To replicate results from a previous genome-wide association study of European ancestry women, in which a positive association was found between uterine leiomyomata (UL) and rs4247357, a ...single-nucleotide polymorphism located near the fatty acid synthase (FASN) gene.
Prospective cohort study.
Not applicable.
African-American women aged 23-50 years, who were premenopausal and had an intact uterus in 1997.
None.
We genotyped rs4247357 among 2,301 incident UL cases and 3,005 controls from the Black Women's Health Study (1997-2011). Odds ratios (ORs) and 95% confidence intervals (CI) were estimated using logistic regression with control for age, geographic region of residence, and percent European ancestry using a panel of validated ancestry informative markers.
Overall, rs4247357 was not associated with UL risk. Relative to the CC genotype, ORs were 1.04 (95% CI 0.92-1.19) for the AC genotype and 1.09 (95% CI 0.93-1.29) for the AA genotype. A positive association was found, however, among those with higher European ancestry (≥40%). Relative to the CC genotype, ORs were 2.03 (95% CI 1.12-3.69) for the AC genotype and 2.44 (95% CI 1.20-4.96) for the AA genotype. Dietary fat intake also appeared to modify the FASN-UL association.
Although there was little overall association between rs4247357 and UL risk, a positive association was observed among women with ≥40% European ancestry. Direct sequencing of this genomic region might be warranted to determine whether rs4247357, or some other variant, is causally related to UL.
Background Evidence from prospective studies consistently links obesity to asthma onset in white women, although there is controversy as to whether the association is causal. There are few data on ...this topic in black women, among whom the prevalence of obesity and asthma is high. Objective We prospectively assessed the relation of body mass index (BMI) to asthma incidence in the Black Women's Health Study. Methods We followed 46,435 women from 1995 through 2005 with biennial mailed questionnaires. Cox regression models were used to estimate incidence rate ratios and 95% CIs. Results During 403,394 person-years of follow-up, 1068 participants reported physician-diagnosed asthma and concurrent use of asthma medication. Compared with women with BMIs of 20 to 24, the multivariate incidence rate ratios for higher categories of BMI increased from 1.26 (95% CI, 1.05-1.51) for BMIs of 25 to 29 to 2.85 (95% CI, 2.19-3.72) for BMIs of 40 or greater, with a significant trend. The association of BMI with asthma risk was consistent across strata of smoking status, age, presence of sleep apnea, parental history of asthma, BMI at age 18 years, and energy expenditure and intake. Conclusion In this large cohort of African American women, there was a positive association between BMI and asthma risk that was similar in magnitude to those observed in longitudinal studies of white women.
Recent population studies suggest a role of smoking in the etiology of breast cancer, but few have been conducted among African American women. In a collaborative project of four large studies, we ...examined associations between smoking measures and breast cancer risk by menopause and hormone receptor status estrogen receptor-positive (ER+), ER-negative (ER-) and triple-negative (ER-, PR-, HER2-). The study included 5791 African American women with breast cancer and 17376 African American controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated in multivariable logistic regression analysis with adjustment for study and risk factors. Results differed by menopausal status. Among postmenopausal women, positive associations were observed for long duration and greater pack-years of smoking: relative to never smoking, fully adjusted ORs were 1.14 (95% CI: 1.03-1.26) for duration ≥20 years and 1.16 (95% CI: 1.01-1.33) for ≥20 pack-years. By contrast, inverse associations were observed among premenopausal women, with ORs of 0.80 (95% CI: 0.68-95) for current smoking and 0.81 (95% CI: 0.69-0.96) for former smoking, without trends by duration. Associations among postmenopausal women were somewhat stronger for ER+ breast cancer. The findings suggest that the relation of cigarette smoking to breast cancer risk in African American women may vary by menopausal status and breast cancer subtype.
Background Many studies have evaluated the association between vitamin and mineral supplement use and the risk of prostate cancer, with inconclusive results. Methods The authors examined the relation ...of use of multivitamins as well as several single vitamin and mineral supplements to the risk of prostate cancer risk among 1,706 prostate cancer cases and 2,404 matched controls using data from the hospital-based case-control surveillance study conducted in the United States. Odds ratios (OR) and 95% confidence intervals (CI) for risk of prostate cancer were estimated using conditional logistic regression model. Results For use of multivitamins that did not contain zinc, the multivariable odds ratios of prostate cancer were 0.6 for 1-4 years, 0.8 for 5-9 years, and 1.2 for 10 years or more, respectively (p for trend = 0.70). Men who used zinc for ten years or more, either in a multivitamin or as a supplement, had an approximately two-fold (OR = 1.9, 95% CI: 1.0, 3.6) increased risk of prostate cancer. Vitamin E, beta-carotene, folate, and selenium use were not significantly associated with increased risk of prostate cancer. Conclusion The finding that long-term zinc intake from multivitamins or single supplements was associated with a doubling in risk of prostate cancer adds to the growing evidence for an unfavorable effect of zinc on prostate cancer carcinogenesis.
A growing body of evidence suggests that physical activity might reduce the risk of depressive symptoms, but there are limited data on Black women.
The objective was to evaluate the association ...between leisure time physical activity and depressive symptoms in U.S. Black women.
Participants included 35,224 women ages 21 to 69 from the Black Women's Health Study, a follow-up study of African American women in which data are collected biennially by mail questionnaire. Women answered questions on past and current exercise levels at baseline (1995) and follow-up (1997). The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms in 1999. Women who reported a diagnosis of depression before 1999 were excluded. We used multivariate logistic regression models to compute odds ratios (ORs) and 95% confidence intervals (CIs) for physical activity in relation to depressive symptoms (CES-D score > or = 16) with control for potential confounders.
Adult vigorous physical activity was inversely associated with depressive symptoms. Women who reported vigorous exercise both in high school (> or = 5 hr per week) and adulthood (> or = 2 hr per week) had the lowest odds of depressive symptoms (OR = 0.76, 95% CI = 0.71-0.82) relative to never active women; the OR was 0.90 for women who were active in high school but not adulthood (95% CI = 0.85-0.96) and 0.83 for women who were inactive in high school but became active in adulthood (95% CI = 0.77-0.91). Although walking for exercise was not associated with risk of depressive symptoms overall, there was evidence of a weak inverse relation among obese women (Body Mass Index > or = 30).
Leisure time vigorous physical activity was associated with a reduced odds of depressive symptoms in U.S. Black women.
Some evidence suggests that depression may increase the risk of adult-onset asthma. No data are available for African American women, in whom the prevalence of depression and asthma is high.
To ...conduct prospective analyses of the relation of depressive symptoms to asthma incidence in the Black Women's Health Study, a prospective cohort of US black women followed since 1995 with mailed biennial questionnaires.
Of 31,848 participants followed from 1999 to 2011, 771 reported incident asthma. Depressive symptoms were ascertained on 1999 and 2005 follow-up questionnaires with the Center for Epidemiological Studies-Depression Scale (CES-D). Participants rated the frequency of 20 symptoms. A score was calculated by summing the responses to all questions. Cox regression models were used to derive incidence rate ratios and 95% confidence intervals for 4 categories of the CES-D score in relation to incident asthma, adjusted for body mass index, smoking, and other covariates.
The multivariable incidence rate ratio in the highest category of CES-D score (≥ 33) compared with the lowest (<16) was 2.08 (95% confidence interval 1.58-2.74), with a significant trend (P < .0001). The incidence rate ratio was higher in women who took antidepressants, were current or former smokers, were not obese, and were at least 40 years old, although there were no statistically significant interactions.
A positive association was observed between CES-D score and the incidence of adult-onset asthma. If the hypothesis is confirmed, depression could contribute substantially to the burden of asthma in adults.
OBJECTIVE: Obesity has risen to epidemic proportions in the United States, leading to an emerging epidemic of type 2 diabetes. African-American women are disproportionately affected by both ...conditions. While an association of overall obesity with increasing risk of diabetes has been documented in black women, the effect of fat distribution, specifically abdominal obesity, has not been studied. We examined the association of BMI, abdominal obesity, and weight gain with risk of type 2 diabetes. RESEARCH METHODS AND PROCEDURES: During eight years of follow-up of 49,766 women from the Black Women's Health Study, 2472 incident cases of diabetes occurred. Cox proportional hazard models were used to estimate incidence rate ratios (IRRs), with control for age, physical activity, family history of diabetes, cigarette smoking, years of education, and time period of data collection. RESULTS: Sixty-one percent of participants had a BMI >=25 kg/m² (WHO definition of overweight). Compared with a BMI of <23 kg/m², the IRR for a BMI of >45 kg/m² was 23 (95% confidence interval, 17.0 to 31.0). The IRR for the highest quintile of waist-to-hip ratio relative to the lowest was 2.3 (95% confidence interval, 2.0 to 2.7) after control for BMI. Furthermore, at every level of BMI, an increased risk was observed for high waist-to-hip ratio relative to low. DISCUSSION: Central obesity, as well as overall obesity, is a strong risk factor for diabetes in African-American women. Efforts to reduce the prevalence of obesity in African-American women are of paramount importance.
We examined the relation between median housing value and hypertension risk among US Black women.
We gathered data from the Black Women's Health Study, a prospective follow-up of 59000 Black women ...aged 21 to 69 years in 1995. Median housing value from US census data was used to measure neighborhood socioeconomic status. Cases of hypertension were identified through postal questionnaires mailed in 1997, 1999, and 2001. Clustered survival regression models were used to estimate incidence rate ratios.
During 180294 person-years of observation, 3780 cases of hypertension were reported. A significant inverse, graded association was found between median housing value and hypertension. The incidence rate ratio for women living in low median housing value neighborhoods relative to high was 1.29 (95% confidence interval=1.14, 1.45) after adjustment for individual risk factors. The association was evident even at higher individual levels of income and education.
Median housing value is inversely associated with hypertension in Black women, independent of individual risk factors. Lowering hypertension risk in Black women will require a greater understanding of the underlying social inequalities that adversely affect health.
Abstract Purpose Uterine leiomyomata (UL) are the primary indication for hysterectomy and are 2–3 times more common in black than white women. Previous studies indicate that early life may be a ...critical time window of susceptibility to UL. We assessed the association of UL with selected intrauterine and early life factors, expanding on previous research by using a prospective design and validated data on exposure and disease. Methods During 1997–2009, we followed 23,505 premenopausal women aged 23–50 years for new diagnoses of UL in the Black Women's Health Study. We used Cox regression models to compute incidence rate ratios (IRR) and 95% confidence intervals, adjusting for potential confounders. Results During 12 years of follow-up, there were 7268 incident UL cases diagnosed by ultrasound (n = 5727) or surgery (n = 1541). There was little evidence of an association between UL and birth weight, gestational age, or exposure to soy formula in infancy. Significant associations were found for being first born, foreign born, or exposed to passive smoke in childhood, but the associations were weak, with IRRs ranging from 1.06 to 1.12. Conclusions These findings do not support the hypothesis that intrauterine and early life factors are strongly related to UL risk.
Background Numerous cross-sectional studies have found higher levels of obesity among residents of auto-oriented, sprawling areas compared to residents of more urban areas. Purpose The association ...between neighborhood urban form and 6-year weight change was prospectively analyzed in the Black Women's Health Study, a cohort study of U.S. black women who enrolled in 1995 and are followed biennially with mailed questionnaires. Methods The analysis included 17,968 women who lived in New York City, Chicago, or Los Angeles and were followed from 1995 to 2001. Factor analysis was used to combine variables describing the urban form of participants' residential neighborhoods into an “urbanicity” score. Mixed linear regression models were used to calculate least-squares means for weight change across quintiles of the urbanicity score. Incidence rate ratios (IRRs) and 95% CIs for incident obesity in relation to the urbanicity score among women who were not obese at baseline were derived from Cox regression models. All results were adjusted for age, region, lifestyle factors, and neighborhood SES. Analyses were conducted in 2008–2010. Results In multivariate analysis, mean weight gain for women in the highest quintile of urbanicity score (most urban) was 0.79 kg less than for those in the lowest quintile, with a significant trend ( p =0.003). The IRR for incident obesity in the highest quintile relative to the lowest was 0.83 (95% CI=0.71, 0.97), with a significant trend ( p =0.042). Conclusions Policies that encourage dense, urban residential development may have a positive role to play in addressing obesity in black women.
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