Assoziationen eines Kardioprotektiven Ernährungsindex mit der Inzidenz des akuten Myokardinfarktes und kardiovaskulären Risikofaktoren bei Männern im mittleren Alter:Ergebnisse der MONICA-KORA-Augsburg-Studien

Ich untersuchte mit den Daten von 1329 deutschen Männern im mittleren Alter, ob die Adhärenz an ein kardiopräventives Ernährungsmuster das Herzinfarktrisiko und die Verteilungen kardiovaskulärer Risikofaktoren günstig beeinflusst. Dafür entwickelte ich einen Ernährungsindex, der Herz-Kreislauf-relevante Nahrungsfaktoren erfasst. Im Längsschnitt wies ich für den Vergleich der extremen Indexkategorien ein adjustiertes Herzinfarktrisiko von 0,60 (95%-Konfidenzintervall: 0,26–1,40) nach. Unter den Männern ohne hohes prävalentes Koronarrisiko betrug dieses Maß 0,35 (0,10–1,17). Im Querschnitt fand ich in einer Subgruppe in der obersten Indexkategorie niedrigere Blutdruck- und Serumcholesterolmittelwerte. Die Daten weisen darauf hin, dass ein höherer Verzehr von pflanzlichen Lebensmitteln und Fisch sowie von Linolsäure im Austausch gegen gesättigte Fettsäuren das Herzinfarktrisiko in der Bevölkerung deutlich senken könnte, möglicherweise zum Teil vermittelt über eine Senkung von Blutdruck und Serumcholesterol

Associations between anxiety, body mass index, and sex hormones in women

Background: Several studies have shown a positive association between anxiety and obesity, particularly in women. We aimed to study whether sex hormone alterations related to obesity might play a role in this association. Patients and methods: Data for this study were obtained from a population-based cohort study (the LIFE-Adult-Study). A total of 3,124 adult women (970 premenopausal and 2,154 postmenopausal) were included into the analyses. The anxiety symptomatology was assessed using the GAD-7 questionnaire (cut-off ≥ 10 points). Sex hormones were measured from fasting serum samples. Results: We did not find significant differences in anxiety prevalence in premenopausal obese women compared with normal-weight controls (4.8% vs. 5.5%). Both obesity and anxiety symptomatology were separately associated with the same sex hormone alteration in premenopausal women: higher total testosterone level (0.97 ± 0.50 in obese vs. 0.86 ± 0.49 nmol/L in normal-weight women, p = 0.026 and 1.04 ± 0.59 in women with vs. 0.88 ± 0.49 nmol/L in women without anxiety symptomatology, p = 0.023). However, women with anxiety symptomatology had non-significantly higher estradiol levels than women without anxiety symptomatology (548.0 ± 507.6 vs. 426.2 ± 474.0 pmol/L), whereas obesity was associated with lower estradiol levels compared with those in normal-weight group (332.7 ± 386.5 vs. 470.8 ± 616.0 pmol/L). Women with anxiety symptomatology had also significantly higher testosterone and estradiol composition (p = 0.006). No associations of sex hormone levels and BMI with anxiety symptomatology in postmenopausal women were found. Conclusions: Although both obesity and anxiety symptomatology were separately associated with higher testosterone level, there was an opposite impact of anxiety and obesity on estradiol levels in premenopausal women. We did not find an evidence that the sex hormone alterations related to obesity are playing a significant role in anxiety symptomatology in premenopausal women. This could be the explanation why we did not find an association between obesity and anxiety. In postmenopausal women, other mechanisms seem to work than in the premenopausal group

Social factors and the prevalence of social isolation in a population-based adult cohort

Purpose: Social isolation has negative effects on physical and brain health across the lifespan. However, the prevalence of social isolation, specifically with regard to sociodemographic and socioeconomic factors, is not well known. Methods: Database was the Leipzig population-based study of adults (LIFE-Adult Study, n = 10,000). The short form of the Lubben Social Network Scale (LSNS-6) was used to assess social isolation (cutoff < 12 points). Sampling weights were applied to account for differences in sampling fractions. Results: Data were available for 9392 study participants; 51.6% were women, the mean age was 45.2 years (SD = 17.3). The prevalence of social isolation was 12.3% (95% CI 11.6-13.0) across ages 18-79 years. Social isolation was more prevalent in men (13.8%, 95% CI 12.8-14.8) compared to women (10.9%, 95% CI 10.0-11.8; [Formula: see text] (1) = 18.83, p < .001), and it showed an increase with increasing age from 5.4% (95% CI 4.7-6.0) in the youngest age group (18-39 years) to 21.7% (95% CI 19.5-24.0) in the oldest age group (70-79 years; [Formula: see text] (4) = 389.51, p < .001). Prevalence differed largely with regard to socioeconomic status (SES); showing lower prevalence in high SES (7.2%, 95% CI 6.0-8.4) and higher prevalence in low SES (18.6%, 95% CI 16.9-20.3; [Formula: see text] (2) = 115.78; p < .001). Conclusion: More than one in ten individuals in the adult population reported social isolation, and prevalence varied strongly with regard to sociodemographic and socioeconomic factors. Social isolation was particularly frequent in disadvantaged socioeconomic groups. From a public health perspective, effective prevention of and intervention against social isolation should be a desired target as social isolation leads to poor health. Countermeasures should especially take into account the socioeconomic determinants of social isolation, applying a life-course perspective

Testosterone imbalance may link depression and increased body weight in premenopausal women

Accumulating evidence supports a link between depression and being overweight in women. Given previously reported sex differences in fat accumulation and depression prevalence, as well as the likely role of sex hormones in both overweight and mood disorders, we hypothesised that the depression-overweight association may be mediated by sex hormones. To this end, we investigated the association of being overweight with depression, and then considered the role of sex hormones in relation to being overweight and depression in a large population-based cohort. We included a total of 3124 women, 970 premenopausal and 2154 postmenopausal from the LIFE-Adult cohort study in our analyses. We evaluated associations between being overweight (BMI >25 kg/m2), sex hormone levels, and depressive symptomatology according to Centre for Epidemiologic Studies Depression (CES-D) scores, and explored mediation of depression in a mediation model. Being overweight was significantly associated with depressive symptoms in premenopausal but not postmenopausal women. Both premenopausal and postmenopausal overweight women had higher free testosterone levels compared with normal weight women. Premenopausal women with depressive symptomatology had higher free testosterone levels compared to women without. We found a significant mediation effect of depressive symptomatology in overweight premenopausal women through free testosterone level. These findings highlight the association between being overweight and depressed, and suggest that high free testosterone levels may play a significant role in depression of overweight premenopausal women. Based on this, pharmacological approaches targeting androgen levels in overweight depressed females, in particular when standard anti-depressive treatments fail, could be of specific clinical relevance

Less animal-based food, better weight status: Associations of the restriction of animal-based product intake with body-mass-index, depressive symptoms and personality in the general population

Restricting animal-based products from diet may exert beneficial effects on weight status; however, less is known about such a diet and emotional health. Moreover, personality traits, for example high neuroticism, may contribute to restrictive eating habits and potentially confound diet-health associations. We aim to systematically assess if restrictive dietary intake of animal-based products relates to lower weight and higher depressive symptoms, and if differences in personality traits play a significant role. Cross-sectional data from the baseline LIFE-Adult study were collected from 2011–2014 in Leipzig, Germany (n = 8943). Main outcomes of interest were dietary frequency of animal-derived products in the last year measured using a Food Frequency Questionnaire (FFQ), body-mass-index (BMI) (kg/m2), and the Center of Epidemiological Studies Depression Scale (CES-D). Personality traits were assessed in a subsample of n = 7906 using the Five Factor Inventory (NEO-FFI). Higher restriction of animal-based product intake was associated with a lower BMI, but not with depression scores. Personality, i.e., lower extraversion, was related to higher frequency of animal product intake. Moreover, personality traits were significantly associated with depressive symptoms, i.e., higher neuroticism, lower extraversion, lower agreeableness, lower conscientiousness, and with higher BMI. These findings encourage future longitudinal studies to test the efficacy of restricting animal-based products as a preventive and therapeutic strategy for overweight and obesity

Alcohol consumption is positively associated with fasting serum ghrelin in non-dependent adults: Results from the population-based LIFE-Adult-Study

Background: Animal experiments and studies in alcohol dependent patients indicate that ghrelin signaling in the brain is causally involved in the regulation of alcohol reward and intake. Increasing ghrelin levels enhances alcohol craving and intake, blocking ghrelin receptors abolishes these effects. If ghrelin is also involved in non-dependent alcohol consumption in humans, though, remains unknown. The aim was therefore to investigate the relationship between ghrelin serum levels and alcohol consumption in a large population-based sample. Methods: Total ghrelin was determined after an overnight fast in 1666 subjects participating in a population-based cross-sectional study (‘LIFE’) including 10,000 adults. 1521 subjects were included in this analysis. Alcohol consumption was assessed using a food frequency questionnaire (FFQ). Multiple linear regression analyses and extreme group comparisons testing for statistical differences of alcohol consumption between the highest and lowest quartile according to ghrelin levels were performed. Results: Alcohol consumption was positively associated with serum ghrelin; total sample: β = 0.003, p = 0.002; men: β = 0.005, p = 0.023; women: β = 0.002, p = 0.007, adjusted for age, BMI and smoking status. Mean alcohol consumption in men/women belonging to the highest quartile of serum ghrelin levels (men: 21.5 (21.1) g/day; women: 7.5 (11.4) g/day) was considerably higher than in those belonging to the lowest quartile (men: 16.5 (19.3) g/day p < 0.002; women: 4.59 (10.7) g/day p = 0.0001). Conclusion: This is the first study showing that alcohol consumption is positively associated with serum ghrelin in a population-based sample. The study provides an initial indication that ghrelin is also involved in the regulation of alcohol consumption in non-dependent subjects

Bewertung einer Leitlinie zur Datenqualität durch Vertreter epidemiologischer Kohortenstudien in Deutschland

High data quality is a precondition for valid scientific conclusions. Indicators should therefore routinely be used to evaluate data quality within the life cycle of health studies. In this project, 15 representatives of seven German population-based cohort studies assessed 51 quality indicators that were proposed in a guideline for networked medical research. The applicability of the indicators to primary data collections was assessed. In addition, their importance was evaluated using a scale ranging from 1 (essential) to 4 (not important). Moreover, their implementation in data quality assessments in the participating studies was evaluated. Comments on potential improvements could be made. Forty-three indicators were rated as applicable. Of these, 29 received a mean importance score of 2 (important) or better, nine received a mean importance score of 1.5 or better. The latter represent a potential core set of data quality indicators for cohort studies. Most indicators that were rated as highly important were used in data quality assessments of the participating studies. Points of criticism regarding the guideline related to its structure and the understandability of some indicators. It was concluded that further improvement of the data quality indicator set will increase its usefulness and applicability in primary data collections. In practice, a small subset of data quality indicators may suffice to capture the most important aspects of data quality in cohort studies.Eine hohe Datenqualität ist wesentlich für valide wissenschaftliche Schlussfolgerungen. Indikatoren sollten daher routinemäßig angewendet werden, um die Datenqualität innerhalb des Lebenszyklus von Gesundheitsstudien zu beurteilen. In dem hier beschriebenen Projekt haben 15 Vertreter von sieben bevölkerungsbezogenen Kohortenstudien in Deutschland 51 Qualitätsindikatoren bewertet, die im Rahmen einer deutschen Leitlinie für die vernetzte medizinische Forschung vorgeschlagen wurden. Die Evaluation betraf die Anwendbarkeit der Indikatoren für primäre Datenerhebungen, deren Wichtigkeit auf einer Skala von 1 (essentiell) bis 4 (nicht wichtig) sowie deren Implementation in den teilnehmenden Kohorten. Verbesserungsvorschläge konnten gemacht werden. 43 Indikatoren wurden als anwendbar angesehen. Davon erhielten 29 eine durchschnittliche Wichtigkeit von mindestens 2 (wichtig), neun eine durchschnittliche Wichtigkeit von mindestens 1,5. Die als am wichtigsten bewerteten Indikatoren geben Hinweise auf einen für Kohortenstudien relevanten Kernsatz von Indikatoren zur Erfassung der Datenqualität. Die Mehrzahl der hoch bewerteten Indikatoren wurde in den teilnehmenden Kohorten im Rahmen der Datenqualitätssicherung betrachtet. Als Schwächen der Leitlinie wurden die Verständlichkeit einzelner Indikatoren sowie die Struktur der Leitlinie identifiziert. Das Konzept von Indikatoren zur Datenqualität sollte weiter verbessert werden, um den Nutzwert und die Anwendbarkeit im Rahmen primärer Datenerhebungen zu erhöhen. In der praktischen Anwendung reicht eine Teilmenge der Indikatoren aus, um wesentliche Aspekte der Datenqualität in Kohortenstudien zu beschreiben