European Journal of Epidemiology最新文献

{"title":"What can be learned when multiple analysts arrive at different estimates.","authors":"Julia M Rohrer, George Davey Smith, Marcus Munafò","doi":"10.1007/s10654-025-01249-2","DOIUrl":"https://doi.org/10.1007/s10654-025-01249-2","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary polyunsaturated fatty acid and risk of gout: a cohort study integrating genetic predisposition and metabolomics.","authors":"Li Chen, Tianqi Tan, Qi Wu, Feipeng Cui, Yashu Chen, Huimin Chen, Ying Zhao, Xia Xiang, Zhilei Shan, Yuhan Tang, Qianchun Deng","doi":"10.1007/s10654-025-01242-9","DOIUrl":"https://doi.org/10.1007/s10654-025-01242-9","url":null,"abstract":"<p><strong>Objectives: </strong>Gout is the most common inflammatory arthritis and affects quality of life. Dietary polyunsaturated fatty acids (PUFAs) have protective effects against various diseases, but its role in gout remains uncertain. Our study aims to assess the association between PUFAs intake and gout risk, the role of genetic factors, and the possible impact of metabolites.</p><p><strong>Methods: </strong>This study included 198,033 participants who were free of gout at baseline and completed at least one reliable dietary assessment in the UK Biobank. Cox proportional hazard models were used to estimate the associations between PUFAs intake and gout risk, and the modified effects of genetic predisposition. Mediation analysis also explored the mediating role of metabolic signature in associations between specific PUFAs intake and gout.</p><p><strong>Results: </strong>Over a median follow-up of 9.47 years, 1,708 incident cases of gout were recorded. Gout risk was significantly associated with the second quartile of linoleic acid (LA) (0.86 [0.75, 1.00]) intake and the highest quartiles of alpha-linolenic acid (ALA) (0.72 [0.62, 0.84]), total PUFA (HR: 0.84 [95% CI:0.71, 0.99]), n-6 PUFA (0.84 [0.71, 0.99]), n-3 PUFA (0.83 [0.71, 0.98]), and eicosapentaenoic acid (EPA) (0.79 [0.68, 0.91]), compared to the lowest quartiles. We observed joint effects of PUFAs intake and genetic susceptibility on gout risk. Mediation analysis showed that high-density lipoprotein (HDL) and triglycerides mediated the associations of ALA and LA with gout risk.</p><p><strong>Conclusion: </strong>Our findings suggested the potential benefits of PUFAs in reducing gout risk, particularly vegetable sources, with HDL and triglycerides as key mediators.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Keep asking: What do I want? What do I have? What do I do? : An approach for combining information to learn about a target population.","authors":"Lawson Ung, Issa J Dahabreh","doi":"10.1007/s10654-025-01222-z","DOIUrl":"https://doi.org/10.1007/s10654-025-01222-z","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postdiagnosis physical activity and dietary inflammatory and insulinemic potential with overall survival in men with nonmetastatic prostate cancer.","authors":"Dong Hoon Lee, Leandro F M Rezende, Gerson Ferrari, Yiwen Zhang, Qiao-Li Wang, Hannah Oh, NaNa Keum, Jinbo Hu, Justin Y Jeon, Lorelei A Mucci, Edward L Giovannucci","doi":"10.1007/s10654-025-01240-x","DOIUrl":"https://doi.org/10.1007/s10654-025-01240-x","url":null,"abstract":"<p><p>Inflammation and insulin resistance are associated with increased mortality in the general population. However, it remains unclear how physical activity and proinflammatory/hyperinsulinemic diets influence overall survival in prostate cancer patients. We analyzed 4779 men with nonmetastatic prostate cancer from the Health Professionals Follow-up Study. Postdiagnosis physical activity and diet were assessed using validated self-reported questionnaires. We used the validated dietary scores to empirically assess the anti-inflammatory (rEDIP) and anti-insulinemic (rEDIH) potential of dietary patterns based upon specific combinations of food groups. Cox regression model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During a median of 15 years of follow-up, we identified 2282 deaths. Compared to men with < 3 MET-h/week of postdiagnosis physical activity, multivariable-adjusted HRs (95% CI) were 0.80 (0.68-0.95) for 9-< 24 MET-h/week, 0.63 (0.53-0.75) for 24-< 48 MET-hours/week and 0.61 (0.51-0.73) for ≥ 48 MET-hours/week in relation to all-cause mortality (P-trend < 0.001). Both vigorous and non-vigorous activities after diagnosis were associated with lower all-cause mortality (P-trend < 0.001). Moreover, post-diagnosis rEDIP and rEDIH scores were inversely associated with all-cause mortality (HR per 1-SD increase: 0.93 (0.89-0.99) for rEDIP; 0.91 (0.86-0.96) for rEDIH). In joint analyses, men with high physical activity and high rEDIP (or rEDIH) score showed approximately 30-36% lower risks of all-cause mortality, compared to those with low physical activity and low diet scores. In conclusion, high physical activity and low proinflammatory and hyperinsulinemic diets were independently associated with decreased risk of all-cause mortality in men with prostate cancer. Men with both high physical activity and low proinflammatory and hyperinsulinemic diets after diagnosis have the lowest mortality rate.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer risk after in utero exposure to diethylstilbestrol.","authors":"Naomi B Boekel, Janneke Verloop, Hester H van Boven, Elisabeth J M van Erp, Lieske Schrijver, Matti A Rookus, Flora E van Leeuwen","doi":"10.1007/s10654-025-01234-9","DOIUrl":"https://doi.org/10.1007/s10654-025-01234-9","url":null,"abstract":"<p><p>In utero exposure to diethylstilbestrol (DES) is associated with increased risk of clear cell adenocarcinoma (CCAC) of the vagina or cervix. It is not clear whether these risks remain increased at older ages, and if the risks of other cancer sites, including breast cancer, are increased. This nationwide cohort study included 12,249 DES-exposed women and 2,070 unexposed sisters. Hormone-related risk factors and medical history were assessed through questionnaires, and cancer incidence through linkages with nationwide registries. Comparison with general population rates showed no difference in overall cancer risk (SIR = 0.98, 95%CI 0.93-1.04) or breast cancer risk (SIR = 1.03, 95%CI 0.96-1.11) for DES-exposed women. The rate of vaginal cancer was strongly increased for DES-exposed women (SIR = 10.5, 95%CI 5.72-17.6) and was increased in all age categories, including age 60-69 years (SIR = 8.3, 95%CI 1.00-29.9). Risks of both CCAC (SIR = 49.1, 95%CI 21.2-96.8) and squamous cell carcinoma (SCC; SIR = 5.86, 95%CI 2.15-12.8) of the vagina were significantly elevated. When comparing DES-exposed women with DES-unexposed sisters, overall cancer risk and risk of breast cancer were similar (HR = 0.93, 95%CI 0.78-1.11 and HR = 0.97, 95%CI 0.76-1.23, respectively). Apart from the established increased risk of vaginal cancer, women exposed to DES in utero do not seem to be at increased risk of cancer, including breast cancer. The risk of vaginal cancer remains increased also for women in their fifties/sixties. Moreover, the increased risk of vaginal cancer was seen for both subtypes CCAC and SCC. Screening for vaginal cancer up to higher ages than currently recommended (< 60 years) should be considered.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IRB for systematic reviews?","authors":"Alexis Descatha, Aurélie Mayet, Khalid Eddahiri","doi":"10.1007/s10654-025-01244-7","DOIUrl":"https://doi.org/10.1007/s10654-025-01244-7","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in LDL-cholesterol levels following aromatase inhibitor treatment in early postmenopausal breast cancer.","authors":"Marie Lund,Giulia Corn,Maj-Britt Jensen,Tonny Petersen,Kim Dalhoff,Bent Ejlertsen,Lars Køber,Jan Wohlfahrt,Mads Melbye","doi":"10.1007/s10654-025-01228-7","DOIUrl":"https://doi.org/10.1007/s10654-025-01228-7","url":null,"abstract":"There is an unsettled concern that treatment with aromatase inhibitors (AIT) may adversely affect lipid-levels. In light of the improved survival of women with breast cancer and increased risk of atherosclerotic cardiovascular disease in older people, unfavorable effects on lipid-levels may represent a significant health concern for this group of patients. We used linked data from nationwide registries, including a clinical breast cancer database with information about allocated and dispensed AIT. Based on these, we investigated changes in plasma lipid-levels (primary outcome: low-density lipoprotein (LDL)-cholesterol, secondary outcomes: high-density lipoprotein (HDL)-cholesterol, total cholesterol, and triglycerides) following AIT in a nationwide cohort of postmenopausal women with early breast cancer, Denmark, 2009-2020. Included women had at least one LDL-cholesterol measurement before and after breast cancer diagnosis. Exposure was allocated and dispensed AIT as compared with not allocated to and no dispensed AIT. Outcome was the adjusted difference in lipid-level-change (from before to after breast cancer diagnosis) according to AIT. Among 10,461 women, there were 22,693 pre-breast cancer LDL-cholesterol measurements and 42,750 post-breast cancer LDL-cholesterol measurements. Overall, 7919 of the women were exposed to AIT and 2542 women were unexposed. For AIT exposed, the LDL-cholesterol-change was - 0.16 mmol/L (mM), and for unexposed, - 0.15 mM, respectively. The corresponding adjusted difference in LDL-cholesterol change for AIT exposed versus unexposed was - 0.03 mM (95% CI - 0.07 to 0.003). We found similar results in analysis of secondary outcomes. This study does not support the concern that AIT adversely affects lipid-levels.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"1 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The healthcare system in Sweden","authors":"Jonas F. Ludvigsson, David Bergman, Catharina Ihre Lundgren, Kristina Sundquist, Jean-Luc af Geijerstam, Anna H. Glenngård, Marie Lindh, Johan Sundström, Johan Kaarme, Jialu Yao","doi":"10.1007/s10654-025-01226-9","DOIUrl":"https://doi.org/10.1007/s10654-025-01226-9","url":null,"abstract":"<p>The Swedish population is characterized by high life expectancy and low avoidable mortality rates. This review outlines the Swedish healthcare system, which offers universal access to all residents and has a long tradition of reforms for social equity. Responsibility for healthcare is shared between the state, the regions, and the municipalities. The Ministry of Health and Social Affairs provides the overall healthcare framework; additionally, several governmental agencies are directly involved in healthcare and public health initiatives. The 21 regions organize, finance, and provide most primary, secondary, and tertiary care, as well as health information channels. Resources for primary care are less plentiful than in many other countries. The 290 municipalities deliver care to elderly people and those with functional impairment. The Swedish healthcare system is primarily tax-funded, with 86% of total healthcare expenditures from public expenses and &lt; 1% from voluntary health insurance. The gross domestic product (GDP) share of healthcare expenditures, 10.5% in 2022, is above the EU average. The level of unmet needs in the population is low, due to universal coverage and caps on user charges except for dental care. Sweden’s healthcare system performs well on care quality and patient satisfaction, but suffers from workforce shortage and care fragmentation. Limitations in care coordination can be attributed to a siloed digital infrastructure and care governance, a low number of hospital beds per capita, and a compensation system that often does not incentivize coordination. Despite these challenges, life expectancy is high and avoidable mortality rates are low in Sweden.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"121 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk tools for predicting long-term sequelae based on symptom profiles after known and undetected SARS-CoV-2 infections in the population.","authors":"Rieke Baumkötter,Simge Yilmaz,Julian Chalabi,Vincent Ten Cate,Ayesha Syed Mamoor Alam,Sepehr Golriz Khatami,Daniela Zahn,Nora Hettich-Damm,Jürgen H Prochaska,Irene Schmidtmann,Kristin Lehnert,Anke Steinmetz,Marcus Dörr,Norbert Pfeiffer,Thomas Münzel,Karl J Lackner,Manfred E Beutel,Philipp S Wild","doi":"10.1007/s10654-025-01223-y","DOIUrl":"https://doi.org/10.1007/s10654-025-01223-y","url":null,"abstract":"The aim was to determine the profile of long-term symptoms after known and undetected SARS-CoV-2 infections and to generate tools for risk and diagnostic assessment of Post-COVID syndrome (PCS). In the population-based Gutenberg COVID-19 Study (N = 10,250), sequential, systematic screening for SARS-CoV-2 was performed in 2020/2021. Individuals received a standardized interview on newly occurred or worsened symptoms since the infection or the pandemic. Robust Poisson regression models were fit to compare the frequency of symptoms between groups. Two scores were developed using machine learning techniques and prospectively validated in an independent cohort. Among n = 942 individuals, prevalence of long-term symptoms was 36.4% among individuals with known SARS-CoV-2 infection, 25.0% in those unknowingly infected, and 28.1% among the controls. Individuals with known infection more often reported smell (Prevalence ratio [PR] = 13.66 [95% confidence interval 4.99;37.41]) and taste disturbances (PR = 5.57 [2.62;11.81]), forgetfulness (PR = 2.88 [1.55;5.35]), concentration difficulties (PR = 2.83 [1.55;5.16], trouble with balance (PR = 2.74 [1.18;6.35]), and dyspnea (PR = 2.22 [1.18;4.19]) than controls. The risk score for predicting long-term sequelae based on symptoms during the acute infection had a cross-validated AUC of 0.74 and 0.72 when applied in an independent cohort (N = 6,570). The diagnostic score providing a probability of the presence of PCS had a cross-validated AUC of 0.66 and of 0.64 in the validation cohort (N = 3,176). Individuals with and without SARS-COV-2 infection reported persistent symptoms, but symptoms attributable to PCS were identified. The data-driven scores may help guide further diagnostic decisions in the initial management of PCS.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"18 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health as a means to flourishing.","authors":"Sandro Galea","doi":"10.1007/s10654-025-01241-w","DOIUrl":"https://doi.org/10.1007/s10654-025-01241-w","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"23 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}