Lancet Regional Health-Europe最新文献

{"title":"Wealth and mortality among late-middle-aged individuals in Norway: a nationwide register-based retrospective study","authors":"Alexi Gugushvili,&nbsp;Øyvind Nicolay Wiborg","doi":"10.1016/j.lanepe.2024.101113","DOIUrl":"10.1016/j.lanepe.2024.101113","url":null,"abstract":"<div><h3>Background</h3><div>In recent decades, we have observed rising wealth inequality while the pace of growth of life expectancy has slowed in many Western welfare democracies. There is scarce evidence, however, on links between wealth and mortality. The main methodological limitation in this area of scholarship is its inability to account for individuals' unobserved heterogeneity, such as personality and genetic factors, which could potentially affect both their wealth level and survival probabilities. This study aims to explore how wealth is linked to mortality risk in late-middle age, providing insights into the broader implications of socioeconomic status on health outcomes.</div></div><div><h3>Methods</h3><div>In this study, we use high-quality register data on wealth and mortality for the entire population of Norway, one of the world's most advanced welfare states with a low income inequality level but a highly uneven distribution of wealth. We address some of the main methodological constraints of the previous research by exploring if wealth at the age of 37–38 predicts mortality up to age 62. The research design employed mitigates the problem of unobserved heterogeneity by using sibling and twin fixed-effects models.</div></div><div><h3>Findings</h3><div>Both Kaplan–Meier survival analyses and the Cox proportional hazard regression results suggest that wealth is an important predictor of mortality even after individuals' observed and unobserved characteristics are accounted for with hazard ratios of 2.39 [95% confidence interval, CI 2.02, 2.83] among men and 1.74 [95% CI 1.39, 2.16] among women for the inverted cumulative density rank coefficients. The most disadvantaged groups are non-partnered men and women at the lower end of wealth distribution. Twin analyses align with the findings for the general population, indicating that wealth's effect on mortality is not confounded by genetic or shared family background factors.</div></div><div><h3>Interpretation</h3><div>Our findings suggest that wealth is an important predictor of mortality, even in an advanced welfare state with comprehensive healthcare provisions, highlighting the need to address inequalities in wealth distribution to improve population health outcomes.</div></div><div><h3>Funding</h3><div>The <span>Research Council of Norway</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"48 ","pages":"Article 101113"},"PeriodicalIF":13.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why are we still in need for novel anti-obesity medications?","authors":"Aaron Novikoff, Gerald Grandl, Xue Liu, Timo D Müller","doi":"10.1016/j.lanepe.2024.101098","DOIUrl":"10.1016/j.lanepe.2024.101098","url":null,"abstract":"<p><p>From the pioneering moment in 1987 when the insulinotropic effect of glucagon-like peptide 1 (GLP-1) was first demonstrated in humans, to today's pharmaceutical gold rush for GLP-1-based treatments of obesity, the journey of GLP-1 pharmacology has been nothing short of extraordinary. The sequential conceptual developments of long-acting GLP-1 receptor (GLP-1R) mono-agonists, GLP-1R/glucose-dependent insulinotropic polypeptide receptor (GIPR) dual-agonists, and GLP-1R/GIPR/glucagon receptor (GcgR) triple agonists, have led to profound body weight-lowering capacities, with benefits that extend past obesity and towards obesity-associated diseases. The GLP-1R/GIPR dual-agonist tirzepatide has demonstrated a remarkable 23% body weight reduction in individuals with obesity over 72 weeks, eclipsing the average result achieved by certain types of bariatric surgery. Meanwhile, the GLP-1R/GIPR/GcgR triple-agonist retatrutide achieves similar body weight loss (∼25%) in just two-thirds of the time, potentially surpassing the efficacy of Roux-en-Y gastric bypass. These remarkable achievements rightfully raise the question whether and why there is still need for novel anti-obesity medications (AOMs) in the future.</p>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"101098"},"PeriodicalIF":13.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11670685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic disparities in lung cancer incidence and differences in diagnostic characteristics: a population-based cohort study in England","authors":"Daniel Tzu-Hsuan Chen ,&nbsp;Jennifer Hirst ,&nbsp;Carol A.C. Coupland ,&nbsp;Weiqi Liao ,&nbsp;David R. Baldwin ,&nbsp;Julia Hippisley-Cox","doi":"10.1016/j.lanepe.2024.101124","DOIUrl":"10.1016/j.lanepe.2024.101124","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer is a leading cause of mortality, yet disparities in lung cancer across different sociodemographic groups in the UK remain unclear. This study investigates ethnicity and sociodemographic disparities and differences in lung cancer in a nationally representative English cohort, aiming to highlight inequalities and promote equitable access to diagnostic advancements.</div></div><div><h3>Methods</h3><div>We conducted a population-based cohort study using health care records from QResearch, a large primary care database in England. The study included adults aged 25 and over, spanning the period of 2005–2019. Lung cancer incidence rates were calculated using age-standardized methods. Multinomial logistic regression was applied to assess associations between ethnicity/sociodemographic factors and diagnostic characteristics (histological type, stage, and cancer grade), adjusting for confounders.</div></div><div><h3>Findings</h3><div>From a cohort of over 17.5 million people, we identified disparities in incidence rates across ethnic groups from 2005 to 2019. Analysis of 84,253 lung cancer cases revealed that younger woman and Individuals of Indian, other Asian, Black African, Caribbean and Chinese backgrounds had a significantly higher risks of adenocarcinoma compared with squamous cell carcinoma than their White counterparts (relative risk ratios [RRR] spanning from 1.52 (95% CI 1.18–1.94) to 2.69 (95% CI 1.43–5.05). Men and current smokers were more likely to be diagnosed at an advanced stage than women and never smokers (RRR: 1.72 [95% CI 1.56–1.90]–2.45 [95% CI 2.16–2.78]). Socioeconomic deprivation was associated with higher risks of moderate or poorly differentiated adenocarcinoma compared with well differentiated (RRRs between 1.35 [CI: 1.02–1.79] and 1.37 [1.05–1.80]).</div></div><div><h3>Interpretation</h3><div>Our study highlights significant differences in lung cancer incidence and in lung cancer diagnostic characteristics related to ethnicity, deprivation and other demographic factors. These findings have important implications for the provision of equitable screening and prevention programmes to mitigate health inequalities.</div></div><div><h3>Funding</h3><div><span>DART</span> (The Integration and Analysis of Data using Artificial Intelligence to Improve Patient Outcomes with Thoracic Diseases) project, <span>Innovate UK</span> (UK Research and Innovation), QResearch® and grants from the <span>NIHR</span> Biomedical Research Centre (Oxford), <span>John Fell Oxford University Press Research Fund</span>, <span>Cancer Research UK</span>, and the <span>Oxford Wellcome Institutional Strategic Support Fund</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"48 ","pages":"Article 101124"},"PeriodicalIF":13.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142656229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First real-life data on COVID-19 vaccine effectiveness against hospitalisation and severe disease from the eastern part of the WHO European Region","authors":"Josip Begovac","doi":"10.1016/j.lanepe.2024.101130","DOIUrl":"10.1016/j.lanepe.2024.101130","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"Article 101130"},"PeriodicalIF":13.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Realizing Germany's leadership potential in global health: a gender equity roadmap","authors":"Nadine Muller ,&nbsp;Heide Weishaar ,&nbsp;Stefanie Theuring ,&nbsp;Beate Kampmann ,&nbsp;Sabine Campe ,&nbsp;Yagmur Demirpehlivan ,&nbsp;Hanna-Tina Fischer","doi":"10.1016/j.lanepe.2024.101118","DOIUrl":"10.1016/j.lanepe.2024.101118","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"Article 101118"},"PeriodicalIF":13.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food consumption by degree of food processing and risk of type 2 diabetes mellitus: a prospective cohort analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC)","authors":"Samuel J. Dicken ,&nbsp;Christina C. Dahm ,&nbsp;Daniel B. Ibsen ,&nbsp;Anja Olsen ,&nbsp;Anne Tjønneland ,&nbsp;Mariem Louati-Hajji ,&nbsp;Claire Cadeau ,&nbsp;Chloé Marques ,&nbsp;Matthias B. Schulze ,&nbsp;Franziska Jannasch ,&nbsp;Ivan Baldassari ,&nbsp;Luca Manfredi ,&nbsp;Maria Santucci de Magistris ,&nbsp;Maria-Jose Sánchez ,&nbsp;Carlota Castro-Espin ,&nbsp;Daniel Rodríguez Palacios ,&nbsp;Pilar Amiano ,&nbsp;Marcela Guevara ,&nbsp;Yvonne T. van der Schouw ,&nbsp;Jolanda M.A. Boer ,&nbsp;Rachel L. Batterham","doi":"10.1016/j.lanepe.2024.101043","DOIUrl":"10.1016/j.lanepe.2024.101043","url":null,"abstract":"<div><h3>Background</h3><div>It is unknown whether the association between ultra-processed food (UPF) intake and type 2 diabetes mellitus differs from other degrees of food processing. We examined the association between degree of food processing and incident type 2 diabetes mellitus.</div></div><div><h3>Methods</h3><div>This was a prospective cohort analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC). Dietary intake was assessed at baseline using dietary questionnaires and classified according to the Nova classification into unprocessed/minimally processed food (MPF), processed culinary ingredients (PCI), processed food (PF) and UPF. Type 2 diabetes mellitus cases were verified through multiple methods. Cox regression and statistical substitution analysis was used to estimate associations between MPF + PCI, PF and UPF intake and incident type 2 diabetes mellitus. To investigate heterogeneity in the association between UPF and incident type 2 diabetes mellitus, UPF sub-group analysis was conducted. Different reference groups were used in each analysis.</div></div><div><h3>Findings</h3><div>Over an average 10.9 years follow-up of 311,892 individuals, 14,236 type 2 diabetes mellitus cases were identified. Each 10% increment of total daily food intake from UPF (%g/day) was associated with 17% (95% confidence interval (95%CI): 1.14–1.19) higher incident type 2 diabetes mellitus. Each 10% increment in MPF + PCI or PF intake was associated with lower incident type 2 diabetes mellitus (MPF + PCI hazard ratio: 0.94 (95%CI: 0.92–0.96); PF hazard ratio: 0.92 (95%CI: 0.89–0.95)). Replacing UPF with MPF + PCI or PF was associated with lower incident type 2 diabetes mellitus. However, heterogeneity was observed across UPF sub-groups, with breads, biscuits and breakfast cereals, sweets and desserts, and plant-based alternatives associated with lower incident type 2 diabetes mellitus.</div></div><div><h3>Interpretation</h3><div>These findings support recommendations to focus on reducing intake of specific UPF for lowering type 2 diabetes mellitus risk.</div></div><div><h3>Funding</h3><div><span>International Agency for Research on Cancer</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101043"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embracing pharmacists’ roles in health-care delivery","authors":"Natasha Azzopardi Muscat ,&nbsp;Paul Sinclair ,&nbsp;Tomas Zapata ,&nbsp;Daragh Connolly ,&nbsp;Gonçalo Sousa Pinto ,&nbsp;Stanislav Kniazkov","doi":"10.1016/j.lanepe.2024.101088","DOIUrl":"10.1016/j.lanepe.2024.101088","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101088"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional quality of diet characterized by the Nutri-Score profiling system and cardiovascular disease risk: a prospective study in 7 European countries","authors":"Mélanie Deschasaux-Tanguy ,&nbsp;Inge Huybrechts ,&nbsp;Chantal Julia ,&nbsp;Serge Hercberg ,&nbsp;Barthélémy Sarda ,&nbsp;Morgane Fialon ,&nbsp;Nathalie Arnault ,&nbsp;Bernard Srour ,&nbsp;Emmanuelle Kesse-Guyot ,&nbsp;Léopold K. Fezeu ,&nbsp;Carine Biessy ,&nbsp;Corinne Casagrande ,&nbsp;Bertrand Hemon ,&nbsp;Elisabete Weiderpass ,&nbsp;Maria G.M. Pinho ,&nbsp;Neil Murphy ,&nbsp;Heinz Freisling ,&nbsp;Pietro Ferrari ,&nbsp;Anne Tjønneland ,&nbsp;Kristina Elin Nielsen Petersen ,&nbsp;Mathilde Touvier","doi":"10.1016/j.lanepe.2024.101006","DOIUrl":"10.1016/j.lanepe.2024.101006","url":null,"abstract":"<div><h3>Background</h3><div>Nutri-Score is a scientifically validated 5-color front-of-pack nutrition label reflecting the nutrient profile of foods. It has been implemented in several European countries on a voluntary basis, pending the revision of the European labeling regulation. Hence, scientific evidence is needed regarding the ability of the nutrient profile underlying the Nutri-Score (uNS-NPS, 2023-updated version) to characterize healthier foods. Our objective was therefore to study the prospective association between the nutritional quality of diet characterized by the uNS-NPS and the risk of cardiovascular diseases in a large European population.</div></div><div><h3>Methods</h3><div>Our analyses included 345,533 participants from the European Prospective Investigation into Cancer and Nutrition study (EPIC, 1992–2010, 7 European countries). Food intakes were assessed at baseline using country-specific dietary questionnaires. The uNS-NPS was calculated as a continuous scale for each food, based on its 100 g content of energy, sugars, saturated fatty acids, salt, fibre, and protein and percentage content of fruit, vegetables, and pulses. A dietary index was derived at the individual level (uNS-NPS DI: energy-weighted mean of uNS-NPS scores of all foods consumed by a participant). Cardiovascular events during follow-up were retrieved using country-specific methods (self-report, registry data). Multi-adjusted Cox models were computed.</div></div><div><h3>Findings</h3><div>Overall, 16,214 first cardiovascular events were reported (median follow-up: 12.3 years; 4,103,133 person-years). The consumption of foods with a higher uNS-NPS score (reflecting a lower overall nutritional quality of diet) was associated with higher risks of total cardiovascular events (Hazards Ratio (HR) for an increment of 1 standard deviation: 1.03 (95% Confidence Interval 1.01–1.05)), especially myocardial infarction (HR = 1.03 (1.01–1.07)), and stroke (HR = 1.04 (1.01–1.07)).</div></div><div><h3>Interpretation</h3><div>In this large prospective study among European adults, a higher risk of cardiovascular diseases (total and several subtypes) was observed in individuals consuming a diet with a lower nutritional value, as graded by the uNS-NPS score. This brings new evidence on the relevance of the updated nutrient profile underlying the Nutri-Score to characterize foods with a healthier nutrient profile.</div></div><div><h3>Funding</h3><div>EPIC-CVD was supported by <span>EU FP7</span>, <span>ERC</span>, UK <span>MRC</span>, <span>British Heart Foundation</span>, and UK <span>NIHR</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101006"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142572316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A health union in support of European and national health solidarity","authors":"Frank Vandenbroucke","doi":"10.1016/j.lanepe.2024.101051","DOIUrl":"10.1016/j.lanepe.2024.101051","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101051"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confidential and non-confidential drug rebates in Switzerland, 2013–2023: empirical analysis of drug rebates, trends over time and re-evaluations","authors":"Noah Rohner,&nbsp;Cascal Herrle,&nbsp;Luca Locher,&nbsp;Kerstin N. Vokinger","doi":"10.1016/j.lanepe.2024.101094","DOIUrl":"10.1016/j.lanepe.2024.101094","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"46 ","pages":"Article 101094"},"PeriodicalIF":13.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}