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dc.contributor.authorJohnsen, Marianne Bakkeen_US
dc.contributor.authorHellevik, Alf Ingeen_US
dc.contributor.authorSmåstuen, Milada Cen_US
dc.contributor.authorLanghammer, Arnulfen_US
dc.contributor.authorFurnes, Oveen_US
dc.contributor.authorFlugsrud, Gunnar Ben_US
dc.contributor.authorNordsletten, Larsen_US
dc.contributor.authorZwart, John-Ankeren_US
dc.contributor.authorStorheim, Kjerstien_US
dc.date.accessioned2018-04-24T12:40:07Z
dc.date.available2018-04-24T12:40:07Z
dc.date.issued2017-12-28
dc.PublishedJohnsen MB, Hellevik AI, Småstuen MC, Langhammer A, Furnes O, Flugsrud GB, Nordsletten L, Zwart J, Storheim K. The mediating effect of body mass index on the relationship between smoking and hip or knee replacement due to primary osteoarthritis. A population-based cohort study (the HUNT study). PLoS ONE. 2017;12(12):e0190288eng
dc.identifier.issn1932-6203
dc.identifier.urihttps://hdl.handle.net/1956/17651
dc.description.abstractTo investigate the total effect of smoking on total hip or knee replacement (THR/TKR) due to primary osteoarthritis (OA) and to quantify the indirect effect of smoking through body mass index (BMI). Participants from the Nord-Trøndelag Health Study (the HUNT Study) were linked to the Norwegian Arthroplasty Register to detect the first THR or TKR due to primary OA. A mediation analysis was used to decompose the total effect of smoking into a direct and indirect effect. BMI was considered a mediator in the analysis. All effects were estimated as hazard ratios (HRs) with 95% confidence intervals (CIs). The indirect effect of smoking mediated through BMI was expressed as a percentage (proportion*100). In total 55 188 participants were followed up during 17.2 years (median). We identified 1322 THRs and 754 TKRs. For men, the total effect of current vs. never smoking revealed a decreased risk of THR (HR 0.59, 95% CI 0.46–0.76) and TKR (HR 0.47, 95% CI 0.32–0.66). For women, current smoking increased the risk of THR (HR 1.34, 95% CI 1.11–1.60). For men, 6% and 7% of the risk reduction for THR and TKR, respectively, was mediated by BMI. We found a negative association between smoking and THR or TKR for men. On the contrary, smoking was associated with increased risk of THR for women. Most of the effect of smoking on joint replacement risk remained unexplained by BMI.en_US
dc.language.isoengeng
dc.publisherPLOSeng
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/4.0eng
dc.titleThe mediating effect of body mass index on the relationship between smoking and hip or knee replacement due to primary osteoarthritis. A population-based cohort study (the HUNT study)en_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2018-02-01T12:46:00Z
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2017 The Author(s)
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0190288
dc.identifier.cristin1543647
dc.source.journalPLoS ONE


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