The interaction of socioeconomic position and type 2 diabetes mellitus family history:A cross-sectional analysis of the Lifelines Cohort and Biobank Study

Background Low socioeconomic position (SEP) and family history of type 2 diabetes mellitus (T2DM) contribute to increased T2DM risk, but it is unclear whether they exacerbate each other's effect. This study examined whether SEP reinforces the association of T2DM family history with T2DM, and whether behavioural and clinical risk factors can explain this reinforcement. Methods We used cross-sectional data on 51 725 participants from Lifelines. SEP was measured as educational level and was self-reported, just as family history of T2DM. T2DM was diagnosed based on measured fasting plasma glucose and glycated haemoglobin, combined with self-reported disease and recorded medication use. We assessed interaction on the additive scale by calculating the relative excess risk due to interaction (RERI). Results ORs of T2DM were highest for males (4.37; 95% CI 3.47 to 5.51) and females (7.77; 5.71 to 10.56) with the combination of low SEP and a family history of T2DM. The RERIs of low SEP and a family history of T2DM were 0.64 (-0.33 to 1.62) for males and 3.07 (1.53 to 4.60) for females. Adjustment for behavioural and clinical risk factors attenuated associations and interactions, but risks remained increased. Conclusion Low SEP and family history of T2DM are associated with T2DM, but they also exacerbate each other's impact in females but not in males. Behavioural and clinical risk factors partly explain these gender differences, as well as the associations underlying the interaction in females. The exacerbation by low SEP of T2DM risks in T2DM families deserves attention in prevention and community care

Absolute and Relative Socioeconomic Health Inequalities across Age Groups

BackgroundThe magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioeconomic position, the health outcome, gender, and as to whether socioeconomic health inequalities are measured in absolute or in relative terms. The aim is to investigate whether absolute and relative socioeconomic health inequalities differ across age groups by indicator of socioeconomic position, health outcome and gender.MethodsThe study sample was derived from the baseline measurement of the LifeLines Cohort Study and consisted of 95,432 participants. Socioeconomic position was measured as educational level and household income. Physical and mental health were measured with the RAND-36. Age concerned eleven 5-years age groups. Absolute inequalities were examined by comparing means. Relative inequalities were examined by comparing Gini-coefficients. Analyses were performed for both health outcomes by both educational level and household income. Analyses were performed for all age groups, and stratified by gender.ResultsAbsolute and relative socioeconomic health inequalities differed across age groups by indicator of socioeconomic position, health outcome, and gender. Absolute inequalities were most pronounced for mental health by household income. They were larger in younger than older age groups. Relative inequalities were most pronounced for physical health by educational level. Gini-coefficients were largest in young age groups and smallest in older age groups.ConclusionsAbsolute and relative socioeconomic health inequalities differed cross-sectionally across age groups by indicator of socioeconomic position, health outcome and gender. Researchers should critically consider the implications of choosing a specific age group, in addition to the indicator of socioeconomic position and health outcome, as findings on socioeconomic health inequalities may differ between them.</p

Risk reclassification analysis investigating the added value of fatigue to sickness absence predictions

Prognostic models including age, self-rated health and prior sickness absence (SA) have been found to predict high (a parts per thousand yen30) SA days and high (a parts per thousand yen3) SA episodes during 1-year follow-up. More predictors of high SA are needed to improve these SA prognostic models. The purpose of this study was to investigate fatigue as new predictor in SA prognostic models by using risk reclassification methods and measures. This was a prospective cohort study with 1-year follow-up of 1,137 office workers. Fatigue was measured at baseline with the 20-item checklist individual strength and added to the existing SA prognostic models. SA days and episodes during 1-year follow-up were retrieved from an occupational health service register. The added value of fatigue was investigated with Net Reclassification Index (NRI) and integrated discrimination improvement (IDI) measures. In total, 579 (51 %) office workers had complete data for analysis. Fatigue was prospectively associated with both high SA days and episodes. The NRI revealed that adding fatigue to the SA days model correctly reclassified workers with high SA days, but incorrectly reclassified workers without high SA days. The IDI indicated no improvement in risk discrimination by the SA days model. Both NRI and IDI showed that the prognostic model predicting high SA episodes did not improve when fatigue was added as predictor variable. In the present study, fatigue increased false-positive rates which may reduce the cost-effectiveness of interventions for preventing SA

Occupational distribution of metabolic syndrome prevalence and incidence differs by sex and is not explained by age and health behavior:results from 75 000 Dutch workers from 40 occupational groups

INTRODUCTION: This study examines the association between 40 occupational groups and prevalence and incidence of metabolic syndrome (MetS), separately for male and female workers, and whether age and health behaviors can explain the association. RESEARCH DESIGN AND METHODS: Data from 74 857 Lifelines Cohort and Biobank Study participants were used to regress occupational group membership, coded by Statistics Netherlands, on the prevalence and incidence of MetS using logistic and Cox regression analyses. MetS diagnosis was based on physical examinations, blood analysis, and recorded medication use. Information on age, smoking status, physical activity, diet and alcohol consumption was acquired using questionnaires. RESULTS: Baseline MetS prevalence was 17.5% for males and 10.6% for females. During a median 3.8 years of follow-up, MetS incidence was 7.8% for males and 13.2% for females. One occupational group was associated with an increased MetS risk in both sexes. Six additional occupational groups had an increased risk for MetS among men, four among women. Highest risks were found for male 'stationary plant and machine operators' (HR: 1.94; 95% CI 1.26 to 3.00) and female 'food preparation assistants' (HR: 1.80; 95% CI 1.01 to 3.22). CONCLUSIONS: Findings suggest that occupational group matters for men and women in MetS development, and that differences in MetS prevalence across occupations are not merely a reflection of selection of metabolically unhealthy workers into specific occupations. The striking sex differences in the occupational distribution of MetS indicate that preventive measures should, with some exceptions, target men and women separately

Recent Results from RHIC & Some Lessons for Cosmic-Ray Physicists

The Relativistic Heavy Ion Collider (RHIC) studies nuclear matter under a variety of conditions. Cold nuclear matter is probed with deuteron-gold collisions, while hot nuclear matter(possibly a quark-gluon plasma (QGP)) is created in heavy-ion collisions. The distribution of spin in polarized nucleons is measured with polarized proton collisions, and photoproduction is studied using the photons that accompany heavy nuclei. The deuteron-gold data shows less forward particle production than would be expected from a superposition of $pp$ collisions, as expected due to saturation/shadowing. Particle production in $AA$ collisions is well described by a model of an expanding fireball in thermal equilibrium. Strong hydrodynamic flow and jet quenching shows that the the produced matter interacts very strongly. These phenomena are consistent with new non-perturbative interactions near the transition temperature to the QGP. This writeup will discuss these results, and their implications for cosmic-ray physicists.Comment: 8 pgs; invited talk presented at the XIVth International Symposium on Very High Energy Cosmic Ray Interactions (ISVHECRI 2006

The Interaction of Genetic Predisposition and Socioeconomic Position With Type 2 Diabetes Mellitus:Cross-Sectional and Longitudinal Analyses From the Lifelines Cohort and Biobank Study

OBJECTIVE: A strong genetic predisposition for type 2 diabetes mellitus (T2DM) may aggravate the negative effects of low socioeconomic position (SEP) in the etiology of the disorder. This study aimed to examine cross-sectional and longitudinal associations and interactions of a genetic risk score (GRS) and SEP with T2DM, and to investigate whether clinical and behavioral risk factors can explain these associations and interactions. METHODS: We used data from 13,027 genotyped participants from the Lifelines study. The GRS was based on single-nucleotide polymorphisms (SNPs) genome-wide associated with T2DM and was categorized into tertiles. SEP was measured as educational level. T2DM was based on biological markers, recorded medication use, and self-reports. Cross-sectional and longitudinal associations, and interactions, between the GRS and SEP on T2DM were examined. RESULTS: The combination of a high GRS and low SEP had the strongest association with T2DM in cross-sectional (OR: 3.84; 95% CI: 2.28, 6.46) and longitudinal analyses (HR: 2.71; 1.39, 5.27), compared to a low GRS and high SEP. Interaction between a high GRS and a low SEP was observed in cross-sectional (relative excess risk due to interaction: 1.85; 0.65, 3.05) but not in longitudinal analyses. Clinical and behavioral risk factors mostly explained the observed associations and interactions. CONCLUSIONS: A high GRS combined with a low SEP provides the highest risk for T2DM. These factors also exacerbated each other's impact cross-sectionally but not longitudinally. Preventive measures should target individual and contextual factors of this high-risk group to reduce the risk of T2DM

Double Spin Asymmetries A_NN and A_SS at sqrt{s}=200 GeV in Polarized Proton-Proton Elastic Scattering at RHIC

We present the first measurements of the double spin asymmetries A_NN and A_SS at sqrt{s}=200 GeV, obtained by the pp2pp experiment using polarized proton beams at the Relativistic Heavy Ion Collider (RHIC). The data were collected in the four momentum transfer t range 0.01<|t|<0.03 (GeV/c)^2. The measured asymmetries, which are consistent with zero, allow us to estimate upper limits on the double helicity-flip amplitudes phi_2 and phi_4 at small t as well as on the difference Delta(sigma_T) between the total cross sections for transversely polarized protons with antiparallel or parallel spin orientations.Comment: 13 pages with 3 figures. Final version accepted by Phys. Lett.

Distinct and stage-specific contributions of TET1 and TET2 to stepwise cytosine oxidation in the transition from naive to primed pluripotency

Cytosine DNA bases can be methylated by DNA methyltransferases and subsequently oxidized by TET proteins. The resulting 5-hydroxymethylcytosine (5hmC), 5-formylcytosine (5fC), and 5-carboxylcytosine (5caC) are considered demethylation intermediates as well as stable epigenetic marks. To dissect the contributions of these cytosine modifying enzymes, we generated combinations of Tet knockout (KO) embryonic stem cells (ESCs) and systematically measured protein and DNA modification levels at the transition from naive to primed pluripotency. Whereas the increase of genomic 5-methylcytosine (5mC) levels during exit from pluripotency correlated with an upregulation of the de novo DNA methyltransferases DNMT3A and DNMT3B, the subsequent oxidation steps turned out to be far more complex. The strong increase of oxidized cytosine bases (5hmC, 5fC, and 5caC) was accompanied by a drop in TET2 levels, yet the analysis of KO cells suggested that TET2 is responsible for most 5fC formation. The comparison of modified cytosine and enzyme levels in Tet KO cells revealed distinct and differentiation-dependent contributions of TET1 and TET2 to 5hmC and 5fC formation arguing against a processive mechanism of 5mC oxidation. The apparent independent steps of 5hmC and 5fC formation suggest yet to be identified mechanisms regulating TET activity that may constitute another layer of epigenetic regulation

Psychometric properties of the CDC Symptom Inventory for assessment of Chronic Fatigue Syndrome

OBJECTIVES: Validated or standardized self-report questionnaires used in research studies and clinical evaluation of chronic fatigue syndrome (CFS) generally focus on the assessment of fatigue. There are relatively few published questionnaires that evaluate case defining and other accompanying symptoms in CFS. This paper introduces the self-report CDC CFS Symptom Inventory and analyzes its psychometric properties. METHODS: One hundred sixty-four subjects (with CFS, other fatiguing illnesses and non fatigued controls) identified from the general population of Wichita, Kansas were enrolled. Evaluation included a physical examination, a standardized psychiatric interview, three previously validated self-report questionnaires measuring fatigue and illness impact (Medical Outcomes Survey Short-Form-36 [MOS SF-36], Multidimensional Fatigue Inventory [MFI], Chalder Fatigue Scale), and the CDC CFS Symptom Inventory. Based on theoretical assumptions and statistical analyses, we developed several different Symptom Inventory scores and evaluated them on their ability to differentiate between participants with CFS and non-fatigued controls. RESULTS: The Symptom Inventory had good internal consistency and excellent convergent validity. A Total score (all symptoms), Case Definition score (CFS case defining symptoms) and Short Form score (6 symptoms with minimal correlation) differentiated CFS cases from controls. Furthermore, both the Case Definition and Short Form scores distinguished people with CFS from fatigued subjects who did not meet criteria for CFS. CONCLUSION: The Symptom Inventory appears to be a reliable and valid instrument to assess symptoms that accompany CFS. It is a positive addition to existing instruments measuring fatigue because it allows other dimensions of the illness to be assessed. Further research is needed to confirm and replicate the current findings in a normative population