Epidemiology and Health

Original Articles

Impaired pulmonary function mediates the impact of preterm birth on later-life stroke: a 2-step, multivariable Mendelian randomization study: Xingzhi Guo, Peng Tang, Chen Hou, Yue Liu, Rui Li; Epidemiol Health. 2023;45:e2023031. Published online March 3, 2023; DOI: https://doi.org/10.4178/epih.e2023031

5,588 View
195 Download
4 Web of Science
2 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Observational studies have suggested an association between preterm birth and stroke in late adulthood, but it remains unclear whether the association is causal. The purpose of this study was to evaluate the causal effects of gestational age on stroke and to determine the pathophysiological mechanisms underlying the causal associations.

METHODS

Two-sample Mendelian randomization (MR) was performed to assess the causal effects of fetal gestational duration, early preterm birth (EPB), preterm birth, or postterm birth on stroke and its subtypes. Two-step Mendelian randomization (TSMR) and multivariable Mendelian randomization (MVMR) were additionally used to determine the role of common stroke risk factors, including cardiovascular diseases, hypertension, pulmonary impairment, inflammation, and metabolic diseases, in mediating the causal associations between gestational age and stroke and its subtypes.

RESULTS

Genetically predicted EPB increased the risk of cardioembolic stroke (CES; odds ratio [OR], 1.115; 95% confidence interval [CI], 1.036 to 1.200; p=0.004) and large artery stroke (LAS; OR, 1.131; 95% CI, 1.031 to 1.241; p=0.009). The TSMR results showed that EPB was associated with a lower forced expiratory volume in the first second and forced vital capacity ratio (FEV1/FVC) (β=-0.020; 95% CI, -0.035 to -0.005; p=0.009), which increased the risk of CES and LAS. Further MVMR analysis showed that the associations between EPB and stroke disappeared after adjustment for FEV1/FVC.

CONCLUSIONS

Our data demonstrate that EPB is causally associated with an elevated risk of CES and LAS, and that pulmonary dysfunction mediates the causal impact of EPB on CES and LAS.

Summary

Key Message
Genetically predicted early preterm birth (EPB) is significantly associated with an increased risk of cardioembolic stroke (CES) and large artery stroke (LAS). Further multivariable Mendelian randomization analysis demonstrates that pulmonary impairment mediates the causal impact of EPB on CES and LAS in adulthood.

Citations

Citations to this article as recorded by

Methodological approaches, challenges, and opportunities in the application of Mendelian randomisation to lifecourse epidemiology: A systematic literature review
Grace M. Power, Eleanor Sanderson, Panagiota Pagoni, Abigail Fraser, Tim Morris, Claire Prince, Timothy M. Frayling, Jon Heron, Tom G. Richardson, Rebecca Richmond, Jessica Tyrrell, Nicole Warrington, George Davey Smith, Laura D. Howe, Kate M. Tilling
European Journal of Epidemiology.2024; 39(5): 501. CrossRef
Causal associations of circulating Helicobacter pylori antibodies with stroke and the mediating role of inflammation
Xingzhi Guo, Peng Tang, Xin Zhang, Rui Li
Inflammation Research.2023; 72(6): 1193. CrossRef

Associations of racial and ethnic discrimination with adverse changes in exercise and screen time during the COVID-19 pandemic in the United States: Tong Xia, Gilbert C. Gee, Jian Li, Xinyue Liu, Jin Dai, Lu Shi, Donglan Zhang, Zhuo Chen, Xuesong Han, Yan Li, Hongmei Li, Ming Wen, Dejun Su, Liwei Chen; Epidemiol Health. 2023;45:e2023013. Published online January 28, 2023; DOI: https://doi.org/10.4178/epih.e2023013

7,180 View
108 Download
1 Web of Science
1 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
During the coronavirus disease 2019 (COVID-19) pandemic, a growing prevalence of racial and ethnic discrimination occurred when many Americans struggled to maintain healthy lifestyles. This study investigated the associations of racial and ethnic discrimination with changes in exercise and screen time during the pandemic in the United States.

METHODS

We included 2,613 adults who self-identified as non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, or Hispanic from the Health, Ethnicity, and Pandemic study, a cross-sectional survey conducted among a nationally representative sample of United States adults between October and November 2020. We assessed self-reported racial and ethnic discrimination by measuring COVID-19-related racial and ethnic bias and examined its associations with changes in exercise and screen time using multivariable logistic regression models. We analyzed data between September 2021 and March 2022.

RESULTS

COVID-19-related racial and ethnic bias was associated with decreased exercise time among non-Hispanic Asian (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.13 to 1.89) and Hispanic people (OR, 1.91; 95% CI, 1.32 to 2.77), and with increased screen time among non-Hispanic Black people (OR, 1.94; 95% CI, 1.33 to 2.85), adjusting for age, sex, education, marital status, annual household income, insurance, and employment status.

CONCLUSIONS

Racial and ethnic discrimination may have adversely influenced exercise and screen time changes among racial and ethnic minorities during the COVID-19 pandemic in the United States. Further studies are needed to investigate the mechanisms through which racial and ethnic discrimination can impact lifestyles and to develop potential strategies to address racial and ethnic discrimination as a barrier to healthy lifestyles.

Summary

Key Message
In this study with a nationally representative sample of Americans, we found that racial discrimination during the COVID-19 pandemic was associated with undesired changes in exercise and screen time, particularly among minorities.

Citations

Citations to this article as recorded by

Asian American Women’s Experiences of Discrimination and Health Behaviors during the COVID-19 Pandemic
Katarina Wang, Alice Guan, Janice Seto, Debora L. Oh, Kathie Lau, Christine Duffy, Esperanza Castillo, Valerie McGuire, Michelle Wadhwa, Clifford G. Tepper, Heather A. Wakelee, Mindy C. DeRouen, Salma Shariff-Marco, Iona Cheng, Scarlett Lin Gomez
Journal of Immigrant and Minority Health.2024; 26(2): 421. CrossRef

The associations of job strain and leisure-time physical activity with the risk of hypertension: the population-based Midlife in the United States cohort study: Xinyue Liu, Timothy A. Matthews, Liwei Chen, Jian Li; Epidemiol Health. 2022;44:e2022073. Published online September 7, 2022; DOI: https://doi.org/10.4178/epih.e2022073

7,531 View
230 Download
4 Web of Science
4 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Job strain is positively associated with incident hypertension, while increasing leisure-time physical activity (LTPA) can reduce incident hypertension. However, the joint associations of job strain and LTPA with incident hypertension among United States workers have yet to be investigated. This study examined the independent and joint associations of job strain and LTPA with incident hypertension.

METHODS

This prospective cohort study (n=1,160) utilized data from the population-based Midlife in the United States study. The associations of job strain and LTPA at baseline with incident hypertension during follow-up were examined using Cox proportional hazards models. High job strain was derived from a combination of high job demands and low job control, and high LTPA was defined as engagement in moderate or vigorous LTPA at least once per week.

RESULTS

During 9,218 person-years of follow-up, the hypertension incidence rate was 30.6 (95% confidence interval [CI], 27.3 to 34.3) per 1,000 person-years. High job strain was associated with a higher risk for hypertension than low job strain (adjusted hazard ratio [aHR], 1.29; 95% CI, 1.00 to 1.67). High LTPA was associated with lower hypertension risk than low LTPA (aHR, 0.77; 95% CI, 0.60 to 0.98). Hypertension risk was higher among workers with high job strain and low LTPA than among those with low job strain and high LTPA (aHR, 1.70; 95% CI, 1.18 to 2.43).

CONCLUSIONS

Job strain and LTPA showed positive and inverse associations, respectively, with incident hypertension. The combination of high job strain and low LTPA was associated with the highest risk for hypertension.

Summary

Key Message
High job strain and low leisure-time physical activity are independent risk factors for hypertension among workers, and those with high job strain and low leisure-time physical activity are at the highest risk, so it is critical that policy interventions target job strain and leisure-time physical activity to reduce hypertension.

Citations

Citations to this article as recorded by

Prospective associations of occupational and leisure-time physical activity with risk of diabetes: a cohort study from the United States
Timothy A Matthews, Xinyue Liu, Liwei Chen, Jian Li
Annals of Work Exposures and Health.2024; 68(6): 581. CrossRef
2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension
Giuseppe Mancia, Reinhold Kreutz, Mattias Brunström, Michel Burnier, Guido Grassi, Andrzej Januszewicz, Maria Lorenza Muiesan, Konstantinos Tsioufis, Enrico Agabiti-Rosei, Engi Abd Elhady Algharably, Michel Azizi, Athanase Benetos, Claudio Borghi, Jana Br
Journal of Hypertension.2023; 41(12): 1874. CrossRef
Adulthood Psychosocial Disadvantages and Risk of Hypertension in U.S. Workers: Effect Modification by Adverse Childhood Experiences
Timothy A. Matthews, Yifang Zhu, Wendie Robbins, Mary Rezk-Hanna, Paul M. Macey, Yeonsu Song, Jian Li
Life.2022; 12(10): 1507. CrossRef
Associations of COVID-19 Related Work Stressors with Psychological Distress: Racial and Ethnic Disparities in Californian Workers
Timothy A. Matthews, Megan Guardiano, Negar Omidakhsh, Lara Cushing, Wendie Robbins, OiSaeng Hong, Jian Li
International Journal of Environmental Research and Public Health.2022; 20(1): 144. CrossRef

First
Prev
Page of 1
Next
Last

Search