Trends in body weight and diabetes in forty years in Iceland

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenOBJECTIVE: Obesity and diabetes are increasing problems worldwide. Therefore, new data on these issues are of importance. Here, we publish data on body mass index (BMI) and prevalence of diabetes of type 2 in Iceland. MATERIAL AND METHODS: Mean BMI (kg/m2), prevalence of diabetes type 2 and obesity in people aged 45-64 years were evaluated from 1967 to 2007. Data on type 2 diabetes was based on four population Icelandic Heart Association studies (newest the REFINE (The Risk Evaluation For INfarct Estimates) Reykjavik study from 2006) with total of 17.757 individuals. Data on BMI was in addition based on three further studies, total 20.519 individuals. The same estimates were then performed for 25-84 year old people in the years 2004-2007. These were based on data from the REFINE Reykjavik study 2.410 individuals and the AGES Reykjavik study 3.027 individuals and. RESULTS: In the years 1967-2007 mean BMI increased by 2 units in both genders (45-64 year) and the prevalence of type 2 diabetes doubled in men, while the increase in women was 50%. In the years 2004-2007 the prevalence of diabetes type 2 in 25-84 year old people was 6% in men and 3% in women and the prevalence of obesity was 23% in men and 21% in women. CONCLUSIONS: Mean BMI is increasing in Iceland, especially after 1980. Prevalence of diabetes coincides with increasing body mass index.Tilgangur: Offita og sykursýki eru vaxandi vandamál og mikilvægt að nýjar upplýsingar um þessa þætti liggi fyrir. Hér er greint frá þróun líkamsþyngdarstuðuls og sykursýki af tegund 2 á Íslandi. Efniviður og aðferðir: Meðallíkamsþyngdar-stuðull (kg/m2), algengi sykursýki af tegund 2 og algengi offitu hjá 45-64 ára voru könnuð frá 1967 til 2007. Algengi sykursýki byggist á fjórum rannsóknum Hjartaverndar: Áfanga I-V í Hóprannsókn 1967-1991, Afkomendarannsókn 1997-2001, Rannsókn á ungu fólki 2001-2003 og Áhættuþáttakönnun frá 2006-2007, samtals 17.757 manns. Könnun á líkamsþyngdarstuðli byggist að auki á gögnum úr Monica-rannsókninni á Íslandi frá 1983, 1988 og 1993, heildarfjöldi 20.519. Sömu þættir voru einnig kannaðir fyrir 25-84 ára frá 2004 til 2007. Þá var notast við Áhættuþáttakönnun Hjartaverndar, 2410 manns og Öldrunarrannsókn Hjartaverndar, 3027 manns. Niðurstöður: Meðallíkamsþyngdarstuðull jókst um tvær einingar hjá báðum kynjum (45-64 ára) og algengi sykursýki af tegund 2 tvöfaldaðist hjá körlum og jókst um 50% hjá konunum á árunum 1967-2007. Algengi sykursýki af tegund 2 hjá 25-84 ára, á árunum 2004-2007 var 6% hjá körlum og 3% hjá konum. Algengi offitu var 23% hjá körlum en 21% hjá konum. Ályktanir: Meðallíkamsþyngdarstuðull hefur aukist undanfarna áratugi, einkum eftir 1980. Sykursýki eykst í hlutfalli við vaxandi ofþyngd

Plasma Leptin Levels and Incidence of Heart Failure, Cardiovascular Disease, and Total Mortality in Elderly Individuals

OBJECTIVE: Obesity predisposes individuals to congestive heart failure (CHF) and cardiovascular disease (CVD). Leptin regulates energy homeostasis, is elevated in obesity, and influences ventricular and vascular remodeling. We tested the hypothesis that leptin levels are associated with greater risk of CHF, CVD, and mortality in elderly individuals. RESEARCH DESIGN AND METHODS: We evaluated 818 elderly (mean age 79 years, 62% women) Framingham Study participants attending a routine examination at which plasma leptin was assayed. RESULTS: Leptin levels were higher in women and strongly correlated with BMI (P < 0.0001). On follow-up (mean 8.0 years), 129 (of 775 free of CHF) participants developed CHF, 187 (of 532 free of CVD) experienced a first CVD event, and 391 individuals died. In multivariable Cox regression models adjusting for established risk factors, log-leptin was positively associated with incidence of CHF and CVD (hazard ratio [HR] per SD increment 1.26 [95% CI 1.03–1.55] and 1.28 [1.09–1.50], respectively). Additional adjustment for BMI nullified the association with CHF (0.97 [0.75–1.24]) but only modestly attenuated the relation to CVD incidence (1.23 [1.00–1.51], P = 0.052). We observed a nonlinear, U-shaped relation between log-leptin and mortality (P = 0.005 for quadratic term) with greater risk of death evident at both low and high leptin levels. CONCLUSIONS: In our moderate-sized community-based elderly sample, higher circulating leptin levels were associated with a greater risk of CHF and CVD, but leptin did not provide incremental prognostic information beyond BMI. Additional investigations are warranted to elucidate the U-shaped relation of leptin to mortality.National Institutes of Health's National Heart, Lung, and Blood Institute (N01-HC25195, N01-HV28178, K24-HL04334, R01-DK080739

PREDICTING HUMAN MOVEMENT TYPE BASED ON MULTIPLE ACCELEROMETERS USING MOVELETS

We introduce statistical methods for prediction of types of human movement based on three tri-axial accelerometers worn simultaneously at the hip, left, and right wrist. We compare the individual performance of the three accelerometers using movelets and propose a new prediction algorithm that integrates the information from all three accelerometers. The development is motivated by a study of 20 older subjects who were instructed to perform 15 different types of activities during in-laboratory sessions. The differences in the prediction performance for different activity types among the three accelerometers reveal subtle yet important insights into how the intrinsic physical features of human movements could be effectively utilized in prediction. The proposed integrative movelet method takes into account those findings to augment the prediction accuracy and improve our understanding of human movement measurements

Association of urinary uromodulin with kidney&nbsp;function decline and mortality: the&nbsp;health ABC study .

BackgroundUrine uromodulin (uUMOD) is a protein secreted by the kidney tubule. Recent studies have suggested that higher uUMOD may be associated with improved kidney and mortality outcomes.MethodsUsing a case-cohort design, we evaluated the association between baseline uUMOD levels and ≥&nbsp;30% estimated glomerular filtration rate (eGFR) decline, incident chronic kidney disease (CKD), rapid kidney function decline, and mortality using standard and modified Cox proportional hazards regression.ResultsThe median value of uUMOD was 25.8&nbsp;µg/mL, mean age of participants was 74 years, 48% were women, and 39% were black. Persons with higher uUMOD had lower prevalence of diabetes and coronary artery disease (CAD), and had lower systolic blood pressure. Persons with higher uUMOD also had higher eGFR, lower urinary albumin to creatinine ratio (ACR), and lower C-reactive protein (CRP). There was no association of uUMOD with &gt;&nbsp;30% eGFR decline. In comparison to those in the lowest quartile of uUMOD, those in the highest quartile had a significantly (53%) lower risk of incident CKD (CI 73%, 18%) and a 51% lower risk of rapid kidney function decline (CI 76%, 1%) after multivariable adjustment. Higher uUMOD was associated with lower risk of mortality in demographic adjusted models, but not after multivariable adjustment.ConclusionHigher levels of uUMOD are associated with lower risk of incident CKD and rapid kidney function decline. Additional studies are needed in the general population and in persons with advanced CKD to confirm these findings.


Classification of occupational activity categories using accelerometry: NHANES 2003–2004

Background An individual’s occupational activity (OA) may contribute significantly to daily physical activity (PA) and sedentary behavior (SB). However, there is little consensus about which occupational categories involve high OA or low OA, and the majority of categories are unclassifiable with current methods. The purpose of this study was to present population estimates of accelerometer-derived PA and SB variables for adults (n = 1112, 20–60 years) working the 40 occupational categories collected during the 2003–2004 National Health and Nutrition Examination Survey (NHANES). Methods ActiGraph accelerometer-derived total activity counts/day (TAC), activity counts/minute, and proportion of wear time spent in moderate-to-vigorous PA [MVPA], lifestyle, and light PA organized by occupational category were ranked in ascending order and SB was ranked in descending order. Summing the ranks of the six accelerometer-derived variables generated a summary score for each occupational category, which was re-ranked in ascending order. Higher rankings indicated higher levels of OA, lower rankings indicated lower levels of OA. Tertiles of the summary score were used to establish three mutually exclusive accelerometer-determined OA groupings: high OA, intermediate OA, and low OA. Results According to their summary score, ‘farm and nursery workers’ were classified as high OA and ‘secretaries, stenographers, and typists’ were classified as low OA. Consistent with previous research, some low OA occupational categories (e.g., ‘engineers, architects, and scientists’, ‘technicians and related support occupations’, ‘management related occupations’, ‘executives, administrators, and managers’, ‘protective services’, and ‘writers, artists, entertainers, and athletes’) associated with higher education and income had relatively greater amounts of MVPA compared to other low OA occupational categories, likely due to the greater percentage of men in those occupations and/or the influence of higher levels of leisure time PA. Men had more TAC, activity counts/minute and time in MVPA, but similar proportions of SB compared to women in all three OA groupings. Conclusions Objectively measured PA allowed for a more precise estimate of the amount of PA and SB associated with different occupations and facilitated systematic classification of the 40 different occupational categories into three distinct OA groupings. This information provides new opportunities to explore the relationship between OA and health outcomes

Incidence and prevalence of total joint replacements due to osteoarthritis in the elderly: risk factors and factors associated with late life prevalence in the AGES-Reykjavik Study.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.Total joint replacements (TJRs) should be considered as one of few definite endpoints in osteoarthritis research. We analyzed factors associated with late-life prevalence and risk factors for incidence of TJRs due to osteoarthritis in a population based cohort.After exclusion of inflammatory arthritis and fractures as causes of TJR, 5170 participants in the AGES-Reykjavik Study (mean age (SD) 76.4(6), 58 % females) were included for osteoarthritis studies. Three thousand one hundred thirty-three of them had a follow-up visit 5 years later.The prevalence of having at least one joint replacement operation due to OA was 13.6 % and the yearly incidence was 1.4 %/year during the five-year follow-up. Factors positively associated with late life prevalence of TJR included BMI, hand OA severity, female gender, finger length ratio and spine BMD. Risk factors for TJRs in the incidence group were symptoms at initial visit, prior TJR in the contralateral joint and BMI. Much stronger associations were seen for TKR than for THR with discriminatory analysis showing an AUC 0.71 for late life prevalence and 0.84 for the incidence.This study illustrates the importance of the different information expressed by late life prevalence vs. incidence on the factors associated with severe osteoarthritis of the knee and hip. The observation that prior TJR is a risk factor for subsequent TJR in the contralateral joint has not been described previously. The high power predictions for TKR suggest that a predictive model may be feasible, particularly if it can be extended by the addition of further predictive variables, perhaps through genetic, biomarker or imaging data.NIH N01-AG-12100 NIA Intramural Research Program Hjartavernd (the Icelandic Heart Association) Althingi (the Icelandic Parliament) Icelandic Osteoarthritis Fund University of Iceland Research Fun

Effect of vertebral fractures on function, quality of life and hospitalisation the AGES-Reykjavik study.

To access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.Understanding the determinants of health burden after a fracture in ageing populations is important. Assess the effect of clinical vertebral and other osteoporotic fractures on function and the subsequent risk of hospitalisation. Individuals from the prospective population-based cohort study Age, Gene/Environment Susceptibility (AGES)-Reykjavik study were examined between 2002 and 2006 and followed up for 5.4 years. A total of 5,764 individuals, 57.7% women, born 1907-35, mean age 77. Method: four groups with a verified fracture status were used; vertebral fractures, other osteoporotic fractures excluding vertebral, non-osteoporotic fractures and not-fractured were compared and analysed for the effect on mobility, strength, QoL, ADL, co-morbidity and hospitalisation. Worst performance on functional tests was in the vertebral fracture group for women (P < 0.0001) and the other osteoporotic fractures group for men (P < 0.05). Both vertebral and other osteoporotic fractures, showed an increased risk of hospitalisation, HR = 1.4 (95% CI: 1.3-1.7) and 1.2 (95% CI: 1.1-1.2) respectively (P < 0.0001). Individuals with vertebral fractures had 50% (P < 0.0001) longer hospitalisation than not-fractured and 33% (P < 0.002) longer than the other osteoporotic fractures group. Individuals with a history of clinical vertebral fracture seem to carry the greatest health burden compared with other fracture groups, emphasising the attention which should be given to those individuals.National Institutes of Health, USA N01-AG-12100 National Institute on Aging Hjartavernd (The Icelandic Heart Association) Althingi (The Icelandic Parliament

Similar decline in mortality rate of older persons with and without type 2 diabetes between 1993 and 2004 the Icelandic population-based Reykjavik and AGES-Reykjavik cohort studies.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.A decline in mortality rates due to cardiovascular diseases and all-cause mortality has led to increased life expectancy in the Western world in recent decades. At the same time, the prevalence of type 2 diabetes, a disease associated with a twofold excess risk of cardiovascular disease and mortality, has been increasing. The objective of this study was to estimate the secular trend of cardiovascular and all-cause mortality rates in two population-based cohorts of older persons, with and without type 2 diabetes, examined 11 years apart.1506 participants (42% men) from the population-based Reykjavik Study, examined during 1991-1996 (median 1993), mean age 75.0 years, and 4814 participants (43% men) from the AGES-Reykjavik Study, examined during 2002-2006 (median 2004), mean age 77.2 years, age range in both cohorts 70-87 years. The main outcome measures were age-specific mortality rates due to cardiovascular disease and all causes, over two consecutive 5.7- and 5.3-year follow-up periods.A 32% decline in cardiovascular mortality rate and a 19% decline in all-cause mortality rate were observed between 1993 and 2004. The decline was greater in those with type 2 diabetes, as illustrated by the decline in the adjusted hazard ratio of cardiovascular mortality in individuals with diabetes compared to those without diabetes, from 1.88 (95% CI 1.24-2.85) in 1993 to 1.46 (95% CI 1.11-1.91) in 2004. We also observed a concurrent decrease in major cardiovascular risk factors in both those with and without diabetes. A higher proportion of persons with diabetes received glucose-lowering, hypertensive and lipid-lowering medication in 2004.A decline in cardiovascular and all-cause mortality rates was observed in older persons during the period 1993-2004, in both those with and without type 2 diabetes. This decline may be partly explained by improvements in cardiovascular risk factors and medical treatment over the period studied. However, type 2 diabetes still persists as an independent risk factor for cardiovascular mortality.National Institute of Health/N01-AG-1-2100 NIA Intramural Research Program Icelandic Heart Association (Hjartavernd) Icelandic Parliament (Althingi

Effects of statin medication on mortality risk associated with type 2 diabetes in older persons: the population-based AGES-Reykjavik Study

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field.OBJECTIVE: To examine if the beneficial effect of statin medication on mortality seen in randomised clinical trials of type 2 diabetes applies equally to observational studies in the general population of older people. DESIGN: A prospective, population-based cohort study. SETTING: Reykjavik, Iceland. PARTICIPANTS: 5152 men and women from the Age, Gene/Environment Susceptibility-Reykjavik Study, mean age 77 years, range of 66-96 years. MAIN OUTCOME MEASURE: Cardiovascular and all-cause mortalities and the RR of dying according to statin use and history of coronary heart disease (CHD) in persons with type 2 diabetes and those without diabetes with a median follow-up time of 5.3 years, until end of 2009. RESULTS: The prevalence of type 2 diabetes was 12.4% of which 35% used statins. Statin use was associated with a 50% (95% CI 8% to 72%) lower cardiovascular mortality and 53% (29% to 68%) lower all-cause mortalities in persons with diabetes. For those without diabetes, statin use was associated with a 16% (-24% to 43%) lower cardiovascular and 30% (11% to 46%) lower all-cause mortalities. Persons with diabetes using statins had a comparable risk of cardiovascular and all-cause mortality to that of the general population without diabetes. The effect was independent of the level of glycaemic control. CONCLUSION: This observational study lends important support to existing data from randomised clinical trials. These data suggest that in the general population of older people with diabetes, statin medication markedly reduces the excess cardiovascular and all-cause mortality risk, irrespective of the presence or absence of coronary heart disease or glucose-lowering medication