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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Mainz//2011; 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi); 20110926-20110929; Mainz; DOC11gmds168 /20110920/
    Publication Date: 2011-09-20
    Keywords: neighbourhood SES ; cardiovascular risk factors ; ddc: 610
    Language: English
    Type: conferenceObject
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  • 2
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    German Medical Science; Düsseldorf, Köln
    In:  50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie; 20050912-20050915; Freiburg im Breisgau; DOC05gmds067 /20050908/
    Publication Date: 2005-09-09
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
    Keywords: RISK-FACTORS ; HEALTH ; smoking ; MYOCARDIAL-INFARCTION ; HYPERTENSION ; GENERAL-POPULATION ; PRIMARY-CARE ; SOUTHERN GERMANY ; METABOLIC-SYNDROME ; POMERANIA SHIP
    Abstract: Diabet. Med. 29, e88-e95 (2012) ABSTRACT: Aim In Germany, regional data on the prevalence of Type 2 diabetes mellitus are lacking for health-care planning and detection of risk factors associated with this disease. We analysed regional variations in the prevalence of Type 2 diabetes and treatment with antidiabetic agents. Methods Data of subjects aged 45-74 years from five regional population-based studies and one nationwide study conducted between 1997 and 2006 were analysed. Information on self-reported diabetes, treatment, and diagnosis of diabetes were compared. Type 2 diabetes prevalence estimates (95% confidence interval) from regional studies were directly standardized to the German population (31 December 2007). Results Of the 11 688 participants of the regional studies, 1008 had known Type 2 diabetes, corresponding to a prevalence of 8.6% (8.1-9.1%). For the nationwide study, a prevalence of 8.2% (7.3-9.2%) was estimated. Prevalence was higher in men (9.7%; 8.9-10.4%) than in women (7.6%; 6.9-8.3%). The regional standardized prevalence was highest in the east with 12.0% (10.3-13.7%) and lowest in the south with 5.8% (4.9-6.7%). Among persons with Type 2 diabetes, treatment with oral antidiabetic agents was more frequently reported in the south (56.9%) and less in the northeast (46.0%), whereas treatment with insulin alone was more frequently reported in the northeast (21.6%) than in the south (16.4%). Conclusion The prevalence of known Type 2 diabetes showed a southwest-to-northeast gradient within Germany, which is in accord with regional differences in the distribution of risk factors for Type 2 diabetes. Furthermore, the treatment with antidiabetic agents showed regional differences.
    Type of Publication: Journal article published
    PubMed ID: 22248078
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  • 4
    Keywords: CIGARETTE-SMOKING ; UNITED-STATES ; NASOPHARYNGEAL CARCINOMA ; CAVITY ; MAXILLARY SINUS ; SINONASAL CANCER ; WOOD DUST ; occupational exposures ; paranasal sinuses ; FORMALDEHYDE
    Abstract: ABSTRACT: BACKGROUND: There are few studies of the effects of nasal snuff and environmental factors on the risk of nasal cancer. This study aimed to investigate the impact of using nasal snuff and of other risk factors on the risk of nasal cancer in German men. METHODS: A population-based case-control study was conducted in the German Federal States of Bavaria and Baden-Wurttemberg. Tumor registries and ear, nose and throat departments provided access to patients born in 1926 or later. RESULTS: Telephone interviews were conducted with 427 cases (mean age 62.1 years) and 2.401 population-based controls (mean age 60.8 years). Ever-use of nasal snuff was associated with an odds ratio (OR) for nasal cancer of 1.45 (95% confidence interval [CI] 0.88-2.38) in the total study population, whereas OR in smokers was 2.01 (95% CI 1.00-4.02) and in never smokers was 1.10 (95% CI 0.43-2.80). The OR in ever-smokers vs. never-smokers was 1.60 (95% CI 1.24-2.07), with an OR of 1.06 (95% CI 1.05-1.07) per pack-year smoked, and the risk was significantly decreased after quitting smoking. Exposure to hardwood dust for at least 1 year resulted in an OR of 2.33 (95% CI 1.40-3.91) in the total population, which was further increased in never-smokers (OR 4.89, 95% CI 1.92-12.49) in analyses stratified by smoking status. The OR for nasal cancer after exposure to organic solvents for at least 1 year was 1.53 (1.17-2.01). Ever-use of nasal sprays/nasal lavage for at least 1 month rendered an OR of 1.59 (1.04-2.44). The OR after use of insecticides in homes was 1.48 (95% CI 1.04-2.11). CONCLUSIONS: Smoking and exposure to hardwood dust were confirmed as risk factors for nasal carcinoma. There is evidence that exposure to organic solvents, and in-house use of insecticides could represent novel risk factors. Exposure to asbestos and use of nasal snuff were risk factors in smokers only.
    Type of Publication: Journal article published
    PubMed ID: 23130889
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  • 5
    Keywords: HEALTH ; PREVALENCE ; LIFE-STYLE ; INEQUALITIES ; HEART-DISEASE ; CARDIOVASCULAR RISK-FACTORS ; PHYSICAL-ACTIVITY ; INSULIN-RESISTANCE ; SOCIOECONOMIC-STATUS ; MULTILEVEL LOGISTIC-REGRESSION
    Abstract: The objective of this study was to investigate the association between residential environment and type 2 diabetes. We pooled cross-sectional data from 5 population-based German studies (1997-2006): the Cardiovascular Disease, Living and Ageing in Halle Study, the Dortmund Health Study, the Heinz Nixdorf Recall Study, the Cooperative Health Research in the Region of Augsburg Study, and the Study of Health in Pomerania. The outcome of interest was the presence of self-reported type 2 diabetes. We conducted mixed logistic regression models in a hierarchical data set with 8,879 individuals aged 45-74 years on level 1; 226 neighborhoods on level 2; and 5 study regions on level 3. The analyses were adjusted for age, sex, social class, and employment status. The odds ratio for type 2 diabetes was highest in eastern Germany (odds ratio = 1.98, 95% confidence interval: 1.81, 2.14) and northeastern Germany (odds ratio = 1.58, 95% confidence interval: 1.40, 1.77) and lowest in southern Germany (reference) after adjustment for individual variables. Neighborhood unemployment rates explained a large proportion of regional differences. Individuals residing in neighborhoods with high unemployment rates had elevated odds of type 2 diabetes (odds ratio = 1.62, 95% confidence interval: 1.25, 2.09). The diverging levels of unemployment in neighborhoods and regions are an independent source of disparities in type 2 diabetes.
    Type of Publication: Journal article published
    PubMed ID: 23648804
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  • 6
    Keywords: POPULATION ; HEALTH ; RISK FACTOR ; BLOOD-PRESSURE ; DISORDERS ; hyperthyroidism ; HYPOTHYROIDISM ; ARTERIAL STIFFNESS ; SUBCLINICAL THYROID-DYSFUNCTION ; ENDOTHELIUM-DEPENDENT VASODILATATION
    Abstract: Background: Recent data from a population-based study in children and adolescents suggest that serum thyrotropin (TSH) levels are associated with arterial blood pressure and hypertension. These results are in agreement with some but not all population-based studies in adults. Discrepancies in results might be explained by drug intake, different iodine supplies, and sizes of populations investigated. In addition, it is not clear whether an association between TSH and hypertension exists longitudinally or only cross-sectionally. Thus, our aim was to investigate cross-sectional and longitudinal associations between thyroid function and arterial blood pressure in a large consortium of cohort studies in adults. Methods: Data from five population-based studies were pooled resulting in 17,023 individuals being available for cross-sectional and 10,048 individuals for longitudinal analyses. Associations of baseline TSH with baseline blood pressure or hypertension were analyzed by multivariable median or logistic regression models. Multivariable median or Poisson regression models were used to investigate associations of baseline TSH with five-year change in arterial blood pressure or incident hypertension. Results: There was a cross-sectional positive association of TSH with arterial blood pressure (p〈0.001) and hypertension (odds ratio [OR]=1.76 [confidence interval (CI) 1.24-2.50], p=0.002). Likewise, hypothyroidism was associated with systolic (beta=1.1 [CI 0.1-2.1], p=0.040) and diastolic blood pressure (beta=1.4 [CI 0.7-2.0], p〈0.001). TSH, however, was not consistently associated with a five-year change in blood pressure or incident hypertension. Conclusions: High serum TSH levels were associated with current hypertension and blood pressure but not with a five-year change in blood pressure and incident hypertension. This argues for only a short-term effect of thyroid hormone levels on arterial blood pressure or a spurious association that needs further evaluation in population-based studies.
    Type of Publication: Journal article published
    PubMed ID: 23427935
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  • 7
    Keywords: MORTALITY ; antibodies ; FUNCTION TESTS ; EXCRETION ; HORMONE CONCENTRATIONS ; REFERENCE INTERVALS ; UNITED-STATES POPULATION ; THYROTROPIN ; EXTREME LONGEVITY ; IODINE INTAKE
    Abstract: BACKGROUND: Age and gender may be involved in the regulation of TSH and thyroid hormones. Reliable investigations concerned with the matter of whether or not these factors are of importance for diagnostic evaluation of the thyroid function are scarce. We used serum values of the CARLA study to calculate reference intervals for TSH, FT3, and FT4 and examine these parameters for their association with age or gender. METHODS: The CARLA study included 967 men and 812 women aged 45 to 83 years. We defined a reference group of 1002 subjects that were free of thyroid disease for data analysis by laboratory analysis and questionnaire, calculated age-dependent moving percentiles (2.5th/97.5th) for TSH, FT4, and FT3 and tested this data set for the confounding factors age and gender. Thereafter, the results were compared to data from the Leipzig Blood Donor study established in 2005. RESULTS: TSH (significant in trend (p = 0.064)) and FT3 (p = 0.001) were inversely associated with age. The correlation of FT3 with age was furthermore influenced by gender (p 〈 0.001). Neither gender nor age influenced values of FT4. CONCLUSIONS: The decreased TSH and FT3 levels with increasing age suggest a diagnostically relevant modification in the feed back regulation of thyroid function of the elderly. FT3 data should thus be interpreted gender-dependent and even age-dependent for males. These findings should be considered for the diagnostic examination of older patients with suspected disorders of thyroid function.
    Type of Publication: Journal article published
    PubMed ID: 25291952
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  • 8
    Keywords: MORTALITY ; RISK ; ATHEROSCLEROSIS ; GLUCOSE ; INDIVIDUALS ; PREVALENCE ; MELLITUS ; CORONARY-HEART-DISEASE ; SOUTHERN GERMANY ; METABOLIC-SYNDROME
    Abstract: BACKGROUND: Population-based data are paramount to investigate the long-term course of diabetes, for planning in healthcare and to evaluate the cost-effectiveness of primary prevention. We analysed regional differences in the incidence of self-reported type 2 diabetes mellitus in Germany. METHODS: Data of participants (baseline age 45-74 years) from five regional population-based studies conducted between 1997 and 2010 were included (mean follow-up 2.2-7.1 years). The incidence of self-reported type 2 diabetes mellitus at follow-up was compared. The incidence rates per 1000 person-years (95% CI) and the cumulative incidence (95% CI) from regional studies were directly standardised to the German population (31 December 2007) and weighted by inverse probability weights for losses to follow-up. RESULTS: Of 8787 participants, 521 (5.9%) developed type 2 diabetes mellitus corresponding to an incidence rate of 11.8/1000 person-years (95% CI 10.8 to 12.9). The regional incidence was highest in the East and lowest in the South of Germany with 16.9 (95% CI 13.3 to 21.8) vs 9.3 (95% CI 7.4 to 11.1)/1000 person-years, respectively. The incidence increased with age and was higher in men than in women. CONCLUSIONS: The incidence of self-reported type 2 diabetes mellitus shows regional differences within Germany. Prevention measures need to consider sex-specific differences and probably can be more efficiently introduced toward those regions in need.
    Type of Publication: Journal article published
    PubMed ID: 25073594
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  • 9
    Keywords: OBESITY ; CARDIOVASCULAR-DISEASE ; ARTERIAL-HYPERTENSION ; MASS ; RECOMMENDATIONS ; HYPERTENSIVE PATIENTS ; CHAMBER QUANTIFICATION ; ELECTROCARDIOGRAPHIC CRITERIA ; LOSARTAN INTERVENTION ; ECG
    Abstract: BACKGROUND: Arterial hypertension is a common disease with high prevalence in the general population. Left ventricular hypertrophy (LVH) is an independent risk factor in arterial hypertension. Electrocardiographic indices like the Sokolow-Lyon index (SLI) are recommended as diagnostic screening methods for LVH. We assessed the diagnostic performance of the SLI in a cohort of a large general population. METHODS: We used electrocardiographic and echocardiographic data from the prospective, population-based cohort study CARdio-vascular Disease, Living and Ageing in Halle (CARLA). Linear and logistic regression models were used to assess the association of SLI with LVH. To assess the impact of the body-mass-index (BMI), we performed interaction analyses. RESULTS: AUC of SLI to predict LVH was 55.3 %, sensitivity of the SLI was 5 %, specificity 97 %. We found a significant association of SLI after covariate-adjustment with echocardiographically detected LVH (increase of left-ventricular mass index, LVMI 7.0 g/m(2) per 1 mV increase of SLI, p 〈 0.0001). However, this association was mainly caused by an association of SLI with the left-ventricular internal diameter (LVIDd, increase of 0.06 cm/m(2) per 1 mV increase of SLI, p 〈 0.0001). In obese (BMI 〉 30 kg/m(2)) we found the strongest association with an increase of 9.2 g/m(2) per 1 mV. CONCLUSIONS: Although statistically significant, relations of SLI and echocardiographic parameters of LVH were weak and mainly driven by the increase in LVIDd, implicating a more eccentric type of LVH in the collective. The relations were strongest when obese subjects were taken into account. Our data do not favour the SLI as a diagnostic screening test to identify patients at risk for LVH, especially in non-obese subjects without eccentric LVH.
    Type of Publication: Journal article published
    PubMed ID: 26169782
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  • 10
    Keywords: POPULATION ; RISK ; HEALTH ; HYPERTENSION ; PREVALENCE ; MANAGEMENT ; GUIDELINES ; MELLITUS ; CARDIOVASCULAR-DISEASE ; PULSE PRESSURE
    Abstract: BACKGROUND: Hypertension is a very common comorbidity and major risk factor for cardiovascular complications, especially in people with Type 2 Diabetes (T2D). Nevertheless, studies in the past have shown that blood pressure is often insufficiently controlled in medical practice. For the DIAB-CARE study, we used longitudinal data based on the German DIAB-CORE Consortium to assess whether health care regarding hypertension has improved during the last decade in our participants. METHODS: Data of the three regional population-based studies CARLA (baseline 2002-2006 and follow-up 2007-2010), KORA (baseline 1999-2001 and follow-up 2006-2008) and SHIP (baseline 1997-2001 and follow-up 2002-2006) were pooled. Stratified by T2D status we analysed changes in frequencies, degrees of awareness, treatment and control. Linear mixed models were conducted to assess the influence of sex, age, study, and T2D status on changes of systolic blood pressure between the baseline and follow-up examinations (mean observation time 5.7 years). We included 4,683 participants aged 45 to 74 years with complete data and accounted for 1,256 participants who were lost to follow-up by inverse probability weighting. RESULTS: Mean systolic blood pressure decreased in all groups from baseline to follow-up (e.g. - 8.5 mmHg in those with incident T2D). Pulse pressure (PP) was markedly higher in persons with T2D than in persons without T2D (64.14 mmHg in prevalent T2D compared to 52.87 mmHg in non-T2D at baseline) and did not change much between the two examinations. Awareness, treatment and control increased considerably in all subgroups however, the percentage of those with insufficiently controlled hypertension remained high (at about 50% of those with hypertension) especially in prevalent T2D. Particularly elderly people with T2D often had both, high blood pressure 〉/=140/90 mmHg and a PP of 〉/=60 mmHg. Blood pressure in men had improved more than in women at follow-up, however, men still had higher mean SBP than women at follow-up. CONCLUSION: Blood pressure management has developed positively during past years in Germany. While hypertension prevalence, awareness and treatment were substantially higher in participants with T2D than in those without T2D at follow-up, hypertension control was achieved only in about half the number of people in each T2D group leaving much room for further improvement.
    Type of Publication: Journal article published
    PubMed ID: 26221962
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