Biomedical subjects

A Aromaa

Publications and source records attributed to A Aromaa.

At least 73 records · Page 4Linked to original sources

PubMed1995

Body iron stores, dietary iron intake and coronary heart disease mortality.

OBJECTIVES: To assess whether increased body iron stores and dietary iron intake are associated with an increased risk of coronary heart disease mortality. DESIGN: A prospective population study with a mean mortality follow-up time of 14 years. SETTING: Participants attending a health screening examination carried out in several localities in Finland. SUBJECTS: All 6086 men and 6102 women aged from 45 to 64 years at the baseline examination without known heart disease, who had had serum iron and total iron binding capacity (TIBC) assessed. In a random fifth of these people, dietary iron intake was assessed by a dietary history. INTERVENTIONS: The study was observational without any interventions. MAIN OUTCOME MEASURES: Mortality from coronary heart disease. RESULTS: Altogether, 739 of the men and 245 of the women died from coronary heart disease. No relationship between TIBC and coronary mortality was observed in the men; in the women, an inverse although not significant association was found. Transferrin saturation was inversely but not significantly associated with coronary mortality in men; in women, the relationship was U-formed with a higher mortality at both the lower and higher ends of the distribution. Adjustment for other risk factors did not alter the results. No association was found with dietary iron intake and coronary mortality. CONCLUSIONS: The results do not corroborate earlier findings that excess body iron stores and increased iron intake are associated with an elevated risk of coronary heart disease.

Coronary Disease↗

PubMed1995

Rheumatoid factor, chronic arthritis and mortality.

OBJECTIVE: To investigate chronic arthritis and rheumatoid factor (RF) for their prediction of premature total and cardiovascular mortality. METHODS: In 1978-80, a representative population sample of 8000 Finns aged 30 or more was invited to participate in a comprehensive health examination; 90% complied. Arthritis was diagnosed on the basis of medical history, symptoms, and physical examination. Serum RF was determined by the sensitised sheep cell agglutination test. RESULTS: By the end of 1992 1597 of the subjects had died from all causes, including 876 deaths from cardiovascular diseases. When adjusted for age, gender and smoking, the relative risk of persons with RF positive arthritis dying from any cause was 1.61 (95% confidence interval (CI) 1.03 to 2.51); RF negative non-erosive arthritis was not associated with mortality (relative risk 1.03; 95% CI 0.72 to 1.49). In the absence of arthritis, 'false positive' RF titres > or = 128 predicted cardiovascular deaths with a relative risk of 1.74 (95% CI 1.06 to 2.86). CONCLUSION: Both RF positive arthritis and false positive RF reactions predict mortality, but through different disease patterns.

Adult↗

PubMed1995

Prevalence and risk factors of varicose veins in lower extremities: mini-Finland health survey.

OBJECTIVE: To study the prevalence and risk factors of clinically important varicose veins in the lower extremities. DESIGN: Cross-sectional study with self-administered questionnaire. SETTING: A national health examination survey, Finland. SUBJECTS: 8000 people from 40 geographical areas representing the adult population aged 30 years and over. RESULTS: The prevalence of varicose veins diagnosed by a physician was 25% in women and 7% in men. Twenty-nine per cent of the men and 53% of the women with diagnosed varicose veins had been treated surgically. Age, height, body mass index (weight/height2), standing at work, and the number of births were expected risk factors associated with varicosities. Unexpectedly, signs of osteoarthrosis were positively, and diabetes negatively, associated with varicose veins. Urban dwelling and high income correlated positively with varicose veins treated surgically in women. CONCLUSIONS: Varicose veins in the lower extremities are common, and demand considerable health service resources. The aetiology of varicose veins is still incompletely understood and more research is needed to develop possible preventive measures.

Adult↗

PubMed1994

Intake of fried meat and risk of cancer: a follow-up study in Finland.

It has been suggested that mutagens in fried meat may be involved in the cancer process. Therefore the relationships between intake of fried meat and subsequent risk of cancers at different sites were studied among 9,990 Finnish men and women, 15-99 years of age and initially free of cancer. The baseline study was carried out in 1966-1972, and cases of cancer were identified through data linkage with the Finnish Cancer Registry. During a 24-year follow-up, 853 cancer cases were diagnosed. The intake of fried meat was estimated from a dietary history interview covering the total diet of the participants during the previous year. There was a positive association between fried meat intake and the risk of female-hormone-related cancers, i.e., cancer of the breast, endometrium and ovary combined. The relative risk of these cancers combined between persons in the highest and lowest tertiles of daily intake of fried meat adjusted for age, personal characteristics and intake of other main food groups was 1.77 (95% confidence interval = 1.11-2.84). Pancreatic and nervous system cancers also presented non-significant suggestive associations. No associations were observed with respect to other single cancer sites studied or to all sites of cancer combined. Further epidemiological efforts are needed to ascertain the potential link between fried-food mutagens and cancer risk.

Adolescent↗

PubMed1994

Serum concentrations of prostate specific antigen and its complex with alpha 1-antichymotrypsin before diagnosis of prostate cancer.

Prostate cancer can be detected at an early, potentially curable stage by screening based on digital rectal examination and serum prostate specific antigen (PSA). The value of screening appears doubtful, based on high 10-year survival rates in selected cases of early prostate cancer, but this follow-up time may be insufficient. By linking the information on 21172 men who took part in a screening examination in Finland, 1968-73, with data from the Finnish Cancer Registry, 44 cases of prostate cancer diagnosed up to 1980 were identified. Serum samples from cancer cases and from 74 controls matched for age and time of sampling were assayed for PSA and its complex with alpha 1-antichymotrypsin (PSA-ACT). With a cut-off for PSA of 2.5 micrograms/L giving 92% specificity, 95% of the cancers developing within the first 5 years, and 52% developing in 6-10 years tested positive. As a potential screening test with a 5-year interval for men under 65, the sensitivity would be 92% and specificity 97%. The ratio of PSA-ACT to total PSA was lower in controls than in patients with cancer. Using this ratio, we could eliminate half of the false-positive results in the range 2.5-25 micrograms/L without loss of sensitivity. Cancer was typically diagnosed 5-10 years after PSA exceeded 2.5 micrograms/L, and the median survival after diagnosis was 3.6 years. 10-year survival after drawing the sample was 71% in cancer cases with a PSA concentration less than 4 micrograms/L and 48% in those with higher concentrations. The corresponding figures at 15 years were 53% and 27%, and at 20 years 43% and 18%, respectively. These results suggest it is advisable to confine screening for prostate cancer to men with a life expectancy of clearly more than 10 years--ie, younger men, who have the greatest chance to benefit from early detection.

Age Distribution↗

PubMed1994

Antioxidant vitamin intake and coronary mortality in a longitudinal population study.

Oxidation of lipoproteins is hypothesized to promote atherosclerosis and, thus, a high intake of antioxidant nutrients may protect against coronary heart disease. The relation between the intakes of dietary carotene, vitamin C, and vitamin E and the subsequent coronary mortality was studied in a cohort of 5,133 Finnish men and women aged 30-69 years and initially free from heart disease. Food consumption was estimated by the dietary history method covering the total habitual diet during the previous year. Altogether, 244 new fatal coronary heart disease cases occurred during a mean follow-up of 14 years beginning in 1966-1972. An inverse association was observed between dietary vitamin E intake and coronary mortality in both men and women with relative risks of 0.68 (p for trend = 0.01) and 0.35 (p for trend < 0.01), respectively, between the highest and lowest tertiles of the intake. Similar associations were observed for the dietary intake of vitamin C and carotenoids among women and for the intake of important food sources of these micronutrients, i.e., of vegetables and fruits, among both men and women. The associations were not attributable to confounding by major nondietary risk factors of coronary heart disease, i.e., age, smoking, serum cholesterol, hypertension, or relative weight. The results support the hypothesis that antioxidant vitamins protect against coronary heart disease, but it cannot be excluded that foods rich in these micronutrients also contain other constituents that provide the protection.

Adult↗

PubMed1994

Body iron stores and risk of cancer.

A high level of available tissue iron may increase the risk of cancer through its contribution to the production of free oxygen radicals. Serum iron, total iron-binding capacity (TIBC) and transferrin saturation levels were studied for their prediction of different cancers in a cohort of 41,276 men and women aged 20-74 years and initially free from cancer. During a mean follow-up of 14 years, 2,469 primary cancer cases were diagnosed. Excess risks of colorectal and lung cancers were found in subjects with transferrin saturation level exceeding 60%. The relative risks, adjusted for age, sex and smoking, were 3.04 for colorectal cancer and 1.51 for lung cancer, in comparison with subjects having lower levels. The risk of lung cancer was inversely related to serum TIBC, with a relative risk between the highest and lowest quartiles of 0.69 for men and 0.19 for women. For the risk of stomach cancer, we detected inverse relationships with serum iron and with transferrin saturation and a positive relationship with TIBC, but these associations weakened when the cancer cases occurring during the 5 first years of follow-up were excluded. High iron stores may increase the risk of colorectal cancer, whereas low iron stores may be an early sign of occult stomach cancer.

Adolescent↗

PubMed1994

Depression and cardiovascular diseases.

We first review the associations between depression and cardiovascular diseases (CVDs). Then we examine them in the nationally representative Mini-Finland Health Survey, which covers 8,000 persons. Chronic somatic diseases and mental disorders were diagnosed using standardized methods. Cross-sectionally, CVDs and neurotic depression were associated both before and after adjustment for covariates. The strongest associations were observed in the case of severe CVDs. During a 6.6 year follow-up, the risk of CVD death and coronary death was elevated in depressed persons both with and without CVDs at entry. Much of the cross-sectional association is probably due to depression caused by CVDs. The outcome of CVD may be poorer in depressed persons. The hypothesis that depression is a cause of CVDs requires further study.

Adult↗

PubMed1994

Serum antioxidants and risk of rheumatoid arthritis.

OBJECTIVES: Oxygen free radicals have been implicated as mediators of tissue damage in patients with rheumatoid arthritis (RA). Thus it is possible that several micronutrients acting as antioxidants and free radical scavengers provide protection against RA. Serum alpha-tocopherol, beta-carotene, and selenium were studied for their associations with the risk of RA. METHODS: A case control study was nested within a Finnish cohort of 1419 adult men and women. During a median follow up of 20 years, 14 individuals initially free of arthritis developed RA. Two controls per each incident case were individually matched for sex, age, and municipality. Serum alpha-tocopherol, beta-carotene and selenium concentrations were measured from stored serum samples. An antioxidant index was calculated as the product of the molar concentrations of these three micronutrients. RESULTS: Elevated risks of RA were observed at low levels of alpha-tocopherol, beta-carotene and selenium, but none of the associations were statistically significant. A significant association, however, was observed with a low antioxidant index (p for trend = 0.03), the relative risk of RA between the lowest tertile and the higher tertiles of its distribution being 8.3 (95% confidence interval 1.0-71.0). CONCLUSIONS: The results of the present study are in line with the hypothesis that a low antioxidant level is a risk factor for RA.

Adult↗

PubMed1994

Antioxidant vitamins in the diet: relationships with other personal characteristics in Finland.

STUDY OBJECTIVE: The study aimed to reveal associations between dietary antioxidant vitamins and other personal characteristics. DESIGN: Population based, cross sectional survey. SETTING: Twenty seven rural, industrial, and semiurban communities in six different regions of Finland. PARTICIPANTS: Subjects included 5304 men and 4750 women aged 15 years or older, who were interviewed about their dietary habits at the baseline study of the Finnish Mobile Clinic Health Examination Survey, 1967-72. MAIN RESULTS: Intakes of carotenoids and vitamins A, E, and C were estimated from dietary history interviews covering the subjects' food consumption in the preceding year. In older age groups intakes of all the vitamins studied were low. Occupation had a profound effect on dietary antioxidant vitamins: intakes were highest in white collar workers and lowest in farmers; those classified as service workers, industrial workers, or housewives came in between. Current smoking was inversely associated with dietary carotenoids and vitamin C, especially in men. The vitamin intakes of ex-smokers were equal to or even slightly higher than those of never smokers. Married men had higher intakes of carotenoids and vitamin C than men living alone. Body mass index was not an important determinant of the intake of antioxidant vitamins. CONCLUSIONS: The associations of dietary antioxidant vitamins with sociodemographic characteristics and smoking were strong enough to exert a confounding or modifying effect in studies on diet and diseases.

Adolescent↗

PubMed1994

Tumour markers and screening for gastrointestinal cancer: a follow up study in Finland.

BACKGROUND: Screening for gastrointestinal cancer is based mainly on a barium contrast x ray method and on identification of occult blood in stools. The methods are relatively expensive, not always acceptable to the participants, and there is only limited evidence of their effectiveness in reducing the mortality from gastrointestinal cancer. OBJECTIVE: To investigate the validity of several tumour markers as a screening test for stomach cancer and for colorectal cancer. METHODS: A registry of 36,265 serum samples drawn during 1968-72 was linked to the cancer registry. Follow up was during 1968-80 when 94 stomach cancers and 95 colorectal cancers were identified. One to two matched case-control design was applied, and the concentrations of CEA, CA 19-9, CA 50, and TATI were assessed. RESULTS: The mean values of the markers between the cases and the controls were almost the same for the total material. Case-control differences were found between the 11 sets with an interval of less than one year between drawing the sample and diagnosis of the cancer. The highest validity was found in CEA for colorectal cancer (specificity 91%; sensitivity 64%) and in CA 19-9 for stomach cancer (specificity 74%; sensitivity 73%). CONCLUSION: CEA, CA 19-9, CA 50, or TATI are not valid screening tests. Case-control differences were found with a potential one year screening interval, but they were not large enough for sufficient validity.

Adolescent↗

PubMed1994

The risk of endometrial cancer in diabetic and hypertensive patients: a nationwide record-linkage study in Finland.

The risk of endometrial cancer (EC) in diabetics and hypertensives was studied as part of the planning of a trial of the efficacy of screening for EC. Two nationwide registers, the Finnish Cancer Registry and the Social Insurance Institution's (SII) population register, were linked to obtain 1715 EC patients diagnosed during 1970-1974 with individually matched controls. Data on the right for state-reimbursed medication for diabetes or hypertension prior to the case's cancer diagnosis was obtained from the SII's population register and was used as indicator of the diseases in question. Diabetes was a strong and hypertension a relatively weak risk factor for EC. The relative risk for the association of EC with diabetes was 4.1 (95% confidence limits 2.7 and 6.9) and with hypertension 1.6 (95% confidence limits 1.3 and 2.1). Diabetics and hypertensives are identifiable risk groups for EC in Finland. Diabetics form a suitable target population for a trial of the efficacy of screening for EC.

Adult↗

PubMed1993

Risk factors for injurious falls leading to hospitalization or death in a cohort of 19,500 adults.

Falls are the most common cause of nonfatal injuries and a major cause of injury death. In order to identify risk factors for injuries from falls, 19,518 persons aged 20-92 years from four regions of Finland were examined and followed up from between 1973 and 1977 to 1984 for 8 to 11 years by identifying hospital admissions or deaths due to fall injuries. During 187,405 person-years, 628 injuries from falls were documented. The risk for injuries from falls was significantly and independently of other factors associated with alcohol intake in all age and sex groups. After adjustment for all the other risk determinants, the relative risks (RR) (95% confidence intervals (CI)) in persons with monthly ethanol intake of 100-499 g, 500-999 g, and > or = 1,000 g were 1.43 (1.13-1.82), 2.32 (1.71-3.17), and 3.05 (2.05-4.55), respectively, compared with abstainers. Body mass index (kg/m2) > or = 30 was associated with an increased risk among women aged < 45 years (RR = 2.8, 95% CI 1.28-5.89), whereas in persons aged > or = 65 years it seemed to be a protective factor both among men (RR = 0.3, 95% CI 0.06-1.19) and women (RR = 0.5, 95% CI 0.30-0.76). Also single marital status, smoking, heavy physical activity during leisure time, use of psychopharmacologic agents, diabetes mellitus, and cardiovascular diseases other than stroke were found to carry independent predictive significance in at least one subgroup of sex and age. In conclusion, alcohol consumption, relative weight, and use of psychopharmacologic agents were seen to be the most relevant risk determinants. Intervention trials based on the predictive factors and on high-risk groups are needed.

Accidental Falls↗

PubMed1993

Serum tumor markers CEA, CA 50, TATI, and NSE in lung cancer screening.

BACKGROUND: There are no effective means for screening for lung cancer, so the authors assessed the utility of four lung cancer tumor makers for screening. METHODS: A case-control study, nested in a cohort study based on the linkage of records of health survey examinees with Finnish Cancer Registry records, was used to test the validity of tumor markers carcinoembryonic antigen (CEA), tumor-associated trypsin inhibitor (TATI), neuron-specific enolase (NSE), and CA 50 in lung cancer screening. Ten years after health examinations, record linkage indicated that 187 men had lung cancer; 344 control subjects, matched for age, sex, and municipality were drawn from the same records. RESULTS: The data allowed assessment of the sensitivity of the marker assays at a 95% specificity level, which was highest for CEA (17% at a concentration level of 5.3 micrograms/l). Logistic discrimination analysis indicated that of the other markers, only TATI, when used in combination, improved the discriminatory power of CEA. CEA and TATI levels correlated significantly with smoking. They also showed a significant gradient toward increasing risk of lung cancer from the lowest to the highest quintiles of marker levels (for CEA, crude relative risk between the highest and lowest quintiles, 8.6). The gradient also was evident in the subgroup whose cancer had been diagnosed more than 5 years after serum specimen collection. The trend persisted, although relative risk was halved after adjustment for smoking. CONCLUSIONS: The markers do not seem to be useful tools for lung cancer screening. However, CEA and TATI levels seem to give information on cancer risk long before the clinical cancer stage, as the quintile-based analyses of marker levels indicate.

Antigens, Tumor-Associated, Carbohydrate↗

PubMed1993

Serum antibodies and subsequent cervical neoplasms: a prospective study with 12 years of follow-up.

Approximately 40,000 blood samples drawn in 1968-1972 by the Social Insurance Institution's mobile clinic in Finland have been stored. Linking cancer incidence data obtained from the Finnish Cancer Registry with this material yielded 32 cases of cervical cancer diagnosed after drawing of the blood sample. These 32 individuals and 64 matched controls were analyzed for serum antibodies indicative of past infection with Chlamydia trachomatis, Neisseria gonorrhoeae, cytomegalovirus, Epstein-Barr virus, and herpes simplex virus type 2. After adjustment for smoking and other sexually transmitted diseases, antibodies to C. trachomatis showed the strongest association with cervical cancer (odds ratio = 5.0 (95% confidence interval 1.6-15.7)), but the numbers were too small for drawing conclusions as to the sexually transmitted diseases with which cervical cancer is most specifically associated.

Adolescent↗

PubMed1993

Reliability and validity of interview data on chronic diseases. The Mini-Finland Health Survey.

The Mini-Finland Health Survey was designed to obtain a comprehensive picture of health and of the need for care in Finnish adults, and to develop methods for monitoring health in the population as a whole. Out of a nationally representative sample of 8000 people aged 30 or over, 7217 (90%) were both interviewed at home by local public health nurses using simple open-ended questions and, independently of this interview, subsequently examined in a two-phase health examination. The estimate of chronic morbidity based on the health interview (56%) was close to the prevalence of definite somatic diseases diagnosed in the health examination (54%), and the agreement between the two methods was moderate (kappa = 0.53). The estimated prevalence of cardiovascular diseases was the same (23%) in the health interview and in the health examination; the agreement was substantial (kappa = 0.74). The prevalence of respiratory and musculoskeletal diseases and mental disorders was underestimated in the interview by 52, 25 and 78%, respectively; the agreement between results of the two methods was relatively low (kappa = 0.43, 0.38 and 0.30, respectively). These results suggest that both the health examination and the health interview methods, as used in this survey, have useful applications in monitoring the population's health.

Adult↗

PubMed1993

Musculoskeletal disorders as determinants of disability in Finns aged 30 years or more.

The relationship between disability and various musculoskeletal disorders was investigated in 7217 men and women representative of the Finnish population aged 30 years or more. They participated in the Mini-Finland Health Survey and were first screened by interview and questionnaire about limitations in daily activities. The outcome variables were reduced working capacity, an occasional need for assistance in daily activities, and a regular need for assistance in daily activities. In a two-phase medical examination, all cases fulfilling predetermined diagnostic criteria of musculoskeletal, cardiovascular, respiratory and mental disorders and diabetes were recorded independently. In multivariate logistic regression analyses, inflammatory arthritis was the strongest determinant of all forms of disability. Osteoarthritis, especially in the hip, was a strong determinant of both occasional and regular need for assistance, and chronic low back pain was a strong determinant of reduced working capacity and occasional need for assistance among those aged 30-64 years. Other musculoskeletal disorders also determined the prevalence disability, but these relationships were reduced by taking comorbidity into account. A low level of education and a low (less than 20 kg/m2) or very high (at least 35 kg/m2) body mass index represented independent determinants of all forms of disability, and a history of physically strenuous work an independent determinant of reduced working capacity, when disabling illness was adjusted for. The proportion of all forms of disability attributable to musculoskeletal disorders, in models including, age, sex, other disabling illness and significant non-medical determinants of disability, was close to 20%. The disorders with the highest community impact were chronic low back pain among those aged 30-64, osteoarthritis of the hips and knees and inflammatory arthritis.

Adult↗

PubMed1993

Cancer incidence among 78,000 asthmatic patients.

The risk of cancer was evaluated among 77,952 asthma patients with bronchial asthma. The series was obtained through linkage of two registers: the Finnish Social Insurance Institution's file of asthma patients and the Finnish Cancer Registry. There was a significant excess risk of lung cancer in both sexes, the standardized incidence ratio (SIR) being 1.32 among men and 1.66 among women. In women, the risk of cancer of the rectum was significantly increased (SIR 1.42), whereas the risks of cancer of the corpus uteri and multiple myeloma were lower than expected (SIR 0.76 and 0.53, respectively). In men, the incidence of cancer of the larynx was significantly reduced (SIR 0.63) and that of the bladder increased (SIR 1.25). When both sexes were combined, cancers of the colon (SIR 1.17) and rectum (SIR 1.28) also showed a significantly elevated risk. A reduction in risk was seen in stomach cancer (SIR 0.88) and lymphatic leukaemia (SIR 0.55). The increased lung cancer risk may be due to local inflammatory changes. It is possible that differences in the immune system, e.g. natural killer cell activity, explain some of the reduced cancer risks.

Adult↗