EVALUATING POPULATION ATTRIBUTABLE FRACTIONS ASSOCIATED WITH ALZHEIMER’S DISEASE RISK FACTORS
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PROVIDER: S-EPMC10738926 | biostudies-literature | 2023 Dec
REPOSITORIES: biostudies-literature
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Project description:Risk factors for hepatocellular carcinoma (HCC) include hepatitis B and C viruses (HBV, HCV), excessive alcohol consumption, rare genetic disorders and diabetes/obesity. The population attributable fractions (PAF) of these factors, however, have not been investigated in population-based studies in the United States.Persons ?68 years diagnosed with HCC (n=6,991) between 1994 and 2007 were identified in the SEER-Medicare database. A 5% random sample (n=255,702) of persons residing in SEER locations were selected for comparison. For each risk factor, odds ratios (ORs), 95% confidence intervals (95% CI) and PAFs were calculated.As anticipated, the risk of HCC was increased in relationship to each factor: HCV (OR 39.89, 95% CI: 36.29-43.84), HBV (OR 11.17, 95% CI: 9.18-13.59), alcohol-related disorders (OR 4.06, 95% CI: 3.82-4.32), rare metabolic disorders (OR 3.45, 95% CI: 2.97-4.02), and diabetes and/or obesity (OR 2.47, 95% CI: 2.34-2.61). The PAF of all factors combined was 64.5% (males 65.6%; females 62.2%). The PAF was highest among Asians (70.1%) and lowest among black persons (52.4%). Among individual factors, diabetes/obesity had the greatest PAF (36.6%), followed by alcohol-related disorders (23.5%), HCV (22.4%), HBV (6.3%) and rare genetic disorders (3.2%). While diabetes/obesity had the greatest PAF among both males (36.4%) and females (36.7%), alcohol-related disorders had the second greatest PAF among males (27.8%) and HCV the second greatest among females (28.1%). Diabetes/obesity had the greatest PAF among whites (38.9%) and Hispanics (38.1%), while HCV had the greatest PAF among Asians (35.4%) and blacks (34.9%). The second greatest PAF was alcohol-related disorders in whites (25.6%), Hispanics (30.1%) and blacks (and 18.5%) and HBV in Asians (28.5%).The dominant risk factors for HCC in the United States among persons ?68 years differ by sex and race/ethnicity. Overall, eliminating diabetes/obesity could reduce the incidence of HCC more than the elimination of any other factor.
| S-EPMC4105976 | biostudies-literature
Project description:Hepatocellular carcinoma (HCC) incidence has been increasing in the United States for several decades; and, as the incidence of hepatitis C virus (HCV) infection declines and the prevalence of metabolic disorders rises, the proportion of HCC attributable to various risk factors may be changing.Data from the Surveillance, Epidemiology, and End Results-Medicare linkage were used to calculate population attributable fractions (PAFs) for each risk factor over time. Patients with HCC (n = 10,708) who were diagnosed during the years 2000 through 2011 were compared with a 5% random sample of cancer-free controls (n = 332,107) residing in the Surveillance, Epidemiology, and End Results areas. Adjusted odds ratios (ORs) and PAFs were calculated for HCV, hepatitis B virus (HBV), metabolic disorders, alcohol-related disorders, smoking, and genetic disorders.Overall, the PAF was greatest for metabolic disorders (32%), followed by HCV (20.5%), alcohol (13.4%), smoking (9%), HBV (4.3%), and genetic disorders (1.5%). The PAF for all factors combined was 59.5%. PAFs differed by race/ethnicity and sex. Metabolic disorders had the largest PAF among Hispanics (PAF, 39.3%; 95% confidence interval [CI], 31.9%-46.7%) and whites (PAF, 34.8%; 95% CI, 33.1%-36.5%), whereas HCV had the largest PAF among blacks (PAF, 36.1%; 95% CI, 31.8%-40.4%) and Asians (PAF, 29.7%; 95% CI, 25.9%-33.4%). Between 2000 and 2011, the PAF of metabolic disorders increased from 25.8% (95% CI, 22.8%-28.9%) to 36% (95% CI, 33.6%-38.5%). In contrast, the PAFs of alcohol-related disorders and HCV remained stable.Among US Medicare recipients, metabolic disorders contribute more to the burden of HCC than any other risk factor, and the fraction of HCC caused by metabolic disorders has increased in the last decade. Cancer 2016;122:1757-65. Published 2016. This article is a U.S. Government work and is in the public domain in the USA..
| S-EPMC5548177 | biostudies-other
Project description:IntroductionA population attributable fraction represents the relative change in disease prevalence that one might expect if a particular exposure was absent from the population. Often, one might be interested in what percentage of this effect acts through particular pathways. For instance, the effect of a sedentary lifestyle on stroke risk may be mediated by blood pressure, body mass index and several other intermediate risk factors.MethodsWe define a new metric, the pathway-specific population attributable fraction (PS-PAF), for mediating pathways of interest. PS-PAFs can be informally defined as the relative change in disease prevalence from an intervention that shifts the distribution of the mediator to its expected distribution if the risk factor were eliminated, and sometimes more simply as the relative change in disease prevalence if the mediating pathway were disabled. A potential outcomes framework is used for formal definitions and associated estimands are derived via relevant identifiability conditions. Computationally efficient estimators for PS-PAFs are derived based on these identifiability conditions.ResultsCalculations are demonstrated using INTERSTROKE-an international case-control study designed to quantify disease burden attributable to a number of known causal risk factors. The applied results suggest that mediating pathways from physical activity through blood pressure, blood lipids and body size explain comparable proportions of stroke disease burden, but a large proportion of the disease burden due to physical inactivity may be explained by alternative pathways.ConclusionPS-PAFs measure disease burden attributable to differing mediating pathways and can generate insights into the dominant mechanisms by which a risk factor affects disease at a population level.
| S-EPMC9749703 | biostudies-literature
Project description:Parkinson's disease is the fastest-growing neurologic disease with seemingly no means of prevention. Intrinsic risk factors (age, sex, and genetics) are inescapable, but environmental factors are not. We identified repeated blows to the head in sports/combat as a potential new risk factor. 23% of PD cases in females were attributable to pesticide/herbicide exposure, and 30% of PD in males were attributable to pesticides/herbicides, military-related chemical exposures, and repeated blows to the head, and therefore could have potentially been prevented.
| S-EPMC10698155 | biostudies-literature
Project description:In 2001-2002, a multicenter, prospective case-control study involving 1,714 participants > or =5 years of age was conducted in Australia to identify risk factors for Campylobacter infection. Adjusted population-attributable risks (PARs) were derived for each independent risk factor contained within the final multivariable logistic regression model. Estimated PARs were combined with adjusted (for the > or =5 years of age eligibility criterion) notifiable disease surveillance data to estimate annual Australian Campylobacter case numbers attributable to each risk factor. Simulated distributions of "credible values" were then generated to model the uncertainty associated with each case number estimate. Among foodborne risk factors, an estimated 50,500 (95% credible interval 10,000-105,500) cases of Campylobacter infection in persons > or =5 years of age could be directly attributed each year to consumption of chicken in Australia. Our statistical technique could be applied more widely to other communicable diseases that are subject to routine surveillance.
| S-EPMC2600281 | biostudies-literature
Project description:Objectives: To assess the relationship between modifiable lifestyle factors and risk of overweight/obesity in Chinese students, and to evaluate the predicting prevalence of overweight if the lifestyle risk factors were removed. Methods: A cross-sectional survey was conducted among 40,141 students in grade three and above (8-24yrs) in 2019 in Zhejiang Province, China. Physical examination was performed, and a self-administered questionnaire was used to collect lifestyle information, including dietary behavior, physical activity, TV watching, sleeping, smoking, drinking, and tooth-brushing habits. Logistic regression models were performed to assess the relationship between overweight/obesity and a series of lifestyle factors. Population attributable fractions (PAFs) were used to calculate the predicting prevalence of overweight/obesity if lifestyle risk factors were removed. Results: The prevalence of overweight/obesity of participants was 25.5% (male 32.3%, female 18.1%). Overweight/obesity were associated with adverse lifestyle factors, such as watch TV ≥1 h/day (OR = 1.14, 95% CI: 1.11-1.22), insufficient sleep (OR = 1.14, 95% CI: 1.11-1.22), and irregular toothbrushing habits (OR = 1.19, 95% CI: 1.01-1.39). Based on the calculated PAFs, the predicted prevalence of overweight/obesity would decline moderately if lifestyle factors were modified, with the magnitudes of decrease vary by sex, age and residence. Generally, a larger reduction was estimated if the sleeping time was increased and TV time was reduced, with the prevalence of overweight/obesity decreased by 1.1% (95% CI: 0.7, 1.5%) and 0.9% (95% CI: 0.6, 1.2%), respectively. Conclusions: Predicted prevalence of overweight/ obesity in Chinese students may decrease if modifiable lifestyle risk factors were removed. The attributable risk for obesity of lifestyle behaviors varied in age, sex and residence groups. The findings of this study may provide insights for planning and optimizing future obesity intervention endeavors.
| S-EPMC8493597 | biostudies-literature
Project description:In view of the fact that there is no effective treatment for dementia, the number of years that dementia patients have to live with dementia will gradually increase for the rest of their lives, and the disability loss caused by dementia will increase. It is urgent to study the influence of risk factors on dementia by making use of the potential of prevention. The purpose of this study is to quantify the burden of dementia disability attributable to risk factors by assessing the population attributable fractions (PAFs) in Jiangxi Province, which is one of the regions of moderate aging process of China. The prevalence data of nine risk factors were obtained through the Sixth National Health Service Survey in 2018, which covered 2713 older people. Levin's formula was used to calculate the PAF for each risk factor for dementia. We adjusted the PAF for communality between risk factors, and used these values to calculate overall weighted PAFs and the years lived with disability (YLDs), which were attributable to nine risk factors. The number of dementia cases and their proportions that can theoretically be prevented by nine identified risk factors were 111636 (99595-120877) and 66.8% (59.6-72.3), respectively. The total YLDs of dementia were estimated to be 61136 (46463-78369) (males: 36434 [24100-49330], females: 23956 [14716-34589]). Physical inactivity (11639 [8845-14920]), low social contact (9324 [7086-11952]), and hearing loss (5668 [4307-7265] were the top three contributors to dementia. The moderate aging areas represented by Jiangxi Province have great potential in the prevention of dementia. Targeted interventions and management of risk factors can effectively reduce the disability burden of dementia.
| S-EPMC9587554 | biostudies-literature
Project description:BackgroundPopulation attributable fractions (PAFs) are frequently used to quantify the proportion of Type 2 diabetes cases due to single risk factors, an approach which may result in an overestimation of their individual contributions. This study aimed to examine Type 2 diabetes incidence associated with multiple risk factor combinations, including the metabolic syndrome, behavioural factors, and specifically, depression and anxiety.MethodsUsing data from the population-based HUNT cohort, we examined incident diabetes in 36,161 Norwegian adults from 1995 to 2008. PAFs were calculated using Miettinen's case-based formula, using relative risks estimated from multivariate regression models.ResultsOverall, the studied risk factors accounted for 50.5% of new diabetes cases (78.2% in men and 47.0% in women). Individuals exposed to both behavioural and metabolic factors were at highest risk of diabetes onset (PAF = 22.9%). Baseline anxiety and depression contributed a further 13.6% of new cases to this combination. Men appeared to be particularly vulnerable to the interaction between metabolic, behavioural and psychological risk factors.ConclusionThis study highlights the importance of risk factor clustering in diabetes onset, and is the first that we know of to quantify the excess fraction of incident diabetes associated with psychological risk factor interactions.
| S-EPMC6251110 | biostudies-literature
Project description:To estimate population attributable fractions (PAF) of acute myocardial infarction (AMI) associated with anthropometric measures by sex and age.The Cohort of Norway study identified 140,790 participants free of cardiovascular disease, 1994-2003. Participants were followed for AMI through 2009 by record linkages through the Cardiovascular Disease in Norway Project. PAFs were adjusted for age, smoking, systolic blood pressure, diabetes, and the ratio of total cholesterol to high-density lipoprotein cholesterol.The PAFs associated with a waist-hip ratio (WHR) in the top two quintiles were 26.1% (95% confidence interval, CI 14.6-36.1) for middle-aged women (<60 years, mean of 41 years) and 9.3% (95% CI 3.0-15.1) for similarly aged men after adjustment for body mass index (BMI) and conventional risk factors. However, PAFs associated with anthropometric measures in elderly participants (? 60 years, mean of 70 years) were non-significant in multivariable analyses. Also, WHR was a significant predictor of AMI among men and women without an enlarged waist circumference (<102 cm for men and?<?88 cm for women) in adjusted analyses.WHR measurements could improve identification of at-risk individuals above and beyond that of conventional risk factors, BMI, or an enlarged waist circumference.
| S-EPMC5071698 | biostudies-other
Project description:The objective of the current study was to determine the proportion of adverse perinatal outcomes that could be potentially prevented if maternal obesity were to be reduced or eliminated (population attributable risk fractions, PARF); and the number needed to treat (NNT) of overweight or obese women to prevent one case of adverse perinatal outcome. Data from the Atlee Perinatal Database on 66,689 singleton infants born in Nova Scotia, Canada, between 2004 and 2014, and their mothers were used. Multivariable-adjusted PARFs and NNTs of maternal pre-pregnancy weight status were determined for various perinatal outcomes under three scenarios: If all overweight and obese women were to i) become normal weight before pregnancy; ii) shift down one weight class; or iii) lose 10% of their body weight, significant relative reductions would be seen for gestational diabetes mellitus (GDM, 57/33/15%), hypertensive disorders of pregnancy (HDP, 26/16/6%), caesarean section (CS, 18/10/3%), and large for gestational age births (LGA, 24/14/3%). The NNT were lowest for the outcomes GDM, induction of labour, CS, and LGA, where they ranged from 13 to 73. The study suggests that a substantial proportion of adverse perinatal outcomes may be preventable through reductions in maternal pre-pregnancy weight.
| S-EPMC4790628 | biostudies-other