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Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study.

https://arctichealth.org/en/permalink/ahliterature280006
Source
Eur J Endocrinol. 2016 Sep;175(3):181-90
Publication Type
Article
Date
Sep-2016
Author
Jakob Dal
Ulla Feldt-Rasmussen
Marianne Andersen
Lars Ø Kristensen
Peter Laurberg
Lars Pedersen
Olaf M Dekkers
Henrik Toft Sørensen
Jens Otto L Jørgensen
Source
Eur J Endocrinol. 2016 Sep;175(3):181-90
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Acromegaly - diagnosis - epidemiology
Adult
Aged
Cohort Studies
Comorbidity
Denmark - epidemiology
Diabetes Mellitus - epidemiology
Female
Heart Failure - epidemiology
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - epidemiology
Prevalence
Prognosis
Registries
Stroke - epidemiology
Abstract
Valid data on acromegaly incidence, complications and mortality are scarce. The Danish Health Care System enables nationwide studies with complete follow-up and linkage among health-related databases to assess acromegaly incidence, prevalence, complications and mortality in a population-based cohort study.
All incident cases of acromegaly in Denmark (1991-2010) were identified from health registries and validated by chart review. We estimated the annual incidence rate of acromegaly per 10(6) person-years (py) with 95% confidence intervals (95% CIs). For every patient, 10 persons were sampled from the general population as a comparison cohort. Cox regression and hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used.
Mean age at diagnosis (48.7 years (CI: 95%: 47.2-50.1)) and annual incidence rate (3.8 cases/10(6) persons (95% CI: 3.6-4.1)) among the 405 cases remained stable. The prevalence in 2010 was 85 cases/10(6) persons. The patients were at increased risk of diabetes mellitus (HR: 4.0 (95% CI: 2.7-5.8)), heart failure (HR: 2.5 (95% CI: 1.4-4.5)), venous thromboembolism (HR: 2.3 (95% CI: 1.1-5.0)), sleep apnoea (HR: 11.7 (95% CI: 7.0-19.4)) and arthropathy (HR: 2.1 (95% CI: 1.6-2.6)). The complication risk was also increased before the diagnosis of acromegaly. Overall mortality risk was elevated (HR: 1.3 (95% CI: 1.0-1.7)) but uninfluenced by treatment modality.
(i) The incidence rate and age at diagnosis of acromegaly have been stable over decades, and the prevalence is higher than previously reported. (ii) The risk of complications is very high even before the diagnosis. (iii) Mortality risk remains elevated but uninfluenced by mode of treatment.
PubMed ID
27280374 View in PubMed
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Age discrimination in osteoporosis screening--data from the Aalborg University Hospital Record for Osteoporosis Risk Assessment (AURORA).

https://arctichealth.org/en/permalink/ahliterature259025
Source
Maturitas. 2014 Apr;77(4):330-5
Publication Type
Article
Date
Apr-2014
Author
Stig Andersen
Peter Laurberg
Source
Maturitas. 2014 Apr;77(4):330-5
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon - methods
Aged
Aged, 80 and over
Ageism
Bone Density - physiology
Denmark
Female
Humans
Logistic Models
Middle Aged
Osteoporosis - diagnosis - physiopathology
Risk factors
Abstract
Old age carries a markedly increased risk of osteoporotic fractures with subsequent disability, dependency and premature death. Timely detection and treatment reduces fracture risk and particular attention should be drawn to age.
To assess the impact of age on referral for osteoporosis screening.
Dual energy X-ray Absorptiometry (DXA) at the Osteoporosis Clinic in North Denmark was reorganised from 2010. Risk factors, anthropometry and bone mineral density were recorded and considered in the reply and recommendations to the referring doctor. We report data from the 8,131 consecutive evaluations in 7914 individuals at the Osteoporosis Clinic from January 1st 2010 through December 31st 2012.
Risk factor data were available in >96% and DXA in 98%. Population DXA frequency decreased markedly after the 7th decade and was performed yearly in 1.2% of the population aged >80 years in North Denmark. The >80 years group had more fragility fractures and lower T-scores (p80 years was a dominant risk factor for fragility fracture (OR 2.4, 95% CI 2.0-2.9; p
PubMed ID
24480671 View in PubMed
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Age impact on clinical risk factors does not justify the age related change in referral pattern for osteoporosis assessment - Data from the Aalborg University Hospital Record for Osteoporosis Risk Assessment (AURORA).

https://arctichealth.org/en/permalink/ahliterature271817
Source
Maturitas. 2015 Mar;80(3):302-7
Publication Type
Article
Date
Mar-2015
Author
Stig Andersen
Peter Laurberg
Source
Maturitas. 2015 Mar;80(3):302-7
Date
Mar-2015
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon - utilization
Age Factors
Aged, 80 and over
Bone Density
Denmark - epidemiology
Female
Hospitals, University
Humans
Logistic Models
Male
Medical Records
Osteoporosis - diagnosis - epidemiology
Referral and Consultation - statistics & numerical data
Risk assessment
Risk factors
Surveys and Questionnaires
Abstract
Osteoporotic fractures with subsequent disability, dependency and premature death are increasingly common with age. Yet, referral for osteoporosis evaluation decreases with age. Why is this, and is it justified?
To assess if age changes the impact of clinical risk factors for osteoporosis.
Clinical risk factors for osteoporosis were informed by a questionnaire and recorded in the AURORA database along with anthropometry and bone mineral density measured by dual energy X-ray absorptiometry (DXA). We included data from the first DXA in all individuals seen at the Osteoporosis Clinic in North Denmark in 2010 through 2012.
Risk factor data were available in >96% and DXA in >98% of the 8131 evaluations. Age 80+ years was the dominant risk factor for fragility fracture (P
PubMed ID
25636241 View in PubMed
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An increased incidence of overt hypothyroidism after iodine fortification of salt in Denmark: a prospective population study.

https://arctichealth.org/en/permalink/ahliterature163527
Source
J Clin Endocrinol Metab. 2007 Aug;92(8):3122-7
Publication Type
Article
Date
Aug-2007
Author
Inge Bülow Pedersen
Peter Laurberg
Nils Knudsen
Torben Jørgensen
Hans Perrild
Lars Ovesen
Lone Banke Rasmussen
Author Affiliation
Department of Endocrinology and Medicine, Aalborg Hospital, Aarhus University Hospital, DK-9000 Aalborg, Denmark. I.Bulow@rn.dk
Source
J Clin Endocrinol Metab. 2007 Aug;92(8):3122-7
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Child
Child, Preschool
Cohort Studies
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Hypothyroidism - epidemiology
Infant
Iodine - administration & dosage
Male
Middle Aged
Population
Prospective Studies
Sodium Chloride, Dietary
Thyrotropin - blood
Thyroxine - blood
Abstract
Iodine fortification (IF) of salt was introduced in Denmark in 1998. Little is known about the effect of a minor increase in iodine intake on the incidence of hypothyroidism. We prospectively identified all new cases of overt hypothyroidism in two areas of Denmark before and for the first 7 yr after IF had been introduced.
A computer-based register was used to identify continuously all new cases of overt hypothyroidism in two subcohorts with previous moderate and mild iodine deficiency (ID), respectively (Aalborg, n = 310,124, urinary iodine = 45 microg/liter; and Copenhagen, n = 225,707, urinary iodine = 61 microg/liter). Data were obtained 1) before IF (1997-1998), 2) during voluntary IF (1999-2000), 3) during early (2001-2002) and 4) during late (2003-2005) period with mandatory IF.
The overall incidence rate of hypothyroidism increased during the study period: baseline, 38.3/100,000.yr; voluntary IF, 43.7 (not significant vs. baseline); early mandatory IF, 48.7 [vs. baseline, rate ratio (RR) = 1.27; 95% confidence interval (CI) = 1.10-1.47]; and late mandatory IF, 47.2 (vs. baseline, RR = 1.23; 95% CI = 1.07-1.42). There was a geographic difference because hypothyroidism increased only in the area with previous moderate ID: Aalborg, late mandatory IF vs. baseline, 40.3/29.7 (RR = 1.11; 95% CI = 1.11-1.66); Copenhagen, 56.7/51.6 (RR = 1.10; 95% CI = 0.90-1.34). The increase occurred in young and middle-aged adults.
Even a cautious iodization of salt was accompanied by a moderate increase in the incidence rate of overt hypothyroidism. This occurred primarily in young and middle-aged subjects with previous moderate ID.
PubMed ID
17504896 View in PubMed
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The association between hypoechogenicity or irregular echo pattern at thyroid ultrasonography and thyroid function in the general population.

https://arctichealth.org/en/permalink/ahliterature167366
Source
Eur J Endocrinol. 2006 Oct;155(4):547-52
Publication Type
Article
Date
Oct-2006
Author
Pernille Vejbjerg
Nils Knudsen
Hans Perrild
Peter Laurberg
Inge Bülow Pedersen
Lone B Rasmussen
Lars Ovesen
Torben Jørgensen
Author Affiliation
Department of Internal Medicine I, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark. pervej01@glostruphosp.kbhamt.dk
Source
Eur J Endocrinol. 2006 Oct;155(4):547-52
Date
Oct-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Autoantibodies - blood
Autoantigens - immunology
Cross-Sectional Studies
Denmark
Female
Humans
Hyperthyroidism - ultrasonography
Hypothyroidism - ultrasonography
Image Processing, Computer-Assisted - statistics & numerical data
Iodide Peroxidase - immunology
Iron-Binding Proteins - immunology
Male
Mass Screening - methods
Middle Aged
Thyroid Diseases - diagnosis - ultrasonography
Thyroid Function Tests
Thyroid Gland - physiology
Thyrotropin - blood
Abstract
Patients with overt hypothyroidism show decreased echogenicity of the thyroid at ultrasonography (US). The aim of this study was to investigate the association between echogenicity of the thyroid/irregular echo pattern, and thyroid function in the general population, i.e. subjects without overt thyroid disease.
A cross-sectional investigation of 4649 randomly selected adult subjects.
Blood samples were analysed for serum TSH, thyroid hormones and thyroid autoantibodies. US of the thyroid was performed.
Participants with decreased echogenicity (n=379) had a higher mean TSH (1.65 mU/l) compared with subjects with normal echogenicity (1.21 mU/l, P
PubMed ID
16990653 View in PubMed
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Association of tobacco smoking with goiter in a low-iodine-intake area.

https://arctichealth.org/en/permalink/ahliterature67387
Source
Arch Intern Med. 2002 Feb 25;162(4):439-43
Publication Type
Article
Date
Feb-25-2002
Author
Nils Knudsen
Inge Bülow
Peter Laurberg
Lars Ovesen
Hans Perrild
Torben Jørgensen
Author Affiliation
Danish Centre for Prevention of Thyroid Diseases (DanThyr), Glostrup University Hospital, Copenhagen, Denmark. nijak@herlevhosp.kbhamt.dk
Source
Arch Intern Med. 2002 Feb 25;162(4):439-43
Date
Feb-25-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cross-Sectional Studies
Denmark - epidemiology
Female
Goiter - complications - epidemiology - ultrasonography
Humans
Interviews
Iodine - deficiency
Linear Models
Male
Middle Aged
Prevalence
Questionnaires
Research Support, Non-U.S. Gov't
Smoking - adverse effects
Smoking Cessation
Thyroid Function Tests
Abstract
BACKGROUND: Goiter development depends on genetic and environmental factors. The major environmental factor is iodine intake, whereas diverging results have been published concerning the association between smoking and goiter. METHODS: A comparable, cross-sectional study was performed of patients from 2 areas in Denmark with mild and moderate iodine deficiency. A random sample of women and men in selected age groups from the general community was investigated; 4649 subjects participated. Smoking habits were investigated with questionnaires and interviews. Ultrasonography and clinical examination of the thyroid were performed, serum thyroglobulin was measured, and iodine concentration in spot urine samples was analyzed. Data were analyzed in linear models and logistic regression analyses. RESULTS: Serum thyroglobulin level and thyroid volume at ultrasonography were positively associated with smoking habits (P
PubMed ID
11863477 View in PubMed
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Birth defects after early pregnancy use of antithyroid drugs: a Danish nationwide study.

https://arctichealth.org/en/permalink/ahliterature106534
Source
J Clin Endocrinol Metab. 2013 Nov;98(11):4373-81
Publication Type
Article
Date
Nov-2013
Author
Stine Linding Andersen
Jørn Olsen
Chun Sen Wu
Peter Laurberg
Author Affiliation
Department of Endocrinology, Aalborg University Hospital, Søndre Skovvej 15, DK-9000 Aalborg, Denmark. stine.a@rn.dk.
Source
J Clin Endocrinol Metab. 2013 Nov;98(11):4373-81
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Abnormalities, Drug-Induced - epidemiology
Adult
Antithyroid Agents - administration & dosage - adverse effects
Carbimazole - administration & dosage - adverse effects
Denmark - epidemiology
Female
Humans
Hyperthyroidism - drug therapy
Infant, Newborn
Male
Methimazole - administration & dosage - adverse effects
Pregnancy
Pregnancy Complications - drug therapy
Pregnancy Trimester, First
Prevalence
Propylthiouracil - administration & dosage - adverse effects
Abstract
Hyperthyroidism in pregnant women should be adequately treated to prevent maternal and fetal complications, but teratogenic effects of antithyroid drug (ATD) treatment have been described. Evidence is still lacking in regard to the safety and choice of ATD in early pregnancy.
Our objective was to determine to which degree the use of methimazole (MMI)/carbimazole (CMZ) and propylthiouracil (PTU) in early pregnancy is associated with an increased prevalence of birth defects.
This Danish nationwide register-based cohort study included 817 093 children live-born from 1996 to 2008. Exposure groups were assigned according to maternal ATD use in early pregnancy: PTU (n = 564); MMI/CMZ (n = 1097); MMI/CMZ and PTU (shifted in early pregnancy [n = 159]); no ATD (ATD use, but not in pregnancy [n = 3543]); and nonexposed (never ATD use [n = 811 730]). Multivariate logistic regression was used to estimate adjusted odds ratio (OR) with 95% confidence interval (95% CI) for diagnosis of a birth defect before 2 years of age in exposed versus nonexposed children.
The prevalence of birth defects was high in children exposed to ATD in early pregnancy (PTU, 8.0%; MMI/CMZ, 9.1%; MMI/CMZ and PTU, 10.1%; no ATD, 5.4%; nonexposed, 5.7%; P
Notes
Comment In: J Clin Endocrinol Metab. 2013 Nov;98(11):4332-524194618
PubMed ID
24151287 View in PubMed
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A cautious iodization programme bringing iodine intake to a low recommended level is associated with an increase in the prevalence of thyroid autoantibodies in the population.

https://arctichealth.org/en/permalink/ahliterature260577
Source
Clin Endocrinol (Oxf). 2011 Jul;75(1):120-6
Publication Type
Article
Date
Jul-2011
Author
Inge B Pedersen
Nils Knudsen
Allan Carlé
Pernille Vejbjerg
Torben Jørgensen
Hans Perrild
Lars Ovesen
Lone B Rasmussen
Peter Laurberg
Source
Clin Endocrinol (Oxf). 2011 Jul;75(1):120-6
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Autoantibodies - blood
Autoantigens - immunology
Denmark - epidemiology
Female
Follow-Up Studies
Humans
Iodide Peroxidase - immunology
Iodine - administration & dosage - pharmacology
Iron-Binding Proteins - immunology
Male
Mandatory Programs - statistics & numerical data
Middle Aged
Nutritional Status
Prevalence
Sex Factors
Sodium Chloride, Dietary - administration & dosage - pharmacology
Thyroglobulin - immunology
Young Adult
Abstract
Autoantibodies against the thyroid gland with thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (Tg-Ab) as the most common can often be demonstrated in serum. The effect of public iodization programmes on antibody prevalence is uncertain.
To measure the concentrations of thyroid autoantibodies in the Danish population before and after mandatory iodization of salt.
Two identical cross-sectional population studies were performed before (Cohort 1 (C1), year 1997-1998, n = 4649, median urinary iodine 61 µg/l) and 4-5 years after (Cohort 2 (C2), year 2004-2005, n = 3570, median urinary iodine 101 µg/l) mandatory iodine fortification of salt was implemented in Denmark. Blood tests were analysed for TPO-Ab and Tg-Ab using sensitive assays.
Antibodies were more frequent in C2 than in C1: TPO-Ab > 30 U/ml, C1 vs C2: 14·3 vs 23·8% (P 20 U/ml, C1 vs C2: 13·7 vs 19·9% (P
Notes
Comment In: Clin Endocrinol (Oxf). 2011 Jul;75(1):10-121521313
PubMed ID
21521277 View in PubMed
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Changes in iodine excretion in 50-69-y-old denizens of an Arctic society in transition and iodine excretion as a biomarker of the frequency of consumption of traditional Inuit foods.

https://arctichealth.org/en/permalink/ahliterature4745
Source
Am J Clin Nutr. 2005 Mar;81(3):656-63
Publication Type
Article
Date
Mar-2005
Author
Stig Andersen
Bodil Hvingel
Kent Kleinschmidt
Torben Jørgensen
Peter Laurberg
Author Affiliation
Department of Endocrinology and Medicine, Aalborg Hospital, Aarhus University Hospital, Denmark. stiga@dadlnet.dk
Source
Am J Clin Nutr. 2005 Mar;81(3):656-63
Date
Mar-2005
Language
English
Publication Type
Article
Keywords
Aged
Biological Markers - urine
Cohort Studies
Diet
Diet Surveys
Dietary Supplements
Female
Food Habits - ethnology
Greenland
Humans
Inuits
Iodine - administration & dosage - deficiency - urine
Life Style
Male
Middle Aged
Multivariate Analysis
Nutritional Requirements
Nutritional Status
Questionnaires - standards
Research Support, Non-U.S. Gov't
Abstract
BACKGROUND: Iodine intake in Greenland has been hypothesized to exceed 10 times the recommended amount. The transition from a traditional Arctic society may change the iodine intake, but no field studies have been performed. OBJECTIVE: We aimed to ascertain iodine intakes, factors affecting iodine intake in circumpolar populations, and the usefulness of urinary iodine excretion as a biomarker for validation of Inuit food-frequency questionnaires. DESIGN: Data were collected in a cohort study of 4 Greenland population groups: Inuit living in the capital city, the major town, and settlements in East Greenland and non-Inuit. Supplement use and lifestyle factors were evaluated with questionnaires, and dietary habits were ascertained with a food-frequency questionnaire. Iodine was measured in spot urine samples. RESULTS: One percent of the population of Greenland was invited, and the participation rate was 95%. Less than 5% of Inuit but 55% of non-Inuit had urinary iodine excretion
PubMed ID
15755836 View in PubMed
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83 records – page 1 of 9.