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The association between longer relative leukocyte telomere length and risk of glioma is independent of the potentially confounding factors allergy, BMI, and smoking.

https://arctichealth.org/en/permalink/ahliterature299110
Source
Cancer Causes Control. 2019 Feb; 30(2):177-185
Publication Type
Journal Article
Date
Feb-2019
Author
Ulrika Andersson
Sofie Degerman
Anna M Dahlin
Carl Wibom
Gunnar Johansson
Melissa L Bondy
Beatrice S Melin
Author Affiliation
Department of Radiation Sciences, Oncology, Umea University, Umea, Sweden. ulrika.l.andersson@umu.se.
Source
Cancer Causes Control. 2019 Feb; 30(2):177-185
Date
Feb-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Aged, 80 and over
Body mass index
Brain Neoplasms - epidemiology - genetics
Case-Control Studies
Confounding Factors (Epidemiology)
Female
Glioma - epidemiology - genetics
Humans
Hypersensitivity - epidemiology
Leukocytes
Male
Middle Aged
Phenotype
Risk factors
Smoking - epidemiology
Sweden - epidemiology
Telomere
Abstract
Previous studies have suggested an association between relative leukocyte telomere length (rLTL) and glioma risk. This association may be influenced by several factors, including allergies, BMI, and smoking. Previous studies have shown that individuals with asthma and allergy have shortened relative telomere length, and decreased risk of glioma. Though, the details and the interplay between rLTL, asthma and allergies, and glioma molecular phenotype is largely unknown.
rLTL was measured by qPCR in a Swedish population-based glioma case-control cohort (421 cases and 671 controls). rLTL was related to glioma risk and health parameters associated with asthma and allergy, as well as molecular events in glioma including IDH1 mutation, 1p/19q co-deletion, and EGFR amplification.
Longer rLTL was associated with increased risk of glioma (OR?=?1.16; 95% CI 1.02-1.31). Similar to previous reports, there was an inverse association between allergy and glioma risk. Specific, allergy symptoms including watery eyes was most strongly associated with glioma risk. High body mass index (BMI) a year prior diagnosis was significantly protective against glioma in our population. Adjusting for allergy, asthma, BMI, and smoking did not markedly change the association between longer rLTL and glioma risk. rLTL among cases was not associated with IDH1 mutation, 1p/19q co-deletion, or EGFR amplification, after adjusting for age at diagnosis and sex.
In this Swedish glioma case-control cohort, we identified that long rLTL increases the risk of glioma, an association not confounded by allergy, BMI, or smoking. This highlights the complex interplay of the immune system, rLTL and cancer risk.
PubMed ID
30560391 View in PubMed
Less detail

Comorbidity, disease burden and mortality across age groups in a Swedish primary care asthma population: An epidemiological register study (PACEHR).

https://arctichealth.org/en/permalink/ahliterature296644
Source
Respir Med. 2018 03; 136:15-20
Publication Type
Journal Article
Observational Study
Date
03-2018
Author
Karin Lisspers
Christer Janson
Kjell Larsson
Gunnar Johansson
Gunilla Telg
Marcus Thuresson
Björn Ställberg
Author Affiliation
Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden. Electronic address: karin.lisspers@ltdalarna.se.
Source
Respir Med. 2018 03; 136:15-20
Date
03-2018
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Acute Disease
Adolescent
Adult
Age Distribution
Aged
Asthma - mortality - physiopathology
Child
Cohort Studies
Comorbidity
Female
Forced Expiratory Volume - physiology
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Patient Acceptance of Health Care - statistics & numerical data
Prognosis
Registries
Risk factors
Sweden - epidemiology
Young Adult
Abstract
Asthma is often associated with other diseases. To identify and manage comorbidities is important, as these conditions may increase the disease burden.
To describe the prevalence of comorbidities, disease burden and mortality across age groups in a large Swedish primary care real-life asthma population.
Observational cohort study of asthma patients, all ages, identified from electronic medical records by ICD-10-CM code, data from 36 primary care centers. Data were linked to national mandatory Swedish health registers. Comorbidities were identified by ICD-10-CM codes and collected from electronic medical records and the National Patient Registers, mortality data from the Cause of Death Register. Exacerbations were defined as hospitalizations due to asthma, and/or emergency visits at hospital and/or prescription claims of oral steroids.
In total 33,468 patients (58% women) were included. The most prevalent comorbidities were acute upper respiratory tract infection (53%), rhinitis (25%), acute lower respiratory tract infection (25%), hypertension (21%), anxiety and depression (20%). The comorbidities associated with highest risk for an exacerbation were COPD OR 1.98 (95%CI: 1.80-2.19), nasal polyps OR 1.75 (95%CI: 1.49-2.05) and rhinitis OR 1.52 (95%CI: 1.41-1.63). All-cause mortality was similar to the Swedish population, 1011 deaths per 100,000 person/year compared with 1058 deaths (standardized risk?=?0.99 [95%CI:0.95-1.04]). The pulmonary related death rate was greater in the study population versus the Swedish population (122 versus 72 per 100,000person/year).
Comorbid disease was frequent in this large real-life asthma population with an impact on exacerbations. To identify and treat comorbidities with impact on asthma outcomes are essential to improve asthma care.
PubMed ID
29501242 View in PubMed
Less detail

Cultural adaptation and validation of the Swedish VEINES-QOL/Sym in patients with venous insufficiency.

https://arctichealth.org/en/permalink/ahliterature296027
Source
Phlebology. 2018 Sep; 33(8):540-546
Publication Type
Journal Article
Date
Sep-2018
Author
Helen Sinabulya
Gunnar Bergström
Jan Hagberg
Gunnar Johansson
Lena Blomgren
Author Affiliation
1 Department of Molecular Medicine and Surgery, Division of Vascular Surgery, Karolinska Institutet, Stockholm, Sweden.
Source
Phlebology. 2018 Sep; 33(8):540-546
Date
Sep-2018
Language
English
Publication Type
Journal Article
Keywords
Adaptation, Psychological
Adult
Aged
Aged, 80 and over
Cohort Studies
Female
Humans
Male
Middle Aged
Surveys and Questionnaires
Sweden - epidemiology
Venous Insufficiency - epidemiology - psychology
Abstract
Objectives To translate and evaluate the psychometric properties of the Venous Insufficiency Epidemiological and Economic Studies (VEINES) questionnaire, divided into two subscales; symptoms (VEINES-Sym) and quality of life (VEINES-QOL), in a Swedish cohort of patients with venous disease. Methods The original questionnaire was translated into Swedish with forward-backward translation and administered to 112 patients who were consecutively recruited and had varying degrees of chronic venous disease. Mean age was 54.5?±?15.2 years (range: 19-83) and 75% of the participants were female. All patients completed the RAND 36-item health survey and the VEINES-QOL/Sym. Results The results showed excellent internal consistency for both VEINES-QOL (Cronbach's alpha (a)?=?0.93) and VEINES-Sym (a?=?0.89). Both the VEINES-QOL and VEINES-Sym correlated well to all the RAND-36 domains, demonstrating good construct validity. Exploratory factor analysis confirmed both subscales of the VEINES-QOL/Sym. Conclusions The Swedish VEINES-QOL/Sym is a valid health-related quality of life instrument for chronic venous disease, both for research purposes and for clinical evaluation.
PubMed ID
28954585 View in PubMed
Less detail

Economic burden of COPD in a Swedish cohort: the ARCTIC study.

https://arctichealth.org/en/permalink/ahliterature289388
Source
Int J Chron Obstruct Pulmon Dis. 2018; 13:275-285
Publication Type
Journal Article
Date
2018
Author
Karin Lisspers
Kjell Larsson
Gunnar Johansson
Christer Janson
Madlaina Costa-Scharplatz
Jean-Bernard Gruenberger
Milica Uhde
Leif Jorgensen
Florian S Gutzwiller
Björn Ställberg
Author Affiliation
Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala.
Source
Int J Chron Obstruct Pulmon Dis. 2018; 13:275-285
Date
2018
Language
English
Publication Type
Journal Article
Abstract
We assessed direct and indirect costs associated with COPD in Sweden and examined how these costs vary across time, age, and disease stage in a cohort of patients with COPD and matched controls in a real-world, primary care (PC) setting.
Data from electronic medical records linked to the mandatory national health registers were collected for COPD patients and a matched reference population in 52 PC centers from 2000 to 2014. Direct health care costs (drug, outpatient or inpatient, PC, both COPD related and not COPD related) and indirect health care costs (loss of income, absenteeism, loss of productivity) were assessed.
A total of 17,479 patients with COPD and 84,514 reference controls were analyzed. During 2013, direct costs were considerably higher among the COPD patient population (€13,179) versus the reference population (€2,716), largely due to hospital nights unrelated to COPD. Direct costs increased with increasing disease severity and increasing age and were driven by higher respiratory drug costs and non-COPD-related hospital nights. Indirect costs (~€28,000 per patient) were the largest economic burden in COPD patients of working age during 2013.
As non-COPD-related hospital nights represent the largest direct cost, management of comorbidities in COPD would offer clinical benefits and relieve the financial burden of disease.
Notes
Cites: Int J Chron Obstruct Pulmon Dis. 2014 Mar 19;9:289-300 PMID 24672234
Cites: Respir Med. 2016 Feb;111:39-46 PMID 26725462
Cites: Popul Health Manag. 2012 Oct;15(5):267-75 PMID 22401150
Cites: COPD. 2015 Aug;12(4):381-9 PMID 25415366
Cites: Respir Med. 2007 Mar;101(3):539-46 PMID 16889949
Cites: Int J Chron Obstruct Pulmon Dis. 2017 Feb 23;12 :735-744 PMID 28260880
Cites: Eur Respir J. 2008 Dec;32(6):1433-42 PMID 19043008
Cites: J Occup Environ Med. 2008 Oct;50(10):1130-8 PMID 18849758
Cites: Respir Med. 2002 Sep;96(9):700-8 PMID 12243316
Cites: PLoS One. 2016 Apr 19;11(4):e0152618 PMID 27092775
Cites: Respir Med. 2010 Mar;104(3):404-11 PMID 19963361
Cites: Respir Med. 2014 Sep;108(9):1345-54 PMID 25002194
Cites: Prim Care Respir J. 2010 Jun;19 Suppl 1:S1-20 PMID 20514388
Cites: PLoS One. 2015 Apr 13;10(4):e0123292 PMID 25875204
Cites: J Glob Health. 2015 Dec;5(2):020415 PMID 26755942
Cites: Respir Med. 2003 Mar;97 Suppl C:S81-9 PMID 12647946
Cites: Eur Respir Rev. 2014 Sep;23(133):345-9 PMID 25176970
Cites: Eur Respir J. 2006 Jan;27(1):188-207 PMID 16387952
Cites: Int J Chron Obstruct Pulmon Dis. 2010 May 06;5:125-32 PMID 20461144
Cites: Dan Med J. 2013 Jan;60(1):A4557 PMID 23340185
Cites: Prim Care Respir J. 2014 Mar;23(1):38-45 PMID 24346825
Cites: BMJ Open. 2014 Jan 06;4(1):e004069 PMID 24394800
Cites: Int J Chron Obstruct Pulmon Dis. 2014 Oct 14;9:1145-54 PMID 25342899
Cites: Arch Intern Med. 2000 Sep 25;160(17):2653-8 PMID 10999980
Cites: Respir Med. 2012 Apr;106(4):540-8 PMID 22100535
Cites: Am J Respir Crit Care Med. 2007 Sep 15;176(6):532-55 PMID 17507545
Cites: Clin Med Insights Circ Respir Pulm Med. 2015 Mar 12;9:5-21 PMID 25788838
Cites: Respir Med. 2013 Dec;107(12):1931-8 PMID 23910072
Cites: Eur Respir J. 2008 Oct;32(4):962-9 PMID 18579551
Cites: Prim Care Respir J. 2013 Dec;22(4):393-9 PMID 24114334
Cites: Int J Chron Obstruct Pulmon Dis. 2015 Dec 03;10:2609-18 PMID 26664109
Cites: COPD. 2005 Sep;2(3):311-8 PMID 17146996
Cites: Respir Med. 2010 May;104(5):697-704 PMID 19954941
Cites: Respir Med. 2008 Sep;102(9):1248-56 PMID 18620852
PubMed ID
29391785 View in PubMed
Less detail

Economic burden of COPD in a Swedish cohort: the ARCTIC study.

https://arctichealth.org/en/permalink/ahliterature295005
Source
Int J Chron Obstruct Pulmon Dis. 2018; 13:275-285
Publication Type
Journal Article
Observational Study
Date
2018
Author
Karin Lisspers
Kjell Larsson
Gunnar Johansson
Christer Janson
Madlaina Costa-Scharplatz
Jean-Bernard Gruenberger
Milica Uhde
Leif Jorgensen
Florian S Gutzwiller
Björn Ställberg
Author Affiliation
Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala.
Source
Int J Chron Obstruct Pulmon Dis. 2018; 13:275-285
Date
2018
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Absenteeism
Age Factors
Aged
Cost of Illness
Female
Health Care Costs - trends
Health Expenditures - trends
Humans
Income
Male
Middle Aged
Models, Economic
Primary Health Care - economics - trends
Pulmonary Disease, Chronic Obstructive - diagnosis - economics - epidemiology - therapy
Registries
Retrospective Studies
Sick Leave - economics
Sweden
Time Factors
Treatment Outcome
Abstract
We assessed direct and indirect costs associated with COPD in Sweden and examined how these costs vary across time, age, and disease stage in a cohort of patients with COPD and matched controls in a real-world, primary care (PC) setting.
Data from electronic medical records linked to the mandatory national health registers were collected for COPD patients and a matched reference population in 52 PC centers from 2000 to 2014. Direct health care costs (drug, outpatient or inpatient, PC, both COPD related and not COPD related) and indirect health care costs (loss of income, absenteeism, loss of productivity) were assessed.
A total of 17,479 patients with COPD and 84,514 reference controls were analyzed. During 2013, direct costs were considerably higher among the COPD patient population (€13,179) versus the reference population (€2,716), largely due to hospital nights unrelated to COPD. Direct costs increased with increasing disease severity and increasing age and were driven by higher respiratory drug costs and non-COPD-related hospital nights. Indirect costs (~€28,000 per patient) were the largest economic burden in COPD patients of working age during 2013.
As non-COPD-related hospital nights represent the largest direct cost, management of comorbidities in COPD would offer clinical benefits and relieve the financial burden of disease.
Notes
Cites: Int J Chron Obstruct Pulmon Dis. 2014 Mar 19;9:289-300 PMID 24672234
Cites: Respir Med. 2016 Feb;111:39-46 PMID 26725462
Cites: Popul Health Manag. 2012 Oct;15(5):267-75 PMID 22401150
Cites: COPD. 2015 Aug;12(4):381-9 PMID 25415366
Cites: Respir Med. 2007 Mar;101(3):539-46 PMID 16889949
Cites: Int J Chron Obstruct Pulmon Dis. 2017 Feb 23;12 :735-744 PMID 28260880
Cites: Eur Respir J. 2008 Dec;32(6):1433-42 PMID 19043008
Cites: J Occup Environ Med. 2008 Oct;50(10):1130-8 PMID 18849758
Cites: Respir Med. 2002 Sep;96(9):700-8 PMID 12243316
Cites: PLoS One. 2016 Apr 19;11(4):e0152618 PMID 27092775
Cites: Respir Med. 2010 Mar;104(3):404-11 PMID 19963361
Cites: Respir Med. 2014 Sep;108(9):1345-54 PMID 25002194
Cites: Prim Care Respir J. 2010 Jun;19 Suppl 1:S1-20 PMID 20514388
Cites: PLoS One. 2015 Apr 13;10(4):e0123292 PMID 25875204
Cites: J Glob Health. 2015 Dec;5(2):020415 PMID 26755942
Cites: Respir Med. 2003 Mar;97 Suppl C:S81-9 PMID 12647946
Cites: Eur Respir Rev. 2014 Sep;23(133):345-9 PMID 25176970
Cites: Eur Respir J. 2006 Jan;27(1):188-207 PMID 16387952
Cites: Int J Chron Obstruct Pulmon Dis. 2010 May 06;5:125-32 PMID 20461144
Cites: Dan Med J. 2013 Jan;60(1):A4557 PMID 23340185
Cites: Prim Care Respir J. 2014 Mar;23(1):38-45 PMID 24346825
Cites: BMJ Open. 2014 Jan 06;4(1):e004069 PMID 24394800
Cites: Int J Chron Obstruct Pulmon Dis. 2014 Oct 14;9:1145-54 PMID 25342899
Cites: Arch Intern Med. 2000 Sep 25;160(17):2653-8 PMID 10999980
Cites: Respir Med. 2012 Apr;106(4):540-8 PMID 22100535
Cites: Am J Respir Crit Care Med. 2007 Sep 15;176(6):532-55 PMID 17507545
Cites: Clin Med Insights Circ Respir Pulm Med. 2015 Mar 12;9:5-21 PMID 25788838
Cites: Respir Med. 2013 Dec;107(12):1931-8 PMID 23910072
Cites: Eur Respir J. 2008 Oct;32(4):962-9 PMID 18579551
Cites: Prim Care Respir J. 2013 Dec;22(4):393-9 PMID 24114334
Cites: Int J Chron Obstruct Pulmon Dis. 2015 Dec 03;10:2609-18 PMID 26664109
Cites: COPD. 2005 Sep;2(3):311-8 PMID 17146996
Cites: Respir Med. 2010 May;104(5):697-704 PMID 19954941
Cites: Respir Med. 2008 Sep;102(9):1248-56 PMID 18620852
PubMed ID
29391785 View in PubMed
Less detail

Exacerbations and healthcare resource utilization among COPD patients in a Swedish registry-based nation-wide study.

https://arctichealth.org/en/permalink/ahliterature299032
Source
BMC Pulm Med. 2018 Jan 25; 18(1):17
Publication Type
Journal Article
Date
Jan-25-2018
Author
Gunnar Johansson
Vasili Mushnikov
Tobias Bäckström
Andreas Engström
Javaria Mona Khalid
Jennifer Wall
Fabian Hoti
Author Affiliation
Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
Source
BMC Pulm Med. 2018 Jan 25; 18(1):17
Date
Jan-25-2018
Language
English
Publication Type
Journal Article
Keywords
Adrenal Cortex Hormones - therapeutic use
Adrenergic beta-2 Receptor Agonists - therapeutic use
Aged
Aged, 80 and over
Asthma - epidemiology
Bronchitis, Chronic - drug therapy - epidemiology
Cardiovascular Diseases - epidemiology
Comorbidity
Disease Progression
Female
Health Resources - statistics & numerical data
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Muscarinic Antagonists - therapeutic use
Pulmonary Disease, Chronic Obstructive - drug therapy - epidemiology
Registries
Severity of Illness Index
Sweden - epidemiology
Symptom Flare Up
Abstract
Exacerbations of chronic obstructive pulmonary disease (COPD) are an important measure of disease severity in terms of impaired disease progression, increased recovery time, healthcare resource utilization, overall morbidity and mortality. We aimed to quantify exacerbation and healthcare resource utilization rates among COPD patients in Sweden with respect to baseline treatments, exacerbation history, and comorbidities.
Patients with a COPD or chronic bronchitis (CB) diagnosis in secondary care at age of =40 years on 1.7.2009 were identified and followed until 1.7.2010 or death. Severe exacerbations were defined as hospitalizations due to respiratory disease, and healthcare resource utilization was measured by all-cause hospitalizations and secondary care visits. Poisson regression was used adjusting for age, gender, time since COPD/CB diagnosis, and Charlson comorbidity index.
In 88,548 patients (54% females, mean age 72 years), previous respiratory hospitalizations and current high use of COPD medication (double or triple therapy) predicted an 8.3-fold increase in severe exacerbation rates and 1.8-fold increase in healthcare resource utilization rates in the following year, compared to patients without combination treatment and/or history of severe exacerbations.
COPD/CB patients with history of severe exacerbations and high use of COPD medication experienced a significantly increased rate of severe exacerbations and healthcare resource utilization during the one-year follow-up.
PubMed ID
29370846 View in PubMed
Less detail

Factors associated with lung cancer in COPD patients.

https://arctichealth.org/en/permalink/ahliterature297602
Source
Int J Chron Obstruct Pulmon Dis. 2018; 13:1833-1839
Publication Type
Journal Article
Observational Study
Date
2018
Author
Martin Sandelin
Stéphanie Mindus
Marcus Thuresson
Karin Lisspers
Björn Ställberg
Gunnar Johansson
Kjell Larsson
Christer Janson
Author Affiliation
Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
Source
Int J Chron Obstruct Pulmon Dis. 2018; 13:1833-1839
Date
2018
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Administration, Inhalation
Adrenal Cortex Hormones - therapeutic use
Age Factors
Aged
Aspirin - adverse effects - therapeutic use
Asthma - complications - drug therapy - epidemiology
Comorbidity
Depression - epidemiology
Female
Heart Failure - epidemiology
Humans
Hypertension - epidemiology
Lung Neoplasms - epidemiology - etiology
Male
Multivariate Analysis
Prospective Studies
Pulmonary Disease, Chronic Obstructive - complications - drug therapy - epidemiology
Retrospective Studies
Risk factors
Sex Factors
Socioeconomic Factors
Sweden - epidemiology
Abstract
The risk of dying of lung cancer is up to eightfold higher in patients with COPD than in age- and gender-matched controls. The aim of this study was to investigate the factors associated with lung cancer in a large cohort of COPD patients from primary care centers.
To analyze whether age, gender, socioeconomic factors, comorbidity, and medication affect the risk of lung cancer in COPD, we used a COPD cohort of primary care patients. Data from primary care medical records and mandatory Swedish national registers were collected and linked in this population-based, retrospective observational registry study (NCT01146392).
Of the total cohort, 19,894 patients were included in the study. Five hundred and ninety-four lung cancer cases were diagnosed, corresponding to 3.0% of the studied population. In a multivariate analysis, the risk of lung cancer was lower if the COPD patients had a concurrent asthma diagnosis (HR: 0.54, CI: 0.41-0.71), while the risk of lung cancer increased with increasing age. A decreased lung cancer risk was observed in an exposure-dependent manner in patients who were prescribed inhaled corticosteroids (HR: 0.52, CI: 0.37-0.73), while the opposite was found for the use of acetylsalicylic acid (HR: 1.58, CI: 1.15-2.16).
In this large population-based cohort, a concurrent asthma diagnosis and use of inhaled corticosteroids were independently related to decreased risk of lung cancer in COPD patients, while the use of acetylsalicylic acid was associated with an increased risk. The findings of the present study should be seen as hypothesis generating and need to be confirmed in prospective studies.
PubMed ID
29922050 View in PubMed
Less detail

Haplotypes in the CYP2R1 gene are associated with levels of 25(OH)D and bone mineral density, but not with other markers of bone metabolism (MrOS Sweden).

https://arctichealth.org/en/permalink/ahliterature300308
Source
PLoS One. 2018; 13(12):e0209268
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Date
2018
Author
Anne Björk
Dan Mellström
Claes Ohlsson
Magnus Karlsson
Hans Mallmin
Gunnar Johansson
Östen Ljunggren
Andreas Kindmark
Author Affiliation
Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Source
PLoS One. 2018; 13(12):e0209268
Date
2018
Language
English
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Biomarkers - blood
Bone Density - genetics
Calcifediol - blood
Calcium - blood
Cholestanetriol 26-Monooxygenase - genetics
Cohort Studies
Cytochrome P450 Family 2 - genetics
Fibroblast Growth Factors - blood
Fractures, Bone - blood - genetics
Haplotypes
Humans
Male
Parathyroid Hormone - blood
Phosphates - blood
Polymorphism, Single Nucleotide
Prospective Studies
Sweden
Abstract
Polymorphisms in the CYP2R1 gene encoding Vitamin D 25-hydroxylase have been reported to correlate with circulating levels of 25-OH vitamin D3 (25(OH)D). It is unknown whether these variations also affect overall bone metabolism. In order to elucidate the overall associations of polymorphisms in the CYP2R1, we studied haplotype tagging single nucleotide polymorphisms (SNPs) in the gene and serum levels of 25(OH)D, calcium, phosphate, parathyroid hormone (PTH) and fibroblast growth factor-23 (FGF23), as well as bone mineral density (BMD).
Baseline data on serum parameters and BMD from MrOS Sweden, a prospective population-based cohort study of elderly men (mean age 75 years, range 69-81), were analyzed. Genotyping was performed for eight SNPs covering the CYP2R1 gene in 2868 men with available samples of DNA. Subjects were followed up concerning incidence of fracture during five years.
There was a significant genetic association with circulating levels of 25(OH)D (4.6-18.5% difference in mean values between SNP alleles), but there were no correlations with levels of calcium, phosphate, PTH or FGF23 for any genetic variant. No differences were found in fracture incidence between the variants. There was an inverse relationship between lower BMD and concomitant higher 25(OH)D for three of the haplotypes (p
PubMed ID
30576350 View in PubMed
Less detail

Health care resource utilization and cost for asthma patients regularly treated with oral corticosteroids - a Swedish observational cohort study (PACEHR).

https://arctichealth.org/en/permalink/ahliterature297711
Source
Respir Res. 2018 Sep 03; 19(1):168
Publication Type
Journal Article
Observational Study
Date
Sep-03-2018
Author
Christer Janson
Karin Lisspers
Björn Ställberg
Gunnar Johansson
Gunilla Telg
Marcus Thuresson
Helene Nordahl Christensen
Kjell Larsson
Author Affiliation
Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, 751 85, Uppsala, Sweden. christer.janson@medsci.uu.se.
Source
Respir Res. 2018 Sep 03; 19(1):168
Date
Sep-03-2018
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Administration, Oral
Adrenal Cortex Hormones - administration & dosage
Adult
Aged
Asthma - economics - epidemiology - therapy
Cohort Studies
Female
Follow-Up Studies
Health Care Costs - trends
Humans
Male
Middle Aged
Patient Acceptance of Health Care
Sweden - epidemiology
Treatment Outcome
Abstract
Patients with severe uncontrolled asthma may receive oral corticosteroid (OCS) treatment regularly. The present study investigated the health care resource utilization and cost in regularly OCS treated Swedish asthma patients.
Primary care medical records data were linked to data from Swedish national health registries. Patients =18 years with a drug claim for obstructive pulmonary diseases during 2007-2009 (index date) and a prior asthma diagnosis, were classified by their OCS claims during the 12-months' post index period: regular OCS equals =5 mg per day; periodic OCS less than 5 mg per day; or non-OCS users. Cost of asthma- and OCS-morbidity-related health care resource utilization were calculated.
A total of 15,437 asthma patients (mean age 47.8, female 62.6%), whereof 223 (1.44%) were regular OCS users, 3054 (19.7%) were periodic, and 12,160 (78.7%) were non-OCS users. Regular OCS users were older and more often females, had lower lung function, greater eosinophil count and more co-morbidities at baseline compared with the other groups. Age-adjusted annual total health care cost was three-times greater in the regular OCS group (€5615) compared with the non-OCS users (€1980) and twice as high as in the periodic OCS group (€2948). The major cost driver in the non-OCS and periodic OCS groups were primary care consultations, whereas inpatient costs were the major cost driver in the regular OCS group. The asthma related costs represented 10-12% of the total cost in all three groups.
In this real-life asthma study in Sweden, the total yearly cost of health care resource utilization for a regular OCS user was three times greater than for a patient with no OCS use, indicating substantial economic and health care burden for asthma patients on regular oral steroid treatment.
PubMed ID
30176850 View in PubMed
Less detail

 Identifying the associated risks of pneumonia in COPD patients: ARCTIC an observational study.

https://arctichealth.org/en/permalink/ahliterature294874
Source
Respir Res. 2018 Sep 10; 19(1):172
Publication Type
Journal Article
Date
Sep-10-2018
Author
Christer Janson
Gunnar Johansson
Björn Ställberg
Karin Lisspers
Petter Olsson
Dorothy L Keininger
Milica Uhde
Florian S Gutzwiller
Leif Jörgensen
Kjell Larsson
Author Affiliation
Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Akademiska sjukhuset, 75185, Uppsala, Sweden. christer.janson@medsci.uu.se.
Source
Respir Res. 2018 Sep 10; 19(1):172
Date
Sep-10-2018
Language
English
Publication Type
Journal Article
Abstract
Inhaled corticosteroids (ICS) are associated with an increased risk of pneumonia in patients with chronic obstructive pulmonary disease (COPD). Other factors such as severity of airflow limitation and concurrent asthma may further raise the possibility of developing pneumonia. This study assessed the risk of pneumonia associated with ICS in patients with COPD.
Electronic Medical Record data linked to National Health Registries were collected from COPD patients and matched reference controls in 52 Swedish primary care centers (2000-2014). Levels of ICS treatment (high, low, no ICS) and associated comorbidities were assessed. Patients were categorized by airflow limitation severity.
A total of 6623 patients with COPD and 48,566 controls were analyzed. Patients with COPD had a more than 4-fold increase in pneumonia versus reference controls (hazard ratio [HR] 4.76, 95% confidence interval [CI]: 4.48-5.06). ICS use increased the risk of pneumonia by 20-30% in patients with COPD with forced expiratory volume in 1 s?=?50% versus patients not using ICS. Asthma was an independent risk factor for pneumonia in the COPD population. Multivariate analysis identified independent predictors of pneumonia in the overall population. The highest risk of pneumonia was associated with high dose ICS (HR 1.41, 95% CI: 1.23-1.62).
Patients with COPD have a greater risk of pneumonia versus reference controls; ICS use and concurrent asthma increased the risk of pneumonia further.
Notes
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PubMed ID
30200965 View in PubMed
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