European Journal of Epidemiology最新文献

{"title":"Outdoor air pollution, road traffic noise, and allostatic load in children aged 6-11 years: evidence from six European cohorts.","authors":"Yuchan Mou,Michelle Sofia Wilhelmina Kusters,Oliver Robinson,Lea Maitre,Rosemary R C McEachan,Wen Lun Yuan,Norun Hjertager Krog,Sandra Andrušaitytė,Mariona Bustamante,Montserrat de Castro Pascual,Audrius Dedele,John Wright,Regina Grazuleviciene,Gunn Marit Aasvang,Johanna Lepeule,Mark Nieuwenhuijsen,Henning Tiemeier,Martine Vrijheid,Errol M Thomson,Mònica Guxens","doi":"10.1007/s10654-025-01227-8","DOIUrl":"https://doi.org/10.1007/s10654-025-01227-8","url":null,"abstract":"Emerging evidence suggests that exposure to air pollutants and road traffic noise triggers stress responses, which mediate physiological responses in multiple organs and tissues. However, epidemiological study in children is sparse. We aimed to evaluate whether outdoor air pollution and road traffic noise are associated with physiological response measured by allostatic load in children. We studied 919 children aged 6-11 years from the HELIX (Human Early Life Exposome) cohort in 6 European countries with 19 biomarkers assessed in four physiological systems-cardiovascular, metabolic, immune/inflammation, and neuroendocrine systems. We then calculated both count-based and continuous scores for each physiological system and generated allostatic load scores (range 0-19). Exposure to air pollution (NO2, PM2.5, PM10, PM2.5absorbance) and road traffic noise (LDEN) based on participants' home, school, and commuting route addresses were estimated for the year prior to outcome assessment. Higher exposure to all air pollutants was associated with a higher allostatic load, although only the association of PM10 survived correction for multiple testing (for count-based allostatic load score: RR = 1.27, 95%CI: 1.08, 1.48; for continuous allostatic load score: β = 0.56, 95% CI: 0.27-0.84, per each 10 µg/m3 increase in PM10). Examining physiological systems separately, higher exposure to air pollution was mainly associated with higher allostatic load in the immune/inflammatory and metabolic systems. No associations between road traffic noise and allostatic load were observed. Our findings suggest that air pollution act as a chronic stressor in manifesting multi-systemic physiological dysregulation in childhood, which may be a precursor of air pollution-related diseases.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"38 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945248","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 Longitudinal Aging Study Amsterdam: design and cohort update 2025.","authors":"Emiel O Hoogendijk,Natasja M van Schoor,Yuwei Qi,Marjolein Visser,Joukje C Swinkels,Marjolein I Broese van Groenou,Almar A L Kok,Tjalling J Holwerda,H Roeline W Pasman,Bregje D Onwuteaka-Philipsen,Sharon Remmelzwaal,Erik van Ingen,Theo G van Tilburg,Aimée-Claire van Haaster,Marleen van der Horst,Jan Poppelaars,Dorly J H Deeg,Martijn Huisman","doi":"10.1007/s10654-025-01238-5","DOIUrl":"https://doi.org/10.1007/s10654-025-01238-5","url":null,"abstract":"The Longitudinal Aging Study Amsterdam (LASA) is an ongoing prospective cohort study of older adults in the Netherlands, with data on multiple domains of functioning available over a period of more than 30 years of follow-up. The study started in 1992 with a nationally representative sample of older adults aged 55-84 years. Over the years, three refresher cohorts (two cohorts aged 55-64 years in 2002 and in 2012, and one cohort aged 60-86 years in 2024) were added. The main aim of LASA was to describe determinants, trajectories and consequences of (changes in) physical, cognitive, emotional and social functioning. LASA has multiple strengths, including its multidisciplinary character, the very long period of follow-up, and the cohort-sequential design which enables the study of longitudinal changes as well as historical time trends in functioning. So far, findings based on data from LASA have been reported in more than 800 scientific publications (see www.lasa-vu.nl ). In this article, we provide an update of the design and methods of LASA, including a description of several ancillary studies such as the Loneliness study and the COVID-19 study.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"121 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945298","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":"Trends in kidney cancer: exploring the impact of sex and age on stage of disease, and prognosis during the past three decades in Denmark-a DaRenCa study.","authors":"Johanne Ahrenfeldt,Jesper Jespersen,Jens Ejrnæs Lyngstrand,Laura Iisager,Anna Krarup Keller,Niels Fristrup,Tinne Laurberg,Iben Lyskjær","doi":"10.1007/s10654-025-01236-7","DOIUrl":"https://doi.org/10.1007/s10654-025-01236-7","url":null,"abstract":"Renal cell carcinoma (RCC) management has advanced due to increased imaging-based diagnoses and improved therapies for metastatic disease. This nationwide registry-based cohort study examines changes in the number of primary RCC cases, stage at diagnosis, prognosis during the past 30 years in Denmark, and how these are associated with sex and age. All Danish patients aged 18 and older diagnosed with primary RCC from 1992 to 2021 with no prior cancer history (except non-melanoma skin cancer) were included and followed from diagnosis until death or end of follow-up (31-12-2023). Statistical analyses included Pearson's χ2, Cramer's V, Wilcoxon rank-sum test, Kruskal-Wallis, competing risk regression, Cox proportional hazard regression, and Kaplan-Meier. 17,423 RCC patients were identified. Primary RCC cases increased from 2,244 in 1992-1996 to 3,947 in 2017-2021. In this period, the proportion of male patients increased from 59 to 72% (P < 0.001). Male patients were younger at diagnosis than female patients (median age 65 vs. 69 years, P < 0.001). Localized cancer cases increased from 44% (N = 983) in 1992-1996 to 70% (N = 2,766) in 2017-2021, while metastatic cases declined from 29% (N = 640) to 17% (N = 652). Median survival for metastatic RCC improved from 4.1 months in 1992-1996 to 13.3 months in 2017-2021. Over three decades, RCC incidence in Denmark has grown, particularly among men, largely due to localized disease, adding pressure on urological departments. The number of metastatic cases remained stable, but survival improved, reflecting advances in early detection and treatment.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"35 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945243","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":"Maternal cannabis use in pregnancy, perinatal outcomes, and cognitive development in offspring: a longitudinal analysis of the ALSPAC cohort using paternal cannabis use as a negative control exposure.","authors":"Daniel J Corsi,Tim T Morris,Zoe E Reed,George Davey Smith","doi":"10.1007/s10654-025-01233-w","DOIUrl":"https://doi.org/10.1007/s10654-025-01233-w","url":null,"abstract":"Maternal cannabis use in pregnancy is reported to be associated with perinatal and neurodevelopmental outcomes in offspring. Such associations, however, may be biased by residual confounding by socioeconomic position (SEP). To assess confounding, we use paternal cannabis use in pregnancy as a negative control exposure. We use data from 15,013 mother-father-child trios from the ALSPAC birth cohort, with participants initially recruited between 1990 and 1992. Exposures were maternal and paternal cannabis use during pregnancy. Neonatal anthropometry, perinatal, cognitive, and neurodevelopmental outcomes were modelled as a function of maternal and paternal cannabis use in pregnancy, adjusting for household-level SEP markers and maternal and paternal tobacco, alcohol, and drug use in pregnancy. We compared the strength of the association between maternal and paternal cannabis on outcomes using Wald tests. 5 and 13% of mothers and fathers reported cannabis use, which was inversely related to measures of SEP. Maternal cannabis use during pregnancy was associated with decreased infant birth weight (b = - 110.2 g, 95% CI - 185.1 to - 35.3 for any cannabis use) and length (b = - 0.45 cm, 95% CI - 0.84 to - 0.07). Maternal cannabis during pregnancy was also associated with neonatal special care admission (odds ratio 1.64, 95% CI 1.05 to 2.56) and lower education achievement scores at age 16 (b = - 19.2, 95% CI - 32.0 to - 6.3). Maternal cannabis use in pregnancy was modestly associated with perinatal outcomes and markers of cognitive development. However, most associations were attenuated after controlling for potential confounders, including SEP, and associations were not quantitatively different from paternal cannabis use. The association of maternal cannabis use in pregnancy with perinatal or cognitive outcomes in offspring may be driven by residual confounding, including SEP, rather than causal biological effects.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"3 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932903","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":"Partial substitution of red or processed meat with plant-based foods and the risk of cardiovascular disease.","authors":"Meri Simojoki,Niina E Kaartinen,Mirkka Maukonen,Kennet Harald,Heli Tapanainen,Demetrius Albanes,Johan G Eriksson,Pekka Jousilahti,Seppo Koskinen,Anne-Maria Pajari,Satu Männistö","doi":"10.1007/s10654-025-01232-x","DOIUrl":"https://doi.org/10.1007/s10654-025-01232-x","url":null,"abstract":"A shift towards more plant-based diets may promote human and planetary health. This modelling study aimed to assess the impact of moderate partial substitution of red or processed meat with plant-based foods on cardiovascular disease (CVD) risk. We used pooled data from five Finnish cohorts (42,868 participants aged ≥ 25 years, 78% men). Median follow-up time was 12.7 years, with 11,031 incident CVD cases. Diet was assessed by a validated food frequency questionnaire. We modelled substitutions of red meat (100 g/week) or processed meat (50 g/week) with corresponding amounts of plant-based foods. Cohort-specific hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards multivariate models adjusted for relevant confounding factors and pooled together using a random effects model. There was a suggestive reduction in CVD risk in men when processed meat was substituted with vegetables or the combination of plant-based foods (HR 0.99, 95% CI 0.99-1.00, P < 0.05). In women, there was an increase in CVD risk when red meat was substituted with legumes (HR 1.10, 95% CI 1.01-1.20, P < 0.05). However, when all cohorts were followed for the same length of time (7.9 years), several plant-based foods reduced CVD risk and none of them increased the risk when partially replacing red or processed meat. Even a small, easily implemented change towards a more plant-based diet may contribute to cardiovascular health at the population level. These findings support global strategies towards healthy and environmentally sustainable diets.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"111 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932909","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":"Possible selection bias in register-based obesity studies.","authors":"Lena Ms Carlsson,Markku Peltonen,Peter Jacobson,Johanna C Andersson-Assarsson,Per-Arne Svensson,Magdalena Taube,Cecilia Karlsson,Sofie Ahlin,Felipe M Kristensson,Rosie Perkins,Ida Arnetorp,Alexander Carlsson,Lucas Admeus,Elin Langegård,Björn Carlsson,Kajsa Sjöholm","doi":"10.1007/s10654-025-01237-6","DOIUrl":"https://doi.org/10.1007/s10654-025-01237-6","url":null,"abstract":"Some studies of obesity treatments use control groups identified from real-world registers, which may differ from people with obesity in the general population. We evaluated whether such control groups affect the results. The SOS study examines long-term mortality post-bariatric surgery. Among volunteers with obesity, 2,007 individuals underwent surgery, while a control group of 2,040 individuals was matched using 18 variables. Age was 37-60 years and BMI was ≥ 34/≥38 kg/m2 for men and women, respectively. We subdivided the control group into those with an obesity diagnosis (n = 177) and those without an obesity diagnosis (n = 1,863) in the Swedish National Patient Register prior to study inclusion. Mortality was determined over a median follow-up period of 26 years. The controls with a prior obesity diagnosis had a higher mortality rate than the controls without a prior obesity diagnosis, with 19.7 (95% CI, 15.5-25.1) and 14.4 (95% CI, 13.3-15.7) deaths per 1000 person-years, respectively. This corresponds to a hazard ratio of 1.45 (95% CI, 1.12-1.89; p = 0.005) and a 3.4-year shorter life expectancy. These results were confirmed in another cohort (n = 2,759, HR = 1.82 [95% CI, 1.47-2.25; p<0.001] and a 6.1-year shorter life expectancy). Controls with obesity identified from real-world datasets may be in poorer health than those who voluntarily participate in clinical studies. Consequently, selection bias could lead to an overestimation of the survival benefits of obesity treatments in research using controls identified by prior obesity diagnosis.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"28 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932908","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":"Cohort profile: the CORDELIA study (Collaborative cOhorts Reassembled Data to study mEchanisms and Longterm Incidence of chronic diseAses).","authors":"Álvaro Hernáez,Anna Camps-Vilaró,Sara Polo-Alonso,Isaac Subirana,Rafel Ramos,Rafael de Cid,Fernando Rodríguez-Artalejo,Roberto Elosua,M Dolores Chirlaque,Pilar Amiano,Marcelino Bermúdez-López,Marcela Guevara,Sergio Cinza-Sanjurjo,María-José Sánchez,Antonio Cabrera de León,Martín Laclaustra,Gemma Rojo-Martínez,María J Guembe-Suescun,Beatriz Pérez-Gómez,Tomás Vega-Alonso,Pere Torán-Monserrat,David Lora-Pablos,José María Huerta,José M Valdivielso,Irene R Dégano,Francisco J Félix-Redondo,Ana María Gandarillas,Sergio Valdés,Xavier Mundet-Tuduri,Pedro L Sánchez,Vicente Martín-Sánchez,Fernando Rigo,Manuela Alonso-Sampedro,Conchi Moreno-Iribas,Juan Carlos Martín-Escudero,Elías Delgado,Maria Grau,Inés Urrutia,Diana Ovejero,Inés Quintela,Ruth Martí-Lluch,Natalia Blay,José R Banegas,Helena Tizón-Marcos,Jesús Humberto Gómez,Amaia Aizpurua,Eva Castro-Boqué,Josu Delfrade,Miguel Ángel Prieto-Díaz,Miguel Rodríguez-Barranco,Delia Almeida-González,Belén Moreno-Franco,Wasima Oualla-Bachiri,Carmen Sayón-Orea,Elena Plans-Beriso,José Eugenio Lozano,Víctor M López-Lifante,Pilar Cancelas-Navia,Natalia Cabrera-Castro,Serafí Cambray,Lluís Zacarías-Pons,Daniel Fernández-Bergés,Encarnación Donoso-Navarro,Cristina Maldonado-Araque,Josep Franch-Nadal,Pedro Ignacio Dorado-Díaz,Alejandro Villarín-Castro,Guillem Frontera-Juan,Francisco Gude,Naroa Andueza,María Téllez-Plaza,Jessica Ares-Blanco,Raquel Cruz,Marc Ribas-Aulinas,Jordi Barretina,Pilar Guallar-Castillón,Miguel Caínzos-Achirica,Sandra Milena Colorado-Yohar,Adrián Llorente,Juan Miguel Diaz-Tocados,Eva Ardanaz,Rafael Manuel Micó-Pérez,Nicolás Francisco Fernandez-Martinez,María Del Cristo Rodríguez-Pérez,Ana Cenarro,Alfonso L Calle-Pascual,Jaume Marrugat","doi":"10.1007/s10654-025-01229-6","DOIUrl":"https://doi.org/10.1007/s10654-025-01229-6","url":null,"abstract":"The CORDELIA Study (Collaborative Cohorts Reassembled Data to Study Mechanisms and Long-term Incidence of Chronic Diseases) combines 35 Spanish population cohorts to investigate the clinical, environmental, genetic, and omics determinants of cardiovascular disease in the Southern European population. It aims to conduct the largest genome-wide association study to date on cardiovascular disease in this population, improve predictions of cardiovascular incidence using genomic and clinical data, and identify subgroups that would benefit most from targeted pharmacological and lifestyle interventions. CORDELIA includes 196,632 individuals (ages 18-84, 54% female, 96% born in Spain, 20% with higher education, recruited from 1989 to 2020, with follow-up periods ranging from 5 to 30 years), with DNA samples available for 117,342 participants (60%). Of the participants, 24% were current smokers, 43% hypertensive, 11% diabetic, 15% medicated with lipid-lowering drugs, 44% overweight, and 27% obese. If not already available, genotyping is being performed using the Axiom™ Spain Biobank array (~ 750,000 variants, including 115,000 specific and 50,000 rare functional variants from the Spanish population). The cohort also includes incident events (coronary heart disease, stroke, heart failure, peripheral artery disease, hypertension, diabetes); date and cause of death; and harmonized data on risk factors (body mass index, waist circumference, lipid profile, blood pressure, glucose, creatinine), lifestyle (smoking, physical activity, diet, alcohol), and socioeconomic status. 99,019 participants (50%) also provide plasma samples. CORDELIA will significantly contribute to understanding the complex interplay of risk factors contributing to cardiovascular disease and advance the fields of precision medicine and public health in Southern European individuals.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"137 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932904","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":"Marital status and risk of cardiovascular disease – a multi-analyst study in epidemiology","authors":"Bernd Kowall, Linda Juel Ahrenfeldt, Jale Basten, Heiko Becher, Tilman Brand, Julia Braun, Swaantje Casjens, Heiner Claessen, Robin Denz, Hans H. Diebner, Sophie Diexer, Nora Eisemann, Eva Furrer, Wolfgang Galetzka, Carolin Girschik, André Karch, Rafael Mikolajczyk, Manuela Peters, Susanne Rospleszcz, Viktoria Rücker, Andreas Stang, Susanne Stolpe, Katherine J. Taylor, Nina Timmesfeld, Marianne Tokic, Hajo Zeeb, Gabriele Berg-Beckhoff, Thomas Behrens, Till Ittermann, Nicole Rübsamen","doi":"10.1007/s10654-025-01235-8","DOIUrl":"https://doi.org/10.1007/s10654-025-01235-8","url":null,"abstract":"<p>In multi-analyst studies, several analysts use the same data to independently investigate identical research questions. Multi-analyst studies have been conducted mainly in psychology, social sciences, and neuroscience, but rarely in epidemiology. Sixteen analyst groups (24 researchers) with backgrounds mainly in statistics, mathematics, and epidemiology were asked to independently perform an analysis on the influence of marital status (never married versus cohabiting married) on cardiovascular outcomes. They were asked to use data from the Survey of Health, Ageing and Retirement in Europe (SHARE), a panel study of 140,000 persons aged 50 years and above from 28 European countries and Israel, and to provide an effect estimate, a comment on their results, and the full syntax of their analyses. In additional analyses beyond the multi-analyst approach, one group selected an exemplary regression model and varied definitions of exposure and outcome and the confounder adjustment set. Each analysis was unique. The size of the 16 datasets used for the analyses ranged from 15,592 to 336,914 observations. The effect estimates (odds ratios, hazard ratios, or relative risks) ranged from 0.72 to 1.02 (reference: cohabiting married) in strictly or partly cross-sectional analyses and from 0.95 to 1.31 in strictly longitudinal analyses. The choice of regression models, adjustment sets for confounding, and variations in the precise definition of exposure and outcome, all had only small effects on the effect estimates. The range of results was mainly due to differences from cross-sectional versus longitudinal analyses rather than to single analytical decisions each of which had less influence.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"24 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143910199","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":"Uncertainty in the estimated effects of statin initiation on risk of dementia: using a multiverse analysis to assess sources of variability","authors":"Erin L. Ferguson, Scott C. Zimmerman, Chen Jiang, Minhyuk Choi, Travis J. Meyers, Thomas J. Hoffmann, Paola Gilsanz, Jingxuan Wang, Akinyemi Oni-Orisan, Rachel A. Whitmer, Neil Risch, Ronald M. Krauss, Chirag J. Patel, Catherine A. Schaefer, M. Maria Glymour","doi":"10.1007/s10654-025-01231-y","DOIUrl":"https://doi.org/10.1007/s10654-025-01231-y","url":null,"abstract":"<p>Mixed evidence on how statins affect dementia risk may reflect variability in model specifications. Alternate specifications are rarely systematically compared. Using an emulated trial design framework, we investigated variation in the estimated effect of statin initiation on dementia across alternative (1) eligibility criteria, (2) confounding variable sets, and (3) outcome definitions. Kaiser Permanente Northern California members’ linked electronic health records from 1996 to 2020 were used to identify statin initiation and dementia diagnoses. Statin initiators were matched on age and low-density lipoprotein cholesterol with up to 5 non-initiators. Possible covariates included clinical (<i>n</i> = 1.4 million); socioeconomic and behavioral (<i>n</i> = 265,224); and genetic (<i>n</i> = 69,573) variables. Using Cox proportional-hazards models, we estimated variation across 1.27 million intent-to-treat estimates for statin initiation varying specification of eligibility, outcome definition, and covariates. Estimated hazard ratios (HRs) for statin initiation on dementia across all specifications ranged from 0.93 to 1.47. The variance of estimates due to model specification differences was 7.6 times larger than the average variance of specific estimates due to finite sample size. Three modeling decisions notably attenuated coefficients [ln(HR)]: requiring a run-in period prior to the emulated trial start date (0.034); adjustment for diabetes (0.030) and cardiovascular disease (0.039); and excluding the first year of follow-up (0.041). HRs from models with all three specifications ranged from 0.99 to 1.15. No specification we evaluated consistently generated protective effects. Estimates of the association between statin initiation and dementia leveraging real world data are sensitive to model specification, especially decisions related to clinical covariates and time-at-risk.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"19 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901298","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":"Tattoos and cutaneous squamous cell carcinoma: a population-based case-control study","authors":"Emelie Rietz Liljedahl, Malin Engfeldt, Kari Nielsen, Anna Jöud, Christel Nielsen","doi":"10.1007/s10654-025-01230-z","DOIUrl":"https://doi.org/10.1007/s10654-025-01230-z","url":null,"abstract":"<p>The prevalence of tattoos in western countries is about 20%. Tattoo ink may contain carcinogenic compounds. The aim of this study was to investigate if tattoo exposure is associated with an increased risk of cutaneous squamous cell carcinoma in individuals. In this population-based case-control study, 2857 cases aged 20 to 60 years, diagnosed between 2014 and 2017, were identified in the Swedish Cancer Registry. Statistics Sweden identified 3 random age- and sex-matched controls per case from the Swedish Total Population Register using incidence-density sampling. In 2019, participants answered a questionnaire regarding lifestyle factors, including tattoos and sun habits. We used logistic regression to investigate if tattoo exposure was associated with the relative risk of cutaneous squamous cell carcinoma. 61% of the cases and 53% of the controls replied to the questionnaire. Among the 1600 cases and the 4551 controls that participated, 15.1% and 17.6% had at least one tattoo before the index date. We found no increased risk of cutaneous squamous cell carcinoma in tattooed compared with non-tattooed individuals (incidence rate ratio, 0.95; 95% confidence interval, 0.78–1.15). Tattoo exposure was not associated with the risk of cutaneous squamous cell carcinoma in this first study of the association. However, more epidemiologic studies are needed before consensus regarding a lack of association can be reached.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"27 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873037","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}