Dataset Information

Ventilatory function as a predictor of mortality in lifelong non-smokers: evidence from large British cohort studies.

ABSTRACT: Reduced ventilatory function is an established predictor of all-cause mortality in general population cohorts. We sought to verify this in lifelong non-smokers, among whom confounding by active smoking can be excluded, and investigate associations with circulatory and cancer deaths.In UK Biobank, among 149 343 white never-smokers aged 40-69 years at entry, 2401 deaths occurred over a mean of 6.5-year follow-up. In the Health Surveys for England (HSE) 1995, 1996, 2001 and Scottish Health Surveys (SHS) 1998 and 2003 combined, there were 500 deaths among 6579 white never-smokers aged 40-69 years at entry, followed for a mean of 13.9 years. SD (z) scores for forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) were derived using Global Lung Initiative 2012 reference equations. These z-scores were related to deaths from all causes, circulatory disease and cancers using proportional hazards models adjusted for age, sex, height, socioeconomic status, region and survey.In the HSE-SHS data set, decreasing z-scores for FEV1 (zFEV1) and FVC (zFVC) were each associated to a similar degree with increased all-cause mortality (hazard ratios per unit decrement 1.17, 95% CI 1.09 to 1.25 for zFEV1 and 1.19, 95% CI 1.10 to 1.28 for zFVC). This was replicated in Biobank (HRs 1.21, 95% CI 1.17 to 1.26 and 1.24, 1.19 to 1.29, respectively). zFEV1 and zFVC were less strongly associated with mortality from circulatory diseases in HSE-SHS (HR 1.22, 95% CI 1.06 to 1.40 for zFVC) than in Biobank (HR 1.47, 95% CI 1.35 to 1.60 for zFVC). For cancer mortality, HRs were more consistent between cohorts (for zFVC: HRs 1.12, 95% CI 1.01 to 1.24 in HSE-SHS and 1.10, 1.05 to 1.15 in Biobank). The strongest associations were with respiratory mortality (for zFVC: HRs 1.61, 95% CI 1.25 to 2.08 in HSE-SHS and 2.15, 1.77 to 2.61 in Biobank).Spirometric indices predicted mortality more strongly than systolic blood pressure or body mass index, emphasising the importance of promoting lung health in the general population, even among lifelong non-smokers.

SUBMITTER: Gupta RP

PROVIDER: S-EPMC5734388 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Ventilatory function as a predictor of mortality in lifelong non-smokers: evidence from large British cohort studies.

Gupta Ramyani P RP Strachan David P DP

BMJ open 20170712 7

<h4>Background</h4>Reduced ventilatory function is an established predictor of all-cause mortality in general population cohorts. We sought to verify this in lifelong non-smokers, among whom confounding by active smoking can be excluded, and investigate associations with circulatory and cancer deaths.<h4>Methods</h4>In UK Biobank, among 149 343 white never-smokers aged 40-69 years at entry, 2401 deaths occurred over a mean of 6.5-year follow-up. In the Health Surveys for England (HSE) 1995, 1996 ...[more]

PMID: 28706094

Similar Datasets

Project description:Background: Some evidence suggests environmental tobacco smoke (ETS) might cause chronic obstructive pulmonary disease (COPD). We reviewed available epidemiological data in never smokers. Methods: We identified epidemiological studies providing estimates of relative risk (RR) with 95% confidence interval (CI) for various ETS exposure indices. Confounder-adjusted RRs for COPD were extracted, or derived using standard methods. Meta-analyses were conducted for each exposure index, with tests for heterogeneity and publication bias. For the main index (spouse ever smoked or nearest equivalent), analyses investigated variation in RR by location, publication period, study type, sex, diagnosis, study size, confounder adjustment, never smoker definition, and exposure index definition. Results: Twenty-eight relevant studies were identified; nine European or Middle Eastern, nine Asian, eight American and two from multiple countries. Five were prospective, seven case-control and 16 cross-sectional. The COPD definition involved death or hospitalisation in seven studies, GOLD stage 1+ criteria in twelve, and other definitions in nine. For the main index, random-effects meta-analysis of 33 heterogeneous (p<0.001) estimates gave a RR of 1.20 (95%CI 1.08-1.34). Higher estimates for females (1.59,1.16-2.19, n=11) than males (1.29,0.94-1.76, n=7) or sexes combined (1.10,0.99-1.22, n=15 where sex-specific not available), and lower estimates for studies of 150+ cases (1.08,0.97-1.20, n=13) partly explained the heterogeneity. Estimates were higher for Asian studies (1.34,1.08-1.67, n=10), case-control studies (1.55,1.04-2.32, n=8), and COPD mortality or hospitalisation (1.40,1.12-1.74, n=11). Some increase was seen for severer COPD (1.29,1.10-1.52, n=7). Dose-response evidence was heterogeneous. Evidence for childhood (0.88,0.72-1.07, n=2) and workplace (1.12,0.77-1.64, n=4) exposure was limited, but an increase was seen for overall adulthood exposure (1.20,1.03-1.39, n=17). We discuss study weaknesses that may bias estimation of the association of COPD with ETS. Conclusions: Although the evidence suggests ETS increases COPD, study weaknesses and absence of well-designed large studies precludes reliable inference of causality. More definitive evidence is required.

Project description:ImportanceEarly-life mental health is known to be associated with socioeconomic adversity and psychological distress in adulthood, but less is known about potential associations with biomarkers and mortality.ObjectiveTo investigate the association between early-life mental health trajectories with biomarkers in midlife and premature mortality.Design, setting, and participantsThis study used data from the British National Child Development Study, a population-based birth cohort. The initial sample of 17 415 individuals consisted of all infants born in Great Britain in a single week in 1958. Analysis began Feburary 2017 and ended May 2020.Main outcomes and measuresBiomarkers collected at age 44 to 45 years were fibrinogen, C-reactive protein, glycated hemoglobin, high- and low-density lipoprotein cholesterol, forced expiratory volume, blood pressure, and waist-to-hip ratio. Information on all-cause mortality was available up to age 58 years and cause-specific mortality up to age 50 years.ResultsBiomarkers were analyzed from 9377 participants (age, 44-45 years, 4712 female [50.3%]) and mortality data from 15 067 participants (age, 58 years; 7379 female [49.0%]). A 4-group longitudinal typology of early-life conduct problems and affective symptoms was identified: (1) stable low, (2) teacher-identified adolescent onset, (3) moderate, and (4) stable high. Compared with the stable-low group, the stable-high (B, 2.308; 95% CI, 0.213-4.404) and teacher-identified adolescent-onset (B, 2.114; 95% CI, 0.725-3.503) groups had less favorable levels of fibrinogen in middle age. Effect modification was observed by sex (P < .005) such that compared with the stable-low group, differences in high-density lipoprotein and abdominal obesity were only observed in female individuals. The stable-high and teacher-identified adolescent-onset groups had elevated risk for all-cause mortality (hazard ratio, 1.878; 95% CI, 1.501-2.350 and hazard ratio, 1.412; 95% CI, 1.174-1.698). Psychopathology-associated mortality was higher in both groups but unintentional injuries-associated mortality only in the stable-high group.Conclusions and relevanceExperiencing affective symptoms and conduct problems in childhood and adolescence is associated with less favorable levels of biomarkers 28 years later and elevated risk of premature mortality. These findings, if causal and generalizable to younger cohorts, may imply that effective interventions on early-life mental health have the potential to shift the distribution of risk and improve population health.

Project description:ObjectiveChild maltreatment (abuse and neglect) has established associations with mental health; however, little is known about its relationship with physical functioning. Physical functioning (ie, the ability to perform the physical tasks of daily living) in adulthood is an important outcome to consider, as it is strongly associated with an individual's ability to work, and future disability and dependency. We aimed to establish whether maltreatment was associated with physical functioning, independent of other early-life factors.Setting1958 British birth cohort.Participants8150 males and females with data on abuse and who participated at age 50 years.Outcome measuresThe primary outcome was poor physical functioning at 50 years (<65 on the Short-Form 36 survey physical functioning subscale). Secondary outcomes included mental health and self-reported health at 50 years.Results23% of participants reported at least one type of maltreatment; 12% were identified with poor physical functioning. Neglect (ORadj 1.55, 95% CI 1.24 to 1.93), psychological abuse (ORadj 1.49, 1.17-1.88) and sexual abuse (ORadj 2.56, 1.66-3.96) were associated with poor physical functioning independent of other maltreatments and covariates, including childhood social class, birth weight and childhood illness. Odds of poor physical functioning increased with multiple types of maltreatment (ptrend <0.001); ORadj ranged from 1.49 (1.23-1.82) for a single type to 2.09 (1.53-2.87) for those reporting > 3 types of maltreatment, compared with those with none. Associations of similar magnitude were observed for mental and self-reported health outcomes.ConclusionsChild neglect, psychological and sexual abuse were associated with poor physical functioning at 50 years, with accumulating risk for those with multiple types of maltreatment. Associations were independent of numerous early-life factors and were comparable in magnitude to those observed for mental health and self-rated health. Prevention or alleviation of the ill effects of maltreatment could be an effective policy intervention to promote healthy ageing.

Project description:Overweight and obesity have been associated with unemployment but less is known about changes in weight associated with changes in employment. We examined weight changes associated with job-loss, retirement and maintaining employment in two samples of working adults in the United Kingdom. This was a prospective study of 7201 adults in the European Prospective Investigation of Cancer (EPIC)-Norfolk study (aged 39-76 years) and 4539 adults in the British Household Panel Survey (BHPS) who were followed up over 43 months and 26 months, respectively. In both samples, changes in measured (EPIC) and self-reported (BHPS) weight were computed for each participant and assessed in relation to three employment transitions: maintaining paid employment, retirement and job-loss. Regression models adjusted for potential confounders. Further analyses evaluated the contribution of diet, physical activity and smoking to weight gain. In EPIC-Norfolk, weight change differed across the three employment transitions for women but not men. The mean (95% CI) annualised change in weight for women who became unemployed over the follow-up period was 0.70 (0.55, 0.85) kg/y while those who maintained employment gained 0.49 (0.43, 0.55) kg/y (P = 0.007). Accounting for changes in smoking, diet and physical activity did not substantially alter the difference in weight gain among groups. In BHPS, job-loss was associated with weight gain of 1.56 (0.89, 2.23) kg/y, while those who maintained employment 0.60 (0.53, 0.68) kg/y (P < 0.001). In both samples, weight changes associated with retirement were similar to those staying in work. In BHPS, job-loss was also associated with significant declines in self-reported well-being and increases in sleep-loss. Two UK-based samples of working adults reveal strong associations between job-loss and excess weight gain. The mediating behaviours are so far unclear but psychosocial mechanisms and sleep-loss may contribute to the excess weight gain among individuals who become unemployed.

Dataset Information

Ventilatory function as a predictor of mortality in lifelong non-smokers: evidence from large British cohort studies.

Publications

Ventilatory function as a predictor of mortality in lifelong non-smokers: evidence from large British cohort studies.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets