Imperial College London

Prof Marc Chadeau-Hyam

Faculty of MedicineSchool of Public Health

Professor of Computational Epidemiology and Biostatistics
 
 
 
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Contact

 

+44 (0)20 7594 1637m.chadeau

 
 
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Location

 

VC7Medical SchoolSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

135 results found

Elliott J, Whitaker M, Bodinier B, Eales O, Riley S, Ward H, Cooke G, Darzi A, Chadeau M, Elliott Pet al., 2021, Predictive symptoms for COVID-19 in the community: REACT-1 study of over one million people, PLoS Medicine, ISSN: 1549-1277

Background:Rapid detection, isolation and contact tracing of community COVID-19 cases are essential measures to limit the community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to identify a parsimonious set of symptoms that jointly predict COVID-19 and whether predictive symptoms differ between B.1.1.7 (Alpha) lineage (predominating as of April 2021in the USA, UK and elsewhere) and wild type.Methods and Findings:We obtained throat and nose swabs with valid SARS-CoV-2 polymerase chain reaction (PCR) test results from 1,147,370 volunteers aged 5 years and above (6,450 positives) in the REal-time Assessment of Community Transmission-1 (REACT-1) study. This involved repeated community-based random surveys of prevalence in England (study rounds 2 to 8, June 2020 to January 2021, response rates 22%-27%). Participants were asked about symptoms occurring in the week prior to testing. Viral genome sequencing was carried out for PCR positive samples with N-gene cycle threshold value < 34 (N = 1,079) in round 8 (January 2021). In univariate analysis, all 26 surveyed symptoms were associated with PCR positivity compared with non-symptomatic people. Stability selection (1,000 penalized logistic regression models with 50% subsampling) among people reporting at least one symptom identified seven symptoms as jointly and positively predictive of PCR positivity in rounds 2–7 (June to December 2020): loss or change of sense of smell, loss or change of sense of taste, fever, new persistent cough, chills, appetite loss and muscle aches. The resulting model (rounds 2–7) predicted PCR positivity in round 8 with area under the curve (AUC) of 0.77. The same seven symptoms were selected as jointly predictive of B.1.1.7 infection in round 8, although comparing B.1.1.7 with wild type, new persistent cough and sore throat were more predictive of B.1.1.7 infection while loss or change of sense of smell was more predictive of the wild type. Main

Journal article

Vlaanderen J, de Hoogh K, Hoek G, Peters A, Probst-Hensch N, Scalbert A, Melén E, Tonne C, de Wit GA, Chadeau-Hyam M, Katsouyanni K, Esko T, Jongsma KR, Vermeulen Ret al., 2021, Developing the building blocks to elucidate the impact of the urban exposome on cardiometabolic-pulmonary disease: The EU EXPANSE project, Environmental Epidemiology, Vol: 5, ISSN: 2474-7882

By 2030, more than 80% of Europe's population will live in an urban environment. The urban exposome, consisting of factors such as where we live and work, where and what we eat, our social network, and what chemical and physical hazards we are exposed to, provides important targets to improve population health. The EXPANSE (EXposome Powered tools for healthy living in urbAN SEttings) project will study the impact of the urban exposome on the major contributors to Europe's burden of disease: Cardio-Metabolic and Pulmonary Disease. EXPANSE will address one of the most pertinent questions for urban planners, policy makers, and European citizens: "How to maximize one's health in a modern urban environment?" EXPANSE will take the next step in exposome research by (1) bringing together exposome and health data of more than 55 million adult Europeans and OMICS information for more than 2 million Europeans; (2) perform personalized exposome assessment for 5,000 individuals in five urban regions; (3) applying ultra-high-resolution mass-spectrometry to screen for chemicals in 10,000 blood samples; (4) evaluating the evolution of the exposome and health through the life course; and (5) evaluating the impact of changes in the urban exposome on the burden of cardiometabolic and pulmonary disease. EXPANSE will translate its insights and innovations into research and dissemination tools that will be openly accessible via the EXPANSE toolbox. By applying innovative ethics-by-design throughout the project, the social and ethical acceptability of these tools will be safeguarded. EXPANSE is part of the European Human Exposome Network.

Journal article

Whitaker M, Elliott J, Chadeau-Hyam M, Riley S, Darzi A, Cooke G, Ward H, Elliott Pet al., 2021, Persistent symptoms following SARS-CoV-2 infection in a random community sample of 508,707 people

IntroductionLong COVID, describing the long-term sequelae after SARS-CoV-2 infection, remains a poorlydefined syndrome. There is uncertainty about its predisposing factors and the extent of theresultant public health burden, with estimates of prevalence and duration varying widely.MethodsWithin rounds 3–5 of the REACT-2 study, 508,707 people in the community in England wereasked about a prior history of COVID-19 and the presence and duration of 29 differentsymptoms. We used uni- and multivariable models to identify predictors of persistence ofsymptoms (12 weeks or more). We estimated the prevalence of symptom persistence at 12weeks, and used unsupervised learning to cluster individuals by symptoms experienced.ResultsAmong the 508,707 participants, the weighted prevalence of self-reported COVID-19 was 19.2%(95% CI: 19.1,19.3). 37.7% of 76,155 symptomatic people post COVID-19 experienced at leastone symptom, while 14.8% experienced three or more symptoms, lasting 12 weeks or more. Thisgives a weighted population prevalence of persistent symptoms of 5.75% (5.68, 5.81) for one and2.22% (2.1, 2.26) for three or more symptoms. Almost a third of people 8,771/28,713 (30.5%)with at least one symptom lasting 12 weeks or more reported having had severe COVID-19symptoms (“significant effect on my daily life”) at the time of their illness, giving a weightedprevalence overall for this group of 1.72% (1.69,1.76). The prevalence of persistent symptomswas higher in women than men (OR: 1.51 [1.46,1.55]) and, conditional on reporting symptoms,risk of persistent symptoms increased linearly with age by 3.5 percentage points per decade oflife. Obesity, smoking or vaping, hospitalisation , and deprivation were also associated with ahigher probability of persistent symptoms, while Asian ethnicity was associated with a lowerprobability. Two stable clusters were identified based on symptoms that persisted for 12 weeks ormore: in the largest cluster, tiredness predominated

Working paper

Elliott J, Whitaker M, Bodinier B, Elliott P, Tzoulaki I, Chadeau-Hyam Met al., 2021, Complementary Variable Selection Methods Highlight Joint Contribution Of Cystatin C And Apolipoprotein B For Cardiovascular Risk Prediction, Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322

Conference paper

Elliott J, Bodinier B, Whitaker M, Tzoulaki I, Elliott P, Chadeau-Hyam Met al., 2021, Cardiovascular Disease, Hypertension, Diabetes And Cystatin C Jointly Predict Covid-19 Mortality Alongside Age, Male Sex And Black Ethnicity, Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322

Conference paper

Tayal U, Fecht D, Chadeau-Hyam M, Owen R, Gregson J, Halliday B, Lota A, Gulliver J, Ware J, Pennell D, Kelly F, Shah A, Miller M, Newby D, Prasad Set al., 2021, AIR POLLUTION AND ADVERSE CARDIAC REMODELLING IN PATIENTS WITH DILATED CARDIOMYOPATHY, 70th Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: 600-600, ISSN: 0735-1097

Conference paper

Elliott J, Bodinier B, Whitaker M, Delpierre C, Vermeulen R, Tzoulaki I, Elliott P, Chadeau Met al., 2021, COVID-19 mortality in the UK Biobank cohort: revisiting and evaluating risk factors, European Journal of Epidemiology, Vol: 36, Pages: 299-309, ISSN: 0393-2990

Background: Most studies of severe/fatal COVID-19 risk have used routine/hospitalisation data without detailed pre-morbid characterisation. Using the community-based UK Biobank ohort, we investigate risk factors for COVID-19 mortality in comparison withnon-COVID-19mortality.MethodsWe investigated demographic, social (education, income, housing, employment), lifestyle (smoking, drinking, body mass index), biological (lipids, cystatin C, vitamin D), medical (comorbidities, medications) and environmental (air pollution) data from UK Biobank (N=473,550) in relation to 459 COVID-19 and 2,626 non-COVID-19 deaths to 21 September 2020. We used univariate, multivariable and penalised regression models. Results: Age (OR=2.76[2.18-3.49]per S.D. [8.1 years], p=2.6x10-17), male sex (OR=1.47[1.26-1.73], p=1.3x10-6) and Black versus White ethnicity (OR=1.21[1.12-1.29], p=3.0x10-7) were independently associated with and jointly explanatory of (area under receiver operating characteristic curve, AUC=0.79) increased risk of COVID-19 mortality. In multivariable regression, alongside demographic covariates, being a healthcare worker, current smoker, having cardiovascular disease, hypertension, diabetes, autoimmune disease, and oral steroid use at enrolment were independently associated with COVID-19 mortality. Penalised regression models selected income, cardiovascular disease, hypertension, diabetes, cystatin C, and oral steroid use as jointly contributing to COVID-19 mortality risk; Black ethnicity, hypertension and oral steroid use contributed to COVID-19 but not non-COVID-19 mortality. Conclusions: Age, male sex and Black ethnicity, as well as comorbidities and oral steroid use at enrolment were associated with increased risk of COVID-19 death. Our results suggest that previously reported associations of COVID-19 mortality with body mass index, low vitamin D, air pollutants

Journal article

Dagnino S, Bodinier B, Guida F, Smith-Byrne K, Petrovic D, Whitaker M, Haugdahl T, Agnoli C, Palli D, Sacerdote C, Panico S, Tumino R, Schulze M, Johansson M, Keski-Rahkonen P, Scalbert A, Vineis P, Mattias J, Sandanger T, Vermeulen R, Chadeau Met al., 2021, Prospective identification of elevated circulating CDCP1 in patients years before onset of lung cancer, Cancer Research, Vol: 81, ISSN: 0008-5472

Increasing evidence points to a role for inflammation in lung carcinogenesis. A small number of circulating inflammatory proteins have been identified as showing elevated levels prior to lung cancer diagnosis, indicating the potential for prospective circulating protein concentration as a marker of early carcinogenesis. In order to identify novel markers of lung cancer risk, we measured a panel of 92 circulating inflammatory proteins in 648 pre-diagnostic blood samples from two prospective cohorts in Italy and Norway (women only). To preserve the comparability of results and protect against confounding factors, the main statistical analyses were conducted in women from both studies, with replication sought in men (Italian participants). Univariate and penalized regression models revealed for the first time higher blood levels of CDCP1 protein in cases that went on to develop lung cancer compared to controls, irrespective of time to diagnosis, smoking habits, and gender. This association was validated in an additional 450 samples. Associations were stronger for future cases of adenocarcinoma where CDCP1 showed better explanatory performance. Integrative analyses combining gene expression and protein levels CDCP1 measured in the same individuals suggested a link between CDCP1 and the expression of transcripts of LRRN3 and SEM1. Enrichment analyses indicated a potential role for CDCP1 in pathways related to cell adhesion and mobility, such as the WNT/β-catenin pathway. Overall, this study identifies lung cancer-related dysregulation of CDCP1 expression years before diagnosis.

Journal article

Elliott J, Whitaker M, Bodinier B, Riley S, Ward H, Cooke G, Darzi A, Chadeau-Hyam M, Elliott Pet al., 2021, Symptom reporting in over 1 million people: community detection of COVID-19

Control of the SARS-CoV-2 epidemic requires rapid identification and isolation of infectedindividuals and their contacts. Community testing in England (Pillar 2) by polymerase chainreaction (PCR) is reserved for those reporting at least one of four ‘classic’ COVID-19 symptoms(loss or change of sense of smell, loss or change of sense of taste, fever, new continuous cough). 1Detection of positive cases in the community might be improved by including additionalsymptoms and their combinations. We used data from the REal-time Assessment of CommunityTransmission-1 (REACT-1) study to investigate symptom profiles for PCR positivity at differentages. Among rounds 2–7 (June to December 2020), an age-stratified, variable selection approachstably selected chills (all ages), headache (5–17 years), appetite loss (18–54 and 55+ years) andmuscle aches (18–54 years) as jointly and positively predictive of PCR positivity together withthe classic four symptoms. Between round 7 (November to December 2020) and round 8(January 2021) when new variant B.1.1.7 predominated, only loss or change of sense of smell(more predictive in round 7) and (borderline) new persistent cough (more predictive in round 8)differed between cases. At any level of PCR testing, triage based on the symptoms identifiedhere would result in more cases detected than the current approach .

Working paper

Carmeli C, Kutalik Z, Mishra PP, Porcu E, Delpierre C, Delaneau O, Kelly-Irving M, Bochud M, Dhayat NA, Ponte B, Pruijm M, Ehret G, Kähönen M, Lehtimäki T, Raitakari OT, Vineis P, Kivimäki M, Chadeau-Hyam M, Dermitzakis E, Vuilleumier N, Stringhini Set al., 2021, Gene regulation contributes to explain the impact of early life socioeconomic disadvantage on adult inflammatory levels in two cohort studies, Scientific Reports, Vol: 11, ISSN: 2045-2322

Individuals experiencing socioeconomic disadvantage in childhood have a higher rate of inflammation-related diseases decades later. Little is known about the mechanisms linking early life experiences to the functioning of the immune system in adulthood. To address this, we explore the relationship across social-to-biological layers of early life social exposures on levels of adulthood inflammation and the mediating role of gene regulatory mechanisms, epigenetic and transcriptomic profiling from blood, in 2,329 individuals from two European cohort studies. Consistently across both studies, we find transcriptional activity explains a substantive proportion (78% and 26%) of the estimated effect of early life disadvantaged social exposures on levels of adulthood inflammation. Furthermore, we show that mechanisms other than cis DNA methylation may regulate those transcriptional fingerprints. These results further our understanding of social-to-biological transitions by pinpointing the role of gene regulation that cannot fully be explained by differential cis DNA methylation.

Journal article

Chadeau M, Bodinier B, Vermeulen R, Karimi M, Zuber V, Castagne R, Elliott J, Muller D, Petrovic D, Whitaker M, Stringhini S, Tzoulaki I, Kivimaki M, Vineis P, Elliott P, Kelly-Irving M, Delpierre Cet al., 2020, Education, biological ageing, all-cause and cause-specific mortality and morbidity: UK Biobank Cohort Study, EClinicalMedicine, Vol: 29-30, ISSN: 2589-5370

BackgroundSocioeconomic position as measured by education may be embodied and affect the functioning of key physiological systems. Links between social disadvantage, its biological imprint, and cause-specific mortality and morbidity have not been investigated in large populations, and yet may point towards areas for public health interventions beyond targeting individual behaviours.MethodsUsing data from 366,748 UK Biobank participants with 13 biomarker measurements, we calculated a Biological Health Score (BHS, ranging from 0 to 1) capturing the level of functioning of five physiological systems. Associations between BHS and incidence of cardiovascular disease (CVD) and cancer, and mortality from all, CVD, cancer, and external causes were examined. We explored the role of education in these associations. Mendelian randomisation using genetic evidence was used to triangulate these findings.FindingsAn increase in BHS of 0.1 was associated with all-cause (HR = 1.14 [1.12–1.16] and 1.09 [1.07–1.12] in men and women respectively), cancer (HR = 1.11 [1.09–1.14] and 1.07 [1.04–1.10]) and CVD (HR = 1.25 [1.20–1.31] and 1.21 [1.11–1.31]) mortality, CVD incidence (HR = 1.15 [1.13–1.16] and 1.17 [1.15–1.19]). These associations survived adjustment for education, lifestyle-behaviours, body mass index (BMI), co-morbidities and medical treatments. Mendelian randomisation further supported the link between the BHS and CVD incidence (HR = 1.31 [1.21–1.42]). The BHS contributed to CVD incidence prediction (age-adjusted C-statistic = 0.58), other than through education and health behaviours.InterpretationThe BHS captures features of the embodiment of education, health behaviours, and more proximal unknown factors which all complementarily contribute to all-cause, cancer and CVD morbidity and premature death.

Journal article

Laine JE, Bodinier B, Robinson O, Plusquin M, Scalbert A, Keski-Rahkonen P, Robinot N, Vermeulen R, Pizzi C, Asta F, Nawrot T, Gulliver J, Chatzi L, Kogevinas M, Nieuwenhuijsen M, Sunyer J, Vrijheid M, Chadeau-Hyam M, Vineis Pet al., 2020, Prenatal exposure to multiple air pollutants, mediating molecular mechanisms, and shifts in birthweight., Environmental Science and Technology (Washington), Vol: 54, Pages: 14502-14513, ISSN: 0013-936X

Mechanisms underlying adverse birth and later in life health effects from exposure to air pollution during the prenatal period have not been not fully elucidated, especially in the context of mixtures. We assessed the effects of prenatal exposure to mixtures of air pollutants of particulate matter (PM), PM2.5, PM10, nitrogen oxides, NO2, NO x , ultrafine particles (UFP), and oxidative potential (OP) of PM2.5 on infant birthweight in four European birth cohorts and the mechanistic underpinnings through cross-omics of metabolites and inflammatory proteins. The association between mixtures of air pollutants and birthweight z-scores (standardized for gestational age) was assessed for three different mixture models, using Bayesian machine kernel regression (BKMR). We determined the direct effect for PM2.5, PM10, NO2, and mediation by cross-omic signatures (identified using sparse partial least-squares regression) using causal mediation BKMR models. There was a negative association with birthweight z-scores and exposure to mixtures of air pollutants, where up to -0.21 or approximately a 96 g decrease in birthweight, comparing the 75th percentile to the median level of exposure to the air pollutant mixture could occur. Shifts in birthweight z-scores from prenatal exposure to PM2.5, PM10, and NO2 were mediated by molecular mechanisms, represented by cross-omics scores. Interleukin-17 and epidermal growth factor were identified as important inflammatory responses underlyingair pollution-associated shifts in birthweight. Our results signify that by identifying mechanisms through which mixtures of air pollutants operate, the causality of air pollution-associated shifts in birthweight is better supported, substantiating the need for reducing exposure in vulnerable populations.

Journal article

Maurel M, Castagné R, Berger E, Bochud M, Chadeau-Hyam M, Fraga S, Gandini M, Hutri-Kähönen N, Jalkanen S, Kivimäki M, Marmot M, McCrory C, Preisig M, Raitakari O, Ricceri F, Salmi M, Steptoe A, Vineis P, Delpierre C, Kelly-Irving Met al., 2020, Patterning of educational attainment across inflammatory markers: Findings from a multi-cohort study, Brain, Behavior, and Immunity, Vol: 90, Pages: 303-310, ISSN: 0889-1591

BACKGROUND: Evidence suggests that the inflammatory reaction, an adaptive response triggered by a variety of harmful stimuli and conditions involved in the risk and development of many chronic diseases, is a potential pathway through which the socioeconomic environment is biologically embedded. Difficulty in interpreting the role of the inflammatory system in the embodiment dynamic arises because of heterogeneity across studies that use a limited but varied number of inflammatory markers. There is no consensus in the literature as to which inflammatory markers beyond the C-reactive protein and to a lesser extent interleukin 6 are related to the social environment. Accordingly, we aimed to investigate the association between educational attainment, and several markers of inflammation - C-reactive protein, fibrinogen, interleukin 6, interleukin 1β and tumor necrosis factor α- in 6 European cohort studies. METHODS: Up to 17,470 participants from six European cohort studies with data on educational attainment, health behaviors and lifestyle factors, and at least two different inflammatory markers. Four sub-datasets were drawn with varying numbers of participants to allow pairwise comparison of the social patterning of C-reactive protein and any other inflammatory markers. To evaluate within each sub-dataset the importance of the context and cohort specificities, linear regression-based analyses were performed separately for each cohort and combined in a random effect meta-analysis to determine the relationship between educational attainment and inflammation. RESULTS: We found that the magnitude of the relationship between educational attainment and five inflammatory biomarkers (C-reactive protein, fibrinogen, interleukin 6 and 1β and tumor necrosis factor α) was variable. By far the most socially patterned biomarker was C-reactive protein, followed by fibrinogen and to lesser extent interleukin 6, where a low educational attainment was associated w

Journal article

Sanikini H, Muller DC, Chadeau-Hyam M, Murphy N, Gunter MJ, Cross AJet al., 2020, Anthropometry, body fat composition and reproductive factors and risk of oesophageal and gastric cancer by subtype and subsite in the UK Biobank cohort, PLoS One, Vol: 15, Pages: 1-22, ISSN: 1932-6203

BackgroundObesity has been positively associated with upper gastrointestinal cancers, but prospective data by subtype/subsite are limited. Obesity influences hormonal factors, which may play a role in these cancers. We examined anthropometry, body fat and reproductive factors in relation to oesophageal and gastric cancer by subtype/subsite in the UK Biobank cohort.MethodsAmong 458,713 UK Biobank participants, 339 oesophageal adenocarcinomas, 124 oesophageal squamous cell carcinomas, 137 gastric cardia and 92 gastric non-cardia cancers were diagnosed during a mean of 6.5 years follow-up. Cox models estimated multivariable hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsBody mass index (BMI), hip circumference, waist circumference, waist-to-hip ratio, waist-to-height ratio, total body fat and trunk fat were positively associated with oesophageal adenocarcinoma (highest vs lowest category: HR = 2.33, 95%-CI:1.65–3.28; HR = 1.56, 95%-CI:1.15–2.13; HR = 2.30, 95%-CI:1.47–3.57; HR = 1.71, 95%-CI:1.01–2.90; HR = 2.87, 95%-CI:1.88–4.38; HR = 1.96, 95%-CI:1.30–2.96; HR = 2.34, 95%-CI:1.70–3.22, respectively). Although there were no statistically significant associations in combined sex analyses, BMI (HR = 1.83, 95%-CI:1.00–3.37), waist circumference (HR = 2.21, 95%-CI:1.27–3.84) and waist-to-hip ratio (HR = 1.92, 95%-CI:1.11–3.29) were associated with gastric cardia cancer in men; however, mutual adjustment attenuated the associations for BMI and waist-to-hip ratio. For oesophageal squamous cell carcinoma, statistically significant inverse associations were observed among women for BMI, hip circumference, waist circumference, waist-to-height ratio, total body fat and trunk fat, although they were based on small numbers. In addition, older age at first (HR = 0.44, 95%-CI:0.22–0.88) and last live birth (HR = 0.44, 95%-CI:0.22–0.87) were inversely associated with oesophageal squamous cell carc

Journal article

Chadeau M, Bodinier B, Elliott J, Whitaker M, Tzoulaki I, Vermeulen R, Kelly-Irving M, Delpierre C, Elliott Pet al., 2020, Risk factors for positive and negative COVID-19 tests: a cautious and in-depth analysis of UK Biobank data, International Journal of Epidemiology, Vol: 49, Pages: 1454-1467, ISSN: 0300-5771

BackgroundThe recent COVID-19 outbreak has generated an unprecedented public health crisis, with millions of infections and hundreds of thousands of deaths worldwide. Using hospital-based or mortality data, several COVID-19 risk factors have been identified, but these may be confounded or biased.MethodsUsing SARS-CoV-2 infection test data (N=4,509 tests; 1,325 positive) from Public Health England, linked to the UK Biobank study, we explored the contribution of demographic, social, health risk, medical, and environmental factors to COVID-19 risk. We used multivariable and penalised logistic regression models for the risk of (i) being tested, (ii) testing positive/negative in the study population and, adopting a test negative design, (iv) the risk of testing positive within the tested population.ResultsIn the fully adjusted model, variables independently associated with the risk of being tested for COVID-19 with OR >1.05 were: male sex; Black ethnicity; social disadvantage (as measured by education, housing and income); occupation (healthcare worker, retired, unemployed); ever smoker; severely obese; comorbidities; and greater exposure to PM2.5-absorbance. Of these, only male sex, non-White ethnicity, lower educational attainment, and none of the comorbidities or health risk factors, were associated with testing positive among tested individuals.ConclusionsWe adopted a careful and exhaustive approach within a large population-based cohort, which enabled us to triangulate evidence linking, male sex, lower educational attainment, non-White ethnicity with the risk of COVID-19. The elucidation of the joint and independent effects of these factors is a high-priority area for further research to inform on COVID-19 natural history.

Journal article

Vineis P, Chadeau M, Dagnino S, Mudway I, Robinson O, Dehghan Aet al., 2020, What's new in the Exposome?, Environment International, Vol: 143, Pages: 1-13, ISSN: 0160-4120

The exposome concept refers to the totality of exposures from a variety of external and internal sources including chemical agents, biological agents, or radiation, from conception onward, over a complete lifetime. It encompasses also “psychosocial components” including the impact of social relations and socio-economic position on health. In this review we provide examples of recent contributions from exposome research, where we believe their application will be of the greatest value for moving forward. So far, environmental epidemiology has mainly focused on hard outcomes, such as mortality, disease exacerbation and hospitalizations. However, there are many subtle outcomes that can be related to environmental exposures, and investigations can be facilitated by an improved understanding of internal biomarkers of exposure and response, through the application of omic technologies. Second, though we have a wealth of studies on environmental pollutants, the assessment of causality is often difficult because of confounding, reverse causation and other uncertainties. Biomarkers and omic technologies may allow better causal attribution, for example using instrumental variables in triangulation, as we discuss here. Even more complex is the understanding of how social relationships (in particular socio-economic differences) influence health and imprint on the fundamental biology of the individual. The identification of molecular changes that are intermediate between social determinants and disease status is a way to fill the gap. Another field in which biomarkers and omics are relevant is the study of mixtures. Epidemiology often deals with complex mixtures (e.g. ambient air pollution, food, smoking) without fully disentangling the compositional complexity of the mixture, or with rudimentary approaches to reflect the overall effect of multiple exposures or components.From the point of view of disease mechanisms, most models hypothesize that several stages need t

Journal article

Brewer H, Hirst Y, Sudha S, Chadeau-Hyam M, Flanagan Jet al., 2020, Cancer Loyalty Card Study (CLOCS): protocol for an observational case-control study focusing on the patient interval in ovarian cancer diagnosis, BMJ Open, Vol: 10, Pages: 1-9, ISSN: 2044-6055

IntroductionOvarian Cancer is the eighth most common cancer in women worldwide, and about one infive women with ovarian cancer do not receive treatment, because they are too unwell by thetime they are diagnosed. Symptoms of ovarian cancer are non-specific or can be associatedwith other common conditions, and women experiencing these symptoms have been shownto self-manage them using over-the-counter medication. Results from a recent proof ofconcept study suggest there may be an increase in the purchases of pain killers andindigestion medication 10-12 months before ovarian cancer diagnosis. We propose a casecontrol study, as part of a larger project called the Cancer Loyalty Card Study (CLOCS), toinvestigate whether a significant change in medication purchases could be an indication forearly signs of ovarian cancer, using data already collected through store loyalty cards.Methods and AnalysisUsing a retrospective case-control design, we aim to recruit 500 women diagnosed withovarian cancer (cases) and 500 women without ovarian cancer (controls) in the UnitedKingdom who hold a loyalty card with at least one participating high street retailer. We willuse pre-existing loyalty card data to compare past purchase patterns of cases with those ofcontrols. In order to assess ovarian cancer risk in participants and their purchase patterns, wewill collect information from participants on ovarian cancer risk factors and clinical dataincluding symptoms experienced before diagnosis from recruited women with ovariancancer.Ethics and disseminationCLOCS was reviewed and approved by the North West - Greater Manchester South ResearchEthics Committee (19/NW/0427). Study outcomes will be disseminated through academicpublications, the study website, social media, and a report to the research sites that supportthe study once results are published.Study Registration NumbersCLOCS is registered with ISRCTN (14897082), NIHR portfolio (CPMS 43323), andclinicaltrials.gov (NCT03994653).

Journal article

Petrovic D, Carmeli C, Bodinier B, Chadeau-Hyam M, Ehret G, Dhayat N, Ponte B, Pruijm M, Bochud M, Stringhini Set al., 2020, Exploring the relation between socioeconomic position and DNA methylation in a European population, Publisher: OXFORD UNIV PRESS, Pages: V385-V385, ISSN: 1101-1262

Conference paper

Chadeau M, Alfano R, Ghantous A, Keski-Rahkonen P, Chatzi L, Espin Perez A, Herceg Z, Kogevinas M, de Kok T, Nawrot T, Novoloaca A, Patel C, Pizzi C, Robinot N, Rusconi F, Scalbert A, Sunyer J, Vermeulen R, Vrijheid M, Vineis P, Robinson O, Plusquin Met al., 2020, A multi-omic analysis of birthweight in newborn cord blood reveals new underlying mechanisms related to cholesterol metabolism, Metabolism: clinical and experimental, Vol: 110, Pages: 1-12, ISSN: 0026-0495

BackgroundBirthweight reflects in utero exposures and later health evolution. Despite existing studies employing high-dimensional molecular measurements, the understanding of underlying mechanisms of birthweight remains limited.MethodsTo investigate the systems biology of birthweight, we cross-sectionally integrated the methylome, the transcriptome, the metabolome and a set of inflammatory proteins measured in cord blood samples, collected from four birth-cohorts (n = 489). We focused on two sets of 68 metabolites and 903 CpGs previously related to birthweight and investigated the correlation structures existing between these two sets and all other omic features via bipartite Pearson correlations.ResultsThis dataset revealed that the set of metabolome and methylome signatures of birthweight have seven signals in common, including three metabolites [PC(34:2), plasmalogen PC(36:4)/PC(O-36:5), and a compound with m/z of 781.0545], two CpGs (on the DHCR24 and SC4MOL gene), and two proteins (periostin and CCL22). CCL22, a macrophage-derived chemokine has not been previously identified in relation to birthweight. Since the results of the omics integration indicated the central role of cholesterol metabolism, we explored the association of cholesterol levels in cord blood with birthweight in the ENVIRONAGE cohort (n = 1097), finding that higher birthweight was associated with increased high-density lipoprotein cholesterol and that high-density lipoprotein cholesterol was lower in small versus large for gestational age newborns.ConclusionsOur data suggests that an integration of different omic-layers in addition to single omics studies is a useful approach to generate new hypotheses regarding biological mechanisms. CCL22 and cholesterol metabolism in cord blood play a mechanistic role in birthweight.

Journal article

Mancini FR, Laine JE, Tarallo S, Vlaanderen J, Vermeulen R, van Nunen E, Hoek G, Probst-Hensch N, Imboden M, Jeong A, Gulliver J, Chadeau-Hyam M, Nieuwenhuijsen M, de Kok TM, Piepers J, Krauskopf J, Kleinjans JCS, Vineis P, Naccarati Aet al., 2020, microRNA expression profiles and personal monitoring of exposure to particulate matter, Environmental Pollution, Vol: 263, ISSN: 0269-7491

An increasing number of findings from epidemiological studies support associations between exposure to air pollution and the onset of several diseases, including pulmonary, cardiovascular and neurodegenerative diseases, and malignancies. However, intermediate, and potentially mediating, biological mechanisms associated with exposure to air pollutants are largely unknown. Previous studies on the human exposome have shown that the expression of certain circulating microRNAs (miRNAs), regulators of gene expression, are altered upon exposure to traffic-related air pollutants. In the present study, we investigated the relationship between particulate matter (PM) smaller than 2.5 μm (PM2.5), PM2.5 absorbance (as a proxy of black carbon and soot), and ultrafine-particles (UFP, smaller than 0.1 μm), measured in healthy volunteers by 24 h personal monitoring (PEM) sessions and global expression levels of peripheral blood miRNAs. The PEM sessions were conducted in four European countries, namely Switzerland (Basel), United Kingdom (Norwich), Italy (Turin), and The Netherlands (Utrecht). miRNAs expression levels were analysed using microarray technology on blood samples from 143 participants. Seven miRNAs, hsa-miR-24-3p, hsa-miR-4454, hsa-miR-4763-3p, hsa-miR-425-5p, hsa-let-7d-5p, hsa-miR-502-5p, and hsa-miR-505-3p were significantly (FDR corrected) expressed in association with PM2.5 personal exposure, while no significant association was found between miRNA expression and the other pollutants. The results obtained from this investigation suggest that personal exposure to PM2.5 is associated with miRNA expression levels, showing the potential for these circulating miRNAs as novel biomarkers for air pollution health risk assessment.

Journal article

Chadeau M, Castagne R, Kelly-Irving M, Krogh V, Palli D, Sacerdote C, Tumino R, Hebbels D, Kleinjans J, de Kok T, Georgiadis P, Kyrtopoulos S, Vermeulen R, Stringhini S, Vineis P, Delpierre Cet al., 2020, A multi-omics approach to investigate the inflammatory response to life course socioeconomic position, Epigenomics, Vol: 12, ISSN: 1750-1911

Aims: Inflammation represents a potential pathway through which socioeconomic position (SEP) is biologically embedded. Materials & Methods: We analysed inflammatory biomarkers in response to life course SEP by integrating multi-omics DNA-methylation, gene expression and protein level in 178 EPIC-Italy participants. Results & Conclusions: We identified 61 potential cis acting CpG loci whose methylation levels were associated with gene expression at a Bonferroni correction. We examined the relationships between life course SEP and these 61 cis-acting regulatory methylation sites (eMS) individually and jointly using several scores. Less advantaged SEP participants exhibit, later in life, a lower inflammatory methylome score, suggesting an overall increased expression of the corresponding inflammatory genes or proteins, supporting the hypothesis that SEP impacts adult physiology through inflammation.

Journal article

Chadeau M, Petrovic D, Haba-Rubio J, de Mestral Vargas C, Kelly-Irving M, Vineis P, Kivimaki M, Nyberg S, Gandini M, Bochud M, Vollenweider P, dErrico A, Barros H, Fraga S, Goldberg M, Zins M, Steptoe A, Delpierre C, Heinzer R, Carmeli C, Stringhini Set al., 2020, The contribution of sleep to social inequalities in cardiovascular disorders: a multi-cohort study, Cardiovascular Research, Vol: 116, Pages: 1514-1524, ISSN: 0008-6363

Aims: Sleep disturbances exhibit a strong social patterning, and inadequate sleep has been associated with adverse health outcomes, including cardiovascular disorders (CVD). However, the contribution of sleep to socioeconomic inequalities in CVD is unclear. This study pools data from eight European cohorts to investigate the role of sleep duration in the association between life-course socioeconomic status (SES) and CVD. Methods and Results We used cross-sectional data from eight European cohorts, totaling 111,205 participants. Life- course SES was assessed using father’s and adult occupational position. Self-reported sleep duration was categorized into recommended (6h-8.5h/night), long (>8.5h/night), and short (<6h/night). We examined two cardiovascular outcomes: coronary heart disease (CHD) and stroke. Main analyses were conducted using pooled data and examined the association between life-course SES and CVD, and the contribution of sleep duration to this gradient using counterfactual mediation. Low father’s occupational position was associated with an increased risk of CHD (men: OR=1.19, 95% CI [1.04;1.37]; women: OR=1.25, 95% CI 61 [1.02;1.54]), with marginal decrease of the gradient after accounting for adult occupational position (men: OR=1.17, 95% CI [1.02;1.35]; women: OR=1.22, 95% CI [0.99;1.52]), and no mediating effect by short sleep duration. Low adult occupational position was associated with an increased risk of CHD in both men and women (men: OR=1.48, 95% CI [1.14;1.92]; women: OR=1.53, 95% CI [1.04;2.21. Short sleep duration meaningfully contributed to the association between adult occupational position and CHD in men, with 13.4% mediation. Stroke did not exhibit a social patterning with any of the variables examined. Conclusion: This study suggests that inadequate sleep accounts to a meaningful proportion of the association between adult occupational position and coronary heart disease, at least in men. With slee

Journal article

Tayal U, Fecht D, Chadeau M, Gulliver J, Ware J, Cook S, Prasad Set al., 2020, RESIDENTIAL EXPOSURE TO FINE PARTICULATE MATTER AIR POLLUTION IS ASSOCIATED WITH IMPAIRED CARDIAC PHENOTYPES IN DILATED CARDIOMYOPATHY, Publisher: BMJ PUBLISHING GROUP, Pages: A2-A3, ISSN: 1355-6037

Conference paper

Appenzeller BMR, Chadeau-Hyam M, Aguilar L, 2020, Skin exposome science in practice : current evidence on hair biomonitoring and future perspectives, JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY, Vol: 34, Pages: 26-30, ISSN: 0926-9959

Journal article

Dagnino S, Bodinier B, Grigoryan H, Rappaport S, Karimi M, Guida F, Polidoro S, Edmands W, Naccarati A, GFiorito G, Sacerdote C, Krogh V, Vermeulen R, Vineis P, Chadeau Met al., 2020, Agnostic Cys34-albumin adductomics and DNA methylation: implication of Nacetylcysteine in lung carcinogenesis years before diagnosis, International Journal of Cancer, Vol: 146, Pages: 3294-3303, ISSN: 0020-7136

Although smoking and oxidative stress are known contributors to lung carcinogenesis, theirmechanisms of action remain poorly understood. To shed light into these mechanisms, weapplied a novel approach using Cys34-adductomics in a lung cancer nested case-controlstudy (n=212). Adductomics profiles were integrated with DNA-methylation data atestablished smoking-related CpG sites measured in the same individuals. Our analysisidentified 42 Cys34-albumin adducts, of which 2 were significantly differentially abundant incases and controls: adduct of N-acetylcysteine (NAC, p=4.15x10-3) and of Cysteinyl-Glycine(Cys-Gly, p=7.89x10-3). Blood levels of the former were found associated to the methylationlevels at 11 smoking related CpG sites. We detect, for the first time in prospective bloodsamples, and irrespective of time-to-diagnosis, decreased levels of NAC adduct in lungcancer cases. Altogether, our results highlight the potential role of these adducts in theoxidative stress response contributing to lung carcinogenesis years before diagnosis.

Journal article

Robinson O, Chadeau Hyam M, Karaman I, Climaco Pinto R, Ala-Korpela M, Handakas E, Fiorito G, Gao H, Heard A, Jarvelin M-R, Lewis M, Pazoki R, Polidoro S, Tzoulaki I, Wielscher M, Elliott P, Vineis Pet al., 2020, Determinants of accelerated metabolomic and epigenetic ageing in a UK cohort, Aging Cell, Vol: 19, Pages: 1-13, ISSN: 1474-9718

Markers of biological aging have potential utility in primary care and public health. We developed a model of age based on untargeted metabolic profiling across multiple platforms, including nuclear magnetic resonance spectroscopy and liquid chromatography–mass spectrometry in urine and serum, within a large sample (N = 2,239) from the UK Airwave cohort. We validated a subset of model predictors in a Finnish cohort including repeat measurements from 2,144 individuals. We investigated the determinants of accelerated aging, including lifestyle and psychological risk factors for premature mortality. The metabolomic age model was well correlated with chronological age (mean r = .86 across independent test sets). Increased metabolomic age acceleration (mAA) was associated after false discovery rate (FDR) correction with overweight/obesity, diabetes, heavy alcohol use and depression. DNA methylation age acceleration measures were uncorrelated with mAA. Increased DNA methylation phenotypic age acceleration (N = 1,110) was associated after FDR correction with heavy alcohol use, hypertension and low income. In conclusion, metabolomics is a promising approach for the assessment of biological age and appears complementary to established epigenetic clocks.

Journal article

Vineis P, Avendano-Pabon M, Barros H, Bartley M, Carmeli C, Carra L, Chadeau-Hyam M, Costa G, Delpierre C, D'Errico A, Fraga S, Giles G, Goldberg M, Kelly-Irving M, Kivimaki M, Lepage B, Lang T, Layte R, MacGuire F, Mackenbach JP, Marmot M, McCrory C, Milne RL, Muennig P, Nusselder W, Petrovic D, Polidoro S, Ricceri F, Robinson O, Stringhini S, Zins Met al., 2020, Special report: the biology of inequalities in health: the lifepath consortium, Frontiers in Public Health, Vol: 8, Pages: 1-37, ISSN: 2296-2565

Funded by the European Commission Horizon 2020 programme, the Lifepath research consortium aimed to investigate the effects of socioeconomic inequalities on the biology of healthy aging. The main research questions included the impact of inequalities on health, the role of behavioral and other risk factors, the underlying biological mechanisms, the efficacy of selected policies, and the general implications of our findings for theories and policies. The project adopted a life-course and comparative approach, considering lifetime effects from childhood and adulthood, and pooled data on up to 1.7 million participants of longitudinal cohort studies from Europe, USA, and Australia. These data showed that socioeconomic circumstances predicted mortality and functional decline as strongly as established risk factors currently targeted by global prevention programmes. Analyses also looked at socioeconomically patterned biological markers, allostatic load, and DNA methylation using richly phenotyped cohorts, unraveling their association with aging processes across the life-course. Lifepath studies suggest that socioeconomic circumstances are embedded in our biology from the outset—i.e., disadvantage influences biological systems from molecules to organs. Our findings have important implications for policy, suggesting that (a) intervening on unfavorable socioeconomic conditions is complementary and as important as targeting well-known risk factors, such as tobacco and alcohol consumption, low fruit and vegetable intake, obesity and a sedentary lifestyle, and that (b) effects of preventive interventions in early life integrate interventions in adulthood. The report has an executive summary that refers to the different sections of the main paper.

Journal article

Laine JE, Baltar VT, Stringhini S, Gandini M, Chadeau-Hyam M, Kivimaki M, Severi G, Perduca V, Hodge AM, Dugue P-A, Giles GG, Milne RL, Barros H, Sacerdote C, Krogh V, Panico S, Tumino R, Goldberg M, Zins M, Delpierre C, Vineis Pet al., 2020, Reducing socio-economic inequalities in all-cause mortality: a counterfactual mediation approach (vol 49, pg 497, 2020), INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, Vol: 49, Pages: 707-707, ISSN: 0300-5771

Journal article

Laine J, Baltar VT, Stringini S, Gandini M, Chadeau-Hyam M, Kivimaki M, Severi G, Perduca V, Hodge AM, Dugué P-A, Giles GG, Milne RL, Barros H, Sacerdote C, Krogh V, Panico S, Tumino R, Goldberg M, Marie Z, Cyrille D, Vineis Pet al., 2020, Reducing socioeconomic inequalities in all-cause mortality: a counterfactual mediation approach, International Journal of Epidemiology, Vol: 49, Pages: 497-510, ISSN: 0300-5771

Background: Socioeconomicinequalities inmortality arewell established, yet the contribution of intermediate risk factors that may underlie these relationships remains unclear.We evaluated the role of multiple modifiable intermediate risk factors underlyingsocioeconomicassociated-mortality and quantifiedthe potentialimpact of reducing early all-cause mortality by hypothetically altering socioeconomic risk factors. Methods: Data were fromsevencohort studies participating in the LIFEPATH consortium (total n=179,090). Using bothsocioeconomic position (SEP) (based on occupation) and education, we estimated thenaturaldirect effect on all-cause mortality, and thenatural indirect effect via the joint mediatingrole of smoking, alcohol intake, dietary patterns, physical activity, body mass index,hypertension, diabetes, and coronary artery disease.Hazard ratios(HR)were estimated, using counterfactual natural effect modelsunder different hypothetical actions of either lower or higher SEP or education. Results: Lower SEP and educationwereassociated with anincreaseinall-cause mortalitywithin an average follow up time of 17.5 years.Mortality wasreducedviamodelled hypothetical actions of increasing SEP oreducation. Through higher educationtheHR was0.85(95% confidence interval (CI) 0.84, 0.86) for women and 0.71(95% CI 0.70, 0.74)for men,compared to lower education. In addition, 34% and 38% of the effect was jointlymediatedfor womenand men, respectively. The benefits from alteringSEP were slightly more modest.Conclusions: Theseobservational findings supportpoliciesto reducemortalityboththrough improving socioeconomic circumstances and increasing education,andby altering intermediaries, such as lifestyle behaviours and morbidities.

Journal article

Elliott J, Bodinier B, Bond TA, Chadeau-Hyam M, Evangelou E, Moons KGM, Dehghan A, Muller DC, Elliott P, Tzoulaki Iet al., 2020, Predictive accuracy of a polygenic risk score-enhanced prediction model vs a clinical risk score for coronary artery disease, JAMA: Journal of the American Medical Association, Vol: 323, Pages: 636-645, ISSN: 0098-7484

Importance The incremental value of polygenic risk scores in addition to well-established risk prediction models for coronary artery disease (CAD) is uncertain.Objective To examine whether a polygenic risk score for CAD improves risk prediction beyond pooled cohort equations.Design, Setting, and Participants Observational study of UK Biobank participants enrolled from 2006 to 2010. A case-control sample of 15 947 prevalent CAD cases and equal number of age and sex frequency–matched controls was used to optimize the predictive performance of a polygenic risk score for CAD based on summary statistics from published genome-wide association studies. A separate cohort of 352 660 individuals (with follow-up to 2017) was used to evaluate the predictive accuracy of the polygenic risk score, pooled cohort equations, and both combined for incident CAD.Exposures Polygenic risk score for CAD, pooled cohort equations, and both combined.Main Outcomes and Measures CAD (myocardial infarction and its related sequelae). Discrimination, calibration, and reclassification using a risk threshold of 7.5% were assessed.Results In the cohort of 352 660 participants (mean age, 55.9 years; 205 297 women [58.2%]) used to evaluate the predictive accuracy of the examined models, there were 6272 incident CAD events over a median of 8 years of follow-up. CAD discrimination for polygenic risk score, pooled cohort equations, and both combined resulted in C statistics of 0.61 (95% CI, 0.60 to 0.62), 0.76 (95% CI, 0.75 to 0.77), and 0.78 (95% CI, 0.77 to 0.79), respectively. The change in C statistic between the latter 2 models was 0.02 (95% CI, 0.01 to 0.03). Calibration of the models showed overestimation of risk by pooled cohort equations, which was corrected after recalibration. Using a risk threshold of 7.5%, addition of the polygenic risk score to pooled cohort equations resulted in a net reclassification improvement of 4.4% (95% CI, 3.5% to 5.3%) for cases and −0.4% (95% CI, &

Journal article

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