American association of clinical endocrinologists and american college of endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity.

A systematic literature review of population prevalence studies of low back pain between 1966 and 1998 was conducted to investigate data homogeneity and appropriateness for pooling. Fifty-six studies were analyzed using methodologic criteria that examined sample representativeness, data quality, and pain definition. Acceptable studies were assessed for homogeneity and appropriateness for pooling. Thirty were methodologically acceptable. Of these there were significant differences in study design, patient age, mode of data collection, potential temporal effects, and prevalence results. Point prevalence ranged from 12% to 33%, 1-year prevalence ranged from 22% to 65%, and lifetime prevalence ranged from 11% to 84%. A limited number of studies were left for analysis, making the pooling of data difficult. A model using uniform best-practice methods is proposed.

The prevalence of low back pain: A systematic review of the literature from 1966 to 1998

https://www.thelancet.com/pdfs/journals/landia/PIIS2213-8587(13)70165-7.pdf

Vitamin D status and ill health: a systematic review

Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies

The epidemiology of chronic venous insufficiency and varicose veins.

Accumulating evidence suggests that inadequate vitamin D levels may predispose people to chronic diseases. The authors aimed to investigate whether serum 25-hydroxyvitamin D (25(OH)D) level predicts mortality from cardiovascular disease (CVD). The study was based on the Mini-Finland Health Survey and included 6,219 men and women aged > or =30 years who were free from CVD at baseline (1978-1980). During follow-up through 2006, 640 coronary disease deaths and 293 cerebrovascular disease deaths were identified. Levels of 25(OH)D were determined from serum collected at baseline. Cox's proportional hazards model was used to assess the association between 25(OH)D and risk of CVD death. After adjustment for potential confounders, the hazard ratio for total CVD death was 0.76 (95% confidence interval (95% CI): 0.60, 0.95) for the highest quintile of 25(OH)D level versus the lowest. The association was evident for cerebrovascular death (hazard ratio = 0.48, 95% CI: 0.31, 0.75) but not coronary death (hazard ratio = 0.91, 95% CI: 0.70, 1.18). A low vitamin D level may be associated with higher risk of a fatal CVD event, particularly cerebrovascular death. These findings need to be replicated in other populations. To demonstrate a causal link between vitamin D and CVD, randomized controlled trials are required.

Vitamin D Status and the Risk of Cardiovascular Disease Death

Objective. Several studies have shown that knee OA is associated with obesity, physical stress at work, traumatic knee injuries, heredity and female gender. However, the body of such evidence comes from cross-sectional or case-control studies, and from only a few follow-up studies, mostly of short duration. Based on the nationwide Mini-Finland Health Survey, we analysed the potential risk factors for prediction of incident knee OA in the long term. Methods. Focused on major health problems, the survey was carried out in 1978-80 in a sample of 8000 subjects, representative of the Finnish population aged ≥ 30 years. Altogether 823 subjects free from knee OA at the baseline were re-examined in 2000-01, and after the intervening 22 years 94 new cases of knee OA were found. Knee OA was diagnosed on both occasions by physicians using information on disease histories, symptoms and standardized clinical examinations. Results. The risk of developing knee OA was strongly associated with BMI (kg/m 2 ); adjusted for age and gender and other covariates, and compared with the reference category (BMI < 25.0); the relative odds ratios (ORs) with 95% CIs were 1.7 (95% CI 1.0, 2.8) and 7.0 (95% CI 3.5, 14.10) for subjects with BMIs 25.0-29.9 and ≥30.0, respectively. Similarly, the adjusted OR for the heaviest category of physical stress at work was 18.3 (95% CI 4.2, 79.4) compared with the lightest category, and 5.1 (95% CI 1.4, 19.0) for permanent complaints due to past knee injury. Conclusions. This prospective study confirms the roles of obesity, heavy work load and knee injury in the aetiology of knee OA.

Obesity, physically demanding work and traumatic knee injury are major risk factors for knee osteoarthritis—a population-based study with a follow-up of 22 years

The prevalence of lumbar disc syndrome (herniated disc or typical sciatica) and its consequences in terms of disability, handicap, and need for medical care were studied as part of the Mini-Finland Health Survey. A sample of 8000 persons representative of the Finnish population aged 30 or over was asked to come for examination, and 7217 (90%) participated. A diagnosis of lumbar disc syndrome based on medical history, symptoms, and standardised physical examination was made for 5.1% of the men and for 3.7% of the women. Half of these patients were assessed to be in need of medical care, over 80% of which was considered to be adequately met. One third of all patients with lumbar disc syndrome had been previously hospitalised for that syndrome, and one fifth of the patients had undergone lumbar surgery. At least slight disability was found in almost 60% of the patients, though severe functional limitations were rare. About 6% of the population's work disability was estimated to be attributable to lumbar disc syndrome.

https://jech.bmj.com/content/jech/41/3/251.full.pdf

Lumbar disc syndrome in Finland.

Background—Recent epidemiological studies have suggested that smoking is a risk factor for rheumatoid factor (RF) positive rheumatoid arthritis (RA). Being overweight, high serum cholesterol, and dietary factors have in some studies been found to be associated with the risk of RA. No attention, however, has been paid to coVee consumption as a risk determinant, though it is a shared covariate of the alleged risk factors. Objectives—This study aimed at examining coVee consumption for its associations with RF positivity and with the risk of RA. Methods—CoVee consumption was studied, firstly, for its association with RF (sensitised sheep cell agglutination titre >128) in a cross sectional survey of 6809 subjects with no clinical arthritis, and secondly, for its prediction of RA in a cohort of 18 981 men and women who had neither arthritis nor a history of it at the baseline examination in 1973‐76. Up to late 1989, 126 subjects of the cohort study had developed RA, of whom, 89 were positive for RF by the time of diagnosis. Results—In the cross sectional survey the number of cups of coVee drunk daily was directly proportional to the prevalence of RF positivity.Adjusted for age and sex this association was significant (p value for linear trend, 0.008), but after further adjustment for smoking the linear trend declined below significance (p=0.06). In the cohort study there was an association between coVee consumption and the risk of RF positive RA that was not due to age, sex, level of education, smoking, alcohol intake, body mass index, or serum cholesterol. After adjustment for these potential confounders the users of four or more cups a day still had a relative risk of 2.20 (95% confidence interval 1.13 to 4.27) for developing RF positive RA compared with those drinking less. CoVee consumption did not predict the development of RF negative RA. Conclusion—CoVee consumption may be a risk factor for RA, possibly through mechanisms contributing to the production of RF. This hypothesis remains to be tested in further studies. (Ann Rheum Dis 2000;59:631‐635)

https://ard.bmj.com/content/annrheumdis/59/8/631.full.pdf

Coffee consumption, rheumatoid factor, and the risk of rheumatoid arthritis

Objectives Potential risk factors and their roles in the aetiology of hip OA are poorly understood. We analysed several alleged risk factors predisposing to hip OA in a 22-yr prospective study. Methods A comprehensive health survey was carried out in 1978-80 in a nationally representative sample of adult Finns. In 2000-01, 1286 participants in that survey were invited for re-examination, and 909 agreed to participate. After excluding those with hip OA at the baseline and those who were no longer working, a total of 840 subjects constituted the present study population. Hip OA was diagnosed on the basis of a standardized clinical examination by physicians who applied uniform criteria both at the baseline and at the re-examination phase. Results After 22 yrs of follow-up, hip OA was diagnosed in 41 subjects (4.9%). Heavy manual labour predicted the risk of developing hip OA [adjusted odds ratio (OR) 6.7; 95% CI 2.3, 19.5]. Permanent damage as a consequence of any musculoskeletal injury was also an independent predictor of hip OA (adjusted OR 5.0; 95% CI 1.9, 13.3). BMI, smoking, alcohol intake and leisure time physical activity were not factors which were predictive for hip OA. Conclusion Heavy physical stress at work and major musculoskeletal injuries are associated with an increased risk of developing clinically diagnosed hip OA.

Risk factors for the development of hip osteoarthritis: a population-based prospective study

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