.
Open this publication in new window or tab >>Low-Frequency Synonymous Coding Variation in CYP2R1 Has Large Effects on Vitamin D Levels and Risk of Multiple Sclerosis
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2017 (English)In: American Journal of Human Genetics, ISSN 0002-9297, E-ISSN 1537-6605, Vol. 101, no 2, p. 227-238Article in journal (Refereed) Published
Abstract [en]

Vitamin D insufficiency is common, correctable, and influenced by genetic factors, and it has been associated with risk of several diseases. We sought to identify low-frequency genetic variants that strongly increase the risk of vitamin D insufficiency and tested their effect on risk of multiple sclerosis, a disease influenced by low vitamin D concentrations. We used whole-genome sequencing data from 2,619 individuals through the UK10K program and deep-imputation data from 39,655 individuals genotyped genome-wide. Meta-analysis of the summary statistics from 19 cohorts identified in CYP2R1 the low-frequency (minor allele frequency = 2.5%) synonymous coding variant g.14900931G>A (p.Asp120Asp) (rs117913124[A]), which conferred a large effect on 25-hydroxyvitamin D (25OHD) levels (-0.43 SD of standardized natural log-transformed 25OHD per A allele; p value = 1.5 x 10(-88)). The effect on 25OHD was four times larger and independent of the effect of a previously described common variant near CYP2R1. By analyzing 8,711 individuals, we showed that heterozygote carriers of this low-frequency variant have an increased risk of vitamin D insufficiency (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 1.78-2.78, p = 1.26 3 10 x(-12)). Individuals carrying one copy of this variant also had increased odds of multiple sclerosis (OR = 1.4, 95% CI = 1.19-1.64, p = 2.63 3 10 x(-5)) in a sample of 5,927 case and 5,599 control subjects. In conclusion, we describe a low-frequency CYP2R1 coding variant that exerts the largest effect upon 25OHD levels identified to date in the general European population and implicates vitamin D in the etiology of multiple sclerosis.

Place, publisher, year, edition, pages
CELL PRESS, 2017
National Category
Genetics
Identifiers
urn:nbn:se:uu:diva-334046 (URN)10.1016/j.ajhg.2017.06.014 (DOI)000406854800007 ()28757204 (PubMedID)
Available from: 2017-11-21 Created: 2017-11-21 Last updated: 2017-11-21Bibliographically approved
Michaëlsson, K., Wolk, A., Melhus, H. & Byberg, L. (2017). Milk, Fruit and Vegetable, and Total Antioxidant Intakes in Relation to Mortality Rates: Cohort Studies in Women and Men. American Journal of Epidemiology, 185(5), 345-361.
Open this publication in new window or tab >>Milk, Fruit and Vegetable, and Total Antioxidant Intakes in Relation to Mortality Rates: Cohort Studies in Women and Men
2017 (English)In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 185, no 5, p. 345-361Article in journal (Refereed) Published
Abstract [en]

High milk consumption might shorten life span through increased oxidative stress. We aimed to determine whether higher mortality rates with high milk consumption are modified by fruit and vegetable intake or total antioxidant intake (oxygen radical absorbance capacity). We used information from food frequency questionnaires completed by 61,420 women in a Swedish cohort (22,391 deaths from the 1987-1990 baseline onward), 36,714 women from a second survey (1997) of this cohort, and 45,280 Swedish men (15,478 deaths from the 1998 baseline onward). Compared with low consumption of milk (< 1 glass/day) and high consumption of fruits/vegetables (>= 5 servings/day), time-updated information revealed an adjusted hazard ratio for death of 2.79 (95% confidence interval (CI): 2.42, 3.21) in women who consumed >= 3 glasses of milk/day and < 1 serving/day of fruit/vegetables and a hazard ratio of 1.60 (95% CI: 1.40, 1.82) in women who consumed the same amount of milk but >= 5 servings/day of fruits/vegetables. The same comparisons in men, based on a single food frequency questionnaire, displayed hazard ratios of 1.31 (95% CI: 1.14, 1.51) and 1.07 (95% CI: 0.97, 1.18), respectively. Total antioxidant consumption showed similar patterns as fruit/vegetable intakes. Dietary antioxidant intake, especially in women, seems to modify the elevated death rate associated with high milk consumption.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS INC, 2017
Keyword
antioxidants, fruit, galactose, lactose, milk, mortality, oxidative stress, vegetables
National Category
Orthopaedics
Identifiers
urn:nbn:se:uu:diva-320263 (URN)10.1093/aje/kww124 (DOI)000397245800005 ()28184428 (PubMedID)
Funder
Swedish Research Council
Available from: 2017-04-18 Created: 2017-04-18 Last updated: 2018-02-22Bibliographically approved
Leavy, B., Michaëlsson, K., Åberg, A. C., Melhus, H. & Byberg, L. (2017). The Impact of Disease and Drugs on Hip Fracture Risk. Calcified Tissue International, 00(1), 1-12.
Open this publication in new window or tab >>The Impact of Disease and Drugs on Hip Fracture Risk
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2017 (English)In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 00, no 1, p. 1-12Article in journal (Refereed) Published
Abstract [en]

We report the risks of a comprehensive range of disease and drug categories on hip fracture occurrence using a strict population-based cohort design. Participants included the source population of a Swedish county, aged ≥50 years (n = 117,494) including all incident hip fractures during 1 year (n = 477). The outcome was hospitalization for hip fracture (ICD-10 codes S72.0-S72.2) during 1 year (2009-2010). Exposures included: prevalence of (1) inpatient diseases [International Classification of Diseases (ICD) codes A00-T98 in the National Patient Register 1987-2010] and (2) prescribed drugs dispensed in 2010 or the year prior to fracture. We present age- and sex-standardized risk ratios (RRs), risk differences (RDs) and population attributable risks (PARs) of disease and drug categories in relation to hip fracture risk. All disease categories were associated with increased risk of hip fracture. Largest risk ratios and differences were for mental and behavioral disorders, diseases of the blood and previous fracture (RRs between 2.44 and 3.00; RDs (per 1000 person-years) between 5.0 and 6.9). For specific drugs, strongest associations were seen for antiparkinson (RR 2.32 [95 % CI 1.48-1.65]; RD 5.2 [1.1-9.4]) and antidepressive drugs (RR 1.90 [1.55-2.32]; RD 3.1 [2.0-4.3]). Being prescribed ≥10 drugs during 1 year incurred an increased risk of hip fracture, whereas prescription of cardiovascular drugs or ≤5 drugs did not appear to increase risk. Diseases inferring the greatest PARs included: cardiovascular diseases PAR 22 % (95 % CI 14-29) and previous injuries (PAR 21 % [95 % CI 16-25]; for specific drugs, antidepressants posed the greatest risk (PAR 16 % [95 % CI 12.0-19.3]).

Keyword
Disease, Dispensed drugs, Hip fracture, Population-based cohort, Risk estimates
National Category
Endocrinology and Diabetes Orthopaedics
Identifiers
urn:nbn:se:uu:diva-307793 (URN)10.1007/s00223-016-0194-7 (DOI)000392023000001 ()27671989 (PubMedID)
Available from: 2016-11-21 Created: 2016-11-21 Last updated: 2018-01-13Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-2815-1217

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