Project description:Rationale: Women have a higher burden of asthma than men. Although sex hormones may explain sex differences in asthma, their role is unclear.Objectives: To examine sex hormone levels and asthma in adults.Methods: Cross-sectional study of serum levels of free testosterone and estradiol and current asthma in 7,615 adults (3,953 men and 3,662 women) aged 18-79 years who participated in the 2013-2014 and 2015-2016 U.S. National Health and Nutrition Examination Survey. Logistic regression was used for the multivariable analysis of sex hormones and current asthma, which was conducted separately in women and men.Measurements and Main Results: Free testosterone levels in the fourth quartile were associated with lower odds of current asthma in women (odds ratio [OR] for the fourth quartile [Q4] vs. Q1, 0.56; 95% confidence interval [CI], 0.39-0.80). Given an interaction between obesity and sex hormones on current asthma, we stratified the analysis by obesity. In this analysis, elevated free testosterone (OR for Q4 vs. Q1, 0.59; 95% CI, 0.37-0.91) and estradiol (OR for Q4 vs. Q1, 0.43; 95% CI, 0.23-0.78) levels were associated with reduced odds of current asthma in obese women, and an elevated serum estradiol was associated with lower odds of current asthma in nonobese men (OR for Q4 vs. Q1, 0.44; 95% CI, 0.21-0.90).Conclusions: Our findings suggest that sex hormones play a role in known sex differences in asthma in adults. Moreover, our results suggest that obesity modifies the effects of sex hormones on asthma in adults.
Project description:BACKGROUND:Cadmium and lead are hazardous pollutants. OBJECTIVE:We examined the relation between serum levels of cadmium and lead and current wheeze, current asthma, and lung function in US adults. METHODS:A cross-sectional study of 13,888 adults aged 20 to 79 years in 2007-2012 National Health and Nutrition Examination Survey (NHANES) was considered. Multivariable logistic or linear regression was used for the analyses of current wheeze, current asthma, and lung function measures (forced expiratory volume in 1 second [FEV1]% predicted, forced vital capacity [FVC]% predicted, FEV1/FVC% predicted, and fractional exhaled nitric oxide [FeNO]), which were conducted first in all participants, and then separately in never/former smokers and current smokers. RESULTS:High levels of serum cadmium were significantly associated with current wheeze in all participants and in current smokers (odds ratio for fourth vs first quartile = 2.84, 95% confidence interval = 2.07-3.90, Pfor linear trend < .01), as well as with current asthma in current smokers. Serum lead was not significantly associated with current wheeze or current asthma, regardless of smoking status. Serum cadmium was significantly associated with lower FEV1% predicted, FEV1/FVC% predicted, and FeNO in all participants and in never/former smokers, and serum lead was significantly associated with lower FEV1/FVC% predicted in all participants, with similar findings in never/former smokers and in current smokers. CONCLUSIONS:Our findings suggest that exposure to cadmium is associated with an increased risk of wheeze and asthma in US adults who currently smoke. Moreover, our results suggest that exposure to cadmium or lead has negative effects on lung function in nonsmoking US adults.
Project description:At the population level, those with more education tend to report better sleep, mirroring the education gradient found in other health outcomes. But research has shown that higher educational attainment does not always confer the same health benefits for Non-Hispanic Black (Black) and Hispanic adults as it does for Non-Hispanic White (White) adults. It is therefore possible that the educational gradient in sleep varies across racial/ethnic groups in the United States. Using the 2004-2018 National Health Interview Survey (N = 356,048), we examined differences in self-reported sleep duration and sleep quality by level of educational attainment and race/ethnicity. Utilizing multinomial (sleep duration) and negative binomial (times in the past week with difficulty falling asleep and staying asleep) regression models, we found that, compared to their less educated counterparts, college or more educated Whites were more likely to report ideal sleep compared to short or long sleep, and also reported fewer times with difficulty falling or staying asleep. The education-sleep association was generally reversed for Black and Hispanic adults, with the worst sleep being reported by those with college-level education. These patterns remained after adjusting for health behaviors, health outcomes, and socioeconomic status. Our study suggests that education does not yield the same protective benefit for sleep among Black and Hispanic adults as it does for White adults, and that highly educated Black and Hispanic adults in particular experience a sleep disadvantage. The differential education gradient in sleep may, therefore, be an important factor underlying current racial and ethnic health disparities.
Project description:To document trends in self-reported sleep duration for the noninstitutionalized U.S. civilian population from 2004 to 2017 and examine how sleep trends vary by race/ethnicity. We use data from the National Health Interview Survey (NHIS) for U.S. noninstitutionalized adults aged 18-84 from 2004 to 2017 (N = 398 382). NHIS respondents were asked how much they slept in a 24-hour period on average, which we categorized as ≤6 hr (short sleep), 7-8 hr (adequate sleep), and ≥9 hr (long sleep). We used multinomial logistic regression models to examine trends in self-reported sleep duration and assess race/ethnic differences in these trends. Our models statistically adjusted for demographic, socioeconomic, familial, behavioral, and health covariates. The prevalence of short sleep duration was relatively stable from 2004 to 2012. However, results from multinomial logistic regression models indicated that there was an increasing trend toward short sleep beginning in 2013 (b: 0.09, 95% CI: 0.05-0.14) that continued through 2017 (b: 0.18, 95% CI: 0.13-0.23). This trend was significantly more pronounced among Hispanics and non-Hispanic blacks, which resulted in widening racial/ethnic differences in reports of short sleep. Recent increases in reports of short sleep are concerning as short sleep has been linked with a number of adverse health outcomes in the population. Moreover, growing race/ethnic disparities in short sleep may have consequences for racial and ethnic health disparities.
Project description:ObjectivesTo investigate the associations of household mold and pesticide use with risk of childhood asthma and examine the potential effect modification by child's sex at a national level in the U.S.MethodsNationally representative data were drawn from the cross-sectional 2017 and 2018 National Surveys of Children's Health. Household mold and pesticide exposures during the past 12 months and physician-diagnosed childhood asthma were assessed by standard questionnaires administered to primary caregivers. Multivariable logistic regression models were used to calculate adjusted odds ratios (aOR) for current asthma, adjusting for child, caregiver, and household covariates. We also examined potential effect modification by child's sex. Sampling weights accounted for the complex survey design.ResultsAmong 41,423 U.S. children in 2017-2018, the weighted prevalence of current asthma was 10.8% in household mold-exposed children, compared with 7.2% in non-exposed children (P < 0.001). After adjusting for covariates including child's obesity, children with household mold exposure compared to those with no household mold exposure had a 1.41-fold (95% CI: 1.07, 1.87) higher odds of current asthma. Associations between household mold and current asthma were pronounced among boys (aOR 1.57; 95% CI: 1.03-2.38) but not girls (aOR 1.28; 0.90-1.83; P for interaction <0.001). No significant associations were observed between household pesticide use and current asthma, after adjusting for covariates.ConclusionsOur findings suggest that household mold is associated with current asthma among children, independent of other major risk factors including child's obesity status. Our findings may inform strategies targeting mitigation of household mold as an important indoor environment factor to address childhood asthma.
Project description:Handgrip strength has been shown an indispensable biomarker for older adults. Furthermore, the association between sleep duration and grip strength in special populations (e.g., type 2 diabetics) has been previously documented. However, the association between sleep duration and grip strength has been less studied in older adults and the dose-response relationship is unclear. Therefore, we drew 1881 participants aged 60 years and older from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 to explore their association and the dose-response relationship. Sleep duration was obtained through self-report. Grip strength data were obtained through a grip test using a handgrip dynamometer and divided into two categories: low grip strength and normal grip strength. Thus, dichotomized grip strength was used as a dependent variable. Poisson regression and restricted cubic spline were used for the main part of the analysis. We found that long sleep duration (≥9 h) was associated with a higher prevalence of low grip strength than the normal sleep duration (7-<9 h) group (IRR: 1.38, 95% CI: 1.12-1.69). Moreover, the gender-stratified analysis did not change the original results. This association was particularly pronounced and further strengthened among participants with normal weight (BMI < 25) (IRR: 2.30, 95% CI: 1.64-3.22) and participants aged 60-70 (IRR: 1.76, 95% CI: 1.40-2.22). In addition, with the increase in sleep duration, the multivariate-adjusted IRRs of low grip strength had a general downward trend at first, followed by a brief period of stability, and then presented an upward trend (p-value for non-linearity = 0.001). According to this study, we found that older adults who had long sleep duration had a higher risk of low grip strength. Muscle insulin utilization and muscle glucose metabolism are closely related to grip strength, so our research emphasizes the importance of maintaining normal sleep duration in older adults and suggests that older adults who sleep for a long period should pay more attention to their muscle health.
Project description:Gender and racial/ethnic disparities in sleep duration are well documented among the U.S. adult population, but we know little about how these disparities are shaped during the early course of adult life, a period marked by substantial changes in social roles that can influence time for sleep.Prospective data was used from the National Longitudinal Survey of Youth 1997 (NLSY97), a U.S.-based representative sample of persons born between 1980 and 1984, who were first interviewed in 1997. Sleep duration was assessed in 2002, 2007/2008, 2009, 2010, and 2011. Random-coefficient models were estimated to examine gender and racial/ethnic disparities in trajectories of sleep duration across early adulthood as a function of educational experiences, employment, and family relationships.Sleep duration declined during early adulthood. Women reported shorter sleep than men from age 18 to 22, but slept longer than men by age 28. Black Young adults reported sleep durations similar to those of White young adults until age 24, after which blacks slept less than whites. Educational experiences and employment characteristics reduced gender and racial/ethnic disparities, but family relationships exacerbated them.This study is the first to establish the emergence of gender and racial/ethnic disparities in sleep duration during early adulthood.
Project description:ObjectiveWe examined the relation between serum-free testosterone and asthma, wheeze, asthma hospitalisations and lung function in older adults.DesignCross-sectional study.SettingUK.Participants256 419 adults aged 40 to 69 years, recruited from 2006 to 2010.Main outcome measuresMultivariable logistic or linear regression was used for the analysis of free testosterone and physician-diagnosed asthma, current wheeze, asthma hospitalisations and lung function measures, which was adjusted for serum estradiol, smoking status and other covariates.ResultsFree testosterone levels above the lowest quartile (Q1) were significantly associated with lower odds of asthma in both women (adjusted OR (aOR) for Q4 (the highest quartile) versus Q1=0.67, 95% CI=0.64 to 0.71) and men (aOR for Q4 versus Q1=0.87, 95% CI=0.82 to 0.91). Among subjects with asthma, free testosterone levels above Q1 were significantly associated with lower odds of current wheeze in women (aOR range=0.78 to 0.87), and free testosterone levels in Q4 were associated with lower odds of current wheeze in men (aOR for Q4 versus Q1=0.86, 95% CI=0.77 to 0.95). Among women with asthma, free testosterone levels in Q4 were also associated with lower odds of ≥1 asthma hospitalisation. Among men, free testosterone was positively associated with FEV1 and FVC. Among women, free testosterone was negatively and weakly associated with FVC.ConclusionIn a large study of British adults, elevated free testosterone levels are associated with lower odds of asthma and current wheeze in women and men, lower odds of asthma hospitalisations in women, and higher FEV1 and FVC in men. DISSEMINATION TO PARTICIPANTS, AND RELATED PATIENT AND PUBLIC COMMUNITIES: The results of the study will be linked to the UK Biobank website.
Project description:BackgroundGenome-wide association studies have identified determinants of chronic obstructive pulmonary disease, asthma, and lung function level; however, none have addressed decline in lung function.ObjectiveWe conducted the first genome-wide association study on the age-related decrease in FEV(1) and its ratio to forced vital capacity (FVC) stratified a priori by asthma status.MethodsDiscovery cohorts included adults of European ancestry (1,441 asthmatic and 2,677 nonasthmatic participants: the Epidemiological Study on the Genetics and Environment of Asthma, the Swiss Cohort Study on Air Pollution and Lung and Heart Disease in Adults, and the European Community Respiratory Health Survey). The associations of FEV(1) and FEV(1)/FVC ratio decrease with 2.5 million single nucleotide polymorphisms (SNPs) were estimated. Thirty loci were followed up by in silico replication (1,160 asthmatic and 10,858 nonasthmatic participants: Atherosclerosis Risk in Communities, the Framingham Heart Study, the British 1958 Birth Cohort, and the Dutch Asthma Study).ResultsMain signals identified differed between asthmatic and nonasthmatic participants. None of the SNPs reached genome-wide significance. The association between the height-related gene DLEU7 and FEV(1) decrease suggested for nonasthmatic participants in the discovery phase was replicated (discovery, P = 4.8 × 10(-6); replication, P = .03), and additional sensitivity analyses point to a relation to growth. The top ranking signal, TUSC3, which is associated with FEV(1)/FVC ratio decrease in asthmatic participants (P = 5.3 × 10(-8)), did not replicate. SNPs previously associated with cross-sectional lung function were not prominently associated with decline.ConclusionsGenetic heterogeneity of lung function might be extensive. Our results suggest that genetic determinants of longitudinal and cross-sectional lung function differ and vary by asthma status.