Michael Gamborg
Frederiksberg Hospital
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Featured researches published by Michael Gamborg.
The American Journal of Gastroenterology | 2005
Tine Jess; Michael Gamborg; Peter Matzen; Pia Munkholm; Thorkild I. A. Sørensen
OBJECTIVES:The risk of intestinal malignancy in Crohns disease (CD) remains uncertain since risk estimates vary worldwide. The global CD population is growing and there is a demand for better knowledge of prognosis of this disease. Hence, the aim of the present study was to conduct a meta-analysis of population-based data on intestinal cancer risk in CD.METHODS:The MEDLINE search engine and abstracts from international conferences were searched for the relevant literature by use of explicit search criteria. All papers fulfilling the strict inclusion criteria were scrutinized for data on population size, time of follow-up, and observed to expected cancer rates. STATA meta-analysis software was used to perform overall pooled risk estimates (standardized incidence ratio (SIR), observed/expected) and meta-regression analyses of the influence of specific variables on SIR.RESULTS:Six papers fulfilled the inclusion criteria and reported SIRs of colorectal cancer (CRC) in CD varying from 0.9 to 2.2. The pooled SIR for CRC was significantly increased (SIR, 1.9; 95% CI 1.4–2.5), as was the risk for colon cancer separately (SIR, 2.5; 95% CI 1.7–3.5). Regarding small bowel cancer, five studies reported SIRs ranging from 3.4 to 66.7, and the overall pooled estimate was 27.1 (95% CI 14.9–49.2).CONCLUSIONS:The present meta-analysis of intestinal cancer risk in CD, based on population-based studies only, revealed an overall increased risk of both CRC and small bowel cancer among patients with CD. However, some of the available data were several decades old, and future studies taking new treatment strategies into account are required.
International Journal of Obesity | 2011
T A Ajslev; C S Andersen; Michael Gamborg; Thorkild I. A. Sørensen; Tine Jess
Objective:To investigate whether delivery mode (vaginal versus by caesarean section), maternal pre-pregnancy body mass index (BMI) and early exposure to antibiotics (<6 months of age) influence childs risk of overweight at age 7 years, hence supporting the hypotheses that environmental factors influencing the establishment and diversity of the gut microbiota are associated with later risk of overweight.Design:Longitudinal, prospective study with measure of exposures in infancy and follow-up at age 7 years.Methods:A total of 28 354 mother–child dyads from the Danish National Birth Cohort, with information on maternal pre-pregnancy BMI, delivery mode and antibiotic administration in infancy, were assessed. Logistic regression analyses were performed with childhood height and weight at the 7-year follow-up as outcome measures.Results:Delivery mode was not significantly associated with childhood overweight (odds ratio (OR):1.18, 95% confidence interval (CI): 0.95–1.47). Antibiotics during the first 6 months of life led to increased risk of overweight among children of normal weight mothers (OR: 1.54, 95% CI: 1.09–2.17) and a decreased risk of overweight among children of overweight mothers (OR: 0.54, 95% CI: 0.30–0.98). The same tendency was observed among children of obese mothers (OR: 0.85, 95% CI: 0.41–1.76).Conclusion:The present cohort study revealed that a combination of early exposures, including delivery mode, maternal pre-pregnancy BMI and antibiotics in infancy, influences the risk of overweight in later childhood. This effect may potentially be explained by an impact on establishment and diversity of the microbiota.
International Journal of Obesity | 2010
Lene Schack-Nielsen; Kim F. Michaelsen; Michael Gamborg; E L Mortensen; Thorkild I. A. Sørensen
Objective:Gestational weight gain (GWG) is associated with childhood obesity. We analyzed whether this effect persists into adulthood and is mediated by effects in childhood.Design:The design of the study a prospective birth cohort study established in 1959–1961.Subjects:The subjects were offspring (n=4234 of whom 2485 had information from the last follow-up) of mothers included in ‘The Copenhagen Perinatal Cohort’ during pregnancy or at birth.Measurements:Information on maternal pre-pregnancy body mass index (BMI), GWG and several potential confounders were collected around delivery. Information on offspring BMI was available from various follow-up examinations from 1 to 42 years of age. The association of GWG with offspring BMI was analyzed by regression models including confounders. Using path analysis, the association of GWG with adult BMI was disentangled into an association mediated through childhood BMI and one independent hereof.Results:GWG was associated with offspring BMI at all ages. At the age of 42 years (n=1540), there was an increasing risk of obesity (odds ratio (OR) 1.08, 95% confidence interval (CI) 1.03–1.14 per kg GWG, P=0.003). Only half of the association of GWG on offspring adult BMI was mediated through birth weight and BMI up to 14 years of age.Conclusion:Greater GWG is associated with an increased BMI in childhood through adulthood and with an increased risk of obesity in adults. Only part of the association with adult BMI is mediated by childhood BMI, suggesting that excessive GWG induces a persisting susceptibility to obesogenic environments. As GWG is greater in women with small pre-pregnancy body weight, this implies a reinforcement of the obesity epidemic in the next generation. Our findings provide support for avoiding excessive GWG.
The American Journal of Clinical Nutrition | 2008
Jennifer L. Baker; Michael Gamborg; Berit L. Heitmann; Lauren Lissner; Thorkild I. A. Sørensen; Kathleen M. Rasmussen
BACKGROUND Weight gained during pregnancy and not lost postpartum may contribute to obesity in women of childbearing age. OBJECTIVE We aimed to determine whether breastfeeding reduces postpartum weight retention (PPWR) in a population among which full breastfeeding is common and breastfeeding duration is long. DESIGN We selected women from the Danish National Birth Cohort who ever breastfed (>98%), and we conducted the interviews at 6 (n = 36 030) and 18 (n = 26 846) mo postpartum. We used regression analyses to investigate whether breastfeeding (scored to account for duration and intensity) reduced PPWR at 6 and 18 mo after adjustment for maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG). RESULTS GWG was positively (P < 0.0001) associated with PPWR at both 6 and 18 mo postpartum. Breastfeeding was negatively associated with PPWR in all women but those in the heaviest category of prepregnancy BMI at 6 (P < 0.0001) and 18 (P < 0.05) mo postpartum. When modeled together with adjustment for possible confounding, these associations were marginally attenuated. We calculated that, if women exclusively breastfed for 6 mo as recommended, PPWR could be eliminated by that time in women with GWG values of approximately 12 kg, and that the possibility of major weight gain (>or=5 kg) could be reduced in all but the heaviest women. CONCLUSION Breastfeeding was associated with lower PPWR in all categories of prepregnancy BMI. These results suggest that, when combined with GWG values of approximately 12 kg, breastfeeding as recommended could eliminate weight retention by 6 mo postpartum in many women.
The American Journal of Gastroenterology | 2010
Natalia Pedersen; Dana Duricova; Margarita Elkjaer; Michael Gamborg; Pia Munkholm; Tine Jess
OBJECTIVES:Extra-intestinal manifestations of inflammatory bowel disease (IBD) are relatively common, whereas the risk of extra-intestinal cancer (EIC) remains uncertain. The aim of this study was to obtain a reliable estimate of the risk of EIC in Crohns disease (CD) and ulcerative colitis (UC) by performing a meta-analysis of population-based cohort studies.METHODS:A systematic literature review was performed using MEDLINE (1966–2009) and abstracts from recent international conferences. Eight population-based cohort studies comprising a total of 17,052 patients with IBD were available. Standardized incidence ratios (SIRs) of EICs were pooled in a meta-analysis approach using STATA software.RESULTS:Overall, IBD patients were not at increased risk of EIC (SIR, 1.10; 95% confidence interval (CI) 0.96–1.27). However, site-specific analyses revealed that CD patients had an increased risk of cancer of the upper gastrointestinal tract (SIR 2.87, 95% CI 1.66–4.96), lung (SIR 1.82, 95% CI 1.18–2.81), urinary bladder (SIR 2.03, 95% CI 1.14–3.63), and skin (SIR 2.35, 95% CI 1.43–3.86). Patients with UC had a significantly increased risk of liver–biliary cancer (SIR 2.58, 95% CI 1.58–4.22) and leukemia (SIR 2.00, 95% CI 1.31–3.06) but a decreased risk of pulmonary cancer (SIR 0.39, 95% CI 0.20–0.74).CONCLUSIONS:Although the overall risk of EIC was not significantly increased among patients with IBD, the risk of individual cancer types differed from that of the background population as well as between CD and UC patients. These findings may primarily be explained by smoking habits, extra-intestinal manifestations of IBD, and involvement of the upper gastrointestinal tract in CD.
The American Journal of Gastroenterology | 2007
Tine Jess; Michael Gamborg; Pia Munkholm; Thorkild I. A. Sørensen
OBJECTIVES:It remains debated whether patients with ulcerative colitis (UC) are at greater risk of dying and whether a possible alteration in mortality can be attributed to specific causes of death. We aimed to clarify this issue by conducting a meta-analysis of population-based inception cohort studies on overall and cause-specific mortality in patients with UC.METHODS:The MEDLINE search engine and abstracts from international conferences were searched for relevant literature by use of explicit search criteria. STATA meta-analysis software was used to calculate pooled risk estimates (SMR, standardized mortality ratio, observed/expected deaths) of overall mortality and specific causes of death and to conduct metaregression analyses of the influence of specific variables on SMR.RESULTS:Ten papers fulfilled the inclusion criteria, reporting SMRs varying from 0.7 to 1.4. The overall pooled estimate was 1.1 (95% confidence interval [CI] 0.9–1.2, P = 0.42). However, greater risk of dying was observed during the first years of follow-up, in patients with extensive colitis, and in patients from Scandinavia. Metaregression analysis showed an increase in SMR by increasing cohort size. UC-related mortality accounted for 17% of all deaths. Mortality from gastrointestinal diseases, nonalcoholic liver diseases, pulmonary embolisms, and respiratory diseases was increased whereas mortality from pulmonary cancer was reduced.CONCLUSIONS:The overall risk of dying in patients with UC did not differ from that of the background population, although subgroups of patients were at greater risk of dying. The cause-of-death distribution seemed to differ from that of the background population.
Inflammatory Bowel Diseases | 2010
Dana Duricova; Natalia Pedersen; Margarita Elkjaer; Michael Gamborg; Pia Munkholm; Tine Jess
Background: An overview of mortality risk among unselected patients with Crohns disease (CD) is lacking. We therefore performed a systematic review and meta‐analysis of population‐based studies on overall and cause‐specific mortality in CD. Methods: MEDLINE (January 1965 to February 2008), abstracts from international conferences and reference lists of selected articles were searched systematically. All articles fulfilling the predefined inclusion criteria were scrutinized for data on population size, time of follow‐up, gender, age, and observed to expected deaths. STATA meta‐analysis software was used to calculate overall and cause‐specific pooled standardized mortality ratios (SMR, observed/expected). Results: Nine studies were included with overall SMRs ranging from 0.72–3.2, resulting in a significantly increased pooled SMR of 1.39 (95% confidence interval [CI]: 1.30–1.49). Regarding cause‐specific mortality, a significantly increased risk of death from cancer (SMR 1.50, 95% CI: 1.18–1.92), in particular of pulmonary cancer (SMR 2.72, 95% CI: 1.35–5.45), as well as chronic obstructive pulmonary disease (SMR 2.55, 95% CI: 1.19–5.47), gastrointestinal diseases (SMR 6.76, 95% CI: 4.37–10.45), and genitourinary diseases (SMR 3.28, 95% CI: 1.69–6.35) was observed. Conclusions: Among unselected patients with CD, overall mortality was slightly but significantly higher than in the general population—primarily explained by deaths from gastrointestinal, respiratory, and genitourinary diseases. Notably, mortality from colorectal cancer was not increased. Inflamm Bowel Dis 2009
Journal of Crohns & Colitis | 2011
Tanja Stenbaek Hansen; Tine Jess; Ida Vind; Margarita Elkjaer; Malene Fey Nielsen; Michael Gamborg; Pia Munkholm
BACKGROUND The role of environmental factors in development of inflammatory bowel disease (IBD) remains uncertain. The aim of the present study was to assess a number of formerly suggested environmental factors in a case-control study of an unselected and recently diagnosed group of patients with IBD and a control group of orthopaedic patients. METHODS A total of 123 patients diagnosed with Crohns disease (CD) and 144 with ulcerative colitis (UC) in Copenhagen (2003-2004) were matched 1:1 on age and gender to 267 orthopaedic controls. Participants received a questionnaire with 87 questions concerning environmental factors prior to IBD/orthopaedic admission. Odds ratios (OR) were calculated by logistic regression. RESULTS Being breastfed >6 months (OR, 0.50; 95% CI, 0.23-1.11) and undergoing tonsillectomy (OR, 0.49; 95% CI, 0.31-0.78) decreased the odds for IBD, whereas appendectomy decreased the odds for UC only (OR, 0.29; 95% CI, 0.12-0.71). Vaccination against pertussis (OR, 2.08; 95% CI, 1.07-4.03) and polio (OR, 2.38; 95% CI, 1.04-5.43) increased the odds for IBD, whereas measles infection increased the odds for UC (OR, 3.50; 95% CI, 1.15-10.6). Low consumption of fibres and high consumption of sugar were significantly associated with development of CD and UC. Smoking increased the risk for CD and protected against UC. CONCLUSION Among Danish patients with CD and UC belonging to an unselected cohort, disease occurrence was found to be associated both with well-known factors such as smoking and appendectomy, and with more debated factors including breastfeeding, tonsillectomy, childhood vaccinations, childhood infections, and dietary intake of fibres and sugar.
American Journal of Epidemiology | 2009
Michael Gamborg; Jennifer L. Baker; Esben Budtz-Jørgensen; Torben Jørgensen; Gorm Jensen; Thorkild I. A. Sørensen
The inverse associations between birth weight and later adverse health outcomes and the positive associations between adult body size and poor health imply that increases in relative body size between birth and adulthood may be undesirable. In this paper, the authors describe life course path analysis, a method that can be used to jointly estimate associations between body sizes at different time points and associations of body sizes throughout life with health outcomes. Additionally, this method makes it possible to assess both the direct effect and the indirect effect mediated through later body size, and thereby the total effect, of size and changes in size on later outcomes. Using data on childhood body size and adult systolic blood pressure from a sample of 1,284 Danish men born between 1936 and 1970, the authors compared results from path analysis with results from 3 standard regression methods. Path analysis produced easily interpretable results, and compared with standard regression methods it produced a noteworthy gain in statistical power. The effect of change in relative body size on adult blood pressure was more pronounced after age 11 years than in earlier childhood. These results suggest that increases in body size prior to age 11 years are less harmful to adult blood pressure than increases occurring after this age.
PLOS ONE | 2010
Lise Geisler Andersen; Lars Ängquist; Johan G. Eriksson; Tom Forsén; Michael Gamborg; Clive Osmond; Jennifer L. Baker; Thorkild I. A. Sørensen
Background Low birth weight and high childhood body mass index (BMI) is each associated with an increased risk of coronary heart disease (CHD) in adult life. We studied individual and combined associations of birth weight and childhood BMI with the risk of CHD in adulthood. Methods/Principal Findings Birth weight and BMI at age seven years were available in 216,771 Danish and Finnish individuals born 1924–1976. Linkage to national registers for hospitalization and causes of death identified 8,805 CHD events during up to 33 years of follow-up (median = 24 years) after age 25 years. Analyses were conducted with Cox regression based on restricted cubic splines. Using median birth weight of 3.4 kg as reference, a non-linear relation between birth weight and CHD was found. It was not significantly different between cohorts, or between men and women, nor was the association altered by childhood BMI. For birth weights below 3.4 kg, the risk of CHD increased linearly and reached 1.28 (95% confidence limits: 1.13 to 1.44) at 2 kg. Above 3.4 kg the association weakened, and from about 4 kg there was virtually no association. BMI at age seven years was strongly positively associated with the risk of CHD and the relation was not altered by birth weight. The excess risk in individuals with a birth weight of 2.5 kg and a BMI of 17.7 kg/m2 at age seven years was 44% (95% CI: 30% to 59%) compared with individuals with median values of birth weight (3.4 kg) and BMI (15.3 kg/m2). Conclusions/Significance Birth weight and BMI at age seven years appeared independently associated with the risk of CHD in adulthood. From a public health perspective we suggest that particular attention should be paid to children with a birth weight below the average in combination with excess relative weight in childhood.