David R Jacobs

University of Minnesota Duluth, Duluth, Minnesota, United States

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Publications (788)4400.07 Total impact

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    ABSTRACT: We report on trends in poststroke survival, both in the early period after stroke and over the long term. We examine these trends by stroke subtype.
    07/2014;
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    ABSTRACT: Non-alcoholic fatty liver disease (NAFLD) is an obesity-related condition associated with cardiovascular mortality. Yet, whether or not NAFLD is independently related to atherosclerosis is unclear. In a population-based cross-sectional sample of middle-aged adults free from liver or heart disease, we tested the hypothesis that NAFLD is associated with subclinical atherosclerosis (coronary artery (CAC) and abdominal aortic calcification (AAC)) independent of obesity.
    Atherosclerosis 06/2014; 235(2):599-605. · 3.71 Impact Factor
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    Seongbeom Cho, David R Jacobs, Kyong Park
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    ABSTRACT: Prior studies focused on bioaccumulation of mercury (Hg) and on large, long-lived fish species as the major environmental source of Hg, but little is known about consumption of small-sized fish or about non-dietary determinants of circulating Hg levels. The purpose of this study was to evaluate whole blood mercury concentration (WBHg) and its major dietary and non-dietary correlates in Korean adults.
    BMC Public Health 05/2014; 14(1):527. · 2.08 Impact Factor
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    ABSTRACT: -Early repolarization (ER), a common electrocardiographic phenotype, has been associated with increased mortality risk in middle-aged adults. Data are sparse on long-term follow-up and outcomes associated with ER in younger adults. -We prospectively examined 5,039 participants (mean age 25 years at baseline, 40% black) from the CARDIA cohort over 23 years. Twelve-lead electrocardiograms were recorded and analyzed at Years 0, 7 and 20 and coded as definite or probable ER using a standardized algorithm. Cox regression was used, and models were adjusted for important baseline and clinical covariates. Kaplan-Meier curves were created for presence of ER and total mortality and cardiovascular (CV) mortality. Participants with ER were more likely to be black, male, smoke, have higher systolic blood pressure, lower heart rate, and BMI, and also higher exercise duration, and longer PR, QRS and QT intervals. ER was associated with total mortality (HR1.77, 1.38-2.28, p<0.01), and CV mortality (HR 1.59, 1.01-2.50, p=0.04) in unadjusted analyses, but adjustment for age, sex, and race attenuated associations almost completely. Sex-race stratified analyses showed no significant associations between ER and outcome for any of the subgroups except blacks. -The presence of ER at any time point over 23 years of follow-up was not associated with adverse outcomes. Black race and male sex confound the unadjusted association of ER and outcomes, with no race-sex interactions noted. Further studies are necessary to understand the factors associated with heightened risk of death in those who maintain ER into and beyond middle age.
    Circulation Arrhythmia and Electrophysiology 04/2014; · 5.95 Impact Factor
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    ABSTRACT: To investigate whether greater cardiorespiratory fitness (CRF) is associated with better cognitive function 25 years later. We studied 2,747 participants in the community-based Coronary Artery Risk Development in Young Adults Study of black and white men and women aged 18 to 30 years at recruitment in 1985-1986 (baseline year 0). Symptom-limited maximal treadmill test durations at years 0 and 20 provided measures of CRF. Cognitive tests at year 25 measured verbal memory (Rey Auditory Verbal Learning Test [RAVLT]), psychomotor speed (Digit Symbol Substitution Test [DSST]), and executive function (Stroop Test). Per minute of baseline CRF, the RAVLT was 0.12 words recalled higher (standard error [SE] = 0.03, p < 0.0001), the DSST was 0.92 digits higher (SE = 0.13, p < 0.0001), and the Stroop Test score was 0.52 lower (better performance, SE = 0.11, p < 0.0001), after accounting for race, sex, age, education, and clinical center. Compared with the lowest quartile of CRF, each cognitive test was 21% to 34% of an SD better in the highest CRF quartile. Further adjustment for lifestyle and clinical measures attenuated coefficients for RAVLT and DSST slightly, while the coefficient predicting the Stroop Test lost more than half its value (p = 0.07). Analysis in the subset of 1,957 participants who also completed the year-20 treadmill test showed that 20-year change in CRF was positively associated only with DSST (p < 0.001). Better verbal memory and faster psychomotor speed at ages 43 to 55 years were clearly associated with better CRF 25 years earlier.
    Neurology 04/2014; · 8.25 Impact Factor
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    ABSTRACT: AimWe investigated the relationship between periodontal disease, a clinical manifestation of periodontal infection, and prediabetes.Methods The National Health and Nutrition Examination Survey, 2009-2010 enrolled 1,165 diabetes-free adults (51% female) aged 30-80 years (mean ± SD=50±14) who received a full-mouth periodontal examination and an oral glucose tolerance test. Participants were classified as having none/mild, moderate or severe periodontitis and also according to mean probing depth≥2.19 mm or attachment loss≥1.78 mm, (respective 75th percentiles). Pre-diabetes was defined according to ADA criteria as either: i) impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). In multivariable logistic regression models, the odds of IFG and IGT were regressed on levels of periodontitis category.ResultsThe odds ratios and 95% confidence intervals for having IGT among participants with moderate or severe periodontitis, relative to participants with none/mild periodontitis were 1.07[0.50,2.25] and 1.93[1.18,3.17], P=0.02. The ORs for having IFG were 1.14[0.74, 1.77] and 1.12[0.58, 2.18], P =0.84. PD≥75th percentile was related to a 105% increase in the odds of IGT: OR[95%CI] =2.05[1.24, 3.39], P=0.005.Conclusions Periodontal infection was positively associated with prevalent impaired glucose tolerance in a cross-sectional study among a nationally representative sample.This article is protected by copyright. All rights reserved.
    Journal Of Clinical Periodontology 04/2014; · 3.69 Impact Factor
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    ABSTRACT: Clinical studies of the associations of vitamin E with lung function have reported conflicting results. However, these reports primarily examine the alpha-tocopherol isoform of vitamin E and have not included the isoform gamma-tocopherol which we recently demonstrated in vitro opposes the function of alpha-tocopherol. We previously demonstrated, in vitro and in animal studies, that the vitamin E isoform alpha-tocopherol protects, but the isoform gamma-tocopherol promotes lung inflammation and airway hyperresponsiveness. To translate these findings to humans, we conducted analysis of 4526 adults in the Coronary Artery Risk Development in Young Adults (CARDIA) multi-center cohort with available spirometry and tocopherol data in blacks and whites. Spirometry was obtained at years 0, 5, 10, and 20 and serum tocopherol was from years 0, 7 and 15 of CARDIA. In cross-sectional regression analysis at year 0, higher gamma-tocopherol associated with lower FEV1 (p = 0.03 in blacks and p = 0.01 in all participants) and FVC (p = 0.01 in blacks, p = 0.05 in whites, and p = 0.005 in all participants), whereas higher alpha-tocopherol associated with higher FVC (p = 0.04 in blacks and whites and p = 0.01 in all participants). In the lowest quartile of alpha-tocopherol, higher gamma-tocopherol associated with a lower FEV1 (p = 0.05 in blacks and p = 0.02 in all participants). In contrast, in the lowest quartile of gamma-tocopherol, higher alpha-tocopherol associated with a higher FEV1 (p = 0.03) in blacks. Serum gamma-tocopherol >10 muM was associated with a 175-545 ml lower FEV1 and FVC at ages 21-55 years. Increasing serum concentrations of gamma-tocopherol were associated with lower FEV1 or FVC, whereas increasing serum concentrations of alpha-tocopherol was associated with higher FEV1 or FVC. Based on the prevalence of serum gamma-tocopherol >10 muM in adults in CARDIA and the adult U.S. population in the 2011 census, we expect that the lower FEV1 and FVC at these concentrations of serum gamma-tocopherol occur in up to 4.5 million adults in the population.
    Respiratory research 03/2014; 15(1):31. · 3.64 Impact Factor
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    ABSTRACT: BACKGROUND: History of gestational diabetes mellitus (GDM) increases lifetime risk of type 2 diabetes (DM) and the metabolic syndrome (MetS), which increase risk of cardiovascular disease. It is unclear, however, whether GDM increases risk of early atherosclerosis independent of pre-pregnancy obesity and subsequent metabolic disease. METHODS AND RESULTS: Of 2787 women (18 to 30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study, we studied 898 (47% black) who were free of DM and heart disease at baseline (1985-1986), delivered ≥1 post-baseline births, reported GDM history, and had common carotid intima media thickness (ccIMT, mm) measured in 2005-2006. We used multivariable linear regression to assess associations between GDM and ccIMT adjusted for race, age, parity, and pre-pregnancy cardiometabolic risk factors. We assessed mediators (weight gain, insulin resistance, blood pressure), and effect modification by incident DM or MetS during the 20-year period. Of the 898 women, 119 (13%) reported GDM (7.6 per 100 deliveries). Average age was 31 at last birth and 44 at ccIMT measurement for GDM and non-GDM groups. Unadjusted mean ccIMT was 0.023 mm higher for GDM than non-GDM groups (P=0.029), but pre-pregnancy BMI attenuated the difference to 0.016 mm (P=0.109). In 777 women without subsequent DM or the MetS, mean ccIMT was 0.023 mm higher for GDM versus non-GDM groups controlling for race, age, parity, and pre-pregnancy BMI (0.784 versus 0.761, P=0.039). Addition of pre-pregnancy insulin resistance index had minimal impact on adjusted mean net ccIMT difference (0.22 mm). Mean ccIMT did not differ by GDM status among 121 women who developed DM or the MetS (P=0.58). CONCLUSIONS: History of GDM may be a marker for early atherosclerosis independent of pre-pregnancy obesity among women who have not developed type 2 diabetes or the metabolic syndrome.
    JAHA. 03/2014; 3(2).
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    ABSTRACT: We investigated whether the addition of left atrial (LA) size determined by echocardiography improves cardiovascular risk prediction in young adults over and above the clinically established Framingham 10-year global CV risk score (FRS). We included white and black CARDIA participants who had echocardiograms in Year-5 examination (1990-91). The combined endpoint after 20 years was incident fatal or non-fatal cardiovascular disease: myocardial infarction, heart failure, cerebrovascular disease, peripheral artery disease, and atrial fibrillation/flutter. Echocardiography-derived M-mode LA diameter (LAD; n = 4082; 149 events) and 2D four-chamber LA area (LAA; n = 2412; 77 events) were then indexed by height or body surface area (BSA). We used Cox regression, areas under the receiver operating characteristic curves (AUC), and net reclassification improvement (NRI) to assess the prediction power of LA size when added to calculated FRS or FRS covariates. The LAD and LAA cohorts had similar characteristics; mean LAD/height was 2.1 ± 0.3 mm/m and LAA/height 9.3 ± 2.0 mm(2)/m. After indexing by height and adjusting for FRS covariates, hazard ratios were 1.31 (95% CI 1.12, 1.60) and 1.43 (95% CI 1.13, 1.80) for LAD and LAA, respectively; AUC was 0.77 for LAD and 0.78 for LAA. When LAD and LAA were indexed to BSA, the results were similar but slightly inferior. Both LAD and LAA showed modest reclassification ability, with non-significant NRIs. LA size measurements independently predict clinical outcomes. However, it only improves discrimination over clinical parameters modestly without altering risk classification. Indexing LA size by height is at least as robust as by BSA. Further research is needed to assess subgroups of young adults who may benefit from LA size information in risk stratification.
    European heart journal cardiovascular Imaging. 02/2014;
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    ABSTRACT: Single measures of blood pressure (BP) levels are associated with the development of atherosclerosis; however, long-term patterns in BP and their effect on cardiovascular disease risk are poorly characterized. To identify common BP trajectories throughout early adulthood and to determine their association with presence of coronary artery calcification (CAC) during middle age. Prospective cohort data from 4681 participants in the CARDIA study, who were black and white men and women aged 18 to 30 years at baseline in 1985-1986 at 4 urban US sites, collected through 25 years of follow-up (2010-2011). We examined systolic BP, diastolic BP, and mid-BP (calculated as [SBP+DBP]/2, an important marker of coronary heart disease risk among younger populations) at baseline and years 2, 5, 7, 10, 15, 20, and 25. Latent mixture modeling was used to identify trajectories in systolic, diastolic, and mid-BP over time. Coronary artery calcification greater than or equal to Agatston score of 100 Hounsfield units (HU) at year 25. We identified 5 distinct mid-BP trajectories: low-stable (21.8%; 95% CI, 19.9%-23.7%; n=987), moderate-stable (42.3%; 40.3%-44.3%; n=2085), moderate-increasing (12.2%; 10.4%-14.0%; n=489), elevated-stable (19.0%; 17.1%-20.0%; n=903), and elevated-increasing (4.8%; 4.0%-5.5%; n=217). Compared with the low-stable group, trajectories with elevated BP levels had greater odds of having a CAC score of 100 HU or greater. Adjusted odds ratios were 1.44 (95% CI, 0.83-2.49) for moderate-stable, 1.86 (95% CI, 0.91-3.82) for moderate-increasing, 2.28 (95% CI, 1.24-4.18), for elevated-stable, and 3.70 (95% CI, 1.66-8.20) for elevated-increasing groups. The adjusted prevalence of a CAC score of 100 HU or higher was 5.8% in the low-stable group. These odds ratios represent an absolute increase of 2.7%, 5%, 6.3%, and 12.9% for the prevalence of a CAC score of 100 HU or higher for the moderate-stable, moderate-increasing, elevated-stable and elevated-increasing groups, respectively, compared with the low-stable group. Associations were not altered after adjustment for baseline and year 25 BP. Findings were similar for trajectories of isolated systolic BP trajectories but were attenuated for diastolic BP trajectories. Blood pressure trajectories throughout young adulthood vary, and higher BP trajectories were associated with an increased risk of CAC in middle age. Long-term trajectories in BP may assist in more accurate identification of individuals with subclinical atherosclerosis.
    JAMA The Journal of the American Medical Association 02/2014; 311(5):490-7. · 29.98 Impact Factor
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    ABSTRACT: To determine if summary estimates of a self-report physical activity questionnaire that does not specifically assess frequency or duration [the Coronary Artery Risk Development in Young Adults (CARDIA) Physical Activity History (PAH)] differs from the summary estimates of one that does (CARDIA Supplemental Questionnaire). Following the Year 25 exam (2010-11), 203 CARDIA black and white men and women (aged 50.3 ± 3.6 years) at the Oakland, CA site participated in this comparison study. The between-questionnaire association and agreement was determined for continuous and categorical estimates based on (1) quartiles and (2) meeting 2008 Physical Activity Guidelines. Differences in participant characteristics by concordance/discordance status were also examined. Finally, receiver operating characteristic (ROC) curves were computed to determine the accuracy of the PAH compared to the supplemental questionnaire. Reported physical activity levels were high and varied significantly by race and sex (all p<0.01). Between-questionnaire estimates were significantly correlated (rho= 0.75 to 0.90; all p<0.001) and had high agreement (κ = 0.51 to 0.80) across all race/sex groups. A higher proportion of women than men were classified as concordant by quartile of vigorous intensity (p=0.001), but no other participant characteristics were associated with concordant/discordant quartile ranking. Participants classified as concordant based on PA guidelines had lower body mass index than those classified as discordant (both p<0.05). The AUC was 0.95 suggesting that the PAH has high accuracy for classifying individuals as meeting physical activity guidelines. Conclusions: Although it is inconvenient that the PAH is not expressed in more standard units, these findings support the practice of not directly assessing frequency and duration, which are frequent sources of reporting error.
    Medicine and science in sports and exercise 02/2014; · 4.48 Impact Factor
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    ABSTRACT: Persistent organic pollutants (POPs) are lipophilic compounds that accumulate mainly in adipose tissue. Recent human evidence links low dose POPs to an increased risk of type 2 diabetes (T2D). As humans are contaminated by POP mixtures and POPs possibly have inverted U-shaped associations with T2D, critical methodological issues arise in evaluating human findings. This review summarizes epidemiological results on chlorinated POPs and T2D, and relevant experimental evidence. It also discusses how features of POPs can affect inferences in humans. The evidence as a whole suggests that, rather than a few individual POPs, it is background exposure to POP mixtures -including organochlorine pesticides and polychlorinated biphenyls- that can increase T2D risk in humans. Inconsistent statistical significance for individual POPs may arise due to differences in POP mixtures between populations. Differences in the observed shape of the dose-response curves may reflect an inverted U-shaped association secondary to mitochondrial dysfunction or endocrine-disruption. Finally, we examine the relationship between POPs and obesity. There is evidence in animal studies that low dose POP mixtures are obesogenic. However, relationships between POPs and obesity in humans have been inconsistent. Adipose tissue plays a dual role of promoting T2D and providing a relatively safe place to store POPs. Large prospective studies with serial measurements of a broad range of POPs, adiposity, and clinically-relevant biomarkers are needed to disentangle the interrelationships among POPs, obesity and the development of T2D. Also needed are laboratory experiments that more closely mimic real-world POP doses, mixtures, and exposure duration in humans.
    Endocrine reviews 01/2014; · 19.76 Impact Factor
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    ABSTRACT: Rationale: Asthma is associated with depression but the temporality of the association has not been established. Objectives: Examine the relationship between elevated depressive symptoms and incident asthma, and between prevalent asthma and incident elevated depressive symptoms in a cohort of young and middle-aged adults. Methods: We examined the longitudinal association between asthma and depressive symptoms bidirectionally in the CARDIA cohort. First, 3,614 participants free of asthma were classified by elevated depressive symptoms at the CARDIA year 5 exam (n= 856 elevated vs. 2,758 not elevated, ages 23-35 years) and followed for 20 years to incident asthma. Then, 3,016 participants free of elevated depressive symptoms were classified by self-reported asthma status (n=188 prevalent versus 2,828 not prevalent) at CARDIA year 5 exam and followed for 20 years until onset of elevated depressive symptoms. Measurements and Main Results: The relative hazard of incident asthma among those with elevated depressive symptoms was 1.26 (95% CI: 1.02-1.56) after adjustment for covariates. When depressive status was modeled as the total number of reports of elevated depressive symptoms prior to the onset of asthma, the adjusted HR=1.15 (95% CI: 1.02-1.29). The hazard of incident elevated depressive symptoms for those with asthma was no different than the hazard in those without asthma (adjusted HR=0.92 (95% CI: 0.70-1.20)). Conclusions: This longitudinal observational study points to depression as a marker of risk for incident adult-onset asthma. On the other hand, prevalent asthma is not associated with incident adult-onset depression.
    American Journal of Respiratory and Critical Care Medicine 01/2014; · 11.04 Impact Factor
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    David R Jacobs, Jerome Ruzzin, Duk-Hee Lee
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    ABSTRACT: Determining the benefits and risks associated with fish intake is a major public health issue. On one hand, fish contain docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), long chain omega-3 fatty acids which have been considered beneficial for human health. Consistent with this concept, a meta-analysis showed moderate, inverse associations of fish consumption with cerebrovascular risk (1). On the other hand, fish may contain various substances like persistent organic pollutants (POPs), including dioxins, polychlorinated biphenyls (PCBs), organochlorine pesticides, and polybrominated diphenyl ethers and heavy metals, including methylmercury, lead, and cadmium, that can negatively affect human health. Consistent with this point, circulating POPs predicted incident stroke in an elderly cohort in Uppsala, Sweden (2). This article is protected by copyright. All rights reserved.
    Journal of Internal Medicine 01/2014; · 6.46 Impact Factor
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    ABSTRACT: History of gestational diabetes mellitus (GDM) increases lifetime risk of type 2 diabetes (DM) and the metabolic syndrome (MetS), which increase risk of cardiovascular disease. It is unclear, however, whether GDM increases risk of early atherosclerosis independent of pre-pregnancy obesity and subsequent metabolic disease. Of 2787 women (18 to 30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study, we studied 898 (47% black) who were free of DM and heart disease at baseline (1985-1986), delivered ≥1 post-baseline births, reported GDM history, and had common carotid intima media thickness (ccIMT, mm) measured in 2005-2006. We used multivariable linear regression to assess associations between GDM and ccIMT adjusted for race, age, parity, and pre-pregnancy cardiometabolic risk factors. We assessed mediators (weight gain, insulin resistance, blood pressure), and effect modification by incident DM or MetS during the 20-year period. Of the 898 women, 119 (13%) reported GDM (7.6 per 100 deliveries). Average age was 31 at last birth and 44 at ccIMT measurement for GDM and non-GDM groups. Unadjusted mean ccIMT was 0.023 mm higher for GDM than non-GDM groups (P=0.029), but pre-pregnancy BMI attenuated the difference to 0.016 mm (P=0.109). In 777 women without subsequent DM or the MetS, mean ccIMT was 0.023 mm higher for GDM versus non-GDM groups controlling for race, age, parity, and pre-pregnancy BMI (0.784 versus 0.761, P=0.039). Addition of pre-pregnancy insulin resistance index had minimal impact on adjusted mean net ccIMT difference (0.22 mm). Mean ccIMT did not differ by GDM status among 121 women who developed DM or the MetS (P=0.58). History of GDM may be a marker for early atherosclerosis independent of pre-pregnancy obesity among women who have not developed type 2 diabetes or the metabolic syndrome.
    Journal of the American Heart Association. 01/2014; 3(2):e000490.
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    ABSTRACT: Previous studies report associations between periodontal infection and cardiorespiratory fitness but no study has examined the association among younger adults. Our objective was to study the association between clinical measures of periodontal infection and cardiorespiratory fitness levels among a population-based sample of younger adults. The Continuous National Health and Nutrition Examination Survey 1999-2004 enrolled 2,863 participants (46% women) who received a partial-mouth periodontal examination and completed a submaximal treadmill test for the assessment of estimated VO2 max(eVO2 max ). Participants were mean±SD age 33±9 years (range = 20-49 years), 30% Hispanic, 48% White, 19% Black, and 3% other. Mean eVO2 max (mL/kg/minute) as well as eVO2 max≤32 mL/kg/minute (20th percentile) were regressed across quartiles of mean probing depth and mean attachment loss in multivariable linear and logistic regression models. After multivariable adjustment, mean eVO2 max levels±SE across quartiles of attachment loss were 39.72±0.37, 39.64±0.34, 39.59±0.36, and 39.85±0.39 (P = 0.99). Mean eVO2 max±SE across quartiles of probing depth were 39.57±0.32, 39.78±0.38, 39.19±0.25, and 40.37±0.53 (P = 0.28). Similarly, multivariable adjusted mean eVO2 max values were similar between healthy participants vs. those with moderate/severe periodontitis: 39.70±0.21 vs. 39.70±0.90 (P = 1.00). The odds ratio (OR) for low eVO2 max comparing highest vs. lowest quartile of attachment loss = 0.89[95% CI 0.64-1.24]. The OR for comparing highest vs. lowest probing depth quartile = 0.77[95% CI 0.51-1.15]. Clinical measures of periodontal infection were not related to cardiorespiratory fitness in a sample of generally healthy younger adults.
    PLoS ONE 01/2014; 9(3):e92441. · 3.73 Impact Factor
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    ABSTRACT: Background Framingham risk score (FRS) underestimates risk in young adults. LV mass (LVM) relates to cardiovascular disease (CVD), with unclear value in youth. In a young biracial cohort, we investigate how FRS predicts CVD over 20 years and the incremental value of LVM. We also explore the predictive ability of different cut-points for hypertrophy. Methods We assessed FRS and echocardiography-derived LVM (indexed by BSA or height2.7) from 3980 African-American and white CARDIA participants (1990–1991); and followed over 20 years for a combined endpoint: cardiovascular death; nonfatal myocardial infarction, heart failure, cerebrovascular disease, and peripheral artery disease. We assessed the predictive ability of FRS for CVD and also calibration, discrimination, and net reclassification improvement for adding LVM to FRS. Results Mean age was 30 ± 4 years, 46% males, and 52% white. Event incidence (n = 118) across FRS groups was, respectively, 1.3%, 5.4%, and 23.1% (p < 0.001); and was 1.4%, 1.3%, 3.7%, and 5.4% (p < 0.001) across quartiles of LVM (cut-points 117 g, 144 g, and 176 g). LVM predicted CVD independently of FRS, with the best performance in normal weight participants. Adding LVM to FRS modestly increased discrimination and had a statistically significant reclassification. The 85th percentile (≥ 116 g/m2 for men; ≥ 96 g/m2 for women) showed event prediction more robust than currently recommended cut-points for hypertrophy. Conclusion In a biracial cohort of young adults, FRS and LVM are helpful independent predictors of CVD. LVM can modestly improve discrimination and reclassify participants beyond FRS. Currently recommended cut-points for hypertrophy may be too high for young adults.
    International journal of cardiology 01/2014; · 7.08 Impact Factor
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    ABSTRACT: Cigarette smoking is an important cause of preventable death globally, but associations between smoking and mortality vary substantially across country and calendar time. Although methodological biases have been discussed, it is biologically plausible that persistent organic pollutants (POPs) like polychlorinated biphenyls (PCBs) and organochlorine (OC) pesticides can affect this association. This study was performed to evaluate if associations of cigarette smoking with mortality were modified by serum concentrations of PCBs and OC pesticides. We evaluated cigarette smoking in 111 total deaths among 986 men and women aged 70 years in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) with mean follow-up for 7.7 years. The association between cigarette smoking and total mortality depended on serum concentration of PCBs and OC pesticides (P value for interaction = 0.02). Among participants in the highest tertile of the serum POPs summary score, former and current smokers had 3.7 (95% CI, 1.5-9.3) and 6.4 (95% CI, 2.3-17.7) times higher mortality hazard, respectively, than never smokers. In contrast, the association between cigarette smoking and total mortality among participants in the lowest tertile of the serum POPs summary score was much weaker and statistically non-significant. The strong smoking-mortality association observed among elderly people with high POPs was mainly driven by low risk of mortality among never smokers with high POPs. As smoking is increasing in many low-income and middle-income countries and POPs contamination is a continuing problem in these areas, the interactions between these two important health-related issues should be considered in future research.
    PLoS ONE 01/2014; 9(5):e95937. · 3.73 Impact Factor
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    ABSTRACT: Background. It was hypothesized that television viewing is predictive of cardiometabolic risk. Moreover, people with hostile personality type may be more susceptible to TV-induced negative emotions and harmful health habits which increase occurrence of cardiometabolic risk. Purpose. The prospective association of TV viewing on cardiometabolic risk was examined along with whether hostile personality trait was a modifier. Methods. A total of 3,269 Black and White participants in the coronary artery risk development in young adults (CARDIA) study were assessed from age 23 to age 35. A cross-lagged panel model at exam years 5, 10, 15, and 20, covering 15 years, was used to test whether hours of daily TV viewing predicted cardiometabolic risk, controlling confounding variables. Multiple group analysis of additional cross-lagged panel models stratified by high and low levels of hostility was used to evaluate whether the association was modified by the hostile personality trait. Results. The cross-lagged association of TV viewing at years 5 and 15 on clustered cardiometabolic risk score at years 10 and 20 was significant (B = 0.058 and 0.051), but not at 10 to 15 years. This association was significant for those with high hostility (B = 0.068 for exam years 5 to 10 and 0.057 for exam years 15 to 20) but not low hostility. Conclusion. These findings indicate that TV viewing is positively associated with cardiometabolic risk. Further, they indicate that hostility might be a modifier for the association between TV viewing and cardiometabolic risk.
    Journal of obesity. 01/2014; 2014:784594.

Publication Stats

35k Citations
4,400.07 Total Impact Points

Institutions

  • 1979–2014
    • University of Minnesota Duluth
      • • Laboratory Medicine and Pathology
      • • Medical School
      • • Department of Family Medicine and Community Health
      Duluth, Minnesota, United States
  • 2013
    • National Institutes of Health
      Maryland, United States
    • San Francisco VA Medical Center
      San Francisco, California, United States
    • University of Wollongong
      • Illawarra Health and Medical Research Institute
      Wollongong, New South Wales, Australia
    • Centers for Disease Control and Prevention
      • National Center for Chronic Disease Prevention and Health Promotion
      Atlanta, Michigan, United States
    • University of Western Australia
      Perth City, Western Australia, Australia
    • Bastyr University
      Kenmore, Washington, United States
    • Shiga University of Medical Science
      Ōtu, Shiga, Japan
  • 2009–2013
    • Johns Hopkins University
      • Division of Cardiology
      Baltimore, Maryland, United States
    • University of Vermont
      • Department of Pathology
      Burlington, VT, United States
    • Leiden University Medical Centre
      • Department of Psychiatry
      Leiden, South Holland, Netherlands
    • Arizona State University
      Phoenix, Arizona, United States
  • 2005–2013
    • Harvard Medical School
      • • Department of Medicine
      • • Division of Nutrition
      Boston, Massachusetts, United States
    • Loyola University
      New Orleans, Louisiana, United States
  • 2004–2013
    • Kyungpook National University
      • • Department of Preventive Medicine
      • • School of Medicine
      Daikyū, Daegu, South Korea
    • University of California, San Francisco
      • • Division of Hospital Medicine
      • • Division of General Internal Medicine
      San Francisco, California, United States
  • 2003–2013
    • University of Oslo
      • • Department of Nutrition
      • • Division of Medicine
      Oslo, Oslo, Norway
  • 2002–2013
    • Columbia University
      • • Department of Epidemiology
      • • Department of Medicine
      • • Division of General Medicine
      New York City, New York, United States
  • 1998–2013
    • Northwestern University
      • Department of Preventive Medicine
      Evanston, IL, United States
  • 2012
    • Kyungpook National University Hospital
      Sŏul, Seoul, South Korea
    • Uppsala University
      • Department of Medical Sciences
      Uppsala, Uppsala, Sweden
  • 2009–2012
    • Carnegie Mellon University
      • Department of Psychology
      Pittsburgh, PA, United States
  • 2007–2012
    • University of North Carolina at Chapel Hill
      • • Department of Nutrition
      • • Department of Family Medicine
      Chapel Hill, NC, United States
    • Exponent
      San Mateo, California, United States
    • Wake Forest University
      • Department of Epidemiology and Prevention
      Winston-Salem, North Carolina, United States
  • 2005–2012
    • University of Texas Health Science Center at Houston
      • • Division of Epidemiology, Human Genetics and Environmental Sciences
      • • Brown Foundation Institute of Molecular Medicine
      Houston, TX, United States
  • 2003–2012
    • University of New Mexico
      • • School of Medicine
      • • Department of Pediatrics
      Albuquerque, NM, United States
  • 1991–2012
    • University of Bergen
      • Department of Biology
      Bergen, Hordaland Fylke, Norway
  • 1979–2012
    • University of Minnesota Twin Cities
      • • Division of Epidemiology and Community Health
      • • Department of Kinesiology
      • • School of Public Health
      • • Department of Pediatrics
      • • Department of Medicine
      Minneapolis, MN, United States
  • 2011
    • Catholic University of Daegu
      • Department of Medicine
      Hayang, North Gyeongsang, South Korea
    • Wake Forest School of Medicine
      Winston-Salem, North Carolina, United States
    • Wageningen University
      • Division of Human Nutrition
      Wageningen, Provincie Gelderland, Netherlands
    • Oakland University
      • Department of Psychology
      Rochester, MI, United States
    • University of Eastern Finland
      • Institute of Public Health and Clinical Nutrition
      Joensuu, Province of Eastern Finland, Finland
  • 2008–2011
    • University of Washington Seattle
      Seattle, Washington, United States
  • 2005–2011
    • University of Michigan
      • Department of Epidemiology
      Ann Arbor, Michigan, United States
  • 2003–2011
    • Mayo Foundation for Medical Education and Research
      • Division of Epidemiology
      Scottsdale, AZ, United States
  • 1997–2011
    • Kurume University
      • Department of Internal Medicine
      Куруме, Fukuoka, Japan
    • University of Alabama at Birmingham
      • • Department of Epidemiology
      • • Division of Preventive Medicine
      Birmingham, AL, United States
  • 2010
    • Tufts University
      Georgia, United States
    • Loyola University Medical Center
      Maywood, Illinois, United States
    • University of Chicago
      • Department of Health Studies
      Chicago, IL, United States
    • University of California, San Diego
      • Department of Family and Preventive Medicine
      San Diego, CA, United States
  • 2005–2010
    • Kaiser Permanente
      Oakland, California, United States
  • 2002–2009
    • University of Rochester
      • Department of Pediatrics
      Rochester, NY, United States
  • 2007–2008
    • KU Leuven
      • • Division of Artherosclerosis and Metabolism
      • • Department of Cardiovascular Sciences
      Leuven, VLG, Belgium
  • 2001–2007
    • Harvard University
      • • Department of Nutrition
      • • Department of Epidemiology
      Boston, MA, United States
    • National Institute for Public Health and the Environment (RIVM)
      • Centre for Prevention and Health Services Research (PZO)
      Utrecht, Utrecht, Netherlands
    • University of Alabama
      • College of Education
      Tuscaloosa, AL, United States
  • 2006
    • University of Wisconsin, Madison
      • Department of Ophthalmology and Visual Sciences
      Madison, MS, United States
  • 2001–2003
    • Kosin University
      • College of Medicine
      Pusan, Busan, South Korea
  • 2000
    • University of Texas Southwestern Medical Center
      • Department of Ophthalmology
      Dallas, TX, United States
  • 1999–2000
    • University of South Carolina
      • Department of Epidemiology & Biostatistics
      Columbia, SC, United States
    • Wayne State University
      Detroit, Michigan, United States
    • Boston Children's Hospital
      Boston, Massachusetts, United States
  • 1988–1995
    • University of Utah
      • Department of Family and Preventive Medicine
      Salt Lake City, UT, United States
  • 1993
    • National Heart, Lung, and Blood Institute
      • Division of Cardiovascular Sciences (DCVS)
      Maryland, United States