The accumulation of deficits approach to describe frailty

The advancing age of the participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study was the incentive to investigate frailty as a major parameter of ageing. The aim of this study was to develop a multidimensional tool to measure frailty in an ageing, free-living study population. The "accumulation of deficits approach" was used to develop a frailty index (FI) to characterize a sub-sample (N = 815) of the EPIC-Potsdam (EPIC-P) study population regarding the aging phenomenon. The EPIC-P frailty index (EPIC-P-FI) included 32 variables from the following domains: health, physical ability, psychosocial and physiological aspects. P-values were calculated for the linear trend between sociodemographic and life style variables and the EPIC-P-FI was calculated using regression analysis adjusted for age. The relationship between the EPIC-P-FI and age was investigated using fractional polynomials. Some characteristics such as age, education, time spent watching TV, cycling and a biomarker of inflammation (C-reactive protein) were associated with frailty in men and women. Interestingly, living alone, having no partner and smoking status were only associated with frailty in men, and alcohol use and physical fitness (VO2max) only in women. The generated, multidimensional FI, adapted to the EPIC-P study, showed that this cohort is a valuable source for further exploration of factors that promote healthy ageing

No association of alcohol use and the risk of ulcerative colitis or Crohn’s disease: data from a European Prospective cohort study (EPIC)

Background The role of long -term alcohol consumption for the risk of developing ulcerative colitis (UC) and Crohn’s disease (CD) is unclear. Aim s For the first time, t o prospectively assess the role of pre -disease alcohol consumption o n the risk of developing UC or CD. Methods Nested within the European Prospective Investigation into Cancer and Nutrition (EPIC - IBD ), incident UC and CD cases and ma tched controls where included. At recruitment, participants completed validated food frequency and lifestyle questionnaires. Alcohol consumption was classified as either: non -use, former, light ( ≤ 0.5 and 1 drink/week), below the recommended limits (BRL) ( ≤ 1 and 2 drinks/day), moderate ( ≤ 2.5 and 5 drinks/day) , or heavy use (>2.5 and >5 drinks/ day) for women and men, respectively ; and was expressed as consumption at enrolment and during lifetime. Conditional logistic regression was applied adjusting for smoking and education , taking light users as the 3 Abstract Background The role of long -term alcohol consumption for the risk of developing ulcerative colitis (UC) and Crohn’s disease (CD) is unclear. Aim s For the first time, t o prospectively assess the role of pre -disease alcohol consumption o n the risk of developing UC or CD. Methods Nested within the European Prospective Investigation into Cancer and Nutrition (EPIC - IBD ), incident UC and CD cases and ma tched controls where included. At recruitment, participants completed validated food frequency and lifestyle questionnaires. Alcohol consumption was classified as either: non -use, former, light ( ≤ 0.5 and 1 drink/week), below the recommended limits (BRL) ( ≤ 1 and 2 drinks/day), moderate ( ≤ 2.5 and 5 drinks/day) , or heavy use (>2.5 and >5 drinks/ day) for women and men, respectively ; and was expressed as consumption at enrolment and during lifetime. Conditional logistic regression was applied adjusting for smoking and education , taking light users as the reference. Results Out of 262,451 participants in 6 countries, 198 UC incident cases/792 controls and 84 CD cases/336 controls were included. At enrolment, 8%/27%/3 2%/2 3%/1 1% UC cases and 7%/2 9%/4 0%/19%/ 5% C D cases were: non -users, light, BRL, moderate and heavy users, respectively. The corresponding figures for lifetime non -use, former, light, BRL, moderate and heavy use were : 3%/5%/2 3%/44%/19%/6% and 5%/2%/25%/44%/23 %/1% for UC and CD cases , respectively. There were no associations between any categories of alcohol consumption and risk of UC or CD in the una djusted and adjusted odds ratios . Conclusion There was no evidence of association s between alcohol use and the odds of developing either UC or CD

Metabolite ratios as potential biomarkers for type 2 diabetes:a DIRECT study

Aims/hypothesis Circulating metabolites have been shown to reflect metabolic changes during the development of type 2 diabetes. In this study we examined the association of metabolite levels and pairwise metabolite ratios with insulin responses after glucose, glucagon-like peptide-1 (GLP-1) and arginine stimulation. We then investigated if the identified metabolite ratios were associated with measures of OGTT-derived beta cell function and with prevalent and incident type 2 diabetes. Methods We measured the levels of 188 metabolites in plasma samples from 130 healthy members of twin families (from the Netherlands Twin Register) at five time points during a modified 3 h hyperglycaemic clamp with glucose, GLP-1 and arginine stimulation. We validated our results in cohorts with OGTT data (n = 340) and epidemiological case–control studies of prevalent (n = 4925) and incident (n = 4277) diabetes. The data were analysed using regression models with adjustment for potential confounders. Results There were dynamic changes in metabolite levels in response to the different secretagogues. Furthermore, several fasting pairwise metabolite ratios were associated with one or multiple clamp-derived measures of insulin secretion (all p Conclusion/interpretation In this study we have shown that the Val_PC ae C32:2 metabolite ratio is associated with an increased risk of type 2 diabetes and measures of insulin secretion and resistance. The observed effects were stronger than that of the individual metabolites and independent of known risk factors.</p

Umwelt-Survey - 1990/92. Bd. 7 Quecksilber-Zusammenhanganalyse

A representative sample of adults (aged 25 to 69) as well as a sample of children (aged 6 to 14) from the general population were studied with respect to mercury levels in their blood and urine. The present report sets out the results of multivariate analyses used to find the main factors (predictors) influencing mercury levels in the blood and urine (criteria) and to quantify their impact. The regression models for mercury levels in urine were nearly the same for subjects from West- and East Germany, which allowed a joint regression model to be formed from the German population. With lower levels of creatinine lower levels of mercury in the urine occur. The number of teeth with amalgam fillings is a significant predictor for adults also the age of the most recent amalgam filling. Mercury levels in urine decrease with increasing age. body mass index, education and gender make up further significant predictors in the case of adults. Mercury levels in the urine of children from East Germany and urban residential areas are higher. No satisfactory model was obtained from the regression analyses for mercury levels in blood. for adults from West and East Germany as well as for children from West Germany, frequency of fish consumption is a significant predictor. Other specific predictors comprise the community size category and family income in the case of adults from West Germany, outdoor physical activity, gender and type of housing in the case of children from West Germany, and the presence of individually operated heating units in the case of children from East Germany. (orig.)Es wurde eine repraesentative Stichprobe von Erwachsenen (25 bis 69 Jahre) sowie eine Stichprobe von Kindern (6 bis 14 Jahre) hinsichtlich ihrer Quecksilbergehalte im Blut und im Urin untersucht. Es werden die Ergebnisse multivariater Zusammenhangsanalysen dargestellt, mit denen die massgeblichen Praediktoren fuer die Quecksilbergehalte in Blut und Urin in ihrer Bedeutung erfasst und in ihrer Wirkung quantifiziert werden. Die Regressionsmodelle fuer die Probanden aus den alten und den neuen Laendern sind annaehernd gleich, so dass ein gemeinsames Regressionsmodell fuer den Quecksilbergehalt im Urin der deutschen Bevoelkerung gebildet werden konnte. Je geringer der Creatiningehalt im Urin ist, desto geringer ist auch der Quecksilbergehalt im Urin. Die Anzahl der Zaehne mit Amalgamfuellungen ist ein starker Praediktor, bei Erwachsenen zusaetzlich das Alter der letzten Amalgamfuellung. Mit zunehmendem Lebensalter liegt ein geringerer Quecksilbergehalt im Urin vor. Der Body Mass Index, der Schulabschluss und das Geschlecht sind weitere Praediktoren. Bei den Kindern treten in den neuen Bundeslaendern und in staedtischen Wohngebieten hoehere Quecksilbergehalte im Urin auf. Die Regressionsanalysen fuer den Quecksilbergehalt im Blut fuehrten zu keinem befriedigenden Modell. Die Haeufigkeit des Fischverzehrs ist bei den Erwachsenen der alten und der neuen Laender sowie bei den Kindern der alten Laender ein bedeutsamer Praediktor. Weitere spezifische Praediktoren sind Gemeindegroessenklasse und Haushaltseinkommen bei Erwachsenen der alten Laender, koerperliche Anstrengung im Freien, Geschlecht und Bebauungsart bei Kindern aus den alten Laendern sowie das Vorhandensein einzeln zu bedienender Oefen bei Kindern aus den neuen Laendern. (orig.)Available from TIB Hannover: RO 2237(1996,7) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEBundesministerium fuer Umwelt, Naturschutz und Reaktorsicherheit, Bonn (Germany)DEGerman

Erratum : No association of alcohol use and the risk of ulcerative colitis or Crohn's disease: Data from a European Prospective cohort study (EPIC) (European Journal of Clinical Nutrition (2017) 71 (512-518) DOI: 10.1038/ejcn.2016.271)

Since the publication of this article, the authors have noticed an error in author affiliation 1. The correct affiliation is: Department of Epidemiology, German Institute of Human Nutrition, Potsdam, Germany. The PDF and html versions have been amended. The authors apologise for any inconvenience caused

Metabolite ratios as potential biomarkers for type 2 diabetes: a DIRECT study.

Aims/hypothesis Circulating metabolites have been shown to reflect metabolic changes during the development of type 2 diabetes. In this study we examined the association of metabolite levels and pairwise metabolite ratios with insulin responses after glucose, glucagon-like peptide-1 (GLP-1) and arginine stimulation. We then investigated if the identified metabolite ratios were associated with measures of OGTT-derived beta cell function and with prevalent and incident type 2 diabetes. Methods We measured the levels of 188 metabolites in plasma samples from 130 healthy members of twin families (from the Netherlands Twin Register) at five time points during a modified 3 h hyperglycaemic clamp with glucose, GLP-1 and arginine stimulation. We validated our results in cohorts with OGTT data (n = 340) and epidemiological case–control studies of prevalent (n = 4925) and incident (n = 4277) diabetes. The data were analysed using regression models with adjustment for potential confounders. Results There were dynamic changes in metabolite levels in response to the different secretagogues. Furthermore, several fasting pairwise metabolite ratios were associated with one or multiple clamp-derived measures of insulin secretion (all p &lt; 9.2 × 10−7). These associations were significantly stronger compared with the individual metabolite components. One of the ratios, valine to phosphatidylcholine acyl-alkyl C32:2 (PC ae C32:2), in addition showed a directionally consistent positive association with OGTT-derived measures of insulin secretion and resistance (p ≤ 5.4 × 10−3) and prevalent type 2 diabetes (ORVal_PC ae C32:2 2.64 [β 0.97 ± 0.09], p = 1.0 × 10−27). Furthermore, Val_PC ae C32:2 predicted incident diabetes independent of established risk factors in two epidemiological cohort studies (HRVal_PC ae C32:2 1.57 [β 0.45 ± 0.06]; p = 1.3 × 10−15), leading to modest improvements in the receiver operating characteristics when added to a model containing a set of established risk factors in both cohorts (increases from 0.780 to 0.801 and from 0.862 to 0.865 respectively, when added to the model containing traditional risk factors + glucose). Conclusion/interpretation In this study we have shown that the Val_PC ae C32:2 metabolite ratio is associated with an increased risk of type 2 diabetes and measures of insulin secretion and resistance. The observed effects were stronger than that of the individual metabolites and independent of known risk factors.</p