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Visuri, I., Eriksson, C., Mårdberg, E., Grip, O., Gustavsson, A., Hjortswang, H., . . . Halfvarson, J. (2019). Anti-TNF agent drug survival in patients with IBD: real-world comparisons of individual anti-TNF agents based on the Swedish National Quality Registry for IBD (SWIBREG). Journal of Crohn's & Colitis, 13(Suppl. 1), S443-S444
Open this publication in new window or tab >>Anti-TNF agent drug survival in patients with IBD: real-world comparisons of individual anti-TNF agents based on the Swedish National Quality Registry for IBD (SWIBREG)
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2019 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 13, no Suppl. 1, p. S443-S444Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2019
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-73336 (URN)10.1093/ecco-jcc/jjy222.773 (DOI)000460544502205 ()
Available from: 2019-03-26 Created: 2019-03-26 Last updated: 2019-03-26Bibliographically approved
Smirnova, J., von Kobyletzki, L., Lindberg, M., Svensson, Å., Langan, S. M. & Montgomery, S. (2019). Atopic dermatitis, educational attainment and psychological functioning: a national cohort study. British Journal of Dermatology, 180(3), 559-564
Open this publication in new window or tab >>Atopic dermatitis, educational attainment and psychological functioning: a national cohort study
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2019 (English)In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, Vol. 180, no 3, p. 559-564Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Atopic dermatitis (AD) might adversely affect academic performance, possibly through influences on psychological functioning such as stress resilience.

OBJECTIVES: To investigate the association of atopic dermatitis with stress resilience, cognitive function and educational attainment.

METHODS: We used data from a national cohort of men who underwent a military conscription examination at ages 17 to 20 years in Sweden between 1969 and 1976. All potential conscripts met a physician who assessed current or previous history of AD. Stress resilience was measured by a psychologist using a semi-structured interview. The conscription assessment included a written cognitive function test. Highest level of achieved education was obtained through record linkage.

RESULTS: The study population included 234 715 men, 1 673 (0·7%) had an AD diagnosis. AD was associated with a greater risk of low stress resilience (adjusted relative risk ratio (RRR) 1·60; 95% confidence interval 1·38 to 1·86). AD was associated with higher cognitive function (b coefficient 0·15; 0·05 to 0·24) and higher educational level (RRR 1·29; 1·13 to 1·47) but adjustment for socioeconomic characteristics of the family of origin attenuated the magnitude of the associations and eliminated statistical significance (b coefficient 0·06; -0·03 to 0·15) and (RRR 1·16; 1·00 to 1·35).

CONCLUSIONS: Swedish males with AD had lower stress resilience in late adolescence but did not have lower cognitive function or poorer educational attainment. The lower stress resilience associated with AD is consistent with an increased risk of possible long-term adverse health outcomes.

Place, publisher, year, edition, pages
Blackwell Science Ltd., 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology Dermatology and Venereal Diseases
Identifiers
urn:nbn:se:oru:diva-69903 (URN)10.1111/bjd.17330 (DOI)000460701000035 ()30339272 (PubMedID)2-s2.0-85058052817 (Scopus ID)
Note

Funding Agencies:

U.K. Economic and Social Research Council (ESRC)  RES-596-28-0001  ES/JO19119/1 

Wellcome Senior Clinical Fellowship  205039/Z/16/Z 

Centre for Clinical Research, Varmland County Council  

Available from: 2018-11-06 Created: 2018-11-06 Last updated: 2019-06-19Bibliographically approved
Cheng, H., Montgomery, S., Green, A. & Furnham, A. (2019). Biomedical, psychological, environmental and behavioural factors associated with adult obesity in a nationally representative sample. Journal of Public Health, Article ID fdz009.
Open this publication in new window or tab >>Biomedical, psychological, environmental and behavioural factors associated with adult obesity in a nationally representative sample
2019 (English)In: Journal of Public Health, ISSN 1741-3842, E-ISSN 1741-3850, article id fdz009Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: To identify personality, biomedical and behavioural factors associated with adult obesity in a large longitudinal sample.

METHOD: In total, 5360 participants with data on personality, neurological functioning, maternal smoking during pregnancy, education and occupation, physical exercise, adult self-reported BMI and obesity were included in the study. Obesity at 55 years was the outcome variable.

RESULTS: The rates of obesity increased from 9.5 to 22.8% from age 33 to 55 years. Logistic regression analyses (adjusted estimates) showed that childhood neurological functioning (OR = 1.32: 1.07-1.63, P < 0.01), maternal smoking during pregnancy (OR = 1.42: 1.22-1.65, P < 0.001), educational qualifications (OR = 0.54: 0.37-0.79, P < 0.01), trait conscientiousness (OR = 0.80:0.74-0.86, P < 0.001) and physical exercise (OR = 0.87: 0.82-0.92, P < 0.001) were significant predictors of obesity at age 55 years for both men and women. Trait extraversion for men (OR = 1.16: 1.07-1.26, P < 0.001) and trait emotional stability for women (OR = 0.90: 0.82-0.99, P < 0.05) were also significant predictors of the outcome variable.

CONCLUSION: Biomedical, psychological, environmental and behavioural factors were all associated with adult obesity.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Childhood neurological conditions, longitudinal, maternal smoking, obesity, personality traits, physical exercise
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-72882 (URN)10.1093/pubmed/fdz009 (DOI)30799484 (PubMedID)
Available from: 2019-03-04 Created: 2019-03-04 Last updated: 2019-03-04Bibliographically approved
Cheng, H., Montgomery, S., Green, A. & Furnham, A. (2019). Childhood heart problems, adulthood emotional stability, and sex associated with self-report heart conditions in adulthood. Journal of Health Psychology
Open this publication in new window or tab >>Childhood heart problems, adulthood emotional stability, and sex associated with self-report heart conditions in adulthood
2019 (English)In: Journal of Health Psychology, ISSN 1359-1053, E-ISSN 1461-7277Article in journal (Refereed) Epub ahead of print
Abstract [en]

The present study investigated biomedical, social, and psychological factors associated with self-reported heart conditions in adulthood in a British cohort. In total, 5697 (50.7% males) participants with data on parental socioeconomic status, childhood cognitive ability, childhood heart problems, educational qualifications, current occupational levels, adulthood personality traits, and the prevalence of self-reported heart conditions in adulthood were included in the study. The prevalence of self-reported heart conditions measured at age 54 years was the outcome variable. Hierarchical logistic regression analysis showed that childhood heart problems identified by physicians (OR = 3.47:1.74-6.92, p < 0.001) and trait emotional stability (OR = 0.83:0.75-0.93, p < 0.001) were the significant and independent predictors of self-reported heart conditions in adulthood. There were also significant sex effects on the prevalence of the outcome variable (OR = 0.53:0.42-0.63, p < 0.001). Both a biomedical and a psychological factor were significantly associated with self-reported heart conditions in adulthood.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
adulthood personality traits, childhood cognitive ability, childhood heart problems, heart conditions in adulthood, longitudinal, United Kingdom
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-71184 (URN)10.1177/1359105318820107 (DOI)000454878400001 ()30599789 (PubMedID)
Note

Funding Agency:

UK Economic and Social Research Council (ESRC)  RES-594-28-0001

Available from: 2019-01-10 Created: 2019-01-10 Last updated: 2019-01-17Bibliographically approved
Lindgren, H., Hasselgren, M., Montgomery, S., Lisspers, K., Ställberg, B., Janson, C. & Sundh, J. (2019). Factors associated with well-controlled asthma-A cross-sectional study [Letter to the editor]. Allergy. European Journal of Allergy and Clinical Immunology
Open this publication in new window or tab >>Factors associated with well-controlled asthma-A cross-sectional study
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2019 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995Article in journal, Letter (Refereed) Epub ahead of print
Place, publisher, year, edition, pages
Munksgaard Forlag, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-75593 (URN)10.1111/all.13976 (DOI)31298735 (PubMedID)
Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-08-16Bibliographically approved
Sundin, P.-O., Udumyan, R., Fall, K. & Montgomery, S. (2019). Grip strength modifies the association between estimated glomerular filtration rate and all-cause mortality. Nephrology, Dialysis and Transplantation, Article ID gfz140.
Open this publication in new window or tab >>Grip strength modifies the association between estimated glomerular filtration rate and all-cause mortality
2019 (English)In: Nephrology, Dialysis and Transplantation, ISSN 0931-0509, E-ISSN 1460-2385, article id gfz140Article in journal (Refereed) Epub ahead of print
Place, publisher, year, edition, pages
Oxford University Press, 2019
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:oru:diva-75586 (URN)10.1093/ndt/gfz140 (DOI)31317193 (PubMedID)
Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-08-16Bibliographically approved
Eriksson, C., Rundquist, S., Cao, Y., Montgomery, S. & Halfvarson, J. (2019). Impact of thiopurines on the natural history and surgical outcome of ulcerative colitis: a cohort study. Gut, 68(4), 623-632
Open this publication in new window or tab >>Impact of thiopurines on the natural history and surgical outcome of ulcerative colitis: a cohort study
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2019 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 68, no 4, p. 623-632Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Thiopurines are used as maintenance therapy in ulcerative colitis (UC), but whether these drugs influence the natural history of the disease is unknown. We aimed to assess the effect of thiopurines in terms of colectomy, hospital admission, progression in disease extent and anti-tumour necrosis factor (TNF) therapy within 10 years from initiation.

DESIGN: Patients diagnosed with UC within the Örebro University Hospital catchment area, during 1963-2010, who initiated thiopurines (n=253) were included. To overcome the risk of confounding by indication, we compared patients who stopped treatment within 12 months because of an adverse reaction (n=76) with patients who continued therapy or discontinued due to other reasons (n=177) and assessed long-term outcomes using Cox regression with adjustment for potential confounding factors.

RESULTS: The cumulative probability of colectomy within 10 years was 19.5% in tolerant patients compared with 29.0% in intolerant (adjusted HR 0.49; 95% CI 0.21 to 0.73). The probability of hospital admission was 34.0% in tolerant versus 56.2% in intolerant patients (adjusted HR 0.36; 95% CI 0.23 to 0.56). The risk for progression in disease extent was 20.4% in tolerant patients compared with 48.8% in intolerant (adjusted HR 0.47; 95% CI 0.21 to 1.06). Within 10 years, 16.1% of tolerant and 27.5% of intolerant patients received anti-TNF therapy (adjusted HR 0.49; 95% CI 0.26 to 0.92).

CONCLUSION: Based on the novel approach of comparing patients tolerant and intolerant to thiopurines, we reveal that thiopurines have a profound beneficial impact of the natural history and long-term colectomy rates of UC.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
6-mercaptopurine, azathioprine, chronic ulcerative colitis, tnf-alpha
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-66417 (URN)10.1136/gutjnl-2017-315521 (DOI)000471830300008 ()29618498 (PubMedID)2-s2.0-85062170737 (Scopus ID)
Note

Funding Agency:

Swedish government's agreement on medical training and research  OLL-549221

Available from: 2018-04-09 Created: 2018-04-09 Last updated: 2019-07-22Bibliographically approved
Lybeck, C., Brenndörfer, E. D., Sällberg, M., Montgomery, S., Aleman, S. & Duberg, A.-S. (2019). Long-term follow-up after cure from chronic hepatitis C virus infection shows occult hepatitis and a risk of hepatocellular carcinoma in noncirrhotic patients.. European Journal of Gastroenterology and Hepathology, 31(4), 506-513
Open this publication in new window or tab >>Long-term follow-up after cure from chronic hepatitis C virus infection shows occult hepatitis and a risk of hepatocellular carcinoma in noncirrhotic patients.
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2019 (English)In: European Journal of Gastroenterology and Hepathology, ISSN 0954-691X, E-ISSN 1473-5687, Vol. 31, no 4, p. 506-513Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Curing hepatitis C virus (HCV) infection primarily aims to prevent severe liver complications. Our objectives were to investigate the long-term presence and impact of occult HCV infection (OCI) and to study the outcomes in terms of liver disease after virological cure.

PATIENTS AND METHODS: A total of 97 patients with achieved sustained virological response (SVR) during 1990-2005 were followed either by a clinical follow-up (FU) visit with blood sampling and liver elastography (n=54) or through national registries for outcomes (n=43). To diagnose OCI among patients with SVR, a highly sensitive method was used to detect HCV-RNA traces in whole blood. The FU duration was a median of 10.5 years, with samples up to 21.5 years after the end of treatment (EOT).

RESULTS: The majority of patients [52 (96%)] were HCV-RNA negative at FU, and regression of fibrosis was statistically significant. OCI was found in two (4%) of them at 8 and 9 years after EOT. These patients had F1 and F2 fibrosis before treatment and F2 at FU, but no other abnormal findings. Three previously noncirrhotic men were diagnosed with hepatocellular carcinoma 8-11 years after EOT.

CONCLUSION: Occult infection could be detected many years after the achievement of SVR but was not associated with the serious liver disease. The majority had persistent viral eradication and regression of fibrosis after SVR. However, an increased risk of hepatocellular carcinoma may persist in the long term after SVR even in noncirrhotic patients. Further studies with FU after direct-acting antiviral therapy and on the long-term impact after cure are needed.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-70277 (URN)10.1097/MEG.0000000000001316 (DOI)30461522 (PubMedID)2-s2.0-85060762793 (Scopus ID)
Available from: 2018-11-22 Created: 2018-11-22 Last updated: 2019-04-04Bibliographically approved
Kennedy, B., Ruoqing, C., Fang, F., Valdimarsdottir, U., Montgomery, S., Larsson, H. & Fall, K. (2019). Low stress resilience in late adolescence and risk of smoking, high alcohol consumption and drug use later in life. Journal of Epidemiology and Community Health, 73(6), 469-501
Open this publication in new window or tab >>Low stress resilience in late adolescence and risk of smoking, high alcohol consumption and drug use later in life
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2019 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 73, no 6, p. 469-501Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: While compromised stress resilience constitutes a recognised risk factor for somatic and psychiatric disease development in general, the knowledge about how individual variation in vulnerability to stress may specifically influence the long-term risks of disadvantageous health behaviours is limited.

METHODS: In this Swedish cohort study, we aimed to investigate the association between stress resilience in late adolescence and adult use of addictive substances. We included 9381 men with information on psychological stress resilience measured during military conscription examinations, who later responded to an extensive health survey (mean age 34.0±7.2 years) including detailed information on substance use. We modelled continuous outcomes using linear regression, binary outcomes with logistic regression and other categorical outcomes with multinomial logistic regression.

RESULTS: We found that low stress resilience in adolescence conferred increased risks of all studied measures of addictive behaviour. After adjusting for childhood socioeconomic information, low stress resilience was associated with adult current regular smoking (relative risk ratio: 5.85, 95% CI 4.32 to 7.93), higher nicotine dependence scores (beta: 0.76, 95% CI 0.29 to 1.23), hazardous use of alcohol (>14 alcoholic drink-equivalents per week, OR: 1.72, 95% CI 1.37 to 2.16), DSM-IV criteria for alcohol dependence (OR: 1.74, 95% CI 1.35 to 2.25), and drug use (OR: 1.77, 95% CI 1.51 to 2.08). The results remained largely unchanged after further adjustments for adult educational attainment and occupation as well as for additional conscription covariates.

CONCLUSION: Low stress resilience in late adolescence appears to be associated with an increased risk of disadvantageous and addictive health behaviours in adulthood.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
Keywords
Alcohol, epidemiology, health behaviour, psychological stress, smoking
National Category
Substance Abuse
Identifiers
urn:nbn:se:oru:diva-72375 (URN)10.1136/jech-2018-211815 (DOI)000471850400004 ()30718261 (PubMedID)2-s2.0-85061156675 (Scopus ID)
Note

Funding Agencies:

European Research Council Consolidator Grant  726413 

Swedish Council for Information on Alcohol and Other Drugs  2017-0095 

Karolinska Institutet through a Senior Researcher Award  

Karolinska Institutet through a Strategic Research Area in Epidemiology Award 

Available from: 2019-02-11 Created: 2019-02-11 Last updated: 2019-07-23Bibliographically approved
Landberg, A., Fält, A., Montgomery, S., Sundqvist, P. & Fall, K. (2019). Overweight and obesity during adolescence increases the risk of renal cell carcinoma. International Journal of Cancer, 145(5), 1232-1237
Open this publication in new window or tab >>Overweight and obesity during adolescence increases the risk of renal cell carcinoma
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2019 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 145, no 5, p. 1232-1237Article in journal (Refereed) Published
Abstract [en]

While overweight among adults has been linked with renal cell carcinoma (RCC) risk, little is known about the potential influence of overweight and obesity during adolescence. To ascertain if adolescent body mass index is associated with subsequent risk of RCC, we identified a cohort of 238,788 Swedish men who underwent mandatory military conscription assessment between 1969 and 1976 at a mean age of 18.5 years. At the time of conscription assessment, physical and psychological tests were performed including measurements of height and weight. Participants were followed through linkage to the Swedish Cancer Registry to identify incident diagnoses of RCC. The association between body mass index (BMI, kg/m(2)) at conscription assessment and subsequent RCC was evaluated using multivariable Cox regression. During a follow-up of up to 37 years, 266 men were diagnosed with RCC. We observed a trend for higher RCC risk with increasing BMI during adolescence, where one-unit increase in BMI conferred a 6% increased risk of RCC (95% CI 1.01-1.10). compared to normal weight men (BMI 18.5- < 25), men with overweight (BMI 25- < 30) or obesity (BMI >= 30) had hazard ratios for RCC of 1.76 (95% CI 1.16-2.67) and 2.87 (95% CI 1.26-6.25), respectively. The link between overweight/obesity and RCC appear to be already established during late adolescence. Prevention of unhealthy weight gain during childhood and adolescence may thus be a target in efforts to decrease the burden of RCC in the adult population.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
adolescence, cancer epidemiology, obesity, overweight, renal cell carcinoma
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-72780 (URN)10.1002/ijc.32147 (DOI)000474668200007 ()30790271 (PubMedID)2-s2.0-85068033223 (Scopus ID)
Note

Funding Agency:

UK Economic and Social Research Council  ES/JO19119/1  RES-596-28-0001

Available from: 2019-02-27 Created: 2019-02-27 Last updated: 2019-07-30Bibliographically approved
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