Statin use and its association with all-cause mortality and incident diabetes/prediabetes in African Americans: Findings from the jackson heart study.
This study investigates the association between statin use and all-cause mortality, as well as the association between statin use and incident diabetes or prediabetes among African Americans.
This study is based on the Jackson Heart Study (JHS), a community-based cohort study of African Americans (AAs). The baseline period for JHS was 9/26/2000 to 3/31/2004. The first follow-up period was from 10/1/2005 to 12/21/2008, and the second follow-up period was from 2/26/2009 to 1/31/2013. All study participants who were statin users or non-users at baseline were included in this study. We applied two common propensity score adjustment techniques to analyze the data: propensity score matching (PSM) and the inverse probability of treatment weighting (IPTW) algorithms.
In this cohort there were 510 deaths. The baseline prevalence of statin use was 13.95% (95% CI: 12.91% - 14.98%), while the baseline rate of all-cause mortality was 11.82% (95% CI: 10.87% - 12.82%). In crude analyses, statin users had an 80% higher risk of mortality compared to non-users, with an odds ratio (OR) of 1.80 (95% CI: 1.43 - 2.27). However, after adjusting for confounders using PSM and IPTW, the adjusted ORs for the association between statin use and mortality were 0.77 (95% CI: 0.53 - 1.12) and 0.80 (95% CI: 0.68 - 0.95), respectively. A post hoc power analysis suggested that the matched analysis was underpowered. The incidence of diabetes/ prediabetes was 39.42% (95% CI: 37.39% - 41.45%), with 879 new cases observed. Statin users had a crude odds ratio (OR) of 2.02 (95% CI: 1.52 - 2.67) for developing diabetes/prediabetes compared to non-users. After adjusting for confounding using PSM) and IPTW, the adjusted ORs were 1.84 (95% CI: 1.21-2.81) and 1.82 (95% CI: 1.59-2.08), respectively.
Statin use was associated with a 20% decrease in all-cause mortality but an 80% increased risk of incident diabetes/prediabetes. Clinicians should consider the implications of these findings when prescribing statins to patients in this population.
Hadgu A
，Yan F
，Effoe V
，Mayberry R
... -
《-》
Association of spontaneous abortion and lifestyle with diabetes mellitus in women: a cross-sectional study in UK Biobank.
Spontaneous abortion has been associated with higher risk of type 2 diabetes mellitus (T2DM) and gestational diabetes mellitus (GDM), while the evidence remains equivocal. This study aimed to examine the association between spontaneous abortion and the risk of T2DM and GDM, and assesses whether lifestyle factors modified this association.
This cross-sectional study used data from the UK Biobank, recruiting 170 599 ever-pregnant women from 22 assessment centers in England, Scotland, and Wales between 2006 and 2010. History of spontaneous abortion was self-reported and was confirmed by using medical records, categorized as none, 1, 2, or ≥3 spontaneous abortions. The primary outcomes, T2DM and GDM, were ascertained from medical records using ICD-10 codes. Multivariable logistic regression was performed to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for sociodemographic and health factors (e.g., age, ethnicity, cancer, chronic hypertension), reproductive factors (e.g., use of oral contraceptives, use of hormone treatment, hypertensive disorders of pregnancy), and lifestyle score. The lifestyle score was constructed based on smoking status, alcohol intake, physical activity, television viewing time, sleep duration, and diet quality. Effect modification by lifestyle score was assessed using multiplicative interaction terms in the regression models.
Among 170 599 ever-pregnant women (mean [SD] age, 56.4 [8.0] years), a history of spontaneous abortion was associated with higher odds of T2DM (OR 1.17, 95% CI 1.10-1.24) and GDM (OR 1.38, 95% CI 1.20-1.60). The odds were higher for recurrent spontaneous abortions (for T2DM: ORs were 1.33 [95% CI 1.14-1.56] for three or more spontaneous abortions, 1.07 [95% CI 0.93-1.23] for two, and 1.09 [95% CI 1.01-1.17] for one compared with none; for GDM: the corresponding ORs were 2.01 [95% CI 1.48-2.71], 1.21 [95% CI 0.90-1.64], and 1.20 [95% CI 1.01-1.42], respectively). The odds of T2DM and GDM higher with less healthy lifestyle behaviors in both categories of spontaneous abortion, although no significant interactions between spontaneous abortion and lifestyle score were observed (P-interaction>0.05).
Spontaneous abortion was associated with higher odds of T2DM and GDM, with a stronger association observed in women who experienced recurrent spontaneous abortions. It is imperative to integrate reproductive history into routine diabetes risk assessment, particularly for women with a history of multiple spontaneous abortions.
Liu S
，Chen Y
，Zhang A
，Chen X
，Yuan L
，Song B
... -
《BMC Pregnancy and Childbirth》
Artificial sweeteners and risk of incident cardiovascular disease and mortality: evidence from UK Biobank.
Artificial sweeteners are widely popular worldwide as substitutes for sugar or caloric sweeteners, but there are still several important unknowns and controversies regarding their associations with cardiovascular disease (CVD). We aimed to extensively assess the association and subgroup variability between artificial sweeteners and CVD and CVD mortality in the UK Biobank cohort, and further investigate the modification effects of genetic susceptibility and the mediation role of type 2 diabetes mellitus (T2DM).
This study included 133,285 participants in the UK Biobank who were free of CVD and diabetes at recruitment. Artificial sweetener intake was obtained from repeated 24-hour diet recalls. Cox proportional hazard models were used to estimate HRs. Genetic predisposition was estimated using the polygenic risk score (PRS). Furthermore, time-dependent mediation was performed.
In our study, artificial sweetener intake (each teaspoon increase) was significantly associated with an increased risk of incident overall CVD (HR1.012, 95%CI: 1.008,1.017), coronary artery disease (CAD) (HR: 1.018, 95%CI: 1.001,1.035), peripheral arterial disease (PAD) (HR: 1.035, 95%CI: 1.010,1.061), and marginally significantly associated with heart failure (HF) risk (HR: 1.018, 95%CI: 0.999,1.038). In stratified analyses, non-whites were at greater risk of incident overall CVD from artificial sweetener. People with no obesity (BMI < 30 kg/m2) also tended to be at greater risk of incident CVD from artificial sweetener, although the obesity interaction is not significant. Meanwhile, the CVD risk associated with artificial sweeteners is independent of genetic susceptibility, and no significant interaction exists between genetic susceptibility and artificial sweeteners in terms of either additive or multiplicative effects. Furthermore, our study revealed that the relationship between artificial sweetener intake and overall CVD is significantly mediated, in large part, by prior T2DM (proportion of indirect effect: 70.0%). In specific CVD subtypes (CAD, PAD, and HF), the proportion of indirect effects ranges from 68.2 to 79.9%.
Our findings suggest significant or marginally significant associations between artificial sweeteners and CVD and its subtypes (CAD, PAD, and HF). The associations are independent of genetic predisposition and are mediated primarily by T2DM. Therefore, the large-scale application of artificial sweeteners should be prudent, and the responses of individuals with different characteristics to artificial sweeteners should be better characterized to guide consumers' artificial sweeteners consumption behavior.
Sun T
，Yang J
，Lei F
，Huang X
，Liu W
，Zhang X
，Lin L
，Sun L
，Xie X
，Zhang XJ
，Cai J
，She ZG
，Xu C
，Li H
... -
《Cardiovascular Diabetology》
ResearchGate
(全网免费下载)
钛学术
(全网免费下载)
