1,721,192 research outputs found
A century of trends in adult human height
Full text linkBeing taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3–19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8–144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.peer-reviewe
Repositioning of the global epicentre of non-optimal cholesterol
Full text linkHigh blood cholesterol is typically considered a feature of wealthy western countries. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends ofHDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular risk-changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.This study was funded by a Wellcome Trust (Biomedical Resource &
Multi-User Equipment grant 01506/Z/13/Z) and the British Heart Foundation (Centre of
Research Excellence grant RE/18/4/34215). C.T. was supported by a Wellcome Trust Research
Training Fellowship (203616/Z/16/Z).peer-reviewe
Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure : a pooled analysis of 1018 population-based measurement studies with 88.6 million participants
Full text linkBACKGROUND: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure.METHODS: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20–29 years to 70–79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure.RESULTS: In 2005–16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association.CONCLUSIONS: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups.This work was supported by the Wellcome Trust [101506/Z/13/Z].peer-reviewe
Diminishing benefits of urban living for children and adolescents' growth and development
Full text linkNCD Risk Factor Collaboration (NCD-RisC) Code and Data Sharing
This repository contains code and data for generating estimates of mean height and mean body-mass index (BMI) of children and adolescents aged 5 to 19 years living in rural and urban areas in 200 countries and territories from 1990 to 2020, as reported in the publication "Diminishing benefits of urban living for children and adolescents’ growth and development" [1].
Contents Guide
data/ The list of data sources used in the study, together with input data used in the model from publicly available sources and contact information for other data sources.
model/ R code for the Bayesian hierarchical model used to analyse the data to estimate mean height and mean BMI by country, year, age and rural and urban place of residence. See methods section of publication [1] for details of the statistical methods.
figures/ R code to produce figures as appeared in publication [1].
utils/ Essential covariate files; functions for producing figures.
Contact
For more information about the paper or the NCD Risk Factor Collaboration, please see www.ncdrisc.org or contact [email protected].
Codes for producing publication figures are provided for transparency and in the spirit of scientific collaboration. We will not be able to answer questions about the details of these codes.
Acknowledgements
The shape file of the maps was based on Natural Earth [2].
Population data used in this analysis were obtained from the 2019 revision to the United Nations' World Population Prospects [3].
Data on percent national population living in urbanisation areas were obtained from the 2018 revision to the United Nations' World Urbanization Prospects [4].
References
NCD Risk Factor Collaboration (NCD-RisC). Diminishing benefits of urban living for children and adolescents’ growth and development. Nature, 2023.
https://www.naturalearthdata.com/
United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Prospects 2019: Highlights (ST/ESA/SER.A/423)
United Nations, Department of Economic and Social Affairs, Population Division (2018). World Urbanization Prospects: The 2018 Revision, Online Editio
Global variation in diabetes diagnosis and prevalence based on fasting glucose and haemoglobin A1c
No full textNCD Risk Factor Collaboration (NCD-RisC) Code and Data Sharing
This repository will contain code and data used in the paper "Global variation in diabetes diagnosis and prevalence based on fasting glucose and haemoglobin A1c" [1].
Contents Guide
NCD_RisC_Nature_Medicine_2023_input_data.xlsx The list of data sources used in the study, together with contact information for data access.
multi-bugs-logbin-model.odc BUGS model code for log-binomial regressions to examine what individual and study level factors were associated with whether participants with screen-detected diabetes were identified by elevated FPG, elevated HbA1c or elevated levels of both. See methods section of the publication [1] for details.
Contact
For more information about the paper or the NCD Risk Factor Collaboration, please see www.ncdrisc.org or contact [email protected].
Reference
NCD Risk Factor Collaboration (NCD-RisC). Global variation in diabetes diagnosis and prevalence based on fasting glucose and haemoglobin A1c. Nature Medicine. 2023.The research was additionally funded by UKRI Research England Policy Support and US Centers for Disease Control and Prevention
Risk Factors for Thyroid Dysfunction in Pregnancy: An Individual Participant Data Meta-Analysis
No full textCopyright 2024, © American Thyroid Association; Published by Mary Ann Liebert, Inc.Background: International guidelines recommend targeted screening to identify gestational thyroid dysfunction. However, currently used risk factors have questionable discriminative ability. We quantified the risk for thyroid function test abnormalities for a subset of risk factors currently used in international guidelines. Methods: We included prospective cohort studies with data on gestational maternal thyroid function and potential risk factors (maternal age, body mass index [BMI], parity, smoking status, pregnancy through in vitro fertilization, twin pregnancy, gestational age, maternal education, and thyroid peroxidase antibody [TPOAb] or thyroglobulin antibody [TgAb] positivity). Exclusion criteria were pre-existing thyroid disease and use of thyroid interfering medication. We analyzed individual participant data using mixed-effects regression models. Primary outcomes were overt and subclinical hypothyroidism and a treatment indication (defined as overt hypothyroidism, subclinical hypothyroidism with thyrotropin >10 mU/L, or subclinical hypothyroidism with TPOAb positivity). Results: The study population comprised 65,559 participants in 25 cohorts. The screening rate in cohorts using risk factors currently recommended (age >30 years, parity ≥2, BMI ≥40) was 58%, with a detection rate for overt and subclinical hypothyroidism of 59%. The absolute risk for overt or subclinical hypothyroidism varied <2% over the full range of age and BMI and for any parity. Receiver operating characteristic curves, fitted using maternal age, BMI, smoking status, parity, and gestational age at blood sampling as explanatory variables, yielded areas under the curve ranging from 0.58 to 0.63 for the primary outcomes. TPOAbs/TgAbs positivity was associated with overt hypothyroidism (approximate risk for antibody negativity 0.1%, isolated TgAb positivity 2.4%, isolated TPOAb positivity 3.8%, combined antibody positivity 7.0%; p < 0.001), subclinical hypothyroidism (risk for antibody negativity 2.2%, isolated TgAb positivity 8.1%, isolated TPOAb positivity 14.2%, combined antibody positivity 20.0%; p < 0.001) and a treatment indication (risk for antibody negativity 0.2%, isolated TgAb positivity 2.2%, isolated TPOAb positivity 3.0%, and combined antibody positivity 5.1%; p < 0.001). Twin pregnancy was associated with a higher risk of overt hyperthyroidism (5.6% vs. 0.7%; p < 0.001). Conclusions: The risk factors assessed in this study had poor predictive ability for detecting thyroid function test abnormalities, questioning their clinical usability for targeted screening. As expected, TPOAb positivity (used as a benchmark) was a relevant risk factor for (subclinical) hypothyroidism. These results provide insights into different risk factors for gestational thyroid dysfunction.National Research and Development Agency of Chile, National Doctoral Scholarshi
Diminishing benefits of urban living for children and adolescents’ growth and development
Full text linkA list of authors and their affiliations appears online.Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.peer-reviewe
Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants
Full text linkNCD Risk Factor Collaboration (NCD-RisC): National Institute of Health Doutor Ricardo Jorge, Portugal (Baltazar Nunes and Marta Barreto)Erratum in: Department of Error. Lancet. 2022 Feb 5;399(10324):520. doi: 10.1016/S0140-6736(22)00061-7. NCD Risk Factor Collaboration (NCD-RisC). "In this Article, Marialaura Bonaccio, Maria Benedetta Donati, and Francesco Gianfagna have been added to the NCD Risk Factor Collaboration list, and Steinar Krokstad's name has been corrected. These corrections have been made to the online version as of Feb 3, 2022"Background: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories.
Methods: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age.
Findings: The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran.
Interpretation: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings.Evidence before this study: We searched MEDLINE (via PubMed) for articles published from inception to Jan 15, 2021, using the search terms ((hypertension[Title] AND (((medication OR treatment) AND control) OR aware*) AND “blood pressure”) OR (cardiovascular[Title] AND risk factor*[Title] AND “blood pressure” AND (((medication OR treatment) AND control) OR aware*))) AND (trend* OR global OR worldwide) NOT patient*[Title]. No language restrictions were applied. We found a few multi-country studies that reported hypertension prevalence, treatment, and control. These studies used up to 135 data sources that had sampled from national or sub-national populations or data from small communities. Few multi-country studies reported trends over time. The largest of these analyses covered snapshots in 2000 and 2010 and grouped countries into high income versus low income and middle income. We also found several studies that analysed trends in individual countries. To our knowledge, there is no study on long-term trends in, nor the contemporary levels of, hypertension prevalence, detection, treatment, and control that covers the entire world.
Added value of this study: To our knowledge, this study is the first comprehensive global analysis of trends in hypertension prevalence, detection, treatment, and control that covers all countries worldwide. The data used in the study were from 184 countries, together covering 99% of the global population, and were subject to rigorous inclusion and exclusion criteria. Data were analysed using a standardised protocol and were pooled using a statistical model designed to incorporate how hypertension and its care and control vary in relation to age, geography, and time.
Implications of all the available evidence: Hypertension care—including detection, treatment, and control—varies substantially worldwide and even within the same region of the world. Sub-Saharan Africa, Oceania, and south Asia have the lowest rates of detection, treatment, and control and many countries in these regions have seen little improvement in these outcomes over the past 30 years. The large improvements observed in some upper-middle-income and recently high-income countries show that the expansion of universal health coverage and primary care can be leveraged to enhance hypertension care and reduce the health burden of this condition.World Health Organizationinfo:eu-repo/semantics/publishedVersio
Lobectomy in patients with differentiated thyroid cancer: experience of a Chilean tertiary center
No full text© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.Purpose: Thyroid lobectomy (TL) is an appropriate treatment for up to 4 cm intrathyroidal differentiated thyroid cancer (DTC). There is scarce data regarding TL outside first-world centers. Our aim is to report a cohort of patients with DTC treated with TL in Chile. Methods: We included DTC patients treated with TL, followed for at least 6 months, characterized their clinicopathological features and classified their risk of recurrence and response to treatment. Results: Eighty-two patients followed for a median of 2.3 years (0.5–7.0). Seventy-three (89%) patients had papillary, 8 (9.8%) follicular and 1 (1.2%) high-grade DTC. The risk of recurrence was low in 56 (68.3%) and intermediate in 26 (31.7%). Eight (9.8%) patients required early completion thyroidectomy and radioiodine. At last follow-up, 52 (70.3%) had excellent, 19 (25.7%) had indeterminate, and 1 (1.4%) had structural incomplete response. Conclusion: In a developing country, TL is an adequate option for appropriately selected DTC patients.National Research and Development Agency of Chile, National Doctoral Scholarshi
Diseño de una escala ecográfica predictora de malignidad en nódulos tiroideos: Comunicación preliminar
No full textBackground: Thyroid nodules are common and associated to a low risk of malignancy. Their clinical assessment usually includes a fine neddle aspiration biopsy (FNAB). Aim To identify ultrasonographic characteristics associated to papillary thyroid carcinoma (PTC) and generate a score that predicts the risk of PTC. Material and methods: Retrospective review of all fine needle aspiration biopsies of the thyroid performed in a lapse of two years. Biopsies that were conclusive for PTC were selected and compared with an equal amount of randomly selected biopsies that disclosed a benign diagnosis. Results: One hundred twenty two biopsies of a total of 1,498 were conclusive for PTC. Univariate analysis showed associations with PTC for the presence of micro-calcifications (Odds ratio (OR) 49.2: 95% confidence intervals (CI) 18.7-140.9), solid predominance (OR 25.1; 95% CI 6-220), hypoechogenicity (OR 23.5, 95% CI 6.5-122.6), irregular borders (OR 17, 95% CI 7.2-42.9), lymph node involvement (OR 12.3, 95% CI2.7-112), central vascularization (OR 12.2, 95% CI 4.8-33.3), local invasion and hyperechogenicity (OR 0.2; CI95% CI 0.03-0.6). Multivariate analysis disclosed microcalcifications (OR 28.1; CI 95% 8.9-89), hypoechogenicity (OR 9.4; 95% CI 1.5-59.5) and irregular borders (OR 4.7; CI 95% 1.5-15) as the variables independently associated with the presence of PTC. The prevalence of PTC in the presence of the three variables was 97.6% (Likelihood ratio (LR) 45) and 5.4% in their absence (LR 0.06). Conclusions: This scale predicts the presence or absence of PTC using simple ultrasound characteristics
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