Publications

190 Publications visible to you, out of a total of 190

Abstract (Expand)

BACKGROUND: The Pittsburgh Sleep Quality Index (PSQI) is frequently used to assess sleep problems in patients. The aim of this study was to provide reference values for this questionnaire, to test psychometric properties, and to analyze associations with psychological, sociodemographic, and behavioral factors. METHODS: A German community sample comprising 9284 adult residents (aged 18-80 years) was surveyed using the PSQI and several other questionnaires. RESULTS: According to the generally accepted cut-off (PSQI > 5), 36% of the general population slept badly. Females reported significantly more sleep problems than males (mean scores: M = 5.5 vs. M = 4.4, respectively; effect size d = 0.35), but there was no linear association between age and sleep quality. Sleep problems were correlated with fatigue, quality of life (physical as well as mental), physical complaints, anxiety, and lack of optimism. Sleep quality was also strongly associated with socioeconomic status, professional situation (poorest sleep quality in unemployed people), and obesity. In addition to the results of the PSQI total score, mean scores of specific components of sleep quality were presented (sleep latency, sleep duration, and use of sleep medication). CONCLUSION: The PSQI proved to be a suitable instrument for measuring sleep quality. Gender differences, psychological factors, and obesity should be taken into account when groups of patients are compared with respect to sleep problems.

Authors: A. Hinz, H. Glaesmer, E. Brahler, M. Loffler, C. Engel, C. Enzenbach, U. Hegerl, C. Sander

Date Published: 21st Feb 2017

Publication Type: Journal article

Abstract (Expand)

The LIFE Child study is a large population-based longitudinal childhood cohort study conducted in the city of Leipzig, Germany. As a part of LIFE, a research project conducted at the Leipzig Research Center for Civilization Diseases, it aims to monitor healthy child development from birth to adulthood and to understand the development of lifestyle diseases such as obesity. The study consists of three interrelated cohorts; the birth cohort, the health cohort, and the obesity cohort. Depending on age and cohort, the comprehensive study program comprises different medical, psychological, and sociodemographic assessments as well as the collection of biological samples. Optimal data acquisition, process management, and data analysis are guaranteed by a professional team of physicians, certified study assistants, quality managers, scientists and statisticians. Due to the high popularity of the study, more than 3000 children have already participated until the end of 2015, and two-thirds of them participate continuously. The large quantity of acquired data allows LIFE Child to gain profound knowledge on the development of children growing up in the twenty-first century. This article reports the number of available and analyzable data and demonstrates the high relevance and potential of the study.

Authors: T. Poulain, R. Baber, M. Vogel, D. Pietzner, T. Kirsten, A. Jurkutat, A. Hiemisch, A. Hilbert, J. Kratzsch, J. Thiery, M. Fuchs, C. Hirsch, F. G. Rauscher, M. Loeffler, A. Korner, M. Nuchter, W. Kiess

Date Published: 2nd Feb 2017

Publication Type: Journal article

Abstract (Expand)

PURPOSE Body surface area is a physiological quantity relevant for many medical applications. In clinical practice, it is determined by empirical formulae. 3D laser-based anthropometry provides an easyy and effective way to measure body surface area but is not ubiquitously available. We used data from laser-based anthropometry from a population-based study to assess validity of published and commonly used empirical formulae. METHODS We performed a large population-based study on adults collecting classical anthropometric measurements and 3D body surface assessments (N = 1435). We determined reliability of the 3D body surface assessment and validity of 18 different empirical formulae proposed in the literature. The performance of these formulae is studied in subsets of sex and BMI. Finally, improvements of parameter settings of formulae and adjustments for sex and BMI were considered. RESULTS 3D body surface measurements show excellent intra- and inter-rater reliability of 0.998 (overall concordance correlation coefficient, OCCC was used as measure of agreement). Empirical formulae of Fujimoto and Watanabe, Shuter and Aslani and Sendroy and Cecchini performed best with excellent concordance with OCCC \textgreater 0.949 even in subgroups of sex and BMI. Re-parametrization of formulae and adjustment for sex and BMI slightly improved results. CONCLUSION In adults, 3D laser-based body surface assessment is a reliable alternative to estimation by empirical formulae. However, there are empirical formulae showing excellent results even in subgroups of sex and BMI with only little room for improvement.

Authors: Andreas Kuehnapfel, Peter Ahnert, Markus Loeffler, Markus Scholz

Date Published: 27th Jan 2017

Publication Type: Journal article

Abstract (Expand)

Background and objectives: Obesity has been associated with increased risk of dementia. Grey and white matter (WM) of the brain are commonly used as biomarkers for early detection of dementia. However, considering WM, available neuroimaging studies had mainly small sample size and yielded less conclusive results (Kullmann et al., 2015). Recently, a positive correlation between obesity and fractional anisotropy (FA) in a middle age group was reported (Birdsill et al. 2017). Furthermore, obesity is related to many medical problems such as diabetes and hypertension. Diabetes and hypertension were found to be correlated with brain structures independently (de Leeuw et al., 2002; Weinstein et al., 2015). Yet, studies rarely investigated non-lesion WM microstructure and its association with diabetes and blood pressure. Therefore we aim to investigate the relation between abdominal obesity, diabetes, blood pressure and WM microstructural variability in a large cohort of community-dwelling healthy adults. Methods: The sample included dementia-free participants (mean age 55 ± 16 years; 50.7% women) of the LIFE cohort with brain MRI scans (n = 1255). WM microstructure was measured with diffusion tensor imaging (DTI). Mean FA was derived from the individual WM skeleton processed by tract-based-spatial-statistic method. Linear regression models were used to assess the relationships between diabetes, blood pressure, waist to hip ratio (WHR) and DTI parameters. Adjustments were made for age, sex, education and Apoe4. Results: The preliminary result indicated diabetes, systolic blood pressure and WHR were independently associated with lower FA, and diabetes explained the most variance besides age. Subgroup analysis revealed both systolic blood pressure and WHR were negatively associated with mean FA in the non-diabetes group (n=1101). Conclusions: The preliminary result of our study indicates that diabetes accelerated brain aging on directional diffusion of WM. Abdominal fat and blood pressure were associated with WM variabilities independently from age, sex and diabetes. With subsequent analysis of additional DTI measures, blood parameters, WM hyperintensity maps and voxel-based microstructural WM “integrity”, we aim to further characterize the associations between obesity, diabetes, blood pressure and WM microstructure. This will contribute to the existing literature and help to disentangle the underlying mechanism.

Authors: Rui Zhang, Frauke Beyer, L. Lampe, T. Luck, S. G. Riedel-Heller, M. Stumvoll, Markus Löffler, M. L. Schroeter, A. Villringer, A. V. Witte

Date Published: 2017

Publication Type: Not specified

Human Diseases: diabetes mellitus, obesity, hypertension

Abstract (Expand)

Epidemiological studies analyze and monitor the health state of a population. They typically use different methods and techniques to capture and to integrate data of interest before they can be analyzed. As new technologies and, thus, devices are available for data capturing, such as wearables, new requirements arise for current data integration approaches. In this paper, we review current techniques and approaches as well as new trends in data capturing and the resulting requirement for its integration.

Authors: T. Kirsten, J. Bumberger, G. Ivanova, P. Dietrich, C. Engel, M. Loeffler, W. Kiess

Date Published: 2017

Publication Type: InBook

Abstract (Expand)

BACKGROUND Women with highly penetrant BRCA mutations have a 55-60 % lifetime risk for breast cancer and a 16-59 % lifetime risk of developing ovarian cancer. However, penetrance differs interindividually,, indicating that environmental and behavioral factors may modify this risk. It is well documented that the risk for sporadic breast cancer disease can be modified by changing lifestyle factors that primarily include physical activity, dietary habits, and body weight. It can thus be hypothesized that the modification of these lifestyle factors may also influence the incidence and progression of cancer in BRCA mutation carriers. METHODS/DESIGN This multicenter, interdisciplinary, prospective, two-armed, randomized (1:1) controlled trial aims to enroll a minimum of 600 BRCA1 and BRCA2 mutation carriers to partake in either a lifestyle intervention or usual care. The study primarily aims to demonstrate an improvement of nutritional behavior (adherence to the Mediterranean diet), body mass index, and physical fitness. Furthermore, the effects on quality of life, stress coping capacity, breast cancer incidence, and mortality will be investigated. The intervention group (IG) will receive a structured lifestyle intervention over 12 months, whereas the control group (CG) will only receive information regarding a healthy lifestyle. During the first 3 months, women in the IG will receive structured, individualized, and mainly supervised endurance training with a minimum of 18 MET-h physical activity per week and nutrition education based on the Mediterranean diet. Over the following 9 months, IG monthly group training sessions and regular telephone contacts will motivate study participants. The CG will receive one general training session about healthy nutrition in accordance with the recommendations of the German Society of Nutrition (standard of care in Germany) and the benefits of regular physical activity on health status. At randomization and subsequent time points (3 and 12 months), cardiopulmonary fitness will be assessed by spiroergometry, and nutritional and psychological status will be assessed by validated questionnaires, interviews, and clinical examinations. DISCUSSION As data on the role of lifestyle intervention in women with a hereditary risk for breast and ovarian cancer are currently lacking, this study will be of major importance from a scientific, as well as a practical advice viewpoint. It will investigate the optimal strategy to improve physical fitness, nutritional status, and psychological factors such as quality of life, perceived stress, optimism, as well as incidence and outcome of cancer in this selected group of women at high risk. If the study indicates a positive long-term outcome, a structured lifestyle intervention program could be added to health care prevention strategies for BRCA1 and BRCA2 mutation carriers. TRIAL REGISTRATION ClinicalTrials.gov: NCT02516540 . Registered on 22 July 2015.

Authors: Marion Kiechle, Christoph Engel, Anika Berling, Katrin Hebestreit, Stephan C. Bischoff, Ricarda Dukatz, Michael Siniatchkin, Katharina Pfeifer, Sabine Grill, Maryam Yahiaoui-Doktor, Ellen Kirsch, Uwe Niederberger, Ute Enders, Markus Löffler, Alfons Meindl, Kerstin Rhiem, Rita Schmutzler, Nicole Erickson, Martin Halle

Date Published: 1st Dec 2016

Publication Type: Journal article

Human Diseases: hereditary breast ovarian cancer syndrome

Abstract (Expand)

BACKGROUND Women with highly penetrant BRCA mutations have a 55-60% lifetime risk for breast cancer and a 16-59% lifetime risk for ovarian cancer. However, penetrance differs interindividually, indicatingg that environmental and behavioral factors may modify this risk. These include lifestyle factors such as physical activity status, dietary habits, and body weight. The modification of penetrance by changing lifestyle factors has not thus far been investigated in a randomized trial in BRCA mutation carriers. METHODS Therefore, we intend to enroll 60 BRCA1/2 mutation carriers in a pilot feasibility study (Lifestyle Intervention Study in Women with Hereditary Breast and Ovarian Cancer (LIBRE) pilot). This multi-center, prospective, controlled trial aims to randomize (1:1) participants into a (1) multi-factorial lifestyle intervention group (IG) versus (2) the control group with usual care (CG). The primary endpoint is feasibility and acceptance of a structured interdisciplinary lifestyle intervention program over 12 months (at least 70% of the patients to complete the 1-year intervention). Furthermore, the effects on physical fitness, BMI, quality of life, and stress coping capacity will be investigated. During the first 3 months, women in the IG will receive structured, individualized and mainly supervised endurance training of \geq18 MET*h/week (MET = metabolic equivalent task) and personal nutritional counseling based on the Mediterranean diet. During the subsequent 9 months, the IG will receive monthly group training sessions and regular telephone contacts for motivation, whereas the CG will only receive usual care (one general counseling on healthy nutrition and benefits of regular physical activity on health status). At randomization and subsequent time points (3, 6, 12 months), cardiopulmonary fitness will be assessed by spiroergometry and nutritional and psychological status by validated questionnaires. DISCUSSION This pilot study will investigate the optimal strategy to improve physical fitness, nutritional habits, and psychological factors in women at high risk for developing breast or ovarian cancer. The results of this pilot feasibility study will be the basis for a larger prospective randomized trial including clinical events (LIBRE). TRIAL REGISTRATION ClinicalTrials.gov, NCT02087592.

Authors: Marion Kiechle, Christoph Engel, Anika Berling, Katrin Hebestreit, Stephan Bischoff, Ricarda Dukatz, Wolf-Dieter Gerber, Michael Siniatchkin, Katharina Pfeifer, Sabine Grill, Maryam Yahiaoui-Doktor, Ellen Kirsch, Uwe Niederberger, Nicole Marter, Ute Enders, Markus Löffler, Alfons Meindl, Kerstin Rhiem, Rita Schmutzler, Nicole Erickson, Martin Halle

Date Published: 1st Dec 2016

Publication Type: Journal article

Human Diseases: hereditary breast ovarian cancer syndrome

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