Annals of Epidemiology最新文献

{"title":"Mortality from cardiovascular disease subtypes among Asian groups in the United States","authors":"Nilay S. Shah MD, MPH ,&nbsp;Xin Tong MPH ,&nbsp;Fleetwood Loustalot PhD ,&nbsp;Rebecca C. Woodruff PhD, MPH","doi":"10.1016/j.annepidem.2025.05.001","DOIUrl":"10.1016/j.annepidem.2025.05.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize contemporary mortality for detailed cardiovascular disease (CVD) subtypes in individual Asian populations in the US.</div></div><div><h3>Methods</h3><div>With vital statistics for non-Hispanic Asian decedents aged ≥ 18 years (overall and individual ethnic groups), age-standardized mortality rates (ASMR) were calculated for ischemic heart disease, cerebrovascular disease, heart failure, arrhythmia, hypertensive heart disease, valvular heart disease, and pulmonary heart disease, with rate ratios for subtype ASMR in individual Asian groups relative to the Asian group overall.</div></div><div><h3>Results</h3><div>During 2018–2022, 123,566 CVD deaths occurred in Asian adults overall (15 % Asian Indian; 24 % Chinese; 20 % Filipino; 12 % Japanese; 8 % Korean; 10 % Vietnamese). Filipino adults had higher ASMR than Asian adults overall for all CVD subtypes. Asian Indian adults had higher ASMR than Asian adults overall for all CVD subtypes except valvular heart disease and cerebrovascular disease. Japanese adults had higher ASMR than Asian adults overall for heart failure and valvular heart disease. Vietnamese adults had a higher cerebrovascular disease ASMR than Asian adults overall. Chinese adults and Korean adults had ASMRs that were similar to or lower than Asian adults overall for all CVD subtypes.</div></div><div><h3>Conclusions</h3><div>CVD ASMRs for Asian adults in aggregate obscures important variability across individual Asian groups.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 82-87"},"PeriodicalIF":3.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between screening history and prognosis of cervical carcinoma in situ and invasive cervical cancer: A population-based cohort study","authors":"Chiung-Shuan Huang MS ,&nbsp;Bo-Yu Hsiao PhD ,&nbsp;Mei-Hsuan Wu PhD ,&nbsp;Chun-Ju Chiang PhD ,&nbsp;Pei-Chun Hsieh MS ,&nbsp;Mei-Ju Chen MS ,&nbsp;Wen-Fang Cheng MD, PhD ,&nbsp;Wen-Chung Lee MD, PhD","doi":"10.1016/j.annepidem.2025.04.015","DOIUrl":"10.1016/j.annepidem.2025.04.015","url":null,"abstract":"<div><h3>Background</h3><div>Cervical cancer remains a significant public health challenge worldwide. This study examines the impact of screening history on the prognosis of cervical carcinoma in situ and invasive cervical cancer among Taiwanese women.</div></div><div><h3>Methods</h3><div>Data from the National Cervical Cancer Screening Registry and Taiwan Cancer Registry were analyzed, encompassing 13,552 cases of cervical carcinoma in situ and 6853 cases of invasive cervical cancer diagnosed between 2009 and 2013. The study examined the relationship between screening history and five-year cumulative probability of death using the Kaplan-Meier method and Cox regression model, adjusting for factors like age, cancer stage, histological type, urbanization level, and treatment received.</div></div><div><h3>Results</h3><div>Screening history was an independent prognostic factor for both invasive cervical cancer and cervical carcinoma in situ, even after adjusting for key confounders. Compared to patients diagnosed within six months of a positive screening result, those diagnosed later or with a negative screening had higher post-diagnosis mortality (adjusted hazard ratios [95 % confidence interval]: 1.42 [1.26–1.59] for invasive cervical cancer and 1.74 [0.52–5.83] for cervical carcinoma in situ), while never-screened patients had even higher mortality (1.61 [1.42–1.81] for invasive cervical cancer and 5.62 [1.29–24.51] for cervical carcinoma in situ). More advanced age at diagnosis, certain histological types, and living in less urbanized areas correlated with an increased risk of post-diagnosis death. Additionally, the absence of treatment post-diagnosis was significantly associated with worse outcomes.</div></div><div><h3>Conclusion</h3><div>Screening history is a crucial independent prognostic factor for cervical carcinoma in situ and invasive cervical cancer. Patients with a recent positive screening result have a markedly better prognosis than those diagnosed later, those with negative screenings, or unscreened individuals. This study emphasizes the importance of regular and timely cervical cancer screenings in improving prognosis and underscores the need to enhance awareness and accessibility of screening programs.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 75-81"},"PeriodicalIF":3.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the population need for preexposure prophylaxis for HIV in the United States","authors":"Athena P. Kourtis ,&nbsp;Jeffrey Wiener ,&nbsp;Weiming Zhu ,&nbsp;Minttu M. Rönn ,&nbsp;Joshua Salomon ,&nbsp;Ya-Lin A. Huang ,&nbsp;Cynthia Lyles ,&nbsp;Rupa R. Patel ,&nbsp;Karen W. Hoover ,&nbsp;Robyn Neblett Fanfair ,&nbsp;Jonathan Mermin","doi":"10.1016/j.annepidem.2025.04.017","DOIUrl":"10.1016/j.annepidem.2025.04.017","url":null,"abstract":"<div><div>Preexposure prophylaxis (PrEP) is highly effective in preventing HIV infections and is recommended for people without HIV who are at ongoing risk of HIV acquisition. In 2019, the U.S. launched the “Ending the HIV Epidemic in the U.S.” initiative, which aims to reduce by 90 % the number of annual new HIV infections. To monitor progress towards this goal, several national indicators have been established, one of which is PrEP coverage. Several ways to monitor PrEP use have been developed, each with its own advantages and disadvantages. We developed a method to estimate PrEP “need” in the U.S. that could be used as a denominator to estimate PrEP coverage. The “population need for PrEP” (PPN) is estimated based on the number of people needed to treat (NNT) with PrEP to prevent an additional HIV infection in subpopulations whose annual HIV incidence is ≥ 1 %. This is done in three steps: 1) calculating NNT for each transmission group using 1 % incidence threshold and clinical trial-and cohort-generated evidence of the degree of PrEP effectiveness in each transmission group, 2) estimating the proportion of new HIV infections in subpopulations with incidence at least 1 % from epidemiologic data, 3) multiplying estimates from steps 1 and 2 with the number of new HIV infections for each transmission group from Surveillance. The estimates for each transmission group are then added together, and the number of current PrEP users is finally added to this estimate to produce PPN. This method is relatively easy to calculate and can provide public health authorities at the national, state, or local level with pragmatic estimates of PrEP “need” among different demographic or transmission groups, which can help with planning, resource allocation, and monitoring progress.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 48-54"},"PeriodicalIF":3.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial disparity in Non-Hodgkin Lymphoma: Parallel survival analysis with data from the DoD central cancer registry and SEER","authors":"Jie Lin ,&nbsp;Alexander A. Dew ,&nbsp;Craig D. Shriver ,&nbsp;Kangmin Zhu","doi":"10.1016/j.annepidem.2025.04.016","DOIUrl":"10.1016/j.annepidem.2025.04.016","url":null,"abstract":"<div><h3>Purpose</h3><div>Barriers to health care access may contribute to the poorer survival of Black patients with Non-Hodgkin Lymphoma (NHL) than their White counterparts in the U.S. general population. The Department of Defense’s (DoD) Military Health System (MHS) provides universal or equal health care access to all its beneficiaries. This study compared overall survival of NHL patients by race in the MHS and U.S. general population, respectively, and aimed to provide evidence on the role of universal health care in reducing racial disparity.</div></div><div><h3>Methods</h3><div>The MHS Patients were identified from the DoD’s Central Cancer Registry (CCR) and the patients from the U.S. general population were identified from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) program. A retrospective cohort study was conducted comparing survival of major NHL subtypes by race in the CCR and the SEER cohorts, respectively.</div></div><div><h3>Results</h3><div>Non-Hispanic Black patients and Non-Hispanic White patients in the CCR cohort had similar survival in Cox regression models sequentially adjusted for different sets of confounders. The hazard ratios (HRs) and 95 % confidence intervals (CIs) comparing Black to White patients for diffuse large B-cell lymphoma (DLBCL), chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), and other NHLs were 1.25 (0.89–1.78), 0.74 (0.39–1.42), and 1.25 (0.89–1.77) in the full models, respectively. In contrast, Black patients in the SEER cohort exhibited significantly worse survival than White patients in all models adjusting for the same sets of confounders. The HRs were 1.46 (95 % CI= 1.40–1.52), 1.57 (95 % CI=1.48–1.67), and 1.61 (95 % CI=1.54–1.68) in the full models for DLBCL, CLL/SLL and other NHL, respectively.</div></div><div><h3>Conclusions</h3><div>Our study supported universal access to health care as an important factor in reducing survival racial disparity among NHL patients.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 67-74"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in all-cause mortality between urban and rural areas based on the intensity of long-term social isolation: Findings from 17-year retrospective cohort study","authors":"Jeong Min Yang ,&nbsp;Jieun Hwang ,&nbsp;Yookyung Boo PhD","doi":"10.1016/j.annepidem.2025.04.014","DOIUrl":"10.1016/j.annepidem.2025.04.014","url":null,"abstract":"<div><h3>Purpose</h3><div>Social Isolation (SI) can lead to differentiated outcomes between urban and rural areas. However, the understanding of its impact remains insufficient. Therefore, this study aimed to identify the differences in mortality risk of SI Trajectories (SIT) between urban and rural areas.</div></div><div><h3>Methods</h3><div>This study included 6284 participants from the Korea Longitudinal Study of Aging. Propensity Score Matching was utilized to match the characteristics between urban and rural participants. Using Trajectory analysis, SIT was classified from 2006 to 2012, and the association with all-cause mortality was investigated through Cox-proportional hazard model from 2013 to 2022.</div></div><div><h3>Results</h3><div>Five SIT types were identified in both urban and rural areas. In urban areas, Ascending (Hazard Ratio [HR]: 1.89, p: 0.033), Mild (HR: 1.86, p: 0.013), and Severe SIT (HR: 2.58, p: 0.000) were significantly associated with all-cause mortality, whereas Descending SIT was not. In rural areas, Ascending (HR: 1.42, p: 0.035), Moderate (HR: 1.59, p: 0.005), and Severe SIT (HR: 1.67, p: 0.005) had higher HR Compared to Non-SIT. A stratified analysis showed a strong association in urban areas for males and those aged ≤ 64, and in rural areas for females and those aged ≥ 65.</div></div><div><h3>Conclusion</h3><div>Based on the differences in SIT between urban and rural areas, future policies should develop specific indicators for managing SI and create tailored regional policies to reduce mortality.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 55-66"},"PeriodicalIF":3.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143913023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis use disorder and mortality among patients with colon cancer","authors":"Raphael E. Cuomo","doi":"10.1016/j.annepidem.2025.04.012","DOIUrl":"10.1016/j.annepidem.2025.04.012","url":null,"abstract":"","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 8-10"},"PeriodicalIF":3.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal asthma in pregnancy and pubertal timing in daughters and sons: A population-based cohort study","authors":"Camilla Lomholt Kjersgaard ,&nbsp;Andreas Ernst ,&nbsp;Sofie Aagaard Sand ,&nbsp;Pernille Jul Clemmensen ,&nbsp;Nis Brix ,&nbsp;Lea Lykke Harrits Lunddorf ,&nbsp;Cecilia Høst Ramlau-Hansen","doi":"10.1016/j.annepidem.2025.04.013","DOIUrl":"10.1016/j.annepidem.2025.04.013","url":null,"abstract":"<div><h3>Purpose</h3><div>We investigated the impact of maternal asthma on children’s pubertal timing as it remains underexplored.</div></div><div><h3>Methods</h3><div>The Danish National Birth Cohort (DNBC) provided information on maternal asthma during pregnancy, supplemented with diagnosis codes from the Danish National Patient Register. The DNBC sub-cohort the Puberty Cohort gave half-yearly information on pubertal timing from 11 years. We estimated adjusted mean age differences in months for reaching Tanner Stages 1–5 for breast, genital and pubic hair development, axillary hair, acne, and voice break, and menarche for daughters, and first ejaculation for sons. Further, a negative control analysis explored confounding, and two mediation analyses explored mediation through birthweight and childhood asthma.</div></div><div><h3>Results</h3><div>In total, 15,819 children and their mothers participated and 6.6 % of the children had mothers with asthma. Results indicated slightly later pubertal development in sons of mothers with asthma (average difference: 1.0 months (95 % confidence intervals −0.4, 2.4)). This association was not mediated by birthweight or childhood asthma. We did not observe any associations among daughters. The negative control analysis suggested some confounding towards the null.</div></div><div><h3>Conclusion</h3><div>Sons of mothers with asthma during pregnancy had slightly later pubertal timing, though the result could also indicate no association.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 40-47"},"PeriodicalIF":3.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of differences in stroke mortality rates between metropolitan and non-metropolitan areas in Japan from 1999 to 2023","authors":"Tasuku Okui","doi":"10.1016/j.annepidem.2025.04.011","DOIUrl":"10.1016/j.annepidem.2025.04.011","url":null,"abstract":"<div><h3>Purpose</h3><div>This research examined trends in stroke mortality rates between metropolitan and non-metropolitan areas in Japan.</div></div><div><h3>Methods</h3><div>Data regarding stroke mortality for individuals aged 40–79 from 1999 to 2023 were sourced from Japan’s Vital Statistics. Age-standardized stroke mortality rate was computed annually for by sex and area. Moreover, an age-period-cohort analysis was performed, and the estimated stroke mortality rate was calculated for each age group, year, and cohort by sex and area.</div></div><div><h3>Results</h3><div>Throughout the years, the age-standardized mortality rate in non-metropolitan areas consistently exceeded that of metropolitan areas, while the difference in the age-standardized mortality rate diminished over years in men. Furthermore, the difference in estimated mortality rates between these two areas diminished and ultimately vanished from the cohorts born in the 1920s to those born in the late 1930s for men and from cohorts born in the 1920s to those born in the early 1950s for women. Conversely, starting from the cohorts born in the 1950s, the regional difference in the estimated mortality rates began to expand in men.</div></div><div><h3>Conclusions</h3><div>The results revealed the difference in age-standardized stroke mortality rates between the areas, and the difference in mortality rate varied depending on the birth cohort.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 1-7"},"PeriodicalIF":3.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A quantitative bias analysis of the association between supervised consumption service use and sharing of injection equipment among people who inject drugs in Toronto, Canada","authors":"Tanner Nassau ,&nbsp;Zachary Bouck ,&nbsp;Seth L. Welles ,&nbsp;Alison A. Evans ,&nbsp;Shaun Hopkins ,&nbsp;Paula Tookey ,&nbsp;Dan Werb ,&nbsp;Ayden I. Scheim","doi":"10.1016/j.annepidem.2025.04.009","DOIUrl":"10.1016/j.annepidem.2025.04.009","url":null,"abstract":"<div><h3>Purpose</h3><div>Supervised consumption services (SCS) prevent fatal overdoses, but less is known about their contemporary impact on infectious disease risk.</div></div><div><h3>Methods</h3><div>We used quantitative bias analyses (QBA) to evaluate the association between SCS use and sharing of injection equipment while accounting for measurement error, selection bias, and unmeasured confounding, drawing on a cross-sectional sample of 695 people who inject drugs in Toronto, Canada surveyed from 2018 to 2020. We estimated the association between self-reported SCS use and equipment sharing using modified Poisson regression. Sensitivity analyses varied SCS use categories and definitions of sharing. QBA estimated the impact of misclassification, selection bias, and unmeasured confounding.</div></div><div><h3>Results</h3><div>Almost all participants (96.6 %) had recently used a needle and syringe program. Frequent SCS use (≥26 % of injections) was not associated with sharing equipment (adjusted prevalence ratio (aPR): 0.98; 95 % CI: 0.77–1.24). Results of sensitivity analyses did not meaningfully differ. In multiple bias analysis, the median bias-adjusted PR of 1.04 (range: 0.83–1.42) suggested no association between regular SCS use (≥75 % of injections) and syringe sharing.</div></div><div><h3>Conclusions</h3><div>In summary, SCS use was not associated with equipment sharing in a context of high needle and syringe program coverage. Misclassification, selection bias, and unmeasured confounding did not appear to impact the observed associations.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 11-16"},"PeriodicalIF":3.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appraising the causal relevance of maternal red blood cell folate and congenital heart disease in offspring: 2-sample Mendelian randomization","authors":"Hongyan Chen ,&nbsp;Xiaotian Chen ,&nbsp;Qinyu Yao ,&nbsp;Jibin Xin ,&nbsp;Yi Zhang ,&nbsp;Xiangyuan Huang ,&nbsp;Dingmei Wang ,&nbsp;Mengru Li ,&nbsp;Tiansong Zhang ,&nbsp;Taavi Tillmann ,&nbsp;Weili Yan ,&nbsp;Guoying Huang","doi":"10.1016/j.annepidem.2025.04.010","DOIUrl":"10.1016/j.annepidem.2025.04.010","url":null,"abstract":"<div><h3>Purpose</h3><div>We performed a 2-sample Mendelian randomization (MR) using maternal <em>MTHFR</em> C677T as the genetic instrument to validate the causal association between maternal red blood cell (RBC) folate and offspring congenital heart disease (CHD) risk.</div></div><div><h3>Methods</h3><div>We obtained the genetic association for RBC folate through pooling data from 2 genome-wide association studies (the Trinity Student Study [<em>n</em> = 2229]) and Shanghai Preconception sub-cohort [<em>n</em> = 980]). We performed a meta-analysis of genetic studies to obtain the association for CHD (35 studies; 6141 CHDs and 14078 controls) and used the Wald ratio method for the 2-sample MR.</div></div><div><h3>Results</h3><div>Maternal <em>MTHFR</em> C677T variant was associated with lower RBC folate (-116 nmol/L per risk allele) and higher CHD risk (odds ratio [OR], 1.32 per allele; 95 % CI, 1.18–1.47). Per 100-nmol/L genetically determined higher RBC folate was associated with 21 % lower CHD risk (OR, 0.79 [0.70–0.90]). The association was evident in the Asian populations (0.72 [0.61–0.85]) and regions with low folate status (0.76 [0.65–0.88]) but not in the Caucasian populations (0.96 [0.89–1.04]) or regions with fortification (0.92 [0.79–1.06]).</div></div><div><h3>Conclusions</h3><div>Our findings support a causal role of maternal folate in offspring CHD risk, mainly confined to Asian populations and regions with low folate status.</div></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"106 ","pages":"Pages 23-29"},"PeriodicalIF":3.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}