ORCID Profile
0000-0003-4479-5127
Current Organisations
Heriot-Watt University School of Engineering and Physical Sciences
,
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: 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: 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: 29-11-2020
DOI: 10.1002/ACN3.51258
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: 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: IOP Publishing
Date: 09-08-2016
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: 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: 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: 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: 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: SPIE
Date: 03-2016
DOI: 10.1117/12.2218883
Publisher: Springer Science and Business Media LLC
Date: 03-06-2020
Publisher: Springer Science and Business Media LLC
Date: 16-11-2021
Publisher: Springer Science and Business Media LLC
Date: 14-11-2021
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: 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.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Marcello Ferrera.