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D Trichopoulos

Publications and source records attributed to D Trichopoulos.

At least 37 records · Page 2Linked to original sources
PubMed2004

An integrated evaluation of socioeconomic and clinical factors in the survival from childhood acute lymphoblastic leukaemia: a study in Greece.

An evaluation of the role of socioeconomic factors in the survival of children with leukaemia, controlling for major clinical prognostic indicators, has been attempted in very few studies and the role of these factors may be different in various cultural settings. Our investigation aims to study the independent role of socioeconomic factors on the prognosis of childhood acute lymphoblastic leukaemia (ALL) in Greece. During a 7-year period (1996-2002) 293 cases of incident ALL were diagnosed and followed up in four Childhood Haematology-Oncology Units, which covered over half of all childhood ALL cases nationwide. At the time of diagnosis, information concerning age, gender, maternal schooling, maternal marital status, sibship size, distance of residence from the treating centre, attendance of day care centre and clinical information was recorded. The influence of these factors on survival was studied by modelling the data through Cox's proportional-hazards regression. After adjustment for clinical prognostic factors, children of mothers who were not currently married, were of low educational level or were living far from the treating centre tended to have lower survival (P-values 0.02, 0.14 and 0.08, respectively). There was also evidence that two factors that are predictive of disease occurrence, that is sibship size and attendance of day care centre, may also predict survival (P-values 0.04 and 0.26, respectively). In conclusion, socioeconomic factors are likely to influence survival from ALL at least in some sociocultural contexts. Moreover, there is evidence that factors that could affect incidence of ALL through modulation of herd immunity may also have prognostic implications for this disease.

Age Factors↗
PubMed2003

Flavonoid intake and breast cancer risk: a case--control study in Greece.

Flavonoids have been investigated for possible inverse associations with various chronic degenerative diseases, but there are no epidemiologic data concerning a possible association between several of the main flavonoid categories and breast cancer risk. We have applied recently published data on the flavonoid content of several foods and beverages on dietary information collected in the context of a large case-control study of 820 women with breast cancer and 1548 control women, conducted in Greece. We found a strong, statistically significant inverse association of flavone intake with breast cancer. The odds ratio for an increment equal to one standard deviation of daily flavone intake (i.e. 0.5 mg day(-1)) was 0.87, with 95% confidence interval 0.77-0.97. The association persisted after controlling for fruit and vegetable consumption, or for other flavonoid intake. This inverse association is compatible with and may explain the reported inverse association of breast cancer with consumption of vegetables, particularly leafy vegetables. After controlling for dietary confounding, there was no association of breast cancer risk with flavanones, flavan-3-ols, flavonols, anthocyanidins or isoflavones.

Breast Neoplasms↗
PubMed2003

Air pollution in relation to manifestations of chronic pulmonary disease: a nested case-control study in Athens, Greece.

Chronic pulmonary diseases are a major cause of morbidity and mortality worldwide. The present study is a case-control study nested in a defined cohort, undertaken in Athens, Greece, in order to investigate the association between long-term exposure to ambient air pollution and the development of chronic bronchitis, emphysema or chronic obstructive pulmonary disease (COPD). Individualized personal exposure assessment has been applied based on long-term residential and occupational subject history linked with geographical air pollution distribution. The first consecutive 3904 participants from the European Prospective Study into Cancer and Nutrition (EPIC), all residents of Athens, were asked to complete a questionnaire. One hundred and sixty-eight participants reporting a history of COPD symptomatology and 168 healthy controls recruited from the same study base individually matched for age and gender, were visited by a physician at their homes for conducting spirometry and a medical interview. Eighty-four of the 168 self-identified as cases were diagnosed as having chronic bronchitis, emphysema or COPD. Logistic regression models were used for statistical evaluation. Cases were more exposed to air pollution compared to controls. The estimated odds ratio (OR) indicates an increase of 37% in the risk of medically confirmed cases per exposure quartile (p = 0.02). When most of the subjects exposed are considered vs. all others, there is a twofold increase in disease risk (p = 0.03). Our findings provide evidence that long-term exposure to air pollution is an important factor in the development of chronic respiratory diseases.

Adult↗
PubMed2003

Tracing the Mediterranean diet through principal components and cluster analyses in the Greek population.

OBJECTIVE: To identify dietary patterns, and their socio-demographic and lifestyle correlates in a large sample of Greek adults, and assess their adherence to the traditional Mediterranean diet. DESIGN: Principal component (PC) analysis was used to identify dietary patterns among 28 034 participants of the Greek branch of the European Prospective Investigation into Cancer and Nutrition. Dietary information was collected through a validated, semiquantitative, food-frequency questionnaire. The extracted PCs were subsequently regressed on sociodemographic and lifestyle variables. Analyses were also performed to classify individuals with similar dietary behavior into clusters. RESULTS: Four PCs were identified: PC1 resembled the Mediterranean diet, PC2 approximated a vegetarian diet with emphasis on seed oils, PC3 reflected a preference for sweets, and PC4 reflected a Western diet. PC1 and PC2 were positively associated with age, education, physical activity, and nonsmoking status. Females, in comparison to males, scored higher on PC1 but lower on PC2. Males, younger, more educated individuals, nonsmokers and residents of Greater Athens (Attica) scored higher on PC3. PC4 was associated with younger age, less education, and current smoking. In cluster analyses, cluster A contrasted clusters B and C in having much higher mean PC1- and PC2-scores and substantially lower PC3- and PC4-scores. PC1 and PC4 were, respectively, positively and inversely correlated with an a priori Mediterranean-diet score; PC2 and PC3 were unrelated to it. CONCLUSION: The Mediterranean-like PC1-score as well as the vegetarian-like PC2 were higher among older, more educated people, and were associated with a healthier lifestyle than PC4, which reflected a Western-type diet. PC1 was strongly positively associated with an a priori Mediterranean-diet score.

Adult↗
PubMed2003

Growth velocity during the first postnatal week of life is linked to a spurt of IGF-I effect.

There is adequate evidence that growth during the perinatal period is linked to the risk of several adult onset diseases, and recent findings indicate that the insulin-like growth factor (IGF) system is involved in prenatal growth, as reflected in birthweight. However, whether major components of the IGF system are involved in the immediate post-natal growth has not been studied. Maternal questionnaires were completed, and laboratory measurements of several variables, including IGF-I, IGF-II and IGF-binding protein-3 (IGFBP-3), were made for a total of 331 apparently healthy full-term newborns, from whom routine blood samples were taken during the first 5 days of their life. Birthweight and weight at the time of bleeding were among the recorded variables, and the difference divided by the age in days of the newborn was considered as reflecting immediate postnatal growth velocity. Immediate postnatal growth velocity was strongly positively associated with IGF-I. The squared adjusted correlation coefficient was 0.29 when IGF-I was incorporated in the model predicting postnatal growth velocity but was only 0.08 when IGF-I was excluded. In contrast, IGF-II and IGFBP-3 had no effect on postnatal growth velocity. It thus appears that IGF-I underlies growth during the immediate postnatal period. To the extent that perinatal growth may affect adult onset diseases, the findings of this study suggest that the action of IGF-I during the immediate postnatal period may represent a process of major importance.

Birth Weight↗
PubMed2003

Maternal and gestational correlates of pregnancy prolactin and growth hormone in USA and China.

The objective of this study is to determine correlates of prolactin and growth hormone levels among pregnant women in the USA and China. We studied 304 pregnant Caucasian and 335 pregnant Chinese women. Levels of prolactin and growth hormone were measured at weeks 16 and 27 of gestation, and correlated with maternal, gestational and perinatal characteristics. Both growth hormone and, to a lesser extent, prolactin were inversely associated with pregnancy weight and body mass index, history of a previous live birth and newborn size, whereas educated women had higher levels of both hormones. Growth hormone levels were lower in women who gained more weight, smoked and had nausea and vomiting during pregnancy, whereas prolactin increased with longer total gestation. We found robust associations between maternal and newborn characteristics on the one hand and prolactin and growth hormone during pregnancy on the other.

Adult↗
PubMed2003

Dietary and lifestyle factors in relation to plasma insulin-like growth factor I in a general population sample.

There is evidence that the insulin-like growth factor system (IGF), particularly IGF-I, is important in human carcinogenesis. We studied in a general, though not strictly random population sample of 620 adults, the relationship of IGF-I to demographic, lifestyle and dietary factors, the latter ascertained through an extensive validated questionnaire. Plasma IGF-I levels declined significantly with age and the decline was more evident among women than among men. Tobacco smoking, body mass index and regular physical activity were unrelated to this hormone and a positive association with height was not statistically significant. Neither protein nor carbohydrate intake was related to plasma IGF-I levels but there was inconsistent evidence that ethanol intake may be inversely associated with plasma IGF-I and saturated and polyunsaturated lipids may be positively associated with it. The findings are evaluated in conjunction with evidence indicating that the incidence of cancer is lower among women than among men, height is a risk factor for several forms of cancer, and saturated and polyunsaturated lipids have been more closely linked to human and animal carcinogenesis than monounsaturated lipids.

Adult↗
PubMed2003

Injuries among disabled children: a study from Greece.

OBJECTIVE: To compare the differential implications of sociodemographic and situational factors on the risk of injury among disabled and non-disabled children. DESIGN: Data from the Emergency Department Injury Surveillance System (EDISS) were used to compare, in a quasi case-control approach, injured children with or without disability with respect to sociodemographic, event and injury variables, and to estimate adjusted odds ratios for the injury in a disabled rather than a non-disabled child. SETTING: Two teaching hospitals in Athens and two district hospitals in the countryside that participate in the EDISS. PATIENTS: In the five year period 1996-2000, 110 066 children were recorded with injuries; 251 among them were identified as having a motor/psychomotor or sensory disability before the injury event. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Mechanism of injury, type of injury, risk-predisposing socioeconomic and environmental variables, odds ratio for injury occurrence. RESULTS: Falls and brain concussion are proportionally more common among disabled children, whereas upper limb and overexertion injuries are less common among them. Urban environment, migrant status, and cold months are also associated with increased odds for injuries to occur among disabled rather than non-disabled children. The odds ratio for the occurrence of an injury among disabled children increases with increasing age. CONCLUSIONS: The results of the study provide the information for the targeting of trials of preventive measure in disabled children at increased risk of severe injuries.

Accidental Falls↗
PubMed2003

Characteristics of farm injuries in Greece.

OBJECTIVES: To assess the characteristics of occupational and leisure farm injuries in Greece. METHODOLOGY: During a five-year period (1996-2000), 4,326 unintentional farm injuries have been recorded by the Emergency Department Injury Surveillance System in Greece. Data concerning demographic variables, accident conditions, and injury characteristics were collected by in person interviews. The data were analyzed by simple cross-tabulation and hierarchical cluster analysis. RESULTS: Injuries from falls on the same level are mainly lower-limb fractures and occur during the winter among older women. Falls from higher level concern migrant workers, who also tend to suffer severe multiple injuries, including concussions, particularly during autumn. Injuries resulting from cutting and piercing instruments, as well as from machinery, are generally open wounds in the upper-limbs, suffered by young migrant workers. Head injuries resulting from striking against an object are more generally spread across socio-demographic variables. Overexertion is the dominant mechanism for dislocations and sprains in the lower limbs. Snake and insect bites are common among younger migrant workers during summer, and they affect the upper limbs during manual work close to the ground. Non-traffic injuries from vehicles are frequently severe, involving head concussion of generally young individuals. CONCLUSIONS: In Greece, farm injuries are frequently serious and require hospitalization. These injuries show distinct patterns among older women (lower-limb fractures), young individuals (non-traffic vehicle-related injuries) and migrant workers (injuries from cutting and piercing instruments, falls from high level, and bites). Prevention strategies should give priority to these population groups. These prevention strategies should include guidance for poorly educated workers, including migrants, enforcement of safety regulations concerning farming machinery, and discouragement of risky farming activities among elderly individuals, particularly women.

Accidents, Occupational↗
PubMed2003

Age-fitness. How achievable with food?

To be fit as we age could be described as "Age fitness". Increasing evidence points to opportunities for greater wellness, health maintenance and reduction of the burden of disease in later life for a growing proportion of the community than previously envisaged. The scope of "age fitness" is social, mental, physiological and physical. We know a great deal about food cultures associated with successful aging--Greek, Okinawan, and Scandinavian, for example. Within these cultures, we are beginning to account for variances in health and survival by integrative scores of food intake and their validation.

Activities of Daily Living↗
PubMed2002

Pre-eclampsia in pregnancy and subsequent risk for breast cancer.

Women who experience pre-eclampsia or hypertension during pregnancy may have a reduced risk for breast cancer later in life. The evidence is based on case-control studies, and here we report the results of a cohort study exploring the link between pre-eclampsia and gestational hypertension diagnosed in the first pregnancy and subsequent risk for breast cancer. We combined information from the Medical Birth Registry and the Cancer Registry in Norway, which are both nation-wide. Between 1967, when the birth registry was established, and 1998, 694 657 women were recorded with a first birth, and classified according to whether pre-eclampsia and/or hypertension was diagnosed in the first pregnancy. Linkage to the Norwegian Cancer Registry identified 5474 new cases of breast cancer diagnosed subsequently to their first delivery. Compared to other parous women, women with pre-eclampsia and/or hypertension diagnosed in their first pregnancy had 19% lower risk (95% confidence interval, 9 to 29%) for breast cancer, after adjustment for attained age, calendar period of diagnosis, age at first birth, and parity. This result was similar for term and preterm deliveries, across the range of offspring birth weight, and for pre- and postmenopausal women. These results suggest that the pathophysiology surrounding pre-eclampsia and gestational hypertension plays an important role in breast cancer etiology. A better understanding of the underlying processes could provide an insight into the pathogenesis of breast cancer.

Birth Weight↗
PubMed2002

Does coffee protect against hepatocellular carcinoma?

We analysed the relation between coffee consumption and hepatocellular carcinoma in two case-control studies conducted between 1984 and 1998 in Italy and Greece, including 834 cases and 1912 controls. Compared to non coffee drinkers, the multivariate odds ratio was 0.7 for drinkers of three or more cups per day.

Adult↗
PubMed2002

Pregnancy related protection against breast cancer depends on length of gestation.

In a prospective study of 694 657 parous women in Norway, 5474 developed breast cancer after their first birth. If the first pregnancy lasted less than 32 weeks, the risk was 22% (95% confidence interval, -3% to 53%) less than after a pregnancy of 40 weeks or more, with a significant declining trend in risk (P for trend=0.02).

Adult↗
PubMed2002

Alpha-foetoprotein in umbilical cord in relation to severe pre-eclampsia, birth weight and future breast cancer risk.

Women born after pre-eclamptic pregnancies have been reported to be at reduced risk of breast cancer as adults, because of reduced intrauterine oestrogen influence on breast tissue; high levels of alpha-foetoprotein (a glycoprotein with anti-oestrogenic properties), however, could also be important. In severe pre-eclampsia, placental function and foetal growth are reduced, and umbilical cord plasma levels of alpha-foetoprotein could reflect the underlying processes. Umbilical cord blood was collected in 12804 consecutive deliveries. Among 307 pregnancies with clinical pre-eclampsia, 66 singleton pregnancies were identified as clinically severe, and 610 singleton pregnancies were selected as controls. Oestradiol and alpha-foetoprotein were measured from umbilical plasma, and birth weight was standardized as the ratio between the observed and expected birth weight, adjusted for differences in gestation length and offspring sex. Cord plasma levels of alpha-foetoprotein were significantly higher in severe pre-eclampsia than controls (P<0.01) after adjustment for gestational age and birth weight. For oestradiol, there was no difference in cord plasma levels between the severe pre-eclampsia group and controls, after adjustment for length of gestation and birth weight. These results suggest that an anti-oestrogenic effect associated with pre-eclampsia may be mediated through high levels of alpha-foetoprotein rather than low levels of oestradiol.

Adult↗
PubMed2002

Birth weight as a predictor of breast cancer: a case-control study in Norway.

The hypothesis that birth weight is positively associated with adult risk of breast cancer implies that factors related to intrauterine growth may be important for the development of this malignancy. Using stored birth records from the two main hospitals in Trondheim and Bergen, Norway, we collected information on birth weight, birth length and placenta weight among 373 women who developed breast cancer. From the same archives, we selected as controls 1150 women of identical age as the cases without a history of breast cancer. Information on age at first birth and parity were collected from the Central Person Registry in Norway. Based on conditional logistic regression analysis, breast cancer risk was positively associated with birth weight and with birth length (P for trend=0.02). Birth weights in the highest quartile (3730 g or more) were associated with 40% higher risk (odds ratio, 1.4, 95% confidence interval, 1.1-1.9) of breast cancer compared to birth weights in the lowest quartile (less than 3090 g). For birth length, the odds ratio for women who were 51.5 cm or more (highest quartile) was 1.3 (95% confidence interval, 1.0-1.8) compared to being less than 50 cm (lowest quartile) at birth. Adjustment for age at first birth and parity did not change these estimates. Placenta weight was not associated with breast cancer risk. This study provides strong evidence that intrauterine factors may influence future risk of breast cancer. A common feature of such factors would be their ability to stimulate foetal growth and, simultaneously, to influence intrauterine development of the mammary gland.

Adult↗
PubMed2002

Lipid, protein and carbohydrate intake in relation to body mass index.

OBJECTIVE: To examine whether the same amount of energy intake has different consequences on body mass index (BMI), depending on the source of energy from specific macronutrients. DESIGN: Cross-sectional study, in the context of the European Prospective Investigation into Cancer and nutrition (EPIC). SETTING: Communities all over Greece. SUBJECTS: A total of 27 862 apparently healthy volunteers, men and women, ages 25-82 y. INTERVENTIONS: None. METHODS: Dietary information was collected through an interviewer-administered semi-quantitative food frequency questionnaire. In the context of a cross-sectional analysis, we calculated changes of BMI per increments of energy intake from protein, carbohydrates, saturated, polyunsaturated and monounsaturated lipids and ethanol, controlling for mutual confounding and other confounders, among all participants, and after exclusion of under-reporters and/or those on a diet. RESULTS: Protein intake was positively associated with BMI. The association was evident when nutrients were not mutually adjusted for and increased after mutual adjustment among nutrients (beta=0.80 kg/m(2) per 418.4 kJ or 100 kcal increment, 95% confidence interval 0.55-1.06 for men, and beta=1.59, 95% CI 1.30-1.88 for women), as well as after exclusion of under-reporters and/or those on a diet. The effects of other macronutrients were less substantial or consistent. CONCLUSIONS: There is evidence indicating that protein intake is conducive to obesity. Moreover, our data suggest that neither saturated or monounsaturated lipids nor carbohydrates are likely to play a major role in increasing BMI over and beyond that indicated by their energy content.

Adult↗