ORCID Profile
0000-0003-3753-974X
Current Organisation
Menzies Institute for Medical Research
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Publisher: The Endocrine Society
Date: 09-01-2019
Abstract: To the best of our knowledge, no previous studies have examined the role of youth calcium intake in the development of impaired glucose metabolism, especially those with long-term high calcium intake. To examine whether youth and long-term (between youth and adulthood) dietary calcium intake is associated with adult impaired glucose metabolism and type 2 diabetes (T2D). The Cardiovascular Risk in Young Finns Study is a 31-year prospective cohort study (n = 1134 age, 3 to 18 years at baseline). Dietary calcium intake was assessed at baseline (1980) and adult follow-up visits (2001, 2007, and 2011). Long-term (mean between youth and adulthood) dietary calcium intake was calculated. Adult impaired fasting glucose (IFG) and T2D. We found no evidence for nonlinear associations between calcium intake and IFG or T2D among females and males (all P for nonlinearity > 0.05). Higher youth and long-term dietary calcium intake was not associated with the risk of IFG or T2D among females or males after adjustment for confounders, including youth and adult body mass index. Youth or long-term dietary calcium intake is not associated with adult risk of developing impaired glucose metabolism or T2D.
Publisher: Elsevier BV
Date: 09-2023
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.JOCD.2014.07.008
Abstract: This is 12-yr follow-up of a randomized controlled trial aimed to evaluate the long-term effects of bone density feedback and osteoporosis education on osteoporosis knowledge and self-efficacy. We examined the effects of feedback of bone density-defined fracture risk (high [T-score <0] vs normal [T-score ≥0] risk) and 2 different educational interventions (the group-based Osteoporosis Prevention and Self-Management Course [OPSMC] vs an osteoporosis leaflet) on osteoporosis knowledge and self-efficacy in women aged 25-44. Seventy-four percent (N = 347) of 470 participants at baseline participated at 12 yr. Overall, the scores were higher for osteoporosis knowledge but lower for self-efficacy at 12 yr. However, neither intervention had an effect on the change in knowledge (T-score, β = 0.4, 95% confidence interval [CI] = -0.3 to 1.1 OPSMC, β = 0.2, 95% CI = -0.5 to 0.9) or self-efficacy (T-score, β = -1.1, 95% CI = -2.5 to 0.4 OPSMC, β = -0.2, 95% CI = -1.6 to 1.3). Women in households with an unemployed main financial provider had a decrease in knowledge at 12 yr compared with those in households with an employed main financial provider in whom knowledge increased (β = -1.95, 95% CI = -3.40 to -0.50), but there were no other predictors of change identified for knowledge or self-efficacy. In conclusion, beneficial effects of both OPSMC and feedback of high fracture risk on osteoporosis knowledge seen previously at 2 yr were not sustained after 12 yr although overall knowledge was still significantly higher than at baseline. Neither intervention improved osteoporosis self-efficacy. More frequent osteoporosis education and bone density feedback may be required to maintain knowledge, and other approaches to improve self-efficacy are necessary.
Publisher: Wiley
Date: 08-07-2020
DOI: 10.1002/JBMR.4044
Publisher: Wiley
Date: 23-09-2020
DOI: 10.1002/JBMR.4143
Publisher: Springer Science and Business Media LLC
Date: 12-09-2020
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.AMEPRE.2017.10.018
Abstract: This study aimed to determine if beneficial effects of in idualized feedback of fracture risk on osteoporosis preventive behaviors and bone mineral density observed in a 2-year trial were sustained long-term. This was a 10-year follow-up of a 2-year RCT in 470 premenopausal women aged 25-44 years, who were randomized to one of two educational interventions (the Osteoporosis Prevention and Self-Management Course [OPSMC] or an osteoporosis information leaflet) and received tailored feedback of their relative risk of fracture in later life (high versus normal risk groups). Bone mineral density of lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry. Physical activity, dietary calcium intake, calcium and vitamin D supplements, and smoking status were measured by questionnaires. From 2 to 12 years, the high-risk group had a smaller decrease in femoral neck bone mineral density (β=0.023, 95% CI=0.005, 0.041 g/cm Feedback of high fracture risk to younger women was associated with long-term improvements in osteoporosis preventive behaviors and attenuated femoral neck bone mineral density loss. Therefore, this could be considered as a strategy to prevent osteoporosis. Australian New Zealand Clinical Trials Registry (ANZCTR) NCT00273260.
Publisher: The Endocrine Society
Date: 28-01-2021
Abstract: The influence of dietary pattern trajectories from youth to adulthood on adult glucose metabolism is unknown. To identify dietary pattern trajectories from youth to adulthood and examine their associations with adult impaired fasting glucose (IFG). Thirty-one-year population-based cohort study among 1007 youths aged 3-18 years at baseline in Finland. Diet intake was assessed in 1980, 1986, 2001, 2007, and 2011. Group-based trajectory modelling was used to identify dietary pattern (identified by factor analysis) trajectories. Adult IFG was measured by the latest available data from 2001, 2007, and 2011. Among 1007 participants, 202 (20.1%) developed IFG and 27 (2.7%) developed type 2 diabetes in adulthood (mean follow-up of 30.7 years mean [SD] age 40.5 [5.0] years). Three dietary patterns were identified at baseline and were retained in 1986 and 2001: “Traditional Finnish,” “High carbohydrate,” and “Vegetables and dairy products.” Three different patterns were identified in 2007, which remained similar in 2011: “Traditional Finnish and high carbohydrate,” “Red meat,” and “Healthy.” Trajectories of increased or stably medium “red meat” pattern scores from youth to adulthood were detrimentally associated with IFG (relative risk 1.46, 95% CI 1.12-1.90 for Medium (M)-stable/M-large increase vs low-stable trajectory) after adjusting for confounders. This association was slightly reduced after further adjusting for long-term dietary fiber intake. Trajectories of an increased or stably moderate adherence to a “red meat” dietary pattern from youth to adulthood are associated with higher risk of adult IFG. This association is partly explained by low dietary fiber intake.
Publisher: SAGE Publications
Date: 11-07-2016
Abstract: Infection with the Epstein-Barr virus (EBV) is associated with an increased risk of multiple sclerosis (MS). We sought genetic loci influencing EBV nuclear antigen-1 (EBNA-1) IgG titers and hypothesized that they may play a role in MS risk. We performed a genome-wide association study (GWAS) of anti-EBNA-1 IgG titers in 3599 in iduals from an unselected twin family cohort, followed by a meta-analysis with data from an independent EBNA-1 GWAS. We then examined the shared polygenic risk between the EBNA-1 GWAS (effective s le size ( N eff ) = 5555) and a large MS GWAS ( N eff = 15,231). We identified one locus of strong association within the human leukocyte antigen (HLA) region, of which the most significantly associated genotyped single nucleotide polymorphism (SNP) was rs2516049 ( p = 4.11 × 10 −9 ). A meta-analysis including data from another EBNA-1 GWAS in a cohort of Mexican-American families confirmed that rs2516049 remained the most significantly associated SNP ( p = 3.32 × 10 −20 ). By examining the shared polygenic risk, we show that the genetic risk for elevated anti-EBNA-1 titers is positively correlated with the development of MS, and that elevated EBNA-1 titers are not an epiphenomena secondary to MS. In the joint meta-analysis of EBNA-1 titers and MS, loci at 1p22.1, 3p24.1, 3q13.33, and 10p15.1 reached genome-wide significance ( p 5 × 10 −8 ). Our results suggest that apart from the confirmed HLA region, the association of anti-EBNA-1 IgG titer with MS risk is also mediated through non-HLA genes, and that studies aimed at identifying genetic loci influencing EBNA immune response provides a novel opportunity to identify new and characterize existing genetic risk factors for MS.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 21-07-2020
Abstract: Whether long‐term exposure to overweight or obesity from early life to adulthood has a detrimental influence on health outcomes is unknown. We aimed to investigate whether duration of overweight or obesity from youth to adulthood is associated with adult cardiometabolic risk. A population‐based cohort study was performed of 1268 youths, aged 3 to 18 years, with follow‐ups at 3, 6, 9, 12, 21, 27, and 31 years. Duration of overweight or obesity over 31‐year follow‐up was calculated. Adulthood outcomes included type 2 diabetes mellitus, impaired fasting glucose, high insulin levels, high carotid intima‐media thickness, hypertension, low high‐density lipoprotein cholesterol, high low‐density lipoprotein cholesterol and triglycerides, arterial pulse wave velocity, carotid artery compliance, Young elastic modulus, and stiffness index. Rates of overweight/obesity were 7.9% at baseline and 55.9% after 31 years. After adjustment for confounders, longer duration of overweight or obesity was associated with increased risk of all outcomes (relative risk ranged from 1.45–9.06 for type 2 diabetes mellitus, impaired fasting glucose, carotid intima‐media thickness, hypertension, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, and triglycerides β from 0.370–0.543 m/s for pulse wave velocity –0.193 to –0.237 %/10 mm Hg for carotid artery compliance 52.1–136.8 mm Hg·mm for Young elastic modulus and 0.554–0.882 for stiffness index). When body mass index was further adjusted, these associations disappeared or were substantially reduced. Detrimental associations of adult body mass index with all outcomes were robust to adjustment for confounders and duration of overweight or obesity. Overweight or obesity in adulthood rather than childhood appears to be more important for adult cardiometabolic health.
Publisher: Elsevier BV
Date: 04-2021
DOI: 10.1016/J.JOCA.2020.12.023
Abstract: To examine the cross-sectional and longitudinal associations of dietary patterns with knee symptoms and structures in patients with knee osteoarthritis (OA). Participants with symptomatic knee OA were recruited from a randomised, placebo-controlled trial conducted in Tasmania (N = 259) and Victoria (N = 133). Diet was assessed by the Anti-Cancer Council of Victoria food frequency questionnaire. Factor analysis was used to identify dietary patterns. Knee symptoms were assessed using Western Ontario and McMaster Universities Arthritis Index (WOMAC) and structures using MRI. Multivariable linear regressions were used to examine associations. Three dietary patterns ("high-fat", "healthy" and "mixed") were identified in whole s le. Participants with higher "healthy pattern" score had lower total WOMAC, pain, function and stiffness scores at baseline but the associations were not significant over 24 months. Three ("western", "vegetable and meat" and "mediterranean") and two ("processed" and "vegetable") patterns were identified in Tasmania and Victoria, respectively. Cross-sectionally, only "mediterranean pattern" and "vegetable pattern" scores were significantly and negatively associated with total WOMAC or function scores. Longitudinally, participants with higher "western pattern" had worsening function (β: 0.35, 95%CI: 0.03, 0.67) and total WOMAC (β: 0.40, 95%CI: 0.07, 0.72) scores furthermore, "vegetable pattern" was associated with decreased WOMAC stiffness score (β: -0.47, 95%CI: -0.93, -0.02). In contrast, dietary patterns were largely not associated with structural changes. Some healthy dietary patterns were associated with reduced joint symptoms but dietary patterns were not associated with joint structure in this s le with knee OA. Further studies are required to confirm these findings.
Publisher: Oxford University Press (OUP)
Date: 02-06-2022
Abstract: Most international guidelines recommend that repeat blood pressure (BP) readings are required for BP classification. Two international guidelines erge from this by recommending that no further BP measurements are required if the first clinic BP is below a hypertension threshold. The extent to which within-visit BP variability patterns change over time, and whether this could impact BP classification is unknown. We sought to examine this. Data were from the Cardiovascular Risk in Young Finns Study, a prospective cohort study. Up to 2799 participants were followed from childhood (9–15 years) to adulthood (18–49 years) over up to six visits. Patterns of within-visit systolic BP (SBP) variability were defined as no-change, decrease, increase between consecutive readings (with 5 mmHg change thresholds). Classification of SBP (normal, high-normal, hypertension) using the first reading was compared with repeat readings. On average, SBP decreased with subsequent measures, but with major in idual variability (no-change: 56.9–62.7% decrease: 24.1–31.6% increase: 11.5–16.8%). Patterns of SBP variability were broadly similar from childhood to adulthood, with the highest prevalence of an increase among participants categorized with normal SBP (12.6–20.3%). The highest prevalence of SBP reclassification occurred among participants with hypertension (28.9–45.3% reclassified as normal or high-normal). The prevalence of reclassification increased with the magnitude of change between readings. There is a major in idual variation of within-visit SBP change in childhood and adulthood and can influence BP classification. This highlights the importance of consistency among guidelines recommending that repeat BP measurements are needed for BP classification.
Publisher: The Endocrine Society
Date: 12-2015
DOI: 10.1210/JC.2015-2849
Abstract: There is no consensus on the definition of vitamin D deficiency for bone health based on serum 25-hydroxyvitamin D (25OHD) levels. Our objective was to determine whether thresholds exist for associations between 25OHD levels and bone outcomes and if low 25OHD levels have adverse effects on bone health. This is a cross-sectional study. This study included secondary school students in Beijing, China, aged 12-15 years. We measured serum 25OHD bone mineral density (BMD) of total body, hip, and lumbar spine (LS) serum PTH bone alkaline phosphatase (BAP) and tartrate-resistant acid phosphatase 5b (TRAP5b) in 222 healthy adolescents (111 girls, 111 boys). The prevalence of low 25OHD was 61% (<30 nmol/liter) and 97% (<50 nmol/liter) (mean 25OHD, 30 nmol/liter). Dietary calcium intake was low (294 and 307 mg/d for boys and girls, respectively). In girls, break-points for 25OHD (nmol/liter) were: total body BMD 20 (95% confidence interval [CI], 14-27), hip BMD 25 (17-34), LS BMD 22 (14-30), TRAP5b 37 (22-52), and PTH 31 (23-38). In boys, break-points were: total body BMD 39 (24-55), TRAP5b 33 (20-45), and PTH 35 (27-43) no break-points were identified for hip and LS BMD. No break-points were identified for BAP in either gender. Below these break-points, higher 25OHD is associated with increased total body BMD, reduced PTH, and TRAP5b, whereas above these break-points, no such relationship exists. Vitamin D deficiency and insufficiency is common in healthy Chinese adolescents. Attaining serum 25OHD levels of more than 20-37 nmol/liter in girls and 33-39 nmol/liter in boys had positive influences on BMD and bone remodelling markers. However, estimates may be affected by low calcium intake and low serum 25OHD levels, with 97% of adolescents having levels below 50 nmol/liter.
Publisher: Springer Science and Business Media LLC
Date: 14-11-2021
Publisher: Springer Science and Business Media LLC
Date: 16-11-2021
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.JPEDS.2019.10.062
Abstract: To estimate and compare tri-ponderal mass index (TMI) and body mass index (BMI) at each age from childhood to young adulthood in the prediction of adulthood obesity-related outcomes. Participants of this observational study (n = 432) were from a 20-year infancy-onset randomized atherosclerosis prevention trial. BMI and TMI were calculated using weight and height measured annually from participants between ages 2 and 20 years. Outcomes were aortic intima-media thickness (at the age of 15, 17, or 19 years), impaired fasting glucose and elevated insulin levels, homeostasis model assessment of insulin resistance index, serum lipids, and hypertension at the age of 20 years. Poisson regressions, Pearson correlation, logistic regression, and area under the curve (AUC) were used to estimate and/or compare associations and predictive utilities between BMI and TMI with all outcomes. The associations and predictive utilities of BMI and TMI with all outcomes were stronger at older ages. BMI had significantly stronger correlations than TMI with insulin (at age 16 years), systolic blood pressure (age 5-20 years), and triglycerides (age 18 years). BMI had significantly greater predictive utilities than TMI for insulin resistance (at age 14-16 years difference in AUC = 0.018-0.024), elevated insulin levels (age 14-16 years difference in AUC = 0.018 and 0.025), and hypertension (age 16 to 20 years difference in AUC = 0.017-0.022) but they were similar for other outcomes. TMI is not superior to BMI at any ages from childhood to young adulthood in the prediction of obesity-related outcomes in young adulthood.
Publisher: Springer Science and Business Media LLC
Date: 26-02-2016
DOI: 10.1007/S00198-016-3545-3
Abstract: This was the first study investigating both linear associations between lower limb muscle strength and balance in middle-aged women and the potential for thresholds for the associations. There was strong evidence that even in middle-aged women, poorer LMS was associated with reduced balance. However, no evidence was found for thresholds. Decline in balance begins in middle age, yet, the role of muscle strength in balance is rarely examined in this age group. We aimed to determine the association between lower limb muscle strength (LMS) and balance in middle-aged women and investigate whether cut-points of LMS exist that might identify women at risk of poorer balance. Cross-sectional analysis of 345 women aged 36-57 years was done. Associations between LMS and balance tests (timed up and go (TUG), step test (ST), functional reach test (FRT), and lateral reach test (LRT)) were assessed using linear regression. Nonlinear associations were explored using locally weighted regression smoothing (LOWESS) and potential cut-points identified using nonlinear least-squares estimation. Segmented regression was used to estimate associations above and below the identified cut-points. Weaker LMS was associated with poorer performance on the TUG (β -0.008 (95 % CI: -0.010, -0.005) second/kg), ST (β 0.031 (0.011, 0.051) step/kg), FRT (β 0.071 (0.047, 0.096) cm/kg), and LRT (β 0.028 (0.011, 0.044) cm/kg), independent of confounders. Potential nonlinear associations were evident from LOWESS results significant cut-points of LMS were identified for all balance tests (29-50 kg). However, excepting ST, cut-points did not persist after excluding potentially influential data points. In middle-aged women, poorer LMS is associated with reduced balance. Therefore, improving muscle strength in middle-age may be a useful strategy to improve balance and reduce falls risk in later life. Middle-aged women with low muscle strength may be an effective target group for future randomized controlled trials. Australian New Zealand Clinical Trials Registry (ANZCTR) NCT00273260.
Publisher: Oxford University Press (OUP)
Date: 04-03-2021
Abstract: Physical inactivity is a risk factor for type 2 diabetes (T2D) and dementia. However, it is unknown if physical activity (PA) intensity is associated with brain health in people with T2D. Therefore, this study aimed to determine (i) associations between PA intensity and step count with both cognition and brain structure and (ii) if apolipoprotein E-ε4 or insulin therapy modifies any associations. Participants were people with T2D (n = 220 aged 55–86 years). An accelerometer worn over the right hip was used to obtain step count and moderate-to-vigorous PA (MVPA) averaged over 7 days. Cognition in 7 domains was obtained using a battery of neuropsychological tests. Brain structure was measured by Magnetic Resonance Imaging. Linear regression models were used to examine associations between step count, MVPA and each cognitive and Magnetic Resonance Imaging measure. Apolipoprotein E-ε4 × PA and insulin therapy × PA product terms were added to the models to examine effect modification. The mean age of participants was 67.9 (SD = 6.3). Higher step count was associated with greater hippoc al volume (β = 0.028, 95% CI = 0.005, 0.051). Insulin therapy modified the association between MVPA and attention–processing speed, such that associations were significant in people receiving insulin therapy (p for interaction = .019). There were no other significant associations. Higher step count and greater time spent in MVPA may be associated with better hippoc al volume and attention–processing speed, respectively, in people with T2D. People with greater diabetes severity (receiving insulin therapy) may get more cognitive benefit from MVPA.
Publisher: Oxford University Press (OUP)
Date: 30-04-2021
Abstract: Muscle strength and balance are major modifiable factors of falls in older adults, but their associations with falls in middle-aged adults are underinvestigated. We aimed to examine the association of baseline and change in leg muscle strength (LMS) and balance with the incidence of falls in a cohort of middle-aged women. This was a 5-year follow-up of a population-based s le of 273 women aged 36–57 years at baseline (2011–2012). Data on LMS (by dynamometer) and balance (timed up and go test, step test, functional reach test, and lateral reach test) were obtained at baseline and 5 years later (2017–2018). After 5 years, falls were recorded monthly for 1 year by questionnaire (2017–2019). Negative binomial/Poisson and log-binomial regressions were used as appropriate to assess associations of baseline and change in LMS and balance with any falls, injurious falls, and multiple falls. Over 1 year, 115 participants (42%) reported at least one fall. Neither baseline nor 5-year change in LMS and balance measures was associated with the risk of any falls, injurious falls, or multiple falls 5 years later, with or without adjusting for confounders at baseline (incidence rate ratio/relative risk ranging from 0.85 to 1.19, 0.90 to 1.20, and 0.82 to 1.36, respectively p & .05 for all). Baseline or change in LMS and balance measures are not associated with incident falls among middle-aged women. The contributions of environmental and other intrinsic factors such as chronic conditions and gait/mobility problems need to be investigated.
Publisher: Springer Science and Business Media LLC
Date: 09-09-2017
DOI: 10.1007/S00198-016-3754-9
Abstract: This was the first study examining optimal vitamin D status for musculoskeletal health in middle-aged women. A 25-hydroxyvitamin D level of at least 29 to 33 nmol/L appears required for optimal musculoskeletal health, but the current cut-off of 50 nmol/L may be warranted. This study aimed to determine whether cut-points exist for associations between serum 25-hydroxyvitamin D (25OHD) and musculoskeletal health outcomes in middle-aged women, below which greater 25OHD levels are associated with musculoskeletal health benefits and above which no such associations exist. This is a cross-sectional study of 344 women aged 36-57 years. Cut-points for associations of serum 25OHD with lumbar spine (LS) and femoral neck (FN) bone mineral density (BMD), lower limb muscle strength (LMS), timed up and go test (TUG), functional reach test (FRT), lateral reach test (LRT), and step test (ST) were explored using locally weighted regression smoothing and nonlinear least-squares estimation, and associations above and below the identified cut-points were estimated using segmented regression. The prevalence of low 25OHD was 28 % (<50 nmol/L). Significant cut-points (nmol/L) were identified for FN BMD 31 (95 % confidence interval (CI): 18, 43), LS BMD 31 (17, 45), TUG 30 (24, 36), ST 33 (24, 31), FRT 31 (18, 43), and LMS 29 (8, 49) but not LRT (42 (-8, 93). Below these cut-points, there were beneficial associations between higher 25OHD level and each outcome, while above the cut-points, there were no beneficial associations. In middle-aged women, there are thresholds for associations between serum 25OHD concentrations and bone density and most balance measures, suggesting that 25OHD levels of at least 29 to 33 nmol/L are required for optimal musculoskeletal health in this population. The current cut-off of 50 nmol/L may be higher than needed for some outcomes but appears warranted overall.
Publisher: Oxford University Press (OUP)
Date: 29-03-2021
Abstract: This study aims to describe the relationships between physical activity (PA), body composition, and multimorbidity over 10 years. Participants (N = 373 49% women average age 61.3 ± 6.7 years) were followed for 10 years. Multimorbidity was defined by self-report as the presence of 2 or more of 12 listed chronic conditions. PA (steps per day) at baseline was assessed by pedometer, handgrip strength (HGS) by dynamometer, and appendicular lean mass (ALM) and total body fat mass by dual-energy x-ray absorptiometry. Relative HGS and ALM were calculated by iding each body mass index (BMI). Regression cubic splines were used to assess evidence for a nonlinear relationship. After 10 years, 45% participants had multimorbidity. There was a nonlinear relationship between PA and multimorbidity—PA was associated with lower multimorbidity risk among in iduals who engaged in & 000 steps/d (relative risk [RR] = 0.91, 95% CI: 0.85, 0.97, per 1 000 steps/d), but not among those who participated in ≥10 000 steps/d (RR = 1.04, 95% CI: 0.93, 1.09, per 1 000 steps/d). Higher BMI (RR = 1.05, 95% CI: 1.02, 1.08, per kg/m2) and fat mass (RR = 1.03, 95% CI: 1.01, 1.04, per kg), and lower relative HGS (RR = 0.85, 95% CI: 0.77, 0.94, per 0.1 psi/kg/m2) and ALM (RR = 0.93, 95% CI: 0.88, 0.98, per 0.1 kg/kg/m2) were linearly associated with a higher risk of multimorbidity. Absolute HGS and ALM were not significantly associated with multimorbidity. These findings highlight the potential clinical importance of maintaining adequate levels of PA and of reducing adiposity and maintaining muscle function for minimizing the risk of multimorbidity in older adults.
Publisher: Springer Science and Business Media LLC
Date: 26-01-2018
DOI: 10.1038/S41430-018-0098-X
Abstract: Vitamin D deficiency is common in adolescents but the optimal dosage regimen for correcting deficiency is unknown. To test the safety and efficacy of two different vitamin D dosage regimens to correct vitamin D deficiency in adolescents. In this 12-month, double-blind, randomized placebo-controlled trial, 28 adolescents (serum 25 hydroxyvitamin D (25(OH)D) of 21 to 50 nmol/L) were randomly assigned to one of three groups: monthly (n = 9 vitamin D3 50,000 IU orally monthly plus three placebo tablets 3-monthly), 3-monthly (n = 9 150,000 IU (3 × 50,000 IU tablets) 3-monthly and placebo orally monthly), or placebo (n = 10 placebo monthly and three placebo tablets 3-monthly). Serum 25(OH)D was measured at baseline, 3, 6 and 12 months. Two participants withdrew after their baseline measurement from the 3-monthly group. At 12 months, one participant was deficient (≤50 nmol/L) in both the monthly and 3-monthly groups, whereas six out of ten in the placebo remained deficient (P = 0.055). At 12 months, the average serum 25(OH)D levels for the monthly, 3-monthly and placebo groups were 76.4, 64.7 and 49.7 nmol/L, respectively (P < 0.001 and P = 0.04 for differences between monthly and placebo groups and 3-monthly and placebo groups respectively, after adjustment for age, sex and seasonal variation). Adherence was 100% and adverse events were minor. Both 50,000 IU monthly and 150,000 IU 3-monthly of vitamin D3 safely and effectively corrects vitamin D deficiency in adolescents. These data provide treatment options which can be used by health practitioners to tailor vitamin D dosage regiments according to patient preference and context.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 21-06-2022
Abstract: Blood pressure associates with arterial stiffness, but the contribution of blood pressure at different life stages is unclear. We examined the relative contribution of childhood, young‐ and mid‐adulthood blood pressure to mid‐adulthood large artery stiffness. The s le comprised 1869 participants from the Cardiovascular Risk in Young Finns Study who had blood pressure measured in childhood (6–18 years), young‐adulthood (21–30 years), and mid‐adulthood (33–45 years). Markers of large artery stiffness were pulse wave velocity and carotid distensibility recorded in mid‐adulthood. Bayesian relevant life course exposure models were used. For each 10‐mm Hg higher cumulative systolic blood pressure across the life stages, pulse wave velocity was 0.56 m/s higher (95% credible interval: 0.49 to 0.63) and carotid distensibility was 0.13%/10 mm Hg lower (95% credible interval: −0.16 to −0.10). Of these total contributions, the highest contribution was attributed to mid‐adulthood systolic blood pressure (relative weights: pulse wave velocity, childhood: 2.6%, young‐adulthood: 5.4%, mid‐adulthood: 92.0% carotid distensibility, childhood: 5.6% young‐adulthood: 10.1% mid‐adulthood: 84.3%), with the greatest in idual contribution coming from systolic blood pressure at the time point when pulse wave velocity and carotid distensibility were measured. The results were consistent for diastolic blood pressure, mean arterial pressure, and pulse pressure. Although mid‐adulthood blood pressure contributed most to mid‐adulthood large artery stiffness, we observed small contributions from childhood and young‐adulthood blood pressure. These findings suggest that the burden posed by arterial stiffness might be reduced by maintaining normal blood pressure levels at each life stage, with mid‐adulthood a critical period for controlling blood pressure.
Publisher: Springer Science and Business Media LLC
Date: 07-08-2019
DOI: 10.1038/S41430-018-0264-1
Abstract: We aimed to examine dietary patterns and their longitudinal associations with socio-demographic and lifestyle factors in older adults. A cohort of 1098 participants aged 50-80 years were followed for 5 years. Dietary intake was assessed at baseline, 2.6 and 5 years using a validated food frequency questionnaire. Dietary patterns were identified at baseline using exploratory factor analysis and pattern scores for each calculated using the weighted sum score method. Associations of dietary pattern scores with participants' characteristics were assessed using linear mixed-effects models. The three dietary patterns identified and the food groups of which they were predominantly composed were as follows: a healthy dietary pattern (vegetables, fruits, nuts, and whole grains) a western dietary pattern (pizza, hamburgers, chips, and potatoes) and a meat and vegetable dietary pattern (red meat, fish, poultry, vegetables, potatoes, and legumes). Being a man, unemployed, a current smoker, less educated, and residing in a socially disadvantaged area were associated with lower healthy dietary pattern scores, but these differences lessened over time, except in current smokers (p < 0.03 for interactions with time). Being a man was associated with higher, but being a current smoker with lower western dietary pattern scores (β = 8.0, 95% CI: 5.3,10.7 and - 6.7: - 10.1,- 3.3, respectively). For the meat and vegetable dietary pattern, being a man and a current smoker were associated with lower scores (β = - 24.9, 95% CI: - 44.9,- 4.9 and - 66.8: - 98.3,- 35.3, respectively), while being unemployed was associated with higher scores but this difference lessened over time (p = 0.018 for interaction with time). In older adults, men, smokers, and those experiencing social disadvantage could be target groups for interventions to improve diets.
Publisher: Springer Science and Business Media LLC
Date: 05-12-2020
DOI: 10.1038/S41430-019-0541-7
Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Publisher: BMJ
Date: 2018
DOI: 10.1136/BMJOPEN-2017-019584
Abstract: Our previous study-level (aggregate data) meta-analysis suggested that vitamin D supplements may be beneficial for bone density specifically in children with vitamin D deficiency. However, the misclassification of vitamin D status inherent in study-level data means that the results are not definitive and cannot provide an accurate assessment of the size of any effect. Therefore, we propose to undertake an in idual patient data (IPD) meta-analysis to determine whether the effect of vitamin D supplementation on bone density in children differs according to baseline vitamin D status, and to specifically estimate the effect of vitamin D in children who are vitamin D deficient. This study has been designed to adhere to the Preferred Reporting Items for Systematic Review and Meta-Analyses of IPD statement. We will include randomised placebo-controlled trials of vitamin D supplementation reporting bone density outcomes at least 6 months after the study commenced in children and adolescents (aged years) without coexistent medical conditions or treatments causing osteoporosis. We will update the search of the original review to cover the period 2009–2017, using the same methods as the original review. Fully anonymised data on all randomised patients will be requested. Outcomes will be femoral neck, total hip, lumbar spine and proximal and distal forearm bone mineral density, and total body bone mineral content. A two-stage IPD meta-analysis will be used to examine the effect of baseline serum 25-hydroxyvitamin D (25(OH)D) on treatment effect for each bone density outcome. Restricted maximum likelihood will be used to estimate the random-effects meta-analysis models, with 95% CI for summary effects. Heterogeneity will be assessed by I 2 and potential publication bias (small-study effects) and availability bias by funnel plots, Egger’s test and Peter’s test. Ethics approval will not be required as the data are to be used for the primary purpose for which they were collected and all original in idual studies had ethics approval. Results of the IPD meta-analysis will be submitted for publication in a peer-reviewed journal. CRD42017068772.
Publisher: BMJ
Date: 24-08-2016
Abstract: The genetic drivers of multiple sclerosis (MS) clinical course are essentially unknown with limited data arising from severity and clinical phenotype analyses in genome-wide association studies. Prospective cohort study of 127 first demyelinating events with genotype data, where 116 MS risk-associated single nucleotide polymorphisms (SNPs) were assessed as predictors of conversion to MS, relapse and annualised disability progression (Expanded Disability Status Scale, EDSS) up to 5-year review (ΔEDSS). Survival analysis was used to test for predictors of MS and relapse, and linear regression for disability progression. The top 7 SNPs predicting MS/relapse and disability progression were evaluated as a cumulative genetic risk score (CGRS). We identified 2 non-human leucocyte antigen (HLA rs12599600 and rs1021156) and 1 HLA (rs9266773) SNP predicting both MS and relapse risk. Additionally, 3 non-HLA SNPs predicted only conversion to MS 1 HLA and 2 non-HLA SNPs predicted only relapse and 7 non-HLA SNPs predicted ΔEDSS. The CGRS significantly predicted MS and relapse in a significant, dose-dependent manner: those having ≥5 risk genotypes had a 6-fold greater risk of converting to MS and relapse compared with those with ≤2. The CGRS for ΔEDSS was also significant: those carrying ≥6 risk genotypes progressed at 0.48 EDSS points per year faster compared with those with ≤2, and the CGRS model explained 32% of the variance in disability in this study cohort. These data strongly suggest that MS genetic risk variants significantly influence MS clinical course and that this effect is polygenic.
Publisher: Springer Science and Business Media LLC
Date: 03-06-2020
Publisher: Elsevier BV
Date: 04-2021
Publisher: Informa UK Limited
Date: 07-11-2017
DOI: 10.1080/07853890.2017.1399446
Abstract: To determine whether vitamin D status in childhood and adolescence (herein collectively referred to as youth) and the long-term status from youth to adulthood is associated with risk of developing type 2 diabetes mellitus (T2DM) and impaired fasting glucose (IFG) in adulthood. This was a 31-year follow-up study of 2300 participants aged 3-18 years. Multinomial logistic regression was used to assess the association of both (a) baseline 25-hydroxyvitamin D (25OHD) levels and (b) the mean of baseline and the latest follow-up 25OHD levels (continuous variable and quartiles) with incident T2DM and IFG (cut-off = 5.6 mmol/L) in adult life. High serum 25OHD levels in youth and also mean values from youth to adulthood were associated with reduced risk of developing T2DM in adulthood (odds ratio, 95% confidence interval= 0.73, 0.57-0.95 and 0.65, 0.51-0.84, respectively, for each SD increment in 25OHD). Compared to Q1, a dose-dependent negative association was observed across other quartiles of youth 25OHD, while the strongest association was found in the Q3 for the mean 25OHD levels. Neither youth nor the mean 25OHD was associated with IFG. High serum 25OHD levels in youth, and from child to adult life, were associated with a reduced risk of developing T2DM in adulthood. Key Messages High serum 25OHD levels in youth, and between youth and adulthood, were associated with a lower risk of T2DM in adulthood. Each SD (15.2 nmol/L) increment in youth serum 25OHD levels was associated with a 26% reduction in odds for T2DM, which was independent of a number of confounding variables and other risk factors for T2DM. A similar magnitude of association was observed for the long-term 25OHD levels between youth and adulthood. These findings suggest a potentially simple and cost-effective strategy for reducing adulthood risk of T2DM starting in an earlier stage of life - improving and maintaining vitamin D status throughout youth and early adulthood.
No related grants have been discovered for Feitong Wu.