Background:Cardiovascular risk is elevated in patients with COPD. Central haemodynamic measurements via wave separation analysis indicate cardiovascular risk independent of well-known limitations of peripheral blood pressure measurements, but have not yet been studied in COPD. We aimed to investigate central haemodynamics and their association with lung function in patients with COPD. Methods:In this cross-sectional evaluation of cohort studies, we used propensity score matching to compare COPD patients from the randomised ELASTIC trial (n=80) to subjects without airflow limitation and cardiovascular diseases from the Heinz Nixdorf Recall study (n=2307) and the Heinz Nixdorf Multi-Generation Study (n=2625). Central haemodynamics were measured noninvasively via wave separation analysis. Forward wave amplitude (FWA) and backward wave amplitude (BWA) were compared between patients and controls matched for age, sex, hypertension and smoking, and were assessed for associations with lung hyperinflation. Results:From the initial study cohorts, we identified 75 pairs of COPD patients and matched controls. We found greater FWA in patients than in matched controls (Cohen's d 0.423, 95% confidence interval (CI) 0.098-0.746). BWA was greater in patients than in unmatched controls (Cohen's d 0.333, 95% CI 0.104-0.562), but did not differ after matching (Cohen's d 0.128, 95% CI -0.193-0.448). On multivariable regression FWA was independently associated with hyperinflation expressed as residual volume to total lung capacity ratio (standardised β -0.188, 95% CI -0.335- -0.037) in patients with COPD. Conclusion:COPD is associated with greater FWA which may contribute to increased cardiovascular risk and appears to be correlated with the degree of hyperinflation in patients with COPD.

During a migraine attack, patients with migraine experience non-persistent cognitive impairment. However, some studies discuss migraine also as a risk factor for dementia in later life. The evidence, particularly with regard to mild cognitive impairment (MCI) as a precursor to dementia, is controversial. The aim of this study is to investigate the risk of incident MCI after five years in initially cognitively healthy participants with vs. without migraine. 2476 participants of the second (t1) and third (t2) examination of the prospective, population-based Heinz Nixdorf Recall Study (t1: 2005-2009, Ø62.9 years; t2: 2010-2015, Ø68.1 years) with complete data on migraine status (t1), cognitive performance (T1&T2) and age-appropriate cognition (t1) were included. MCI (at t2) was defined according to Winblad et al. (2004); migraine (at t1) was defined as self-reported diagnosis. Log-linear regression analyses with Poisson distribution were used to calculate the relative risk (RR) for incident MCI with 95% confidence interval (CI) for migraine vs. no migraine (unadjusted; adjusted for age, sex, education, alcohol consumption, smoking status, body mass index, depression according to directed acylic graph). 328 (13.2%) of the 2476 participants reported a migraine. Overall, 28 (8.5%) participants with migraine vs. 239 (11.1%) without migraine met the criteria for MCI at t2. There was no increased risk of incident MCI (unadjusted: RR 0.77, 95% CI 0.52-1.14; adjusted: RR 0.77, 95% CI 0.52-1.16) in participants with migraine. Even though migraine attacks impair cognitive performance, our data show no longitudinal association between migraine and MCI as a precursor to dementia. In further analyses, a distinction should be made between migraine with and without aura.

Type 2 diabetes mellitus (T2DM) is considered a risk factor for dementia. The association of T2DM and mild cognitive impairment (MCI) is reported inconsistently and appears to be gender- and age-specific. The aim of the present study was to investigate the (gender- and age-specific) risk of incident MCI five years later in initially cognitively healthy participants with vs. without known T2DM. 1467 subjects of the second (t1) and third (t2) follow-up examination of the prospective, population-based Heinz Nixdorf Recall Study (t1: 2005-2009, Ø62.9 years; t2: 2010-2015, Ø68.1 years) with complete data regarding T2DM (t1), complete cognitive assessments (t1&t2) and with a cognitive performance within the age- and education-adjusted norm (cognitively healthy; t1) were included. MCI at t2 was defined present, if the cognitive performance was below the age- and education-adjusted norm in at least one cognitive domain with or without reported subjective cognitive decline. Known T2DM (t1) was defined as self-reported physician-confirmed diagnosis or use of antidiabetic medication (n = 145 (9.8%)). Using log-linear regression analyses with Poisson distribution, the relative risk (RR) for incident MCI with 95% confidence interval (CI) for T2DM vs. no T2DM was calculated (adjusted (adj.) for age, body mass index, smoking status according to directed acyclic graph; stratified by gender and age (50-65 years, middle-aged & 66-80 years, old-aged)). Overall, 57 (39.3%) participants with T2DM vs. 363 (27.5%) without T2DM met criteria for MCI at t2. There was an increased RR of incident MCI (adj.: RR 1.31, 95% CI 0.98-1.74) in participants with T2DM at t1. After stratification, the association was primarily present in middle-aged participants (adj.: RR 1.67, 95% CI 1.09-2.56 vs. RR 1.09, 95% CI 0.74.-1.60 in old-aged participants), especially in middle-aged men (adj.: RR 1.84, 95% CI 1.09-3.11 vs. RR 1.29, 95% CI 0.59-2.83 in middle-aged women). Our longitudinal data confirm T2DM as a risk factor for incident MCI, especially for men aged 50-65 years. Prevention of T2DM therefore could help to preserve cognitive performance and delay the development of dementia.

BACKGROUND:The aim of the study was to estimate the sex-specific prevalence and incidence of atrial fibrillation or flutter (AF) in the German population-based Heinz Nixdorf Recall study. METHODS:We analysed data from 4814 participants at baseline 2000-2003 (T0, 50.2% women, 45-75 years), first and second follow-up examination (T1: n=4157, 2005-2008; T2: n=3087, 2010-2015) and yearly postal questionnaires for the AF occurrence until 29 November 2023. We determined the AF prevalence at T0, if participants were aware of having AF at T0, if participants with ECG-proven AF at T0 were anticoagulated, the cumulative incidence and the incidence rate per 1000 person-years over two decades of follow-up. RESULTS:Overall, 152 (3.2%) participants were identified with AF at or before T0. Of those, only n=89 (58.6%) participants were able to name an existing AF diagnosis. n=80 (1.7%) participants had ECG-confirmed AF and 13 (0.3%) participants were not aware of having AF at T0. Of 4662 participants without AF at T0, 640 (13.7%) developed AF during a median follow-up time of 16.7 (Q1; Q3: 10.5-18.9) years. The overall incidence rate was 9.4 (95% CI: 8.7 to 10.1) per 1000 person-years. CONCLUSIONS:The results of our study show that AF is an epidemic disease in the middle-aged and elderly population. The proportion of patients who do not know that they have AF should be reduced in the future. Patients also need to be better informed about their disease and anticoagulation. This is important in order to prevent avoidable adverse events.

In a large population-based cohort of individuals who underwent electron-beam CT, coronary artery calcium score was independently associated with incident lung cancer diagnosis but did not demonstrate potential to improve risk stratification in lung cancer screening.

Introduction:As studies on the association between type 2 diabetes mellitus (T2DM) and mild cognitive impairment (MCI), including amnestic (aMCI) and non-amnestic (naMCI) subtypes, vary by sex and age, we investigated the sex- and age-specific effects of T2DM on incident MCI after five years in a population-based sample. Methods:A total of 145 participants with T2DM and 1322 without T2DM were included. MCI was defined using established criteria excluding subjective cognitive decline. Adjusted relative risks (aRRs) were calculated considering age, education, body mass index, smoking, and alcohol intake, and stratified by sex and age (middle-aged: 50-65 years; old-aged: 66-80 years). Results:MCI occurred in 39.3% (n = 57) of participants with T2DM versus 27.5% (n = 363) without (aRR: 1.29, 95% confidence interval [CI]: 0.97-1.73). Middle-aged men showed an association with naMCI (aRR: 2.35, 95% CI: 1.26-4.39) and middle-aged women with aMCI (aRR: 2.05, 95% CI: 0.58-7.21). Discussion:T2DM increases MCI risk, particularly in middle-aged individuals with poorly controlled T2DM, emphasizing the need for prevention strategies. Highlights:Longitudinal results from the population-based Heinz Nixdorf Recall study in Germany.Incident mild cognitie impairment (MCI) was more common in type 2 diabetes mellitus (T2DM; 39% vs 28%).T2DM affects incident MCI and subtypes in middle-aged, not old-aged; stronger in men with poorly controlled T2DM.Importance of enhancing age- and sex-specific prevention at the population level.

BACKGROUND:During a migraine attack, patients with migraine experience non-persistent cognitive impairment. However, some studies discuss migraine also as a risk factor for dementia in later life. The evidence, particularly with regard to mild cognitive impairment (MCI) as a precursor to dementia, is controversial. The aim of this study is to investigate the risk of incident MCI after five years in initially cognitively healthy participants with vs. without migraine. METHOD:2476 participants of the second (t1) and third (t2) examination of the prospective, population-based Heinz Nixdorf Recall Study (t1: 2005-2009, Ø62.9 years; t2: 2010-2015, Ø68.1 years) with complete data on migraine status (t1), cognitive performance (T1&T2) and age-appropriate cognition (t1) were included. MCI (at t2) was defined according to Winblad et al. (2004); migraine (at t1) was defined as self-reported diagnosis. Log-linear regression analyses with Poisson distribution were used to calculate the relative risk (RR) for incident MCI with 95% confidence interval (CI) for migraine vs. no migraine (unadjusted; adjusted for age, sex, education, alcohol consumption, smoking status, body mass index, depression according to directed acylic graph). RESULT:328 (13.2%) of the 2476 participants reported a migraine. Overall, 28 (8.5%) participants with migraine vs. 239 (11.1%) without migraine met the criteria for MCI at t2. There was no increased risk of incident MCI (unadjusted: RR 0.77, 95% CI 0.52-1.14; adjusted: RR 0.77, 95% CI 0.52-1.16) in participants with migraine. CONCLUSION:Even though migraine attacks impair cognitive performance, our data show no longitudinal association between migraine and MCI as a precursor to dementia. In further analyses, a distinction should be made between migraine with and without aura.

AbstractINTRODUCTIONThe aim of the study was to estimate the population‐based dementia incidence in Germany over a period of two decades.METHODSWe analyzed data from 4814 participants of the population‐based Heinz Nixdorf Recall study (49.8% men, 45–75 years at baseline period 2000–2003), who have been monitored for the occurrence of cognitive decline and dementia. We calculated the cumulative incidence of dementia and its major subtypes and the incidence rate per 1000 person‐years over two decades.RESULTSDuring a median follow‐up of 18.2 (Q1–Q3: 11.3–20.6) years, a total of 298 participants (6.2%) developed dementia (22.1% Alzheimer´s disease, 23.5% vascular dementia, 15.1% mixed dementia, 9.1% other dementia, 30.2% unspecified). The overall incidence rate was 3.9 per 1000 person‐years.DISCUSSIONOur study is the only current population‐based study in Germany that estimates the incidence of dementia. In order to reduce the high proportion of unspecific dementia diagnoses, diagnostics urgently need to be improved.Highlights New data on the incidence of dementia in Germany in participants ≥45 years of age. Participants have been monitored for dementia incidence over two decades. The overall incidence in our cohort was 3.9 per 1000 person‐years. Many patients had unspecific dementia diagnoses in their medical records. Further diagnostic evaluation should be available for all dementia patients.

Abstract Background Cross-sectional and longitudinal studies have been conducted to investigate the association between migraine and any headache and white matter hyperintensities (WMH). However, studies are inconsistent regarding the strength of the association and its clinical significance. The aim of our study was to investigate the association between headache and its subtypes (migraine with aura (MigA+), migraine without aura (MigA-), non-migraine headache (nonMigHA)) and WMH and its course in the population-based 1000BRAINS study using state-of-the-art imaging techniques and migraine classification according to modified international classification of headache disorders. Methods Data from 1062 participants (45% women, 60.9 ± 13.0 years) with ever or never headache (neverHA) and complete quantitative (WMH volume) and qualitative (Fazekas classification) WMH data at first imaging and after 3.7 ± 0.7 years (393 participants) were analyzed. The sex-specific association between headache and its subtypes and WMH volume and its change was evaluated by linear regression, between headache and its subtypes and Fazekas score high vs. low (2–3 vs. 0–1) by log-binomial regression, adjusted for confounders. Results The lifetime prevalence of headache was 77.5% (10.5% MigA+, 26.9% MigA-, 40.1% nonMigHA). The median WMH volume was 4005 (IQR: 2454–6880) mm3 in women and 4812 (2842–8445) mm3 in men. Women with any headaches (all headache types combined) had a 1.23 [1.04; 1.45]-fold higher WMH volume than women who reported never having had a headache. There was no indication of higher Fazekas grading or more WMH progression in women with migraine or any headaches. Men with migraine or any headaches did not have more WMH or WMH progression compared to men without migraine or men who never had headache. Conclusions Our study demonstrated no increased occurrence or progression of WMH in participants with mgiraine. But, our results provide some evidence of greater WMH volume in women with headache of any type including migraine. The underlying pathomechanisms and the reasons why this was not shown in men are unclear and require further research.

Objectives: To describe the epidemiology and prognostic value of the coronary artery calcium (CAC) among individuals with prediabetes. Research Design and Methods: We pooled participants free of clinical ASCVD from 4 prospective cohorts Multi-Ethnic Study of Atherosclerosis (MESA), Heinz-Nixdorf Recall Study (HNR), Framingham Heart Study (FHS) and Jackson Heart Study (JHS). Two definitions were used for prediabetes: inclusive (fasting plasma glucose [FPG] ≥100-<126 mg/dL and hemoglobin A1c [HbA1c] ≥5.7-<6.5%, if available, among participants not taking glucose-lowering medications) and restrictive (FPG ≥110-<126 mg/dL and HbA1c ≥5.7-<6.5%, if available). Results: The study included 13,376 participants (mean age 58 years, 54% women, 57% White, 27% Black). The proportion with CAC≥100 was 17%, 22%, and 37% among those with euglycemia, prediabetes, and diabetes, respectively. Over a median (25th – 75th percentile) follow up time of 14.6 (7.8-16.4) years, individuals with prediabetes and CAC≥100 had higher unadjusted 10-year incidence of ASCVD (13.4%) than the overall group of those with diabetes (10.6%). In adjusted analyses, using the inclusive definition of prediabetes, compared to individuals with euglycemia the hazard ratio (HR) (95% confidence interval) for ASCVD was 0.79 (0.62, 1.01) for prediabetes and CAC=0, 0.70 (0.54, 0.89) for prediabetes and CAC 1-99, 1.54 (1.27, 1.88) for prediabetes and CAC≥100; and 1.64 (1.39, 1.93) for diabetes. Using the restrictive definition, the HR for ASCVD was 1.63 (1.29, 2.06) for prediabetes and CAC≥100. Conclusions: CAC≥100 is frequent among individuals with prediabetes, and identifies a high ASCVD risk subgroup in which the adjusted ASCVD risk is similar to people with diabetes.

AIMS:The 2021 European Society of Cardiology prevention guidelines recommend the use of (lifetime) risk prediction models to aid decisions regarding initiation of prevention. We aimed to update and systematically recalibrate the LIFEtime-perspective CardioVascular Disease (LIFE-CVD) model to four European risk regions for the estimation of lifetime CVD risk for apparently healthy individuals. METHODS AND RESULTS:The updated LIFE-CVD (i.e. LIFE-CVD2) models were derived using individual participant data from 44 cohorts in 13 countries (687 135 individuals without established CVD, 30 939 CVD events in median 10.7 years of follow-up). LIFE-CVD2 uses sex-specific functions to estimate the lifetime risk of fatal and non-fatal CVD events with adjustment for the competing risk of non-CVD death and is systematically recalibrated to four distinct European risk regions. The updated models showed good discrimination in external validation among 1 657 707 individuals (61 311 CVD events) from eight additional European cohorts in seven countries, with a pooled C-index of 0.795 (95% confidence interval 0.767-0.822). Predicted and observed CVD event risks were well calibrated in population-wide electronic health records data in the UK (Clinical Practice Research Datalink) and the Netherlands (Extramural LUMC Academic Network). When using LIFE-CVD2 to estimate potential gain in CVD-free life expectancy from preventive therapy, projections varied by risk region reflecting important regional differences in absolute lifetime risk. For example, a 50-year-old smoking woman with a systolic blood pressure (SBP) of 140 mmHg was estimated to gain 0.9 years in the low-risk region vs. 1.6 years in the very high-risk region from lifelong 10 mmHg SBP reduction. The benefit of smoking cessation for this individual ranged from 3.6 years in the low-risk region to 4.8 years in the very high-risk region. CONCLUSION:By taking into account geographical differences in CVD incidence using contemporary representative data sources, the recalibrated LIFE-CVD2 model provides a more accurate tool for the prediction of lifetime risk and CVD-free life expectancy for individuals without previous CVD, facilitating shared decision-making for cardiovascular prevention as recommended by 2021 European guidelines.

Background:There are indications for sex-specific differences regarding the association between kallikrein-8 (KLK8) and cognitive impairment in early stages of Alzheimer's disease for which KLK8 may be an early blood-based biomarker. These may be due to different levels of sex hormones. To correctly interpret KLK8 blood concentrations, sex-specific analyses are needed. Objective:The aim of our exploratory study was to investigate sex-specific differences in blood-based KLK8 in participants of the population-based Heinz Nixdorf Recall study with different cognitive status and the association between KLK8 and sex hormones. Methods:In 290 participants (45% women, 69.7±7.4 years (mean±SD)) we investigated sex-specific serum KLK8 differences between cognitively unimpaired (CU, 43%) and cognitively impaired (CI) participants and the association between KLK8 and dehydroepiandrosteronsulfate (DHEAS), estradiol and testosterone, using adjusted multiple linear regression. Results:The mean±SD KLK8 was similar for CU men (808.1±729.6 pg/ml) and women (795.9±577.7 pg/ml); adjusted mean-difference [95%-CI]: -95.3 [-324.1;133.5] pg/ml. KLK8 was lower in CI women (783.5±498.7 pg/ml) than men (1048.4±829 pg/ml); -261 [-493.1; -29] pg/ml. In men but not women, there was a weak indication for a positive slope between estradiol (11.9 [-0.4;24.3] pg/ml) and DHEAS (1.4 [-0.5;3.3] pg/ml) with KLK8, while testosterone had no impact. Conclusions:The results suggested a different role for KLK8 in the development of cognitive impairment in men and women, potentially influenced by sex hormones. To use blood KLK8 as an early biomarker, further research on hormonal regulation of KLK8 expression is needed as a part of the investigation of the KLK8 involvement in cognitive impairment and Alzheimer's disease pathology.

Introduction: The population of men and women who are overweight (defined as a BMI 25-29.9 kg/m 2 ) continues to grow at fast pace. The prevalence and prognostic implications of a high coronary artery calcium (CAC) score in this group are poorly defined. Aims: Using a multiethnic cohort of men and women, we compared the ASCVD event-risk at follow up in normal weight, overweight, and obese individuals, overall and further stratified by CAC scores. Methods: Individual-level pooled analysis of participants from MESA, JHS, HNR, and FHS free of ASCVD at baseline and in whom CAC and BMI data were available. Participants with BMI <18.5 kg/m 2 were excluded. CAC was categorized as =0, 1-99, and ≥100 Agatston Units. The primary outcome was ASCVD events during follow-up, comprising fatal and non-fatal coronary heart disease and stroke events. Results: A total of 14,740 participants were included. The BMI was distributed as follows: BMI <25 kg/m 2 : 27.4%, BMI 25-29.9 kg/m 2 : 40.0%, BMI 30-34.9 kg/m 2 : 20.8%, BMI >=35 kg/m 2 : 11.8%. Among overweight participants, 52% had CAC>0, and 22% had CAC≥100 (17% prevalence among individuals with normal weight). The distribution of CAC by BMI categories is presented in the Figure. The incidence of ASCVD events among overweight participants was: 3.8 per 1000 person-years for those with CAC=0, 8.1 for CAC>0 - <=99, and 20.7 for CAC≥100. In regression analyses, compared to BMI 18.5-25 kg/m 2 individuals (reference group), the adjusted HR of ASCVD events for overweight participants with CAC≥100 was higher than that for unselected obese participants (Figure). A sub-analysis restricted to participants free of prediabetes and diabetes yielded similar trends, with the combination overweight+high CAC score being associated with a higher ASCVD risk than those with obesity. Conclusions: The ASCVD risk of overweight people with CAC≥100 is higher than that observed among individuals with BMI≥30 kg/m 2 . Overweight individuals with high CAC scores comprise relatively frequent and high-risk group, which may benefit from systematic detection and aggressive risk-reduction interventions.

The aim was to investigate prevalence of dry eye syndrome (DES) in a population-based sample in Germany. The association between coexisting eye diseases and DES was also of interest. We recontacted participants of the Heinz Nixdorf Recall study between 2018 and 2021 by postal questionnaire that included the Women’s Health Study questionnaire on DES. We estimated prevalence of DES and examined DES-associated factors among 2095 participants aged 62–91 years. We performed interaction analyses between sex and coexisting eye diseases in relation to the DES prevalence and performed bias analyses to examine the robustness of the results. The DES prevalence was 31.5% (34–36% after correction for potential non-response bias, 24.1% after correction for outcome misclassification) and it was almost 2.1-times higher in women than in men (women 42.3%, men 20.4%). Among DES subjects, 70.3% had received treatment in the previous 12 months. There was synergism between female sex and coexisting eye diseases (cataract, glaucoma, macular degeneration) in terms of DES prevalence. The extrapolated numbers of patients aged 62–91 years with DES in Germany are 1.1–1.3 million men and 6.1–6.8 million women. The observed synergism may be explained by differences in ocular physiology, subjective perception and response behavior. Women with eye diseases (cataract, glaucoma, macula degeneration) appear to have a markedly higher susceptibility to suffer from DES than men, so that a diagnostic workup of DES symptoms is particularly justified in women with these eye diseases.

Background: There is residual risk of atherosclerotic cardiovascular disease (ASCVD) that remains despite adequate risk factor (RF) control. Coronary artery calcium (CAC) has demonstrated value in ASCVD risk stratification. We evaluated the value of CAC in identifying residual risk of ASCVD events among those with traditional RF control. Methods: Participants without clinical ASCVD were pooled from the Multi-Ethnic Study of Atherosclerosis, Heinz Nixdorf Recall Study, Framingham Heart Study, and Jackson Heart Study. RF control was classified as “guideline-concordant” and “optimal” (Figure 1). Participants were stratified by the number of controlled RFs at baseline and CAC score (CAC = 0, 1-99, ≥100). Cox proportional hazards models examined the association between CAC and incident ASCVD events. Results: The study included 14,780 individuals (mean age 58 years (SD: 11), 54% female, 59% White, 27% Black, 50% CAC = 0). Over a median follow-up of 14.6 years, there were 1,441 incident ASCVD events. The distribution of CAC and ASCVD event incidence is shown in Panel A; 10% of those with 3 optimal RFs and 19% of those with 3 guideline-concordant RFs controlled had CAC > 100. The rate of ASCVD events decreased with more RFs controlled and increased with higher CAC. Overall, optimal RF control was associated with lower ASCVD event rates compared to guideline-concordant control. At every level of RF control, CAC > 100 was associated with increased HRs for incident ASCVD (Panel B). Those with CAC ≥ 100 and controlled RFs experienced ASCVD rates numerically comparable to or exceeding those with uncontrolled RFs but CAC = 0 (Panel A). Adjusted HR (95% CI) for ASCVD events with CAC > 100 compared to CAC = 0 was 5.0 (2.0, 12.9) in optimal RF control and 3.7 (2.6, 5.4) in guideline-concordant RF control. Conclusion: There is significant heterogeneity in residual ASCVD risk among those with optimal or guideline-concordant traditional RF control and CAC can help identify this risk. Irrespective of RF control, a higher CAC burden was associated with increased ASCVD risk. Future studies could use CAC testing to identify those with higher residual ASCVD risk despite effective traditional RF control to target for novel therapies.

We aimed to examine the concordance of type-2 diabetes, prediabetes and the metabolic syndrome in couples. In cross-sectional analyses, we used data from 1173 couples with index persons from the Heinz Nixdorf Recall Study (2011–2015), a population-based cohort study in Western Germany, and partners from the associated Heinz Nixdorf Multigeneration Study (2013–2016). Mean age (standard deviation) was 67.2 (6.6) years in index persons, and 67.8 (7.7) years in partners. The exposure was the presence of diabetes, prediabetes or metabolic syndrome in index persons, the outcome was the presence of the same health status in partners. Diabetes was defined by either self-reported diagnosis, intake of antidiabetic drugs or insulin, or HbA1c ≥ 6.5%. If the index person had prediabetes or diabetes, the partner was 1.46 (95% CI 1.07–2.00) times more likely to have diabetes than partners of index persons without the condition in the crude model (adjusted model: 1.33 (0.97–1.83)). For self-reported diabetes and for the metabolic syndrome, the corresponding prevalence ratios were 1.33 (0.90–1.97) and 1.17 (1.03–1.32), respectively (adjusted models: 1.23 (0.77–1.94), 1.04 (0.91–1.18)). In German couples, there was weak to moderate concordance of type-2 diabetes, prediabetes and the metabolic syndrome in crude, but poor concordance in adjusted models.

Background: Blood kallikrein-8 is supposed to be a biomarker for mild cognitive impairment (MCI) due to Alzheimer’s disease (AD), a precursor of AD dementia. Little is known about the association of kallikrein-8 and non-AD type dementias. Objective: To investigate whether blood kallikrein-8 is elevated in individuals with non-amnestic MCI (naMCI), which has a higher probability to progress to a non-AD type dementia, compared with cognitively unimpaired (CU) controls. Methods: We measured blood kallikrein-8 at ten-year follow-up (T2) in 75 cases and 75 controls matched for age and sex who were participants of the population-based Heinz Nixdorf Recall study (baseline: 2000–2003). Cognitive performance was assessed in a standardized manner at five (T1) and ten-year follow-up. Cases were CU or had subjective cognitive decline (SCD) at T1 and had naMCI at T2. Controls were CU at both follow-ups. The association between kallikrein-8 (per 500 pg/ml increase) and naMCI was estimated using conditional logistic regression: odds ratios (OR) and 95% confidence intervals (95% CI) were determined, adjusted for inter-assay variability and freezing duration. Results: Valid kallikrein-8 values were measured in 121 participants (45% cases, 54.5% women, 70.5±7.1 years). In cases, the mean kallikrein-8 was higher than in controls (922±797 pg/ml versus 884±782 pg/ml). Kallikrein-8 was not associated with having naMCI compared to being CU (adjusted; OR: 1.03 [95% CI: 0.80–1.32]). Conclusion: This is the first population-based study that shows that blood kallikrein-8 tends not to be elevated in individuals with naMCI compared with CU. This adds to the evidence of the possible AD specificity of kallikrein-8.

Percutaneous image-guided tumor ablation of liver malignancies has become an indispensable therapeutic procedure. The aim of this evaluation of the prospectively managed multinational registry of the voluntary German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR) was to analyze its use, technical success, and complications in clinical practice. All liver tumor ablations from 2018 to 2022 were included. Technical success was defined as complete ablation of the tumor with an ablative margin. A total of 7228 liver tumor ablations from 136 centers in Germany and Austria were analyzed. In total, 31.4

Background: The population of adults with prediabetes is growing worldwide. The value of coronary artery calcium (CAC) testing to assess ASCVD risk in this group is poorly defined. Methods: We pooled participants free of clinical ASCVD from 4 prospective cohort studies including the Multi-Ethnic Study of Atherosclerosis (MESA), Heinz Nixdorf Recall (HNR) Study, Framingham Heart Study (FHS), and Jackson Heart Study (JHS). Participants were classified as having euglycemia, prediabetes, and diabetes. Cox proportional hazards models were used to study the association between glycemia status and CAC burden and incident ASCVD, adjusting for potential confounders. Results: The study population included 14,780 participants with mean (SD) age 58 (11) years, 54% women, 57% White, 27% Black, and 16% Other. A total of 11,429 had euglycemia, 810 had prediabetes, and 2,207 had diabetes. The distribution of CAC is shown in Panel A. Among those with prediabetes, 31% had CAC > 100. Individuals with prediabetes and CAC > 100 had higher event rates than participants with diabetes and those with diabetes and a guideline indication for GLP1RA/SGLT2i therapy (Panel B). In adjusted analyses, compared to individuals with euglycemia, the HR (95% CI) for ASCVD was 0.70 (0.41, 1.19) for prediabetes and CAC=0, 1.10 (0.76, 1.06) for prediabetes and CAC 1-99, 1.80 (1.37, 2.38) for prediabetes and CAC≥100, 1.82 (1.56, 2.13) among those with diabetes and 1.69 (1,42, 2.02) among those with diabetes and an indication for GLP1RA/SGLT2i. Conclusion: CAC > 100 is frequent among individuals with prediabetes and identifies a subgroup at very high risk of ASCVD events. Adjusted 10-year ASCVD risk among individuals with prediabetes and CAC ≥100 is similar compared to people with diabetes and those with a guideline indication for GLP1RA/SGLT2i. Future clinical trials should assess whether individuals with prediabetes and CAC ≥100 benefit from cardiovascular risk-reduction with GLP1RA and/or SGLT2i.