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Expression of the iron hormone hepcidin distinguished different types of anemia in African children
Pasricha, S.R. ; Atkinson, S.H. ; Armitage, A.E. ; Khandwala, S. ; Veenemans, J. ; Cox, S.E. ; Eddowes, L.A. ; Hayes, T. ; Doherty, C.P. ; Demir, A.Y. ; Tijhaar, E.J. ; Verhoef, H. ; Prentice, A.M. ; Drakesmith, H. - \ 2014
Science Translational Medicine 6 (2014)235. - ISSN 1946-6234 - 7 p.
randomized controlled-trials - deficiency anemia - chronic disease - serum hepcidin - round-robin - ferritin - malaria - supplementation - homeostasis - hemoglobin
Childhood anemia is a major global health problem resulting from multiple causes. Iron supplementation addresses iron deficiency anemia but is undesirable for other types of anemia and may exacerbate infections. The peptide hormone hepcidin governs iron absorption; hepcidin transcription is mediated by iron, inflammation, and erythropoietic signals. However, the behavior of hepcidin in populations where anemia is prevalent is not well established. We show that hepcidin measurements in 1313 African children from The Gambia and Tanzania (samples taken in 2001 and 2008, respectively) could be used to identify iron deficiency anemia. A retrospective secondary analysis of published data from 25 Gambian children with either postmalarial or nonmalarial anemia demonstrated that hepcidin measurements identified individuals who incorporated >20% oral iron into their erythrocytes. Modeling showed that this sensitivity of hepcidin expression at the population level could potentially enable simple groupings of individuals with anemia into iron-responsive and non–iron-responsive subtypes and hence could guide iron supplementation for those who would most benefit.
Adherence to predefined dietary patterns and incident type 2 diabetes in European populations: EPIC-InterAct Study
Kröger, J. ; Schulze, M.B. ; Romaguera, D. ; Feskens, E.J.M. - \ 2014
Diabetologia 57 (2014)2. - ISSN 0012-186X - p. 321 - 333.
chronic disease - fatty-acids - mediterranean diet - insulin-resistance - physical-activity - quality index - risk-factors - dash diet - nutrition - cancer
Aims/hypothesis - Few studies have investigated the relationship between predefined dietary patterns and type 2 diabetes incidence; little is known about the generalisability of these associations. We aimed to assess the association between predefined dietary patterns and type 2 diabetes risk in European populations. Methods - From among a case-cohort of 12,403 incident diabetes cases and 16,154 subcohort members nested within the prospective European Prospective Investigation into Cancer and Nutrition study, we used data on 9,682 cases and 12,595 subcohort participants from seven countries. Habitual dietary intake was assessed at baseline with country-specific dietary questionnaires. Two diet-quality scores (alternative Healthy Eating Index [aHEI], Dietary Approaches to Stop Hypertension [DASH] score) and three reduced rank regression (RRR)-derived dietary-pattern scores were constructed. Country-specific HRs were calculated and combined using a random-effects meta-analysis. Results - After multivariable adjustment, including body size, the aHEI and DASH scores were not significantly associated with diabetes, although for the aHEI there was a tendency towards an inverse association in countries with higher mean age. We observed inverse associations of the three RRR-derived dietary-pattern scores with diabetes: HRs (95% CIs) for a 1-SD difference were 0.91 (0.86, 0.96), 0.92 (0.84, 1.01) and 0.87 (0.82, 0.92). Random-effects meta-analyses revealed heterogeneity between countries that was explainable by differences in the age of participants or the distribution of dietary intake. Conclusions/interpretation - Adherence to specific RRR-derived dietary patterns, commonly characterised by high intake of fruits or vegetables and low intake of processed meat, sugar-sweetened beverages and refined grains, may lower type 2 diabetes risk.
Long-Term Physical Functioning and Its Association With Somatic Comorbidity and Comorbid Depression in Patients With Established Rheumatoid Arthritis: A Longitudinal Study
Hoek, J. ; Roorda, L.D. ; Boshuizen, H.C. ; Hees, J. van; Rupp, I. ; Tijhuis, G.J. ; Dekker, J. ; Bos, G.A.M. van den - \ 2013
Arthritis Care & Research 65 (2013)7. - ISSN 2151-464X - p. 1157 - 1165.
quality-of-life - chronic disease - health survey - co-morbidity - metaanalysis - prevalence - classification - outcomes - impact - sf-36
ObjectiveTo describe long-term physical functioning and its association with somatic comorbidity and comorbid depression in patients with established rheumatoid arthritis (RA). MethodsLongitudinal data over a period of 11 years were collected from 882 patients with RA at study inclusion. Patient-reported outcomes were collected in 1997, 1998, 1999, 2002, and 2008. Physical functioning was measured with the Health Assessment Questionnaire and the physical component summary score of the Short Form 36 health survey. Somatic comorbidity was measured by a questionnaire including 12 chronic diseases. Comorbid depression was measured with the Center for Epidemiologic Studies Depression Scale. We distinguished 4 groups of patients based on comorbidity at baseline. ResultsSeventy-two percent of the patients at baseline were women. The mean +/- SD age was 59.3 +/- 14.8 years and the median disease duration was 5.0 years (interquartile range 2.0-14.0 years). For the total group of patients with RA, physical functioning improved over time. Patients with somatic comorbidity, comorbid depression, or both demonstrated worse physical functioning than patients without comorbidity at all data collection points. Both groups with comorbid depression had the lowest scores. Only patients with both somatic comorbidity and comorbid depression showed significantly less improvement in physical functioning over time. ConclusionBoth somatic comorbidity and comorbid depression were negatively associated with physical functioning during an 11-year followup period. Furthermore, their combination seems to be especially detrimental to physical functioning over time. These results emphasize the need to take somatic comorbidity and comorbid depression into account in the screening and treatment of patients with RA.
Anemia in relation to body mass index and waist circumference among chinese women
Qin, Y. ; Boonstra, A. ; Pan, X. ; Dai, Y.C. ; Zhao, J. ; Zimmerman, M.B. ; Kok, F.J. - \ 2013
Nutrition Journal 12 (2013). - ISSN 1475-2891 - 3 p.
iron-deficiency - chronic disease - obesity - population - overweight - zinc
Background: This study aimed to investigate the relationship of anemia and body mass index among adult women in Jiangsu Province, China. Data were collected in a sub-national cross-sectional survey, and 1,537 women aged 20 years and above were included in the analyses. Subjects were classified by body mass index (BMI) categories as underweight, normal weight, overweight and obese according to the Chinese standard. Central obesity was defined as a waist circumference >= 80 cm. Anemia was defined as hemoglobin concentration <12 g/dl. Prevalence ratios (PRs) of the relationship between anemia and BMI or waist circumference were calculated using Poisson regression. Findings: Overall, 31.1% of the Chinese women were anemic. The prevalence of overweight, obesity and central obesity was 34.2%, 5.8% and 36.2%, respectively. The obese group had the highest concentrations of hemoglobin compared with other BMI groups. After adjustment for confounders, overweight and obese women had a lower PR for anemia (PR: 0.72, 95% CI: 0.62-0.89; PR: 0.59, 95% CI: 0.43-0.79). Central obesity was inversely associated with anemia. Conclusion: In this Chinese population, women with overweight/obesity or central obesity were less likely to be anemic as compared to normal weight women. No measures are required currently to target anemia specifically for overweight and obese people in China.
The Dutch Healthy Diet index (DHD-index): an instrument to measure adherence to the Dutch Guidelines for a Healthy diet
Lee, L. van; Geelen, A. ; Hooft Van Huysduynen, E.J.C. ; Vries, J.H.M. de; Veer, P. van 't; Feskens, E.J.M. - \ 2012
Nutrition Journal 11 (2012). - ISSN 1475-2891
episodically consumed foods - chronic disease - eating index-2005 - physical-activity - patterns - nutrition - nutrients - recall - risk - questionnaire
Background The objective was to develop an index based on the Dutch guidelines for a healthy diet of 2006 that reflects dietary quality and to apply it to the Dutch National Food Consumption Survey (DNFCS) to examine the assocations with the micronutrient intakes. Methods A total of 749 men and women, aged 19-30 years, contributed two 24-hour recalls and additional questionnaires in the DNFCS of 2003. The Dutch Healthy Diet index (DHD-index) includes ten components representing the ten Dutch Guidelines for a Healthy Diet. Per component the score ranges between zero and ten, resulting in a total score between zero (no adherence) and 100 (complete adherence). Results The mean+/-SD of the DHD-index was 60.4 +/-11.5 for women and 57.8 +/-10.8 for men (P for difference = 0.002). Each component score increased across the sex-specific quintiles of the DHD-index. An inverse association was observed between the sex-specific quintiles of the DHD-index and total energy intake. Calcium, Riboflavin, and vitamin E intake decreased with increasing DHD-index, an inverse association which disappeared after energy adjustment. Vitamin C showed a positive association across quintiles, also when adjusted for energy. For folate, iron, magnesium, potassium, thiamin, and vitamin B6 a positive association emerged after adjustment for energy. Conclusions The DHD-index is capable of ranking participants according to their adherence to the Dutch Guidelines for a Healthy Diet by reflecting variation in nine out of ten components that constitute when based on two 24-hour recalls. Furthermore, the index showed to be a good measure of nutrient density of diets