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1دورية أكاديمية
المؤلفون: Michael Fleming, Amrita Bandyopadhyay, James S. McLay, David Clark, Albert King, Daniel F. Mackay, Ronan A. Lyons, Kapil Sayal, Sinead Brophy, Jill P. Pell
المصدر: BMC Public Health, Vol 22, Iss 1, Pp 1-9 (2022)
مصطلحات موضوعية: Attention-deficit hyperactivity disorder, Relative age, Data linkage, Children, Education, School, Public aspects of medicine, RA1-1270
الوصف: Abstract Background Previous studies suggest an association between age within schoolyear and attention-deficit hyperactivity disorder (ADHD). Scotland and Wales have different school entry cut-off dates (six months apart) and policies on holding back children. We aim to investigate the association between relative age and treated attention deficit hyperactivity disorder (ADHD) in two countries, accounting for held-back children. Methods Routine education and health records of 1,063,256 primary and secondary schoolchildren in Scotland (2009–2013) and Wales (2009–2016) were linked. Logistic regression was used to examine the relationships between age within schoolyear and treated ADHD, adjusting for child, maternity and obstetric confounders. Results Amongst children in their expected school year, 8,721 (0.87%) had treated ADHD (Scotland 0.84%; Wales 0.96%). In Wales, ADHD increased with decreasing age (youngest quartile, adjusted OR 1.32, 95% CI 1.19–1.46) but, in Scotland, it did not differ between the youngest and oldest quartiles. Including held-back children in analysis of their expected year, the overall prevalence of treated ADHD was 0.93%, and increased across age quartiles in both countries. More children were held back in Scotland (57,979; 7.66%) than Wales (2,401; 0.78%). Held-back children were more likely to have treated ADHD (Scotland OR 2.18, 95% CI 2.01–2.36; Wales OR 1.70, 95% CI 1.21–2.31) and 81.18% of held-back children would have been in the youngest quartile of their expected year. Conclusions Children younger within schoolyear are more likely to be treated for ADHD, suggesting immaturity may influence diagnosis. However, these children are more likely to be held back in countries that permit flexibility, attenuating the relative age effect.
وصف الملف: electronic resource
Relation: https://doaj.org/toc/1471-2458
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2دورية أكاديمية
المؤلفون: Lisa J. Adams, Jill P. Pell, Daniel F. Mackay, David Clark, Albert King, Michael Fleming
المصدر: PLoS Medicine, Vol 20, Iss 4 (2023)
مصطلحات موضوعية: Medicine
الوصف: Background While special educational needs (SEN) are increasingly recorded among schoolchildren, infant breastfeeding has been associated with reduced incidence of childhood physical and mental health problems. This study investigated relationships between infant feeding method and risk of all-cause and cause-specific SEN. Methods and findings A population cohort of schoolchildren in Scotland was constructed by linking together health (maternity, birth, and health visitor records) and education (annual school pupil census) databases. Inclusion was restricted to singleton children, born in Scotland from 2004 onwards with available breastfeeding data and who attended local authority mainstream or special schools between 2009 and 2013. Generalised estimating equation models with a binomial distribution and logit link function investigated associations between infant feeding method at 6 to 8 weeks and all-cause and cause-specific SEN, adjusting for sociodemographic and maternity factors. Of 191,745 children meeting inclusion criteria, 126,907 (66.2%) were formula-fed, 48,473 (25.3%) exclusively breastfed, and 16,365 (8.5%) mixed-fed. Overall, 23,141 (12.1%) children required SEN. Compared with formula feeding, mixed feeding and exclusive breastfeeding, respectively, were associated with decreased all-cause SEN (OR 0.90, 95% CI [0.84,0.95], p < 0.001 and 0.78, [0.75,0.82], p < 0.001), and SEN attributed to learning disabilities (0.75, [0.65,0.87], p < 0.001 and 0.66, [0.59,0.74], p < 0.001), and learning difficulties (0.85, [0.77,0.94], p = 0.001 and 0.75, [0.70,0.81], p < 0.001). Compared with formula feeding, exclusively breastfed children had less communication problems (0.81, [0.74,0.88], p = 0.001), social–emotional–behavioural difficulties (0.77, [0.70,0.84], p = 0.001), sensory impairments (0.79, [0.65,0.95], p = 0.01), physical motor disabilities (0.78, [0.66,0.91], p = 0.002), and physical health conditions (0.74, [0.63,0.87], p = 0.01). There were no significant associations for mixed-fed children (communication problems (0.94, [0.83,1.06], p = 0.312), social–emotional–behavioural difficulties (0.96, [0.85,1.09], p = 0.541), sensory impairments (1.07, [0.84,1.37], p = 0.579), physical motor disabilities (0.97, [0.78,1.19], p = 0.754), and physical health conditions (0.93, [0.74,1.16], p = 0.504)). Feeding method was not significantly associated with mental health conditions (exclusive 0.58 [0.33,1.03], p = 0.061 and mixed 0.74 [0.36,1.53], p = 0.421) or autism (exclusive 0.88 [0.77,1.01], p = 0.074 and mixed 1.01 [0.84,1.22], p = 0.903). Our study was limited since only 6- to 8-week feeding method was available precluding differentiation between never-breastfed infants and those who stopped breastfeeding before 6 weeks. Additionally, we had no data on maternal and paternal factors such as education level, IQ, employment status, race/ethnicity, or mental and physical health. Conclusions In this study, we observed that both breastfeeding and mixed feeding at 6 to 8 weeks were associated with lower risk of all-cause SEN, and SEN attributed to learning disabilities and learning difficulty. Many women struggle to exclusively breastfeed for the full 6 months recommended by WHO; however, this study provides evidence that a shorter duration of nonexclusive breastfeeding could nonetheless be beneficial with regard to the development of SEN. Our findings augment the existing evidence base concerning the advantages of breastfeeding and reinforce the importance of breastfeeding education and support. In a cohort of 191,745 Scottish schoolchildren, Michael Fleming and colleagues explore infant feeding methods and special educational need. Author summary Why was this study done? Infant breastfeeding has been associated with reduced physical and mental health problems in childhood which contribute toward special educational need (SEN). Previous studies have not investigated the impact of mixed feeding, have not adjusted for child, maternal, and pregnancy confounders, have encountered bias, or have used a narrow definition of SEN. What did the researchers do and find? We linked national, routinely collected, health data (maternity, birth, and health visitor records) and education data (annual school pupil census) together to investigate the association between mode of infant feeding at 6 to 8 weeks of age and both all-cause and cause-specific SEN in Scotland. Our study cohort comprised all singleton children, born in Scotland from 2004 onwards with available breastfeeding data and who attended local authority mainstream or special schools in Scotland between 2009 and 2013. Outcomes for 48,473 exclusively breastfed children and 16,365 mixed-fed children, respectively, were compared to 126,907 formula-fed children, adjusting for sociodemographic and maternity factors. Compared to children who were formula-fed, we observed that, after adjusting for available sociodemographic and maternity factors, exclusively breastfed children and mixed-fed children both had lower risk of all-cause SEN and SEN attributed to learning disabilities and learning difficulties. Exclusively breastfed children additionally had lower risk of communication problems, social–emotional–behavioural difficulties, sensory impairments, physical motor disabilities, and physical health conditions. What do these findings mean? For women who struggle to breastfeed for the full 6 months recommended by WHO, our study suggests that a shorter duration of nonexclusive breastfeeding could still be beneficial with regard to the development of SEN. Our findings augment the existing evidence base concerning the advantages of breastfeeding and reinforce the importance of breastfeeding education and support.
وصف الملف: electronic resource
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3دورية أكاديمية
المؤلفون: Fanny Petermann-Rocha, Peter Hanlon, Stuart R. Gray, Paul Welsh, Jason M. R. Gill, Hamish Foster, S. Vittal Katikireddi, Donald Lyall, Daniel F. Mackay, Catherine A. O’Donnell, Naveed Sattar, Barbara I. Nicholl, Jill P. Pell, Bhautesh D. Jani, Frederick K. Ho, Frances S. Mair, Carlos Celis-Morales
المصدر: BMC Medicine, Vol 18, Iss 1, Pp 1-9 (2020)
مصطلحات موضوعية: COVID-19, Coronavirus, Frailty, Risk factors, Medicine
الوصف: Abstract Background Frailty has been associated with worse prognosis following COVID-19 infection. While several studies have reported the association between frailty and COVID-19 mortality or length of hospital stay, there have been no community-based studies on the association between frailty and risk of severe infection. Considering that different definitions have been identified to assess frailty, this study aimed to compare the association between frailty and severe COVID-19 infection in UK Biobank using two frailty classifications: the frailty phenotype and the frailty index. Methods A total of 383,845 UK Biobank participants recruited 2006–2010 in England (211,310 [55.1%] women, baseline age 37–73 years) were included. COVID-19 test data were provided by Public Health England (available up to 28 June 2020). An adapted version of the frailty phenotype derived by Fried et al. was used to define frailty phenotype (robust, pre-frail, or frail). A previously validated frailty index was derived from 49 self-reported questionnaire items related to health, disease and disability, and mental wellbeing (robust, mild frailty, and moderate/severe frailty). Both classifications were derived from baseline data (2006–2010). Poisson regression models with robust standard errors were used to analyse the associations between both frailty classifications and severe COVID-19 infection (resulting in hospital admission or death), adjusted for sociodemographic and lifestyle factors. Results Of UK Biobank participants included, 802 were admitted to hospital with and/or died from COVID19 (323 deaths and 479 hospitalisations). After analyses were adjusted for sociodemographic and lifestyle factors, a higher risk of COVID-19 was observed for pre-frail (risk ratio (RR) 1.47 [95% CI 1.26; 1.71]) and frail (RR 2.66 [95% CI 2.04; 3.47]) individuals compared to those classified as robust using the frailty phenotype. Similar results were observed when the frailty index was used (RR mildly frail 1.46 [95% CI 1.26; 1.71] and RR moderate/severe frailty 2.43 [95% CI 1.91; 3.10]). Conclusions Frailty was associated with a higher risk of severe COVID-19 infection resulting in hospital admission or death, irrespective of how it was measured and independent of sociodemographic and lifestyle factors. Public health strategies need to consider the additional risk that COVID-19 poses in individuals with frailty, including which additional preventive measures might be required.
وصف الملف: electronic resource
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4دورية أكاديمية
المؤلفون: Michael Fleming, James S. McLay, David Clark, Albert King, Daniel F. Mackay, Helen Minnis, Jill P. Pell
المصدر: PLoS Medicine, Vol 18, Iss 11 (2021)
مصطلحات موضوعية: Medicine
الوصف: Background Looked after children are defined as children who are in the care of their local authority. Previous studies have reported that looked after children have poorer mental and physical health, increased behavioural problems, and increased self-harm and mortality compared to peers. They also experience poorer educational outcomes, yet population-wide research into the latter is lacking, particularly in the United Kingdom. Education and health share a bidirectional relationship; therefore, it is important to dually investigate both outcomes. Our study aimed to compare educational and health outcomes for looked after children with peers, adjusting for sociodemographic, maternity, and comorbidity confounders. Methods and findings Linkage of 9 Scotland-wide databases, covering dispensed prescriptions, hospital admissions, maternity records, death certificates, annual pupil census, examinations, school absences/exclusions, unemployment, and looked after children provided retrospective data on 715,111 children attending Scottish schools between 2009 and 2012 (13,898 [1.9%] looked after). Compared to peers, 13,898 (1.9%) looked after children were more likely to be absent (adjusted incidence rate ratio [AIRR] 1.27, 95% confidence interval [CI] 1.24 to 1.30) and excluded (AIRR 4.09, 95% CI 3.86 to 4.33) from school, have special educational need (SEN; adjusted odds ratio [AOR] 3.48, 95% CI 3.35 to 3.62) and neurodevelopmental multimorbidity (AOR 2.45, 95% CI 2.34 to 2.57), achieve the lowest level of academic attainment (AOR 5.92, 95% CI 5.17 to 6.78), and be unemployed after leaving school (AOR 2.12, 95% CI 1.96 to 2.29). They were more likely to require treatment for epilepsy (AOR 1.50, 95% CI 1.27 to 1.78), attention deficit hyperactivity disorder (ADHD; AOR 3.01, 95% CI 2.76 to 3.27), and depression (AOR 1.90, 95% CI 1.62 to 2.22), be hospitalised overall (adjusted hazard ratio [AHR] 1.23, 95% CI 1.19 to 1.28) for injury (AHR 1.80, 95% CI 1.69 to 1.91) and self-harm (AHR 5.19, 95% CI 4.66 to 5.78), and die prematurely (AHR 3.21, 95% CI 2.16 to 4.77). Compared to children looked after at home, children looked after away from home had less absenteeism (AIRR 0.35, 95% CI 0.33 to 0.36), less exclusion (AIRR 0.63, 95% CI 0.56 to 0.71), less unemployment (AOR 0.53, 95% CI 0.46 to 0.62), and better attainment (AIRR 0.31, 95% CI 0.23 to 0.40). Therefore, among those in care, being cared for away from home appeared to be a protective factor resulting in better educational outcomes. The main limitations of this study were lack of data on local authority care preschool or before 2009, total time spent in care, and age of first contact with social care. Conclusions Looked after children had poorer health and educational outcomes than peers independent of increased neurodevelopmental conditions and SEN. Further work is required to understand whether poorer outcomes relate to reasons for entering care, including maltreatment and adverse childhood events, neurodevelopmental vulnerabilities, or characteristics of the care system. In this record-linkage study in Scotland, Michael Fleming and colleagues compare educational and health outcomes for children who are in the care of their local authority with the outcomes of their peers. Author summary Why was this study done? Looked after children, defined as children placed in the care of their local authority, comprise a vulnerable cohort exhibiting poorer educational and health outcomes compared to peers. Only a few small sample studies have been conducted in the UK, and a recent systematic review reported an urgent need for more population-wide research into the educational outcomes of children placed in social care services. To our knowledge, no previous UK studies have dually investigated educational and health outcomes of looked after children compared to peers using an unselected, nationwide cohort. What did the researchers do and find? We linked together 9 Scotland-wide databases to compare educational and health outcomes of looked after children against peers, adjusting for sociodemographic, maternity, and comorbidity confounders. Looked after children had increased risk of school absenteeism and exclusion; special educational need (SEN); poor academic attainment; unemployment; hospitalisation and mortality; and treatment for epilepsy, attention deficit hyperactivity disorder (ADHD), depression, and neurodevelopmental multimorbidity. Among children in care, those looked after away from home had less absenteeism, less exclusion, less unemployment, and better attainment. What do these findings mean? Looked after children had poorer health and educational outcomes than peers independent of increased neurodevelopmental conditions and SEN. Among those in care, being cared for away from home appeared to be a protective factor resulting in better educational outcomes. Further work is required to understand whether poorer outcomes relate to reasons for entering care, including maltreatment and adverse childhood events, neurodevelopmental vulnerabilities, or characteristics of the care system.
وصف الملف: electronic resource
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5دورية أكاديمية
المؤلفون: Jana J. Anderson, Stuart R. Gray, Paul Welsh, Daniel F. Mackay, Carlos A. Celis-Morales, Donald M. Lyall, John Forbes, Naveed Sattar, Jason M. R. Gill, Jill P. Pell
المصدر: BMC Medicine, Vol 18, Iss 1, Pp 1-12 (2020)
مصطلحات موضوعية: UK Biobank, Sugar, Diet, Mortality, Fruit juice, Medicine
الوصف: Abstract Background Recent efforts to address the obesity epidemic have focused on sugar consumption, especially sugar-sweetened beverages. However, sugar takes many forms, is only one contributor to overall energy consumption and is correlated with other health-related lifestyle factors. The objective was to investigate the associations with all-cause mortality of sugar- and artificially sweetened beverages and naturally sweet juices. Methods Setting: UK Biobank, UK. Participants joined the UK Biobank study from 2006 to 2010 and were followed up until 2016; 198,285 men and women aged 40–69 years were eligible for this study (40% of the UK Biobank), of whom 3166 (1.6%) died over a mean of 7 years follow-up. Design: prospective population-based cohort study. Exposure variables: dietary consumption of sugar-sweetened beverages, artificially sweetened beverages, naturally sweet juices (100% fruit/vegetable juices) and total sugar intake, self-reported via 24-h dietary assessment tool completed between 2009 and 2012. Main outcome: all-cause mortality. Cox regression analyses were used to study the association between the daily intake of the above beverages and all-cause mortality. Models were adjusted for sociodemographic, economic, lifestyle and dietary confounders. Results Total energy intake, total sugar intake and percentage of energy derived from sugar were comparable among participants who consumed > 2/day sugar-sweetened beverages and > 2/day fruit/vegetable juices (10,221 kJ/day versus 10,381 kJ/day; 183 g versus 190 g; 30.6% versus 31.0%). All-cause mortality was associated with total sugar intake (highest quintile adj. HR 1.28, 95% CI 1.06–1.55) and intake of sugar-sweetened beverages (> 2/day adj. HR 1.84, 95% CI 1.42–2.37) and remained so in sensitivity analyses. An association between artificially sweetened beverage intake and mortality did not persist after excluding deaths in the first 2 years of follow-up (landmark analysis) nor after excluding participants with recent weight loss. Furthermore, the inverse association between fruit/vegetable juice intake and mortality did not persist after additional adjustment for a diet quality score. Conclusions Higher mortality is associated with sugar-sweetened beverages specifically. The lack of an adverse association with fruit/vegetable juices suggests that source of sugar may be important and the association with artificially sweetened beverage may reflect reverse causation.
وصف الملف: electronic resource
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6دورية أكاديمية
المؤلفون: Claire E. Hastie, Daniel F. Mackay, Tom L. Clemens, Mark P. C. Cherrie, Lauren J. Megaw, Gordon C. S. Smith, Sarah J. Stock, Chris Dibben, Jill P. Pell
المصدر: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 13 (2021)
مصطلحات موضوعية: environmental exposures, preeclampsia, seasonal variations, UV light, Diseases of the circulatory (Cardiovascular) system, RC666-701
الوصف: Background Risk of preeclampsia varies by month of delivery. We tested whether this seasonal patterning may be mediated through maternal vitamin D concentration using antenatal exposure to UV‐B radiation as an instrumental variable. Methods and Results Scottish maternity records were linked to antenatal UV‐B exposure derived from satellites between 2000 and 2010. Logistic regression analyses were used to explore the association between UV‐B and preeclampsia, adjusting for the potential confounding effects of month of conception, child's sex, gestation, parity, and mean monthly temperature. Of the 522 896 eligible singleton deliveries, 8689 (1.66%) mothers developed preeclampsia. Total antenatal UV‐B exposure ranged from 43.18 to 101.11 kJ/m2 and was associated with reduced risk of preeclampsia with evidence of a dose‐response relationship (highest quintile of exposure: adjusted odds ratio, 0.57; 95% CI, 0.44–0.72; P
وصف الملف: electronic resource
Relation: https://doaj.org/toc/2047-9980
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7دورية أكاديمية
المؤلفون: Michael Fleming, Catherine A. Fitton, Markus F. C. Steiner, James S. McLay, David Clark, Albert King, Daniel F. Mackay, Jill P. Pell
المصدر: BMC Public Health, Vol 19, Iss 1, Pp 1-12 (2019)
مصطلحات موضوعية: Epilepsy, Educational outcomes, Health, Population cohort, Record linkage, Prescribing, Public aspects of medicine, RA1-1270
الوصف: Abstract Background Childhood epilepsy can adversely affect education and employment in addition to health. Previous studies are small or highly selective producing conflicting results. This retrospective cohort study aims to compare educational and health outcomes of children receiving antiepileptic medication versus peers. Methods Record linkage of Scotland-wide databases covering dispensed prescriptions, acute and psychiatric hospitalisations, maternity records, deaths, annual pupil census, school absences/exclusions, special educational needs, school examinations, and (un)employment provided data on 766,244 children attending Scottish schools between 2009 and 2013. Outcomes were adjusted for sociodemographic and maternity confounders and comorbid conditions. Results Compared with peers, children on antiepileptic medication were more likely to experience school absence (Incidence Rate Ratio [IRR] 1.43, 95% CI: 1.38, 1.48), special educational needs (Odds ratio [OR] 9.60, 95% CI: 9.02, 10.23), achieve the lowest level of attainment (OR 3.43, 95% CI: 2.74, 4.29) be unemployed (OR 1.82, 95% CI: 1.60, 2.07), be admitted to hospital (Hazard Ratio [HR] 3.56, 95% CI: 3.42, 3.70), and die (HR 22.02, 95% CI: 17.00, 28.53). Absenteeism partly explained poorer attainment and higher unemployment. Girls and younger children on antiepileptic medication had higher risk of poor outcomes. Conclusions Children on antiepileptic medication fare worse than peers across educational and health outcomes. In order to reduce school absenteeism and mitigate its effects, children with epilepsy should receive integrated care from a multidisciplinary team that spans education and healthcare.
وصف الملف: electronic resource
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8دورية أكاديمية
المؤلفون: Edward Morrison, Donald M Lyall, Jill P. Pell, Daniel F. Mackay, Fergus N. Doubal, Joanna M. Wardlaw, Terence Quinn, Stephen Makin
المصدر: Cerebral Circulation - Cognition and Behavior, Vol 2, Iss , Pp 100015- (2021)
مصطلحات موضوعية: Specialties of internal medicine, RC581-951, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
الوصف: Background: Blood pressure-lowering medications, antiplatelet drugs and statins are often prescribed to asymptomatic patients with white matter hyperintensities (WMH). A clinical trial is needed, but potential trial participants would be excluded if they already had another indication to take the medication. It is likely that many patients with WMH would already have a recognised vascular-related indication for these drugs.We used data from the UK Biobank study to determine what proportion of people with WMH were not taking these drugs and would be potentially able to enter a clinical trial of antiplatelet drugs, statins, or BP-lowering medication. Methods: We used the UK Biobank MRI sub-study of healthy volunteers aged 40–70 years as our cohort. We considered that WMH volumes in the top quartile (2.7–89 mls) were severe enough for a patient to be at risk of progression and be offered treatment. Such patients could also be included in a hypothetical clinical trial if there were no contraindications. Using the product licenses, we defined exclusion criteria for four hypothetical clinical trials of aspirin, clopidogrel, statins, and tight BP control. We then calculated what proportion of patients would still be eligible if these criteria were applied. Results: 5794/23,179 patients had WMH in the top quartile. Of these, 4006/5794 69% (95% CI 68–70%) would be eligible for a trial of aspirin; with 81% (95% CI 80–82%) eligible for a trial of clopidogrel; 56% (95% CI 55–58%) of patients would be eligible to enter into a trial of a lower BP target, and 58% (95%CI 57–59%) would be able to enter a trial of a statin. Conclusions: Over 80% of patients with WMH in the UK biobank would be eligible to enter a trial of an antiplatelet and just over half would be eligible to enter a trial of a statin or BP-lowering medication.
وصف الملف: electronic resource
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9دورية أكاديمية
المؤلفون: Shadrach Dare, Abraham R. Oduro, Seth Owusu-Agyei, Daniel F. Mackay, Laurence Gruer, Alfred Kwesi Manyeh, Ernest Nettey, James F. Phillips, Kwaku Poku Asante, Paul Welaga, Jill P. Pell
المصدر: Global Health Action, Vol 14, Iss 1 (2021)
مصطلحات موضوعية: neonatal mortality rate, cause of death, risk factors, ghana, child health, Public aspects of medicine, RA1-1270
الوصف: Background Reducing neonatal mortality rates (NMR) in developing countries is a key global health goal, but weak registration systems in the region stifle public health efforts. Objective To calculate NMRs, investigate modifiable risk factors, and explore neonatal deaths by place of birth and death, and cause of death in two administrative areas in Ghana. Methods Data on livebirths were extracted from the health and demographic surveillance systems in Navrongo (2004–2012) and Kintampo (2005–2010). Cause of death was determined from neonatal verbal autopsy forms. Univariable and multivariable logistic regression were used to analyse factors associated with neonatal death. Multiple imputations were used to address missing data. Results The overall NMR was 18.8 in Navrongo (17,016 live births, 320 deaths) and 12.5 in Kintampo (11,207 live births, 140 deaths). The annual NMR declined in both areas. 54.7% of the births occurred in health facilities. 70.9% of deaths occurred in the first week. The main causes of death were infection (NMR 4.3), asphyxia (NMR 3.7) and prematurity (NMR 2.2). The risk of death was higher among hospital births than home births: Navrongo (adjusted OR 1.14, 95% CI: 1.03–1.25, p = 0.01); Kintampo (adjusted OR 1.76, 95% CI: 1.55–2.00, p
وصف الملف: electronic resource
Relation: https://doaj.org/toc/1654-9880
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10دورية أكاديمية
المؤلفون: Daniel F. Mackay, Tom L. Clemens, Claire E. Hastie, Mark P.C. Cherrie, Chris Dibben, Jill P. Pell
المصدر: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 8, Iss 23 (2019)
مصطلحات موضوعية: environmental factors, epidemiology, myocardial infarction, UV radiation, Diseases of the circulatory (Cardiovascular) system, RC666-701
الوصف: Background Myocardial infarction exhibits seasonal patterning, with higher amplitude at increased latitude. Epidemiological evidence suggests that sunlight is protective against cardiovascular disease, independent of ambient temperature, but ultraviolet B–mediated vitamin D production has been discounted as causal. We aimed to determine whether ultraviolet A is associated with the seasonal patterning of myocardial infarction. Methods and Results Routine hospitalization data were used to determine monthly incidence of myocardial infarction in Scotland between 2000 and 2011. Small‐area–level aggregated data were obtained on ambient temperature from the Meteorological Office and ultraviolet A and ultraviolet B irradiance from NASA satellites. Autoregressive distributed lag models were run for ultraviolet A and myocardial infarction, including adjustment for ambient temperature and ultraviolet B. Monthly incidence of myocardial infarction displayed winter peaks and summer troughs superimposed on the underlying trend, with a mean amplitude of 0.31 (95% CI: 0.21, 0.41) myocardial infarctions per 100 000 population per month. Ultraviolet A exposure was inversely associated with myocardial infarction independent of ambient temperature (coefficient, −0.05; 95% CI, −0.09, −0.01; P=0.015) and ultraviolet B UVB (coefficient, −0.05; 95% CI, −0.09, −0.02; P=0.004). Conclusions Further research is required to explore whether an ultraviolet‐mediated mechanism different to vitamin D, such as nitric oxide–mediated vasodilatation, may play a causal role in the seasonal and geographical patterning of myocardial infarction.
وصف الملف: electronic resource
Relation: https://doaj.org/toc/2047-9980
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