Comparison of Two-Criterion Evolutionary Filtering Techniques in Cardiovascular Predictive Modelling

The association between five socioeconomic indices (lifetime occupation, education, income, ownership of material possessions, and childhood socioeconomic status) and plasma fibrinogen levels was investigated in middle-aged Finnish men who were part of the Kuopio Ischemic Heart Disease Risk Factor Study. The Kuopio Ischemic Heart Disease Risk Factor Study is based on a representative age-stratified sample of 2,682 men aged 42, 48, 54, and 60 years. The data were collected between 1984 and 1989. The present analysis is restricted to the 2,011 men for whom information on fibrinogen and all covariates was available. The covariates were alcohol consumption, body mass index, physical fitness, smoking, coffee consumption, high density lipoprotein cholesterol, low density lipoprotein cholesterol, blood leukocyte count, and prevalent disease (at least one sign of ischemic heart disease, hypertension, diabetes, or previous stroke). An age-adjusted inverse association was found between levels of plasma fibrinogen and four of the five socioeconomic indices: current income, education, lifetime occupation status, and current material possessions. After adjustment for the covariates, the association persisted for education, current income, and lifetime occupation. Analysis of the joint effect of childhood and adult socioeconomic status indicated that those who were economically disadvantaged at both times had the highest fibrinogen levels, but the fibrinogen levels of those who were not poor as adults had no variation by childhood socioeconomic status.

PurposeTo investigate associations of total dietary choline intake and its major dietary form, phosphatidylcholine, with type 2 diabetes risk.MethodsWe included 2332 men aged 42–60 years at baseline in 1984–1989 from the Kuopio Ischaemic Heart Disease Risk Factor Study in eastern Finland. Dietary intakes were assessed with 4-d food recording at baseline. Type 2 diabetes diagnosis was based on self-administered questionnaires, fasting and 2-h oral glucose tolerance test blood glucose measurements, or by record linkage to national health registries. Multivariable-adjusted Cox proportional hazards regression models were used for statistical analysis.ResultsDuring the mean 19.3-year follow-up, 432 men had type 2 diabetes diagnosis. After multivariable adjustments, those in the highest vs. lowest choline intake quartile had 25% (95% CI 2–43%) lower relative risk (P trend across quartiles = 0.02) and those in the highest vs. lowest phosphatidylcholine quartile had 41% (95% CI 22–55%) lower relative risk (P trend < 0.001) of type 2 diabetes.ConclusionsHigher choline intake, especially phosphatidylcholine, was associated with lower type 2 diabetes risk among men.

Dietary proteins and protein sources and risk of death: the Kuopio Ischaemic Heart Disease Risk Factor Study

Egg consumption, cholesterol intake, and risk of incident stroke in men: the Kuopio Ischaemic Heart Disease Risk Factor Study

Association of dietary cholesterol and egg intakes with the risk of incident dementia or Alzheimer disease: the Kuopio Ischaemic Heart Disease Risk Factor Study ,

The role of flavonoids in CVD, especially in strokes, is unclear. Our aim was to study the role of flavonoids in CVD. We studied the association between the intakes of five subclasses (flavonols, flavones, flavanones, flavan-3-ols and anthocyanidins), a total of twenty-six flavonoids, on the risk of ischaemic stroke and CVD mortality. The study population consisted of 1950 eastern Finnish men aged 42-60 years free of prior CHD or stroke as part of the prospective population-based Kuopio Ischaemic Heart Disease Risk Factor Study. During an average follow-up time of 15.2 years, 102 ischaemic strokes and 153 CVD deaths occurred. In the Cox proportional hazards model adjusted for age and examination years, BMI,systolic blood pressure, hypertension medication, serum HDL- and LDL-cholesterol, serum TAG, maximal oxygen uptake, smoking, family history of CVD, diabetes, alcohol intake, energy-adjusted intake of folate, vitamin E, total fat and saturated fat intake (percentage of energy), men in the highest quartile of flavonol and flavan-3-ol intakes had a relative risk of 0.55 (95% CI 0.31, 0.99) and 0.59 (95% CI 0.30, 1.14) for ischaemic stroke, respectively, as compared with the lowest quartile. After multivariate adjustment, the relative risk for CVD death in the highest quartile of flavanone and flavone intakes were 0.54 (95% CI 0.32, 0.92) and 0.65 (95% CI 0.40, 1.05), respectively. The present results suggest that high intakes of flavonoids may be associated with decreased risk of ischaemic stroke and possibly with reduced CVD mortality.

Association between serum zinc and later development of metabolic syndrome in middle aged and older men: The Kuopio Ischaemic Heart Disease Risk Factor Study

Based on case-control and prospective studies elevated blood total homocysteine (tHcy) has been suggested to be an independent risk factor for cardiovascular diseases (CVD). The purpose of the study was to explore the joint effect of increased serum tHcy concentration and other risk factors on the risk of CVD mortality in middle-aged men without a history of heart disease or stroke. A prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. Eastern Finland. Subjects. A total of 802 men aged 46-64 years, examined in 1991-93. CVD mortality event. The mean serum tHcy concentration was 10.8 micromol L(-1) (SD 3.3). During the average follow-up time of 10.8 years 50 men experienced a CVD death. The hazard rate ratio for CVD mortality was 1.80 (95% confidence interval: 1.02-3.19) in men in the highest serum tHcy third versus lower thirds after adjustment for cardiovascular risk factors. Furthermore, elevated serum tHcy concentration appeared to increase the risk of CVD death in men who smoke or who have high circulating concentrations of serum total or LDL cholesterol, apo-B apolipoprotein or plasma fibrinogen. We conclude that homocysteine may increase the risk of CVD mortality in middle-aged men from Eastern Finland, and it may especially increase the risk when present with other risk factors for CVD.

Serum Lycopene and the Risk of Cancer: The Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study

There remains a dearth of life-course studies analyzing childhood environment and late-life chronic illness. In particular, few have addressed possible early-life predictors of dementia. This study examines relationships between childhood stress and later-age dementia, specifically Alzheimer's disease (AD). We used data from 2682 men in the population-based Kuopio Ischemic Heart Disease Risk Factor Study who participated in extensive baseline health examinations and interviews between 1984 and 1989, when they were between 42 and 61 years of age. Childhood events were documented in these structured interviews. We created a composite childhood stress variable that included living in custody or an orphanage, experience of crisis in childhood, having problems with teachers and emigrating because of war. Data on incident cases of dementia, including AD, were obtained through 2014 via national health register linkages. Risk of developing dementia was estimated using Cox regression adjusting for age, education, income and prior/existing diseases at baseline. Childhood stress was associated with increased risk of dementia (HR = 1.86, 95% CI: 1.12-3.10). Associations remained statistically significant after adjustment for age, education, income and other covariates (HR = 1.93, 95% CI: 1.14-3.25). Associations were marginally significant with AD, with HRs of similar magnitude. Childhood stress plays an important role in late-life dementia risk among men. Support systems should be developed for children suffering from stressful conditions. Further research examining childhood social and environmental effects on later morbidity, in diverse populations, is necessary to develop a holistic understanding of life-course disease burden.

Animal and plant protein intakes have indicated opposite associations with cardiovascular mortality risk. Whether dietary proteins are associated with risk of heart failure (HF) is unclear. Thus, we examined the associations of proteins from different food sources with risk of HF. The study included 2441 men aged 42 to 60 years at the baseline examinations in 1984 to 1989 in the Kuopio Ischaemic Heart Disease Risk Factor Study. Protein intakes at baseline were assessed with 4-day dietary records. Data on incident HF cases were obtained from national registers. HF risk according to protein intake was estimated by Cox proportional hazard ratios. During the mean follow-up of 22.2 years, 334 incident HF cases occurred. Higher intake of total protein indicated a trend toward increased risk of HF (multivariable-adjusted hazard ratio in the highest versus lowest quartile=1.33; 95% confidence interval: 0.95-1.85; P-trend=0.05). The associations between specific types and sources of protein with incident HF were consistent with this overall finding although not all associations reached statistical significance. For example, the hazard ratio in the highest versus lowest quartile was 1.43 (95% confidence interval: 1.00-2.03; P-trend=0.07) for total animal protein and 1.17 (95% confidence interval: 0.72-1.91; P-trend=0.35) for total plant protein. In middle-aged men, higher protein intake was marginally associated with increased risk of HF. URL: https://www.clinicaltrials.gov. Unique identifier: NCT03221127.

Benefits of life-long physical activity (PA) are widely recognized. Fewer studies have investigated how being young competing athlete reflects to later life body composition and PA. PURPOSE: To investigate the impact of participation in competitive sports in youth on the body composition and subjectively and objectively measured PA at middle- age. METHODS: The study participants are 47-to-55-year old Finnish women (n=985) attending to the Estrogenic Regulation of Muscle Apoptosis study (ERMA). Their participation in competitive sports at the age of 13-to-16 was assessed with retrospective self-report. Midlife lean body mass (LBM), skeletal muscle mass (SMM) and fat mass (FM) were measured with bioimpedance (Inbody 720) after overnight fast (n=866). Midlife PA included 7-scaled self-estimate that was reclassified to form sedentary, light, moderate and vigorous PA categories (n=985), a detailed assessment of leisure-time PA volume, duration and intensity (a modified Kuopio Ischemic Heart Disease Risk Factor Study Questionnaire, n=982) enabling calculation of mean daily metabolic equivalent (MET-h/day) index as a proxy of the previous 12 months PA and objectively measured total PA over seven-days by hip-worn accelerometer (Actigraph GT3X+ or wGT3X+, n=734). Statistical differences were tested using chi-squared test, independent samples t-test or Mann-Whitney U test. RESULTS: Participants were assigned into youth athlete (n=136) or non-athlete (n=849) groups based on their participation in competitive sports at the age of 13-to-16. Youth athlete group had 1.5 kg higher LBM (p=0.002) and 1.0 kg higher SMM (p=0.001) at middle-age, but no statistically significant difference in FM. Youth athletes reported more vigorous PA (32.4% vs. 20.3%, p=0.007) and higher leisure-time MET index (4.3 vs. 3.4 h/day, p<0.001) than non-athletes. No difference was observed in accelerometer-measured sedentary time, light PA, moderate-to-vigorous PA or total PA (counts) between groups. CONCLUSION: Participation in sport competitions as a teenager has long lasting health benefits that associates with healthier body composition and higher leisure-time PA later in life. However, the discrepancy between self-reports and objective measures needs further studies to delineate the benefits of different components of PA.

Dietary intake of magnesium and the risk of epilepsy in middle-aged and older Finnish men: A 22-year follow-up study in a general population.

The purpose of this study was to evaluate the relation between FSH and lipid levels in postmenopausal women from the Kuopio Ischaemic Heart Disease Risk Factor Study. Postmenopausal women (n = 588) aged 53 to 73 years and not using hormone therapy were included. The relation between FSH and total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TGs) was evaluated using linear regression, adjusting for estradiol, body mass, smoking, and other hormonal and lifestyle factors. The relation between FSH, dyslipidemia, and abnormal lipid levels were also evaluated. FSH was positively and linearly associated with TC (P = 0.001) and LDL-C (P = 0.01) in all participants, with stronger relations seen in younger compared with older postmenopausal women. FSH was less strongly associated with HDL-C and TG. FSH was not associated with dyslipidemia; however, higher FSH was associated with increased risk of high TC (P = 0.02) and high LDL-C (P = 0.03). These data suggest that higher FSH in postmenopausal women is related to higher levels of both TC and LDL-C.

Association between depressive symptoms and serum concentrations of homocysteine in men: a population study