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Bruce D.,University of Western Australia | Hunter M.,Busselton Population Medical Research Institute | Peters K.,University of Western Australia | Davis T.,University of Western Australia | Davis W.,University of Western Australia
Age and Ageing | Year: 2015

Aims: fear of falling is an important falls-related symptom that has received little attention in studies of falls risk in older adults with type 2 diabetes. Methods: matched pairs of participants with diabetes or with normoglycaemia (n = 186 per group) recruited from a community-based survey underwent an assessment of fear of falling and associated falls risk factors. Multivariate methods examined associations between fear of falling and risk factors for history of recent falls. Results: compared with the normoglycaemic participants, those with diabetes had worse mobility (slow timed Up and Go test times: 16.2 versus 4.9%, P < 0.01), more fear of falling (24.2 versus 15.1%, P < 0.05) and more activity restriction from fear of falling (indoors: 14.0 versus 4.8%, P = 0.006), but there was no increase in reported recent falls. In the combined sample, a history of recent falls was negatively associated with fear-related limitation of outdoor activities (odds ratio (95% confidence interval): 0.30 (0.15-0.58), P < 0.001) and positively associated with age (1.65 (1.20-2.28) per 10-year increase, P = 0.002) and use of antidepressants (2.14 (1.02-4.50, P = 0.044). The frequency of falls in those with recurrent falls was negatively associated with measures of balance. Conclusions: type 2 diabetes is associated with increased fear of falling and fear-associated activity restriction, and this modifies the risk of falls even in the face of increased falls risk factors including worse mobility. Future studies of falls in diabetes need to consider that fear of falling is an important modifier of the relationship between risk factors and falls. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

Loth D.W.,Erasmus University Rotterdam | Artigas M.S.,University of Leicester | Artigas M.S.,National Health Research Institute | Gharib S.A.,University of Washington | And 190 more authors.
Nature Genetics | Year: 2014

Forced vital capacity (FVC), a spirometric measure of pulmonary function, reflects lung volume and is used to diagnose and monitor lung diseases. We performed genome-wide association study meta-analysis of FVC in 52,253 individuals from 26 studies and followed up the top associations in 32,917 additional individuals of European ancestry. We found six new regions associated at genome-wide significance (P < 5 × 10-8) with FVC in or near EFEMP1, BMP6, MIR129-2-HSD17B12, PRDM11, WWOX and KCNJ2. Two loci previously associated with spirometric measures (GSTCD and PTCH1) were related to FVC. Newly implicated regions were followed up in samples from African-American, Korean, Chinese and Hispanic individuals. We detected transcripts for all six newly implicated genes in human lung tissue. The new loci may inform mechanisms involved in lung development and the pathogenesis of restrictive lung disease.© 2014 Nature America, Inc. All rights reserved.

Bell L.,Princess Margaret Hospital | Hung J.,University of Western Australia | Knuiman M.,University of Western Australia | Divitini M.,University of Western Australia | And 8 more authors.
Journal of Paediatrics and Child Health | Year: 2013

Aim This study aims to analyse the continuous relationship of each cardiometabolic risk factor with body mass index (BMI) and waist circumference percentiles in a population-based sample of children. Methods A cross-sectional sample of 996 school children aged 6-16.9 years in Busselton, Western Australia, (2005-2007) had anthropometry and fasting blood tests for total cholesterol, high density lipoprotein, low density lipoprotein, triglycerides, glucose, insulin, high-sensitive C-reactive protein, liver function tests and adiponectin. Age- and menarche (for girls)-adjusted means of each risk factor were related to BMI and waist circumference centiles across the full normal-overweight-obese range. Results The correlations between BMI and waist circumference (boys 0.91 and girls 0.91) and between BMI z-score and waist z-score (boys 0.80 and girls 0.82) were high. An increase in insulin across all centile groups (for BMI and waist circumference) was found in both sexes. An increase was found for diastolic blood pressure and systolic blood pressure z-score, high density lipoprotein, high-sensitive C-reactive protein, alanine transaminase and gamma-glutamyltransferase in only the centile groups >85% for BMI and waist circumference for both sexes. Mixed and sex-discordant results were found for triglycerides, adiponectin and glucose. Conclusion There are important differences in the relationships between increasing BMI/adiposity, and each comorbidity and these relationships can differ between boys and girls. This information has implications for screening and management of adiposity-related cardiometabolic risk factors in children and for public health initiatives to reduce future burden of cardiovascular disease. © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Bruce D.G.,University of New South Wales | Bruce D.G.,Fremantle Hospital Unit | Davis W.A.,University of New South Wales | Hunter M.L.,University of New South Wales | And 4 more authors.
Journal of Diabetes and its Complications | Year: 2016

Aims To assess whether a personal history of depression assists in risk prediction for depression in type 2 diabetes. Methods Age- and sex-matched participants with and without diabetes from the Busselton Health Survey were assessed for current and previous depression using the 9-item Patient Health Questionnaire and the Brief Lifetime Depression Scale (BLDS). In the diabetic participants, the temporal relationship between first depression episode and diabetes onset was also explored. Results In 184 paired participants (age 70.2 ± 10.1 years, 50% female), those with diabetes had a higher prevalence of any current depression (12.5% vs 4.3%, P < 0.01) and lifetime history of major depression (30.6% vs 21.1%, P = 0.06) compared to those without diabetes. After adjustment, lifetime major depression history was independently associated with any current depression in the combined sample (odds ratio (95% CI): 5.55 (3.09-9.98), P < 0.001), in those with diabetes (4.17 (2.00-8.71), P < 0.001), in those without diabetes (8.29 (3.24-21.23), P < 0.001) and in diabetes whether sub-divided by depression first occurring before or after diabetes onset (before: 3.16 (1.38-7.24), P = 0.007; after: 2.77 (1.00-7.70), P = 0.051). Conclusions Obtaining a lifetime history of major depression using the BLDS assists in depression risk prediction in type 2 diabetes regardless of whether depression preceded diabetes onset or not. © 2016 Elsevier Inc. All rights reserved.

Bowatte G.,University of Melbourne | Lodge C.J.,University of Melbourne | Knibbs L.D.,University of Queensland | Lowe A.J.,University of Melbourne | And 17 more authors.
Journal of Allergy and Clinical Immunology | Year: 2016

Background: Traffic-related air pollution (TRAP) exposure is associated with allergic airway diseases and reduced lung function in children, but evidence concerning adults, especially in low-pollution settings, is scarce and inconsistent. Objectives: We sought to determine whether exposure to TRAP in middle age is associated with allergic sensitization, current asthma, and reduced lung function in adults, and whether these associations are modified by variants in Glutathione S-Transferase genes. Methods: The study sample comprised the proband 2002 laboratory study of the Tasmanian Longitudinal Health Study. Mean annual residential nitrogen dioxide (NO2) exposure was estimated for current residential addresses using a validated land-use regression model. Associations between TRAP exposure and allergic sensitization, lung function, current wheeze, and asthma (n = 1405) were investigated using regression models. Results: Increased mean annual NO2 exposure was associated with increased risk of atopy (adjusted odds ratio [aOR], 1.14; 95% CI, 1.02-1.28 per 1 interquartile range increase in NO2 [2.2 ppb]) and current wheeze (aOR, 1.14; 1.02-1.28). Similarly, living less than 200 m from a major road was associated with current wheeze (aOR, 1.38; 95% CI, 1.06-1.80) and atopy (aOR, 1.26; 95% CI, 0.99-1.62), and was also associated with having significantly lower prebronchodilator and postbronchodilator FEV1 and prebronchodilator forced expiratory flow at 25% to 75% of forced vital capacity. We found evidence of interactions between living less than 200 m from a major road and GSTT1 polymorphism for atopy, asthma, and atopic asthma. Overall, carriers of the GSTT1 null genotype had an increased risk of asthma and allergic outcomes if exposed to TRAP. Conclusions: Even relatively low TRAP exposures confer an increased risk of adverse respiratory and allergic outcomes in genetically susceptible individuals. © 2016 American Academy of Allergy, Asthma & Immunology.

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