Markku Heliovaara

Publications (3)7.29 Total impact

• Article: Serum cotinine predicts bronchial obstruction regardless of self-reported smoking history.

  Tuula Vasankari, Pekka Jousilahti, Paul Knekt, Jukka Marniemi, Sami Heistaro, Kari Lppo, Markku Heliovaara
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  ABSTRACT: We studied ability of serum cotinine and detailed history of smoking to predict bronchial obstruction. The baseline study was done during the Mini-Finland Health Survey in 1980 and the follow-up study during the Health 2000 Survey in 2000 for a total of 662 persons free from bronchial obstruction at baseline. Spirometric values of the ratio of forced expiratory volume in one second to forced vital capacity (FEV%) <80% were defined as moderate and <70% as severe bronchial obstruction at follow-up. Cotinine was determined from frozen serum samples collected at baseline. For those who reported at baseline not to smoke currently but whose serum cotinine (≥100 μg/l) indicated active smoking, the age- and sex-adjusted odds ratio of bronchial obstruction at follow-up was 2.55 (95% CI 1.26-5.19) compared with the ''true non-smokers'' (<100 μg/l). Among current smokers, after adjustment for age, sex, pack years, daily consumption of cigarettes, and inhalation of smoke, the odds ratio of moderate and severe bronchial obstruction was 1.61 (95% CI 1.12- 2.32) and 1.97 (95% CI 1.10-3.54) per an increment of one standard deviation (367 μg/l) in serum cotinine. The predictive value of all the interview measures of past or current smoking was clearly lower. Serum cotinine concentration is a useful predictor for development of obstruction. Smoking history alone may be insufficient in risk factor studies focusing on smoking-related diseases.
  Scandinavian Journal of Public Health 03/2011; 39(5):547-52. · 1.39 Impact Factor
• Article: Recommendations for standardization and phenotype definitions in genetic studies of osteoarthritis: the TREAT-OA consortium.

  H J M Kerkhof, I Meulenbelt, T Akune, N K Arden, A Aromaa, S M A Bierma-Zeinstra, A Carr, C Cooper, J Dai, M Doherty, [......], A Sudo, A Tamm, A E Tamm, A Tsezou, A Uchida, A G Uitterlinden, J M Wilkinson, N Yoshimura, A M Valdes, J B J van Meurs
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  ABSTRACT: To address the need for standardization of osteoarthritis (OA) phenotypes by examining the effect of heterogeneity among symptomatic (SOA) and radiographic osteoarthritis (ROA) phenotypes. Descriptions of OA phenotypes of the 28 studies involved in the TREAT-OA consortium were collected. We investigated whether different OA definitions result in different association results by creating various hip OA definitions in one large population based cohort (the Rotterdam Study I (RSI)) and testing those for association with gender, age and body mass index using one-way ANOVA. For ROA, we standardized the hip-, knee- and hand ROA definitions and calculated prevalence's of ROA before and after standardization in nine cohort studies. This procedure could only be performed in cohort studies and standardization of SOA definitions was not feasible at this moment. In this consortium, all studies with SOA phenotypes (knee, hip and hand) used a different definition and/or assessment of OA status. For knee-, hip- and hand ROA five, four and seven different definitions were used, respectively. Different hip ROA definitions do lead to different association results. For example, we showed in the RSI that hip OA defined as "at least definite joint space narrowing (JSN) and one definite osteophyte" was not associated with gender (P =0.22), but defined as "at least one definite osteophyte" was significantly associated with gender (P=3×10(-9)). Therefore, a standardization process was undertaken for ROA definitions. Before standardization a wide range of ROA prevalence's was observed in the nine cohorts studied. After standardization the range in prevalence of knee- and hip ROA was small. Phenotype definitions influence the prevalence of OA and association with clinical variables. ROA phenotypes within the TREAT-OA consortium were standardized to reduce heterogeneity and improve power in future genetics studies.
  Osteoarthritis and Cartilage 11/2010; 19(3):254-64. · 3.90 Impact Factor
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  Available from: Marjaana Lahti-Koski

  Article: Fat free mass and obesity in relation to educational level.

  Elina Seppänen-Nuijten, Marjaana Lahti-Koski, Satu Männistö, Paul Knekt, Harri Rissanen, Arpo Aromaa, Markku Heliövaara
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  ABSTRACT: The aim of the study was to describe the body composition of Finnish adults, especially by education, and to investigate whether fat-free mass (FFM) can explain educational gradients relating to body mass index (BMI) and waist-to-hip ratio (WHR). Data for this cross-sectional study were based on data collected in 2000-2001 for the Health 2000 Survey. Of the nationally representative sample of 8,028 Finnish men and women aged 30 years and older, 6,300 (78.5%) were included in the study. Body composition measurements were carried out in the health examination, where FFM was assessed with eight-polar bioelectrical impedance analysis. Questions on education were included in the health interview. The mean FFM varied by education in older (>or= 65 y.) men only. In the middle-aged group (30-64 y.), highly educated men were less likely to belong to the lowest quintile of FFM (OR 0.67, 95%CI 0.48-0.93) compared with the least educated subjects. The level of education was inversely associated with the prevalence of high BMI and WHR in middle-aged men. In women, the respective associations were found both in middle-aged women and their older counterparts. Adjustment for FFM slightly strengthened the associations of education with BMI and WHR. The association between education and FFM is weak. Educational gradients of high BMI and high WHR cannot be explained by FFM.
  BMC Public Health 12/2009; 9:448. · 2.00 Impact Factor