Stockholm County Council

About: Stockholm County Council is a government organization based out in Stockholm, Sweden. It is known for research contribution in the topics: Population & Poison control. The organization has 1410 authors who have published 2429 publications receiving 78936 citations.

Evidence for a causal relationship between low vitamin D, high BMI, and pediatric-onset MS.

Abstract: Objective: To utilize Mendelian randomization to estimate the causal association between low serum vitamin D concentrations, increased body mass index (BMI), and pediatric-onset multiple sclerosis (MS) using genetic risk scores (GRS). Methods: We constructed an instrumental variable for vitamin D (vitD GRS) by computing a GRS for 3 genetic variants associated with levels of 25(OH)D in serum using the estimated effect of each risk variant. A BMI GRS was also created that incorporates the cumulative effect of 97 variants associated with BMI. Participants included non-Hispanic white individuals recruited from over 15 sites across the United States (n = 394 cases, 10,875 controls) and Sweden (n = 175 cases, 5,376 controls; total n = 16,820). Results: Meta-analysis findings demonstrated that a vitD GRS associated with increasing levels of 25(OH)D in serum decreased the odds of pediatric-onset MS (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.55, 0.94; p = 0.02) after controlling for sex, genetic ancestry, HLA-DRB1*15:01, and over 100 non–human leukocyte antigen MS risk variants. A significant association between BMI GRS and pediatric disease onset was also demonstrated (OR 1.17, 95% CI 1.05, 1.30; p = 0.01) after adjusting for covariates. Estimates for each GRS were unchanged when considered together in a multivariable model. Conclusions: We provide evidence supporting independent and causal effects of decreased vitamin D levels and increased BMI on susceptibility to pediatric-onset MS.

Familial hemophagocytic lymphohistiocytosis and viral infections

Abstract: A retrospective study was performed in 32 children with hemophagocytic lymphohistiocytosis, 16 of whom had affected siblings. Altogether 22 of these children, of whom the majority (13/22) were familial cases, had clinical or laboratory signs of infection. Laboratory analysis demonstrated Epstein-Barr virus in five children, cytomegalovirus in three and human parvovirus in two. Two siblings with onset of familial hemophagocytic lymphohistiocytosis within one month of each other, both of whom demonstrated serological indications of a recent human parvoviral infection at onset, are described. It is concluded that a viral infection cannot serve as the sole criterion for distinguishing a virus-associated hemophagocytic syndrome as an entity separate from familial hemophagocytic lymphohistiocytosis. Instead, it is suggested that viral infections may elicit a bout of the familial hemophagocytic lymphohistiocytosis disorder in genetically predisposed individuals.

Risk behaviours, victimisation and mental distress among adolescents in different family structures

Abstract: Previous studies have shown an elevated risk with regard to social and behavioural domains in adolescents of single parents. However, the diversity of single parent families concerning gender of the resident parent has seldom been taken into account when investigating the relation between family structure and children’s negative outcomes. Thus, the aim of this study was to investigate risk behaviours, victimisation and mental distress among adolescents in different family structures using more detailed sub-groups of single parents (i.e., single mother, single father and shared physical custody). The sample consisted of 15,428 ninth graders from all municipal and private schools in the county of Stockholm (response rate 83.4%). Risk behaviours included use of alcohol, illicit drugs and smoking. Victimisation was measured by experiences of exposure to bullying and physical violence. Mental distress was assessed with the anxious/depressed and aggressive behaviour syndrome scales in the Youth Self Report (YSR). Bivariate and multivariate logistic regression analyses were used to investigate the associations between family structure and outcome variables. Adolescents in single-mother/father families were at higher risk of risk behaviours, victimisation and mental distress than their counterparts in two-parent families. However, after control for possible confounders the associations between victimisation, aggressive behaviour problems and single motherhood were no longer significant, whereas these relations remained for children living with single fathers. Adolescents in shared physical custody run no increased risk of any of the studied outcomes (except drunkenness) after adjustment for covariates. Post hoc analyses revealed that adolescents in single-father families were at higher risk for use of alcohol, illicit drugs, drunkenness, and aggressive behaviour as compared to their peers in single-mother families, whereas no differences were found between adolescents in single-mother families and those in shared physical custody. Children of single parents should not be treated as a homogenous group when planning prevention and intervention programmes. Researchers and professionals should be aware of and consider the specific problems of single parent children and that their problems may vary depending on their living arrangements.

Overweight decreases the chance of achieving good response and low disease activity in early rheumatoid arthritis

Abstract: Aim To investigate whether overweight/obesity at diagnosis affects the chances of decrease in disease activity and pain in early rheumatoid arthritis (RA). Method We investigated incident RA cases from the population-based Epidemiological Investigation of risk factors for Rheumatoid Arthritis (EIRA) study (2006– 2009, N=495) with clinical follow-up in the Swedish Rheumatology Quality Register. At diagnosis, 93% received disease-modifying antirheumatic drugs (DMARDs) (86% methotrexate). The odds of achieving a good response according to the DAS28-based European League Against Rheumatism (EULAR) criteria, low disease activity (DAS28<3.2), remission (DAS28<2.6) or pain remission (visual analogue scale ≤20 mm) at 3months and 6-months follow-up, were calculated using logistic regression, adjusting for potential confounders. Results Significant dose-response relationships were found between Body Mass Index (BMI) and change of disease activity as well as pain at both time points. Patients with BMI ≥25 had 51% lower odds of achieving low disease activity (odds ratio (OR=0.49 (95% CI 0.31 to 0.78)) and 42% lower odds of remission (OR=0.58 (95% CI 0.37 to 0.92)) at the 6-months visit, compared to normal-weight patients. This effect was also present at 3 months, where we also found a 43% decreased odds of pain remission (OR=0.57 (95% CI 0.37 to 0.88)). No effect modification was found for anti-citrullinated protein antibody (CCP)-status, sex, prednisolone treatment or DAS28 at diagnosis. Conclusions Overweight at diagnosis significantly decreases the chance of achieving good disease control during the early phase of RA.