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Biomedical subjects

J W Twisk

Publications and source records attributed to J W Twisk.

At least 19 recordsLinked to original sources

NT-proBNP reflects right ventricular structure and function in pulmonary hypertension.

The aim of the current study was to investigate whether alterations in N-terminal pro brain natriuretic peptide (NT-proBNP) reflect changes in right ventricular structure and function in pulmonary hypertension patients during treatment. The study consisted of 30 pulmonary hypertension patients; 15 newly diagnosed and 15 on long-term treatment. NT-proBNP, right heart catheterisation and cardiac magnetic resonance imaging measurements were performed, at baseline and follow-up. There were no significant differences between newly diagnosed patients and those on treatment at baseline or follow-up with respect to NT-proBNP, haemodynamics and right ventricular parameters. Relative changes in NT-proBNP during treatment were correlated to the relative changes in right ventricular end-diastolic volume index (r = 0.59), right ventricular mass index (r = 0.62) and right ventricular ejection fraction (r = -0.81). N-terminal pro brain natriuretic peptide measurements reflect changes in magnetic resonance imaging-measured right ventricular structure and function in pulmonary hypertension patients. An increase in N-terminal pro brain natriuretic peptide over time reflects right ventricular dilatation concomitant to hypertrophy and deterioration of systolic function.

Adult↗

Comparison of the haemodynamic effects of right ventricular outflow-tract pacing with right ventricular apex pacing: a quantitative review.

The right ventricular apex has been used for cardiac stimulation because this position is easily accessible and is associated with a stable position of the electrode with a low dislodgement rate. This position, however, is associated with a dyssynchronous left ventricular contraction with subsequent deleterious haemodynamic effects. Alternative stimulation sites have been studied extensively because of a potentially better haemodynamic effect compared with right ventricular apex pacing. Using a Cochrane search strategy, nine studies were selected to analyze the haemodynamic effects of right ventricular outflow-tract pacing. The results of these studies (n=217) were pooled and indicated a significantly better haemodynamic effect (odds ratio 0.34, confidence interval 0.15-0.53) compared with right ventricular apex pacing. Therefore, these data suggest that right ventricular outflow-tract pacing may offer a modest but significant benefit over right ventricular apex pacing in patients selected for pacemaker implantation on the basis of symptomatic bradyarrhythmias.

Bradycardia↗

Memory complaints and APOE-epsilon4 accelerate cognitive decline in cognitively normal elderly.

OBJECTIVE: To investigate to what extent subjective memory complaints and APOE-epsilon4 allele carriage predict future cognitive decline in cognitively intact elderly persons, by evaluating both their separate and combined effects. METHODS: We selected 1,168 subjects from the population-based Longitudinal Aging Study Amsterdam who were 62 to 85 years of age and had no obvious cognitive impairment at baseline (Mini-Mental State Examination [MMSE] score, > or =27). Memory complaints and APOE phenotypes were assessed at baseline. MMSE, the Auditory Verbal Learning Test (memory: immediate recall and delayed recall), and the Alphabet Coding Task-15 (information processing speed) were used to study cognitive decline. Follow-up data were collected after 3 and 6 years. Data were analyzed with generalized estimating equations, adjusted for age, sex, education, and depression. RESULTS: Baseline memory complaints were reported by 25.5% of the cognitively intact elderly persons. Overall, 25.3% of the subjects were carriers of at least one APOE-epsilon4 allele. Memory complaints were associated with a greater rate of decline in all cognitive measures, except immediate recall. In addition, APOE-epsilon4 allele carriers had a greater rate of cognitive decline shown by MMSE scores and slower information processing speeds after 6 years. The effects of both memory complaints and APOE-epsilon4 allele carriage were additive: subjects with both factors had a two times higher cognitive decline than did subjects without both factors. CONCLUSIONS: Both memory complaints and APOE-epsilon4 allele carriage predict cognitive decline at an early stage. This finding highlights the importance of subjective memory complaints, which are important even at an early stage when objective tests are still unable to detect cognitive deficits and are especially important for elderly carriers of the APOE-epsilon4 allele because they have an additional risk.

Aged↗

A 15-year physical activity pattern is positively related to aerobic fitness in young males and females (13-27 years).

The purpose of this paper is to test the hypothesis that daily physical activity over a period of 15 years has been beneficial to aerobic fitness in young male and female participants (13-27 years) in the Amsterdam Growth and Health Longitudinal Study. Only subjects with the maximal data of six sets of measurements were included (83 male and 98 female participants). Daily physical activity was assessed using a standardized interview on activity and expressed as a weighted activity score. Aerobic fitness was assessed using a maximal running test on a treadmill and measuring the maximal oxygen uptake (VO2max) and the maximal slope of the track (Smax). To assess the longitudinal relationship between daily physical activity and aerobic fitness a real longitudinal analysis was carried out with generalized estimating equations, adjusting for differences in initial aerobic fitness at age 13, and for other lifestyle (dietary intake, smoking and alcohol consumption) and biological parameters (biological age, body fat, blood pressure and concentration of serum cholesterol). A significant relationship (P < 0.01) was observed between daily physical activity and both VO2max and Smax. It can be concluded that the development of aerobic fitness between the age of 13 and 27 years is independently and positively related to daily physical activity in this group of male and female participants in the study. The functional implications, however, are small: a relatively high increase in the weighted physical activity score of 30% over a period of 15 years results in a 2%-5% increase in aerobic fitness.

Adolescent↗

Clustering of risk factors for coronary heart disease. the longitudinal relationship with lifestyle.

PURPOSE: The purpose of this study was to investigate whether or not clustering of biological coronary heart disease (CHD) risk factors exists and to investigate the longitudinal relationship between lifestyle parameters (dietary intake, daily physical activity, smoking behaviour, alcohol consumption) and a biological CHD risk factor clustering score. This was defined as belonging to one or more gender specific 'high risk' quartiles for the following CHD risk factors: ratio between total serum cholesterol and high density lipoprotein cholesterol (TC:HDL), mean arterial blood pressure (MABP), body fatness [sum of skinfolds (SSF)], and cardiopulmonary fitness (VO2-max). METHODS: The data were derived from the Amsterdam Growth and Health Study, an observational longitudinal study in which six repeated measurements were carried out over a period of 15 years covering adolescence and young adulthood. The longitudinal relationships were analysed with generalized estimating equations. RESULTS: The results showed significant clustering for the TC:HDL ratio, SSF, and VO(2)-max. MABP was not significantly associated with the other CHD risk factors. Daily physical activity and alcohol consumption (only for males) were both inversely related to the clustering score. None of the other lifestyle parameters showed significant relationships with the clustering score. CONCLUSIONS: Based on this small longitudinal study, it can be stated that during adolescence and young adulthood both daily physical activity and alcohol consumption were related to a healthy CHD risk profile.

Adolescent↗

The longitudinal effect of depression on functional limitations and disability in older adults: an eight-wave prospective community-based study.

BACKGROUND: The temporal relationship between depression and adverse functional outcomes in older adults is ambiguous. In the present eight-wave prospective community-based study, the longitudinal effect of depression on functional limitations and disability (in terms of disability days and bed days) was studied, thereby taking into account the role of chronic physical diseases. METHODS: The study is based on a sample which at the outset consisted of 325 non-depressed and 327 depressed persons (55-85 years) drawn from a larger random community based sample in the Netherlands. Generalized estimating equations time-lag models were used to examine the longitudinal relation between depression and both functional limitations and disability. RESULTS: Functional limitations were very persistent over time, whereas disability days and bed days were more fluctuating functional outcomes. Only in the presence of chronic physical diseases, there was a significant longitudinal association between depression at the previous measurement and functional limitations, disability days and bed days at the next measurement. The effect on functional limitations was small, which was probably partly due to their persistent nature. CONCLUSIONS: The finding of a longitudinal relationship between depression and functional outcomes in older adults with a compromised health status provides a rationale for treatment of chronic physical diseases as well as depression in depressed chronically ill elderly, in order to prevent a spiralling decline in psychological and physical health.

Aged↗

Effects of health measurements and health information in youth and young adulthood in dietary intake--20-y study results from the Amsterdam Growth and Health Longitudinal Study.

BACKGROUND: The Amsterdam Growth and Health Longitudinal Study (AGAHLS) is a 20 y observational study concerning biological, psychological and lifestyle risk factors for cardiovascular disease and osteoporosis. In the AGAHLS two cohorts can be distinguished: the so-called Multi-Measurement Group (MMG), which received eight repeated measurements, and a Bi-Measurement Group (BMG), which received two measurements, one at the beginning and one at the end of the 20 y period. OBJECTIVE: In health-related longitudinal research, the outcomes of the study may be influenced by the measurements themselves and the health information provided. It was hypothesized that the repeated measurements and the health information given to the MMG would result in a more healthy dietary intake in comparison to the BMG. DESIGN: The MMG consisted of 164 subjects and the BMG consisted of 90 subjects. At the start of the study, subjects were teenagers of 13-y-old. The hypothesis was tested with use of regression analysis, analysing group differences in mean individual change scores. RESULTS: Only the MMG showed a significantly larger decrease in the intake of mono- and disaccharides compared to the BMG. CONCLUSIONS: The effect of the repeated measurements and the health information provided on dietary intake was relatively small, since it was only one out of the 14 nutrients that differed between the MMG and the BMG.

Adolescent↗

Is calculating pack-years retrospectively a valid method to estimate life-time tobacco smoking? A comparison between prospectively calculated pack-years and retrospectively calculated pack-years.

AIMS: To investigate the relative validity of retrospectively calculated pack-years (py-retro) by comparing py-retro with prospectively calculated pack-years (py-pro). DESIGN: A 23-year ongoing cohort study (1977-2000). PARTICIPANTS: One hundred and fifty-four males and females, 13 years old in 1977 and 36 years old in 2000. SETTING: Amsterdam, the Netherlands. MEASUREMENTS: To calculate py-pro, current smoking and quitting efforts were investigated nine times in a period of 23 years with the help of an interview or a questionnaire. At the age of 36, subjects filled out a comprehensive questionnaire about their smoking history, to calculate py-retro. Individual differences between py-pro and py-retro were calculated. In addition, Cohen's kappa was calculated after categorising py-pro and py-retro into three groups. FINDINGS: (1) Py-retro does not under- or overestimate life-time tobacco smoking. (2) The relative validity of py-retro was moderate due to large individual differences between py-pro and py-retro. (3) The individual differences between py-pro and py-retro became larger, the higher the number of pack-years. (4) Mean difference (and 95% limits of agreement) between py-pro and py-retro was -0.039 (-5.23, 5.32) when average pack-years was < 5.2 and -1.17 (-10.00, 14.65) when pack-years > or = 5.2. 5. Cohen's kappa between categorized py-pro and py-retro was 0.79. CONCLUSIONS: Future researchers in the field of smoking should be aware of the moderate relative validity of py-retro. Categorizing py-retro into smoking groups results in a misclassification error that is smaller than the quantitative error in continuous py-retro, but goes together with a loss of information.

Adolescent↗

Longitudinal trends in and tracking of energy and nutrient intake over 20 years in a Dutch cohort of men and women between 13 and 33 years of age: The Amsterdam growth and health longitudinal study.

The purpose of the present study was to describe the longitudinal development of nutrient intake and to determine the stability of this intake from adolescence into adulthood. Longitudinal data of the Amsterdam Growth and Health Longitudinal Study were analysed; the dietary intake of 200 subjects (males and females) was repeatedly measured (eight times) over a period of 20 years, covering the age period of 13-33 years. Dietary intake was determined with the detailed crosscheck dietary history interview. With use of multivariate ANOVA for repeated measurements, trends in macro- and micronutrients over time and differences between genders were analysed. Furthermore, stability coefficients, corrected for time-dependent (biological age) and time-independent covariates (gender) were calculated, taking into account all the measurements. The results showed significant time and gender effects for energy intake (kJ) and the following macronutrients: protein (g and % total energy supply), fat (g) and carbohydrate (g). Interaction effects between time and gender diminished when the macronutrients were calculated as a percentage of total energy intake. The micronutrients Ca, Fe and vitamins changed significantly over time and showed an interaction effect with gender, with the exception of cholesterol intake (mg/MJ), which did not show an interaction effect of time and gender. The tracking of the nutrient intake showed relatively low but significant stability coefficients for all macro- and micronutrients (0.28-0.52). In conclusion, dietary intake does change considerably over time, with the exception of polyunsaturated fat intake (% total energy supply) for both males and females and fat intake in females. Furthermore, stability coefficients for nutrients appeared to be low to moderate. Although these coefficients may be somewhat attenuated as a result of the relatively large measurement error of the dietary intake measurement, they suggest moderate stability of diet over time. These findings may imply that dietary intake is changeable and suggest that disease prevention measures can be implemented in adulthood.

Adolescent↗

Socio-economic position and coronary heart disease risk factors in youth. Findings from the Young Hearts Project in Northern Ireland.

BACKGROUND: This study investigates the existence of socioeconomic differentials in behavioural and biological risk factors for coronary heart disease in young people from Northern Ireland, taking into account differences in biological maturation. METHODS: A school-based prospective study, with measurements in 1989/1990 and 1992/1993. Socio-economic position was based on occupational level of the main family breadwinner. Behavioural risk factors included were physical inactivity, the intake of total energy, dietary fat and a number of micronutrients. Biological risk factors included were blood pressure, body fatness, lipoproteins and cardio-pulmonary fitness. Biological maturation was based on Tanner's stages. PARTICIPANTS: 251 boys and 258 girls who were measured at the age of 12 years and re-examined at the age of 15 years. RESULTS: Cross-sectional analyses showed that socio-economic differences in cholesterol intake (in boys) and physical inactivity and total energy intake (in girls) were present at 12 and 15 years of age, while differences in fat and fruit intake and smoking behaviour (in boys and girls) became established at the age of 15 years, with unfavourable levels in subjects in the manual group. Longitudinal analyses confirmed that differences in behavioural risk factors exist or develop during adolescence. No clear pattern of differences in biological risk factors was found by socio-economic position. Adjustment for biological maturation did not materially alter the results. CONCLUSION: Differences in lifestyle by socio-economic position seem to become established in adolescence. These differences however, are not (yet) reflected in differences in biological risk factors by socio-economic position.

Adolescent↗

Long-term homocysteine-lowering treatment with folic acid plus pyridoxine is associated with decreased blood pressure but not with improved brachial artery endothelium-dependent vasodilation or carotid artery stiffness: a 2-year, randomized, placebo-controlled trial.

Homocysteine is associated with atherothrombotic disease, which may be mediated through associations of homocysteine levels with blood pressure, endothelial function, or arterial stiffness. In a placebo-controlled, randomized clinical trial, we measured blood pressure, brachial artery endothelium-dependent vasodilation, and common carotid artery stiffness in 158 clinically healthy siblings of patients with premature atherothrombotic disease at baseline and after 1 and 2 years of homocysteine-lowering treatment with folic acid (5 mg) plus pyridoxine (250 mg). Intention-to-treat analyses limited to participants (n=130) who underwent at least 1 measurement after the baseline visit showed that compared with placebo, treatment with folic acid plus pyridoxine was associated with a 3.7-mm Hg (95% CI -6.8 to -0.6 mm Hg) lower systolic and a 1.9-mm Hg (95% CI -3.7 to -0.02 mm Hg) lower diastolic blood pressure over the 2-year trial period. Together with the decreased occurrence of abnormal exercise electrocardiography tests reported previously, our results support the hypothesis that homocysteine-lowering treatment with folic acid plus pyridoxine has beneficial vascular effects. Because no effects could be demonstrated on brachial artery endothelium-dependent vasodilation or on common carotid artery stiffness, the present study does not support the hypothesis that the cardiovascular effects of homocysteine are mediated through these factors, at least in clinically healthy individuals.

Adult↗

Personality characteristics and alcohol consumption: longitudinal analyses in men and women followed from ages 13 to 32.

OBJECTIVE: The purpose of the present study was to investigate the relation between personality characteristics and alcohol consumption. Using a general population of young and generally healthy men and women, the focus was not on alcoholism but on the full scope of alcohol consumption, including abstinence and moderate levels of consumption. Modification of the relation between personality and alcohol consumption by gender, age and type of beverage was investigated. METHOD: The population consisted of 483 (259 female) subjects from the Amsterdam Growth and Health Longitudinal Study; they were aged 13 to 32 years over the 20-year course of the study, during which span measurements were taken between two and seven times. The longitudinal relation between five subscales of the Dutch Personality Inventory (DPI) and alcohol consumption were assessed with generalized estimating equations. RESULTS: Low prevalence of heavy alcohol consumption was found in this population. Abstinence from alcohol was more common among subjects who scored higher on Social Inadequacy, Rigidity and Self-sufficiency subscales. The amount of alcohol consumed was higher in drinkers who scored low on Rigidity and Social Inadequacy. Gender, age and type of alcoholic beverage modified some of the found relationships (e.g., adult women who scored high on Dominance were more likely to be the firmer wine drinkers). No significant relationships were found between alcohol consumption and the DPI Inadequacy subscale. CONCLUSIONS: Alcohol consumption was associated with lower scores on Social Inadequacy, Rigidity and Self-sufficiency.

Adolescent↗

Physical activity guidelines for children and adolescents: a critical review.

Since it is generally accepted that the onset of many chronic diseases lies in early childhood, preventive strategies should start as early in life as possible. Physical inactivity is recognised as an important determinant for chronic disease and the prevalence of physical inactivity is increasing during adolescence. Therefore, in the last 10 years much effort has been put into the development of physical activity guidelines for children and adolescents. In this critical review it is shown that the scientific evidence on which these guidelines are based is rather weak. There is only marginal evidence that physical activity during youth is related to adult health status. There is, however, hardly any evidence for a certain dose-response relationship or a particular threshold value from which guidelines can be obtained. Furthermore, it can be suggested that although the value of physical activity guidelines for children and adolescents for public health purposes is beyond doubt, perhaps these guidelines should focus on aspects other than possible health benefits.

Adolescent↗

[Roaming through methodology. XXII. Application of techniques for longitudinal data analysis].

Longitudinal studies are characterised by repeated measurements of the outcome variable on the same individuals. This implicates that observations are correlated and that statistical techniques, such as linear regression analysis cannot be used. Special longitudinal techniques correct for the dependency in repeated observations by analysing the development of a certain individual in time. Depending on the research question, the distribution of the outcome variable, and the number of repeated measurements, a certain technique should be chosen. Sophisticated longitudinal techniques like generalized estimating equations and random-coefficient models are most recommendable.

Data Interpretation, Statistical↗

Effect of homocysteine-lowering treatment with folic acid plus vitamin B6 on progression of subclinical atherosclerosis: a randomised, placebo-controlled trial.

BACKGROUND: A high plasma homocysteine concentration is associated with increased risk of atherothrombotic disease. We investigated the effects of homocysteine-lowering treatment (folic acid plus vitamin B6) on markers of subclinical atherosclerosis among healthy siblings of patients with premature atherothrombotic disease. METHODS: We did a randomised, placebo-controlled trial among 158 healthy siblings of 167 patients with premature atherothrombotic disease. 80 were assigned placebo and 78 were assigned 5 mg folic acid and 250 mg vitamin B6 daily for 2 years. The primary endpoint was the development or progression of subclinical atherosclerosis as estimated from exercise electrocardiography, the ankle-brachial pressure index, and carotid and femoral ultrasonography. FINDINGS: Ten participants in the treatment group, and 14 in the placebo group dropped out. Vitamin treatment, compared with placebo, was associated with a decrease in fasting homocysteine concentration (from 14.7 to 7.4 micromol/L vs from 14.7 to 12.0 micromol/L), and in postmethionine homocysteine concentration (from 64.9 to 34.9 micromol/L vs from 64.8 to 50.3 micromol/L). It was also associated with a decreased rate of abnormal exercise electrocardiography tests (odds ratio 0.40 [0.17-0.93]; p=0.035). There was no apparent effect of vitamin treatment on ankle-brachial pressure indices (0.87 [0.56-1.33]), or on carotid and peripheral-arterial outcome variables (1.02 [0.26-4.05] and 0.86 [0.47-1.59], respectively). INTERPRETATION: Homocysteine-lowering treatment with folic acid plus vitamin B6 in healthy siblings of patients with premature atherothrombotic disease is associated with a decreased occurrence of abnormal exercise electrocardiography tests, which is consistent with a decreased risk of atherosclerotic coronary events.

Blood Pressure↗

Positive and negative life events: the relationship with coronary heart disease risk factors in young adults.

OBJECTIVE: to investigate the influence of positive and negative life events (including daily uplifts and daily hassles) on several biological and lifestyle coronary heart disease (CHD) risk factors. METHODS: from the Amsterdam Growth and Health Longitudinal Study (AGHLS), a cross-section sample of 207 males and 231 females aged 32/33 years was used. RESULTS: hardly any associations were found between both positive and negative life events and biological CHD risk factors. On the other hand, daily uplifts and positive life events were positively related to lifestyle. For both positive and negative life events coping behaviour played a role in these relationships. Furthermore, it was shown that the associations of health-related variables with daily uplifts and hassles were comparable to those found for major positive and negative life events. CONCLUSION: This study could not fully determine whether or not different mechanisms play a role in the health benefits of positive life events compared to the health burdens of negative life events.

Adaptation, Psychological↗

Blood cholesterol levels of 32-year-old alcohol consumers are better than of nonconsumers.

Blood cholesterol levels are expected to be important factors in the causal pathway between alcohol consumption and CHD. The relation between alcohol consumption and blood cholesterol levels is investigated in 130 men and 145 women aged 32.4 years old (+/-1.0), from the Amsterdam Growth and Health Longitudinal Study. When controlled for gender, cholesterol levels at age 13.1 years, and lifestyle at adult age (smoking, physical activity, dietary habits), no significant differences were found for total cholesterol (TC) levels between alcohol consumers and nonconsumers. Serum high-density lipoprotein (HDL) cholesterol levels were 0.12 mmol/l higher in subjects consuming >/=100 grams of alcohol per week than in nonconsumers (p < 0.05). Regression coefficients of subjects consuming 10 to 50, or 50 to 100 g alcohol per week did not differ statistically from those of nonconsumers. The positive relation between alcohol consumption and serum HDL was modified by smoking (found in nonsmokers, but not in smokers). No differences between beer, wine, and spirits were found for their relation with serum HDL. In conclusion, 32.4-year-old nonsmoking subjects who consumed >/=100 g of alcohol per week had improved HDL levels compared with nonconsumers, whereas the protective effect of drinking smaller amounts of alcohol did not reach statistical significance.

Adult↗