Aim
To characterize the impact of the COVID‐19 pandemic on diabetes diagnosis using data from Alberta's Tomorrow Project (ATP), a population‐based cohort study of chronic diseases in Alberta, Canada.
...Materials and Methods
The ATP participants who were free of diabetes on 1 April 2018 were included in the study. A time‐segmented regression model was used to compare incidence rates of diabetes before the COVID‐19 pandemic, during the first two COVID‐19 states of emergency, and in the period when the state of emergency was relaxed, after adjusting for seasonality, sociodemographic factors, socioeconomic status, and lifestyle behaviours.
Results
Among 43 705 ATP participants free of diabetes (65.5% females, age 60.4 ± 9.5 years in 2018), the rate of diabetes was 4.75 per 1000 person‐year (PY) during the COVID‐19 pandemic (up to 31 March 2021), which was 32% lower (95% confidence interval CI 21%, 42%; p < 0.001) than pre‐pandemic (6.98 per 1000 PY for the period 1 April 2018 to 16 March 2020). In multivariable regression analysis, the first COVID‐19 state of emergency (first wave) was associated with an 87.3% (95% CI −98.6%, 13.9%; p = 0.07) reduction in diabetes diagnosis; this decreasing trend was sustained to the second COVID‐19 state of emergency and no substantial rebound (increase) was observed when the COVID‐19 state of emergency was relaxed.
Conclusions
The COVID‐19 public health emergencies had a negative impact on diabetes diagnosis in Alberta. The reduction in diabetes diagnosis was likely due to province‐wide health service disruptions during the COVID‐19 pandemic. Systematic plans to close the post‐COVID‐19 diagnostic gap are required in diabetes to avoid substantial downstream sequelae of undiagnosed disease.
Physical inactivity is one of the leading causes of chronic metabolic disease including obesity. Increasing physical activity (PA) has been shown to improve cardiometabolic and musculoskeletal health ...and to be associated with a distinct gut microbiota composition in trained athletes. However, the impact of PA on the gut microbiota is inconclusive for individuals performing PA in their day‐to‐day life. This study examined the role of PA and hand‐grip strength on gut microbiome composition in middle‐aged adults (40–65 years, n = 350) with normal (18.5–24.9 kg/m2) and overweight (25–29.9 kg/m2) body mass index (BMI). PA was recorded using the International Physical Activity Questionnaire, and hand‐grip strength was measured using a dynamometer. Serum samples were assessed for lipidomics while DNA was extracted from fecal samples for microbiome analysis. Overweight participants showed a higher concentration of triacylglycerols, and lower concentrations of cholesteryl esters, sphingomyelin, and lyso‐phosphotidylcholine lipids (p < .05) compared with those with normal BMI. Additionally, overweight participants had a lower abundance of the Oscillibacter genus (p < .05). The impact of PA duration on the gut microbiome was BMI dependent. In normal but not overweight participants, high PA duration showed greater relative abundance of commensal taxa such as Actinobacteria and Proteobacteria phyla, as well as Collinsella and Prevotella genera (p < .05). Furthermore, in males with normal BMI, a stronger grip strength was associated with a higher relative abundance of Faecalibacterium and F. prausnitzii (p < .05) compared with lower grip strength. Taken together, data suggest that BMI plays a significant role in modeling PA‐induced changes in gut microbiota.
Physical activity is a potent mediator of gut microbiota composition. In this study, the impact of low, moderate, and high physical activity levels on gut microbiome composition was examined in middle‐aged adults with normal and overweight body mass index (BMI). Data were collected using online surveys, anthropometric measurements, 16S rRNA microbial sequencing, and serum lipidomics. Findings show the importance of BMI in attaining physical activity‐induced gut microbiome changes.
We investigated the association of social jetlag (misalignment between the internal clock and socially required timing of activities) and prostate cancer incidence in a prospective cohort in Alberta, ...Canada. Data were collected from 7455 cancer-free men aged 35-69 years enrolled in Alberta's Tomorrow Project (ATP) from 2001-2007. In the 2008 survey, participants reported usual bed- and wake-times on weekdays and weekend days. Social jetlag was defined as the absolute difference in waking time between weekday and weekend days, and was categorized into three groups: 0-<1 h (from 0 to anything smaller than 1), 1-<2 h (from 1 to anything smaller than 2), and 2+ h. ATP facilitated data linkage with the Alberta Cancer Registry in June 2018 to determine incident prostate cancer cases (
= 250). Hazard ratios (HR) were estimated using Cox proportional hazards regressions, adjusting for a range of covariates. Median follow-up was 9.57 years, yielding 68,499 person-years. Baseline presence of social jetlag of 1-<2 h (HR = 1.52, 95% CI: 1.10 to 2.01), and 2+ hours (HR = 1.69, 95% CI: 1.15 to 2.46) were associated with increased prostate cancer risk vs. those reporting no social jetlag (
for trend = 0.004). These associations remained after adjusting for sleep duration (
for trend = 0.006). With respect to chronotype, the association between social jetlag and prostate cancer risk remained significant in men with early chronotypes (
for trend = 0.003) but attenuated to null in men with intermediate (
for trend = 0.150) or late chronotype (
for trend = 0.381). Our findings suggest that greater than one hour of habitual social jetlag is associated with an increased risk of prostate cancer. Longitudinal studies with repeated measures of social jetlag and large samples with sufficient advanced prostate cancer cases are needed to confirm these findings.
We propose a method to predict when a woman will develop breast cancer (BCa) from her lifestyle and health history features. To address this objective, we use data from the Alberta’s Tomorrow Project ...of 18,288 women to train Individual Survival Distribution (ISD) models to predict an individual’s Breast-Cancer-Onset (BCaO) probability curve. We show that our three-step approach–(1) filling missing data with multiple imputations by chained equations, followed by (2) feature selection with the multivariate Cox method, and finally, (3) using MTLR to learn an ISD model–produced the model with the smallest L1-Hinge loss among all calibrated models with comparable C-index. We also identified 7 actionable lifestyle features that a woman can modify and illustrate how this model can predict the quantitative effects of those changes–suggesting how much each will potentially extend her BCa-free time. We anticipate this approach could be used to identify appropriate interventions for individuals with a higher likelihood of developing BCa in their lifetime.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Recent rodent microbiome experiments suggest that besides Akkermansia, Parasutterella sp. are important in type 2 diabetes and obesity development. In the present translational human study, we aimed ...to characterize Parasutterella in our European cross-sectional FoCus cohort (n = 1,544) followed by validation of the major results in an independent Canadian cohort (n = 438). In addition, we examined Parasutterella abundance in response to a weight loss intervention (n = 55). Parasutterella was positively associated with BMI and type 2 diabetes independently of the reduced microbiome α/β diversity and low-grade inflammation commonly found in obesity. Nutritional analysis revealed a positive association with the dietary intake of carbohydrates but not with fat or protein consumption. Out of 126 serum metabolites differentially detectable by untargeted HPLC-based MS-metabolomics, L-cysteine showed the strongest reduction in subjects with high Parasutterella abundance. This is of interest, since Parasutterella is a known high L-cysteine consumer and L-cysteine is known to improve blood glucose levels in rodents. Furthermore, metabolic network enrichment analysis identified an association of high Parasutterella abundance with the activation of the human fatty acid biosynthesis pathway suggesting a mechanism for body weight gain. This is supported by a significant reduction of the Parasutterella abundance during our weight loss intervention. Together, these data indicate a role for Parasutterella in human type 2 diabetes and obesity, whereby the link to L-cysteine might be relevant in type 2 diabetes development and the link to the fatty acid biosynthesis pathway for body weight gain in response to a carbohydrate-rich diet in obesity development.
We propose a method to predict when a woman will develop breast cancer (BCa) from her lifestyle and health history features. To address this objective, we use data from the Alberta's Tomorrow Project ...of 18,288 women to train Individual Survival Distribution (ISD) models to predict an individual's Breast-Cancer-Onset (BCaO) probability curve. We show that our three-step approach-(1) filling missing data with multiple imputations by chained equations, followed by (2) feature selection with the multivariate Cox method, and finally, (3) using MTLR to learn an ISD model-produced the model with the smallest L1-Hinge loss among all calibrated models with comparable C-index. We also identified 7 actionable lifestyle features that a woman can modify and illustrate how this model can predict the quantitative effects of those changes-suggesting how much each will potentially extend her BCa-free time. We anticipate this approach could be used to identify appropriate interventions for individuals with a higher likelihood of developing BCa in their lifetime.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Oral iron supplementation is the first-line treatment for addressing iron deficiency, a concern particularly relevant to women who are susceptible to sub-optimal iron levels. Nevertheless, the impact ...of iron supplementation on the gut microbiota of middle-aged women remains unclear. To investigate the association between iron supplementation and the gut microbiota, healthy females aged 40-65 years (
= 56, BMI = 23 ± 2.6 kg/m
) were retrospectively analyzed from the Alberta's Tomorrow Project. Fecal samples along with various lifestyle, diet, and health questionnaires were obtained. The gut microbiota was assessed by 16S rRNA sequencing. Individuals were matched by age and BMI and classified as either taking no iron supplement, a low-dose iron supplement (6-10 mg iron/day), or high-dose iron (>100 mg/day). Compositional and functional analyses of microbiome data in relation to iron supplementation were investigated using various bioinformatics tools. Results revealed that iron supplementation had a dose-dependent effect on microbial communities. Elevated iron intake (>100 mg) was associated with an augmentation of Proteobacteria and a reduction in various taxa, including
,
,
,
,
, and
. Metagenomic prediction further suggested the upregulation of iron acquisition and siderophore biosynthesis following high iron intake. In conclusion, adequate iron levels are essential for the overall health and wellbeing of women through their various life stages. Our findings offer insights into the complex relationships between iron supplementation and the gut microbiota in middle-aged women and underscore the significance of iron dosage in maintaining optimal gut health.
Background & Aims RAC1 is a guanosine triphosphatase that has an evolutionarily conserved role in coordinating immune defenses, from plants to mammals. Chronic inflammatory bowel diseases are ...associated with dysregulation of immune defenses. We studied the role of RAC1 in inflammatory bowel diseases using human genetic and functional studies and animal models of colitis. Methods We used a candidate gene approach to HapMap-Tag single nucleotide polymorphisms in a discovery cohort; findings were confirmed in 2 additional cohorts. RAC1 messenger RNA expression was examined from peripheral blood cells of patients. Colitis was induced in mice with conditional disruption of Rac1 in phagocytes by administration of dextran sulfate sodium. Results We observed a genetic association between RAC1 with ulcerative colitis in a discovery cohort, 2 independent replication cohorts, and in combined analysis for the single nucleotide polymorphisms rs10951982 ( Pcombined UC = 3.3 × 10−8 , odds ratio = 1.43 95% confidence interval: 1.26–1.63) and rs4720672 ( Pcombined UC = 4.7 × 10−6 , odds ratio = 1.36 95% confidence interval: 1.19–1.58). Patients with inflammatory bowel disease who had the rs10951982 risk allele had increased expression of RAC1 compared to those without this allele. Conditional disruption of Rac1 in macrophage and neutrophils of mice protected against dextran sulfate sodium–induced colitis. Conclusions Human studies and knockout mice demonstrated a role for the guanosine triphosphatase RAC1 in the development of ulcerative colitis; increased expression of RAC1 was associated with susceptibility to colitis.
IntroductionOccupational data in prospective cohort studies is often underutilized due to the human and financial resources required to code open-ended text, such as job titles. Recognizing the value ...of occupational data in health research, as well as potential errors associated with manual coding, an Automated Coding Algorithm (ACA)-NOC algorithm was developed utilizing a Natural Language Processing approach.ObjectivesWe tested the ACA-NOC algorithm on two regional cohorts of a pan-Canadian cohort study, which represents the largest dataset an algorithm of this kind has been applied to. This process will harmonize and greatly expand the utility of the occupational data, enrich the research platforms, and further refine the efficiency of the algorithm.MethodsThe ACA-NOC algorithm was tested on data from the Canadian Partnership for Tomorrow’s Health (CanPath), a longitudinal cohort examining the role of genetic, environmental, lifestyle, and behavioural factors in the development of cancer and chronic disease. Using an iterative and interactive approach, the algorithm was applied to job title data from 111,000 questionnaires from two regional cohorts, coding the data to the Canadian National Occupation Classification (NOC) system. The algorithm was further refined based on each round of analysis, increasing the quantity of accurately coded data.ResultsResults from this research demonstrate the ability to refine the ACA-NOC algorithm with a 10% overall improvement in exact matching from the baseline algorithm. There were also instances where the algorithm performance was superior to the manual coding. The utilization of the algorithm offers significant savings in time, human resources and cost compared to a singular manual coding approach.ConclusionsThe coding and harmonization of this multi-cohort data demonstrates the value of the ACA-NOC algorithm, while increasing the utility of the CanPath data and research related to occupational health. Future research may involve comparisons between CanPath and international cohorts.
Abstract
Recently, we introduced a novel measure of “average life span shortened” (ALSS) to improve comparability of premature mortality over time. In this study, we applied this novel measure to ...examine trends in premature mortality caused by hematological cancers in Canada from 1980 to 2015. Mortality data for Hodgkin lymphoma, non-Hodgkin lymphoma, multiple myeloma, and leukemia were obtained from the World Health Organization mortality database. Years of life lost was calculated according to Canadian life tables. ALSS was defined as the ratio between years of life lost and expected life span. Over the study period, age-standardized rates of mortality decreased for all types of hematological cancers. Our new ALSS measure showed favorable trends in premature mortality for all types of hematological cancers among both sexes. For instance, men with non-Hodgkin lymphoma lost an average of 23.7% of their life span in 1980 versus 16.1% in 2015, while women with non-Hodgkin lymphoma lost an average of 21.7% of their life span in 1980 versus 15.5% in 2015. Results from this study showed that patients with hematological cancers experienced prolonged survival over a 35-year period although the magnitude of these life span gains varied by types of hematological cancers.
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