PKznA7refs.MYD}?Lupisan, S. P. Ruutu, P. Abucejo-Ladesma, P. E. Quiambao, B. P. Gozum, L. Sombrero, L. T. Romano, V. Herva, E. Riley, I. Simoes, E. A. F.2007Predictors of death from severe pneumonia among children 2-59 months old hospitalized in Bohol, Philippines: implications for referral criteria at a first-level health facility962-971(Tropical Medicine & International Health128AugObjective To determine predictors of death among children 2 - 59 months old admitted to hospital with severe pneumonia. methods Prospective observational study from April 1994 to May 2000 to investigate serious infections in children less than 5 years old admitted to a tertiary care government hospital in a rural province in central Philippines. The quality of clinical and laboratory work was monitored. The WHO classification for severe pneumonia was used for patient enrolment. Results There were 1249 children with severe pneumonia and no CNS infection. Thirty children died. Using univariate analysis, the following factors were significantly associated with death: age 2 - 5 months, dense infiltrates on chest radiography and presence of definite bacterial pathogens in the blood. Stepwise logistic regression analysis revealed the following independent predictors of death: age 2 - 5 months, weight for age z- score less than) 2 SD, dense infiltrates on chest radiography and definite pathogens isolated in the blood. When the results of chest radiographs and blood cultures were not included to mimic facilities available at first- level facilities, age 2 - 5 months and weight for age z- score less than) 2 SD remained independent predictors of death. Conclusion When resources are limited, children with lower chest wall indrawing ( severe pneumonia) who are 2 - 5 months old or moderately to severely malnourished should be referred for immediate higher- level care.://000249200500008 1360-2276ISI:000249200500008 {}?@Perola, M. Sammalisto, S. Hiekkalinna, T. Martin, N. G. Visscher, P. M. Montgomery, G. W. Benyamin, B. Harris, J. R. Boomsma, D. Willemsen, G. Hottenga, J. J. Christensen, K. Kyvik, K. O. Sorensen, T. I. A. Pedersen, N. L. Magnusson, P. K. E. Spector, T. D. Widen, E. Silventoinen, K. Kaprio, J. Palotie, A. Peltonen, L.2007bCombined genome scans for body stature in 6,602 European twins: Evidence for common Caucasian loci 1019-1028 Plos Genetics36JunKTwin cohorts provide a unique advantage for investigations of the role of genetics and environment in the etiology of variation in common complex traits by reducing the variance due to environment, age, and cohort differences. The GenomEUtwin (http://www.genomeutwin.org) consortium consists of eight twin cohorts (Australian, Danish, Dutch, Finnish, Italian, Norwegian, Swedish, and United Kingdom) with the total resource of hundreds of thousands of twin pairs. We performed quantitative trait locus (QTL) analysis of one of the most heritable human complex traits, adult stature (body height) using genome-wide scans performed for 3,817 families (8,450 individuals) derived from twin cohorts from Australia, Denmark, Finland, Netherlands, Sweden, and United Kingdom with an approximate tencentimorgan microsatellite marker map. The marker maps for different studies differed and they were combined and related to the sequence positions using software developed by us, which is publicly available (https://apps.bioinfo.helsinki.fi/software/cartographer.aspx). Variance component linkage analysis was performed with age, sex, and country of origin as covariates. The covariate adjusted heritability was 81% for stature in the pooled dataset. We found evidence for a major QTL for human stature on 8q21.3 (multipoint logarithm of the odds 3.28), and suggestive evidence for loci on Chromosomes X, 7, and 20. Some evidence of sex heterogeneity was found, however, no obvious female-specific QTLs emerged. Several cohorts contributed to the identified loci, suggesting an evolutionarily old genetic variant having effects on stature in European-based populations. To facilitate the genetic studies of stature we have also set up a website that lists all stature genome scans published and their most significant loci (http://www.genomeutwin.org/stature_ gene_ map.htm).://000248349300015 1553-7390ISI:000248349300015e97}?cAuro, K. Alanne, M. Kristiansson, K. Silander, K. Kuulasmaa, K. Salomaa, V. Peltonen, L. Perola, M.2007RCombined effects of thrombosis pathway gene variants predict cardiovascular events 1244-1253 Plos Genetics37JulThe genetic background of complex diseases is proposed to consist of several low-penetrance risk loci. Addressing this complexity likely requires both large sample size and simultaneous analysis of different predisposing variants. We investigated the role of four thrombosis genes: coagulation factor V (F5), intercellular adhesion molecule 1 (ICAM1), protein C (PROC), and thrombomodulin (THBD) in cardiovascular diseases. Single allelic gene variants and their pairwise combinations were analyzed in two independently sampled population cohorts from Finland. From among 14,140 FINRISK participants (FINRISK-92, n = 5,999 and FINRISK-97, n =8,141), we selected for genotyping a sample of 2,222, including 528 incident cardiovascular disease (CVD) cases and random subcohorts totaling 786. To cover all known common haplotypes (> 10%), 54 single nucleotide polymorphisms (SNPs) were genotyped. Classification-tree analysis identified 11 SNPs that were further analyzed in Cox's proportional hazard model as single variants and pair-wise combinations. Multiple testing was controlled by use of two independent cohorts and with false-discovery rate. Several CVD risk variants were identified: In women, the combination of F5 rs7542281 x THBD rs1042580, together with three single F5 SNPs, was associated with CVD events. Among men, PROC rs1041296, when combined with either ICAM1 rs5030341 or F5 rs2269648, was associated with total mortality. As a single variant, PROC rs1401296, together with the F5 Leiden mutation, was associated with ischemic stroke events. Our strategy to combine the classification-tree analysis with more traditional genetic models was successful in identifying SNPs-acting either in combination or as single variants-predisposing to CVD, and produced consistent results in two independent cohorts. These results suggest that variants in these four thrombosis genes contribute to arterial cardiovascular events at population level.://000248350000011 1553-7390ISI:000248350000011e120d}?3Nyrhinen, T. Hietala, M. Puukka, P. Leino-Kilpi, H.2007Consequences as ethical issues in diagnostic genetic testing - a comparison of the perceptions of patients/parents and personnel47-63New Genetics and Society261'Diagnostic genetic tests are intended for the patient's good, but they may also have adverse consequences. The purpose of this study was to describe the consequences of diagnostic genetic testing and to compare the perceptions of adult patients/parents and personnel, to determine which factors were associated with the respondents' perceptions concerning the consequences of diagnostic genetic testing and to find out how the ethical principles manifest themselves in the consequences. The data were collected using a structured questionnaire from patients or parents ( n = 106) and personnel ( n = 162) during diagnostic genetic testing at three Finnish university hospitals. Both groups of respondents thought that the testing had more beneficial impacts on the patient's life control than on their family life and social life, and staff estimated that these impacts are less favourable than did patients/parents in all areas of life. Several background variables were associated with these perceptions. It is important that efforts are stepped up to improve genetic counselling, particularly with regard to the consequences of testing on family and social life. Further research is needed to explore the differences between the two groups studied here by analysing attitudes towards and the contents of counselling.://000248888100003 1463-6778ISI:000248888100003}?}Janus, E. D. Laatikainen, T. Dunbar, J. A. Kilkkinen, A. Bunker, S. J. Philpot, B. Ticleman, P. A. Tirimacco, R. Heistaro, S.2007JOverweight, obesity and metabolic syndrome in rural southeastern Australia147-152Medical Journal of Australia1873Aug-Objective: To measure the prevalence of overweight, obesity and the metabolic syndrome (MetS) in rural Australia. Design, setting and participants: Cross-sectional surveys were conducted in two rural areas in Victoria and South Australia in 2004-2005. A stratified random sample of men and women aged 25-74 years was selected from the electoral roll. Data were collected by a self-administered questionnaire, physical measurements and laboratory tests. Main outcome measures: Prevalence of overweight and obesity, as defined by body mass index (BMI) and waist circumference; prevalence of MetS and its components. Results: Data on 806 participants (383 men and 423 women) were analysed. Based on BMI, the prevalence of overweight and obesity combined was 74.1% (95% CI, 69.7%-78.5%) in men and 64.1% (95% CI, 59.5%-68.7%) in women. Based on waist circumference, the prevalence of overweight and obesity was higher in women (72.4%; 95% CI, 68.1%-76.7%) than men (61.9%; 95% CI, 57.0%-66.8%). The overall prevalence of obesity was 30.0% (95% CI, 26.8%-33.2%) based on BMI (>= 30.0 kg/m(2)) and 44.7% (95% CI, 41.2%-48.1%) based on waist circumference (>= 102 cm [men] and >= 88 cm [women]). The prevalence of MetS as defined by the US National Cholesterol Education Program Adult Treatment Panel III 2005 criteria was 27.1% (95% CI, 22.7%-31.6%) in men and 28.3% (95% CI, 24.0%-32.6%) in women; based on International Diabetes Federation criteria, prevalences for men and women were 33.7% (95% CI, 29.0%-38.5%) and 30.1% (95% CI, 25.7%-34.5%), respectively. Prevalences of MetS, central (abdominal) obesity, hyperglycaemia, hypertension and hypertriglyceridaemia increased with age. Conclusions: In rural Australia, prevalences of MetS, overweight and obesity are very high. Urgent population-wide action is required to tackle the problem.://000248825300005 0025-729XISI:000248825300005}?LLehtonen, A. Ahlfors, H. Veckman, V. Miettinen, M. Lahesmaa, R. Julkunen, I.2007eGene expression profiling during differentiation of human monocytes to macrophages or dendritic cells710-720Journal of Leukocyte Biology823SepOMacrophages and dendritic cells (DC) are APC, which regulate innate and adaptive immune responses. Macrophages function locally mainly, maintaining inflammatory responses in tissues, whereas DC take up microbes, mature, and migrate to local lymph nodes to present microbial antigens to naive T cells to elicit microbe-specific immune responses. Blood monocytes can be differentiated in vitro to macrophages or DC by GM-CSF or GM-CSF + IL-4, respectively. In the present study, we performed global gene expression analyses using Affymetrix HG-U133A Gene Chip oligonucleotide arrays during macrophage and DC differentiation. During the differentiation process, 340 and 350 genes were up-regulated, and 190 and 240 genes were down-regulated in macrophages and DC, respectively. There were also more that 200 genes, which were expressed differentially in fully differentiated macrophages and DC. Macrophage-specific genes include, e. g., CD14, CD163, C5R1, and Fc gamma R1A, and several cell surface adhesion molecules, cytokine receptors, WNT5A and its receptor of the Frizzled family FZD2, fibronectin, and Fc gamma R1A were identified as DC-specific. Our results reveal significant differences in gene expression profiles between macrophages and DC, and these differences can partially explain the functional differences between these two important cell types.://000249022200030 0741-5400ISI:000249022200030f}?'Kanerva, M. Ollgren, J. Lyytikainen, O.2007]Antimicrobial use in Finnish acute care hospitals: data from national prevalence survey, 2005440-444%Journal of Antimicrobial Chemotherapy602AugCObjectives: In Finland, use of antimicrobials in ambulatory care is moderate, but some reports suggest that hospital use is higher than in other European countries. We evaluated the amount and type of antimicrobials administered in Finnish acute care hospitals. Patients and methods: We analysed data collected in the national prevalence survey of nosocomial infections (NIs) during February-March 2005 in all tertiary care, all secondary care and 25% of other acute care hospitals. All inpatients present on the study day in acute care wards for adults were included (n = 8234). The names and use-days of antimicrobials in Anatomical Therapeutic Class groups J01 -J05 were collected on the study day and retrospectively for the previous 6 days. Results: On the study day, 39% of patients had received at least one, 14% at least two and 3% at least three antimicrobials; patients with NI represented 21%, 29% and 45% of these groups, respectively. The prevalence of patients receiving any antimicrobial was 53% in intensive care patients and varied in other specialties from 0% in ophthalmology to 63% in dental and oral surgery. Within a 7 day period, the total use of antibacterial agents (J01) was 64 use-days per 100 patient-days. Cephalosporins were the most frequently used antimicrobials, followed by quinolones and metronidazole. Conclusions: The prevalence and spectrum of antimicrobial use in Finnish acute care hospitals were high. NI patients contributed markedly to the total usage. The NI survey with a 7 day data collection period provided insights into the use-density of antimicrobials.://000248986500038 0305-7453ISI:000248986500038#}?FBarker, D. J. P. Osmond, C. Forsen, T. J. Kajantie, E. Eriksson, J. G.2007+Maternal and social origins of hypertension565-571 Hypertension503Sep,We previously reported that in 2003 people from the Helsinki birth cohort whose blood pressures were measured, 2 different paths of growth preceded the development of hypertension. People already diagnosed with hypertension were small at birth but of average body size at age 11 years. People newly diagnosed with hypertension grew slowly in utero and through childhood. We have now examined how the mother's body size, placental size, and living conditions after birth, 3 influences that affect growth, affect hypertension. Diagnosed hypertension was associated with low placental weight and poor living conditions after birth. The odds ratios were 1.6 (95% CI, 1.1 to 2.3) in people with placental weights < 550 g, compared with those with weights > 750 g, and 2.2 (95% CI, 1.5 to 3.3) in people whose fathers were laborers compared with those in upper middle-class families. Newly diagnosed hypertension was associated with a small anteroposterior diameter of the mother's bony pelvis, a known consequence of rickets or lesser degrees of malnutrition in infancy. The odds ratio was 2.2 ( 95% CI, 1.4 to 3.5) in people whose mothers' pelvic external conjugate diameters were < 18 cm when compared with people whose mothers' diameters were >= 19 cm. We conclude that one path of growth that leads to hypertension is initiated by fetal undernutrition, which may make a baby vulnerable to postnatal stress, whereas the other originates in a functional incapacity in the mother's metabolism, possibly protein metabolism, which she acquired through undernutrition during her infancy.://000248945100023 0194-911XISI:000248945100023)}? CHypponen, E. Hartikainen, A. L. Sovio, U. Jarvelin, M. R. Pouta, A.2007KDoes vitamin D supplementation in infancy reduce the risk of pre-eclampsia? 1136-1139&European Journal of Clinical Nutrition619SepVitamin D has been suggested to affect the balance between T helper (Th1) and (Th2) type cytokines by favouring Th2 domination. We investigated the association between infant vitamin D supplementation and later pre-eclampsia, a disorder suggested to be dominated by Th1 response. We used data on 2969 women born in the Northern Finland Birth Cohort 1966 of whom 68 (2.3%) had pre-eclampsia in their first pregnancy. Risk of pre-eclampsia was halved (OR 0.49, 95% confidence interval (CI) 0.26-0.92) in participants who had received vitamin D supplementation regularly during the first year of life and this association was not affected by adjustment for own birth order, birth weight, gestational age, social class in 1966 and hospitalizations or pregnancy-induced hypertension of their mothers. Together with earlier observations on a reduced risk of type 1 diabetes after vitamin D supplementation, these data suggest that vitamin D intake in infancy may affect long-term programming of the immune response pattern.://000249276900014 0954-3007ISI:000249276900014}? NSliventoinen, K. Pankow, J. Lindstrom, J. Jousilahti, P. Hu, G. Tuomilehto, J.2005The validity of the Finnish Diabetes Risk Score for the prediction of the incidence of coronary heart disease and stroke, and total mortality451-458>European Journal of Cardiovascular Prevention & Rehabilitation125Oct@Background Cardiovascular disease shares several risk factors with type 2 diabetes. We tested whether the Finnish Diabetes Risk Score (FINDRISC), recently developed in a Finnish population to estimate the future risk of diabetes, would also identify individuals at high risk of coronary heart disease (CHD) and stroke, and total mortality in this same population. Design Independent risk factor surveys were conducted in 1987,1992, and 1997 in Finland, comprising 8268 men and 9457 women aged 25-64 years and free of CHD and stroke at baseline. During the follow-up until the end of 2001, 699 incident acute CHD events, 324 acute stroke events, and 765 deaths occurred. Methods The data were analysed by using receiver operating characteristic (ROC) curves and the Cox-regression model. Results The areas under the ROC curves (AUC) were 71% for CHD, 73% for stroke, and 68% for total mortality in men and 78, 68, and 72% in women, respectively. The addition of systolic and diastolic blood pressures, total and high-density lipoprotein cholesterol, and smoking increased the AUC values modestly (the change of the absolute values from 2.6 to 6.5%), but the additional use of plasma glucose had only a slight effect on the AUC values for CHD and stroke. Conclusions The FINDRISC is a reasonably good predictor of CHD, stroke and total mortality.://000249264700006 1741-8267ISI:000249264700006 }? 'Ylonen, S. K. Virtanen, S. M. Groop, L.2007ZThe intake of potatoes and glucose metabolism in subjects at high risk for Type 2 diabetes 1049-1050Diabetic Medicine249Sep://000248966300017 0742-3071ISI:000248966300017 n}? Niinikoski, H. Lagstrom, H. Jokinen, E. Siltala, M. Roennemaa, T. Viikari, J. Raitakari, O. T. Jula, A. Marniemi, J. Nonto-Salonen, K. Simell, O.2007Impact of repeated dietary Counseling between infancy and 14 years of age on dietary intakes and serum lipids and lipoproteins - The STRIP study 1032-1040 Circulation1169AugBackground-Atherosclerosis development might be delayed or prevented by dietary measures. The aims of the present study were to evaluate the effect of low-saturated-fat, low-cholesterol dietary counseling on fat intakes, growth, serum cholesterol values, and pubertal development in children and adolescents. Methods and Results-In the randomized prospective Special Turku Coronary Risk Factor Intervention Project ( STRIP), a low-saturated-fat, low-cholesterol diet was introduced to intervention infants (n=540) at 7 months of age, and control children (n=522) received an unrestricted diet. Dietary intakes, serum cholesterol values, somatic growth, and development were followed up throughout childhood and adolescence. Saturated fat intakes, serum total cholesterol, and low-density lipoprotein cholesterol values were lower (P < 0.001) in the intervention than in control children during the 14 years, whereas high-density lipoprotein cholesterol values in the 2 study groups showed no difference. Boys had lower total and low-density lipoprotein cholesterol concentrations than girls throughout childhood (P < 0.001), and the intervention effect on serum cholesterol concentration was larger in boys than girls. The 2 study groups showed no difference in growth, body mass index, pubertal development, or age at menarche ( median, 13.0 and 12.8 years in the intervention and control girls, respectively; P=0.52). The cholesterol values decreased as puberty progressed. Mean concentrations of total and high-density lipoprotein cholesterol decreased from approximate to 4.5 and approximate to 1.4 mmol/ L, respectively, in Tanner stage 1 ( prepubertal) boys to approximate to 3.9 and approximate to 1.1 mmol/ L in Tanner stage 4 ( late pubertal) boys. Conclusions-Repeated dietary counseling remains effective in decreasing saturated fat and cholesterol intake and serum cholesterol values at least until 14 years of age. Puberty markedly influences serum cholesterol concentrations.://000249031100009 0009-7322ISI:000249031100009.}? [Mikkilae, V. Rasnan, L. Raitakari, O. T. Marniemi, J. Pietinen, P. Ronnemaa, T. Viikari, J.2007Major dietary patterns and cardiovascular risk factors from childhood to adulthood. The Cardiovascular Risk in Young Finns Study218-225British Journal of Nutrition981JulStudies on the impact of single nutrients on the risk of CVD have often given inconclusive results. Recent research on dietary patterns has offered promising information on the effects of diet as a whole on the risk of CVD. The Cardiovascular Risk in Young Finns Study is an ongoing, prospective cohort study with a 21-year follow-up to date. The subjects were children and adolescents at baseline (3-18 years, n 1768) and adults at the latest follow-up study (24-39 years, n 1037). We investigated the associations between two major dietary patterns and several risk factors for CVD. In longitudinal analyses with repeated measurements, using multivariate mixed linear regression models, the traditional dietary pattern (characterised by high consumption of rye, potatoes, butter, sausages, milk and coffee) was independently associated with total and LDL cholesterol concentrations, apolipoprotein B and C-reactive protein concentrations among both genders, and also with systolic blood pressure and insulin levels among women and concentrations of homocysteine among men (P<0 center dot 05 for all). A dietary pattern reflecting more health-conscious food choices (such as high consumption of vegetables, legumes and nuts, tea, rye, cheese and other dairy products, and alcoholic beverages) was inversely, but less strongly associated with cardiovascular risk factors. Our results support earlier findings that dietary patterns have a role in the development of CVD.://000248305100030 0007-1145ISI:000248305100030 }?Bogers, R. P. Bemelmans, W. J. E. Hoogenveen, R. T. Boshuizen, H. C. Woodward, M. Knekt, P. van Dam, R. M. Hu, F. B. Visscher, T. L. S. Menotti, A. Thorpe, R. J. Jamrozik, K. Calling, S. Strand, B. H. Shipley, M. J.2007Association of overweight with increased risk of coronary heart disease partly independent of blood pressure and cholesterol levels - A meta-analysis of 21 cohort studies including more than 300,000 persons 1720-1728Archives of Internal Medicine16716SepBackground: The extent to which moderate overweight (body mass index [BMI], 25.0-29.9 [calculated as weight in kilograms divided by height in meters squared]) and obesity ( BMI, >= 30.0) are associated with increased risk of coronary heart disease (CHD) through adverse effects on blood pressure and cholesterol levels is unclear, as is the risk of CHD that remains after these mediating effects are considered. Methods: Relative risks (RRs) of CHD associated with moderate overweight and obesity with and without adjustment for blood pressure and cholesterol concentrations were calculated by the members of a collaboration of prospective cohort studies of healthy, mainly white persons and pooled by means of random-effects models (RRs for categories of BMI in 14 cohorts and for continuous BMI in 21 cohorts; total N=302296). Results: A total of 18 000 CHD events occurred during follow-up. The age-, sex-, physical activity-, and smoking-adjusted RRs (95% confidence intervals) for moderate overweight and obesity compared with normal weight were 1.32 (1.24-1.40) and 1.81 (1.56-2.10), respectively. Additional adjustment for blood pressure and cholesterol levels reduced the RR to 1.17 (1.11-1.23) for moderate overweight and to 1.49 (1.32-1.67) for obesity. The RR associated with a 5-unit BMI increment was 1.29 (1.22-.35) before and 1.16 (1.11-1.21) after adjustment for blood pressure and cholesterol levels. Conclusions: Adverse effects of overweight on blood pressure and cholesterol levels could account for about 45% of the increased risk of CHD. Even for moderate overweight, there is a significant increased risk of CHD independent of these traditional risk factors, although confounding (eg, by dietary factors) cannot be completely ruled out.://000249343000003 0003-9926ISI:000249343000003c}?LEnattah, N. S. Trudeau, A. Pimenoff, V. Maiuri, L. Auricchio, S. Greco, L. Rossi, M. Lentze, M. Seo, J. K. Rahgozar, S. Khalil, I. Alifrangis, M. Natah, S. Groop, L. Shaat, N. Kozlov, A. Verschubskaya, G. Comas, D. Bulayeva, K. Mehdi, S. Q. Terwilliger, J. D. Sahi, T. Savilahti, E. Perola, M. Sajantila, A. Jarvela, I. Peltonen, L.2007dEvidence of still-ongoing convergence evolution of the lactase persistence T-13910 alleles in humans615-625"American Journal of Human Genetics813SepA single-nucleotide variant, C/T-13910, located 14 kb upstream of the lactase gene (LCT), has been shown to be completely correlated with lactase persistence (LP) in northern Europeans. Here, we analyzed the background of the alleles carrying the critical variant in 1,611 DNA samples from 37 populations. Our data show that the T-13910 variant is found on two different, highly divergent haplotype backgrounds in the global populations. The first is the most common LP haplotype (LP H98) present in all populations analyzed, whereas the others (LP H8-H12), which originate from the same ancestral allelic haplotype, are found in geographically restricted populations living west of the Urals and north of the Caucasus. The global distribution pattern of LP T-13910 H98 supports the Caucasian origin of this allele. Age estimates based on different mathematical models show that the common LP T-13910 H98 allele (similar to 5,000-12,000 years old) is relatively older than the other geographically restricted LP alleles (similar to 1,400-3,000 years old). Our data about global allelic haplotypes of the lactose-tolerance variant imply that the T-13910 allele has been independently introduced more than once and that there is a still-ongoing process of convergent evolution of the LP alleles in humans.://000249128200018 0002-9297ISI:0002491282000181F}?LVikstedt, R. Metso, J. Hakala, J. Olkkonen, V. M. Ehnholm, C. Jauhiainen, M.2007Cholesterol Efflux from Macrophage Foam Cells Is Enhanced by Active Phospholipid Transfer Protein through Generation of Two Types of Acceptor Particles BiochemistrySep 272Phospholipid transfer protein (PLTP) is expressed by macrophage-derived foam cells in human atherosclerotic lesions, suggesting a regulatory role for PLTP in cellular cholesterol homeostasis. However, the exact role of PLTP in the reverse cholesterol transport pathway is not known. PLTP is present in plasma as two forms, a highly active (HA-PLTP) and a lowly active (LA-PLTP) form. In this study we clarify the role of the two forms of PLTP in cholesterol efflux from [3H]cholesterol oleate-acetyl-LDL-loaded THP-1 macrophages. Incubation of HDL in the presence of HA-PLTP resulted in the formation of two types of acceptor particles, prebeta-HDL and large fused HDL. HA-PLTP increased prebeta-HDL formation and caused a 42% increase in [3H]cholesterol efflux to HDL, while LA-PLTP neither formed prebeta-HDL nor increased cholesterol efflux. Removal of the formed prebeta-HDL by immunoprecipitation decreased cholesterol efflux by 47%. Neither HA- nor LA-PLTP enhanced cholesterol efflux to lipid-free apoA-I. Importantly, also the large fused HDL particles formed during incubation of HDL with HA-PLTP acted as efficient cholesterol acceptors. These observations demonstrate that only HA-PLTP increases macrophage cholesterol efflux, via formation of efficient cholesterol acceptors, prebeta-HDL and large fused HDL particles.0006-2960 (Print)17900150National Public Health Institute, Department of Molecular Medicine, Biomedicum, P.O. Box 104, FI-00251 Helsinki, Finland, and Wihuri Research Institute, Kalliolinnantie 4, FI-00140 Helsinki, Finland.IF}?`Keskitalo, K. Silventoinen, K. Tuorila, H. Perola, M. Pietilainen, K. H. Rissanen, A. Kaprio, J.2007QGenetic and environmental contributions to food use patterns of young adult twins Physiol BehavSep 5The contribution of genetic factors to individual differences in food use was estimated in a large population-based twin cohort of young adults (22- to 27-year-old). Male and female twins (n=2009 complete twin pairs) evaluated use-frequencies of 24 food items using 5 categories (1=never-5=several times a day) in a postal questionnaire. Foods were categorized by factor analysis. Estimates of the relative proportions of additive genetic, shared environmental, and unshared environmental effects on the use-frequency of food items and factor scores were obtained by quantitative genetic modeling of twin data based on linear structural equations. Four factors of food use were identified: "healthy" foods, high-fat foods, sweet foods, and meats. The variance of the use-frequency of food items and food categories was explained by additive genetic and unshared environmental influences, whereas shared environmental factors did not contribute to food use. The average proportions of genetic effects on the total variance of the use-frequency of food items and food categories were 40% and 45%, respectively. Sex differences were observed in the magnitude of genetic influences for use-frequency of four food items (chocolate, other sweets, fried foods, and meat), and in genetic factors underlying the use of three (fresh vegetables, fruits, and cheeses) items. In conclusion, family environment does not appear to influence the food use of young adults and thus nutritional education should be targeted at this age group to support development of healthy eating patterns. In addition, the results illuminate the importance of the sex-specific genetic effects on food use.0031-9384 (Print)17897688Department of Food Technology, University of Helsinki, P.O. Box 66, FI-00014 University of Helsinki, Finland; Department of Molecular Medicine, National Public Health Institute, Finland. B}?Crane, C. Williams, J. M. Hawton, K. Arensman, E. Hjelmeland, H. Bille-Brahe, U. Corcoran, P. De Leo, D. Fekete, S. Grad, O. Haring, C. Kerkhof, A. J. Lonnqvist, J. Michel, K. Salander Renberg, E. Schmidtke, A. van Heeringen, C. Wasserman, D.2007The Association between Life Events and Suicide Intent in Self-Poisoners with and without a History of Deliberate Self-Harm: A Preliminary Study367-378Suicide Life Threat Behav374AugThe associations between life events in the 12 months preceding an episode of self-poisoning resulting in hospital attendance (the index episode), and the suicide intent of this episode were compared in individuals for whom the index episode was their first, episode and in individuals in whom it was a recurrence of DSH. Results indicated a significant interaction between independent life events, repetition status, and gender in the prediction of suicide intent, the association between life events and intent being moderated by repetition status in women only. The results provide preliminary evidence to suggest the presence of a suicidal process in women, in which the impact of negative life events on suicide intent diminishes across episodes.0363-0234 (Print)17896878_1 Centre for Suicide Research, University of Oxford Department of Psychiatry, 2 National Suicide Research Foundation, Cork, Ireland, 3 Department of Social Work and Health Science, Norwegian University of Science and Technology, Trondheim, and Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway, 4 Centre for Suicidological Research, Odense, Denmark, 5 National Suicide Research Foundation, Cork, Ireland, 6 University of Padua, Italy (now at Australian Institute for Suicide Research and Prevention, Griffith University, Australia), 7 Department of Psychiatry, University of Pecs, Hungary, 8 University Psychiatric Hospital, Ljubljana, Slovenia, 9 Psychiatric State Hospital Hall in Tirol, Austria, 10 Department of Clinical Psychology, Vrije Universiteit, The Netherlands, 11 National Public Health Institute, Department of Mental Health and Alcohol Research and Department of Psychiatry, University of Helsinki, Finland, 12 University Psychiatric Services, University of Bern, Switzerland, 13 Department of Clinical Sciences, Division of Psychiatry, Umea University, Sweden, 14 Department of Clinical Psychology, Clinic for Psychiatry and Psychotherapy, University of Wurzburg, Germany, 15 Unit for Suicide Research, Department of Psychiarty,Ghent University, Belgium, 16 Centre for Suicide Research and Prevention, Karolinska Institute, Sweden.F}?Koushik, A. Hunter, D. J. Spiegelman, D. Beeson, W. L. van den Brandt, P. A. Buring, J. E. Calle, E. E. Cho, E. Fraser, G. E. Freudenheim, J. L. Fuchs, C. S. Giovannucci, E. L. Goldbohm, R. A. Harnack, L. Jacobs, D. R., Jr. Kato, I. Krogh, V. Larsson, S. C. Leitzmann, M. F. Marshall, J. R. McCullough, M. L. Miller, A. B. Pietinen, P. Rohan, T. E. Schatzkin, A. Sieri, S. Virtanen, M. J. Wolk, A. Zeleniuch-Jacquotte, A. Zhang, S. M. Smith-Warner, S. A.2007SFruits, Vegetables, and Colon Cancer Risk in a Pooled Analysis of 14 Cohort StudiesJ Natl Cancer InstSep 25Background Fruit and vegetable intakes have been associated with a reduced risk of colon cancer; however, in more recent studies associations have been less consistent. Statistical power to examine associations by colon site has been limited in previous studies. Methods Fruit and vegetable intakes in relation to colon cancer risk were examined in the Pooling Project of Prospective Studies of Diet and Cancer. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated separately in 14 studies using Cox proportional hazards model and then pooled using a random-effects model. Intakes of total fruits and vegetables, total fruits, and total vegetables were categorized according to quintiles and absolute cutpoints. Analyses were conducted for colon cancer overall and for proximal and distal colon cancer separately. All statistical tests were two-sided. Results Among 756217 men and women followed for up to 6 to 20 years, depending on the study, 5838 were diagnosed with colon cancer. The pooled multivariable RRs (95% CIs) of colon cancer for the highest versus lowest quintiles of intake were 0.91 (0.82 to 1.01, P(trend) = .19) for total fruits and vegetables, 0.93 (0.85 to 1.02, P(trend) = .28) for total fruits, and 0.94 (0.86 to 1.02, P(trend) = .17) for total vegetables. Similar results were observed when intakes were categorized by identical absolute cut points across studies (pooled multivariable RR = 0.90, 95% CI = 0.77 to 1.05 for 800 or more versus <200 g/day of total fruits and vegetables, P(trend) = .06). The age-standardized incidence rates of colon cancer for these two intake categories were 54 and 61 per 100000 person-years, respectively. When analyzed by colon site, the pooled multivariable RRs (95% CIs) comparing total fruit and vegetable intakes of 800 or more versus less than 200 g/day were 0.74 (0.57 to 0.95, P(trend) = .02) for distal colon cancers and 1.02 (0.82 to 1.27, P(trend) = .57) for proximal colon cancers. Similar site-specific associations were observed for total fruits and total vegetables. Conclusion Fruit and vegetable intakes were not strongly associated with colon cancer risk overall but may be associated with a lower risk of distal colon cancer.1460-2105 (Electronic)17895473Affiliations of authors: Departments of Nutrition (AK, DJH, ELG, SASW), Biostatistics (DS), and Epidemiology (DJH, DS, JEB, ELG, SMZ, SASW), Harvard School of Public Health, Boston, MA; The Center for Health Research, Loma Linda University School of Medicine, Loma Linda, CA (WLB, GEF); Department of Epidemiology, Maastricht University, Maastricht, The Netherlands (PAvdB); Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA (EEC, MLM); Channing Laboratory (EC, CSF, ELG, DJH) and Division of Preventive Medicine (JEB, SMZ); Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo, NY (JLF); Department of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, NY (JRM); Department of Adult Oncology, Dana-Farber Cancer Institute, Boston, MA (CSF); Department of Food and Chemical Risk Analysis, TNO Quality of Life, Zeist, The Netherlands (RAG); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN (LH, DRJ); Karmanos Cancer Institute/Department of Pathology, Wayne State University School of Medicine, Detroit, MI (IK); Nutritional Epidemiology Unit, National Cancer Institute, Milan, Italy (VK, SS); Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden (SCL, AW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (MFL, AS); Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (ABM); Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland (PP, MJV); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY (TER); Department of Environmental Medicine, Division of Epidemiology, New York, NY (AZJ). 3}?Holl, K. Lundin, E. Kaasila, M. Grankvist, K. Afanasyeva, Y. Hallmans, G. Lehtinen, M. Pukkala, E. Surcel, H. M. Toniolo, P. Zeleniuch-Jacquotte, A. Koskela, P. Lukanova, A.2007Effect of long-term storage on hormone measurements in samples from pregnant women: The experience of the Finnish Maternity Cohort1-7 Acta OncolSep 24PValidity of biobank studies on hormone associated cancers depend on the extent the sample preservation is affecting the hormone measurements. We investigated the effect of long-term storage (up to 22 years) on immunoassay measurements of three groups of hormones and associated proteins: sex-steroids [estradiol, progesterone, testosterone, dihydroepiandrosterone sulphate (DHEAS), sex hormone-binding globulin (SHBG)], pregnancy-specific hormones [human chorionic gonadotropin (hCG), placental growth hormone (pGH), alpha-fetoprotein (AFP)], and insulin-like growth factor (IGF) family hormones exploiting the world largest serum bank, the Finnish Maternity Cohort (FMC). Hormones of interest were analyzed in a random sample of 154 Finnish women in the median age (29.5 years, range 25 to 34 years) of their first pregnancy with serum samples drawn during the first trimester. All hormone measurements were performed using commercial enzyme-linked- or radio-immunoassays. Storage time did not correlate with serum levels of testosterone, DHEAS, hCG, pGH and total IGFBP-1. It had a weak or moderate negative correlation with serum levels of progesterone (Spearman's ranked correlation coefficient (r(s))=-0.36), IGF-I (r(s)=-0.23) and IGF binding protein (BP)-3 (r(s)=-0.38), and weak positive correlation with estradiol (r(s)=0.23), SHBG (r(s)=0.16), AFP (r(s)=0.20) and non-phosphorylated IGF binding protein (BP)-1 (r(s)=0.27). The variation of all hormone levels studied followed the kinetics reported for early pregnancy. Bench-lag time (the time between sample collection and freezing for storage) did not materially affect the serum hormone levels. In conclusion, the stored FMC serum samples can be used to study hormone-disease associations, but close matching for storage time and gestational day are necessary design components of all related biobank studies.0284-186X (Print)17891670[Department of Child and Adolescent Health, National Public Health Institute, Oulu, Finland.}?XHyvarinen, A. Sebastian, A. Pekkanen, J. Larsson, L. Korppi, M. Putus, T. Nevalainen, A.2006Characterizing microbial exposure with ergosterol, 3-hydroxy fatty acids, and viable microbes in house dust: determinants and association with childhood asthma149-57Arch Environ Occup Health614cActinobacteria/ isolation & purification Air Pollution, Indoor/ adverse effects Asthma/ etiology Case-Control Studies Child Child, Preschool Dust/ analysis Environmental Exposure/ adverse effects Ergosterol/ isolation & purification Fatty Acids, Omega-3/ adverse effects/analysis Finland Fungi/ isolation & purification Housing Humans Infant Linear ModelsJul-AugThe authors assessed determinants of ergosterol, 3-OH fatty acids (FAs), and viable microbes in vacuum cleaner dust, and investigated the association between these microbial markers and childhood asthma. The authors studied the homes of 36 children who were new cases of childhood asthma and the homes of 36 controls. Home characteristics explained 34% to 44% of the variation in levels of different microbial groups. Determinants of 3-OH FAs were a lower level of cleanliness, having a fireplace, having livestock, and moisture damage; determinants of viable bacteria were the level of home repair needed and the material used in the building frame of the home. Ergosterol was associated with the presence of livestock and the practice of cleaning rugs outside; viable fungi was associated with the material used in the building frame, visible mold, and the practice of cleaning rugs outside. Exposure to mesophilic actinomycetes was nonsignificantly associated with risk of asthma. The authors concluded that the variation of microbial levels in dust could be explained relatively well by home characteristics, and suggested that exposure to mesophilic actinomycetes may increase the risk of new asthma.1933-8244 (Print)17867568iNational Public Health Institute, Environmental Health Department, Kuopio, Finland. Anne.Hyvarinen@ktl.fia}?nSmura, T. Blomqvist, S. Paananen, A. Vuorinen, T. Sobotova, Z. Bubovica, V. Ivanova, O. Hovi, T. Roivainen, M.2007Enterovirus surveillance reveals proposed new serotypes and provides new insight into enterovirus 5'-untranslated region evolution2520-6 J Gen Virol88Pt 95' Untranslated Regions/ genetics DNA, Viral/chemistry/genetics Enterovirus A, Human/ classification/ genetics/isolation & purification Evolution, Molecular Humans Molecular Sequence Data Phylogeny Rhinovirus/classification/genetics SerotypingSepwHuman enteroviruses are currently grouped into five species Human enterovirus A (HEV-A), HEV-B, HEV-C, HEV-D and Poliovirus. During surveillance for enteroviruses serologically non-typable enterovirus strains were found from acute flaccid paralysis patients and healthy individuals. In this study, we report isolates of recently described enterovirus types EV76 and EV90 of HEV-A species and characterize two new enterovirus type candidates, EV96 and EV97, to species HEV-C and HEV-B, respectively. Analysis of partial 3D regions of EV96 strains revealed sequence divergence consistent with several recombination events between EV96, other HEV-C viruses and polioviruses. Phylogenetic analysis of all available 5'-untranslated region sequences of human entero- and rhinovirus prototype strains and 10 simian enterovirus strains suggested interspecies recombination involving this region.0022-1317 (Print)17698662Enterovirus Laboratory, Department of Viral Diseases and Immunology, National Public Health Institute (KTL), Mannerheimintie 166, FIN-00300 Helsinki, Finland. F}?bSuvisaari, J. M. Saarni, S. I. Perala, J. Suvisaari, J. V. Harkanen, T. Lonnqvist, J. Reunanen, A.2007pMetabolic syndrome among persons with schizophrenia and other psychotic disorders in a general population survey1045-55J Clin Psychiatry687Aged Aged, 80 and over Comorbidity Epidemiologic Studies Female Finland/epidemiology Health Surveys Humans Male Metabolic Syndrome X/ epidemiology Middle Aged Prevalence Psychotic Disorders/ epidemiology Schizophrenia/ epidemiologyJulOBJECTIVE: To determine the prevalence of metabolic syndrome and investigate its components in individuals with psychotic disorders and individuals using antipsychotic medication in a general population study. METHOD: The study population was a nationally representative, 2-stage cluster sample of 8028 persons aged 30 years or over from Finland. The field work for this study took place between September 2000 and June 2001. Laboratory and other measurements related to metabolic syndrome were taken in a health examination. We used the Structured Clinical Interview for DSM-IV (SCID-I) and case note data when making diagnostic assessments according to DSM-IV-TR criteria. Metabolic syndrome was diagnosed according to Adult Treatment Panel III criteria. Subjects who had not fasted the required 4 hours were excluded from the analysis. Prevalences of metabolic syndrome, adjusting for age, sex, and hours of fasting, were estimated by calculating predicted marginals, evaluated at 8 hours of fasting. RESULTS: The prevalence estimates of metabolic syndrome were 36.2% (SE = 7.3), 41.4% (SE = 6.3), and 25.0% (SE = 8.6) among subjects with schizophrenia, other nonaffective psychosis, and affective psychosis, respectively, compared with 30.1% (SE = 0.8) in subjects without psychotic disorders. Subjects with schizophrenia had significantly lower high-density lipoprotein cholesterol and higher tri-glyceride and glucose levels and larger waist circumference, but also lower systolic blood pressure, than the remaining study population (all p values < .05). While all markers of metabolic syndrome were elevated among subjects with other nonaffective psychotic disorders, only the difference in waist circumference was statistically significant (p < .05). The prevalence of metabolic syndrome was significantly elevated among users of high-potency (52.1% [SE = 6.6]; p < .001) but not low-potency (39.0% [SE = 6.9]) and atypical (23.4% [SE = 10.8]) antipsychotic medication. CONCLUSION: Nonaffective psychotic disorders are associated with abdominal obesity and glucose and lipid abnormalities. Regular monitoring and active treatment of metabolic abnormalities are essential in this patient population.1555-2101 (Electronic)17685741}Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland. jaana.suvisaari@ktl.fi}?JHu, G. Jousilahti, P. Nissinen, A. Bidel, S. Antikainen, R. Tuomilehto, J.2007`Coffee consumption and the incidence of antihypertensive drug treatment in Finnish men and women457-64Am J Clin Nutr862Adult Antihypertensive Agents/ therapeutic use Blood Pressure/drug effects Coffee/ metabolism Cross-Sectional Studies Diet Female Finland/epidemiology Humans Hypertension/ drug therapy/ epidemiology Male Middle Aged Proportional Hazards Models Prospective Studies QuestionnairesAugHBACKGROUND: Only 2 prospective studies have previously investigated the association between coffee consumption and incident hypertension, and the findings are equivocal. OBJECTIVE: The objective was to determine the relation between coffee consumption and the incidence of antihypertensive drug treatment. DESIGN: We prospectively followed 24 710 Finnish subjects aged 25-64 y without a history of antihypertensive drug treatment, coronary heart disease, or stroke at baseline. Daily coffee consumption was assessed by questionnaires. RESULTS: During a mean follow-up period of 13.2 y, 2505 participants started antihypertensive drug treatment. The multivariate-adjusted (age, sex, study year, education, leisure-time physical activity, smoking, body mass index, high total cholesterol, history of diabetes, and alcohol, tea, fruit, vegetable, sausage, and bread consumption) hazard ratios for antihypertensive drug treatment associated with the amount of coffee consumed daily (0-1, 2-3, 4-5, 6-7, or >or=8 cups) were 1.00, 1.29 (95% CI: 1.09, 1.54), 1.26 (95% CI: 1.06, 1.49), 1.24 (95% CI: 1.04, 1.48), and 1.14 (95% CI: 0.94, 1.37) (P for trend = 0.024), respectively. This trend became marginally significant after additional adjustment for baseline systolic blood pressure (P for trend = 0.077). CONCLUSIONS: The results indicate that coffee drinking seems to increase the risk of antihypertensive drug treatment, and this risk was higher in subjects with low-to-moderate coffee intakes; however, there was no significantly increased trend in drinkers of approximately 1 cup (100 mL)/d or >or=8 cups/d.0002-9165 (Print)17684219Department of Health Promotion and Chronic Diseases Prevention, National Public Health Institute, Helsinki, Finland. hu.gang@ktl.fi}?MVartiainen, E. Pennanen, M. Haukkala, A. Dijk, F. Lehtovuori, R. De Vries, H.2007YThe effects of a three-year smoking prevention programme in secondary schools in Helsinki249-56Eur J Public Health173kAdolescent Adolescent Behavior Case-Control Studies Educational Status Family Female Finland/epidemiology Health Education/ methods Humans Incidence Male Peer Group Program Evaluation Questionnaires Risk Factors School Health Services/ organization & administration Smoking/epidemiology/ prevention & control Smoking Cessation/ methods/statistics & numerical dataJunBACKGROUND: This study evaluates the effects of a 3-year smoking prevention programme in secondary schools in Helsinki. The study is part of the European Smoking prevention Framework Approach (ESFA), in which Denmark, Finland, the Netherlands, Portugal, Spain and the UK participated. METHODS: A total of 27 secondary schools in Finland participated in the programme (n = 1821). Schools were randomised into experimental (13) and control groups (14). The programme included 14 information lessons about smoking and refusal skills training. The 3-year smoking prevention programme was also integrated into the standard curriculum. The community-element of the programme included parents, parish confirmation camps and dentists. The schools in the experimental group received the prevention programme and the schools in the control group received the standard health education curriculum. RESULTS: Among baseline never smokers (60.8%), the programme had a significant effect on the onset of weekly smoking in the experimental group [OR = 0.63 (0.45-0.90) P = 0.009] when compared with the control group. Being female, doing poorly at school, having parents and best friends who smoke and more pocket money to spend compared with others were associated with an increased likelihood of daily and weekly smoking onset. These predictors did not have an interaction effect with the experimental condition. CONCLUSION: This study shows that a school- and community-based smoking prevention programme can prevent smoking onset among adolescents.1101-1262 (Print)17208954sHealth Promotion and Chronic Disease Prevention, National Public Health Institute, Finland. erkki.vartiainen@ktl.fi k}?VRogacheva, A. Laatikainen, T. Tossavainen, K. Vlasoff, T. Panteleev, V. Vartiainen, E.2007mChanges in cardiovascular risk factors among adolescents from 1995 to 2004 in the Republic of Karelia, Russia257-62Eur J Public Health173-Adolescent Adolescent Behavior Blood Pressure Body Mass Index Cardiovascular Diseases/ epidemiology/etiology Cholesterol/blood Cross-Sectional Studies Female Health Status Indicators Health Surveys Humans Male Prevalence Questionnaires Risk Factors Russia/epidemiology Sex Factors Smoking/epidemiologyJunBACKGROUND: In Russia, cardiovascular mortality is among the highest in the world. Behaviours related to the development of cardiovascular disease are usually adopted in childhood and adolescence. Very little information exists on prevalence and trends of risk factors among Russian youth. This study aims to investigate changes in the prevalence of cardiovascular risk factors among adolescents in the Republic of Karelia, Russia, from 1995 to 2004. METHODS: Cross-sectional surveys on chronic disease risk factors were carried out among 15-year-old adolescents in Pitkaranta region, in the Republic of Karelia. The surveys were conducted in all 10 secondary schools in the Pitkaranta region. All ninth-grade students in 1995 (N = 385, response rate 95%) and in 2004 (N = 395, response rate 85%) were included in the survey samples. RESULTS: Systolic blood pressure decreased statistically significantly among boys (from 119 to 116 mmHg). Diastolic blood pressure decreased statistically significantly among both girls (from 64 to 59 mmHg) and boys (from 62 to 59 mmHg). Total cholesterol increased statistically significantly only among girls (from 3.9 to 4.1 mmol/l). Body mass index did not exhibit any significant changes in both genders. Daily smoking rate doubled statistically significantly among girls from 7% to 15%. CONCLUSION: The study results show changes in the prevalence of cardiovascular disease risk factors among adolescents in the Republic of Karelia occurring over the last decade. Active measures need to be taken to prevent the increase in smoking prevalence, especially among girls, and to avert the unfavourable development of other risk factors in the future.1101-1262 (Print)16998205wDepartment of Epidemiology and Health Promotion, National Public Health Institute, Finland. anastasiya.rogacheva@ktl.fi o}?;Hu, G. Jousilahti, P. Peltonen, M. Bidel, S. Tuomilehto, J.2006xJoint association of coffee consumption and other factors to the risk of type 2 diabetes: a prospective study in Finland1742-9Int J Obes (Lond)30122Adult Aged Alcohol Drinking/epidemiology Body Mass Index Coffee Diabetes Mellitus, Type 2/epidemiology/etiology/ prevention & control Diet/statistics & numerical data Epidemiologic Methods Female Finland/epidemiology Humans Male Middle Aged Motor Activity Obesity/complications/epidemiology Sex Factors TeaDecOBJECTIVe: To examine joint associations of coffee consumption and other factors (including physical activity, obesity and alcohol consumption) with the risk of type 2 diabetes. DESIGN: Prospective follow-up study. SUBJECTS: In all, 10 188 Finnish men and 11 197 women aged 35-74 years without a history of stroke, coronary heart disease or diabetes at baseline. MEASUREMENT: A self-administered questionnaire data on coffee, tea, alcohol and other food consumption, physical activity, smoking, socio-economic factors and medical history, together with measured height, weight and blood pressure using standardized protocol. RESULTS: During a mean follow-up of 13.4 years, there were 964 incident cases of type 2 diabetes. Multivariate-adjusted (age, study year, systolic blood pressure, education, smoking, physical activity, body mass index (BMI) and fruit, vegetable, sausage, bread, alcohol and tea consumption) hazard ratio of type 2 diabetes in participants who drank 0-2, 3-6 and > or =7 cups of coffee were 1.00, 0.77 and 0.66 (P=0.022 for trend) in men, 1.00, 0.71 and 0.52 (P=0.001 for trend) in women, and 1.00, 0.75 and 0.61 (P<0.001 for trend) in men and women combined (adjusted also for sex), respectively. This inverse association was consistent in subjects with any joint levels of physical activity and BMI, and in alcohol drinkers and non-drinkers. Among obese and inactive people, coffee drinking of seven cups or more daily reduced the risk of type 2 diabetes to half. CONCLUSIONS: Coffee drinking was associated with a reduced risk of type 2 diabetes in both men and women, and this association was observed regardless of the levels of physical activity, BMI and alcohol consumption.0307-0565 (Print)16652136tDepartment of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland. hu.gang@ktl.fiPK nA7I/**refs.FRM 0B< !// !HPRIMARYyearIndex 6ByP/) idreference_type text_stylesauthoryear title pages secondary_title volume numbernumber_of_volumessecondary_authorplace_published publishersubsidiary_authoredition keywords type_of_workdate2)  abstractlabelurltertiary_titletertiary_author notes isbn custom_1 custom_2 custom_3 custom_4alternate_titleaccession_number call_number short_title custom_5 custom_6sectionoriginal_publicationH) reprint_editionreviewed_itemauthor_addressimagecaption custom_7 electronic_resource_number link_to_pdf translated_author translated_titlename_of_databasedatabase_providerresearch_notes language access_datelast_modified_date !! 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