Papers by Clement Adebamowo
Journal of Clinical Oncology, May 20, 2010
e12061 Background: Analysis of associations between insulin and cancer risk using Prescription Da... more e12061 Background: Analysis of associations between insulin and cancer risk using Prescription Databases and Cancer Registers is complicated and should only be undertaken with extreme caution and employing advanced statistical and epidemiological methodologies. Methods: Interaction between methodologists, diabetologists and oncologists is also critical. Failure to do so can result in unfortunate events with potential societal implications as could have happened following the recent publication of a flawed database analysis of the association between a long-acting insulin analogue and an increased risk of cancer. Such reports cause unnecessary confusion and concern among patients and their physicians. Results: Prescription Databases were not established with such analyses in mind, and cannot identify many critical limitations such as changes in insulin type during study observation (“switchers”). Notably, those who use more than one type of insulin simultaneously pose specific problems but restriction of t...
Scientific Reports, Nov 1, 2023
There has been no previous systematic, epidemiological study of the reproductive risk factors for... more There has been no previous systematic, epidemiological study of the reproductive risk factors for uterine fibroids (UF) in African populations despite African women having the highest burden of UF in the world. Improved knowledge of the associations between UF and reproductive factors would contribute to better understanding of the etiology of UF and may suggest novel opportunities for prevention and therapeutic interventions. We used nurse administered questionnaires to survey the demographic and reproductive risk factors of UF among 484 women who are members of the African Collaborative Center for Microbiome and Genomics Research (ACCME) Study Cohort in central Nigeria, and who had transvaginal ultrasound diagnosis (TVUS). We used logistic regression models to the evaluate associations between reproductive risk factors and UF, adjusted for significant covariates. In our multivariable logistic regression models, we found inverse associations with number of children (OR = 0.83, 95%CI = 0.74-0.93, p-value = 0.002), parity (OR = 0.41, 95%CI = 0.24-0.73, p-value = 0.002), history of any type of abortion (OR = 0.53, 95%CI = 0.35-0.82, p-value = 0.004), duration of use of Depot Medroxyprogesterone Acetate (DMPA) (p-value for trend = 0.02), menopausal status (OR = 0.48, 95%CI = 0.27-0.84, p-value = 0.01), and a non-linear positive association with age (OR = 1.04, 95%CI = 1.01-1.07, p-value = 0.003). Other reproductive risk factors that have been reported in other populations (age at menarche and menopause, and oral contraceptives) were not associated with UF in this study. Our study confirms some of the reproductive risk factors for UF that have been found in other populations and shows that some of them are stronger in the Nigerian population. The associations we found with DMPA suggest opportunities for further research to understand the mechanisms of action of progesterone and its analogues in the etiology of UF, their potential use for prevention and treatment of UF. African women have some of the highest prevalence of uterine fibroids (UF) in the world where it is associated with significant morbidity, economic and health systems costs, and occasional mortality 1-6 . The reported incidence and prevalence of UF varies significantly globally, by study design, method of diagnosis, age distribution, racial and ethnic composition of study participants 1,7 . Among women in High-Income Countries (HIC), the cumulative incidence of UF by the age of 50 years ranges from 70 to 80% 1,8 . We previously showed that previous studies of UF in Africa were facilities-based, lacked adequate power, and had poor study design 2 . In our population based study of Nigerian women who were participating in a prospective cohort study, we diagnosed UF using transvaginal ultrasound, and found a prevalence of 45.1% 3 . Several studies in other populations suggest associations between reproductive factors and UF 9,10 . High parity, early age at menarche and at first birth have been inversely associated with risk of UF, while age at last full term birth is positively associated with UF . Though both estradiol and progesterone are critical for development
BMC Nursing, Feb 21, 2006
Background: Smooth working relationships between nurses and doctors are necessary for efficient h... more Background: Smooth working relationships between nurses and doctors are necessary for efficient health care delivery. However, previous studies have shown that this is often absent with negative impact on the quality of health care delivery. In 2002, we studied factors that affect nursedoctor working relationships in University Teaching Hospitals (UTH) in Southern Nigeria in order to characterize it and identify managerial and training needs that might be used to improve it. Method: Questionnaire survey of doctors and nurses working in four UTH in Southern Nigeria was done in 2002. The setting and subjects were selected by random sampling procedures. Information on factors in domains of work, union activities, personnel and hospital management were studied using closed and open-ended questionnaires. Results: Nurse-doctor working relationships were statistically significantly affected by poor afterwork social interaction, staff shortages, activist unionism, disregard for one's profession, and hospital management and government policies. In general, nurses had better opinion of doctors' work than doctors had about nurses' work. Working relationships between doctors and nurses need to be improved through improved training and better working conditions, creation of better working environment, use of alternative methods of conflict resolution and balanced hospital management and government policies. This will improve the retention of staff, job satisfaction and efficiency of health care delivery in Nigeria.
Journal of Clinical Oncology, Jun 1, 2023
Purpose: Detecting signals of micrometastatic disease in patients with early breast cancer (EBC) ... more Purpose: Detecting signals of micrometastatic disease in patients with early breast cancer (EBC) could improve risk stratification and allow better tailoring of adjuvant therapies. We previously showed that postoperative serum metabolomic profiles were predictive of relapse in a single-center cohort of estrogen receptor (ER)-negative EBC patients. Here, we investigated this further using preoperative serum samples from ER-positive, premenopausal women with EBC who were enrolled in an international phase III trial. Experimental Design: Proton nuclear magnetic resonance (NMR) spectroscopy of 590 EBC samples (319 with relapse or !6 years clinical follow-up) and 109 metastatic breast cancer (MBC) samples was performed. A Random Forest (RF) classification model was built using a training set of 85 EBC and all MBC samples. The model was then applied to a test set of 234 EBC samples, and a risk of recurrence score was generated on the basis of the likelihood of the sample being misclassified as metastatic. Results: In the training set, the RF model separated EBC from MBC with a discrimination accuracy of 84.9%. In the test set, the RF recurrence risk score correlated with relapse, with an AUC of 0.747 in ROC analysis. Accuracy was maximized at 71.3% (sensitivity, 70.8%; specificity, 71.4%). The model performed independently of age, tumor size, grade, HER2 status and nodal status, and also of Adjuvant! Online risk of relapse score. Conclusions: In a multicenter group of EBC patients, we developed a model based on preoperative serum metabolomic profiles that was prognostic for disease recurrence, independent of traditional clinicopathologic risk factors.
Biokemistri, Jun 1, 2003
Twenty newly diagnosed breast cancer patients were assessed for serum vitamin A, β -carotene and ... more Twenty newly diagnosed breast cancer patients were assessed for serum vitamin A, β -carotene and total cholesterol levels with their matched control (n = 20). The mean age and standard deviation of pre-menopausal breast cancer patients was 34.75± 6.57 while the mean age and standard deviation for controls was 32.00 ±8.79 years. There was no statistical difference in age between the two groups (P< 0.05). There was evidence of decrease in the mean serum vitamin A with increasing stage of advanced breast cancer. However, the mean serum β-carotene level showed significant decrease in trend with increasing stage of advanced breast cancer (P< 0.05). Serum total cholesterol was negatively correlated with serum vitamin A but was found to be positively correlated though non-significantly with serum β-carotene in breast cancer patients and control (r = 0.10, p> 0.95 for cases; r = 0.05, p> 0.05 for control). .
International Journal of Epidemiology, Dec 6, 2018
BMC Public Health, May 29, 2014
Background: Physical inactivity levels are rising in many countries with major implications for t... more Background: Physical inactivity levels are rising in many countries with major implications for the prevalence of non-communicable diseases and the general health of the population worldwide. We conducted this study to examine leisure-time physical activity levels among African adults in an urban setting. Methods: We conducted a cross-sectional study among a random sample of 1,058 adults at a government worksite, in Abuja, an urban Nigerian city. We used log-binomial regression models to estimate the multivariable-adjusted associations of correlates of physical activity. The mean age of the study population was 42 ± 9.3 years, 60% were men and 40% were women. The mean metabolic equivalent hours per week for all the participants was 6.8 ± 7.2. In univariate analysis comparing the lowest to highest tertiles of physical activity, the prevalence ratio (PR) and (95% confidence interval, CI) was 0.95 (0.81-1.11) p = 0.49, comparing women to men; compared to those aged <30 years the PR (95% CI) was 0.70 (0.57-0.86), 0.70 (0.58-0.85) and 0.78 (0.63-0.96) for age 30-39, 40-49 and ≥50 years respectively, p for trend = 0.03; compared to those who were normal weight, the PR was 0.93 (0.79-1.10) and 0.90 (0.74-1.09) for overweight and obese persons respectively, p = 0.26. The PR for age was attenuated to non-significant levels in multivariable analyses. Being married was a statistically significant correlate of higher physical activity levels, the PR comparing unmarried to married persons in multivariate analysis was 0.81 (0.67-0.97), p = 0.03. Conclusions: More than 80% of urban, professional Nigerian adults do not meet the WHO recommendations of physical activity. Urbanized Africans in this study population had low levels of leisure-time physical activity, independent of age, sex and body-mass index. This has major implications for the prevalence of non-communicable diseases in this population.
American Journal of Pathology, Aug 1, 1999
Instability in the repeat size of microsatellite sequences has been described in both hereditary ... more Instability in the repeat size of microsatellite sequences has been described in both hereditary nonpolyposis and sporadic colorectal cancers. Tumors expressing microsatellite instability are identified through the comparison of the repeat sizes at multiple microsatellite loci between tumor and matched normal tissue DNA. The use of a five-marker panel including two mononucleotide repeat microsatellites, BAT-25 and BAT-26 , has recently been suggested for the clinical determination of tumor microsatellite instability. The BAT-25 and BAT-26 loci included in this panel have both demonstrated sensitivity to microsatellite instability and normal quasimonomorphic allelic patterns , which has simplified the distinction between normal and unstable alleles. However, in this study , we identified allelic variations in the size of the poly(A) tract at BAT-26 in 12.6% of 103 healthy African-Americans screened. In addition , 18.4% exhibited allelic size variations in the poly(T) tract at BAT-25. Finally , 2.9% showed variant alleles at both BAT-25 and BAT-26 loci. Screening a small population of Nigerians confirmed the polymorphic nature of both loci and the ethnic origin of alleles not identified in other populations studied thus far. Our results dispute the quasimonomorphic nature of both BAT-25 and BAT-26 in all populations and support the need for thorough population studies to define the different allelic profiles and frequencies at microsatellite loci.
BMC Proceedings, Jun 1, 2012
Global heart, Mar 1, 2016
The establishment of the Human Heredity and Health in Africa (H3Africa) cardiovascular disease (C... more The establishment of the Human Heredity and Health in Africa (H3Africa) cardiovascular disease (CVD) working group and subsequent meeting during the Fourth annual H3Africa Consortium meeting in Cape Town, South Africa, provided opportunities for new collaborations as well as avenues to develop a road map for harmonizing efforts to address CVD within the continent . One of the outcomes of this collaboration was a journal special issue publication comprising a series of articles describing the epidemiology of CVD, stroke, end-stage kidney disease, rheumatic heart disease, sickle cell disease, and other infectious and noncommunicable diseases related to CVD conditions .
BMC Medical Ethics, Apr 27, 2014
Background: The study examined the knowledge and attitudes to personal genomics testing for compl... more Background: The study examined the knowledge and attitudes to personal genomics testing for complex diseases among Nigerians and identified how the knowledge and attitudes vary with gender, age, religion, education and related factors. Methods: Data were collected using qualitative method in 2 districts of the Federal Capital Territory. In the study, eight (8) Focused Group Discussions (FGDs) and twenty seven ( ) Key Informant Interviews (KIIs) were conducted. Participants for the research were recruited among healthy Nigerians, individuals with complex diseases, health care professionals, community leaders and health policy makers. Result: Analysis of the result showed that most respondents in both FGDs and KIIs had limited knowledge about genomics test initially. Their understanding of the test however improved after explanation on its concept. Participants showed positive attitude towards genomics tests. Nevertheless they expressed fear over direct to consumer personal genomics testing, testing unborn babies and disclosure of results to third parties. Culture and religion were found to influence the perspectives of respondents on genomics test particularly those aspects that could either directly contradict their beliefs and practices or lead to actions which contradict them. In conclusion, most Nigerians interviewed had limited knowledge of genomics test but with supportive attitude towards its use in predicting future risk of complex diseases after understanding the test concept. Genomics testing for complex diseases was not a common practice in Nigeria.
Journal of Acquired Immune Deficiency Syndromes, Apr 1, 2019
The Annual Awards Gala will be held Wednesday, October 24 at the Four Seasons Hotel, Baltimore. A... more The Annual Awards Gala will be held Wednesday, October 24 at the Four Seasons Hotel, Baltimore. A gala reception will begin at 6:30 pm followed by dinner at 7:15 pm. We look forward to welcoming you to Baltimore this October as we continue our annual tradition of excellent science and provocative discussion.
Journal of Acquired Immune Deficiency Syndromes, 2016
would like to thank the following organizations. Without their continued and generous support, th... more would like to thank the following organizations. Without their continued and generous support, this meeting would not be possible.
Journal of Clinical Oncology, May 20, 2011
e12020 Background: Developing countries are undergoing epidemiological transitions with increasin... more e12020 Background: Developing countries are undergoing epidemiological transitions with increasing prevalence of non-communicable diseases (NCD) including cancers. In many African countries increasing prevalence of obesity makes this the second commonest risk factor for cancers after infections. In this study, we evaluated the prevalence of BMI in an urbanized Nigerian population. METHODS 1059 workers at a government office in Nigeria answered an interviewed administered questionnaire and had anthropometric characteristics measured in a study of body size, dietary energy intake and physical activity in fall of 2010. RESULTS The mean age (SD) of participants was 41.5 (9.3) years and mean BMI (SD) was 27.0 (4.9). 36% of our study population are overweight and 25% are obese. We found the mean BMI (SD) and proportion overweight/obese for age groups ≤20 years, 21-30, 31-40, 41-50, 51-60 and >60 years to be 21.7 (2.4) years, 10% / 0%; 24.0(3.5), 34% / 4.5%; 27.3(5.3), 32% / 32%; 27.7 (4.7), 42% / 31%; 27.5 (4.9), 39% / 28%; and 26.2 (3.7) 56% / 13%. CONCLUSIONS Our result shows that the BMI of urbanized Nigerian adults increases with age. As obesity is a modifiable risk factor for NCD, adults should be encouraged to engage in lifestyle activities that will prevent obesity as a modality to reduce cancer incidence in Africa.
Journal of Acquired Immune Deficiency Syndromes, Apr 1, 2011
Welcome 12th Annual International Meeting of the Institute of Human Virology of the University of... more Welcome 12th Annual International Meeting of the Institute of Human Virology of the University of Maryland School of Medicine dear colleagues and friends, University of Calabria President Giovanni Latorre and I welcome you to the 12th Annual Meeting of the Institute of Human Virology (IHV). for the first time since the meeting began in the mid-1970s at the National Cancer Institute, it is taking place outside the Baltimore/Washington, dC area. The setting for this year's meeting, Tropea, Italy, is one of extraordinary beauty and ancient historical contributions. The region is among the oldest civilization in Europe and includes the location of Pythagorus, Herodotus, and other greats of the ancient world, as well as the land of origin of many famous Greek legends, some told by Homer. Today, Tropea attracts visitors to the Costa degli dei (Coast of the Gods), one of the most beautiful regions in Italy and food afficionados seeking the famous local red onion that was hailed by the Roman Pliny the Elder for its gastronomic and healing potential. Nearby are the ancient Aeolian islands. Together with Calabria and Sicily, their cultures dating back thousands of years before Christ, also with their many legends. It is important that we acknowledge Professor Arnaldo Caruso, of the University of Brescia but who originally hails from Calabria, chair of the Italian Organizing Committee; without his vision and support, this meeting in Calabria would not be possible. dr. Caruso currently holds an Adjunct Professorship at IHV and the University of
Current developments in nutrition, Jun 1, 2020
International Journal of Cancer, Jun 17, 2022
Circulation
High blood pressure is a heritable risk factor for cardiovascular disease, stroke and other chron... more High blood pressure is a heritable risk factor for cardiovascular disease, stroke and other chronic conditions. There is an increasing prevalence of high blood pressure in sub-Saharan Africa. We aimed to identify genetic variants underlying blood pressure traits in Sub-Saharan Africa. We conducted a GWAS, meta-analyses and gene-set analyses of blood pressure traits (systolic, diastolic, pulse pressure), in African populations. We used the African Collaborative Center for Microbiome and Genomics Research data (ACCME, n=~15,000) for GWAS discovery and the Africa America Diabetes Mellitus study data (AADM, n=~5,200), for GWAS replication. Multiple SNPs were identified reaching genome-wide significance. The lead SNP from the elevated blood pressure group was on chromosome 16 (rs148403740, minor allelic frequency (MAF)=0.0176, p= 9.28x10 -9 , odds ratio(OR)= 2.58) nearest to the MGRN1 gene. The lead SNP from the hypertension stage 1 group was on chromosome 7 (rs4236415, MAF= 0.4912, p= 1...
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Papers by Clement Adebamowo