BACKGROUND: The evidence for an association between alcohol consumption and risk of atrial fibrillation is conflicting. METHODS: We prospectively examined the association between alcohol consumption and risk of atrial fibrillation or flutter among 47 949 participants (mean age, 56 years) in the Danish Diet, Cancer, and Health Study. The consumption of alcohol was analyzed as sex-specific quintiles by Cox proportional hazards regression models. RESULTS: The mean +/- SD consumption of alcohol per day was 28.2 +/- 25 g in men and 13.9 +/- 15 g in women. During follow-up (mean, 5.7 years), atrial fibrillation or flutter developed in 556 subjects (374 men and 182 women). After adjusting for established risk factors, there was a modest increase in risk of atrial fibrillation or flutter by increasing alcohol consumption in men. When using the lowest quintile of alcohol consumption in men as a reference, the adjusted hazard rate ratios in men in quintiles 2, 3, 4, and 5 were 1.04, 1.44, 1.25, and 1.46, respectively (P for trend, .04). When using the lowest quintile of alcohol consumption in women as a reference, the adjusted hazard rate ratios in women in quintiles 2, 3, 4, and 5 were 1.09, 1.27, 1.23, and 1.14, respectively (P for trend, .69). Inclusion of information on the frequency of alcohol consumption and the preferred source of alcohol did not change these associations. CONCLUSIONS: Consumption of alcohol was associated with an increased risk of atrial fibrillation or flutter in men. In women, moderate consumption of alcohol did not seem to be associated with risk of atrial fibrillation or flutter.
We prospectively examined the association between alcohol consumption and risk of atrial fibrillation or flutter among 47,949 participants (mean age 56 years) in the Danish Diet, Cancer and Health Study. During follow-up (mean 5.7 years) atrial fibrillation or flutter developed in 556 subjects (374 men and 182 women). We found that consumption of alcohol was associated with an increased risk of atrial fibrillation or flutter in men. In women, moderate consumption of alcohol did not seem to be associated with an increased risk of atrial fibrillation or flutter.
We studied whether the reduction in bone turnover by use of antiresorptive drugs is detrimental in patients with diabetes who already have low bone turnover due to hyperglycemia in a nationwide cohort study from Denmark. All users of antiresorptive drugs against osteoporosis between 1996 and 2006 (n = 103,562) were the exposed group, with three age- and gender-matched controls from the general population (n = 310,683). Patients on bisphosphonates and raloxifene had a higher risk of hip, spine, and forearm fractures. However, no difference was observed in the antifracture efficacy between patients with diabetes and nondiabetic controls or between patients with type 1 and type 2 diabetes. Too few were users of strontium to allow analysis for this compound. The excess risk of fractures among patients treated with bisphosphonates or raloxifene compared to nonexposed controls was due to the higher a priori risk of fractures among patients treated for osteoporosis. Diabetes does not seem to affect the fracture-preventive potential of bisphosphonates or raloxifene. The low-turnover state of diabetes thus does not seem to be a hindrance to the effect of these drugs against osteoporosis. Therefore, patients with diabetes should receive treatment for osteoporosis in the same way as nondiabetic patients.
Antithyroid drugs (ATDs) may have teratogenic effects, but more evidence is needed on the risk and types of birth defects after the use of methimazole (MMI) and propylthiouracil (PTU). This study aimed to evaluate the association between the use of ATDs in early pregnancy and birth defects.
Swedish nationwide register-based cohort study.
The study included 684 340 children live-born in Sweden from 2006 to 2012. Exposure groups defined by maternal ATD use in early pregnancy were MMI (n?=?162); PTU (n?=?218); MMI and PTU (n?=?66); ATD before or after, but not in pregnancy (n?=?1551) and non-exposed (never ATD (n?=?682 343)). Outcome was cumulative incidence of birth defects diagnosed before two years of age.
The cumulative incidence of birth defects was not significantly different in children exposed to MMI (6.8%, P?=?0.6) or PTU (6.4%, P?=?0.4) vs non-exposed (8.0%). For subtypes of birth defects, MMI was associated with an increased incidence of septal heart defects (P?=?0.02). PTU was associated with ear (P?=?0.005) and obstructive urinary system malformations (P?=?0.006). A case of choanal atresia was observed after exposure to both MMI and PTU. The incidence of birth defects in children born to mothers who received ATD before or after, but not in pregnancy, was 8.8% and not significantly different from non-exposed (P?=?0.3), MMI exposed (P?=?0.4) or PTU exposed (P?=?0.2).
MMI and PTU were associated with subtypes of birth defects previously reported, but the frequency of ATD exposure in early pregnancy was low and severe malformations described in the MMI embryopathy were rarely observed.
This study aims to quantify bone mineral density (BMD) changes following surgery in patients with primary hyperparathyroidism (PHPT) and to assess their relationship with clinical and biochemical variables.
A historic cohort of 236 PHPT patients with DXA scans pre- and 1-year postoperatively, clinical data, and biochemical data was analyzed.
The mean age was 60 years (range 19-86) and 81 % of the patients were women. A significant postoperative 2.6 % (95 % CI, 2.1; 3.1) increase in lumbar spine BMD was seen. The increase in BMD was positively associated with preoperative plasma PTH (p?=?0.002), Ca(2+) (p?
The aim of the present study was to investigate bone status and biological mechanisms involved in the negative impact of anorexia nervosa (AN) on osteogenesis.
A total of 30 AN patients from Aalborg University Hospital who underwent bone scans were included in a cross-sectional study. Biochemical data, bone scans (dual-energy X-ray absorptiometry (DXA)) as well as general health and medical information had been collected during the 2009-2011 period and stored via local and national clinical databases in Denmark, and from these databases we identified all patients with an AN diagnosis who underwent bone scans.
AN patients had a mean Z-score of -1.5 to -1.6 in lumbar spine and total hip, respectively. The hip Z-score decreased with duration of disease, and a positive correlation was seen between serum 25-hydroxy-vitamin D level and spine Z-score but not hip Z-score. Bone mineral density did not seem to change with time since diagnosis. Additionally, a negative correlation between serum 25-hydroxy-vitamin D levels and serum total alkaline phosphatase levels was found. A serum 25-hydroxy-vitamin D level below 50 nmol/l was associated with increased alkaline phosphatase levels.
Rather than clinical measures including BMI and biochemical measures disease duration was the main predictor of bone status. This implies that long-term disease should be a main factor in selecting patients for referral to DXA. Moreover, results from this study indicate normal osteoblastic response to malnutrition.
The present study was not registered due to its register-based design. However, the study was approved by the Danish Data Protection Agency.
BACKGROUND: It is not known whether the consumption of caffeine is associated with excess risk of atrial fibrillation. OBJECTIVE: We evaluated the risk of atrial fibrillation or flutter in association with daily consumption of caffeine from coffee, tea, cola, cocoa, and chocolate. DESIGN: We prospectively examined the association between the amount of caffeine consumed per day and the risk of atrial fibrillation or flutter among 47 949 participants (x age: 56 y) in the Danish Diet, Cancer, and Health Study. Subjects were followed in the Danish National Registry of Patients and in the Danish Civil Registration System. The consumption of caffeine was analyzed by quintiles with Cox proportional-hazard models. RESULTS: During follow-up (x: 5.7 y), atrial fibrillation or flutter developed in 555 subjects (373 men and 182 women). When the lowest quintile of caffeine consumption was used as a reference, the adjusted hazard ratios (95% CIs) in quintiles 2, 3, 4, and 5 were 1.12 (0.87, 1.44), 0.85 (0.65, 1.12), 0.92 (0.71, 1.20), and 0.91 (0.70, 1.19), respectively. CONCLUSION: Consumption of caffeine was not associated with risk of atrial fibrillation or flutter.
Comment In: Am J Clin Nutr. 2005 Mar;81(3):539-4015755819
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are effective procedures for patients with moderate-to-severe osteoarthritis. Mortality rates after THA and TKA may have changed because of new surgical techniques, improvement of peri- and postoperative care, and performance of surgery in older patients having multiple comorbidities. However, data on secular mortality trends are scarce. We undertook this study to evaluate mortality patterns between 1989 and 2007 in patients undergoing elective THA and TKA.
In a Danish retrospective nationwide cohort study, 71,812 patients who underwent THA and 40,642 patients who underwent TKA were identified between January 1989 and December 2007. All-cause and disease-specific mortality was assessed, stratified by calendar periods. Using Cox proportional hazards models, relative risks (RRs) of mortality were calculated between different calendar periods, adjusted for age, sex, and comorbid diseases.
Since the early 1990s, short-term survival following elective THA and TKA has greatly improved. Compared with the period between 1989 and 1991, 60-day mortality rates between 2004 and 2007 were substantially lower for patients undergoing THA (RR 0.40, 95% confidence interval [95% CI] 0.28-0.58) and for patients undergoing TKA (RR 0.37, 95% CI 0.21-0.67). This trend was far superior to what was seen in the general population. The decrease in mortality was greatest for deaths from myocardial infarction, venous thromboembolism, pneumonia, and stroke. Patients tended to have more presurgical comorbidity over time, and the duration of hospital stay was roughly halved.
Mortality rates following elective THA and TKA have decreased substantially since the early 1990s, despite patients having more presurgical comorbidity. These findings are reassuring for patients undergoing elective THA or TKA.
Osteoporosis is a debilitating condition characterized by fractures, pain and premature death. Risk factors for osteoporosis predict the risk of fragility fractures.
To describe the occurrence of risk factors for osteoporosis among populations in Nuuk, the capital of Greenland.
A random sample of women born in 1934-42, 1945-47, 1956, and men born in 1956 were selected from the national civil registry. A questionnaire was sent out in Greenlandic and Danish on risk factors for osteoporosis: family history, smoking habits, alcohol intake, presence of disease, sun exposure, intake of dairy products, age at menopause (women) and number of falls. Additional questions included the frequency of back pain, previous fractures, intake of vitamin D and calcium supplements, use of anti-osteoporotic drugs, steroids and other drugs.
The questionnaire was sent to 317 subjects confirmed to be living at an address in Nuuk and 181 (57.1%) responded. More young women than older women were smokers (60.6% vs. 35.0%; p=0.022) while limited sun exposure was reported by more of the old women (37.2% vs. 5.6%; p=0.003). Family history of osteoporosis was reported by 15.0%, without difference between groups. Alcohol and milk intake did not differ between groups. Premature menopause was reported by 17.9% of the women. Falls within the last year were reported by 42.4% with fewer falls in the oldest age group (21.9% vs. 50.0%; p=0.005). Frequency of fragility fractures increased with age (5.7% vs. 24.3% vs. 30.4%; p=0.02) and the risk of a fragility fracture increased with age (p=0.004; OR, 95% CI: 4.5, 1.6-12.2, reference: below 70 years), when adjusted for smoking, gender and falls. The use of anti-osteoporotic drugs was low (3.4%) while 28.8% took calcium and vitamin D supplements.
Age is a dominating risk factor for fragility fractures in Greenland. The use of anti-osteoporotic drugs is low in Greenland, even if osteoporotic fractures are common in old age.
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