Gender-adjusted Models Research Articles

Contextualising Experiences of Co-Occurring Mental Ill-Health and Substance Use Among Trans, Non-Binary, and Gender Diverse Young People: Implications for Tailored Harm Reduction Approaches.

Though significant research highlights higher rates of mental ill-health and substance use among trans, non-binary and gender diverse (henceforth 'trans') young people, little research has considered patterns, contextual characteristics, and correlates of co-occurring experiences of mental ill-health and substance use among trans young people. Using data from the Trans Pathways study, we used prevalence ratios and age- and gender-adjusted logistic regression models to examine prevalence and differences of co-occurring substance use (past six-month cigarette use, alcohol use, and other drug use) and contextual characteristics of substance use (past six-month solitary alcohol and/or drug use, substance use for coping) by mental ill-health (depression disorder, anxiety disorder, past 12-month self-harm thoughtsand behaviours,suicidal thoughts, planning, and attempt/s). Age- and gender-adjusted models assessed associations between co-occurring depressive and anxiety disorders and recent cigarette, alcohol, and other drug use (six co-occurring items total) and 18 interpersonal stressors. Significantly increased odds of smoking or recentuse of cannabis or sedatives was observed among trans young people reporting depressive disorder, anxiety disorder (aORs ranging 1.8-3.1). Trans young people who reported recent smoking or use of cannabis, inhalants, or sedatives, had 40% to 80% reduced odds of past 12-month self-harm thoughts, self-harm behaviours,suicidal thoughts, and suicide attempt/s (aORs ranging 0.2-0.6). On the other hand, solitary alcohol and/or other drug use and substance use for coping was significantly associated with increased odds of all mental ill-health outcomes. Issues with school, secure housing, and intimate partner abuse were themost robust correlates of co-occurring mental ill-health and substance use. Trans young people using substances, especially cigarettes, cannabis, and sedatives, often so do with co-occurring experiences of depression and anxiety though limited substance use in more 'social' contexts may confer benefits for preventingself-harm and suicide thoughts and behaviours. Continued research in partnership with trans young people is warranted to conceptualise more nuanced and precise conceptualparameters of trans-affirming substance useharm reduction approaches.

Association between deep learning measured retinal vessel calibre and incident myocardial infarction in a retrospective cohort from the UK Biobank

BackgroundCardiovascular disease is a leading cause of global death. Prospective population-based studies have found that changes in retinal microvasculature are associated with the development of coronary artery disease. Recently, artificial...

Comparison of circulating and excreted metals and of autoimmunity between two Great Plains Tribal communities

Metals contaminants of the environment from mine waste have been implicated as contributing agents in autoimmune disease. The current study compares metals and autoimmunity in two Tribal communities residing in the Black Hills and the Bighorn Mountains geographical regions that are scattered with extant hard rock mines. With documented drinking water contamination in both communities, in vivo levels of more than half of the measured serum and urine metals differed between the two communities and were substantially different from their national median values. Serum autoantibodies associated with systemic autoimmune disease were rare or at low-level, but antibodies to denatured (single-stranded) DNA and thyroid-specific autoantibodies were commonly elevated, especially in women. A three-tier statistical modeling process was carried out to examine individual metals exposure as predictors of autoantibody levels. For the most part only weak positive associations between individual metals and systemic autoantibodies were found, although univariate quantile regression analysis showed positive statistical associations of serum lead and antimony with anti-chromatin and anti-histone autoantibodies. Using age and gender-adjusted multivariable statistical models, metals did not predict anti-thyroglobulin or -thyroid peroxidase significantly and metals were generally negative predictors of the other autoantibodies. Overall these results suggest that elevated levels of environmental metals and metalloids in these communities may result in suppression of autoantibodies associated with systemic autoimmune disease.

Evaluation of pre-Games effects of the Tokyo 2020 Olympic Games on Japanese population-level physical activity: a time-series analysis

BackgroundThe Olympic Games represent an opportunity to create a ‘physical activity legacy’ that promotes physical activity at the population level in the host nations and cities. However, previous studies showed little increase in population-level physical activity following the Olympics. The upsurge of public interest in sports and physical activity participation before the Olympics may diminish rapidly following the Games. We examined the pre-Games effects of the Olympics on Japanese population-level physical activity after the announcement of Tokyo’s successful bid for the 2020 Olympic and Paralympic Games in September 2013.MethodsWe used publicly available data from serial cross-sectional surveys conducted with nationally or regionally representative samples in Japan seven years before and after the announcement (from 2006–2020). The outcomes were 1) daily step counts and 2) exercise habit prevalence (≥ 30 min/day, ≥ 2 days/week, and over a year) from the National Health and Nutrition Surveys Japan (NHNS-J; 14 time points; aggregated data); and 3) sports participation (at least once a week) from the National Sports-Life Survey conducted every two years (NSLS; eight time points; individual-level data of 18,867 adults) and from the Public Opinion Survey on Sports Participation of Tokyo Residents (POSSP; eight time points; aggregated data). Age- and gender-adjusted regression models were used to estimate changes in the outcomes before and after the announcement.ResultsThere were no significant pre-Games effects of the Olympics on national-level physical activity participation among Japanese adults. Sports participation (56.4% and 57.5%, respectively; P = 0.518), daily steps (6,535 and 6,686 steps/day; P = 0.353), and exercise habit (30.7% and 29.1%, P = 0.309) did not change significantly before and after the announcement. Although an increase in sports participation among Tokyo residents was not found in the NSLS (61.5% and 59.3%, P = 0.227), it was observed in the POSSP (49.1% and 57.7%, P = 0.019). Nonetheless, this increase might not be related to the pre-Games effects since the trend diminished following the announcement.ConclusionsPopulation-level physical activity did not show significant changes until 2020. Realising the physical activity legacy of an Olympics may require strategic promotion and cross-agency partnership implementation in the pre- and post-event period.

Red and Processed Meat Intake in Relation to Non-Alcoholic Fatty Liver Disease Risk: Results from a Case-Control Study.

Data on the association between dietary red meat intake and non-alcoholic fatty liver disease (NAFLD) are limited. We designed this case-control study to determine the association between red and processed meat consumption and risk of NAFLD in Iranian adults. A total of 999 eligible subjects, including 196 NAFLD patients and 803 non-NAFLD controls were recruited from hepatology clinics in Tehran, Iran. A reliable and validated food frequency questionnaire was used to evaluate the red and processed meat intakes. The analyzes performed showed that in an age- and gender-adjusted model, patients with the highest quartile of red meat intake had an approximately three-fold higher risk of NAFLD than those with the lowest quartile of intake (odds ratio [OR], 3.42; 95% confidence interval [CI], 2.16–5.43; p value < 0.001). Moreover, patients in the highest quartile of processed meat intake had a 3.28 times higher risk of NAFLD, compared to the lowest quartile(OR, 3.28; 95% CI, 1.97–5.46; p value < 0.001).Both these associations remained significant by implementing additional adjustments for body mass index, energy intake, dietary factors, diabetes, smoking, and physical activity (OR, 3.65; 95% CI, 1.85–7.18; p value < 0.001 and OR, 3.25; 95% CI, 1.57–6.73; p value = 0.002, respectively).Our findings indicate that both red and processed meat intakes are related to the increased odds of NAFLD; however, prospective studies are needed to confirm these results.

Mortality prediction using clinical and laboratory features in elderly patients with severe community-acquired pneumonia.

Severe community-acquired pneumonia (SCAP) is a serious health threat in elderly individuals, and a prospective, observational study was conducted to explore the prognostic factors. Patients (≥65 years old) with SCAP that had an intensive care unit (ICU) stay >24 h were recruited at our center. Clinical and laboratory data were collected and various assessment scores were calculated. The follow-up period was censored at the date of death or at hospital discharge, whichever came first. A total of 120 elderly patients with SCAP were included. Among them, 61 were cured (survival group) and 59 died due to SCAP (mortality group). Multivariate logistic regression analysis showed that chronic obstructive pulmonary disorder (COPD, β=2.061, P=0.008) and CD3+CD4+ T cell count (β=-0.019, P=0.017) were independent prognostic factors for death in elderly patients with SCAP. The area under the receiver operating characteristic (ROC) curve (AUROC) for the age- and gender-adjusted model was estimated to be 0.915 [95% confidence interval (CI): 0.858-0.972] for mortality, and the sensitivity and specificity of the model were 91.53% and 86.89%, respectively. Our findings suggest that COPD and the CD3+CD4+ T cell count are independent prognostic factors for mortality, and the constructed model was moderately accurate in the prediction of mortality for elderly patients with SCAP.

Serum Copper and Zinc Levels and Colorectal Cancer in Adults: Findings from the National Health and Nutrition Examination 2011-2016.

Several studies have indicated an association between serum copper and zinc levels and colorectal cancer, but results were controversial. This study assessed the association of serum copper, zinc, and copper/zinc ratio with colorectal cancer in US adults aged 20years and older through the use of National Health and Nutrition Examination Survey (NHANES) 2011-2016 data. Serum concentrations of copper and zinc were measured using inductively coupled plasma dynamic reaction cell mass spectrometry (ICP-DRC-MS). Odds ratios with 95% confidence intervals (ORs with CIs) were calculated for serum copper, zinc, and copper/zinc ratio by multivariate logistic regression. A total of 4663 participants (2320 males and 2343 females) with 24 colorectal cancer patients were included in the analyses. We did not observe a statistically significant association between serum copper level and colorectal cancer (top vs bottom quartile multivariate OR 1.71; 95% CI, 0.37-7.88; P for trend = 0.429). In addition, serum zinc level was also not significantly associated with colorectal cancer (top vs bottom quartile multivariate OR 0.72; 95% CI, 0.12-4.27; P for trend = 0.346). While in the age- and gender-adjusted model, there seemed to be a trend that participants with higher copper/zinc ratio level had higher odds of colorectal cancer than participants with lower copper/zinc ratio level; no statistically significant association was observed in multivariate-adjusted models. Our findings did not support a significant association between serum copper and zinc level and colorectal cancer risk in the general US population. Furthermore, large longitudinal studies should be needed to confirm these findings.

Sociodemographic differences in motives for food selection: results from the LoCard cross-sectional survey

BackgroundAlthough sociodemographic differences in dietary intake have been widely studied, the up-to-date evidence on the corresponding variations in motives for food selection is limited. We investigated how sociodemographic characteristics and special diets in households are associated with the relative importance of various food motives.MethodsParticipants were members of the S Group loyalty card program across Finland who consented to release their grocery purchase data to be used for research purposes and responded to a web-based questionnaire in 2018 (LoCard study). Self-reported information on sociodemographic factors (age, gender, marital status, living situation, education, household income), special diets in household and food motives (Food Choice Questionnaire) were utilized in the present analyses (N = 10,795). Age- and gender-adjusted linear models were performed separately for each sociodemographic predictor and motive dimension (derived by factor analysis) outcome. The importance of each sociodemographic predictor was evaluated based on an increase in R2 value after adding the predictor to the age- and gender-adjusted model.ResultsAge emerged as a central determinant of food motives with the following strongest associations: young adults emphasized convenience (∆R2 = 0.09, P < 0.001) and mood control (∆R2 = 0.05, P < 0.001) motives more than middle-aged and older adults. The relative importance of cheapness decreased with increasing socioeconomic position (SEP) (∆R2 = 0.08, P < 0.001 for income and ∆R2 = 0.04, P < 0.001 for education). However, the price item (“is good value for money”) depicting the concept of worth did not distinguish between SEP categories. Considerations related to familiarity of food were more salient to men (∆R2 = 0.02, P < 0.001) and those with lower SEP (∆R2 = 0.03, P < 0.001 for education and ∆R2 = 0.01, P < 0.001 for income). Respondents living in households with a vegetarian, red-meat-free, gluten-free or other type of special diet rated ethical concern as relatively more important than households with no special diets (∆R2 = 0.02, P < 0.001).ConclusionsWe observed sociodemographic differences in a range of food motives that might act as barriers or drivers for adopting diets that benefit human and planetary health. Interventions aiming to narrow SEP and gender disparities in dietary intake should employ strategies that take into account higher priority of familiarity and price in daily food selection in lower-SEP individuals and males.

415 Risk of Obstructive Sleep Apnea after Treatment of Head and Neck Squamous Cell Carcinoma

Abstract Introduction Head and neck cancers (HNC) or their treatment may be associated with an increased risk of obstructive sleep apnea (OSA). Small studies that examined OSA risk factors in adults with HNC reported conflicting results. This study examined associations between tumor characteristics and risk of OSA among patients at least one year free of head and neck squamous cell carcinoma (HNSCC). Methods For this cross-sectional study of HNSCC patients at a large academic medical center, inclusion criteria were age ≥18 years, with absence of tracheostomy or mental impairment. The STOP-BANG questionnaire, with a threshold ≥3, was used to identify high risk for OSA. Descriptive statistics were used to compare demographic and health characteristics between OSA risk groups. Logistic and linear regression models adjusted for age and gender were used to examine associations between demographics, anthropometric measures, and OSA risk. Results Among 67 participants, 57 (85%) were male, mean age was 62.0±8.0 (s.d.) years, mean body mass index (BMI) was 28.7±4.6 Kg/m2, and mean neck circumference (NC) was 16.3±1.2 inches. A total of 50 (75%) participants received chemoradiation only. High OSA risk was observed in 40 (60%) of the participants. Tumor location, tumor stage, and type of cancer treatment were not different between OSA risk groups. Body mass index and NC were greater in the high OSA risk group (BMI 29.6±4.5 Kg/m2 vs. 27.3±4.1 Kg/m2, p=0.03; NC 16.5±1.3 inches vs. 15.8±0.5 inches, p=0.01). In age and gender-adjusted logistic regression models, BMI (OR=1.2, 95% CI 1.0, 1.4) and NC (OR=2.9, 95% CI 1.1, 7.3) were associated with high OSA risk. Adjusted linear regression models showed that BMI (β=0.10, 95%CI 0.04, 0.17) and NC (β=0.64, 95%CI 0.32, 0.96) were associated with STOP-BANG scores. Conclusion High OSA risk was quite common after HNSCC treatment. However, measured HNSCC characteristics were not different between high and low OSA risk groups. Instead, OSA risk factors included BMI and NC, as often reported in non-HNSCC patients as well. Prospective studies before and after cancer treatment will be needed to further elucidate potential roles of HNSCC and its treatment in subsequent OSA incidence. Support (if any) Dr. Gavidia’s work was supported by an NIH/NINDS T32-NS007222 grant.

A practical laboratory index to predict institutionalization and mortality \u2013 an 18-year population-based follow-up study

BackgroundPreviously, several indexes based on a large number of clinical and laboratory tests to predict mortality and frailty have been produced. However, there is still a need for an easily applicable screening tool for every-day clinical practice.MethodsA prospective study with 10- and 18-year follow-ups. Fourteen common laboratory tests were combined to an index. Cox regression model was used to analyse the association of the laboratory index with institutionalization and mortality.ResultsThe mean age of the participants (n = 1153) was 73.6 (SD 6.8, range 64.0–100.0) years. Altogether, 151 (14.8%) and 305 (29.9%) subjects were institutionalized and 422 (36.6%) and 806 (69.9%) subjects deceased during the 10- and 18-year follow-ups, respectively. Higher LI (laboratory index) scores predicted increased mortality. Mortality rates increased as LI scores increased both in unadjusted and in age- and gender-adjusted models during both follow-ups. The LI did not significantly predict institutionalization either during the 10- or 18-year follow-ups.ConclusionsA practical index based on routine laboratory tests can be used to predict mortality among older people. An LI could be automatically counted from routine laboratory results and thus an easily applicable screening instrument in clinical settings.

Burden of Elevated Body Mass Index and Its Association With Non-Communicable Diseases in Patients Presenting to an Endocrinology Clinic.

IntroductionIn the last 45 years, the worldwide rate of obesity has risen by nearly three-folds. Globally, 650 million adults are obese and more than 1.9 billion are overweight. The estimated prevalence of overweight and obesity in Pakistan was found to be 25% and obesity prevalence alone was 10.3% using the Asian-specific body mass index (BMI) criteria. According to the World Health Organization, overweight and obesity increase the risk of non-communicable diseases (NCDs).ObjectivesThe aim of this retrospective observational study was to determine the burden of elevated BMI and its association with NCDs among patients presenting to a private endocrinology clinic.Study designThis was a retrospective observational study conducted at Medicell Institute of Diabetes, Endocrinology & Metabolism (MIDEM), and the study duration was two years.MethodologyMedical records of the patients who visited MIDEM from January 2017 to December 2018 were reviewed. Patients’ data such as age (in years), gender, height (in cm), and weight (in kg), along with primary complaints and comorbidities were retrieved. BMI was calculated by dividing weight (in kg) by squared height (in m2).ResultsA total of 613 records were reviewed. The median age and BMI were 38 years (IQR=18 - 80 years) and 28.8 kg/m2 (IQR=24.6-33.05 kg/m2),respectively. Out of 613 patients, 10.6% were overweight and 72.6% were obese. Among 510 (83.2%) patients with elevated BMI (≥23 kg/m2), the most frequent associated NCDs were dyslipidemia (39.2%), diabetes (32.5%), hypertension (31.4%), thyroid disorders (28.6%), metabolic syndrome (25%), subfertility (14.9%), impaired glucose tolerance (12.7%) and autoimmune diseases (6.9%). On age- and gender-adjusted logistic regression model, the risk of dyslipidemia, hypertension, and diabetes was significantly higher in overweight and obese patients.ConclusionThis study demonstrated a high prevalence of obesity in patients visiting the endocrinology clinic. Obesity was identified as an independent risk factor for dyslipidemia, hypertension, and diabetes. Future studies are suggested to determine the burden of obesity and establish its association with NCDs in the general population.

Prognostic value of coronary artery calcium scoring and computed tomography coronary angiography in remote Indigenous and non-Indigenous Australians

BackgroundThe long-term prognostic utility of coronary calcification and coronary artery disease on computed tomography coronary angiography (CTCA) in remote Indigenous and non-Indigenous Australians is not known. MethodsConsecutive patients undergoing CTCA from 2013 to 2017 in Central Australia were followed-up for major adverse cardiovascular events (MACE). Results347 patients were included (50 ± 12 years; 47% female; 39% Indigenous). 172 (50.0%) exhibited coronary calcification. CTCA demonstrated no coronary artery disease (CAD) in 137 (39.5%), non-obstructive CAD in 149 (42.9%), and obstructive CAD in 61 (17.6%) patients. Although Indigenous ethnicity was associated with coronary calcification and baseline CAD in age- and gender-adjusted models, this association was non-significant after accounting for comorbidities. Over 4.6 years (IQR 3.52–5.68) of follow-up, MACE incidence rates per 100 person-years were 2.92 (CI 1.92–4.44) and 0.48 (CI 0.18–1.27) in those with and without calcification respectively (p = 0.001), and 0.15 (CI 0.02–1.09), 1.32 (CI 0.69–2.54), and 6.23 (CI 3.81–10.16) in patients with no, non-obstructive, and obstructive CAD respectively (p < 0.001). Coronary calcification and obstructive CAD were associated with 5-fold (HR 5.25, 95% CI 1.66–16.59, p = 0.005) and 6-fold (HR 6.35, 95% CI 2.70–14.89, p < 0.001) greater hazards of MACE respectively in multivariable models, with no significant interaction by ethnicity in these associations seen. ConclusionsThe prognostic value of coronary calcification and CAD on CTCA amongst remote Indigenous individuals appears similar to that seen in non-Indigenous populations. Our data suggest that coronary artery calcium scoring and CTCA can be used to risk-stratify in remote settings where a normal study is associated with an excellent prognosis for at least two years.

Obesity as a risk factor for hospitalization in COronaVirus Disease-19 (COVID-19) patients: Analysis of the Tuscany regional database

Background and aimsAim of the present study is to determine the role of obesity as a risk factor for COronaVirus Disease-19 (COVID-19) hospitalization. Methods and resultsThis observational study was performed using Istituto Superiore di Sanità (ISS) Tuscany COVID-19 database by the Agenzia Regionale Sanità (ARS), including all COVID-19 cases registered until April 30th, 2020, with reported information on chronic diseases. The principal outcome was hospitalization. An age and gender-adjusted logistic regression model was used to assess the association of clinical and demographic characteristics with hospitalization. Further multivariate models were applied. Of 4481 included subjects (36.9% aged over 70 years), 1907 (42.6%) were admitted to hospital. Obesity was associated with hospitalization after adjusting for age and gender. The association of obesity with hospitalization retained statistical significance in a fully adjusted model, including possible confounders (OR: 2.99 [IC 95% 2.04–4.37]). The effect of obesity was more evident in younger (<70 years) than in older (≥70 years) subjects. ConclusionsThe present data confirm that obesity is associated with an increased risk of hospitalization in patients with COVID-19. Interestingly, the association of obesity with hospitalization was greater in younger (<70 years) patients.

Acute geriatric treatment of older trauma patients : Influence on mobility, autonomy and postdischarge destination

HintergrundDie geriatrische frührehabilitative Komplexbehandlung (GFK) wird bei hochbetagten hospitalisierten Patienten eingesetzt, um die Selbstversorgungsfähigkeit wiederherzustellen und eine Pflegebedürftigkeit zu vermeiden.Ziel der ArbeitZiel der Arbeit war es, die Veränderungen von Mobilität und Selbsthilfefähigkeit bei alterstraumatologischen Patienten* im Rahmen der GFK zu beschreiben.Material und MethodenMobilität, Ganggeschwindigkeit und Selbsthilfefähigkeit von 164 hospitalisierten Alterstraumatologiepatienten wurde zu Beginn und bei Abschluss der GFK erfasst. Wir analysierten die Veränderungen der Mobilität während GFK (t-Test), und welche Mobilitätsmerkmale mit einer Entlassung nach Hause vs. einer Entlassung in die Langzeitpflege assoziiert sind (alters- und geschlechtsadjustiertes Regressionsmodell).ErgebnisseDie Patienten verbesserten ihre Mobilität gemessen mittels Short Physical Performance Battery (SPPB) um 1,8 ± 2,1 Punkte, die Ganggeschwindigkeit um 0,10 ± 0,14 m/s und den Barthel-Index um 13 ± 16 Punkte (alle p < 0,001). Die Zahl nichtgehfähiger Patienten verringerte sich von 43 auf 14 % (p = 0,003). Die Mehrzahl (73 %) der vor der Hospitalisation zu Hause lebenden Patienten wurde direkt oder nach einer überbrückenden spitalexternen Rehabilitation nach Hause entlassen.SchlussfolgerungDie Datenanalyse zeigt signifikante und klinisch relevante Verbesserungen in den Bereichen Mobilität und Selbstständigkeit bei Alterstraumatologiepatienten. Die Mehrzahl der Patienten konnte wieder nach Hause austreten.Zusatzmaterial onlineZusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00391-020-01812-4) enthalten.

High prevalence of neurological sequelae and multiple chemical sensitivity among occupants of a Finnish police station damaged by dampness microbiota

Objectives: The aim of the study was to estimate the risks of different symptoms after the exposure to indoor air dampness microbiota (DM).Methods: This cross-sectional retrospective cohort-based study compared morbidity risks in DM exposed (n = 116) vs. unexposed cohort (n = 45). Gender-adjusted log-binomial regression models were used to calculate risk ratios (RR). The analysis of indoor dust toxicity was based on the inhibition of the motion of boar spermatozoa in vitro. Conventional microbiological work-up was performed in an accredited laboratory.Results: Compared to the unexposed cohort, the study cohort had statistically significant (p < 0.05) risks to develop symptoms of the central nervous system RR = 2.85 (95% CI 1.19-6.85), fatigue RR = 2.82 (1.55-5.11), Multiple Chemical Sensitivity (MCS) RR = 2.81 (1.06-7.46), cardiac arrhythmia RR = 9.58 (1.33-68.81) and respiratory symptoms RR = 2.66 (1.58-4.48).Conclusions: The results of this study corroborate our earlier findings that toxic indoor air may cause a plethora of neurological symptoms. Higher than in the control group the prevalence of MCS associated with the exposure to DM. Bad indoor air is therefore not only a risk for respiratory problems and asthma but should be viewed broader as a systemic biotoxicosis. Therefore, psychologization of this disorder without mentioning the underlying insulting mechanisms should be discouraged.

Big data, observational research and P-value: a recipe for false-positive findings? A study of simulated and real prospective cohorts

BackgroundAn increasing number of observational studies combine large sample sizes with low participation rates, which could lead to standard inference failing to control the false-discovery rate. We investigated if the ‘empirical calibration of P-value’ method (EPCV), reliant on negative controls, can preserve type I error in the context of survival analysis.MethodsWe used simulated cohort studies with 50% participation rate and two different selection bias mechanisms, and a real-life application on predictors of cancer mortality using data from four population-based cohorts in Northern Italy (n = 6976 men and women aged 25–74 years at baseline and 17 years of median follow-up).ResultsType I error for the standard Cox model was above the 5% nominal level in 15 out of 16 simulated settings; for n = 10 000, the chances of a null association with hazard ratio = 1.05 having a P-value < 0.05 were 42.5%. Conversely, EPCV with 10 negative controls preserved the 5% nominal level in all the simulation settings, reducing bias in the point estimate by 80–90% when its main assumption was verified. In the real case, 15 out of 21 (71%) blood markers with no association with cancer mortality according to literature had a P-value < 0.05 in age- and gender-adjusted Cox models. After calibration, only 1 (4.8%) remained statistically significant.ConclusionsIn the analyses of large observational studies prone to selection bias, the use of empirical distribution to calibrate P-values can substantially reduce the number of trivial results needing further screening for relevance and external validity.

Thinspiration and fitspiration in everyday life: An experience sampling study

We used experience sampling to examine thinspiration and fitspiration in the everyday lives of women and men. Undergraduates (N = 108, 21% men) completed a 1-week smartphone-facilitated experience sampling protocol containing self-report measures of thinspiration and fitspiration exposure, body satisfaction, and affective functioning. Multi-level, gender-adjusted models examined the unique and interactive associations of exposure to thinspiration and fitspiration. Women reported a weekly average of 8.4 thinspiration exposures and 9.5 fitspiration exposures, while men reported 2.3 and 4.9 exposures, respectively. The median self-reported duration of each exposure was 2–3 min, with no difference in exposure duration between thinspiration and fitspiration. Unique thinspiration exposure was associated with lower body satisfaction, lower positive affect, and higher negative affect (Cohen’s ds = |0.07–0.09|, small). Unique fitspiration exposure was associated with lower body satisfaction and positive affect (ds = |0.03–0.04|, small), but not negative affect. The pattern of associations for interactive exposure (i.e., exposure to both thinspiration and fitspiration) was near-identical to the pattern for unique thinspiration exposure (ds = |0.06–0.08|). We conclude that women and men exposed to thinspiration and fitspiration in their everyday lives may subsequently experience lower body satisfaction and poorer affective functioning.

Depression, emotional eating and long-term weight changes: a population-based prospective study

BackgroundEmotional eating (i.e. eating in response to negative emotions) has been suggested to be one mechanism linking depression and subsequent development of obesity. However, studies have rarely examined this mediation effect in a prospective setting and its dependence on other factors linked to stress and its management. We used a population-based prospective cohort of adults and aimed to examine 1) whether emotional eating mediated the associations between depression and 7-year change in body mass index (BMI) and waist circumference (WC), and 2) whether gender, age, night sleep duration or physical activity moderated these associations.MethodsParticipants were Finnish 25- to 74-year-olds who attended the DILGOM study at baseline in 2007 and follow-up in 2014. At baseline (n = 5024), height, weight and WC were measured in a health examination. At follow-up (n = 3735), height, weight and WC were based on measured or self-reported information. Depression (Center for Epidemiological Studies - Depression Scale), emotional eating (Three-Factor Eating Questionnaire-R18), physical activity and night sleep duration were self-reported. Age- and gender-adjusted structural equation models with full information maximum likelihood estimator were used in the analyses.ResultsDepression and emotional eating were positively associated and they both predicted higher 7-year increase in BMI (R2 = 0.048) and WC (R2 = 0.045). The effects of depression on change in BMI and WC were mediated by emotional eating. Night sleep duration moderated the associations of emotional eating, while age moderated the associations of depression. More specifically, emotional eating predicted higher BMI (P = 0.007 for the interaction) and WC (P = 0.026, respectively) gain in shorter sleepers (7 h or less), but not in longer sleepers (9 h or more). Depression predicted higher BMI (P < 0.001 for the interaction) and WC (P = 0.065, respectively) increase in younger participants, but not in older participants.ConclusionsOur findings offer support for the hypothesis that emotional eating is one behavioural mechanism between depression and development of obesity and abdominal obesity. Moreover, adults with a combination of shorter night sleep duration and higher emotional eating may be particularly vulnerable to weight gain. Future research should examine the clinical significance of our observations by tailoring weight management programs according to these characteristics.

Abstract P078: Racial Differences in the Association Between Diabetes and Length of Residence Among African Migrants to the US

Background: In the US, length of residence has been shown to increase diabetes risk in migrants. Unfortunately, there is a dearth of research on the topic for African migrants especially as it relates racial differences. However, the prevalence of diabetes is higher in North Africa compared to sub-Saharan Africa. Thus, the goal of our study was to assess the effects of race on the association between the length of residence and diabetes among African migrants. Hypothesis: There is a positive association between length of residence and diabetes among non-Black African migrants compared to Black African migrants. Methods: Data from the 2010-2017 NHIS (National Health Interview Survey) were analyzed. The initial sample selected 1911 individuals, 18 years or older, whose birthplace was Africa and who answered questions about diabetes diagnosis. After selecting on non-missing values, the final sample included 1899 African migrants. Chi-square tests and logistic models were used to assess the association between race, length of residence divided into less than 10 years vs 10 years or more and, diabetes. Results were weighted to account for the complex sampling design. Results: The prevalence of diabetes in the selected population was 5.9 % (95% CI: 4.8%-7.1%). The prevalence was significantly higher (p=0.027) for non-Black migrants (8.2%, 95% CI: 5.7-11.6%) compared to non-Black migrants (5.1%, 95% CI: 4.1- 6.3%). Additionally, a larger proportion of non-Black migrants (74.5%, 95% CI: 69.9-78.5%) had resided in the US for 10 years or more compared to Black migrants (58.6%, 95% CI: 55.6-61.6%; p&lt;0.001). The age-and gender-adjusted regression analysis revealed there was no significant association between diabetes and length of residence (OR= 1.41, 95% CI: 0.78-2.55) in the general African migrant population. While the association remained non-significant among non-Black African migrants (OR=0.54, 95% CI: 0.15-1.92), the age-and gender-adjusted model revealed that Black Africans who had lived in the US for 10 years or more were twice more likely to be diabetic compared to those who had lived in the country for less than 10 years (OR=2.02, 95% CI: 1.09-3.77). Conclusions: In conclusion, in the US, the association between length of residence and diabetes was significant for Black Africans and non-significant for non-Black Africans. These results suggest the need for diabetes prevention programs that acknowledge the racial and cultural diversity of African migrants.

Iris colour and astigmatism among Chinese teenagers

Background/aimsIris colour might contribute to refractive development, but it is uncertain whether it is related to astigmatism. We aim to examine the association of iris colour with the presence of...