Metabolic biomarkers and gallstone disease – a population-based study

Objectives: The objectives for this study were to examine the associations between metabolic biomarkers of obesity including insulin resistance, vascular dysfunction, systemic inflammation, genetic susceptibility and ultrasound proven gallstone disease or cholecystectomy in a population-based cross-sectional study. Material and methods: A total of 2650 participants were included, of whom 422 had gallstone disease. Associations between selected metabolic biomarkers and gallstone disease were estimated by multivariable logistic regression models and expressed as odds ratio (OR) and 95% confidence interval (CI). Results: Gallstone disease was associated with fasting glucose (OR 1.14, 95% CI [1.05;1.24]), fasting insulin (OR 1.03, 95% CI [1.01;1.05]), homeostasis model assessment insulin resistance (OR 1.18, 95% CI [1.02;1.36]), the metabolic syndrome (OR 1.51, 95% CI [1.16;1.96]), white blood cell count (OR 1.07, 95% CI [1.00;1.15]) and C-reactive protein (OR 1.03, 95% CI [1.01;1.05]). A tendency towards an association for soluble urokinase plasminogen activator receptor was also found (OR 1.08, 95% CI [0.99;1.18]). The MC4R(rs17782313) (OR 1.27, 95% CI [1.02;1.58]), MAP2K5(rs2241423) (OR 1.80, 95% CI [1.04;3.41]), NRXN3(rs10146997) (OR 1.26, 95% CI [1.01;1.57]), HHEX(rs1111875) (OR 1.29, 95% CI [1.03;1.62]), FAIM2(rs7138803) (OR 0.66, 95% CI [0.48;0.91]), and apolipoprotein E4 allele (OR 0.76, 95% CI [0.59;0.98]) were associated with gallstone disease. Urinary albumin was not associated with gallstone disease. The association between BMI and gallstone disease was explained by insulin resistance. Conclusions: Biomarkers of insulin resistance, systemic inflammation and genetic obesity or type 2 diabetes risk alleles seem to be associated with gallstone disease. Future studies should explore temporal associations and genetic associations in other populations in order to clarify targets for prevention or intervention

Ischemic heart failure as a complication of incident acute myocardial infarction: Timing and time trends: A national analysis including 78,814 Danish patients during 2000–2009

Aim: Heart failure is a serious complication of acute myocardial infarction leading to poor prognosis. We aimed at exploring time trends of heart failure and their impact on mortality among patients with an incident acute myocardial infarction. Methods: From the National Patient Danish Registry we collected data on all patients hospitalized with an incident of acute myocardial infarction during 2000–2009 and identified cases with in-hospital heart failure (presented on admission or developing heart failure during acute myocardial infarction hospitalization) or post-discharge heart failure (a hospitalization or outpatient visit following acute myocardial infarction discharge), and assessed in-hospital, 30-day and 1-year mortality. Results: Of the 78,814 patients included in the study, 10,248 (13.0%) developed in-hospital heart failure. The odds of in-hospital heart failure declined 0.9% per year (odds ratio=0.991, 95% confidence interval: 0.983–0.999). In-hospital heart failure was associated with 13% (odds ratio=1.13, 95% confidence interval: 1.06–1.20) and 14% (odds ratio=1.14, 95% confidence interval: 1.07–1.20) higher in-hospital and 30-day mortality, respectively. Of the 61,637 patients discharged alive without in-hospital heart failure, 5978 (9.7%) experienced post-discharge heart failure, 4116 (6.7%) were hospitalized and 1862 (3.0%) were diagnosed at outpatient clinics. The risk of heart failure requiring hospitalization declined 5.5% per year (hazard ratio=0.945, 95% confidence interval: 0.934–0.955) whereas the risk of heart failure diagnosed at outpatient clinics increased 13.4% per year (hazard ratio=1.134, 95% confidence interval: 1.115–1.153). Post-discharge heart failure was associated with 239% (hazard ratio=3.39, 95% confidence interval: 3.18–3.63) higher 1-year mortality. Conclusions: In-hospital and post-discharge heart failure requiring hospitalization decreased whereas post-discharge heart failure diagnosed at outpatient clinics increased among incident acute myocardial infarction patients during 2000–2009. The development of heart failure, especially after acute myocardial infarction discharge, indicates a poor prognosis

Supplemental_Material – Supplemental material for Ischemic heart failure as a complication of incident acute myocardial infarction: Timing and time trends: A national analysis including 78,814 Danish patients during 2000–2009

Supplemental material, Supplemental_Material for Ischemic heart failure as a complication of incident acute myocardial infarction: Timing and time trends: A national analysis including 78,814 Danish patients during 2000–2009 by Gerhard Sulo, Enxhela Sulo, Torben Jørgensen, Allan Linnenberg, Eva Prescott, Grethe S. Tell and Merete Osler in Scandinavian Journal of Public Healt

Ischemic heart failure as a complication of incident acute myocardial infarction: Timing and time trends: A national analysis including 78,814 Danish patients during 2000–2009

Aim: Heart failure is a serious complication of acute myocardial infarction leading to poor prognosis. We aimed at exploring time trends of heart failure and their impact on mortality among patients with an incident acute myocardial infarction. Methods: From the National Patient Danish Registry we collected data on all patients hospitalized with an incident of acute myocardial infarction during 2000–2009 and identified cases with in-hospital heart failure (presented on admission or developing heart failure during acute myocardial infarction hospitalization) or post-discharge heart failure (a hospitalization or outpatient visit following acute myocardial infarction discharge), and assessed in-hospital, 30-day and 1-year mortality. Results: Of the 78,814 patients included in the study, 10,248 (13.0%) developed in-hospital heart failure. The odds of in-hospital heart failure declined 0.9% per year (odds ratio=0.991, 95% confidence interval: 0.983–0.999). In-hospital heart failure was associated with 13% (odds ratio=1.13, 95% confidence interval: 1.06–1.20) and 14% (odds ratio=1.14, 95% confidence interval: 1.07–1.20) higher in-hospital and 30-day mortality, respectively. Of the 61,637 patients discharged alive without in-hospital heart failure, 5978 (9.7%) experienced post-discharge heart failure, 4116 (6.7%) were hospitalized and 1862 (3.0%) were diagnosed at outpatient clinics. The risk of heart failure requiring hospitalization declined 5.5% per year (hazard ratio=0.945, 95% confidence interval: 0.934–0.955) whereas the risk of heart failure diagnosed at outpatient clinics increased 13.4% per year (hazard ratio=1.134, 95% confidence interval: 1.115–1.153). Post-discharge heart failure was associated with 239% (hazard ratio=3.39, 95% confidence interval: 3.18–3.63) higher 1-year mortality. Conclusions: In-hospital and post-discharge heart failure requiring hospitalization decreased whereas post-discharge heart failure diagnosed at outpatient clinics increased among incident acute myocardial infarction patients during 2000–2009. The development of heart failure, especially after acute myocardial infarction discharge, indicates a poor prognosis

Supplementary Material for: Trends in Costs of Thyroid Disease Treatment in Denmark during 1995–2015

Background: Iodine fortification (IF) may contribute to changes in costs of thyroid disease treatment through changes in disease patterns. From a health economic perspective, assessment of the development in costs of thyroid disease treatment in the population is pertinent. Objectives: To assess the trends in annual medicine and hospital costs of thyroid disease treatment during 1995–2015 in Denmark, i.e., before and after the introduction of mandatory IF in 2000. Methods: Information on treatments for thyroid disease (antithyroid medication, thyroid hormone therapy, thyroid surgery, and radioiodine treatment) was obtained from nationwide registers. Costs were valued at 2015 prices using sales prices for medicines and the Danish Diagnosis-Related Group (DRG) and Danish Ambulatory Grouping System (DAGS) tariffs of surgeries/radioiodine treatments. Results were adjusted for changes in population size and age and sex distribution. Results: The total direct medicine and hospital costs of thyroid disease treatment increased from EUR ∼190,000 per 100,000 persons in 1995 to EUR ∼270,000 per 100,000 persons in 2015. This was mainly due to linearly increased costs of thyroid hormone therapy and increased costs of thyroid surgery since 2008. Costs of antithyroid medication increased slightly and transiently after IF, while costs of radioiodine treatment remained constant. Costs of thyroid hormone therapy and thyroid surgery did not follow the development in the prevalence of hypothyroidism and structural thyroid diseases observed in concurrent studies. Conclusion: The costs of total direct medicine and hospital costs for thyroid disease treatment in Denmark increased from 1995 to 2015. This is possibly due to several factors, e.g., changes in treatment practices, and the direct effect of IF alone remains to be estimated

Supplementary Material for: Trends in Costs of Thyroid Disease Treatment in Denmark during 1995–2015

Background: Iodine fortification (IF) may contribute to changes in costs of thyroid disease treatment through changes in disease patterns. From a health economic perspective, assessment of the development in costs of thyroid disease treatment in the population is pertinent. Objectives: To assess the trends in annual medicine and hospital costs of thyroid disease treatment during 1995–2015 in Denmark, i.e., before and after the introduction of mandatory IF in 2000. Methods: Information on treatments for thyroid disease (antithyroid medication, thyroid hormone therapy, thyroid surgery, and radioiodine treatment) was obtained from nationwide registers. Costs were valued at 2015 prices using sales prices for medicines and the Danish Diagnosis-Related Group (DRG) and Danish Ambulatory Grouping System (DAGS) tariffs of surgeries/radioiodine treatments. Results were adjusted for changes in population size and age and sex distribution. Results: The total direct medicine and hospital costs of thyroid disease treatment increased from EUR ∼190,000 per 100,000 persons in 1995 to EUR ∼270,000 per 100,000 persons in 2015. This was mainly due to linearly increased costs of thyroid hormone therapy and increased costs of thyroid surgery since 2008. Costs of antithyroid medication increased slightly and transiently after IF, while costs of radioiodine treatment remained constant. Costs of thyroid hormone therapy and thyroid surgery did not follow the development in the prevalence of hypothyroidism and structural thyroid diseases observed in concurrent studies. Conclusion: The costs of total direct medicine and hospital costs for thyroid disease treatment in Denmark increased from 1995 to 2015. This is possibly due to several factors, e.g., changes in treatment practices, and the direct effect of IF alone remains to be estimated

MOESM1 of Burden of allergic respiratory disease: a systematic review

Additional file 1: Table S1. Database search strategies; Figure S1. RQLQ domain scores by allergy phenotype. Studies are listed from the top as SAR, Mixed, and PAR; Figure S2 SF-36 domain scores by allergy phenotype. Studies are listed from the top as SAR, Mixed, and PAR

Burden of allergic respiratory disease: a systematic review

Abstract This meta-analysis compared the health-related quality of life (HRQL) of patients with allergic rhinitis (AR) and/or allergic asthma (AA) caused by perennial house dust mite (HDM) versus AR and/or AA caused by seasonal pollen allergy. Following a systematic search, the identified studies used the disease-specific rhinitis quality of life questionnaire or generic instruments (SF-36 and SF-12). Summary estimates obtained by meta-analysis showed that HRQL in patients with perennial HDM allergy was significantly worse than that of patients with seasonal pollen allergy, when measured by both disease-specific and generic HRQL instruments, and was reflected by an impact on both physical and mental health. A systematic review of cost data on AR and AA in selected European countries demonstrated that the majority of the economic burden was indirectly caused by high levels of absenteeism and presenteeism; there was little or no evidence of increasing or decreasing cost trends. Increased awareness of the detrimental effects of AR and/or AA on patientsâ HRQL and its considerable cost burden might encourage early diagnosis and treatment, in order to minimize the disease burden and ensure beneficial and cost-effective outcomes

Burden of allergic respiratory disease: a systematic review

Abstract This meta-analysis compared the health-related quality of life (HRQL) of patients with allergic rhinitis (AR) and/or allergic asthma (AA) caused by perennial house dust mite (HDM) versus AR and/or AA caused by seasonal pollen allergy. Following a systematic search, the identified studies used the disease-specific rhinitis quality of life questionnaire or generic instruments (SF-36 and SF-12). Summary estimates obtained by meta-analysis showed that HRQL in patients with perennial HDM allergy was significantly worse than that of patients with seasonal pollen allergy, when measured by both disease-specific and generic HRQL instruments, and was reflected by an impact on both physical and mental health. A systematic review of cost data on AR and AA in selected European countries demonstrated that the majority of the economic burden was indirectly caused by high levels of absenteeism and presenteeism; there was little or no evidence of increasing or decreasing cost trends. Increased awareness of the detrimental effects of AR and/or AA on patientsâ HRQL and its considerable cost burden might encourage early diagnosis and treatment, in order to minimize the disease burden and ensure beneficial and cost-effective outcomes

Common variants in the hERG (KCNH2) voltage-gated potassium channel are associated with altered fasting and glucose-stimulated plasma incretin and glucagon responses

Abstract Background Patients with long QT syndrome due to rare loss-of-function mutations in the human ether-á-go-go-related gene (hERG) have prolonged QT interval, risk of arrhythmias, increased secretion of insulin and incretins and impaired glucagon response to hypoglycemia. This is caused by a dysfunctional Kv11.1 voltage-gated potassium channel. Based on these findings in patients with rare variants in hERG, we hypothesized that common variants in hERG may also lead to alterations in glucose homeostasis. Subsequently, we aimed to evaluate the effect of two common gain-of-function variants in hERG (rs36210421 and rs1805123) on QT interval and plasma levels of glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), insulin and glucagon during an oral glucose tolerance test (OGTT). We used two population-based cohorts for evaluation of the effect of common variants in hERG on QT-interval and circulation levels of incretins, insulin and glucagon. The Danish population-based Inter99 cohort (n = 5895) was used to assess the effect of common variants on QT-interval. The Danish ADDITION-PRO cohort was used (n = 1329) to study genetic associations with levels of GLP-1, GIP, insulin and glucagon during an OGTT. Results Carriers of either the minor A-allele of rs36210421 or the minor G-allele of rs1805123 had ~ 2 ms shorter QT interval per risk allele (p = 0.025 and p = 1.9 × 10− 7). Additionally, both variants were associated with alterations in pancreatic and gut hormone release among carriers. The minor A- allele of rs36210421 was associated with increased GLP-1 and decreased GIP response to oral glucose stimulation, whereas the minor G-allele of rs1805123 is associated with decreased fasting plasma insulin and glucagon release. A genetic risk score combining the two gene variants revealed reductions in glucose-stimulated GIP, as well as suppressed glucagon response to increased glucose levels during an OGTT. Conclusions Two common missense polymorphisms of the Kv11.1 voltage-gated hERG potassium channel are associated with alterations in circulating levels of GIP and glucagon, suggesting that hERG potassium channels play a role in fasting and glucose-stimulated release of GIP and glucagon. Trial registration ClinicalTrials.gov ( NCT00289237 ). Trial retrospectively registered at February 9, 2006. Studies were approved by the Ethical Committee of the Central Denmark Region (journal no. 20080229) and by the Copenhagen County Ethical Committee (KA 98155)