The Lancet Regional Health - Europe

ObjectivesAn update to the NICE Type 2 diabetes (T2DM) guideline in February 2022 recommended an SGLT2 inhibitor be offered to people with heart failure (HF) or cardiovascular disease (CVD) as comorbidities and considered for people at high CVD risk. We report uptake of this guideline in England by September 2023. DesignObservational cohort study. SettingGeneral practices contributing to the Clinical Practice Research Data Link, linked to hospital admission records. Participants587,826 people...

Suicide is one of the worlds leading public health problems, with more than 720,000 deaths annually. Suicide has traditionally been studied from an individual perspective. However, research has increasingly highlighted the influence of community-level factors on suicide risk. This study aimed to (1) analyse the spatial distribution of suicide mortality at the provincial level in Spain (2018-2022); (2) perform stratified analyses by sex and age group; and (3) compare suicide risk across differen...

BackgroundDeath certificates record both an underlying cause and contributing conditions, yet mortality statistics predominantly report only the underlying cause. We quantify this "hidden burden" across all ICD-10 conditions in Australian mortality data using the multiple-to-underlying ratio (MUR): total death certificate mentions divided by underlying cause deaths. MethodsWe analysed Australian Bureau of Statistics Causes of Death 2023 data (N = 187,268 registered deaths) to compute the ratio ...

PurposeBody dissatisfaction is common, particularly among those with higher BMIs. Issues with BMI as an adiposity measure may limit our understanding of body dissatisfaction determinants. We investigate the association of childhood trajectories of BMI, fat mass index (FMI), and fat-free mass index (FFMI) with body dissatisfaction at age 14, and sex differences in these associations. MethodsWe used latent class growth analysis to model trajectories of BMI (3-14 years), FMI and FFMI (7-14 years) ...

ImportanceInfants born small or large for gestational age exhibit different growth patterns compared with appropriate-for-gestational age counterparts. Evidence is lacking on how birth weight centiles beyond conventional thresholds predict early life growth. ObjectiveQuantify association of birth weight centile range with infant and child growth. DesignProspective cohort study. SettingFrance, Netherlands, Portugal, Singapore, United Kingdom, United States. ParticipantsSingletons from seven b...

Background. Early identification of risk for hospitalisation is crucial to reducing public health burden. Immune and endocrine-related markers are robust indicators of disease in epidemiological studies, but their value has not been consistently established with severe disorders requiring hospitalisation. Patterning of biomarker expression through latent profile analysis (LPA), may improve predictive accuracy for clinical outcomes above individual biomarkers alone. Method. Four biomarkers (C-rea...

The early childhood environment influences later mental health, but it remains unclear which aspects are most important for reducing inequalities. We quantified how socioeconomic inequalities in mental health at 5 and 17 years (y) would change under hypothetical interventions on five aspects of the early childhood environment. We analysed parent-reported data from the UK Millennium Cohort Study (n=15513). Socioeconomic circumstances (SEC) were assessed using maternal education at 9 months. Menta...

Recent findings suggest that sugar rationing during the first 1000 days of life may influence chronic disease risk in adulthood. Given the link between mental health and non-communicable diseases, early-life sugar restriction may be associated with later-life incidence of anxiety and depression. Using UK Biobank data, participants born between October 1, 1951, and March 31, 1956 (n = 46,448) were grouped by duration of exposure to sugar rationing: R270 (rationed from conception to 270 days of li...

BackgroundThe COVID-19 pandemic disproportionately affected vulnerable populations, including individuals with rare diseases (RDs) and, in the general population, those from ethnic minority backgrounds. However, the intersectional risk, and how these vulnerabilities combine, is poorly understood. A comprehensive baseline map of RD prevalence by granular ethnicity is required to investigate the pandemics true impact on these complex patient groups. MethodsThis study had two aims: (1) to generate...

Background and AimsThe glucagon-like peptide-1 receptor agonist (GLP-1 RA) semaglutide has demonstrated efficacy for the secondary prevention of cardiovascular disease among patients with overweight/obesity without diabetes mellitus. However, the comparative effectiveness of GLP-1 RA versus other antiobesity medications (e.g. phentermine-topiramate) not been evaluated. MethodsThis was a retrospective, observational, cohort study using target trial emulation methodology using the Truveta electro...

BackgroundAdolescence and early adulthood are periods of increased mortality risk, and young people with neurodisability may be particularly vulnerable, yet evidence on mortality during the transition from paediatric to adult services is limited. ObjectivesTo estimate all-cause and cause-specific mortality risk from ages 11 to 22 years in young people with and without neurodisability in England. MethodsWe used the Education and Child Health Insights from Linked Data (ECHILD) database to follow...

BackgroundInitial reports from the Netherlands indicate a decline in routine childhood vaccination uptake during and after the COVID-19 pandemic, with emerging evidence of reduced parental vaccine confidence. This study aimed to evaluate the long-term impact of the COVID-19 pandemic on routine childhood vaccination uptake. MethodsWe conducted a retrospective nationwide cohort study including all children born in the Netherlands in 2016-2024. First-dose DTaP-IPV vaccination status by age six mon...

ObjectivesTo examine associations between cardiometabolic conditions and health-related quality of life (HRQoL) and to evaluate whether condition-associated HRQoL changed from 2001 to 2022. MethodsWe analyzed nationally representative data from U.S. adults aged [≥]18 years in the Medical Expenditure Panel Survey, 2001-2022. Survey years without BMI data (2017, 2019, 2021) were excluded. EQ-5D utilities were mapped from SF-12 scores using a validated algorithm. For each survey year, survey-we...

BackgroundGLP-1 receptor agonists (GLP-1RAs) and SGLT2 inhibitors (SGLT2Is) have established cardiovascular benefits for patients with type 2 diabetes mellitus (T2DM), with similar class-level effectiveness found in previous studies. However, real-world comparative effectiveness assessments of individual agents remain limited. ObjectivesTo compare the cardiovascular effectiveness of individual GLP-1RAs and SGLT2Is. MethodsWe conducted a multi-national, retrospective, new-user active-comparator...

The biomarker MetaboHealth represents a novel indicator of overall health in middle age and may potentially be suitable as actionable health check in prevention strategies. MetaboHealth is a blood-based metabolomic composite score that predicts a wide range of age-related conditions and mortality in large European cohorts. Here, we investigated whether MetaboHealth can be personalised and limited to clinically validated metabolomic markers. Next, we assessed whether the updated MetaboHealth scor...

BackgroundOlder age is widely considered a risk factor for post-acute sequelae of SARS-CoV-2 infection (PASC), typically attributed to immunosenescence and inflammaging. However, whether this association reflects intrinsic biological ageing or accumulated comorbidity burden remains unclear, with implications for clinical risk stratification. MethodsWe conducted a retrospective cohort study using the Precision PASC Research Cohort (P2RC) from Mass General Brigham, comprising 133,792 COVID-19 pat...

BackgroundHealth status influences uptake of COVID-19 vaccination, with vaccinated individuals generally being healthier than their unvaccinated counterparts. However, the extent to which this healthy vaccinee effect biases vaccine effectiveness estimates remains unclear. This study investigated how different levels of the healthy vaccinee effect may impact these estimates. MethodsThree national, matched, retrospective cohort studies were conducted on the population of Qatar from February 5, 20...

1.Disease-specific Polygenic Risk Scores (PRS) are usually evaluated against the incidence of diseases they were derived for. Individuals may be more interested in how these PRS influence their probable cause of death. Using UK Biobank data, we examined the top 10 causes of death among individuals in the highest quintile of disease-specific PRS for Alzheimers disease, bowel cancer, cardiovascular disease, coronary artery disease, ischaemic stroke, breast cancer, epithelial ovarian cancer, and pr...

IntroductionNational trends in youth suicide risk may mask significant regional variations within a country. This article attempts to account for spatio-temporal trends through a comparative analysis across South America and Europe. This paper analyzes the spatiotemporal patterns in suicide mortality among young people (10-29 years) in Argentina, Chile, Spain, and Uruguay during the period 1997-2021. MethodsOfficial data from vital statistics and population censuses of the four countries were a...

FluSurvey is a participatory surveillance system used to monitor trends in influenza and other respiratory viruses through weekly symptom surveys among the UK population. We aimed to characterise the wider impact of "influenza-like illnesses" (ILI) among FluSurvey participants and assess correlations of ILI with other established influenza surveillance systems. We included data reported by FluSurvey participants over the 2023-24 and 2024-25 winter seasons. Using weekly symptoms surveys, we deri...