Prevalence of knee pain and knee OA in southern Sweden and the proportion that seeks medical care.

The aim of this study was to estimate the prevalence of frequent knee pain in radiographic, symptomatic and clinically defined knee OA in middle-aged and elderly patients and the proportion that seeks medical care

The effect of DPP-4 inhibitors on asthma control : an administrative database study to evaluate a potential pathophysiological relationship

Acknowledgments The authors acknowledge Koustubh Ranade (MedImmune, Gaithersburg, MD, USA) and Stephen Johnston, a member of the steering committee who was employed by Truven Health Analytics at the time the study was conducted, for their contributions to this study . Truven Health Analytics, an IBM Company, received funding from AstraZeneca in relation to this study. This work was previously presented as a poster at the annual international conference of the American Thoracic Society, May 19–24, 2017, Washington, DC (Colice G, et al. The Effect of Dipeptidyl-Peptidase-4 Inhibitors on Asthma Control: An Administrative Database Study to Evaluate a Potential Pathophysiological Relationship. Am J Respir Crit Care Med. 2017;195:A3050).Peer reviewedPublisher PD

Heterogeneity within and between physician-diagnosed asthma and/or COPD : NOVELTY cohort

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Prospective observational study in patients with obstructive lung disease : NOVELTY design

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BP Variability and Cardiovascular Autonomic Function in Relation to Forced Expiratory Volume: A Population-Based Study.

Background Cardiovascular autonomic dysfunction is associated with increased incidence of cardiovascular diseases (CVD). This population-based study explored whether low FEV(1) or low vital capacity (VC) is associated with autonomic dysfunction, as measured by the spontaneous heart rate variability (HRV) and systolic BP variability (SBPV). Methods SBPV and HRV were recorded during 5 min of controlled breathing in men and women, aged 70 years. FEV(1) and VC were recorded in 901 subjects. Of them, information on HRV and SBPV was available in 820 and 736 subjects, respectively. Measures of autonomic function, ie, SBPV in the low-frequency (LF) and high-frequency (HF) domains, HRV and baroreceptor sensitivity (BRS), were studied in sex-specific quartiles of FEV1 and VC. Results Low FEV(1) was associated with high SBPV in the HF domain. Mean SBPV-HF was 5.2, 4.5, 4.1 and 3.8 mm Hg, respectively, in subjects with FEV(1) in the first (low), second, third and fourth quartile (trend: p < 0.001). This relationship persisted after adjustments for potential confounding factors. Low VC was significantly associated with high SBPV-HF in the crude analysis, but not after adjustment for confounding factors. Neither FEV(1) nor VC showed any significant relationship with BRS, HRV or SBPV in the LF domain. Conclusion In this population-based study, low FEV(1) was associated with high systolic BP variability in the HF domain. It is suggested that high beat-to-beat variability in BP could contribute to the increased cardiovascular risk in subjects with moderately reduced FEV(1)

No association between inhaled corticosteroids and whole body DXA in postmenopausal women.

Purpose Postmenopausal women treated with corticosteroids are regarded as a high-risk group due to the effect of both natural bone loss and possible adverse effects of treatment with inhaled corticosteroids (IC). Objective To compare bone mineral density (BMD) in postmenopausal women exposed only to IC (IC group, n = 106) with that of BMD in women not exposed to corticosteroids (n = 124) and women exposed to oral and/or intra-articular injections in addition to inhaled corticosteroids (OC group, n = 3 1). The women were recruited from a population-based prospective cohort study. Methods Dual X-ray absorptiometry (DXA) technique was used to measure BMD in whole body, spine, pelvis and lower extremities. A health questionnaire and an interview about past and present medication use were used. Results The mean duration and dose of IC were 9.5 +/- 4.5 years and 615 mu g daily. Whole body BMD did not significantly differ between the IC group (1.103 g/cm(2)) and the unexposed group (1.087 g/cm(2)). Within the IC group, BMD stratified for cumulative dose of IC, duration or current dose above or below 800 jig did not differ. Z-score BMD for tertiles did not differ when comparing the IC and OC groups. Conclusion No difference in BMD was noted between postmenopausal women exposed to inhaled corticosteroids and unexposed controls nor was there any dose response relationship between inhaled corticosteroid therapy and BMD. Copyright (c) 2006 John Wiley & Sons, Ltd

Blood biomarkers and measures of pulmonary function-A study from the Swedish twin registry.

OBJECTIVE: There is great need of biomarkers for research and clinical purposes in COPD. This study explored the relationships between ten putative plasma biomarkers of COPD and physiological measures of reduced lung function. METHODS: FEV(1), FVC, residual volume/total lung capacity (RV/TLC) and CO diffusion capacity (D(L)CO) were assessed in 357 subjects from the Swedish Twin Registry. The lung function measures were studied in relation to plasma levels of desmosines, C-reactive protein (CRP), plasminogen inhibitor activator (PAI-1) concentration and activity, tissue inhibitor of metalloproteinase (TIMP-1), clara cell protein 16 (CC16), surfactant protein D (SPD), matrix metalloproteinase 9 (MMP-9), hepatocyte growth factor (HGF) and interleukin (IL)-8. RESULTS: After adjustments for age, sex, height, BMI and smoking, FEV(1) was significantly associated with PAI-1 activity and desmosines. RV/TLC was significantly associated with CC16, PAI-1 concentration and PAI-1 activity, and D(L)CO was significantly associated with desmosines, TIMP-1 and CRP. When the multivariate analysis was restricted to subjects with COPD (i.e., FEV(1)/FVC < 0.70), CRP and desmosines were inversely associated with lung function. CONCLUSION: Several biomarkers were associated with lung function in this cross-sectional study. Especially CRP and desmosines could be useful markers to assess disease severity in subjects with COPD

Effect of leisure time physical activity on severe knee or hip osteoarthritis leading to total joint replacement: a population-based prospective cohort study

BACKGROUND: Studies on leisure time physical activity as risk factor or protective factor for knee or hip osteoarthritis (OA) show divergent results. Longitudinal prospective studies are needed to clarify the association of physical activity with future OA. The aim was to explore in a prospective population-based cohort study the influence of leisure time physical activity on severe knee or hip OA, defined as knee or hip replacement due to OA. METHODS: Leisure time physical activity was reported by 28320 participants (mean age 58 years (SD 7.6), 60% women) at baseline. An overall leisure time physical activity score, taking both duration and intensity of physical activities into account, was created. The most commonly reported activities were also used for analysis. The incidence of knee or hip replacement due to OA over 11 years was monitored by linkage with the Swedish hospital discharge register. Cox’s proportional hazards model (crude and adjusted for potential confounding factors) was used to assess the incidence of total joint replacement, or osteotomy (knee), in separate analyses of leisure time physical activity. RESULTS: There was no significant overall association between leisure time physical activity and risk for knee or hip replacement due to OA over the 11-year observation time. For women only, the adjusted RR (95% CI) for hip replacement was 0.66 (0.48, 0.89) (fourth vs. first quartile), indicating a lower risk of hip replacement in those with the highest compared with the lowest physical activity. The most commonly reported activities were walking, bicycling, using stairs, and gardening. Walking was associated with a lower risk of hip replacement (adjusted RR 0.76 (95% CI 0.61, 0.94), specifically for women (adjusted RR 0.75 (95% CI 0.57, 0.98)). CONCLUSIONS: In this population-based study of middle-aged men and women, leisure time physical activity showed no consistent overall relationship with incidence of severe knee or hip OA, defined as joint replacement due to OA, over 11 years. For women, higher leisure time physical activity may have a protective role for the incidence of hip replacement. Walking may have a protective role for hip replacement, specifically for women

Association of knee pain and different definitions of knee osteoarthritis with health-related quality of life : A population-based cohort study in southern Sweden

Background: While the impact of knee pain and knee osteoarthritis (OA) on health-related quality of life (HRQoL) has been investigated in the literature, there is a lack of knowledge on the impact of different definitions of OA on HRQoL. The main aim of this study was to measure and compare the impact of knee OA and its different definitions on HRQoL in the general population. Methods: A random sample of 1300 participants from Malmö, Sweden with pain in one or both knees in the past 12 months with duration ≥4 weeks and 650 participants without were invited to clinical and radiographic knee examination. A total of 1527 individuals with a mean (SD) age 69.4 (7.2) participated and responded to both generic (EQ-5D-3L) and disease-specific (the Knee injury and Osteoarthritis Outcome Score) questionnaires. Knee pain was defined as pain during the last month during most of the days. Knee OA was defined radiographically (equivalent to Kellgren and Lawrence grade ≥2) and clinically according to the American College of Rheumatology (ACR) criteria. Results: Of participants with either knee pain or knee OA or both, 7 % reported no problem for the EQ-5D-3L attributes. The corresponding proportion among references (neither knee pain nor OA) was 42 %. The participants with knee pain and OA had all HRQoL measures lower compared to those with knee pain but no OA. The ACR clinical definition of knee OA was associated with lower HRQoL than the definition based on radiographic knee OA (adjusted difference -0.08 in UK EQ-5D-3L index score). Conclusions: Applying different definitions of knee OA result in different levels of HRQoL and this is mainly explained by the knee pain experience. These differences may lead to discrepant conclusions from cost-utility analyses