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Biomedical subjects

M Koskenvuo

Publications and source records attributed to M Koskenvuo.

At least 19 recordsLinked to original sources
PubMed2003

Self-reported happiness in life and suicide in ensuing 20 years.

OBJECTIVE: The aim of this study was to investigate the relationship between self-reported unhappiness and suicide. METHODS: A sample of adult Finns unselected for health status (N = 29,067) responded to a question on happiness in life with five alternatives: very happy (15.9 %), fairly happy (63.4 %), cannot say (12.9 %), fairly unhappy (6.9 %), very unhappy (1 %). Cox regression was used to study the suicide risk. RESULTS: From 1976 to 1995, 182 suicides occurred. At baseline, unhappiness was associated with older age, male gender, sickness, living alone, smoking, heavy alcohol consumption, physical inactivity and belonging to intermediate social class. The risk of suicide increased with decreasing happiness. The very unhappy compared with the very happy had an age-adjusted hazard ratio (HR) of 10.84 (95 % CI 3.93-29.94) for suicide. After adjusting for the above-mentioned factors this HR was 7.01 (95% CI 2.44-20.08). CONCLUSION: Self-reported unhappiness is strongly associated with subsequent suicide in a long follow-up. Moreover, it seems to indicate also cumulative health hazards.

Adolescent↗
PubMed2003

Life events and depressiveness - the effect of adjustment for psychosocial factors, somatic health and genetic liability.

OBJECTIVE: To study the nature of the relationship of life events with depressiveness. METHOD: In 1990, 9947 Finnish adult twins aged 33-60 years participated in a questionnaire study, with no missing data on the analysed variables. The relationship between stressful life-events and depressiveness, based on Beck Depression Inventory (BDI) classified as normal, mild or moderate, was analysed using multinomial regression for all subjects with adjustment for the effect of age, sex, health status, social support, marital status, social class, and personality variables. These same factors were analyzed among 643 twin pairs discordant for depressiveness. RESULTS: High BDI score categories were strongly associated with stressful life events in all individuals and equally strongly within discordant twin pairs, both monozygotic and dizygotic. Poor somatic health and lack of social support also increased depressiveness. CONCLUSION: The effect of life events predicting depressiveness was independent of social support, somatic disease, sex and genetic liability.

Adaptation, Psychological↗
PubMed2003

Lifestyle differences in twin pairs discordant for basal cell carcinoma of the skin.

BACKGROUND: Basal cell carcinoma (BCC) of the skin is a multifactorial disease with a complex interplay of genetic, environmental and lifestyle factors, including patterns of solar exposure, with childhood exposure being of particular relevance. Case-control studies in disease-discordant twin pairs adjust for familial factors and improve the power of conventional case-control studies. OBJECTIVES: To investigate the roles of sociodemographic, dietary, medication, hormonal and other lifestyle factors in the aetiology of BCC. METHODS: The study base comprised all same-sex twins who had answered the baseline health questionnaire of the Finnish Adult Twin Cohort Study in 1975. Information on all histologically confirmed cases of BCC was retrieved from the nationwide cancer registry. The first twin to have BCC was defined as the case and his/her co-twin (alive at the time of diagnosis) as the control. Only pairs with the first BCC between 1976 and 1999 were included in the study (n = 333). Conditional logistic regression analyses were used to assess BCC risk by study factors. RESULTS: A significantly increased risk was associated with smoking status in females but not in males. The risk was higher in dizygotic than in monozygotic females, possibly indicating the presence of a gene-smoking interaction. Suggestive but statistically nonsignificant increases in risk were observed for higher education, urticaria and atopic eczema, use of nonsteroidal anti-inflammatory drugs and coffee. A suggestive risk decrease was observed for outdoor work. No clear effects were observed for marital status, body mass index, use of alcohol, tea, fruit and vegetables or oral contraceptives. CONCLUSIONS: The results suggest a role for smoking and possibly also for other lifestyle factors in the risk of contracting BCC.

Adult↗
PubMed2003

Food hypersensitivity among Finnish university students: association with atopic diseases.

BACKGROUND: Food hypersensitivity (FH) is commonly suspected, especially among adults with atopic diseases. Symptoms of FH vary from oral allergy syndrome (OAS) to gastrointestinal, respiratory and systemic reactions. More data are needed regarding patient groups at risk for FH, and symptoms and foods responsible for the reactions. METHODS: FH was studied in 286 Finnish university students. Four study groups were selected: subjects (i) with current atopic dermatitis (AD) with or without allergic rhinoconjunctivits (ARC) or asthma (n = 41); (ii) with past AD with or without ARC or asthma (n = 89); (iii) with ARC or asthma (n = 69); (iv) without clinically confirmed atopic disease (n = 87). A thorough clinical examination was performed with a questionnaire specifying adverse events to foods. In addition, IgE specific to five foods, and skin prick tests to four foods were determined. RESULTS: FH was reported by 172 subjects (60.1%), more often by females (66.3%) than by males (47.9%) (P = 0.003). FH was most frequent among subjects with AD, among those with current AD in 73.2%, with past AD in 66.3%, and with ARC or asthma in 63.8%; 44.8% of subjects without any atopic disease reported FH. Kiwi fruit caused symptoms most frequently (38.4%), followed by milk (32.6%), apple (29.1%), tomato (27.9%), citrus fruits (25.0%), tree nuts (23.3%), and peanut (17.4%). A total of 720 separate symptoms to 25 food items were reported. OAS was most common (51.2%), followed by gastrointestinal symptoms (23.5%), worsening of AD (11.4%), urticaria (4.2%), rhinitis or conjunctivitis (5.7%) and asthma (4.0%). Severe reactions occurred in 3.5% (25/720). Negative IgE and skin prick test to foods predicted well negative history, but the value of positive test results was limited. CONCLUSIONS: FH was reported most often by students with current AD and multiple atopic diseases. Severe reactions occurred especially in patients with ARC and asthma. After excluding lactose intolerance, milk hypersensitivity was frequently reported.

Adolescent↗
PubMed2003

Factors associated to lifestyle and risk of adult onset asthma.

BACKGROUND: Asthma prevalence has been increasing especially in developed countries. The change seems to be associated with changes in lifestyle. We have made a prospective study to assess the effect of lifestyle factors, including smoking, educational level, physical activity and obesity on adult onset asthma. METHODS: A population of 10,597 adult twins, initially free of asthma was followed for 9 years. The main outcome measure was questionnaire-based report of physician diagnosed asthma. Logistic regression was used to estimate the risk of asthma predicted by lifestyle factors, with adjustment for atopy and respiratory symptoms. RESULTS: Obesity at baseline increased asthma risk (multivariable adjusted OR = 3.00, 95% CI: 1.64-5.50 for those with BMI > or = 30 compared to those with normal weight BMI: 20-24.99). Taller height was associated to lower asthma incidence. Leisure time physical activity had a slightly protective effect on asthma risk among men (P for trend = 0.037) while smoking and education did not have significant effects on the risk of adult onset asthma. CONCLUSIONS: Obesity was associated to the risk of adult onset asthma, while short height and low leisure time physical activity can be considered as other potential risk factors.

Adult↗
PubMed2002

Population-based twin study of the effects of migration from Finland to Sweden on endothelial function and intima-media thickness.

Finnish men have higher coronary heart disease (CHD) mortality than Swedish men do. To assess the impact of migration to a country with lower CHD mortality on subclinical atherosclerosis, we measured early functional and structural atherosclerotic vascular changes in twins discordant for migration from Finland to Sweden. Conventional CHD risk factors, flow-mediated dilatation (FMD) of the brachial artery, carotid intima-media thickness, and carotid artery compliance were measured in 74 male twin pairs (20 monozygous, 54 dizygous), aged 42 to 69 years, in which co-one twin had migrated more than 20 years ago permanently to Sweden. There were no significant differences in CHD risk factors except for diastolic blood pressure and body fat percentage, which were higher in Sweden. In all subjects, mean FMD was non-significantly higher in Sweden (5.7+/-4.3% vs 4.9+/-4.2%, P=0.22), but in monozygous twins the difference in FMD was highly significant (7.2+/-4.4 vs 3.7+/-2.9%, P=0.003). There was no significant difference in intima-media thickness or carotid artery compliance between Sweden and Finland. We conclude that in Finnish monozygous twins the endothelial function is better among the twins that have migrated to a country with lower CHD prevalence.

Adult↗
PubMed2002

Childhood farm environment and asthma and sensitization in young adulthood.

BACKGROUND: Farm environment in childhood may protect against sensitization, allergic rhinitis, and asthma. METHODS: Subjects were obtained from 10 667 Finnish first-year university students who responded to a questionnaire survey on IgE-mediated diseases. Two random samples were selected from 1631 respondents in Turku: subjects with asthma or wheezing, and subjects without asthmatic symptoms. A total of 296 subjects (72%) participated. Skin prick tests (SPT), measurements of IgE-antibodies, methacholine challenge, and bronchodilation tests were performed. Weighted occurrence of current asthma and sensitization among students from "childhood farm" and "childhood nonfarm" environments were analyzed. RESULTS: Current asthma was found in 3.1% of subjects with childhood farm environment, and in 12.4% with nonfarm environment (odds ratio (OR) 0.22; 95% confidence interval (CI) 0.07-0.70). There were fewer positive SPT to birch (8.3 vs. 24.2%, OR 0.28, 95% CI 0.07-1.15) and timothy pollen (12.6 vs. 30.3%, OR 0.33, 95% CI 0.09-1.20) among subjects with childhood farm environment, but more sensitization to house-dust mite (22.0 vs. 4.9%, OR 5.43, 95% CI 1.60-18.46). Sensitization to cat (RAST class >/= 3) was less common in subjects with farm compared to nonfarm environments in childhood (1.5 vs. 13.1%; OR 0.10, 95% CI 0.02-0.47). CONCLUSIONS: Farm environment in childhood protects against adult asthma and sensitization-especially to cat-the most important asthma related allergen. In contrast, sensitization to house-dust mite was more common in farming subjects.

Adolescent↗
PubMed2002

Life dissatisfaction as a predictor of fatal injury in a 20-year follow-up.

OBJECTIVE: To investigate the role of life satisfaction (LS) in fatal injuries with special references to unintentional injuries and whether health status modifies this relationship. METHOD: A sample of adult Finns unselected for health status (n=29 173) responded in 1975 to a LS scale. Nationwide registry for deaths was used. The dissatisfied were compared with the satisfied by Cox regression. RESULTS: During 1976-1995, 469 fatal injuries occurred, of which 235 were unintentional. Dissatisfaction predicted fatal unintentional [hazard ratio (HR)=2.83; 95% confidence interval (CI) 1.77-4.51] and intentional injury (HR=3.26; 2.01-5.30). The risk of fatal unintentional injury was 7.8-fold (women) and 4.0-fold (men) increased in the sick and dissatisfied compared with the healthy and satisfied. A repeatedly reported dissatisfaction (1975, 1981) provided a HR of 5.17 (1.48-18.0) for unintentional injury death during 1981-1995. The found effect was partly mediated through health behavior and social situation. CONCLUSION: Life dissatisfaction predicts both unintentional and intentional injury death.

Adult↗
PubMed2002

Acquired preference especially for dietary fat and obesity: a study of weight-discordant monozygotic twin pairs.

OBJECTIVE: To determine the independent associations of dietary preference for fat with obesity without the confounding by genetic effects. DESIGN: Descriptive comparison of the responses of monozygotic twins discordant for obesity to questions concerning current and past preference for dietary fat, current overconsumption of fatty items and recalled food consumption compared to the co-twin. SETTING: The Research and Development Centre of the Social Insurance Institution, Finland. SUBJECTS: Twenty-three healthy monozygotic twin pairs who were discordant for obesity (BMI difference at least 3 kg/m(2)). MAIN OUTCOME MEASURES: Obesity status of the twin, as a function of the current and recalled dietary preferences and selected psychosocial variables. RESULTS: The obese twins reported current preference for fatty foods three times more frequently than the lean co-twin. Moreover, when comparing recalled taste for fat at the time the twins left their parental homes, both the obese and lean co-twins consistently recalled that the obese twin had greater preference for fatty foods in young adulthood, and that the lean twin had less. Psychological characteristics of lean and obese co-twins did not differ. CONCLUSION: Acquired preference for fatty foods is associated with obesity, independent of genetic background. Modification of fat preferences may be an important step in the prevention of obesity in the general population.

Adult↗
PubMed2002

Malignant skin cancers in the Finnish Twin Cohort: a population-based study, 1976-97.

BACKGROUND: Both hereditary and environmental factors are implicated in the aetiology of cutaneous neoplasms. Studies of twins make it possible to estimate the contribution of inherited genes to the development of disease. OBJECTIVE: To assess the importance of hereditary and environmental factors (including physical environment and lifestyles) in malignant melanoma and malignant nonmelanoma of the skin. METHODS: The Finnish Twin Cohort, comprising 25 882 adult like-sexed twins with established zygosity, was linked with the Finnish Cancer Registry to identify malignant skin cancers in a prospective follow-up from 1976 to 1997. Standardized incidence ratios were computed based on national rates. RESULTS: Sixty twins were diagnosed with melanoma and 49 twins with nonmelanoma during the follow-up. The risks of these cancers did not differ from the risk in the population at large. There was only one pair where both twins had a malignant skin cancer (dizygotic male twins both with squamous cell carcinoma). CONCLUSIONS: The near-total lack of concordance for skin cancer in twin pairs suggests that environmental and not hereditary effects are most important in the causation of malignant skin cancers in a white population with low levels of sun exposure.

Adolescent↗
PubMed2002

Stressful life events promote the manifestation of asthma and atopic diseases.

BACKGROUND: Psychosocial stress is known to aggravate asthma. Less is known about the impact of stressful life events on the expression of asthma and atopic disorders. OBJECTIVE: To determine whether the onset of asthma, allergic rhinitis or conjunctivitis, and atopic dermatitis, are associated with stressful life events. METHODS: A postal survey on risk factors for asthma and atopic diseases was carried out among 10 667 Finnish first-year university students aged 18-25 years. Stressful life events, (i) severe disease or death of a family member, and (ii) parental or personal conflicts, were retrospectively recorded during the preceding year, 1-5 years, 6-10 years, and more than 10 years prior to the survey response. In a case-control setting, conditional multiple logistic regression analysis was used to assess the temporal association between major stressful life events occurring during a period either preceding, concomitant or subsequent with subject's diagnoses. RESULTS: Concomitant parental and personal conflicts increased the risk of asthma (OR 1.72, 95% CI 1.10-2.69) when adjusted by parental asthma, education and passive smoking at early age. Concomitant severe disease or death of mother, father or spouse (OR 1.52, 95% CI 1.09-2.16) and precedent parental and personal conflicts (OR 1.75, 95% CI 1.15-2.77) increased the risk of manifestation of allergic rhinoconjunctivitis when adjusted for parental atopic disease, education and passive smoking. Subjects' asthma and atopic dermatitis, but not allergic rhinoconjunctivitis, were related to excess of subsequent stressful life events. CONCLUSION: An association between stressful life events and subjects' asthma, allergic rhinoconjunctivitis and atopic dermatitis is suggested.

Adult↗
PubMed2002

Visceral fat and psychosocial stress in identical twins discordant for obesity.

OBJECTIVES: Accumulation of intra-abdominal fat has been suggested, but not yet proved, to be basically as a result of chronic psychosocial stress causing arousal of hypothalamic-pituitary-adrenal cortex axis. Our objectives were to study the association between psychosocial stress, obesity and body fat distribution when genetic factors are identical. DESIGN: Monozygotic twins discordant for obesity were examined in an in-patient setting. SUBJECTS: Adult monozygotic twin pairs (12 female, 8 male) with an average intrapair difference of 17 kg in body weight. They were divided into two groups: in group A the visceral fat area of the obese cotwin was higher and, in group B, lower than the gender-specific median value. MAIN MEASURES: Hormonal, physiological and psychological distress indicators, and sleep measures. RESULTS: Daily urinary cortisol and noradrenaline excretion were higher in the obese cotwins when compared with the nonobese cotwins in group A but not in group B (P=0.026 and 0.020 when intrapair differences were compared between groups A and B, respectively). In serum cortisol, ACTH and CBG concentrations a similar trend was not statistically significant. In group A, the obese cotwins consumed almost 2.5 times as much alcohol as their lean cotwins, whilst in group B the situation was the opposite. The mean amount of active sleep was significantly higher and that of quiet sleep significantly lower in the obese than the lean cotwins only in group A. Intrapair differences in emotional reactions indicating distress and lack of subjective energy were seen only in group A. CONCLUSION: When genetic factors are identical, visceral fat accumulation, rather than obesity in general, is associated with increased psychosocial stress and concomitant hormonal changes.

Adipose Tissue↗
PubMed2002

Migration and mortality: a 20 year follow up of Finnish twin pairs with migrant co-twins in Sweden.

STUDY OBJECTIVE: Finland has a higher mortality overall and for major causes of death than Sweden, primarily in men. The objective of this study was to analyse mortality in migrants from Finland to Sweden. DESIGN: A longitudinal study based on the Finnish Twin Cohort Study. Information about migration from Finland to Sweden, duration of stay in Sweden for the migrants, and deaths 1976-1995 was obtained from national registers. Observed numbers of deaths in migrants were compared with expected numbers based on the age standardised mortality experience of the Finnish Twin Cohort. First deaths in migrants and non-migrants of migrant discordant pairs were compared controlling for genetic and early childhood factors. PARTICIPANTS: Twin pairs of the Finnish Twin Cohort Study where at least one twin had migrated to Sweden (1542 twin pairs). MAIN RESULTS: Among men, migrants from Finland to Sweden showed an overall similar mortality compared with all subjects of the Finnish Twin Cohort (SMR 1.1; 95% CI 0.9 to 1.4). Mortality from non-violent causes was increased for migrants with at most 20 years in Sweden (SMR 1.9; 95% CI 1.2 to 2.6) and decreased in those with a longer stay (SMR 0.7; 95% CI 0.4 to 0.9). Similar results were obtained concerning first deaths in twin pairs discordant for migration. Among women, migrants had an increased mortality overall (SMR 1.4; 95% CI 1.0 to 1.8), from cardiovascular disease (SMR 1.7; 95% CI 1.0 to 2.7), and from violent causes (SMR 2.5; 95% CI 1.2 to 4.6) compared with all women of the Finnish Twin Cohort. In analyses of migrant discordant pairs only first deaths from cardiovascular disease tended to be more common in the migrants than in non-migrant co-twins. CONCLUSIONS: Migrants from Finland to Sweden seem to have an overall mortality comparable to that prevailing in Finland suggesting no strong influence on mortality by the migration. Duration of stay seems to be associated with mortality in the migrants, at least in men, with a lower mortality after several years in Sweden.

Adult↗
PubMed2001

Quantitative-trait-locus analysis of body-mass index and of stature, by combined analysis of genome scans of five Finnish study groups.

In recent years, many genomewide screens have been performed, to identify novel loci predisposing to various complex diseases. Often, only a portion of the collected clinical data from the study subjects is used in the actual analysis of the trait, and much of the phenotypic data is ignored. With proper consent, these data could subsequently be used in studies of common quantitative traits influencing human biology, and such a reanalysis method would be further justified by the nonbiased ascertainment of study individuals. To make our point, we report here a quantitative-trait-locus (QTL) analysis of body-mass index (BMI) and stature (i.e., height), with genotypic data from genome scans of five Finnish study groups. The combined study group was composed of 614 individuals from 247 families. Five study groups were originally ascertained in genetic studies on hypertension, obesity, osteoarthritis, migraine, and familial combined hyperlipidemia. Most of the families are from the Finnish Twin Cohort, which represents a population-wide sample. In each of the five genome scans, approximately 350 evenly spaced markers were genotyped on 22 autosomes. In analyzing the genotype data by a variance-component method, we found, on chromosome 7pter (maximum multipoint LOD score of 2.91), evidence for QTLs affecting stature, and a second locus, with suggestive evidence for linkage to stature, was detected on chromosome 9q (maximum multipoint LOD score of 2.61). Encouragingly, the locus on chromosome 7 is supported by the data reported by Hirschhorn et al. (in this issue), who used a similar method. We found no evidence for QTLs affecting BMI.

Body Height↗
PubMed2001

Insufficient sleep--a population-based study in adults.

STUDY OBJECTIVES: Insufficient sleep (sleep deprivation) is a common problem of considerable health, social, and economical impact. We assessed its prevalence and associations, and the role of genetic influences. DESIGN: Panel study based on questionnaires administered in 1981 and 1990. SETTING/PATIENTS: 12.423 subjects aged 33-60 years included in the Finnish Twin Cohort, representative of the Finnish population. INTERVENTIONS: N/A. MEASUREMENTS: A difference of 1 hour between the self-reports of the sleep need and the sleep length was considered insufficient sleep. Associations with education, life style, work, psychological characteristics and sleep-wake variables were assessed. Structural equation modelling techniques were used to compare genetic models among monozygotic and dizygotic twin pairs. RESULTS: In 1990, the prevalence of insufficient sleep was 20.4% (16.2% in men and 23.9% in women). 44% of those with insufficient sleep in 1981 also had it 9 years later (Spearman correlation for persistence 0.334). In multivariate analyses, the strongest positively associated factors were daytime sleepiness (women: odds ratio 3.87, 95% confidence limits 3.24-4.63/men: 3.77, 2.98-4.75), insomnia (2.48, 1.92-3.19/2.91, 2.17-3.90), not able to sleep without disturbance (1.95, 1.47-2.60/2.54, 1.66-3.89), and evening type (2.10, 1.65-2.69/1.73, 1.25-2.41). Among men, also weekly working hours > or =75 was strongly associated (3.23, 1.54-6.78). "Not working" was negatively associated in both genders (0.68, 0.51-0.89/0.59, 0.42-0.83). Two thirds of the interindividual variability in the liability to insufficient sleep was attributed to non-genetic factors. CONCLUSIONS: Insufficient sleep is a common and long-standing condition, most strongly associated with sleep/wake variables. One third of the liability to it is attributed to genetic influences. Sleep sufficiency should be assesssed in health examinations of working adults.

Adult↗
PubMed2001

Stress of daily activities and risk of breast cancer: a prospective cohort study in Finland.

The belief that life stress enhances breast cancer is common, but there are few prospective epidemiological studies on the relationship of life stress and breast cancer. We have investigated the association between stress of daily activities (SDA) and breast-cancer risk in a prospective cohort study of 10,519 Finnish women aged 18 years or more. SDA measures a subject's own appraisal of daily stress. It was assessed in 1975 and 1981 by a self-administered questionnaire, which also provided information on subject characteristics and other known breast-cancer risk factors. Follow-up data for breast cancer from 1976 to 1996 were attained through record linkage to the Finnish Cancer Registry. Study subjects were divided into 3 groups based on their SDA scores in 1975: no stress (23% of subjects), some stress (68%) and severe stress (9%). Hazard ratios (HRs) and respective 95% confidence intervals (CIs) for incidence of breast cancer by level of SDA were obtained from the Cox proportional hazards model. We identified 205 incident breast cancers in the cohort. Multivariable-adjusted HRs for breast-cancer risk were 1.00 (reference), 1.11 (95% CI 0.78-1.57) and 0.96 (95% CI 0.53-1.73) by increasing level of stress. Neither shifting of the SDA cut-off points nor restricting the analysis to women who reported the same level of SDA in 1975 and 1981 materially altered the results. We found no evidence of an association between self-perceived daily stress and breast-cancer risk.

Activities of Daily Living↗
PubMed2001

Sense of coherence as a predictor of subjective state of health: results of 4 years of follow-up of adults.

UNLABELLED: A number of cross-sectional population studies have shown that a strong sense of coherence (SOC) is associated with various aspects of good perceived health. The association does not seem to be entirely attributable to underlying associations of SOC with other variables, such as age or level of education. OBJECTIVE: The aim of the study reported here was to determine whether SOC predicted subjective state of health. METHODS: The study was carried out as a two-way panel mail survey of 1976 individuals with 4 years interval for two collections of data. The statistical method used was multivariate cumulative logistic modeling. Age, initial subjective state of health, initial occupational training level, and initial degree of social integration were included as potential explanatory variables. RESULTS: A strong SOC predicted good health in women and men. CONCLUSIONS: SOC can be interpreted as an autonomous internal resource contributing to a favorable development of subjective state of health. SOC data should, however, be regarded as complementary to and not a substitute for information already known to be associated with increased risk of future ill health.

Adolescent↗