BackgroundHeart failure (HF) is a serious condition with increasing prevalence, high morbidity, and increased mortality. Obesity is an established risk factor for HF. Fluctuation in body mass index (BMI) has shown a higher risk of cardiovascular outcomes. We investigated the association between BMI variability and incident HF. Methods and ResultsIn the UK Biobank, we established a prospective cohort after excluding participants with prevalent HF or cancer at enrollment. A total of 99 368 White participants with ≥3 BMI measures during >2 years preceding enrollment were included, with a median follow‐up of 12.5 years. The within‐participant variability of BMI was evaluated using standardized SD and coefficient of variation. The association of BMI variability with incident HF was assessed using Fine and Gray's competing risk model, adjusting for confounding factors and participant‐specific rate of BMI change. Higher BMI variability measured in both SD and coefficient of variation was significantly associated with higher risk in HF incidence (SD: hazard ratio [HR], 1.05 [95% CI, 1.03–1.08],P<0.0001; coefficient of variation: HR, 1.07 [95% CI, 1.04–1.10],P<0.0001). ConclusionsLongitudinal health records capture BMI fluctuation, which independently predicts HF incidence.
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Fine particulate matter and polycystic ovarian morphology
Abstract Background Polycystic ovary morphology (PCOM) is an ultrasonographic finding that can be present in women with ovulatory disorder and oligomenorrhea due to hypothalamic, pituitary, and ovarian dysfunction. While air pollution has emerged as a possible disrupter of hormone homeostasis, limited research has been conducted on the association between air pollution and PCOM. Methods We conducted a longitudinal cohort study using electronic medical records data of 5,492 women with normal ovaries at the first ultrasound that underwent a repeated pelvic ultrasound examination during the study period (2004–2016) at Boston Medical Center. Machine learning text algorithms classified PCOM by ultrasound. We used geocoded home address to determine the ambient annual average PM 2.5 exposures and categorized into tertiles of exposure. We used Cox Proportional Hazards models on complete data ( n = 3,994), adjusting for covariates, and additionally stratified by race/ethnicity and body mass index (BMI). Results Cumulative exposure to PM 2.5 during the study ranged from 4.9 to 17.5 µg/m 3 (mean = 10.0 μg/m 3 ). On average, women were 31 years old and 58% were Black/African American. Hazard ratios and 95% confidence intervals (CI) comparing the second and third PM 2.5 exposure tertile vs. the reference tertile were 1.12 (0.88, 1.43) and 0.89 (0.62, 1.28), respectively. No appreciable differences were observed across race/ethnicity. Among women with BMI ≥ 30 kg/m 2 , we observed weak inverse associations with PCOM for the second (HR: 0.93, 95% CI: 0.66, 1.33) and third tertiles (HR: 0.89, 95% CI: 0.50, 1.57). Conclusions In this study of reproductive-aged women, we observed little association between PM 2.5 concentrations and PCOM incidence. No dose response relationships were observed nor were estimates appreciably different across race/ethnicity within this clinically sourced cohort.
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- Award ID(s):
- 1914792
- PAR ID:
- 10382481
- Date Published:
- Journal Name:
- Environmental Health
- Volume:
- 21
- Issue:
- 1
- ISSN:
- 1476-069X
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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