The carcinogenicity of cigar and pipe smoking is established but the effect of detailed smoking characteristics is less well defined. We examined the effects on cancer incidence of exclusive cigar and pipe smoking, and in combination with cigarettes, among 102395 men from Denmark, Germany, Spain, Sweden and UK in the EPIC cohort. Hazard ratios (HR) and their 95% confidence intervals (CI) for cancer during a median 9 year follow-up from ages 35-70 years were estimated using proportional hazards models. Compared to never smokers, HR of cancers of lung, upper aero-digestive tract and bladder combined was 2.2 (95% CI: 1.3, 3.8) for exclusive cigar smokers (16 cases), 3.0 (2.1, 4.5) for exclusive pipe smokers (33 cases) and 5.3 (4.4, 6.4) for exclusive cigarette smokers (1069 cases). For each smoking type, effects were stronger in current than in ex-smokers, and in inhalers than in non-inhalers. Ever smokers of both cigarettes and cigars (HR 5.7 (4.4, 7.3), 120 cases) and cigarettes and pipes (5.1 (4.1, 6.4), 247 cases) had as high a raised risk as had exclusive cigarette smokers. In these smokers, the magnitude of the raised risk was smaller if they had switched to cigars or pipes only (i.e. quit cigarettes) and had not compensated with greater smoking intensity. Cigar and pipe smoking is not a safe alternative to cigarette smoking. The lower cancer risk of cigar and pipe smokers as compared to cigarette smokers is explained by lesser degree of inhalation and lower smoking intensity. (c) 2010 UICC.
To assess the relationship of percentage of indigenous ancestry with body mass index (BMI) and waist to hip ratio (WHR) among Native Hawaiians.
A cross-sectional, observational study among 567 rural native Hawaiian men and women, aged 30 or older, enrolled between 1993-96.
Ancestry was assessed by self-report, and was verified with a brief genealogical interview. Anthropometric measurements, as well as dietary and physical activity histories were also obtained.
Percentage Hawaiian ancestry was significantly associated with increased body mass index (BMI), waist to hip ratio (WHR), and age. The association between percentage Hawaiian ancestry and both anthropometric measures persisted after adjusting for age, leisure time physical activity and total dietary energy intake.
Obesity and central adiposity were highly prevalent among Hawaiians participating in this study. The association between BMI and WHR with percentage Hawaiian ancestry, unexplained by differences in diet and physical activity, suggests genetic factors play an important role in the high prevalence of obesity observed among Native Hawaiians.
Valine and Leucine at HLA-DRß1 position 11 associate with radiographic progression in rheumatoid arthritis, independent of the Shared Epitope alleles but not independent of anti-citrullinated peptide antibodies.
Objective For decades it has been known that the HLA-DRB1 Shared Epitope (SE) alleles are associated with an increased risk on development and progression of rheumatoid arthritis (RA). Recently, new insights into variations in the peptide-binding grooves of HLA-molecules that predispose to RA-development are obtained: position 11 in HLA-DR?1 (Valine and Leucine), position 9 in HLA-B (Aspartic acid) and position 9 in HLA-DP?1 (Phenylalanine). This study investigated whether these variants also associate with radiographic progression within RA, independent of SE-status and ACPA. Methods In total 4,911 radiograph-sets of 1,878 RA-patients, included in the Leiden-EAC (Netherlands), Ume? (Sweden), HCSC-RAC (Spain) and NDB (USA) cohorts, were studied. HLA was imputed using SNP-data of the Immunochip and the mentioned amino acids were tested in relation to radiographic progression per cohort using an additive model. Results of the four cohorts were combined in inverse-variance weighted meta-analyses using a fixed effects model. Analyses were conditioned on SE-status and anti-citrullinated-peptide antibodies (ACPA). Results Valine and Leucine at HLA-DR?1 position 11 associated with more radiographic progression (meta-analysis p=5.11x10(-7) ); this effect was independent of SE-status (meta-analysis p=0.022) but not independent of ACPA. Aspartic acid at HLA-DP?1 position 9 associated with more severe radiographic progression (meta-analysis p=0.024), though not independent of SE-status. Phenylalanine at HLA-B position 9 was not associated with radiographic progression. Conclusion Valine and Leucine at HLA-DR?1 position 11 conferred risk to a higher rate of radiographic progression independent of SE-status but not independent of ACPA. This supports the relevance of these amino acids at position 11. This article is protected by copyright. All rights reserved.