Papers by Adekunle Fakunle
Hypertension
Background: This study aimed to develop a risk-scoring model for hypertension among Africans. Met... more Background: This study aimed to develop a risk-scoring model for hypertension among Africans. Methods: In this study, 4413 stroke-free controls were used to develop the risk-scoring model for hypertension. Logistic regression models were applied to 13 vascular risk factors. We randomly split the data set into training and testing data at a ratio of 80:20. Constant and standardized weights were assigned to factors significantly associated with hypertension in the regression model to develop a probability risk score on a scale of 0% to 100% using a logistic regression model. The model accuracy was assessed to estimate the cutoff score for discriminating between hypertensives. Results: Mean age was 59.9±13.3, 56.0% were hypertensives, and 7 factors, including diabetes, age in years, waist circumference, body mass index, highest education completed, family history of cardiovascular diseases, and current alcohol use, were associated with hypertension. Cohen κ was maximal at ≥0.28, and a ...
Environmental Research, Aug 1, 2023
Environmental health perspectives, Oct 26, 2020
European Heart Journal, Nov 1, 2020
Background: Inflammatory processes are proposed to underlie mental disorders. To investigate a po... more Background: Inflammatory processes are proposed to underlie mental disorders. To investigate a possible immune dysregulation in bipolar disorder (BD), we analysed differences in the interrelationship between peripheral inflammatory biomarkers of patients and non-mentally-ill comparison participants (HC). Methods: We analysed a dataset from community-based participants with BD (M/F: 24/35) and age-and-gender-matched HC participants (45/51), collected over two-weeks. Peripheral blood was drawn at the same time from each participant on three occasions one week apart. 18 cytokines, chemokines and CRP were analysed using a high sensitivity multiplex panel/ELISA. Participants with signs of acute inflammation were excluded. Means across the three samples were computed. Results: First, a principal component analysis was conducted on HC yielding 7 distinct rotated components (RC). Based on these components, 7 mean composites of inflammatory markers for each participant were calculated, of which two were significantly elevated in BD compared to HC. The same procedure was applied to BD, yielding 6 RCs, of which two were significantly elevated in BD versus HC. Both analyses revealed components containing CRP, Interleukin (IL) 6 and macrophage-derived chemokine (MDC), of which MDC and IL6 were elevated in BD versus HC (CRP: no difference). Second, correlation matrices were calculated between all biomarkers and examination of correlation matrices between the two groups yielded significant differences (X2 (N ¼ 150) ¼ 72.297, p < 0.00001). Conclusions: These results provide evidence for differences in the interrelationship between inflammatory biomarkers in BD versus HC, pointing towards CRP, IL6 and MCD and altered relationships between eotaxin-1 (CCL11) and interferon-gamma-induced protein 10 (IP10).
BMC Pulmonary Medicine, Dec 9, 2022
Background: This study aimed to investigate the association between exposure to diverse indoor mi... more Background: This study aimed to investigate the association between exposure to diverse indoor microbial aerosols and lower respiratory tract infections (LRTI) among children aged 1 to 59 months in Ibadan, Nigeria. Methods: One hundred and seventy-eight (178) hospital-based LRTI cases among under-five children were matched for age (± 3 months), sex and geographical location with 180 community-based controls (under-five children without LRTI). Following consent from caregivers of eligible participants, a child's health questionnaire, clinical proforma and standardized home-walkthrough checklist were used to collect data. Participant homes were visited and sampled for indoor microbial exposures using active sampling approach by Anderson sampler. Indoor microbial count (IMC), total bacterial count (TBC), and total fungal count (TFC) were estimated and dichotomized into high (> median) and low (≤ median) exposures. Alpha diversity measures including richness (R), Shannon (H) and Simpson (D) indices were also estimated. Conditional logistic regression models were used to test association between exposure to indoor microbial aerosols and LRTI risk among under-five children. Results: Significantly higher bacterial and fungal diversities were found in homes of cases (R = 3.00; H = 1.04; D = 2.67 and R = 2.56; H = 0.82; D = 2.33) than homes of controls (R = 2.00; H = 0.64; D = 1.80 and R = 1.89; H = 0.55; D = 1.88) p < 0.001, respectively. In the multivariate models, higher categories of exposure to IMC (aOR = 2.67, 95% CI 1.44-4.97), TBC (aOR = 2.51, 95% CI 1.36-4.65), TFC (aOR = 2.75, 95% CI 1.54-4.89), bacterial diversity (aOR = 1.87, 95% CI 1.08-3.24) and fungal diversity (aOR = 3.00, 95% CI 1.55-5.79) were independently associated with LRTI risk among underfive children. Conclusions: This study suggests an increased risk of LRTI when children under the age of five years are exposed to high levels of indoor microbial aerosols.
European Heart Journal, Nov 1, 2020
Environmental epidemiology, Mar 29, 2023
Journal of Stroke and Cerebrovascular Diseases
Journal of Stroke and Cerebrovascular Diseases
Stroke
Background: Using tailored mobile health interventions to improve global vascular risk awareness ... more Background: Using tailored mobile health interventions to improve global vascular risk awareness and control is yet to be investigated for primary stroke prevention in Africa. Methods: This 2-arm pilot randomized controlled trial involved 100 stroke-free adults with at least 2 vascular risk factors for stroke. Eligible participants were assigned randomly to a control arm offering 1-time counseling (n=50) or a 2-month educational intervention arm (n=50) comprising a stroke video and riskometer app aimed at improving stroke risk factor awareness and health-seeking behavioral modification to control total vascular risk. Reduction in total stroke risk score was the primary outcome while feasibility and process measures were secondary outcomes. Results: All enrolled participants completed the 2-month follow-up (retention rate=100%). The mean (SD) age of participants was 59.5 (±12.5) years, 38% were males. The mean change in stroke risk score at 2 months was −11.9% (±14.2) in the interven...
Journal of Stroke and Cerebrovascular Diseases
Journal of Stroke and Cerebrovascular Diseases
Journal of the Neurological Sciences
Previous genome-wide association studies (GWAS) of stroke, the second leading cause of death, hav... more Previous genome-wide association studies (GWAS) of stroke, the second leading cause of death, have been conducted in populations of predominantly European ancestry.1,2 We undertook cross-ancestry GWAS meta-analyses of stroke and its subtypes in 110,182 stroke patients (33% non-European) and 1,503,898 control individuals of five ancestries from population- and clinic-based studies, nearly doubling the number of cases in previous stroke GWAS. We identified association signals at 89 independent loci, of which 61 were novel. Effect sizes were overall highly correlated across ancestries. Cross-ancestry fine-mapping, in silico mutagenesis analysis using a novel machine-learning approach,3 transcriptome and proteome-wide association analyses revealed putative causal genes (e.g. SH3PXD2A and FURIN) and variants (e.g. at GRK5 and NOS3). Using a novel three-pronged approach,4 we provided genetic evidence for putative drug effects, highlighting F11, KLKB1, PROC, GP1BA, and VCAM1 as possible ta...
International Journal of Environmental Research and Public Health, 2020
The association between household air pollution and lower respiratory tract infections (LRTI) amo... more The association between household air pollution and lower respiratory tract infections (LRTI) among children under five years of age has been well documented; however, the extent to which the microbiome within the indoor environment contributes to this association is uncertain. The home assessment of indoor microbiome (HAIM) study seeks to assess the abundance of indoor microbiota (IM) in the homes of under-five children (U-5Cs) with and without LRTI. HAIM is a hospital- and community-based study involving 200 cases and 200 controls recruited from three children’s hospitals in Ibadan, Nigeria. Cases will be hospital-based patients with LRTI confirmed by a pediatrician, while controls will be community-based participants, matched to cases on the basis of sex, geographical location, and age (±3 months) without LRTI. The abundance of IM in houses of cases and controls will be investigated using active and passive air sampling techniques and analyzed by qualitative detection of bacteria...
Neurology, 2020
ObjectiveTo characterize risk factors for spontaneous intracerebral hemorrhage (sICH) occurrence ... more ObjectiveTo characterize risk factors for spontaneous intracerebral hemorrhage (sICH) occurrence and severity among West Africans.MethodsThe Stroke Investigative Research and Educational Network (SIREN) study is a multicenter case-control study involving 15 sites in Ghana and Nigeria. Patients were adults ≥18 years old with CT-confirmed sICH with age-, sex-, and ethnicity-matched stroke-free community controls. Standard instruments were used to assess vascular, lifestyle, and psychosocial factors. Factors associated with sICH and its severity were assessed using conditional logistic regression to estimate odds ratios (ORs) and population-attributable risks (PARs) with 95% confidence intervals (CIs) for factors.ResultsOf 2,944 adjudicated stroke cases, 854 were intracerebral hemorrhage (ICH). Mean age of patients with ICH was 54.7 ± 13.9 years, with a male preponderance (63.1%), and 77.3% were nonlobar. Etiologic subtypes of sICH included hypertension (80.9%), structural vascular ano...
Environmental Epidemiology, 2019
gene expression, and evidence has shown global dysregulation of miRNA profiles in ALS patients. E... more gene expression, and evidence has shown global dysregulation of miRNA profiles in ALS patients. Extracellular vesicles (EVs) are membrane-protected compartments released by cells that transport nucleic acids and exogeneous chemicals such as heavy metals around the body. While encapsulated in EVs, miRNAs are highly stable. The stability and relevance to ALS pathology warrants further study of the potential use of miRNAs as biomarkers for diagnosis and progression. We aimed to characterize the circulating EV miRNA profiles of 100 ALS patients derived from the United States ALS Registry. Methods: We isolated EV-encapsulated RNA from the plasma of 100 patients using the exoRNeasy Serum/Plasma Maxi kit (Qiagen). We measured miRNA yield/purity on an Agilent Bioanalyzer 2100 small RNA kit. We profiled miRNAs using small RNA deep sequencing on the Illumina Genome Analyzer IIx platform. Results: Of the 514 miRNAs detected, 42 were found in 100% of ALS samples. Among these, 24 (57%) were already described to be dysregulated in ALS. Importantly, we confirmed a pro-inflammatory signature previously found in both sporadic ALS patient and SOD1 mouse model monocytes that includes miR-27a, miR-155, miR-146a, and miR-532-33. Three of these miRNAs were detected in 100% of our samples, with miR-155 detected in 93%. Conclusions: In the largest study described so far looking specifically at the EV-miRNA profile of ALS patients, we were able to confirm several miRNAs that have been linked to ALS. Analyses are ongoing to validate these by qRT-PCR. We will also further investigate novel miRNA candidates that are linked to ALS pathogenic progression by stratifying the sample based on the time since diagnosis.
Clinical and Experimental Hypertension, 2012
We assessed whether subitem scores on the Mini-Mental State Examination (MMSE) associated indepen... more We assessed whether subitem scores on the Mini-Mental State Examination (MMSE) associated independently with cerebral white matter hyperintensity (WMH) and lacunar infarction (LI). Magnetic resonance imaging (MRI) and neuropsychological evaluation (MMSE) were performed in 1008 elderly individuals from the Ohasama Study (348 men, 660 women [65.5%]; age 68.0 ± 6.0 [mean ± SD] years; MMSE score, 26.5 ± 2.9). The relationships between MRI findings and MMSE subitem scores were analyzed by logistic regression. Significant associations were observed between the MMSE subitems &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Orientation to place&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and WMH, and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Copy a figure&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and LI. Pathological changes were detected by brain MRI associated with a decrease in cognitive function in healthy elderly individuals.
Journal of Geriatric Psychiatry and Neurology, 2020
Objectives: Depression is a risk factor for stroke. There is a knowledge gap on the predictors of... more Objectives: Depression is a risk factor for stroke. There is a knowledge gap on the predictors of prestroke depression in stroke survivors living in low- and middle-income countries (LMICs). We estimated prevalence and predictors of prestroke depression, as well as its association with poststroke depression (PSD) in the largest study of stroke in Africa. Methods: We evaluated information collected as part of the Stroke Investigative Research and Education Network (SIREN) study, a multicentre, case-control study conducted at 15 sites in Ghana and Nigeria. Prestroke depression status was ascertained in stroke survivors using a validated self-report tool, while PSD was assessed using a stroke specific screening tool for depression (“HRQOLISP-E”). Independent associations were investigated using complementary log-log regression and binary logit models. Results: Among 1,977 participants, prestroke depression was found in 141 (7.1%). In multivariate analyses, prestroke depression was sign...
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Papers by Adekunle Fakunle