Anne-Sofie Furberg

• Lund, Marianne; Norbye, Anja Margrete Davis; Furberg, Anne-Sofie; Johansson, Jonas; Wilsgaard, Tom & Winther, Anne [Show all 8 contributors for this article] (2026). Associations between BMI trajectories and young adult bone: a 10-yr follow-up from the Norwegian Fit Futures cohort. JBMR Plus. 10(10). doi: 10.1093/jbmrpl/ziag143. Full text in Research Archive Show summary

  BMI is a well-established determinant of bone health; however, most evidence is derived from cross-sectional or short- term studies, providing limited insight into how long-term BMI development influences skeletal maturation. We aimed to investigate the associations between long-term BMI trajectories and skeletal development from adolescence into young adulthood. Data were derived from 1114 participants in the population-based Fit Futures study with repeated measurements (2010-2011 [FF1], 2012-2013[FF2], and 2021-2022[FF3]). Group-based trajectory modeling identified 3 BMI trajectories: low-stable, moderate-increasing, and high-stable. Sex-stratified linear mixed-effects models estimated adjusted mean DXA- derived areal BMD (aBMD) and BMC at the total body (TB), TH, and FN. Participants in the moderate-increasing and high- stable trajectories consistently exhibited higher aBMD and BMC than those in the low-stable trajectory across all skeletal sites throughout follow-up. For TB aBMD, compared with the low-stable trajectory, the moderate-increasing trajectory was associated with β =.06 g/cm2 (95% CI: 0.05-0.08) in females and β =.08 g/cm2 (95% CI: 0.06-0.10)in males, whereas the corresponding estimates for the high-stable trajectory were β =.10 g/cm2 (95% CI: 0.07-0.17) and β =.10 g/cm2 (95% CI: 0.06- 0.15), respectively (all p<.001). Despite continued increases in BMI, the moderate-increasing trajectory was not associated with proportionally greater skeletal accrual than the high-stable trajectory, and statistically significant trajectory-by-time interactions were limited to TB outcomes. BMI trajectories established during adolescence were associated with persistent differences in attained skeletal levels rather than differential skeletal accrual into young adulthood. These findings underscore the importance of adolescence as a critical period for the attainment of peak bone mass.

• Hadler-Olsen, Elin Synnøve; Mulic, Aida Gacic; Furberg, Anne-Sofie & Petrenya, Natalia (2026). Enamel Caries in Young Adults and Progression From Adolescence: Fit Futures, a Longitudinal Cohort Study. International Dental Journal. ISSN 0020-6539. 76(5). doi: 10.1016/j.identj.2026.109739. Full text in Research Archive
• Bollemeijer, Juliette; Page, Christian Magnus; Klein, Isabel; Danielsen, Kjersti; Furberg, Anne-Sofie & Jenssen, Marita [Show all 13 contributors for this article] (2026). Chronic Pain and Pain Tolerance in Psoriasis: A Cross-sectional Study of Three Population-based Cohorts in the Netherlands and Norway. Acta Dermato-Venereologica. ISSN 0001-5555. 106. doi: 10.2340/actadv.v106.adv-2026-0510. Full text in Research Archive Show summary

  Pain is increasingly recognized as an important butunder-addressed symptom in psoriasis. Although oftenattributed to psoriatic arthritis (PsA) or skin-relatedpain, individuals with psoriasis or PsA also reportpain in other musculoskeletal structures, including axialand buttock pain (1, 2). Quantitative sensory testing(QST) uses standardized experimental stimuli to assesspain thresholds and tolerance, and small studies inpsoriasis or PsA have reported reduced pressure painthresholds (3, 4). However, large population-basedstudies assessing chronic pain and QST measures inpsoriasis, both with and without PsA, are lacking,despite the substantial impact of pain in psoriasis onhealth-related quality of life (5). Using data from threelarge population-based cohorts in the Netherlands andNorway, we therefore examined whether individualswith psoriasis differ from controls in chronic pain,number of pain sites, pain intensity and pain toleranceassessed by 2 QST measures: the cold pressor test(CPT) and cuff pressure algometry (PAlg). We alsoevaluated the influence of PsA, psoriasis activity andseverity on these associations.

• Pettersen, Torkild; Fuskevåg, Ole Martin; Figenschau, Yngve Anton; Evensen, Elin Kristin; Furberg, Anne-Sofie & Winther, Anne [Show all 7 contributors for this article] (2026). 11-oxygenated androgens in healthy young adults: Does use of hormonal contraceptives matter? The Fit Futures Study. Journal of Endocrinological Investigation. ISSN 0391-4097. 49(5), p. 1059–1070. doi: 10.1007/s40618-025-02793-0. Full text in Research Archive
• Danielsen, Anders Skyrud; Johansen, Amalie; Sare, Miriam; Lim, Cherry; Bjørnholt, Jørgen & Furberg, Anne-Sofie [Show all 7 contributors for this article] (2025). Two decades of bacteraemia in Norway: an ecological study of incidence and shifts in microbial epidemiology, 2005–2024. Scientific Reports. 15. doi: 10.1038/s41598-025-28472-x. Full text in Research Archive Show summary

  This study aimed to describe temporal changes in the incidence and microbial composition of bacteraemia in Norway from 2005 to 2024. Using national surveillance data from all microbiology laboratories, combined with contextual indicators such as population size, hospital activity, immunosuppression, and cancer incidence, we conducted an ecological analysis of annual aggregated data. The number of isolates from blood cultures increased from 10,964 in 2005 to 22,679 in 2024, or from 238.0 to 408.6 per 100,000 people, while the estimated blood culture positivity rate remained stable at approximately 6%. Escherichia coli, Staphylococcus aureus, and Klebsiella spp. were the most frequent pathogens in 2024, while the proportion of Streptococcus pneumoniae declined by nearly 40%. The apparent rise in the Gram-negative to Gram-positive ratio was largely explained by this decline in pneumococci. Regression models showed a steady increase in incidence of bacteraemia over time, with minimal impact of age adjustment. Increased diagnostic activity is probably driven by a larger share of inpatients meeting criteria for blood culture, consistent with a frailer and more complex case-mix. The relative stability of estimated positivity rate and the proportion of coagulase-negative staphylococci support that the rise reflects a real increase in the underlying burden of bloodstream infections.

• Sagelv, Edvard Hamnvik; Winther, Anne; Emaus, Nina; Evensen, Elin Kristin; Christoffersen, Tore & Dennison, Elaine [Show all 9 contributors for this article] (2025). Does tobacco use influence bone mineral density levels in a Norwegian youth cohort followed from adolescence to young adulthood? The Fit Futures Study (2010-2022). BMJ Open. 15(8). doi: 10.1136/bmjopen-2025-101654. Full text in Research Archive
• Husby, Marit; Frydenberg, Hanne; Myklebust, Tor Åge; Skei, Nina Vibeche; Solligård, Erik & Thune, Inger [Show all 8 contributors for this article] (2025). Cancer patients with sepsis: Prognostic insights from a population-based cohort study in Norway. Cancer Epidemiology, Biomarkers and Prevention. ISSN 1055-9965. 35 (2026)(2), p. 264–275. doi: 10.1158/1055-9965.epi-25-1018. Full text in Research Archive Show summary

  Background: Patients with cancer who had sepsis experience a higher mortality risk than noncancer patients. However, it remains unclear how this risk varies with cancer type and metastasis status, sex, age, and infecting microbe. Methods: This nationwide cohort study included all noncancer patients and those with cancer ≥18 years hospitalized with sepsis in Norway from 2008 to 2021. Cancer status, sepsis, and hospital mortality were identified from the Norwegian Patient Registry (International Classification of Diseases 10th revision codes). Multivariable regression analyses estimated absolute and relative risks (RR) of hospital mortality across subgroups. Results: Of 222,832 hospitalized patients with sepsis, 37,692 (16.9%) had cancer. Hospital mortality was higher in patients with cancer, at 16.9% (males) and 16.2% (females) with nonmetastatic disease, and at 27.1% (males) and 26.2% (females) with metastatic disease. Compared with noncancer patients, adjusted RRs (95% confidence interval) of hospital death were 1.39 (1.34–1.44, males) and 1.63 (1.55–1.71, females) for nonmetastatic cancer and 2.27 (2.18–2.37, males) and 2.75 (2.62–2.89, females) for metastatic cancer. The type of cancer was a key prognostic factor. The association between cancer and mortality was strongest in metastatic patients below 50 years [males 40–49 years: RR, 5.94 (4.43–7.97); females 18–39 years: RR, 8.28 (5.12–13.37)] and in those with gram-negative sepsis. Conclusions: The increased hospital mortality in patients with cancer varied with cancer type and the presence of metastasis. The association between cancer and mortality was strongest in females and young adults, as well as in gram-negative sepsis. Impact: Knowledge of the specific aspects of sepsis in patients with cancer may improve cancer care and guide future research on targeted sepsis therapies.

• Rognmo, Kamilla; Opdal, Ida Marie; Handegård, Bjørn Helge; Horsch, Alexander; Lillevoll, Kjersti & Furberg, Anne-Sofie [Show all 8 contributors for this article] (2025). The relationship between self-reported and device-based measurements of physical activity and mental distress among adolescents: results from the fit futures study. BMC Public Health. 25. doi: 10.1186/s12889-025-23902-x. Full text in Research Archive Show summary

  The potential for physical activity to prevent or alleviate mental distress among adolescents is unclear, partially due to a lack of studies using objective measurements of physical activity. The purpose of the present study is to investigate the cross-sectional and longitudinal relationship between self-reported and device-based measurements of physical activity and mental distress among adolescents. A second aim is to explore the degree to which the relationship differs according to physical activity measurement method. Cross-sectional and longitudinal data from the Norwegian population-based Fit Futures study in 2010-11 and 2012-13 were used. Mean age of the participants was 16.2 years at baseline. Physical activity was measured by self-report and by accelerometer. Mental distress was self-reported. Multiple linear regression analyses were used to analyze the association between physical activity and mental distress, adjusted by demographic, health and life-style variables and peer acceptance. Using cross-sectional data, self-reported physical activity and objectively measured minutes in moderate to vigorous physical activity were negatively associated with mental distress, up until inclusion of peer acceptance as a covariate in the fully adjusted model. After adjusting for peer acceptance, all but three effects were non-significant. Neither self-reported nor objectively measured physical activity at baseline was significantly related to mental distress at follow-up, after adjusting for baseline mental distress. Cross-sectionally, both self-reported and objectively measured moderate to vigorous physical activity were significantly related to lower mental distress, but adjusting for peer acceptance rendered the associations mainly non-significant. This finding highlights the important role played by social factors among adolescents, possibly impacting both depressive symptoms and physical activity levels. Physical activity at baseline was not related to mental distress at follow-up, adjusted for baseline mental distress, neither for device-based nor self-reported physical activity.

• Hammer, Tord Markussen; Johansson, Jonas; Emaus, Nina; Furberg, Anne-Sofie; Gracia-Marco, Luis & Morseth, Bente [Show all 12 contributors for this article] (2025). Changes in accelerometer-measured physical activity and self-reported leisure time physical activity from adolescence to young adulthood: a longitudinal cohort study from the Fit Futures Study. International Journal of Behavioral Nutrition and Physical Activity. 22(1). doi: 10.1186/s12966-025-01799-4. Full text in Research Archive Show summary

  Background: Adolescence is associated with declining physical activity (PA) levels, and potential prevailing changes into young adulthood are indicated, but less explored. This study investigates longitudinal changes in PA from adolescence to young adulthood among males and females in a North Norwegian cohort. Methods: In the population-based Fit Futures Study, PA was assessed with both questionnaires (Saltin-Grimby Physical Activity Level Scale) and accelerometers (ActiGraph) at ages ~ 16 (n self−report =936; n accelerometer =674), ~ 18 (n self−report =808; n accelerometer =507), and ~ 27 (n self−report =648; n accelerometer =466). We used mixed effects models to analyze longitudinal changes in accelerometer-measured PA and sedentary time, alongside mixed effects multinomial logistic regression for changes in self-reported leisure time PA. Results: We observed a significant non-linear U-shaped trend in accelerometer-measured moderate-to-vigorous PA (MVPA) over time ( p  < 0.001), with an initial decline in minutes per day from age 16 (mean ± SD: 70.7 ± 25.2) to age 18 (62.3 ± 23.8), followed by an increase to age 27 (67.5 ± 30.4). At age 16, males exhibited higher MVPA than females. By age 18 and 27, MVPA levels were similar between sexes. Accelerometer-measured sedentary time decreased linearly across all three surveys ( p  = 0.002). We observed distributional shifts in self-reported leisure time PA over time: vigorously- and highly active proportions declined, while the moderately active proportion increased, and the proportion of sedentary participants remained stable (~ 20%). Compared to vigorously active, the odds of reporting sedentary (OR: 1.07, 95% CI: 1.03 to 1.11), moderately active (OR: 1.11, 95% CI: 1.07 to 1.15), and highly active (OR: 1.07, 95% CI: 1.03 to 1.11) increased with each year from age 16 (all p  ≤ 0.001). Compared to moderately active, the odds of reporting other categories decreased over time (ORs: 0.92 to 0.96, all p  ≤ 0.001). Conclusions: We observed non-linear changes in accelerometer-measured MVPA, indicating a U-shaped trend with a decline from 16 to 18 years, followed by an increase to age 27. Self-reported leisure time PA levels declined from adolescence to young adulthood, with decreasing proportions highly and vigorously active, while the proportion moderately active increased and the proportion of sedentary was unchanged. These results indicate that from adolescence to young adulthood, not all PA changes lead exclusively to increased sedentariness.

• Jenssen, Marita; Arora, Nikhil; Løset, Mari; Åsvold, Bjørn Olav; Thomas, Laurent Francois & VAssmyr, Ole-Jørgen Bekkevold [Show all 13 contributors for this article] (2025). Exploring Interaction between Genetically Predicted Body Mass Index and Serum 25-Hydroxyvitamin D Levels on the Odds for Psoriasis in UK Biobank and the HUNT Study: A Factorial Mendelian Randomization Study. JID Innovations. 5(2). doi: 10.1016/j.xjidi.2024.100336. Full text in Research Archive Show summary

  Mendelian randomisation (MR) studies show that higher body mass index (BMI) and lower 25-hydroxyvitamin D (25[OH]D) increase psoriasis risk. The combined effect of these factors has not been explored using factorial MR. Using cross-sectional data from UK Biobank (UKB, n=398 404) and the Trøndelag Health Study (HUNT, n=86 648), we calculated polygenic risk scores for BMI and 25(OH)D to estimate odds ratios for psoriasis using 2x2 and continuous factorial MR. We quantified additive interaction by relative excess risk due to interaction (RERI)-estimates. We also performed traditional observational analyses in UKB. There were 12 207 (3.1%) participants with psoriasis in UKB and 7794 (9.0%) in HUNT. In 2x2 factorial MR, we found no evidence of relative excess risk for psoriasis due to interaction between genetically predicted higher BMI and lower 25(OH)D, neither in UKB (RERI -0.01, 95% confidence interval (CI) -0.08, 0.07) nor in HUNT (RERI -0.04, 95% CI -0.14, 0.06). The same was observed in the continuous factorial MR and observational analyses. In conclusion, this study did not find evidence of interaction between BMI and 25(OH)D on the risk of psoriasis. Given minor differences in measured BMI and 25(OH)D between the factorial groups, small effects may have been undetected.

• Joakimsen, Henrik Lykke; Brendlien, Astrid; Furberg, Anne-Sofie; Nielsen, Christopher Sivert; Grimnes, Guri & Evensen, Elin Kristin (2025). Age at menarche and its association with preschool BMI among girls in Northern Norway. PLOS ONE. 20(5). doi: 10.1371/journal.pone.0322986. Full text in Research Archive
• Oyeyemi, Sunday Oluwafemi; Averina, Maria; Huber, Sandra; Charles, Dolley; Furberg, Anne-Sofie & Yigzaw, Kassaye Yitbarek [Show all 9 contributors for this article] (2025). Per- and polyfluoroalkyl substances and associated proteomic biomarker patterns of immuno-suppression and cell-proliferation in an adolescent population from Northern Norway : the Fit Futures Study. Environmental Research. ISSN 0013-9351. 282(October). doi: 10.1016/j.envres.2025.122096. Full text in Research Archive Show summary

  Background: Per- and polyfluoroalkyl substances (PFAS) are stable man-made chemicals which are extensively used in the production of common consumer products. High human exposure has been associated with immunotoxicity. This study aimed to explore the relationship between PFAS exposure and proteomic biomarkers in a cross-sectional cohort of an adolescent population in northern Norway. Methods: This study included 839 adolescents. The serum concentration of 18 PFAS and 92 proteomic biomarkers were measured. Eight PFAS and 75 biomarkers were detected in >70 % of the sample population, respectively. This study investigated these eight PFAS and 75 biomarkers. Factor analysis (FA) was used to reduce the dimensionality of the 75 biomarkers into factors/patterns. We applied a multivariate regression modelling by fitting factors as dependent variables with each of the PFAS as independent variables in separate models. Results: Of the five factors extracted by the FA, Factor 2 loaded 10 biomarkers crucial in the development of innate and adaptive immunity. Factor 3 loaded five biomarkers which are important in mitogenic, cell-proliferation, and inflammation processes. Perfluorooctanesulfonate (PFOS), perfluoroundecanoate (PFUnDA), and perfluoroheptane sulfonate (PFHpS) were inversely associated with Factor 2: PFOS, (β = −0.26 [95 % CI -0.42, −0.11]); PFUnDA, (β = −0.20 [95 % CI -0.30, −0.10]); and PFHpS, (β = −0.17 [95 % CI -0.28, −0.05]); while perfluorooctanoate (PFOA) was positively associated with Factor 3: PFOA, (β = 0.28 [95 % CI 0.12, 0.44]). Conclusion: Exposure to PFOS, PFUnDA, and PFHpS were associated with biomarkers related to immunosuppression, while exposure to PFOA was associated with biomarkers related to carcinogenesis.

• Lund, Charlotte Indre; Rosseland, Leiv Arne; Steingrímsdóttir, Ólöf Anna; Engdahl, Bo Lars; Stubhaug, Audun & Furberg, Anne-Sofie [Show all 7 contributors for this article] (2024). How is age at menopause and reproductive lifespan associated with chronic pain outcomes in postmenopausal women? Pain. ISSN 0304-3959. 166(1), p. 144–152. doi: 10.1097/j.pain.0000000000003333. Full text in Research Archive Show summary

  Female sex is a prominent risk factor for chronic pain, although the underlying mechanisms are not fully understood. This cross-sectional study aimed to investigate the relationship between age at menopause, reproductive lifespan, and chronic pain in a sample of postmenopausal women aged 40 to 93 years. Data were collected from the Tromsø study conducted in Norway between 2015 and 2016 (Tromsø7). Chronic pain was assessed using a single question, which formed a sample size of 5741 participants. Chronic widespread pain was evaluated using the more comprehensive Graphical Index of Pain, resulting in a sample size of 5920 women. Premenopausal women and those who experienced menstrual cessation due to chemotherapy/radiation or hormonal intrauterine devices were excluded from the analysis. Adjusted relative risk ratios with 95% confidence intervals were calculated to determine associations. The results showed that early menopause was associated with a 1% increase in the prevalence of chronic pain for each year of

• Jenssen, Marita; Furberg, Anne-Sofie; Jorde, Rolf; Wilsgaard, Tom & Danielsen, Kjersti (2024). The association between serum 25-hydroxyvitamin D levels and psoriasis in a large population-based cohort : a cross-sectional analysis of The Tromsø Study 2015–16. British Journal of Dermatology. ISSN 0007-0963. 190(5), p. 680–688. doi: 10.1093/bjd/ljad472. Full text in Research Archive Show summary

  Background: Case–control studies indicate an association between lower serum 25-hydroxyvitamin D [25(OH)D] levels and psoriasis. Data from larger population-based cohorts including mild cases are sparse. Objectives: To investigate the association between 25(OH)D and psoriasis in a large population-based cohort, and assess possible effect modification by overweight. Methods: Data from the Tromsø Study 2015–16 (Tromsø7), which included 19 520 participants from the general population aged 40–79 years, were subjected to a cross-sectional analysis. We assessed the shapes of the relationships between 25(OH)D and psoriasis using fractional polynomials. Odds ratios (ORs) for lifetime and active psoriasis were estimated using logistic regression. Adjusted models included month of blood sampling, body mass index (BMI), age and sex. Two-way and additive interaction between BMI and 25(OH)D were explored. Results: From a total of 19 520 participants [10 203 women (52.3%); mean age 56.3 years (SD 10.4); mean 25[OH]D, 63.4 nmol L−1 (SD 21.9)], 2088 (10.7%) reported lifetime psoriasis and 1179 (6.0%) reported active psoriasis the past 12 months. There was no association between 25(OH)D and lifetime psoriasis [OR per 10 nmol L−1 increase in 25(OH)D 1.02, 95% confidence interval (CI) 0.99–1.04]. The relationship between 25(OH)D and active psoriasis was suggested to be nonlinear, but the model was not significant (P = 0.098). There was evidence for a superadditive effect (i.e. larger than the sum of the factors) of BMI > 27.5 kg m−2 and 25(OH)D < 25 nmol L−1 on the odds for active psoriasis (OR 1.92, 95% CI 1.18–3.12), but not for lifetime psoriasis (OR 1.41, 95% CI 0.93–2.15). There was no evidence for two-way interaction between BMI and 25(OH)D. Conclusions: This large population-based study found no significant relationship between 25(OH)D and psoriasis. The analysis may have been underpowered to detect a threshold effect in the lower 25(OH)D spectrum. Interaction analysis indicates that high BMI and vitamin D deficiency combined increase the odds of active psoriasis more than the sum of these factors, with an estimated 92% higher odds for active psoriasis in participants with BMI > 27.5 kg m−2 and 25(OH)D < 25 nmol L−1. Providing advice to prevent vitamin D deficiency may be considered in the follow-up of overweight patients with psoriasis.

• Sagelv, Edvard Hamnvik; Emaus, Nina Alice; Evensen, Elin Kristin; Christoffersen, Tore; Dennison, Elaine & Furberg, Anne-Sofie [Show all 11 contributors for this article] (2024). Acquisition of peak bone mass in a Norwegian youth cohort : longitudinal findings from the Fit Futures study 2010–2022. Archives of Osteoporosis. ISSN 1862-3522. 19. doi: 10.1007/s11657-024-01414-2. Full text in Research Archive Show summary

  Summary: In a Norwegian youth cohort followed from adolescence to young adulthood, bone mineral density (BMD) levels declined at the femoral neck and total hip from 16 to 27 years but continued to increase at the total body indicating a site-specific attainment of peak bone mass. Purpose: To examine longitudinal trends in bone mineral density (BMD) levels in Norwegian adolescents into young adulthood. Method: In a prospective cohort design, we followed 980 adolescents (473 (48%) females) aged 16–19 years into adulthood (age of 26–29) on three occasions: 2010–2011 (Fit Futures 1 (FF1)), 2012–2013 (FF2), and 2021–2022 (FF3), measuring BMD (g/cm2) at the femoral neck, total hip, and total body with dual x-ray absorptiometry (DXA). We used linear mixed models to examine longitudinal BMD changes from FF1 to FF3. Results: From the median age of 16 years (FF1), femoral neck BMD (mean g/cm2 (95% CI)) slightly increased in females from 1.070 (1.059–1.082) to 1.076 (1.065–1.088, p = 0.015) at the median age of 18 years (FF2) but declined to 1.041 (1.029–1.053, p < 0.001) at the median age of 27 years (FF3). Similar patterns were observed in males: 16 years, 1.104 (1.091–1.116); 27 years, 1.063 (1.050–1.077, p < 0.001); and for the total hip in both sexes (both p < 0.001). Total body BMD increased from age 16 to 27 years in both sexes (females: 16 years, 1.141 (1.133–1.148); 27 years, 1.204 (1.196–1.212), p < 0.001; males: 16 years, 1.179 (1.170–1.188); 27 years, 1.310 (1.296–1.315), p < 0.001). Conclusion: BMD levels increased from 16 to 18 years at the femoral and total hip sites in young Norwegian females and males, and a small decline was observed at the femoral sites when the participants were followed up to 27 years. Total body BMD continued to increase from adolescence to young adulthood.

• Norström, Madelaine; Simonsen, Gunnar Skov; Slettemeås, Jannice Schau; Furberg, Anne-Sofie & Urdahl, Anne Margrete (2023). Evaluation of the One Health-Ness of 20 Years of Antimicrobial Resistance Surveillance in Norway. Antibiotics. 12(7). doi: 10.3390/antibiotics12071080. Full text in Research Archive Show summary

  We evaluated the One Health-ness (OH-ness) of the surveillance system for antimicrobial resistance (AMR) in Norway by using the recently developed “Evaluation tool for One Health epidemiological surveillance capacities and capabilities” (OH–EpiCap tool). First, we defined the Norwegian AMR surveillance system that we would evaluate. The tool was applied by a group of stakeholders (key persons in the Norwegian AMR surveillance programmes and authors of this paper). The evaluation was performed using a consensus approach. The evaluation resulted in an overall OH-ness score of 68% across all three dimensions included in the tool: Organisation, Operation, and Impact. Suggestions for improvement were only indicated within the areas of internal evaluation and operational costs, whereas most of the indicators included in the tool showed good adherence to the One Health principles. By performing this internal evaluation, we recognized that AMR surveillance in the environment needs to be included in a more systematic and standardized way to improve the OH-ness as defined by the quadripartite organisations. Last but not least, it was beneficial to bring key stakeholders together to conduct the evaluation. It increased a joint perception of the OH-ness of AMR surveillance in Norway and encouraged further collaboration in the future.

• Averina, Maria; Huber, Sandra; Almås, Bjørg; Brox, Jan; Jacobsen, Bjarne K. & Furberg, Anne-Sofie [Show all 7 contributors for this article] (2023). Early menarche and other endocrine disrupting effects of per- and polyfluoroalkyl substances (PFAS) in adolescents from Northern Norway. The Fit Futures study. Environmental Research. ISSN 0013-9351. 242. doi: 10.1016/j.envres.2023.117703. Full text in Research Archive Show summary

  Background: Per- and polyfluoroalkyl substances (PFAS) comprise a large group of chemicals that are ubiquitous in the environment and include recognized persistent organic pollutants. The aim of this cross-sectional study was to investigate possible endocrine disrupting effects of different PFAS in adolescents. Methods: Serum concentrations of PFAS, thyroid, parathyroid and steroid hormones were measured in 921 adolescents aged 15–19 years in the Fit Futures study, Northern Norway. The questionnaire included data on self-reported age at menarche and puberty development score (PDS). Multiple linear and logistic regression analyses and principle component analyses (PCA) were used to assess associations of PFAS with hormones concentrations and puberty indices. Results: In girls, total PFAS (∑PFAS), perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), perfluorononanoate (PFNA), perfluorodecanoate (PFDA) were positively associated with dehydroepiandrosterone sulfate (DHEAS) and negatively associated with 11-deoxycorticosterone (11-DOC)/DHEAS ratio. In boys, the associations with 11-DOC/DHEAS ratio were positive for ∑PFAS, perfluoroheptanoate (PFHpA), perfluoroheptane sulfonate (PFHpS), PFOA, and PFOS. Perfluoroundecanoate (PFUnDA) was negatively associated with free thyroxine (fT4) and free triiodothyronine (fT3) in boys. PFNA and PFDA were also negatively associated with fT3 in boys. Serum parathyroid hormone concentration (PTH) was negatively associated with ∑PFAS and perfluorohexane sulfonate (PFHxS) in girls, and with PFOS in boys. PFDA and PFUnDA were positively associated with early menarche, while ∑PFAS and PFOA were positively associated with PDS in boys. No associations of PFAS with serum testosterone, follicle-stimulating hormone, or luteinizing hormone were found in either sex. In girls, PFOA was positively associated with free testosterone index (FTI). In boys, PFOA was positively associated with androstendione and 17-OH-progesterone, while PFHpA was positively associated with estradiol. Conclusions: Serum concentrations of several PFAS were associated with parathyroid and steroid hormones in both sexes, and with thyroid hormones in boys, as well as with early menarche in girls and higher PDS in boys.

• Jenssen, Marita; Furberg, Anne-Sofie; Jorde, Rolf; Wilsgaard, Tom & Danielsen, Kjersti (2023). Effect of vitamin D supplementation on psoriasis severity in patients with lower-range serum 25-hydroxyvitamin D levels : a randomized clinical trial. JAMA dermatology. ISSN 2168-6068. 159(5), p. 518–525. doi: 10.1001/jamadermatol.2023.0357. Full text in Research Archive Show summary

  Importance: Topical vitamin D analogues are routine treatment for psoriasis, but the effect of oral supplementation has not been established. Objective To examine the effect of vitamin D supplementation on psoriasis severity throughout the winter. Design, Setting, and Participants: This randomized, double-blind placebo-controlled clinical trial with 2 parallel groups was performed through 2 winter seasons (2017 to 2018 and 2018 to 2019). Randomization was computer generated. All participants, health care clinicians, and outcome assessors were masked to group assignment. Each participant was followed for 4 months. The presented analyses were conducted in May 2022. The trial was conducted at the clinical research unit of the University Hospital of North Norway (Tromsø; Norway). Adults from the general population in Tromsø with active plaque psoriasis and 25-hydroxyvitamin D (25[OH]D) levels of less than 24 ng/mL (to convert to nmol/L, multiply by 2.496) were included. Intervention Vitamin D (cholecalciferol, 100 000 IU, loading dose, followed by 20 000 IU/week) or placebo for 4 months. Main outcomes and Measures: Psoriasis Area Severity Index (PASI) (primary outcome), Physician Global Assessment, self-administered PASI, and Dermatology Life Quality Index scores (secondary outcomes). Results: A total of 122 participants (46 women [37.7%]; mean [SD] age, 53.6 [10.0] years; mean [SD] PASI score, 3.1 [2.0]; mean [SD] serum 25(OH)D, 14.9 [3.9] ng/mL) were included. Of these, 60 (49.2%) were randomized to the vitamin D group and 62 (50.8%) to the placebo group. A total of 120 participants (59 vitamin D [49.2%]/61 placebo [51.8%]) completed the study. By completion, mean (SD) 25(OH)D levels were 29.7 (5.2) ng/mL (vitamin D) and 12.0 (3.8) ng/mL (placebo). There was no significant difference in change in PASI score between the groups (adjusted difference, 0.11; 95% CI, −0.23 to 0.45). There was no significant difference in change in Physician Global Assessment score (adjusted odds ratio, 0.66; 95% CI, 0.27-1.63), self-administered PASI (adjusted difference, −0.60; 95% CI, −1.76 to 0.55) or Dermatology Life Quality Index (adjusted difference, −0.86; 95% CI, −1.9 to 0.19) between the groups. No adverse effects of the intervention were registered. Conclusion and Relevance: The results of this randomized clinical trial showed that vitamin D supplementation did not affect psoriasis severity. Low baseline severity scores may explain the lack of measurable effect. Levels of 25(OH)D in the intervention group increased to a less-than-expected degree based on previous experimental data from the same source population, and this may have affected the results.

• Norström, Madelaine; Slettemeås, Jannice Schau; Urdahl, Anne Margrete; Simonsen, Gunnar Skov & Furberg, Anne-Sofie (2023). Evaluation of the One Health-ness of 20 years of antimicrobial surveillance in Norway. In Simonsen, Gunnar Skov; Blix, Hege Salvesen; Helgesen, Kari Marie Olli & Urdahl, Anne Margrete (Ed.), NORM/NORM-VET 2022, Usage of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Norway. NORM/Veterinærinstituttet. Full text in Research Archive
• Beldo, Sigurd Klemetsen; Aars, Nils Abel; Christoffersen, Tore; Furberg, Anne-Sofie; Halvorsen, Peder Andreas & Hansen, Bjørge Hermann [Show all 10 contributors for this article] (2022). Criterion validity of the Saltin-Grimby Physical Activity Level Scale in adolescents : the Fit Futures Study. PLOS ONE. 17(9), p. 1–13. doi: 10.1371/journal.pone.0273480. Full text in Research Archive Show summary

  Background: The Saltin-Grimby Physical Activity Level Scale (SGPALS) is commonly used to measure physical activity (PA) in population studies, but its validity in adolescents is unknown. This study aimed to assess the criterion validity of the SGPALS against accelerometry in a large sample of adolescents. A secondary aim was to examine the validity across strata of sex, body mass index (BMI), parental educational level, study program and self-reported health. Methods: The study is based on data from 572 adolescents aged 15–17 years who participated in the Fit Futures Study 2010–11 in Northern Norway. The participants were invited to wear an accelerometer (GT3X) attached to their hip for seven consecutive days. We used Spearman’s rho and linear regression models to assess the validity of the SGPALS against the following accelerometry estimates of PA; mean counts/minute (CPM), steps/day, and minutes/ day of moderate-to-vigorous physical activity (MVPA). Results: The SGPALS correlated with mean CPM (ρ = 0.40, p<0.01), steps/day (ρ = 0.35, p<0.01) and MVPA min/day (ρ = 0.35, p<0.01). We observed no differences between correlations within demographic strata (all p>0.001). Higher scores on SGPALS were associated with a higher CPM, higher number of steps per day and more minutes of MVPA per day, with the following mean differences in PA measurements between the SGPALS ranks: CPM increased by 53 counts (95% CI: 44 to 62), steps/day increased by 925 steps (95% CI: 731 to 1118), and MVPA by 8.4 min/day (95% CI: 6.7 to 10.0). Mean difference between the highest and lowest SGPALS category was 2947 steps/day (6509 vs. 9456 steps/day) and 26.4 min/day MVPA (35.2 minutes vs 61.6 minutes). Conclusion: We found satisfactory ranking validity of SGPALS measured against accelerometry in adolescents, which was fairly stable across strata of sex, BMI, and education. However, the validity of SGPALS in providing information on absolute physical activity levels seem limited.

• Linkas, Jonas; Ahmed, Luai A.; Csifcsak, Gabor; Emaus, Nina; Furberg, Anne-Sofie & Grimnes, Guri [Show all 9 contributors for this article] (2022). C-Reactive Protein and TGF-α Predict Psychological Distress at Two Years of Follow-Up in Healthy Adolescent Boys : the Fit Futures Study. Frontiers in Psychology. 13, p. 1–12. doi: 10.3389/fpsyg.2022.823420. Full text in Research Archive Show summary

  Objective: The scarcity of research on associations between inflammatory markers and symptoms of depression and anxiety during adolescence has yielded inconsistent results. Further, not all studies have controlled for potential confounders. We explored the associations between baseline inflammatory markers and psychological distress including moderators at follow-up in a Norwegian adolescent population sample. Methods: Data was derived from 373 girls and 294 boys aged 15–18 years at baseline, in the Fit Futures Study, a large-scale 2-year follow-up study on adolescent health. Baseline data was gathered from 2010 to 2011 and follow-up data from 2012 to 2013. Psychological distress was measured with Hopkins Symptom Checklist (HSCL-10). Serum levels of the following inflammatory markers were measured: C-reactive protein (CRP), Interleukin 6 (IL-6), Transforming growth factor alpha (TGF-α), Tumor necrosis factor alpha variant 1 (TRANCE), and variant 2 (TWEAK). Independent associations between baseline inflammatory markers and HSCL-10 at follow-up were explored by linear regressions, in sex-stratified analyses. Results: In girls, analyses showed positive associations between all inflammatory markers and HSCL-10, except for TRANCE. However, all associations were non-significant in crude as well as in adjusted analyses. In boys, CRP (p = 0.03) and TGF-α (p < 0.01) showed significant associations with HSCL-10, that remained significant after adjustment. Additionally, moderators were found. In boys, CRP was associated with HSCL-10 in those with high body fat and those being physical inactive, and the association between TWEAK and HSCL-10 was dependent upon sleep duration. Conclusion: There were significant prospective associations between CRP, TFG-α, and HSCL-10 in boys aged 15–18 years at baseline.

• Linkas, Jonas; Ahmed, Luai Awad; Csifcsak, Gabor; Emaus, Nina; Furberg, Anne-Sofie & Pettersen, Gunn [Show all 8 contributors for this article] (2022). Two-year changes in sleep duration are associated with changes in psychological distress in adolescent girls and boys: the fit futures study. Health Psychology and Behavioral Medicine. 10(1), p. 1159–1175. doi: 10.1080/21642850.2022.2147936. Full text in Research Archive Show summary

  <p><i>Objective -</i> Studies indicate an inverse association between sleep duration and psychological distress. We aimed to explore associations between changes in sleep duration and changes in psychological distress in girls and boys. <p><i>Methods -</i> The Fit Futures Study is a broad adolescent study providing data from 373 girls and 294 boys aged 15–18 years collected in 2010/2011 (FF1) and 2012/2013 (FF2). Psychological distress was measured by the Hopkins Symptom Checklist (HSCL-10) and sleep duration was self-reported. Change score variables were calculated as the change between baseline and follow-up for sleep duration and HSCL-10, respectively. Associations between changes in sleep duration and changes in HSCL-10 were explored by linear regressions, in gender-stratified analyses. <p><i>Results -</i> At FF1, girls and boys slept on average 6.93 (SD = 1.08) and 7.05 (SD = 1.20) hours per night respectively, and correspondingly, 6.83 (SD = 1.19) and 6.85 (SD = 1.21) at FF2. At FF1, 22.8% of the girls and 25.8% of the boys slept ≤ 6 h per night, and correspondingly 28.0% and 28.2% at FF2. In girls and boys, one unit increase (30 min) in sleep duration was associated with a decrease in HSCL-10 score of B [95% CI] = −0.090 [−0.131, −0.048], p < 0.001, and −0.054 [−0.091, −0.017], p < 0.001, respectively. The associations remained significant after adjusting for confounders. <p><i>Conclusion -</i> Our findings show that increased sleep duration was associated with decreased psychological distress during adolescence. Future studies should examine the causality between sleep duration and psychological distress.

• Stensen, Dina Benedicte Berg; Cañadas, Rafael Nozal; Småbrekke, Lars; Olsen, Karina; Nielsen, Christopher Sivert & Svendsen, Kristian [Show all 11 contributors for this article] (2022). Social network analysis of Staphylococcus aureus carriage in a general youth population. International Journal of Infectious Diseases. ISSN 1201-9712. 123(October), p. 200–209. doi: 10.1016/j.ijid.2022.08.018. Full text in Research Archive Show summary

  Objectives Staphylococcus aureus carriage increases infection risk. We used social network analysis to evaluate whether contacts have the same S. aureus genotype indicating direct transmission, or whether contagiousness is an indirect effect of contacts sharing the same lifestyle or characteristics. Methods The Fit Futures 1 study collected data on social contact among 1038 high school students. S. aureus carriage was determined from two nasal swab cultures and S. aureus genotype from spa-typing of a positive throat swab. Results S. aureus carriage and spa-type were transmitted in the social network (p<0.001). The probability of carriage increased by 5.0% for each S. aureus positive friend. Male sex was associated with a 15% lower risk of transmission compared to female sex, although the prevalence of carriage was higher for men (36% versus 24%). Students with medium physical activity level, medium/high alcohol-use, or normal-weight had higher number of contacts and increased risk of transmission (p<0.002). Conclusions We demonstrate direct social transmission of S. aureus. Lifestyle factors are associated with risk of transmission suggesting indirect social group effects on S. aureus carriage from friends having more similar environmental exposures. The male predominance in carriage is determined by sex-specific predisposing host characteristics as social transmission is less frequent than in females. Information on social network may add to a better understanding of S. aureus epidemiology. Keywords: Staphylococcus aureus, population-based study, spa-type, network analysis

• Linkas, Jonas; Ahmed, Luai A.; Csifcsak, Gabor; Emaus, Nina; Furberg, Anne-Sofie & Grimnes, Guri [Show all 9 contributors for this article] (2022). Are pro-inflammatory markers associated with psychological distress in a cross-sectional study of healthy adolescents 15–17 years of age? : the Fit Futures study. BMC Psychology. 10, p. 1–13. doi: 10.1186/s40359-022-00779-8. Full text in Research Archive Show summary

  Background: Inflammatory markers have been associated with depression and anxiety disorder in adolescents. Less is known about the association between inflammation and subclinical symptoms in the form of psychological distress. We investigated prevalence of psychological distress and examined the associations between common pro-inflammatory markers and psychological distress in an adolescent population sample. Methods: The study was based on data from 458 girls and 473 boys aged 15–17 years from the Fit Futures Study, a large-scale study on adolescent health, conducted in Northern Norway. Psychological distress was measured with the Hopkins Symptom Checklist (HSCL-10). Serum-levels of the following low-grade inflammatory markers were measured: C-reactive protein (CRP), interleukin 6 (IL-6), transforming growth factor-alpha (TGF-α), tumor necrosis factor alpha variant 1 (TRANCE) and tumor necrosis factor alpha variant 2 (TWEAK). Associations between quartiles of inflammatory markers and HSCL-10 were examined by logistic regression and adjusted for potential confounders in sex-stratified analyses. Results: The proportion of psychological distress above cutoff were 26.9% and 10.8% among girls and boys, respectively. In both girls and boys, crude analysis showed positive associations between all inflammatory markers and HSCL-10, except for TWEAK and TRANCE in boys. However, none of these associations were statistically significant. Further, there were no significant findings in the adjusted analyses. Conclusion: There was a higher prevalence of psychological distress in girls compared to boys. Pro-inflammatory markers were not significantly associated with psychological distress in data from healthy adolescents aged 15–17 years.

• Lund, Charlotte Indre; Engdahl, Bo Lars; Rosseland, Leiv Arne; Stubhaug, Audun; Grimnes, Guri & Furberg, Anne-Sofie [Show all 8 contributors for this article] (2022). The association between age at menarche and chronic pain outcomes in women: the Tromsø Study, 2007 to 2016. Pain. ISSN 0304-3959. 163(9), p. 1790–1799. doi: 10.1097/j.pain.0000000000002579. Full text in Research Archive Show summary

  Sex differences in chronic pain are well established with documented predominance in women. This study assessed relationships between age at menarche and chronic pain, site-specific chronic pain, pain characteristics, and chronic widespread pain (CWP). We used data from the Tromsø Study conducted in 2007 to 2008 and 2015 to 2016 (Tromsø 6 and Tromsø 7 waves) including participants aged 30 to 99 years. The associations between age at menarche and chronic pain were examined in Tromsø 6 (n 5 6449), Tromsø 7 (n 5 5681), and the combination of Tromsø 6 and Tromsø 7 (n 5 12,130). Tromsø 7 data were used further to examine the associations between age at menarche and site-specific chronic pain, 4 pain characteristics (pain duration, pain intensity, episode duration, and episode frequency), and CWP. All analyses were adjusted for body mass index, age, and economic status of the household in childhood. Lower age at menarche was associated with an increased risk of chronic pain in all 3 samples (risk ratio for each year delay in menarche 0.98, 95% CI [0.97 to 0.99] across samples). Risk differences were 20.014, CI 95% (20.02 to 20.005) in Tromsø 6, 20.011, CI 95% (20.02 to 20.02) in Tromsø 7, and 20.012, CI 95% (20.02 to 20.01) in the combined sample. Age at menarche was significantly associated with chronic pain in the neck, abdomen, and both arms, and CWP. Of the 4 pain characteristics, pain duration was statistically significant. We conclude that early menarche is an independent risk factor for pain across a broad spectrum of pain outcomes. Keywords: chronic pain, sex differences in pain, site-specific chronic pain, pain characteristics, chronic widespread pain, early menarche, exposure to estrogen

• Mohus, Randi Marie; Gustad, Lise Tuset; Furberg, Anne-Sofie; Moen, Martine Kjølberg; Liyanarachi, Kristin Vardheim & Askim, Åsa Susanne [Show all 14 contributors for this article] (2022). Explaining sex differences in risk of bloodstream infections using mediation analysis in the population-based HUNT study in Norway. Scientific Reports. 12(1). doi: 10.1038/s41598-022-12569-8. Full text in Research Archive Show summary

  Previous studies indicate sex differences in incidence and severity of bloodstream infections (BSI). We examined the effect of sex on risk of BSI, BSI mortality, and BSI caused by the most common infecting bacteria. Using causal mediation analyses, we assessed if this effect is mediated by health behaviours (smoking, alcohol consumption), education, cardiovascular risk factors (systolic blood pressure, non-HDL cholesterol, body mass index) and selected comorbidities (cardiovascular disease, chronic kidney disease, diabetes, cancer history and chronic lung disease). This prospective study included 64,040 participants (46.8% men) in the population-based HUNT2 Survey (1995−97) linked with hospital records in incident BSI. During median follow-up of 14.8 years, 1840 (2.9%) participants (51.3% men) experienced a BSI and 396 (0.6%) died (56.6% men). Men had 41% higher risk of first-time BSI (95% confidence interval (CI), 28−54%) than women. Together, health behaviours, education, cardiovascular risk factors and the selected comorbidities mediated 34% of the excess risk of BSI observed in men. The HR of BSI mortality was 1.87 (95%CI, 1.53−2.28), for BSI due to S. aureus 2.09 (1.28−2.54), S. pneumoniae 1.36 (1.05−1.76), and E. coli 0.97 (0.84−1.13) in men vs women. This population-based study shows that men have higher risk of BSI and BSI mortality than women. One-third of this effect was mediated by potential modifiable risk factors for incident BSI.

• Stensen, Dina Benedicte Berg; Småbrekke, Lars; Olsen, Karina; Grimnes, Guri; Nielsen, Christopher Sivert & Ericson, Johanna U [Show all 9 contributors for this article] (2022). Circulating sex-steroids and Staphylococcus aureus nasal carriage in a general male population. Epidemiology and Infection. ISSN 0950-2688. 150, p. 1–4. doi: 10.1017/S0950268822000735. Full text in Research Archive Show summary

  Male sex is associated with higher risk of both colonisation and infection with Staphylococcus aureus (S. aureus). However, the role of sex-steroids in colonisation among men is largely unknown. Thus, the aim of this study was to investigate possible associations between circulating sex-steroids and nasal carriage of S. aureus in a general male population. The population-based Tromsø6 study (2007–2008) included 752 males aged 31–87 years with serum sex-steroids measured by liquid chromatography tandem mass spectrometry and two nasal swab samples for the assessment of S. aureus carriage. Multivariable logistic regression models were used to study the association between sex-steroid concentrations and S. aureus persistent nasal carriage (two positive swabs vs. others), while adjusting for potential confounding factors. S. aureus persistent nasal carriage prevalence was 32%. Among men aged 55 years and above (median age 65 years), there was an inverse dose-response relationship between serum concentration of testosterone and persistent nasal carriage, and carriers had significantly lower mean levels of testosterone (P = 0.028, OR = 0.94 per nmol/l change in testosterone; 95% CI = 0.90–0.98). This association was attenuated when adjusting for body mass index and age (OR = 0.96 per nmol/l change in testosterone; 95% CI = 0.91–1.01). There was no association in the total population. This large population-based study suggests that testosterone levels may be inversely related to S. aureus persistent nasal carriage in older men. Future studies addressing biological mechanisms underlying the male predisposition to S. aureus colonisation and infection may foster preventive interventions that take sex-differences into account. Keywords: circulating sex-steroids, population-based study, Staphylococcus aureus carriage, testosterone

• Solvin, Åshild Øksnevad; Chawla, Konika; Olsen, Lene Christin; Hegre, Siv Anita; Danielsen, Kjersti & Jenssen, Marita [Show all 11 contributors for this article] (2021). MicroRNA profiling of psoriatic skin identifies 11 miRNAs associated with disease severity. Experimental Dermatology. ISSN 0906-6705. 31(4), p. 535–547. doi: 10.1111/exd.14497. Full text in Research Archive Show summary

  MicroRNAs (miRNAs) are small non-coding RNAs that have emerged as central regulators of gene expression and powerful biomarkers of disease. Much is yet unknown about their role in psoriasis pathology. To globally characterize the miRNAome of psoriatic skin, skin biopsies were collected from psoriatic cases (n = 75) and non-psoriatic controls (n = 46) and RNA sequenced. Count data were meta-analysed with a previously published dataset (cases, n = 24, controls, n = 20), increasing the number of psoriatic cases fourfold from previously published studies. Differential gene expression analyses were performed comparing lesional psoriatic (PP), non-lesional psoriatic (PN) and control (NN) skin. Further, functional enrichment and cell-specific analyses were performed. Across all contrasts, we identified 439 significantly differentially expressed miRNAs (DEMs), of which 85 were novel for psoriasis and 11 were related to disease severity. Meta-analyses identified 20 DEMs between PN and NN, suggesting an inherent change in the constitution of all skin in psoriasis. By integrating the miRNA transcriptome with mRNA target interactions, we identified several functionally enriched terms, including “thyroid hormone signalling,” “insulin resistance” and various infectious diseases. Cell-specific expression analyses revealed that the upregulated DEMs were enriched in epithelial and immune cells. This study provides the most comprehensive overview of the miRNAome in psoriatic skin to date and identifies a miRNA signature related to psoriasis severity. Our results may represent molecular links between psoriasis and related comorbidities and have outlined potential directions for future functional studies to identify biomarkers and treatment targets.

• Stangvaltaite-Mouhat, Lina; Furberg, Anne-Sofie; Drachev, Sergei Nikolaevich & Trovik, Tordis A (2021). Common social determinants for overweight and obesity, and dental caries among adolescents in Northern Norway : a cross-sectional study from the Tromsø Study Fit Futures cohort. BMC Oral Health. 21, p. 1–12. doi: 10.1186/s12903-021-01406-5. Full text in Research Archive Show summary

  Background: Non-communicable general and oral health conditions share common risk factors. Studies investigating common social determinants as risk factors for overweight/obesity and dental caries among the same adolescents are scarce and inconclusive. Methods: This cross-sectional study included data from 464 girls and 494 boys from the population-based Tromsø study Fit Futures, which included first-year students attending upper secondary school in 2010–2011 from two municipalities in Northern Norway (1038 participants in total, 93% participation rate). Multivariable binary logistic regression analyses stratified by sex were used to investigate the association between socioeconomic position indicators (adolescent’s own study program, parents’ education and employment status) and overweight/obesity indicated by body weight and waist circumference, untreated dental caries in dentine, and when these conditions were considered simultaneously. Results: Boys enrolled in the general studies and sports programs (versus vocational) had lower odds of being overweight/obese (POR 0.42, 95% CI 0.20–0.86 and POR 0.24, 95% CI 0.08–0.73, respectively), of having high waist circumference (POR 0.39, 95% CI 0.21–0.75 and POR 0.25, 95% CI 0.10–0.64, respectively), dental caries (POR 0.57, 95% CI 0.32–0.99 and POR 0.47, 95% CI 0.22–0.98, respectively), and being simultaneously overweight/obese, having high waist circumference and dental caries (POR 0.24, 95% CI 0.07–0.81 and POR 0.11, 95% CI 0.01–0.98, respectively). Girls enrolled in the general studies program (versus vocational) had lower odds of having dental caries (POR 0.50, 95% CI 0.30–0.84). Conclusions: Adolescent’s own study program was identified to be a common social determinant for overweight/obesity and dental caries among boys. These results support the broader concept of social determinants as common risk factors for general and oral health conditions, and call for common health promotion strategies addressing these common social determinants among adolescents. However, there is a need for more studies to investigate and better understand the influence of social determinants on health conditions among adolescents.

• Flatby, Helene Marie; Rasheed, Humaira; Ravi, Anuradha; Thomas, Laurent; Liyanarachi, Kristin Vardheim & Afset, Jan Egil [Show all 15 contributors for this article] (2021). Risk of lower respiratory tract infections: a genome-wide association study with Mendelian randomization analysis in three independent European populations. Clinical Microbiology and Infection (CMI). ISSN 1198-743X. 28(5), p. 732.e1–732.e7. doi: 10.1016/j.cmi.2021.11.004. Full text in Research Archive Show summary

  Objective: Lower respiratory tract infections (LRTIs) are a leading cause of morbidity and mortality worldwide. Few studies have previously investigated the genetic susceptibility and potential risk factors for LRTI. Methods: We used data from UK Biobank, HUNT, and FinnGen, to conduct a genome-wide association study (GWAS). Cases were subjects hospitalized with LRTI, and controls were subjects with no such hospitalization. We conducted stratification and interaction analyses to evaluate if the genetic effect of LRTI differed by sex or smoking. Mendelian randomization [MR] analyses were conducted to identify the unconfounded relationship between cardiometabolic risk factors and LRTI. Results: A total of 25,320 cases and 575,294 controls were included. The 15q25.1 locus reached genome-wide significance in the meta-analysis (rs10519203: OR = 0.94, P = 3.87e-11). The protective effect of effect allele of rs10519203 was present among smokers (OR = 0.90 [95% CI = 0.87 - 0.92, P = 1.38e-15]) but not among never-smokers (OR = 1.01 [95% CI = 0.97 - 1.06, P = 5.20e-01]). In MR analyses, we found that increasing body mass index (OR = 1.31 [95% CI = 1.24 - 1.40, P = 3.78e-18]), lifetime smoking (OR = 2.83 [95% CI = 2.34 - 3.42, P = 6.56e-27]), and systolic blood pressure robustly increased the risk of LRTIs (OR = 1.11 [95% CI = 1.02 - 1.22, P = 1.48e-02]). Conclusion: A region in 15q25.1 was strongly associated with LRTI susceptibility. Reduction of the prevalence of smoking, overweight, obesity, and hypertension may reduce the disease burden of LRTIs. Keywords: body mass index, genome-wide association study, lowerrespiratory tract infection, mendelianrandomization, pneumonia, respiratory infection, smoking

• Stensen, Dina Benedicte Berg; Småbrekke, Lars; Olsen, Karina; Grimnes, Guri; Nielsen, Christopher Sivert & Ericson, Johanna U [Show all 9 contributors for this article] (2021). Circulating sex-steroids and Staphylococcus aureus nasal carriage in a general female population. European Journal of Endocrinology (EJE). ISSN 0804-4643. 184(2), p. 333–342. doi: 10.1530/EJE-20-0877. Full text in Research Archive Show summary

  Objective: Staphylococcus aureus is a major human pathogen, and nasal carriers have an increased risk for infection and disease. The exploration of host determinants for nasal carriage is relevant to decrease infection burden. Former studies demonstrate lower carriage prevalence in women and among users of progestin-only contraceptives. The aim of this study was to investigate the possible associations between circulating sex-steroid hormones and nasal carriage of Staphylococcus aureus in a general population. Methods: In the population-based sixth Tromsø study (2007–2008) nurses collected nasal swab samples from 724 women aged 30–87 not using any exogenous hormones, and 700 of the women had a repeated nasal swab taken (median interval 28 days). We analysed a panel of serum sex-steroids by liquid chromatography tandem mass spectrometry, and collected information about lifestyle, health and anthropometric measures. Multivariable logistic regression was used to study the association between circulating sex-steroids and Staphylococcus aureus carriage (one swab) and persistent carriage (two swabs), while adjusting for potential confounding factors. Women in luteal phase were excluded in the analysis of androgens. Results: Staphylococcus aureus persistent nasal carriage prevalence was 22%. One standard deviation increase in testosterone and bioavailable testosterone was associated with lower odds of persistent nasal carriage, (OR = 0.57; 95% CI = 0.35–0.92 and OR = 0.52, 95% CI = 0.30–0.92) respectively. Analysis stratified by menopause gave similar findings. Persistent carriers had lower average levels of andros tenedione and DHEA, however, not statistically significant. Conclusion: This large population-based study supports that women with lower levels of circulating testosterone may have increased probability of Staphylococcus aureus persistent carriage.

• Averina, Maria; Brox, Jan; Huber, Sandra & Furberg, Anne-Sofie (2021). Exposure to perfluoroalkyl substances (PFAS) and dyslipidemia, hypertension and obesity in adolescents : the Fit Futures study. Environmental Research. ISSN 0013-9351. 195(April), p. 1–8. doi: 10.1016/j.envres.2021.110740. Full text in Research Archive Show summary

  Background Prevalence of obesity, hypertension and dyslipidemia has been increasing in children and adolescents worldwide. Exposure to environmental pollutants may contribute to this development. Our aim was to study associations between perfluoroalkyl substances (PFAS) and dyslipidemia, hypertension and obesity in a population-based sample of adolescents. Methods Serum PFAS concentrations were measured in 940 adolescents, mean age 16.4 (SD 1.3) years, from the cross-sectional Fit Futures study by the UHPLC-MS/MS method. The following endpoints were used: hypertension (systolic blood pressure over 130 mmHg and/or diastolic blood pressure over 80 mmHg); obesity (body mass index over 2 z-score, WHO charts for adolescents); dyslipidemia (total cholesterol ≥ 5.17 mmol/L, and/or LDL-cholesterol ≥ 3.36 mmol/l, and/or apolipoprotein B ≥ 1.10 g/L). Results Perfluorooctane sulfonate (PFOS), perfluorononanoate (PFNA), perfluorodecanoate (PFDA) and perfluoroundecanoate (PFUnDA) serum concentrations were positively associated with apolipoprotein B, total- and LDL cholesterol. The highest vs. lowest quartiles of total PFAS (∑PFAS), PFNA and PFDA concentrations were positively associated with the risk of dyslipidemia: OR 2.24 (95% CI 1.10-4.54), OR 2.30 (95% CI 1.16-4.57) and 2.36 (95% CI 1.08-5.16), respectively. The highest vs. lowest quartiles of ∑PFAS, perfluorohexane sulfonate (PFHxS), PFOS, perfluorooctanoate (PFOA) concentrations were positively associated with the risk of hypertension: OR 1.91 (95% CI 1.12-3.26), OR 2.06 (95% CI 1.16-3.65), 1.86 (95% CI 1.08-3.19) and 2.08 (95% CI 1.17-3.69) respectively. PFHxS and perfluoroheptane sulfonate (PFHpS) concentrations were positively associated with obesity. Conclusions This cross-sectional study showed a possible link between several PFAS and dyslipidemia, hypertension and obesity in Norwegian adolescents. Keywords: dyslipidemia, hypertension, obesity, PFAS, cardiovascular risk factors

• Nilsen, Ole-Andreas; Emaus, Nina; Christoffersen, Tore; Winther, Anne; Evensen, Elin & Thrane, Gyrd [Show all 9 contributors for this article] (2021). The influence of snuff and smoking on bone accretion in late adolescence : the Tromsø study, Fit Futures. Archives of Osteoporosis. ISSN 1862-3522. 16(1), p. 1–13. doi: 10.1007/s11657-021-01003-7. Full text in Research Archive Show summary

  Summary: Areal bone mineral density (aBMD) predicts future fracture risk. This study explores associations between use of tobacco and bone accretion in Norwegian adolescents. Our results indicate that use of snuff is negatively associated with accretion of aBMD in adolescence and may be a signal of increased future fracture risk. Purpose: Bone mineral accrual in childhood and adolescence is a long-term primary preventive strategy of osteoporosis. Areal bone mineral density (aBMD) is a surrogate measure of bone strength and a predictor of fracture risk. The aim of this population-based 2-year follow-up cohort study was to explore associations between use of snuff and smoking and changes (∆) in aBMD in Norwegian girls and boys aged 15–17 years at baseline. Methods: The first wave of the Tromsø study, Fit Futures was conducted from 2010 to 2011. Femoral neck (FN), total hip (TH), and total body (TB) bone mineral content (BMC) and aBMD were measured by dual-energy X-ray absorptiometry. Information on use of snuff, smoking habits, and other lifestyle related variables were collected through self-administered questionnaires. Two years later, during 2012–2013, the measurements were repeated in the second wave. The present study included 349 girls and 281 boys and compared “non-users” (n = 243 girls, 184 boys) with “users” (n = 105 girls, 96 boys) of snuff and “non-smokers” (n = 327 girls, 249 boys) with “smokers” (n = 21 girls, 31 boys) using linear regression adjusted for age, baseline height and weight, change in height and weight, pubertal maturation, physical activity, ethnicity, alcohol consumption, diagnosis known to affect bone, and medication known to affect bone. The influence of “double use” on bone accretion was also explored. Results: In girls, no associations between use of snuff and ∆aBMD were found. In boys, use of snuff was associated with reduced bone accretion in all ∆aBMD models. Sensitivity analysis with exclusion of “sometimes” users of snuff strengthened associations at femoral sites in girls and attenuated all associations in boys. In girls, no associations between smoking and ∆aBMD were found. In boys, only the association with TB ∆aBMD was significant in the fully adjusted models. In girls, “double users” analyses showed similar association to smoking. In boys, nearly all models showed statistically significant associations with a difference of ~ 1–2% in ∆aBMD between “non-users” and “double users” during 2 years of follow-up. Conclusions: Our results indicate that tobacco use in late adolescence could be detrimental to bone accretion and may be a signal of increased fracture risk in adult life.

• Beldo, Sigurd; Morseth, Bente; Christoffersen, Tore; Halvorsen, Peder Andreas; Hansen, Bjørge Hermann & Furberg, Anne-Sofie [Show all 8 contributors for this article] (2020). Prevalence of accelerometer-measured physical activity in adolescents in Fit Futures - part of the Tromsø Study. BMC Public Health. 20. doi: 10.1186/s12889-020-09171-w. Full text in Research Archive Show summary

  <i>Background</i> - Previous studies show large variations in physical activity (PA) levels among adolescents. However, the number of studies is limited and even fewer studies have assessed PA in adolescents by accelerometer devices. This study aimed to describe accelerometer-measured PA levels in adolescents in a population-based cohort in Northern Norway.<p> <p><i>Methods</i> - In 611 students aged 16–17 years attending the Fit Futures Study, PA was measured by Actigraph GT3X for seven consecutive days. PA was expressed as total PA volume (counts per minute, CPM), time spent in intensity zones, steps per day, and fulfilment of WHO recommendation (i.e. accumulation of 60 min or more of at least moderate intensity PA per day). Potential correlates of PA such as sex, socioeconomic status, study program, self-perceived health, and PA variations by weekday versus weekend were also examined.<p> <p><i>Results</i> - 16% of the girls and 25% of the boys fulfilled current WHO-recommendations. Total PA volume (CPM) was higher in boys than in girls (353 (SD 130) versus 326 (SD 114) CPM, <i>p</i> < 0.05). PA levels differed with study program and increased with better self-perceived health, but were not associated with socioeconomic status. Both boys and girls were more active on weekdays than weekends (altogether; 350 (SD 124) versus 299 (SD 178) CPM, <i>p</i> < 0.05).<p> <p><i>Conclusions</i> - In this cohort of adolescents, less than 25% of 16–17-year-old boys and girls fulfilled the WHO recommendations. The levels of physical activity in 16–17-year-old adolescents are similar to previous data reported in adults.

• Vorobieva, Veronika; Furberg, Anne-Sofie; Slotved, Hans-Christian; Bazhukova, Tatiana; Haldorsen, Bjørg & Caugant, Dominique A [Show all 9 contributors for this article] (2020). Epidemiological and molecular characterization of Streptococcus pneumoniae carriage strains in pre-school children in Arkhangelsk, northern European Russia, prior to the introduction of conjugate pneumococcal vaccines. BMC Infectious Diseases. 20, p. 1–14. doi: 10.1186/s12879-020-04998-5. Full text in Research Archive Show summary

  Background: The 13-valent Pneumococcal Conjugate Vaccine (PCV-13) was introduced in the National Immunization Programme (NIP) schedule in Russia in March 2014. Previously, the 7-valent Pneumococcal Conjugate Vaccine (PCV-7) was marketed in Russia in 2009 but has never been offered for mass vaccination. A carriage study was performed among children in Arkhangelsk in 2006. The objective was to determine the prevalence of carriage, serotype distribution, antimicrobial susceptibility and the molecular structure of Streptococcus pneumoniae strains before marketing and introduction of PCV-13. Methods: A cross-sectional study was conducted on a cluster-randomized sample of children and a self-administrated questionnaire for parents/guardians. Nasopharyngeal samples were collected from 438 children younger than 7 years attending nurseries and kindergartens in the Arkhangelsk region, Russia. Detailed demographic data, as well as information about the child’s health, traveling, exposure to antimicrobials within the last 3 months and anthropometric measurements were collected for all study subjects. Variables extracted from the questionnaire were analysed using statistic regression models to estimate the risk of carriage. All pneumococcal isolates were examined with susceptibility testing, serotyping and multilocus sequence typing. Results: The overall prevalence of asymptomatic carriage was high and peaking at 36 months with a rate of 57%. PCV-13 covered 67.3% of the detected strains. High rates of non-susceptibility to penicillin, macrolides and multidrug resistance were associated with specific vaccine serotypes, pandemic clones, and local sequence types. Nine percent of isolates represented three globally disseminated disease-associated pandemic clones; penicillin- and macrolide-resistant clones NorwayNT-42 and Poland6B-20, as well as penicillin- and macrolide-susceptible clone Netherlands3-31. A high level of antimicrobial consumption was noted by the study. According to the parent’s reports, 89.5% of the children used at least one antimicrobial regime since birth. None of the hypothesised predictors of S. pneumoniae carriage were statistically significant in univariable and multivariable logistic models. Conclusions: The study identified a high coverage of the PCV-13-vaccine, but serotype replacement and expansion of globally disseminated disease-associated clones with non-vaccine serotypes may be expected. Further surveillance of antimicrobial resistance and serotype distribution is therefore required.

• Aars, Nils Abel; Beldo, Sigurd; Jacobsen, Bjarne K.; Horsch, Alexander; Morseth, Bente & Emaus, Nina [Show all 8 contributors for this article] (2020). Association between objectively measured physical activity and longitudinal changes in body composition in adolescents : the Tromsø study fit futures cohort. BMJ Open. 10(10), p. 1–9. doi: 10.1136/bmjopen-2020-036991. Full text in Research Archive Show summary

  Objectives Physical activity may be important in deterring the obesity epidemic. This study aimed to determine whether objectively measured physical activity in first year of upper secondary high school predicted changes in body composition over 2 years of follow-up in a cohort of Norwegian adolescents (n=431). Design A longitudinal study of adolescents (mean age of 16 (SD 0.4) at baseline, 60.3% girls) participating in the Fit Futures studies 1 (2010–2011) and 2 (2012–2013). Setting All eight upper secondary high schools in two municipalities in Northern Norway. Participants Students participating in both studies and under the age of 18 at baseline and with valid measurement of physical activity at baseline and body composition in both surveys. Primary and secondary outcomes Change in objectively measured body mass index and waist circumference and change in dual-energy X-ray absorptiometry measured fat mass index, lean mass index (LMI) and appendicular LMI (aLMI) between baseline and follow-up. Results At baseline, boys had significantly higher physical activity volume (p=0.01) and spent on average of 6.4 (95% CI 2.1 to 10.6) more minutes in moderate-tovigorous physical activity (MVPA) than girls (p<0.01). In girls, multivariate regression analyses showed that more sedentary time was negatively associated with changes in LMI (p<0.01) and aLMI (p<0.05), whereas more light activity had opposite effects on these measures (p<0.01 and p<0.05, respectively). No significant associations between measures of baseline physical activity and changes in body composition parameters were observed in boys. Conclusions In this cohort of Norwegian adolescents, sedentary and light physical activity was associated with changes in LMI and aLMI in girls, but not boys. Minutes spent in MVPA in first year of upper secondary high school was not associated with changes in measures of body composition in neither sex after 2 years.

• Opdal, Ida Marie; Morseth, Bente; Handegård, Bjørn Helge; Lillevoll, Kjersti; Nilsen, Wendy & Nielsen, Christopher Sivert [Show all 9 contributors for this article] (2020). Is change in mental distress among adolescents predicted by sedentary behavior or screen time? Results from the longitudinal population study The Tromsø Study: Fit Futures. BMJ Open. 10(2). doi: 10.1136/bmjopen-2019-035549. Full text in Research Archive Show summary

  <i>Objective</i> - There is growing interest in the relationship between sedentary behaviour and mental distress among adolescents, but the majority of studies to date have relied on self-reported measures with poor validity. Consequently, current knowledge may be affected by various biases. The aim of this study was to investigate the cross-sectional and longitudinal association between (1) objectively measured sedentary time and (2) self-reported screen time with mental distress among adolescents participating in The Tromsø Study: Fit Futures, in order to see if the association is dependent on mode of measurement of sedentary behaviour.<p><p> <i>Design</i> - Prospective study.<p><p> <i>Setting</i> - Sample drawn from upper secondary school students (mean age 16.3 years at baseline) from two municipalities in Northern Norway participating in The Tromsø Study: Fit Futures 1 and 2.<p><p> <i>Participants</i> - 686 adolescents (54.5% female), with complete self-reported and accelerometer data after multiple imputation.<p><p> <i>Primary outcome measures</i> - Mental distress assessed via the Hopkins Symptom Checklist-10 (HSCL-10).<p><p> <i>Results</i> - Minutes in sedentary behaviour measured by accelerometer showed no significant relationship with mental distress in neither crude, partly adjusted nor multiple adjusted hierarchic linear regression analyses. Self-reported screen time was positively associated with mental distress in all analyses (multiple adjusted, B=0.038, p=0.008, 95% CI 0.010 to 0.066). However, the effect was small.<p><p> <i>Conclusions</i> - Self-reported screen time was associated with slightly elevated mental distress 2 years later, whereas objectively measured minutes in sedentary behaviour was not, indicating a discrepancy in the results depending on measurement methods.

• Nilsen, Ole-Andreas; Ahmed, Luai A.; Winther, Anne; Christoffersen, Tore; Thrane, Gyrd & Evensen, Elin [Show all 10 contributors for this article] (2019). Body weight and body mass index influence bone mineral density in late adolescence in a two -year follow -up study. The Tromsø Study: Fit Futures. JBMR Plus. doi: 10.1002/jbm4.10195. Full text in Research Archive Show summary

  Determinants of bone acquisition in late adolescence and early adulthood are not well‐described. This 2‐year follow‐up study explored the associations of body weight (BW), body mass index (BMI), and changes in weight status with adolescent bone accretion in a sample of 651 adolescents (355 girls and 296 boys) between 15 and 19 years of age from The Tromsø Study: Fit Futures. This Norwegian population‐based cohort study was conducted from 2010 to 2011 and was repeated from 2012 to 2013. We measured femoral neck, total hip, and total body bone mineral content and areal bone mineral density (aBMD) by dual‐energy X‐ray absorptiometry. We measured height, BW, calculated BMI (kg/m ²), and collected information on lifestyle at both surveys. Mean BMI (SD) at baseline was 22.17 (3.76) and 22.18 (3.93) in girls and boys, respectively. Through multiple linear regression, baseline BW and BMI were positively associated with ∆aBMD over 2 years of follow‐up at all skeletal sites in boys ( <i>p</i> < 0.05), but not in girls. ∆BW and ∆BMI predicted ∆aBMD and ∆BMC in both sexes, but the strength of the associations was moderate. Individuals who lost weight during follow‐up demonstrated a slowed progression of aBMD accretion compared with those gaining weight, but loss of BW or reduction of BMI during 2 years was not associated with net loss of aBMD. In conclusion, our results confirm that adequate BW for height in late adolescence is important for bone health. Associations between change in weight status and bone accretion during follow‐up were moderate and unlikely to have any clinical implication on adolescents of normal weight. Underweight individuals, particularly boys, are at risk of not reaching optimal peak bone mass and could benefit from an increase in BMI.

• Opdal, Ida Marie; Morseth, Bente; Handegård, Bjørn Helge; Lillevoll, Kjersti; Ask, Helga & Nielsen, Christopher Sivert [Show all 10 contributors for this article] (2019). Change in physical activity is not associated with change in mental distress among adolescents: The Tromsø Study: Fit Futures. BMC Public Health. 19:916. doi: 10.1186/s12889-019-7271-6. Full text in Research Archive Show summary

  <i>Background</i>: Previous research shows that physical activity has a protective effect on mental distress in adults, but the relationship is less researched and seems more ambiguous for adolescents. Studies in this field have typically been cross-sectional by design and based on self-reported physical activity measures, which are known to be vulnerable to response bias. The aim of this study was to investigate the relationship between change in objectively assessed physical activity as measured by accelerometer and change in mental distress among adolescents using longitudinal data from The Tromsø Study: Fit Futures.<p> <p><i>Method</i>: This study was based on data from 676 upper-secondary school students (mean age 16.23 years at baseline, 45.26% boys) from The Tromsø Study: Fit Futures. Physical activity, mental distress and covariates were measured at baseline (T1) and follow-up (T2) 2 years later. Physical activity was objectively measured with an ActiGraph GT3X accelerometer over 7 days. Mental distress was measured with the Hopkins Symptom Checklist-10 (HSCL-10). Change score variables were computed as the difference between T1 and T2 in number of steps, number of minutes of moderate to vigorous physical activity (MVPA) and mental distress between T1 and T2, and analyzed using linear regression analysis.<p> <p><i>Results</i>: Changes in steps per day were not associated with changes in mental distress in neither the crude, partially, nor fully adjusted model. Neither was changes in minutes of MVPA per day. Interaction effects between change in both steps per day and minutes of MVPA and gender were also not statistically significant, nor was the interaction effects between baseline levels of mental distress and physical activity.<p> <p><i>Conclusion</i>: The results of our study indicate that for adolescents in the sample, change in physical activity is unrelated to change in mental distress over a two-year period.<p>

• Averina, Maria; Brox, Jan; Huber, Sandra; Furberg, Anne-Sofie & Sørensen, Martin (2019). Serum perfluoroalkyl substances (PFAS)and risk of various allergies in adolescents. The Tromsø study Fit Futures in Northern Norway. Environmental Research. ISSN 0013-9351. 169, p. 114–121. doi: 10.1016/j.envres.2018.11.005. Full text in Research Archive Show summary

  <b>Background:</b> Exposure to environmental pollutants may contribute to the development of asthma and other allergies. The aim of this study was to investigate possible associations between asthma and other allergies with exposure to perfluoroalkyl substances (PFASs) in adolescents from the Arctic region of Norway.<br><b> Methods</b> The Tromsø study Fit Futures 1 (TFF1) and 3-year follow-up Fit Futures 2 study (TFF2) included 675 adolescents that completed a questionnaire about health conditions and underwent a clinical examination with blood tests and fractional nitric oxide (FeNO) measurement. Serum concentrations of 18 PFASs were measured by UHPLC-MS/MS method. <br><b>Results</b> Total PFASs (ΣPFAS) serum concentration over 4th quartile was positively associated with asthma in the TFF1 (OR 3.35 (95% CI 1.54–7.29), p = 0.002). Total perfluorooctane sulfonate (ΣPFOS), linear PFOS (linPFOS), linear perfluorohexane sulfonate (linPFHxS) concentrations over 4th quartiles were associated with 2 times higher odds of asthma in the TFF1. The positive associations between ΣPFAS, ΣPFOS, linPFOS and asthma remained statistically significant in the TFF2. ΣPFAS and linPFHxS concentrations over 3rd tertiles were associated with positive marker of eosinophilic airways inflammation FeNO> 25 ppb. Concentrations of ΣPFOS and linPFOS over 3rd quartiles were positively associated with self-reported nickel allergy (OR 2.25 (95% CI 1.17–4.35) p = 0.016 and OR 2.53 (95% CI 1.30–4.90) p = 0.006, respectively). Allergic rhinitis, self-reported pollen allergy, food allergy and atopic eczema were not associated with PFASs concentrations. <br><b>Conclusions</b> This study of Norwegian adolescents showed a positive association between several PFASs and asthma, as well as between PFOS and nickel allergy.

• Stensen, Dina Benedicte Berg; Småbrekke, Lars; Olsen, Karina; Grimnes, Guri; Nielsen, Christopher Sivert & Simonsen, Gunnar Skov [Show all 8 contributors for this article] (2019). Hormonal contraceptive use and Staphylococcus aureus nasal and throat carriage in a Norwegian youth population. PLOS ONE. 14(7). doi: 10.1371/journal.pone.0218511. Full text in Research Archive Show summary

  <i>Background</i>: Use of hormonal contraceptives has been associated with <i>Staphylococcus aureus</i> nasal carriage in adult women. However, the role of hormonal contraceptives in S. aureus colonization among adolescents and associations with progestin only contraceptives are unknown.<p> <p><i>Methods</i>: We obtained nasal and throat swab samples from 439 girls aged 17–21 years in the population-based Tromsø study Fit Futures, 2012–2013, Norway, with information on lifestyle, health and biomarkers. We used multivariable logistic regression to study the association between use of hormonal contraceptives and <i>Staphylococcus aureus</i> carriage while adjusting for potential confounding factors.<p> <p><i>Results</i>: <i>Staphylococcus aureus</i> nasal carriage prevalence were 34%, 42%, and 61% among progestin-only users, non-users, and progestin-estrogen combination contraceptive users, respectively (P<0.001). Use of combination contraceptives doubled the odds of nasal carriage (non-users reference; OR = 2.31, 95%CI = 1.43–3.74). The OR of nasal carriage was 0.29 among progestin-only users compared to combination contraceptives users (95% CI = 0.12–0.67).<p> <p><i>Discussion</i>: In this study, use of combination hormonal contraceptives was associated with higher risk of <i>Staphylococcus aureus</i> nasal carriage in adolescent girls. Experimental design studies are needed to establish the role of exogenous sex steroids in <i>Staphylococcus aureus</i> colonization in women.

• Schistad, Ellina Iordanova; Kong, Xiang Yi; Furberg, Anne-Sofie; Bäckryd, Emmanuel; Grimnes, Guri & Emaus, Nina [Show all 12 contributors for this article] (2019). A population-based study of inflammatory mechanisms and pain sensitivity. Pain. ISSN 0304-3959. 161(2), p. 338–350. doi: 10.1097/j.pain.0000000000001731. Full text in Research Archive Show summary

  Two recent studies suggest that experimental pain sensitivity is associated with low-grade systemic inflammation. However, only 2 biomarkers have been identified, and the studies were conducted in adult individuals where confounding effects of comorbid diseases cannot be excluded. We therefore tested associations between pain sensitivity and 119 inflammation-related serum biomarkers in 827 healthy adolescents (15-19 years) in the population-based Tromsø Study: Fit Futures. The main outcome measure was cold-pressor pain tolerance (CPT), tested by placing the dominant hand in circulating cold (3°C) water for a maximum of 105 seconds. Secondary outcomes were heat and pressure pain threshold and tolerance. Twelve proteins and 6 fatty acids were significantly associated with CPT after adjustment for possible confounding factors and correction for multiple comparisons. Of these, all fatty acids and 10 proteins were protective, ie, higher biomarkers levels were associated with increased CPT, whereas 2 biomarkers were associated with lower tolerance. Taken together, these biomarkers predicted completion of the tolerance test with a C-statistic of 0.65. Results for heat and pressure pain tolerance were remarkably similar, strengthening the generalizability of our findings. In this cohort of young healthy individuals, we found a relationship between inflammation-related biomarkers and pain tolerance and thresholds. Biomarkers with anti-inflammatory and analgesic effects predominated, suggesting that the development of prophylactic dietary or pharmaceutical treatments may be possible.

• Averina, Maria; Brox, Jan; Huber, Sandra & Furberg, Anne-Sofie (2018). Perfluoroalkyl substances in adolescents in northern Norway: Lifestyle and dietary predictors. The Tromsø study, Fit Futures 1. Environment International. ISSN 0160-4120. 114, p. 123–130. doi: 10.1016/j.envint.2018.02.031. Full text in Research Archive
• Winther, Anne; Jørgensen, Lone; Ahmed, Luai A.; Christoffersen, Tore; Furberg, Anne-Sofie & Grimnes, Guri [Show all 10 contributors for this article] (2018). Bone mineral density at the hip and its relation to fat mass and lean mass in adolescents: the Tromsø Study, Fit Futures. BMC Musculoskeletal Disorders. 19(21). doi: 10.1186/s12891-018-1933-x. Full text in Research Archive Show summary

  <p><i>Background</i>: Positive association between body weight and bone mass is well established, and the concept of body mass index (BMI) is associated with higher areal bone mineral density (aBMD) and reduced fracture risk. BMI, that comprises both fat mass (FM) and lean mass (LM) may contribute to peak bone mass achievement in different ways. This study explored the influence of body composition in terms of total body LM and FM on hip aBMD-values in adolescence.</p> <p><i>Methods</i>: In 2010/2011, 93% of the region’s first-year upper-secondary school students (15–17 years old) in Tromsø, Norway attended the Tromsø Study, Fit Futures. Areal BMD at femoral neck (aBMDFN) and total hip (aBMDTH) (g/cm2), total body LM and FM (g) were measured by dual energy X-ray absorptiometry (DXA). Height and weight were measured, and BMI calculated. Lifestyle variables were collected by self-administered questionnaires and interviews, including questions on time spent on leisure time physical activity. Stratified analyses of covariance and regression models included 395 girls and 363 boys. Crude results were adjusted for age, height, sexual maturation, physical activity levels, vitamin D levels, calcium intake, alcohol consumption and smoking habits.</p> <p><i>Results</i>: Unadjusted distribution indicated higher aBMD-levels at higher LM-levels in both genders (p < 0.001), but higher aBMD at higher FM-levels were found only in girls (p < 0.018). After multiple adjustments, aBMDFN-levels in girls were associated by 0.053 g/cm2 and 0.032 g/cm2 per standard deviation (SD) change in LM and FM (p < 0.001). Corresponding values in boys were 0.072 and 0.025 (p < 0.001). The high LM groups accounted for the highest aBMD-levels, while aBMD-levels at the LM/FM-combinations indicated different patterns in girls compared to boys. The adjusted odds ratio (95% CI) for low levels of aBMDFN was 6.6 (3.4,13.0) in boys, compared to 2.8 (1.6,4.9) in girls per SD lower LM.</p> <p><i>Conclusions</i>: LM and FM should be regarded as strong predictors for bone mass and hence bone strength in adolescents. A gender specific difference indicated that high lean mass is of crucial importance prominently in boys. In adolescents with low lean mass, especially in girls, high fat mass may partially ameliorate the effect of deficient lean mass levels.</p>

• Evensen, Elin; Emaus, Nina; Furberg, Anne-Sofie; Kokkvoll, Ane Sofie; Wells, Jonathan & Wilsgaard, Tom [Show all 8 contributors for this article] (2018). Adolescent body composition and associations with body size and growth from birth to late adolescence. The Tromsø study: Fit Futures—A Norwegian longitudinal cohort study. Pediatric Obesity. ISSN 2047-6302. doi: 10.1111/ijpo.12492. Full text in Research Archive
• Aars, Nils Abel; Jacobsen, Bjarne K.; Furberg, Anne-Sofie & Grimsgaard, Sameline (2018). Self‐reported physical activity during leisure time was favourably associated with body composition in Norwegian adolescents. Acta Paediatrica. ISSN 0803-5253. 108(6), p. 1122–1127. doi: 10.1111/apa.14660. Full text in Research Archive
• Engebretsen, Solveig; Frigessi, Arnoldo; Engø-Monsen, Kenth; Furberg, Anne-Sofie; Stubhaug, Audun & Blasio, Birgitte Freiesleben De [Show all 7 contributors for this article] (2018). The peer effect on pain tolerance. Scandinavian Journal of Pain. ISSN 1877-8860. 18(3), p. 467–477. doi: 10.1515/sjpain-2018-0060. Full text in Research Archive Show summary

  Background and aims:<br> Twin studies have found that approximately half of the variance in pain tolerance can be explained by genetic factors, while shared family environment has a negligible effect. Hence, a large proportion of the variance in pain tolerance is explained by the (non-shared) unique environment. The social environment beyond the family is a potential candidate for explaining some of the variance in pain tolerance. Numerous individual traits have previously shown to be associated with friendship ties. In this study, we investigate whether pain tolerance is associated with friendship ties. <br> Methods:<br> We study the friendship effect on pain tolerance by considering data from the Tromsø Study: Fit Futures I, which contains pain tolerance measurements and social network information for adolescents attending first year of upper secondary school in the Tromsø area in Northern Norway. Pain tolerance was measured with the cold-pressor test (primary outcome), contact heat and pressure algometry. We analyse the data by using statistical methods from social network analysis. Specifically, we compute pairwise correlations in pain tolerance among friends. We also fit network autocorrelation models to the data, where the pain tolerance of an individual is explained by (among other factors) the average pain tolerance of the individual’s friends. <br> Results: <br> We find a significant and positive relationship between the pain tolerance of an individual and the pain tolerance of their friends. The estimated effect is that for every 1 s increase in friends’ average cold-pressor tolerance time, the expected cold-pressor pain tolerance of the individual increases by 0.21 s (p-value: 0.0049, sample size n=997). This estimated effect is controlled for sex. The friendship effect remains significant when controlling for potential confounders such as lifestyle factors and test sequence among the students. Further investigating the role of sex on this friendship effect, we only find a significant peer effect of male friends on males, while there is no significant effect of friends’ average pain tolerance on females in stratified analyses. Similar, but somewhat lower estimates were obtained for the other pain modalities. <br> Conclusions:<br> We find a positive and significant peer effect in pain tolerance. Hence, there is a significant tendency for students to be friends with others with similar pain tolerance. Sex-stratified analyses show that the only significant effect is the effect of male friends on males. <br> Implications:<br> Two different processes can explain the friendship effect in pain tolerance, selection and social transmission. Individuals might select friends directly due to similarity in pain tolerance, or indirectly through similarity in other confounding variables that affect pain tolerance. Alternatively, there is an influence effect among friends either directly in pain tolerance, or indirectly through other variables that affect pain tolerance. If there is indeed a social influence effect in pain tolerance, then the social environment can account for some of the unique environmental variance in pain tolerance. If so, it is possible to therapeutically affect pain tolerance through alteration of the social environment.

• Haugen, Pål; Simonsen, Gunnar Skov; Primicerio, Raul; Furberg, Anne-Sofie & Småbrekke, Lars (2018). Antibiotics to outpatients in Norway—Assessing effect of latitude and municipality population size using quantile regression in a cross-sectional study. Pharmaceutical statistics. ISSN 1539-1604. 17(1), p. 4–11. doi: 10.1002/pst.1831. Full text in Research Archive Show summary

  High antibiotic consumption rates are associated to high prevalence of antimicrobial resistance. Geographical differences in dispensing rates of antibiotics are frequently analysed using statistical methods addressing the central tendency of the data. Yet, examining extreme quantiles may be of equal or greater interest if the problem relates to the extremes of consumption rates, as is the case for antimicrobial resistance. The objective of this study was to investigate how geographic location (latitude) and municipality population size affect antibiotic consumption in Norway. We analysed all outpatient antibiotic prescriptions (n > 14 000 000) in Norway between 2004 and 2010 using quantile regression. Data were stratified by year, and we aggregated individual data to municipality, county, or latitudinal range. We specified the quantile regression models using directed acyclic graphs and selected the model based on Akaike information criteria. Yearly outpatient antibiotic consumption in Norway varied up to 10‐fold at municipality level. We found geographical variation to depend on the number of inhabitants in a municipality and on latitude. These variables interacted, so that consumption declined with increasing latitude when municipality population sizes were small, but the effect of latitude diminished as the number of inhabitants increased. Aggregation to different levels of spatial resolution did not significantly affect our results. In Norway, outpatient antibiotic dispensing rates decreases with latitude at a rate contingent on municipality population size. Quantile regression analysis provides a flexible and powerful tool to address problems related to high, or low, dispensing rates.

• Evensen, Elin; Skeie, Guri; Wilsgaard, Tom; Christoffersen, Tore; Dennison, Elaine & Furberg, Anne-Sofie [Show all 9 contributors for this article] (2018). How Is Adolescent Bone Mass and Density Influenced by Early Life Body Size and Growth? The Tromsø Study: Fit Futures—A Longitudinal Cohort Study From Norway. JBMR Plus. 2(5), p. 268–280. doi: 10.1002/jbm4.10049. Full text in Research Archive Show summary

  The effect of birth weight and childhood body mass index (BMI) on adolescents’ bone parameters is not established. The aim of this longitudinal, population‐based study was to investigate the association of birth weight, childhood BMI, and growth, with adolescent bone mass and bone density in a sample of 633 adolescents (48% girls) from The Tromsø Study: Fit Futures. This population‐based cohort study was conducted in 2010–2011 and 2012–2013 in Tromsø, Norway. Bone mineral content (BMC) and areal BMD (aBMD) were measured at total hip (TH) and total body (TB) by dual‐energy X‐ray absorptiometry (DXA) and converted to internal Z‐scores. Birth weight and childhood anthropometric measurements were retrospectively obtained from the Medical Birth Registry of Norway and childhood health records. Associations between birth weight, BMI, and growth were evaluated by fitting linear mixed models with repeated measures of BMC and aBMD at ages 15 to 17 and 18 to 20 years as the outcome. In crude analysis, a significant positive association (p < 0.05) with TB BMC was observed per 1 SD score increase in birth weight, observed in both sexes. Higher rate of length growth, conditioned on earlier size, from birth to age 2.5 years, and higher rate of weight gain from ages 6.0 to 16.5 years, conditioned on earlier size and concurrent height growth, revealed stronger associations with bone accrual at ages 15 to 20 years compared with other ages. Compared with being normal weight, overweight/obesity at age 16.5 years was associated with higher aBMD Z‐scores: β coefficient (95% confidence interval [CI]) of 0.78 (0.53, 1.03) and 1.08 (0.85, 1.31) in girls, 0.63 (0.42, 0.85) and 0.74 (0.54, 0.95) in boys at TH and TB, respectively. Similar associations were found for BMC. Being underweight was consistently negatively associated with bone parameters in adolescence. In conclusion, birth weight influences adolescent bone mass but less than later growth and BMI in childhood and adolescence. © 2018 The Authors. JBMR Plus Published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research

• Evensen, Elin; Emaus, Nina; Kokkvoll, Ane Sofie; Wilsgaard, Tom; Furberg, Anne-Sofie & Skeie, Guri (2017). The relation between birthweight, childhood body mass index, and overweight and obesity in late adolescence: a longitudinal cohort study from Norway, The Tromsø Study, Fit Futures. BMJ Open. 7:e015576(6), p. 1–13. doi: 10.1136/bmjopen-2016-015576. Full text in Research Archive Show summary

  <i>Objectives</i>: Childhood overweight/obesity is associated with later overweight/obesity. However, the association between birth weight and later overweight/obesity has not been established. The aim of this study was to investigate the relation between both birth weight and childhood body mass index (BMI), and adolescent overweight/obesity in a Norwegian population.<p> <p><i>Methods</i>: The Tromsø Study – Fit Futures is a population-based cohort study conducted in 2010–2011 and 2012–2013 in Tromsø, Norway. A representative sample of 961 adolescents participated. Longitudinal anthropometric data were obtained from the Medical Birth Registry of Norway, childhood health records at 2–4 and 5–7 years of age, and repeated measurements at 15–18 and 18–20 years of age. Outcome was defined as normal weight (adult BMI <25 kg/m2) or overweight/ obese (adult BMI ≥2 5 kg/m2) at 15–20 years of age according to international age- and sex-specific cut-off values for children. Associations were investigated using generalised estimating equations.<p> <p><i>Results</i>: In adjusted analyses, a 1-SD (586 g) higher birth weight was associated with a higher OR for overweight/obesity at 15–20 years of age (OR 1.25, 95% CI 1.06 to 1.48). Childhood BMI was also associated with overweight/obesity at 15–20 years of age: a 1-SD (1.35 kg/m2) increase in BMI at age 2–4 years rendered an OR of 1.66 (95% CI 1.40 to 1.96); a 1-SD (1.83 kg/ m2) increase in BMI at age 5–7 years rendered an OR of 3.23 (95% CI 2.56 to 4.07). When compared with normal-weight children, those with severe overweight/ obesity in childhood (adult BMI ≥27 kg/m2) showed stronger associations with overweight/obesity at 15–20 years of age: OR 3.01 (95% CI 1.47 to 6.18) and OR 11.51 (95% CI 6.63 to 19.99) at ages 2–4 and 5–7, respectively.<p> <p><i>Conclusion</i>: Associations between birth weight and overweight/obesity at 15–20 years of age were modest, whereas the influence of BMI at 2–4 and 5–7 years on overweight/obesity at 15–20 years was moderate to strong.<p>

• Schistad, Ellina Iordanova; Stubhaug, Audun; Furberg, Anne-Sofie; Engdahl, Bo Lars & Nielsen, Christopher Sivert (2017). C-reactive protein and cold-pressor tolerance in the general population: the Tromsø Study. Pain. ISSN 0304-3959. 158(7), p. 1280–1288. doi: 10.1097/j.pain.0000000000000912. Full text in Research Archive
• Christoffersen, Tore; Ahmed, Luai A.; Daltveit, Anne Kjersti; Dennison, Elaine; Evensen, Elin & Furberg, Anne-Sofie [Show all 14 contributors for this article] (2017). The influence of birth weight and length on bone mineral density and content in adolescence: The Tromsø Study, Fit Futures. Archives of Osteoporosis. ISSN 1862-3522. 12. doi: 10.1007/s11657-017-0348-x. Full text in Research Archive Show summary

  Summary The influence of birth weight and length on bone mineral parameters in adolescence is unclear. We found a positive association between birth size and bone mineral content, attenuated by lifestyle factors. This highlights the impact of environmental stimuli and lifestyle during growth. Purpose The influence of birth weight and length on bone mineral density and content later in life is unclear, especially in adolescence. This study evaluated the impact of birth weight and length on bone mineral density and content among adolescents. Methods We included 961 participants from the population-based Fit Futures study (2010–2011). Dual-energy X-ray absorptiometry (DXA) was used to measure bone mineral density (BMD) and bone mineral content (BMC) at femoral neck (FN), total hip (TH) and total body (TB). BMD and BMC measures were linked with birth weight and length ascertained from the Medical Birth Registry of Norway. Linear regression models were used to investigate the influence of birth parameters on BMD and BMC. Results Birth weight was positively associated with BMD-TB and BMC at all sites among girls; standardized β coefficients [95% CI] were 0.11 [0.01, 0.20] for BMD-TB and 0.15 [0.06, 0.24], 0.18 [0.09, 0.28] and 0.29 [0.20, 0.38] for BMC-FN, TH and TB, respectively. In boys, birth weight was positively associated with BMC at all sites with estimates of 0.10 [0.01, 0.19], 0.12 [0.03, 0.21] and 0.15 [0.07, 0.24] for FN, TH and TB, respectively. Corresponding analyses using birth length as exposure gave significantly positive associations with BMC at all sites in both sexes. The significant positive association between birth weight and BMC-TB in girls, and birth length and BMC-TB in boys remained after multivariable adjustment. Conclusions We found a positive association between birth size and BMC in adolescence. However, this association was attenuated after adjustment for weight, height and physical activity during adolescence.

• Danielsen, Kjersti; Wilsgaard, Tom; Olsen, Anne Olaug & Furberg, Anne-Sofie (2017). Overweight and Weight Gain Predict Psoriasis Development in a Population-based Cohort. Acta Dermato-Venereologica. ISSN 0001-5555. 97(3), p. 332–339. doi: 10.2340/00015555-2530. Full text in Research Archive Show summary

  Overweight is a proposed risk factor for psoriasis. How­ever, evidence from prospective studies is limited. The aim of this study was to investigate the association be­tween overweight, weight gain and risk of psoriasis, and potential synergism with smoking, within a population-based cohort including 8,752 individuals followed from 1994 up to 2008. There was a 32% increased odds of psoriasis from a body mass index (BMI) of 27 kg/m2, in multi­variable logistic regression analysis, further increasing to 43% at BMI 28 kg/m2, and to 71% at BMI ≥ 30 kg/m2 in non-smokers. There was a dose-response association between weight gain from age 25 years, with up to 90% higher odds of psoriasis from middle age, independent of weight category. There was no indication of a synergism between overweight and smoking, and no interaction with sex. Overweight and weight gain represent modifiable risk factors that may be targets for primary prevention of psoriasis.

• Sand, Anne-Sofie; Furberg, Anne-Sofie; Lian, Olaug S; Nielsen, Christopher Sivert; Pettersen, Gunn & Winther, Anne [Show all 7 contributors for this article] (2017). Cross-sectional study of the differences between measured, perceived and desired body size and their relations with self-perceived health in young adults: The Tromsø Study - Fit Futures 2. Scandinavian Journal of Public Health. ISSN 1403-4948. 45(3), p. 322–330. doi: 10.1177/1403494817690941. Full text in Research Archive Show summary

  Aims: The aim of this study was to explore the relationships between measured body size (body mass index (BMI)), perceived body size, weight change wishes and self-perceived health in young adults. Methods: The participants were recruited from a school-based population study in Norway, the Tromsø Study: Fit Futures 2, carried out in 2012–2013. A total of 629 young women and men (aged 18–23 years) reported on the main variables. The data were collected through weight and height measurements and questionnaires. The analyses were performed with descriptive statistics, the χ2 test and Student’s t-test. Results: A total of 20% of the women and 28% of the men were overweight or obese. There were considerable discrepancies between the measured BMI and perceived body size in both sexes. A substantial number of participants wanted to change their weight. Among the 174 women who reported that they were trying to lose weight, as many as 57 (32.8%) had a low normal weight (BMI 18.5–21.9 kg/m2). Correspondingly, among the 66 men who reported that they wanted to gain weight, as many as 19 (28.8%) had a high normal weight (BMI 22–24.9 kg/m2). We found no relation between body size perceptions, weight change wishes and self-perceived health. Conclusions: Discrepancies between measured and perceived body size and weight change wishes are common findings in young adults. The lack of relation with self-perceived health found in our study is surprising and not easy to interpret. To gain more knowledge about these matters, further research, including both qualitative and quantitative studies, is needed.

• Nilsen, Ole-Andreas; Ahmed, Luai A.; Winther, Anne; Christoffersen, Tore; Furberg, Anne-Sofie & Grimnes, Guri [Show all 8 contributors for this article] (2017). Changes and tracking of bone mineral density in late adolescence: the Tromsø Study, Fit Futures. Archives of Osteoporosis. ISSN 1862-3522. 12:37, p. 1–11. doi: 10.1007/s11657-017-0328-1. Full text in Research Archive Show summary

  <p><i>Summary</i>: Areal bone mineral density (aBMD) predicts future fracture risk. This study explores the development of aBMD and associated factors in Norwegian adolescents. Our results indicate a high degree of tracking of aBMD levels in adolescence. Anthropometric measures and lifestyle factors were associated with deviation from tracking.</p> <p><i>Purpose</i>: Norway has one of the highest reported incidences of hip fractures. Maximization of peak bone mass may reduce future fracture risk. The main aims of this study were to describe changes in bone mineral levels over 2 years in Norwegian adolescents aged 15–17 years at baseline, to examine the degree of tracking of aBMD during this period, and to identify baseline predictors associated with positive deviation from tracking.</p> <p><i>Methods</i>: In 2010–2011, all first year upper secondary school students in Tromsø were invited to the Fit Futures study and 1038 adolescents (93%) attended. We measured femoral neck (FN), total hip (TH), and total body (TB) aBMD as g/cm2 by DXA. Two years later, in 2012–2013, we invited all participants to a follow-up survey, providing 688 repeated measures of aBMD.</p> <p><i>Results</i>: aBMD increased significantly (p < 0.05) at all skeletal sites in both sexes. Mean annual percentage increase for FN, TH, and TB was 0.3, 0.5, and 0.8 in girls and 1.5, 1.0, and 2.0 in boys, respectively (p < 0.05). There was a high degree of tracking of aBMD levels over 2 years. In girls, several lifestyle factors predicted a positive deviation from tracking, whereas anthropometric measures appeared influential in boys. Baseline z-score was associated with lower odds of upwards drift in both sexes.</p> <p><i>Conclusions</i>: Our results support previous findings on aBMD development in adolescence and indicate strong tracking over 2 years of follow-up. Baseline anthropometry and lifestyle factors appeared to alter tracking, but not consistently across sex and skeletal sites.

• Hanssen, Anne-Merethe; Kindlund, Bert; Stenklev, Niels Christian; Furberg, Anne-Sofie; Fismen, Silje & Olsen, Renate Slind [Show all 8 contributors for this article] (2017). Localization of Staphylococcus aureus in tissue from the nasal vestibule in healthy carriers. BMC Microbiology. 17(1). doi: 10.1186/s12866-017-0997-3. Full text in Research Archive Show summary

  <p><b>Background:</b> Colonization of the body is an important step in Staphylococcus aureus infection. S. aureus colonizes skin and mucous membranes in humans and several animal species. One important ecological niche of S. aureus is the anterior nares. More than 60% of the S. aureus in the nose are found in vestibulum nasi. Our aim was to describe the localization of S. aureus in nasal tissue from healthy carriers.</p> <p><b>Methods:</b> Punch skin biopsies were taken from vestibulum nasi from healthy volunteers (S. aureus carriers and non−/intermittent carriers, n = 39) attending the population-based Tromsø 6 study. The tissue samples were processed as frozen sections before immunostaining with a specific S. aureus antibody, and finally evaluated by a confocal laser-scanning microscope.</p> <p><b>Results:</b> Our results suggest that S. aureus colonize both the upper and lower layers of the epidermis within the nasal epithelium of healthy individuals. The number of S. aureus in epidermis was surprisingly low. Intracellular localization of S. aureus in nasal tissue from healthy individuals was also detected.</p> <p><b>Conclusions:</b> Knowledge of the exact localization of S. aureus in nasal tissue is important for the understanding of the host responses against S. aureus. Our results may have consequences for the eradication strategy of S. aureus in carriers, and further work can provide us with tools for targeted prevention of S. aureus colonisation and infection.

• Jasienska, Grazyna; Bribiescas, Richard G.; Furberg, Anne-Sofie; Helle, Samuli & Mora, Alejandra Núñez-de la (2017). Human reproduction and health: an evolutionary perspective. The Lancet. ISSN 0140-6736. 390(10093), p. 510–520. doi: 10.1016/S0140-6736(17)30573-1. Full text in Research Archive
• Sørensen, Martin; Klingenberg, Claus; Wickman, Magnus; Sollid, Johanna U Ericson; Furberg, Anne-Sofie & Bachert, Claus [Show all 7 contributors for this article] (2017). Staphylococcus aureus enterotoxin sensitization is associated with allergic poly-sensitization and allergic multimorbidity in adolescents. Allergy. European Journal of Allergy and Clinical Immunology. ISSN 0105-4538. 72(10), p. 1548–1555. doi: 10.1111/all.13175. Full text in Research Archive
• Christoffersen, Tore; Emaus, Nina; Dennison, Elaine; Furberg, Anne-Sofie; Gracia-Marco, Luis & Grimnes, Guri [Show all 10 contributors for this article] (2017). The association between childhood fractures and adolescence bone outcomes: a population-based study, the Tromsø Study, Fit Futures. Osteoporosis International. ISSN 0937-941X. 29(2), p. 441–450. doi: 10.1007/s00198-017-4300-0. Full text in Research Archive Show summary

  <p><i>SUMMARY</i>: Childhood fracture may predict persistent skeletal fragility, but it may also reflect high physical activity which is beneficial to bone development. We observe a difference in the relationship between previous fracture and bone outcome across physical activity level and sex. Further elaboration on this variation is needed.</p> <p><i>PURPOSE</i>: Childhood fracture may be an early marker of skeletal fragility, or increased levels of physical activity (PA), which are beneficial for bone mineral accrual. This study investigated the association between a previous history of childhood fracture and adolescent bone mineral outcomes by various PA levels.</p> <p><i>METHODS</i>: We recruited 469 girls and 492 boys aged 15-18 years to this study. We assessed PA levels by questionnaire and measured areal bone mineral density (aBMD) and bone mineral content (BMC) using dual-energy X-ray absorptiometry (DXA) at arm, femoral neck (FN), total hip (TH), and total body (TB) and calculated bone mineral apparent density (BMAD, g/cm3). Fractures from birth to time of DXA measurements were retrospectively recorded. We analyzed differences among participants with and without fractures using independent sample t test. Multiple linear regression was used to examine the association between fractures and aBMD and BMC measurements according to adolescent PA.</p> <p><i>RESULTS</i>: Girls with and without a previous history of fracture had similar BMC, aBMD, and BMAD at all sites. In multiple regression analyses stratified by physical activity intensity (PAi), there was a significant negative association between fracture and aBMD-TH and BMC-FN yet only in girls reporting low PAi. There was a significant negative association between forearm fractures, BMAD-FN, and BMAD-arm among vigorously active boys.</p> <p><i>CONCLUSION</i>: Our findings indicate a negative association between childhood fractures and aBMD/BMC in adolescent girls reporting low PAi. In boys, such an association appears only in vigorously active participants with a history of forearm fractures.

• Iversen, Anita; Frydenberg, Hanne; Furberg, Anne-Sofie; Flote, Vidar Gordon; Finstad, Sissi Espetvedt & McTiernan, Anne [Show all 11 contributors for this article] (2016). Cyclic endogenous estrogen and progesterone vary by mammographic density phenotypes in premenopausal women. European Journal of Cancer Prevention. ISSN 0959-8278. 25(1), p. 9–18. doi: 10.1097/CEJ.0000000000000130. Full text in Research Archive Show summary

  Estrogen and progesterone are key factors in the development of breast cancer, but it remains unclear whether these hormones are associated with mammographic density phenotypes in premenopausal women. We measured percent mammographic density, nondense area, and absolute mammographic density using computer-assisted breast density readings (Madena) from digitized mammograms taken on a scheduled day of the menstrual cycle (day 7-12) among 202 healthy, premenopausal women (Energy Balance and Breast cancer Aspects Study-I). Daily salivary concentrations of 17β-estradiol and progesterone throughout an entire menstrual cycle and fasting morning serum concentrations of hormones on 3 specific days of the menstrual cycle were assessed. Salivary and serum 17β-estradiol and progesterone were positively associated with percent mammographic density, we observed by 1 SD increase in overall salivary estradiol (β-value equal to 2.07, P=0.044), luteal salivary progesterone (β-value equal to 2.40, P=0.020). Women with above-median percent mammographic density had a 20% higher mean salivary 17β-estradiol level throughout the menstrual cycle. The odds ratio for having above-median percent mammographic density (>28.5%) per 1 SD increase in overall salivary 17β-estradiol was 1.66 (95% confidence interval 1.13-2.45). Women in the top tertile of the overall average daily 17β-estradiol concentrations had an odds ratio of 2.54 (confidence interval 1.05-6.16) of above-median percent mammographic density compared with women in the bottom tertile. Our finding of a relationship between estrogen, progesterone, and percent mammographic density and not with other mammographic density phenotypes in premenopausal women is biologically plausible, but needs to be replicated in larger studies.

• Tham, See Wan; Palermo, Tonya M; Holley, Amy Lewandowski; Zhou, Chuan; Stubhaug, Audun & Furberg, Anne-Sofie [Show all 7 contributors for this article] (2016). A population-based study of quantitative sensory testing in adolescents with and without chronic pain. Pain. ISSN 0304-3959. 157(12), p. 2807–2815. doi: 10.1097/j.pain.0000000000000716. Full text in Research Archive
• Sørensen, Martin; Wickman, Magnus; Sollid, Johanna U Ericson; Furberg, Anne-Sofie & Klingenberg, Claus (2016). Allergic disease and Staphylococcus aureus carriage in adolescents in the Arctic region of Norway. Pediatric Allergy and Immunology. ISSN 0905-6157. 27(7), p. 728–735. doi: 10.1111/pai.12595. Full text in Research Archive
• Frydenberg, Hanne; Thune, Inger; Lofterød, Trygve; Mortensen, Elin Synnøve; Eggen, Anne Elise & Risberg, Terje [Show all 12 contributors for this article] (2016). Pre-diagnostic high-sensitive C-reactive protein and breast cancer risk, recurrence, and survival. Breast Cancer Research and Treatment. ISSN 0167-6806. 155(2), p. 345–354. doi: 10.1007/s10549-015-3671-1. Full text in Research Archive

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• Danielsen, Anders Skyrud; Johansen, Amalie; Sare, Miriam; Lim, Cherry; Bjørnholt, Jørgen & Furberg, Anne-Sofie [Show all 7 contributors for this article] (2026). The microbial winners and losers in all Norwegian blood cultures over two decades, 2005–2024. Full text in Research Archive Show summary

  Background Bacteraemia incidence and microbial epidemiology are evolving globally, and is likely influenced by demographic changes [1,2]. The Norwegian Surveillance System for Antimicrobial Resistance (NORM) provides an opportunity to assess long-term trends in bacteraemia and their drivers, as all findings in blood cultures from all microbiological laboratories nationally are reported to the system [3]. This study aimed to describe temporal changes in bacteraemia incidence and microbial composition in Norway from 2005 to 2024, contextualising trends with population-level indicators. Methods We analysed national data on deduplicated blood culture isolates from 2005 to 2024, using reports from NORM. Isolates were classified into 21 species categories. Blood culture positivity rates were estimated at seven hospitals, adjusting for catchment populations. Contextual indicators were retrieved from national registries. Temporal trends in incidence (per 100,000 population) were modelled using negative binomial regression, adjusted for population age structure (≥70 years). Calendar year was included as a restricted cubic spline to capture non-linear trends. Results We analysed a total of 319,149 blood culture isolates from 2005 to 2024, with a yearly increase from 10,964 in 2005 to 22,679 in 2024, corresponding to 238 to 409 per 100,000 population (71.7% increase). Blood culture positivity remained stable at approximately 6%. Escherichia coli increased by 64%, Klebsiella spp. by 146%, and Staphylococcus aureus by 70%. Streptococcus pneumoniae declined by 49%, from 22 to 11 per 100,000. Most species showed increased incidence, with Gram-negative organisms rising more than Gram-positives. Streptococcus dysgalactiae and the "other" Gram-positive and Gram-negative categories also increased substantially. The population aged ≥70 years grew by 37.7%, while hospital bed-days declined by 37.3%. Conclusion This study shows a steady rise in bacteraemia incidence in Norway over the two decades. The stability of blood culture positivity rates suggests that the observed trends may reflect a real increase in infection burden. The decline in S. pneumoniae may reflect the impact of childhood pneumococcal vaccination. The relative increase in Gram-negative organisms and some emerging species indicate an increasing diversity, possibly due to changes in the patient case-mix, with importance for treatment regimens.

• Husby, Marit; Frydenberg, Hanne; Myklebust, Tor Åge; Skei, Nina Vibeche; Solligård, Erik & Gustad, Lise Tuset [Show all 7 contributors for this article] (2025). Sex and age disparities in mortality risk among cancer patients with sepsis: A population-based study in Norway. Dr.med. - Norwegian Journal of Epidemiology. Suppl.. 33, p. 63–63. doi: https:/www.ntnu.no/ojs/index.php/norepid. Full text in Research Archive
• Lund, Charlotte; Rosseland, Leiv Arne; Steingrímsdóttir, Ólöf Anna; Engdahl, Bo Lars; Stubhaug, Audun & Furberg, Anne-Sofie [Show all 7 contributors for this article] (2025). Reply to Huang and Chen. Pain. ISSN 0304-3959. 166(3), p. 710–711. doi: 10.1097/j.pain.0000000000003467. Full text in Research Archive
• Husby, Marit; Frydenberg, Hanne; Gustad, Lise Tuset; Skei, Nina Vibeche; Myklebust, Tor Åge & Solligård, Erik [Show all 7 contributors for this article] (2024). Trends in sepsis mortality in cancer patients. A nationwide register-based study in Norway (poster 239). Full text in Research Archive
• Linkas, Jonas; Ahmed, Luai A.; Csifcsak, Gabor; Emaus, Nina; Furberg, Anne-Sofie & Grimnes, Guri [Show all 9 contributors for this article] (2022). Corrigendum: C-Reactive Protein and TGF-α Predict Psychological Distress at Two Years of Follow-Up in Healthy Adolescent Boys: The Fit Futures Study (Front. Psychol., (2022), 13, 823420, 10.3389/fpsyg.2022.823420). Frontiers in Psychology. 13. doi: 10.3389/fpsyg.2022.953498. Full text in Research Archive
• Mohus, Randi Marie; Gustad, Lise Tuset; Furberg, Anne-Sofie; Moen, Martine Kjølberg; Liyanarachi, Kristin Vardheim & Askim, Åsa Susanne [Show all 14 contributors for this article] (2021). Sex differences in incidence of bloodstream infections and the mediating role of known risk factors. Results from the population-based HUNT study in Norway. Norsk Epidemiologi, Supplement. ISSN 0803-4206. Full text in Research Archive
• Løvsletten, Ola; Njølstad, Inger; Bønaa, Kaare Harald; Eggen, Anne Elise; Furberg, Anne-Sofie & Grimsgaard, Sameline [Show all 10 contributors for this article] (2021). Is the ongoing obesity epidemic partly explained by concurrent decline in cigarette smoking? Insights from a longitudinal population study. the Tromsø Study 1994-2016. Full text in Research Archive
• Stensen, Dina Benedicte Berg; Småbrekke, Lars; Olsen, Karina; Grimnes, Guri; Nielsen, Christopher Sivert & Sollid, Johanna Ericson [Show all 9 contributors for this article] (2021). Circulating sex-steroids and Staphylococcus aureus nasal carriage in a general female population. Full text in Research Archive
• Stensen, Dina Benedicte Berg; Cañadas, Rafael A. Nozal; Småbrekke, Lars; Olsen, Karina; Nielsen, Christopher Sivert & Svendsen, Kristian [Show all 11 contributors for this article] (2021). Social network analysis of Staphylococcus aureus carriage in a general youth population. Full text in Research Archive
• Stensen, Dina Benedicte Berg; Småbrekke, Lars; Olsen, Karina; Nielsen, Christopher Sivert; Sollid, Johanna Ericson & Simonsen, Gunnar Skov [Show all 9 contributors for this article] (2021). Circulating sex-steroids and Staphylococcus aureus nasal carriage in a general population in Norway. Full text in Research Archive
• Grimsgaard, Sameline; Hopstock, Laila Arnesdatter; Furberg, Anne-Sofie; Wilhelmsen, Janne & Kanstad, Kristin Maren (2020). Tromsøundersøkelsen - samarbeid med Tromsø og Finnmark Fylkeskommune. Full text in Research Archive
• Solvin, Åshild Øksnevad; Chawla, Konika; Olsen, Lene Christin; Danielsen, Kjersti; Jenssen, Marita & Furberg, Anne-Sofie [Show all 10 contributors for this article] (2019). Combined mRNA and miRNA Analysis of Psoriatic Skin. Forum for Nordic Dermato-Venereology. ISSN 1402-2915. 24(2), p. 60–61. Full text in Research Archive
• Solvin, Åshild Øksnevad; Chawla, Konika; Olsen, Lene Christin; Danielsen, Kjersti; Jenssen, Marita & Furberg, Anne-Sofie [Show all 10 contributors for this article] (2019). Combined mRNA and miRNA Analysis of Psoriatic Skin. Full text in Research Archive
• Furberg, Anne-Sofie (2019). NORM - Norsk overvåkingssystem for antibiotikaresistens hos mennesker. Full text in Research Archive
• Furberg, Anne-Sofie (2019). Energibalanse, kreft og infeksjoner – et folkehelseperspektiv. Full text in Research Archive
• Løset, Mari; Solvin, Åshild Øksnevad; Chawla, Konika; Olsen, Lene Christin; Danielsen, Kjersti & Jenssen, Marita [Show all 10 contributors for this article] (2019). Differentially Expressed miRNAs and mRNAs in Psoriatic Skin. Full text in Research Archive
• Solvin, Åshild Øksnevad; Chawla, Konika; Olsen, Lene Christin; Danielsen, Kjersti; Jenssen, Marita & Furberg, Anne-Sofie [Show all 10 contributors for this article] (2019). Differentially Expressed miRNAs and mRNAs in Psoriatic Skin. Full text in Research Archive
• Aars, Nils Abel; Beldo, Sigurd; Jacobsen, Bjarne K.; Horsch, Alexander; Morseth, Bente & Emaus, Nina [Show all 8 contributors for this article] (2019). The association between objectively measured physical activity and longitudinal changes in body composition in adolescents; The Tromsø Study Fit Futures Cohort. Full text in Research Archive
• Solvin, Åshild Øksnevad; Chawla, Konika; Olsen, Lene Christin; Danielsen, Kjersti; Jenssen, Marita & Furberg, Anne-Sofie [Show all 10 contributors for this article] (2019). Differentially Expressed miRNAs and mRNAs in Psoriatic Skin. Journal of Investigative Dermatology. ISSN 0022-202X. 139(9S). Full text in Research Archive
• Njølstad, Inger; Bønaa, Kaare Harald; Eggen, Anne Elise; Furberg, Anne-Sofie; Grimsgaard, Sameline & Hopstock, Laila Arnesdatter [Show all 10 contributors for this article] (2019). Is the ongoing overweight/obesity epidemic partly explained by concurrent decline in smoking? Full text in Research Archive
• Karlsen, Anna; Simonsen, Gunnar Skov; Olsen, Karina; Sollid, Johanna U Ericson; Grimnes, Guri & Nielsen, Christopher Sivert [Show all 8 contributors for this article] (2019). Smokeless Tobacco and Carriage of Staphylococcus aureus; The Tromsø Study – Fit Futures 1. Norsk Epidemiologi, Supplement. ISSN 0803-4206. 28, p. 25–25. Full text in Research Archive
• Devold, Jonas Arvola & Furberg, Anne-Sofie (2019). Atopic disease in relation to Staphylococcus aureus carriage and spa type distribution in a subarctic adult population. Norsk Epidemiologi, Supplement. ISSN 0803-4206. 28, p. 26–26. Full text in Research Archive
• Furberg, Anne-Sofie & Simonsen, Gunnar Skov (2019). Antibiotikaresistens i Norge i endring. Indremedisineren. ISSN 1891-1617. 11(1), p. 26–29. Full text in Research Archive
• Averina, Maria; Huber, Sandra; Brox, Jan & Furberg, Anne-Sofie (2017). Serum perfluoroalkyl substances (PFAS) in schoolchildren from northern Norway: Dietary impact. Full text in Research Archive
• Christoffersen, Tore; Ahmed, Luai A.; Daltveit, Anne Kjersti; Dennison, Elaine M.; Evensen, Elin & Furberg, Anne-Sofie [Show all 14 contributors for this article] (2017). Erratum to: The influence of birth weight and length on bone mineral density and content in adolescence: The Troms? Study, Fit Futures. Archives of Osteoporosis. ISSN 1862-3522. 12(62). doi: 10.1007/s11657-017-0358-8. Full text in Research Archive
• Huber, Sandra; Averina, Maria; Njølstad, Inger; Furberg, Anne-Sofie; Bolann, Bjørn Johan & Kjær, Mette [Show all 7 contributors for this article] (2017). Perfluoroalkyl substances in different cohorts from North Norway. Full text in Research Archive
• Stensen, Dina; Småbrekke, Lars; Olsen, Karina; Grimnes, Guri; Nielsen, Christopher Sivert & Simonsen, Gunnar Skov [Show all 8 contributors for this article] (2017). Hormonal contraceptive use and Staphylococcus aureus nasal and throat carriage in a Norwegian youth population. The Tromsø Study Fit Futures 2. Full text in Research Archive
• Skeie, Guri; Sandvær, Vårin; Furberg, Anne-Sofie & Grimnes, Guri (2017). Intake of sugar-sweetened beverages in adolescents from Troms, Norway. Full text in Research Archive
• Aars, Nils Abel; Jacobsen, Bjarne K.; Furberg, Anne-Sofie; Nielsen, Christopher Sivert & Grimsgaard, Sameline (2017). Physical Activity and Body Composition; Cross Sectional Results from the Tromsø Study - Fit Futures Cohort 2010-11. Full text in Research Archive
• Vikan, Ida Marie Nyhagen; Primicerio, Raul; Simonsen, Gunnar Skov; Sollid, Johanna U Ericson; Nielsen, Christopher Sivert & Olsen, Karina [Show all 7 contributors for this article] (2016). Transmission of Staphylococcus aureus in social networks. Full text in Research Archive
• Furberg, Anne-Sofie (2016). Forskning i Norsk overvåkingssystem for antibiotikaresistens hos mikrober (NORM) gjennom 15 år. Full text in Research Archive
• Danielsen, Kjersti; Wilsgaard, Tom; Olsen, Anne Olaug & Furberg, Anne-Sofie (2016). Overweight and weight gain predict psoriasis development in a population-based cohort - The Tromsø Study. Full text in Research Archive
• Skeie, Guri; Sandvær, Vårin; Furberg, Anne-Sofie & Grimnes, Guri (2016). The Tromsø Study - Fit Futures: Intake of sugar-sweetened beverages in adolescents. Full text in Research Archive
• Vikan, Ida Marie Nyhagen; Primicerio, Raul; Simonsen, Gunnar Skov; Sollid, Johanna U Ericson; Nielsen, Christopher Sivert & Olsen, Karina [Show all 7 contributors for this article] (2016). Transmission of Staphylococcus aureus in social networks. Full text in Research Archive
• Løkeland-Stai, Mette; Hornæs, Mona Tornensis; Tufta, Jon Gunnar; Askeland, Olaug Margrete; Hammer, Elisabeth Lende & Strøm, Marianne Sørlie [Show all 18 contributors for this article] (2020). Årlig driftsrapport 2019. Helseregistre ved Folkehelseinstituttet. Folkehelseinstituttet. Full text in Research Archive Show summary

  Hovedbudskap: Folkehelseinstituttet, som er databehandlingsansvarlig og databehandler for flere helseregistre, gir årlig ut en driftsrapport for disse. For 2019 er det laget én felles rapport for alle registrene. Driftsrapporten er en standardisert rapport som gir grunnlag for en samlet oversikt over driften av helseregistrene Folkehelseinstituttet er dataansvarlig for. Rapporten omtaler organisering, ansvar og myndighet, og hvordan opplysningene behandles i registeret. Driftsrapporten omtaler hvor komplett registeret er i forhold til antall hendelser, hvor fullstendige opplysningene er og dekningsgraden på institusjons- eller enhetsnivå. Den viser også hvordan dataene brukes til overordnet helsestatistikk, helseanalyser, kvalitetsforbedring av tjenestene og i vitenskaplige publikasjoner. Folkehelseinstituttet rapporterer årlig om driften av registrene til Helse- og omsorgsdepartementet og til Datatilsynet.

• Simonsen, Gunnar Skov & Furberg, Anne-Sofie (2019). Driftsrapport 2018 - Norsk overvåkingssystem for antibiotikaresistens hos mikrober NORM. Folkehelseinstituttet. Full text in Research Archive Show summary

  Driftsrapporten er en standardisert rapport som gir grunnlag for en samlet oversikt over driften av helseregistrene Folkehelseinstituttet er dataansvarlig og databehandler for. Driftsrapporten brukes også blant annet til å oppfylle enkelte av helseregistrenes forskriftsfestede meldeplikt til Datatilsynet.

• Simonsen, Gunnar Skov & Furberg, Anne-Sofie (2018). Årlig driftsrapport 2017. Norsk overvåkingssystem for antibiotikaresistens hos mikrober (NORM). Folkehelseinstituttet. Full text in Research Archive Show summary

  NORM har i 2017 ferdigutviklet og publisert en egen interaktiv kartløsning, NORM-atlas, for presentasjon av NORM-databasen online. I det web-baserte NORM-atlaset kan man lage en tilpasset og dynamisk rapport for forekomst av antibiotikaresistens ved å velge geografisk område og tidsperiode i tillegg til type klinisk isolat, mikrobe og antimikrobielt middel. Denne nye applikasjonen gjør det raskt og enkelt å fremstille forskjeller i forekomst av antibiotikaresistens mellom ulike geografiske områder og utvikling over tid. Laboratoriene, helseforvaltningen, helsetjenesten, forskere og allmennheten kan selv gjøre spørringer for å hente ut oversikter over lokale og aktuelle resistensforhold. Slik oppdatert og tilpasset informasjon er viktig støtte til overvåking og tiltak for forebygging av antibiotikaresistens.

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