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Xu M, Wang HX, Zu P, Jiang N, Bian JF, Xu JR, Luo W, Zhu P. Association Between Preeclampsia and Blood Pressure in Offspring: A Systematic Review and Meta-Analysis. Curr Hypertens Rep 2024:10.1007/s11906-024-01306-3. [PMID: 38780756 DOI: 10.1007/s11906-024-01306-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE OF REVIEW Pregnancy-induced preeclampsia is a severe pregnancy complication and preeclampsia has been associated with an increased risk of chronic hypertension for offspring. However, the magnitude of the overall effect of exposure to preeclampsia in pregnancy on blood pressure (BP) in offspring is unknown. This systematic review and meta-analysis was sought to systematically assess the effects of preeclampsia on the BP of the offspring. RECENT FINDINGS Of 2550 publications identified, 23 studies were included. The meta-analysis indicated that preeclampsia increases the potential risk of hypertension in offspring. Systolic blood pressure (SBP) was 2.0 mm Hg (95% CI: 1.2, 2.8) and diastolic blood pressure (DBP) was 1.4 mm Hg (95% CI: 0.9, 1.9) higher in offspring exposed to pre-eclampsia in utero, compared to those born to normotensive mothers. The correlations were similar in stratified analyses of children and adolescents by sex, geographic area, ages, and gestational age. During childhood and young adulthood, the offspring of pregnant women with preeclampsia are at an increased risk of high BP. It is crucial to monitor their BP.
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Affiliation(s)
- Min Xu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Environment and Population health across the Life Course, Anhui Medical University, Hefei, China
- Center for Big Data and Population Health of IHM, School of Public Health, Anhui Medical University, Hefei, China
| | - Hai-Xia Wang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Environment and Population health across the Life Course, Anhui Medical University, Hefei, China
| | - Ping Zu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Environment and Population health across the Life Course, Anhui Medical University, Hefei, China
| | - Nan Jiang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Environment and Population health across the Life Course, Anhui Medical University, Hefei, China
| | - Jing-Feng Bian
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Environment and Population health across the Life Course, Anhui Medical University, Hefei, China
| | - Ji-Rong Xu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Environment and Population health across the Life Course, Anhui Medical University, Hefei, China
| | - Wei Luo
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China
- Anhui Provincial Key Laboratory of Environment and Population health across the Life Course, Anhui Medical University, Hefei, China
| | - Peng Zhu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China.
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China.
- Anhui Provincial Key Laboratory of Environment and Population health across the Life Course, Anhui Medical University, Hefei, China.
- Center for Big Data and Population Health of IHM, School of Public Health, Anhui Medical University, Hefei, China.
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Chen J, Wang Y, Li W, Zhang Y, Cao R, Peng X, Zhang J, Liu K, Han M, Fu L. Physical activity and eating behaviors patterns associated with high blood pressure among Chinese children and adolescents. BMC Public Health 2023; 23:1516. [PMID: 37558994 PMCID: PMC10413547 DOI: 10.1186/s12889-023-16331-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Physical activity and eating behavior are associated with hypertension in children and adolescents. Revealing the associations between physical activity patterns, eating behavior patterns and high blood pressure (HBP) could help improve the problem of hypertension from the actual children's physical activities and eating behaviors. METHODS A total of 687 students aged 8-15 years were selected from two nine-year primary and secondary schools using stratified cluster random sampling method. The students' body height, weight, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured, and their physical activity time and eating behaviors were surveyed by using CLASS questionnaire and self-made eating behavior questionnaire, respectively. Exploratory factor analysis (EFA) was used to extract moderate to vigorous physical activity factor (MVPAF), sedentary activity factor (SAF), healthy eating behavior factor (HEBF), unhealthy eating behavior factor (UHEBF). MVPAF ≥ SAF was defined as moderate to vigorous physical activity pattern (MVPAP), MVPAF < SAF was defined as sedentary activity pattern (SAP). HEBF ≥ UHEBF was defined as healthy eating behavior pattern (HEBP), while the opposite was defined as unhealthy eating behavior pattern (UHEBP). Lifestyles includes physical activity patterns and eating behavior patterns. RESULTS The overall prevalence of hypertension was 5.8% (40/687), and was 5.69% (21/369) in boys and 5.97% (19/318) in girls, respectively. The MVPAF and UHEBF in boys were significantly higher than those in girls (P < 0.01), while the SAF in girls was significantly higher than that in boys (P < 0.05). The SAF was positively correlated with SBP in girls (β(SE) = 0.14 (0.50), P = 0.016), and was positively correlated with SBP (β(SE) = 0.21 (1.22), P = 0.000 and DBP (β(SE) = 0.14 (0.49), P = 0.006) in boys. The MVPAF was negatively correlated with DBP (β(SE)=-0.11 (0.40), P = 0.022) in boys. In boys, the SAP increased the risks of HBP (OR (95% CI):3.34 (1.30-8.63)) and high DBP (OR (95% CI):3.08 (1.02-9.34)) compared with MVPAP. CONCLUSION Compared with the boys with MVPAP, boys with SAP may increase the risks of HBP and high DBP. The SAF may be positively associated with SBP in boys and girls, while the MVPAF may be negatively associated with DBP in boys.
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Affiliation(s)
- Jiaoyan Chen
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Yuanyuan Wang
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Wenxiu Li
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Ya Zhang
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Ruiyao Cao
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Xingwang Peng
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Juan Zhang
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Keke Liu
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Mei Han
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Lianguo Fu
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China.
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Rudge MVC, Alves FCB, Hallur RLS, Oliveira RG, Vega S, Reyes DRA, Floriano JF, Prudencio CB, Garcia GA, Reis FVDS, Emanueli C, Fuentes G, Cornejo M, Toledo F, Valenzuela-Hinrichsen A, Guerra C, Grismaldo A, Valero P, Barbosa AMP, Sobrevia L. Consequences of the exposome to gestational diabetes mellitus. Biochim Biophys Acta Gen Subj 2023; 1867:130282. [PMID: 36436753 DOI: 10.1016/j.bbagen.2022.130282] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/14/2022] [Accepted: 11/16/2022] [Indexed: 11/26/2022]
Abstract
The exposome is the cumulative measure of environmental influences and associated biological responses throughout the lifespan, including those from the environment, diet, behaviour, and endogenous processes. The exposome concept and the 2030 Agenda for the Sustainable Development Goals (SDGs) from the United Nations are the basis for understanding the aetiology and consequences of non-communicable diseases, including gestational diabetes mellitus (GDM). Pregnancy may be developed in an environment with adverse factors part of the immediate internal medium for fetus development and the external medium to which the pregnant woman is exposed. The placenta is the interface between maternal and fetal compartments and acts as a protective barrier or easing agent to transfer exposome from mother to fetus. Under and over-nutrition in utero, exposure to adverse environmental pollutants such as heavy metals, endocrine-disrupting chemicals, pesticides, drugs, pharmaceuticals, lifestyle, air pollutants, and tobacco smoke plays a determinant role in the development of GDM. This phenomenon is worsened by metabolic stress postnatally, such as obesity which increases the risk of GDM and other diseases. Clinical risk factors for GDM development include its aetiology. It is proposed that knowledge-based interventions to change the potential interdependent ecto-exposome and endo-exposome could avoid the occurrence and consequences of GDM.
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Affiliation(s)
- Marilza V C Rudge
- Department of Gynaecology and Obstetrics, Botucatu Medical School, São Paulo State University (UNESP), 18618-687 Botucatu, São Paulo, Brazil.
| | - Fernanda C B Alves
- Department of Gynaecology and Obstetrics, Botucatu Medical School, São Paulo State University (UNESP), 18618-687 Botucatu, São Paulo, Brazil
| | - Raghavendra L S Hallur
- Department of Gynaecology and Obstetrics, Botucatu Medical School, São Paulo State University (UNESP), 18618-687 Botucatu, São Paulo, Brazil; Centre for Biotechnology, Pravara Institute of Medical Sciences (DU), Loni-413736, Rahata Taluk, Ahmednagar District, Maharashtra, India
| | - Rafael G Oliveira
- Department of Gynaecology and Obstetrics, Botucatu Medical School, São Paulo State University (UNESP), 18618-687 Botucatu, São Paulo, Brazil
| | - Sofia Vega
- Department of Gynaecology and Obstetrics, Botucatu Medical School, São Paulo State University (UNESP), 18618-687 Botucatu, São Paulo, Brazil; Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrician, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - David R A Reyes
- Department of Gynaecology and Obstetrics, Botucatu Medical School, São Paulo State University (UNESP), 18618-687 Botucatu, São Paulo, Brazil
| | - Juliana F Floriano
- Department of Gynaecology and Obstetrics, Botucatu Medical School, São Paulo State University (UNESP), 18618-687 Botucatu, São Paulo, Brazil
| | - Caroline B Prudencio
- Department of Gynaecology and Obstetrics, Botucatu Medical School, São Paulo State University (UNESP), 18618-687 Botucatu, São Paulo, Brazil
| | - Gabriela A Garcia
- São Paulo State University (UNESP), School of Sciences, Postgraduate Program in Materials Science and Technology (POSMAT), 17033-360 Bauru, São Paulo, Brazil
| | - Fabiana V D S Reis
- Department of Gynaecology and Obstetrics, Botucatu Medical School, São Paulo State University (UNESP), 18618-687 Botucatu, São Paulo, Brazil
| | - Costanza Emanueli
- National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
| | - Gonzalo Fuentes
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, 9713GZ Groningen, The Netherlands; Faculty of Health Sciences, Universidad de Talca, Talca 3460000, Chile; Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrician, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Marcelo Cornejo
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, 9713GZ Groningen, The Netherlands; Faculty of Health Sciences, Universidad de Talca, Talca 3460000, Chile; Faculty of Health Sciences, Universidad de Antofagasta, Antofagasta 02800, Chile; Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrician, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Fernando Toledo
- Faculty of Basic Sciences, Universidad del Bío-Bío, Chillán 3780000, Chile; Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrician, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Andrés Valenzuela-Hinrichsen
- Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrician, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Catalina Guerra
- Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrician, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Adriana Grismaldo
- Tecnologico de Monterrey, Eutra, The Institute for Obesity Research (IOR), School of Medicine and Health Sciences, Monterrey, Nuevo León 64710, Mexico; Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrician, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Paola Valero
- Faculty of Health Sciences, Universidad de Talca, Talca 3460000, Chile; Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrician, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Angelica M P Barbosa
- Department of Gynaecology and Obstetrics, Botucatu Medical School, São Paulo State University (UNESP), 18618-687 Botucatu, São Paulo, Brazil; Department of Physiotherapy and Occupational Therapy, School of Philosophy and Sciences, São Paulo State University (UNESP), 17525-900 Marília, São Paulo, Brazil
| | - Luis Sobrevia
- Department of Gynaecology and Obstetrics, Botucatu Medical School, São Paulo State University (UNESP), 18618-687 Botucatu, São Paulo, Brazil; Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, 9713GZ Groningen, The Netherlands; Tecnologico de Monterrey, Eutra, The Institute for Obesity Research (IOR), School of Medicine and Health Sciences, Monterrey, Nuevo León 64710, Mexico; Department of Physiology, Faculty of Pharmacy, Universidad de Sevilla, Seville E-41012, Spain; University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston QLD 4029, Queensland, Australia; Cellular and Molecular Physiology Laboratory (CMPL), Department of Obstetrician, Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile.
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Zhang X, Wang Y, Xiao W, Jiang D, Zhou J, Ye X, Wu S, Li S, Song P. Hyperglycaemia in pregnancy and offspring blood pressure: a systematic review and meta-analysis. Diabetol Metab Syndr 2023; 15:10. [PMID: 36653821 PMCID: PMC9850544 DOI: 10.1186/s13098-023-00978-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 01/05/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Hyperglycemia in pregnancy (HIP) is suggested to be a risk factor for elevated blood pressure (BP) in offspring. However, the empirical evidence was mixed. Thus, this systematic review and meta-analysis was conducted to synthesize current evidence assessing the association between HIP and BP in offspring. METHODS We searched PubMed, MEDLINE, and Embase to identify articles published from inception until 9 February 2021. A random-effects meta-analysis was performed to calculate a pooled effect size and 95% confidence interval (CI). Furthermore, the effects were evaluated separately while grouping by the offspring's sex, region, economic level, published year, insulin treatment status, and BP measurement. Each article was independently reviewed for quality. RESULTS Of 3385 citations identified, 23 studies involving 88695 offspring were included. The study found that the offspring of women with HIP had an increased level of both systolic blood pressure (SBP; mean difference 1.90, 95% CI 1.09 to 2.70 mmHg, P < 0.001) and diastolic blood pressure (DBP; mean difference 0.87 mmHg, 95% CI 0.11 to 1.17 mmHg, P = 0.02) compared with those whose mothers with normal blood glucose during pregnancy. According to subgroup analyses, gestational diabetes mellitus (GDM) appeared to have varied impacts on offspring BP by sex of offspring, region and economic level of family, published year, maternal insulin treatment status, and BP measurement. CONCLUSION Current evidence showed that HIP was associated with an elevated BP in offspring. Prenatal interventions targated on reducing HIP might be beneficial for controlling for offspring BP.
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Affiliation(s)
- Xinyue Zhang
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yinlin Wang
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Wenhan Xiao
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Denan Jiang
- International School of Medicine, Zhejiang University, Yiwu, Zhejiang, China
| | - Jiali Zhou
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Xinxin Ye
- Department of Sport and Exercise Science, College of Education, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shiqi Wu
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Shuting Li
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China.
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Zhang M, Brady TM, Buckley JP, Appel LJ, Hong X, Wang G, Liang L, Wang X, Mueller NT. Metabolome-Wide Association Study of Cord Blood Metabolites With Blood Pressure in Childhood and Adolescence. Hypertension 2022; 79:2806-2820. [PMID: 36111548 PMCID: PMC9649875 DOI: 10.1161/hypertensionaha.122.20139] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/28/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND No studies have examined whether the cord blood metabolome-a reflection of in utero metabolism-influences blood pressure (BP) in children. OBJECTIVES To examine prospective associations of cord blood metabolites with systolic BP (SBP), diastolic BP (DBP), and risk of elevated BP in childhood and adolescence. METHODS In the Boston Birth Cohort, we measured metabolites in cord blood plasma, and SBP and DBP at clinic visits between 3 and 18 years. We examined associations of cord metabolites with SBP and DBP percentiles using linear mixed models and with elevated BP using mixed-effects Poisson regression. RESULTS Our study included 902 mother-child dyads (60% Black, 23% Hispanic, 45% female). Children were followed for a median of 9.2 (interquartile range, 6.7-11.7) years, and the median number of BP observations per child was 7 (interquartile range, 4-11). After false discovery rate correction, 3 metabolites were associated with SBP, 96 with DBP, and 24 with elevated BP; 2 metabolites (1-methylnicotinamide, dimethylguanidino valeric acid) were associated with all 3 outcomes, and 21 metabolites were associated with both DBP and elevated BP. After multivariable adjustment, 48 metabolites remained significantly associated with DBP. Metabolites that showed the strongest associations with SBP, DBP, and elevated BP included nucleotides (eg, xanthosine, hypoxanthine, xanthine) and acylcarnitines (eg, C6 and C7 carnitines), which represent fatty acid oxidation and purine metabolism pathways. CONCLUSIONS In our urban and predominantly racial/ethnic minority cohort, we provide evidence that metabolomic alterations in utero, in particular, acylcarnitine- and purine-metabolism metabolites, may be involved in the early life origins of hypertension.
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Affiliation(s)
- Mingyu Zhang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD
| | - Tammy M Brady
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jessie P Buckley
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lawrence J Appel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD
- Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Xiumei Hong
- Center on the Early Life Origins of Disease, Johns Hopkins University, Baltimore, MD
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Guoying Wang
- Center on the Early Life Origins of Disease, Johns Hopkins University, Baltimore, MD
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Liming Liang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Xiaobin Wang
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
- Center on the Early Life Origins of Disease, Johns Hopkins University, Baltimore, MD
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Noel T Mueller
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD
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Prevalence and subtypes of hypertension in normal-weight and obese Indian adolescents: a cross-sectional study. J Hum Hypertens 2022; 36:1003-1010. [PMID: 34526646 DOI: 10.1038/s41371-021-00605-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 07/24/2021] [Accepted: 09/01/2021] [Indexed: 11/08/2022]
Abstract
This cross-sectional study examined the prevalence, stages, subtypes of hypertension, and the associated risk factors in adolescent school children in Western India. We screened 2,644 adolescents, from 10 different private and government schools in urban and rural areas for hypertension, as defined by the 2017 Clinical Practice Guidelines. The association of stages and subtypes with age, gender, body mass index, type of school, and place of residence was analysed. 197 children (7.5%) had hypertension; 170 (6.4%) had stage I, 27 (1%) had stage II and 76 (2.9%) had elevated blood pressure (EBP). The risk of EBP was higher in children > 15 years of age (p = 0.006). Compared with normal-weight children, obese, and overweight children had a higher risk of hypertension [odds ratio (OR) 9 (5.84, 13.88) and 3.77 (2.59, 5.48) respectively], whereas underweight children had a lower risk [OR 0.39 (0.16, 0.98)]. Normal-weight hypertension was seen in 5.2% and was higher in children from government schools (9.4%). Systolic-diastolic hypertension (SDH) was the most common subtype, seen in 136 (5.1%). SDH was more common in girls, in rural children, and in those with stage II hypertension. Isolated diastolic hypertension, seen in 51 (1.9%), was more common in boys, in urban children, and in those with EBP.
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Cleal JK, Poore KR, Lewis RM. The placental exposome, placental epigenetic adaptations and lifelong cardio-metabolic health. Mol Aspects Med 2022; 87:101095. [DOI: 10.1016/j.mam.2022.101095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 03/04/2022] [Accepted: 03/12/2022] [Indexed: 12/15/2022]
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Eitmann S, Mátrai P, Németh D, Hegyi P, Lukács A, Bérczi B, Czumbel LM, Kiss I, Gyöngyi Z, Varga G, Balaskó M, Pétervári E. Maternal overnutrition elevates offspring's blood pressure-A systematic review and meta-analysis. Paediatr Perinat Epidemiol 2022; 36:276-287. [PMID: 35041216 PMCID: PMC9305555 DOI: 10.1111/ppe.12859] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 12/13/2021] [Accepted: 12/19/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Maternal overnutrition during pregnancy predisposes the offspring to cardiometabolic diseases. OBJECTIVES This systematic review and meta-analysis aimed to investigate the association between maternal overnutrition and offspring's blood pressure (BP) and the effect of offspring's obesity on this association. DATA SOURCES PubMed, EMBASE, Clinicaltrials.gov, CENTRAL. STUDY SELECTION AND DATA EXTRACTION Human studies published in English before October 2021 were identified that presented quantitative estimates of association between maternal overnutrition just before or during pregnancy and the offspring's BP. SYNTHESIS Random-effect model with the DerSimonian and Laird weighting method was used to analyse regression coefficients or mean differences. RESULTS After selection, 17 observational studies (140,517 mother-offspring pairs) were included. Prepregnancy body mass index (ppBMI) showed positive correlation with BP in offspring (regression coefficient for systolic: 0.38 mmHg per kg/m2 , 95% confidence interval (CI) 0.17, 0.58; diastolic: 0.10 mmHg per kg/m2 , 95% CI 0.05, 0.14). These indicate 1.9 mmHg increase in systolic and 0.5 mmHg increase in diastolic BP of offspring with every 5 kg/m2 gain in maternal ppBMI. Results on coefficients adjusted for offspring's BMI also showed association (systolic: 0.08 mmHg per kg/m2 , 95% CI 0.04, 0.11; diastolic: 0.03 mmHg per kg/m2 , 95% CI 0.01, 0.04). Independent from ppBMI, gestational weight gain (GWG) showed positive correlation with systolic BP (systolic BP: 0.05 mmHg per kg, 95% CI 0.01, 0.09), but not after adjustment for offspring's BMI. Mean systolic BP was higher in children of mothers with excessive GWG than in those of mothers with optimal GWG (difference: 0.65 mmHg, 95% CI 0.25, 1.05). CONCLUSIONS Independent from offspring's BMI, higher prepregnancy BMI may increase the risk for hypertension in offspring. The positive association between GWG and offspring's systolic BP is indirect via offspring's obesity. Reduction in maternal obesity and treatment of obesity in children of obese mothers are needed to prevent hypertension.
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Affiliation(s)
- Szimonetta Eitmann
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
| | - Péter Mátrai
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
| | - Dávid Németh
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
| | - Péter Hegyi
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary,Szentágothai Research CentreMedical SchoolUniversity of PécsPécsHungary,Centre for Translational MedicineSemmelweis UniversityBudapestHungary,Division of Pancreatic Diseases, Heart and Vascular CenterSemmelweis UniversityBudapestHungary
| | - Anita Lukács
- Department of Physiology, Anatomy and NeuroscienceFaculty of Science and InformaticsUniversity of SzegedSzegedHungary
| | - Bálint Bérczi
- Department of Public Health MedicineMedical SchoolUniversity of PécsPécsHungary
| | - László Márk Czumbel
- Department of Oral BiologyFaculty of DentistrySemmelweis UniversityBudapestHungary
| | - István Kiss
- Department of Public Health MedicineMedical SchoolUniversity of PécsPécsHungary
| | - Zoltán Gyöngyi
- Department of Public Health MedicineMedical SchoolUniversity of PécsPécsHungary
| | - Gábor Varga
- Department of Oral BiologyFaculty of DentistrySemmelweis UniversityBudapestHungary
| | - Márta Balaskó
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
| | - Erika Pétervári
- Institute for Translational MedicineMedical SchoolUniversity of PécsPécsHungary
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9
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Abstract
PURPOSE OF REVIEW The prevalence of hypertension in adolescents and young adults has increased in part due to the obesity epidemic. The clinical impact and future cardiovascular risk of this underestimated public health problem is an evolving field. RECENT FINDINGS The development of hypertension is predicted by tracking of elevated blood pressure from childhood to adulthood. Young hypertensive individuals have lower awareness, slower diagnosis rates, and poorer blood pressure control than older patients. Increased awareness, appropriate screening, early identification, and individualized treatment approaches for elevated blood pressure could prevent development of hypertension in adulthood and cardiovascular events in later life. The optimal blood pressure management for young adults with a low 10-year risk of atherosclerotic cardiovascular disease of < 10% remains challenging due to lack of randomized controlled trials. Evidence-based recommendations are needed to implement appropriate measures for time of treatment initiation, preferred antihypertensive drug class to be used and optimal target blood pressure level from childhood through young adulthood.
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10
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He Z, Mi Y, Yang H, Ji J, Gao J, Zhang W, Wu P, Xu Z, Wang S, Luo X. Late-Pregnancy Dysglycemia After Negative Testing for Gestational Diabetes and Risk of the Large-for-Gestational-Age Newborns: A Nest Case-Control Study Based on the Xi'an Longitudinal Mother-Child Cohort Study. Front Pediatr 2022; 10:829706. [PMID: 35656378 PMCID: PMC9152353 DOI: 10.3389/fped.2022.829706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/26/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The implications of gestational diabetes mellitus (GDM) on the short- and long-term health outcomes of both mother and child have been extensively studied. However, studies related to negative Oral Glucose Tolerance Test (OGTT) results in the second trimester but dysglycemia in late pregnancy on maternal and infant pregnancy outcomes are rare. METHODS We conducted a nest case-control study within the Xi'an Longitudinal Mother-Child Cohort study (XAMC) to investigate the risk of adverse pregnancy outcomes in mothers and children with maternal negative mid-pregnancy OGTT results but high glycated hemoglobin (HbA1c) levels (≥5.7%) in late pregnancy. All target women who delivered from January 1st, 2017 to December 31st, 2018 in Northwest Women's and Children's Hospital in Xi'an were enrolled as the case group (HbA1c ≥ 5.7%). Others with HbA1c < 5.7% but without GDM were selected as the control group (HbA1c < 5.7%) by matching with the same delivery period. The logistic regression models were used to find out the risk factors of adverse pregnancy outcomes in the target population. RESULTS A total of 2,116 and 1,907 women were finally enrolled in the case and control groups, respectively. Compared to the control group, more newborns with macrosomia (9.2% vs 4.1%, P < 0.001) and large for gestational age (LGA) (23.7% vs. 13.5%, P < 0.001), but less small for gestational age (SGA) (4.4% vs. 6.1%, P = 0.017) were found in the case group. The differences in other outcomes were not statistically significant. The multiple logistic regression analysis showed that gestational age, fetal length, prenatal HbA1c, and total cholesterol (TG) were independent risk factors for newborns with large-for-gestational-age (LGA). The case group had a 2.516-fold (95% CI, 1.692-3.739) risk of delivering LGA newborns compared to the control group. CONCLUSION The glycemic management during the late pregnancy of non-GDM women should be given special consideration to reduce the risk of overweight offspring at birth.
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Affiliation(s)
- Zhangya He
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, China.,Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, China
| | - Yang Mi
- Department of Obstetrics and Gynecology, Northwest Women's and Children's Hospital, Xi'an, China
| | - Hexiang Yang
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, China.,Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, China
| | - Jing Ji
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, China.,Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, China.,Department of Obstetrics and Gynecology, Northwest Women's and Children's Hospital, Xi'an, China
| | - Jiayi Gao
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, China.,Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, China.,Emergency Medical Center, Xi'an Public Health Center, Xi'an, China
| | - Wanyu Zhang
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, China.,Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, China.,Department of Shaanxi Health Supervision Center, Xi'an, China
| | - Pei Wu
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, China.,Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, China
| | - Zhangrui Xu
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, China.,Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, China
| | - Shanshan Wang
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, China.,Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, China
| | - Xiaoqin Luo
- Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University, Xi'an, China.,Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, China
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11
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Rousseau-Ralliard D, Richard C, Hoarau P, Lallemand MS, Morillon L, Aubrière MC, Valentino SA, Dahirel M, Guinot M, Fournier N, Morin G, Mourier E, Camous S, Slama R, Cassee FR, Couturier-Tarrade A, Chavatte-Palmer P. Prenatal air pollution exposure to diesel exhaust induces cardiometabolic disorders in adulthood in a sex-specific manner. ENVIRONMENTAL RESEARCH 2021; 200:111690. [PMID: 34273365 DOI: 10.1016/j.envres.2021.111690] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/09/2021] [Accepted: 07/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Results from observational and experimental studies indicate that exposure to air pollutants during gestation reduces birth weight, whereas little is known on potential cardiometabolic consequences for the offspring at adulthood. OBJECTIVES Our aim was to evaluate the long-term effects of gestational exposure to diesel engine exhaust (DE) on adult offspring phenotype in a rabbit model. METHODS The protocol was designed to mimic human exposure in large European cities. Females rabbits were exposed to diluted (1 mg/m3) DE (exposed, n = 9) or clean air (controls, n = 7), from 3 days after mating, 2 h/d and 5 d/wk in a nose-only inhalation system throughout gestation (gestation days 3-27). After birth and weaning, 72 offspring (47 exposed and 25 controls) were raised until adulthood (7.5 months) to evaluate their cardio-metabolic status, including the monitoring of body weight and food intake, fasting biochemistry, body composition (iDXA), cardiovascular parameters and glucose tolerance. After a metabolic challenge (high fat diet in males and gestation in females), animals were euthanized for postmortem phenotyping. RESULTS Sex-specific responses to maternal exposure were observed in adult offspring. Age-related increases in blood pressure (p = 0.058), glycaemia (p = 0.029), and perirenal fat mass (p = 0.026) as well as reductions in HDL-cholesterol (p = 0.025) and fat-to-body weight ratio (p = 0.011) were observed in exposed males, suggesting a metabolic syndrome. Almost only trends were observed in exposed females with higher triglycerides and decreased bone density compared to control females. Metabolic challenges triggered or amplified some biological responses, especially in females. CONCLUSIONS In utero exposure to air pollution predisposed rabbit offspring to cardiometabolic disorders in a sex-specific manner.
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Affiliation(s)
- Delphine Rousseau-Ralliard
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France; Ecole Nationale Vétérinaire d'Alfort, BREED, 94700, Maisons-Alfort, France.
| | - Christophe Richard
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France; MIMA2 Platform, INRAE, 78350, Jouy-en-Josas, France
| | - Pauline Hoarau
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France
| | | | - Lucie Morillon
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France
| | - Marie-Christine Aubrière
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France; Ecole Nationale Vétérinaire d'Alfort, BREED, 94700, Maisons-Alfort, France
| | - Sarah A Valentino
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France; Ecole Nationale Vétérinaire d'Alfort, BREED, 94700, Maisons-Alfort, France
| | - Michèle Dahirel
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France; Ecole Nationale Vétérinaire d'Alfort, BREED, 94700, Maisons-Alfort, France
| | - Marine Guinot
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France
| | - Natalie Fournier
- Lip(Sys)2 - EA 7357, Athérosclérose et macrophages: impact des phospholipides et des fonctions mitochondriales sur l'efflux du cholestérol, Université Paris Saclay, UFR de Pharmacie, 92290, Châtenay-Malabry, France; Laboratoire de Biochimie, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpital Européen Georges Pompidou, 75015, Paris, France
| | - Gwendoline Morin
- Université Paris-Saclay, INRAE, UE SAAJ, 78350, Jouy en Josas, France
| | - Eve Mourier
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France
| | - Sylvaine Camous
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France
| | - Rémy Slama
- Inserm and Univ. Grenoble Alpes, U823, IAB Research Center, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, 38700, Grenoble, France
| | - Flemming R Cassee
- Centre for Sustainability, Environment and Health, National Institute for Public Health and the Environment, Bilthoven, Netherlands; Institute of Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Anne Couturier-Tarrade
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France; Ecole Nationale Vétérinaire d'Alfort, BREED, 94700, Maisons-Alfort, France
| | - Pascale Chavatte-Palmer
- Université Paris-Saclay, UVSQ, INRAE, BREED, 78350, Jouy-en-Josas, France; Ecole Nationale Vétérinaire d'Alfort, BREED, 94700, Maisons-Alfort, France; MIMA2 Platform, INRAE, 78350, Jouy-en-Josas, France
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12
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Life-Course Implications of Pediatric Risk Factors for Cardiovascular Disease. Can J Cardiol 2021; 37:766-775. [PMID: 33581191 DOI: 10.1016/j.cjca.2021.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/19/2022] Open
Abstract
The concept that origins of cardiovascular disease (CVD) begin in childhood is supported by substantial evidence. Prospective studies beginning in childhood report associations of childhood obesity, abnormal blood pressure (BP), dyslipidemia, diabetes, and tobacco use with intermediate CVD markers, including left ventricular hypertrophy and vascular stiffness in young adulthood. Trajectory analyses from longitudinal studies describe discrete BP pathways from childhood to young adult status of hypertension and prehypertension. Among individuals with familial hypercholesterolemia, abnormal low-density lipoprotein cholesterol levels are present in childhood. Some children are at risk for future CVD owing to hereditary factors, psychosocial stress, race, low birth weight, or other nonmodifiable exposures. Behavioural factors, including suboptimal diet, sedentary activity, and tobacco use, in childhood augment risk and can be modified to reduce risk. Pharmacologic treatments are reserved for those at high levels of the BP and cholesterol distributions and for those with diabetes and additional risk factors.
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13
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Crisafulli A, Bassareo PP, Kelleher S, Calcaterra G, Mercuro G. Factors Predisposing to Hypertension in Subjects Formerly Born Preterm: Renal Impairment, Arterial Stiffness, Endothelial Dysfunction or Something Else? Curr Hypertens Rev 2020; 16:82-90. [PMID: 31244440 PMCID: PMC7499358 DOI: 10.2174/1573402115666190627140523] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/21/2019] [Accepted: 05/26/2019] [Indexed: 12/23/2022]
Abstract
Subjects formerly born preterm subsequently develop arterial - particularly isolated systolic- hypertension more frequently than their peers born at term. Numerous factors may influence this predisposition, including an incomplete nephrogenesis, implying the presence of kidneys with a reduced number of nephrons and consequent reduction in haematic filtration, increased sodium absorption and activation of renin-angiotensin-aldosterone system, increased arterial rigidity produced by an elastin deficiency previously observed in anatomic specimens of human immature aorta, and reduced endothelial nitric oxide excretion, due to high blood levels of ADMA, a strong direct inhibitor of nitric oxide that exerts a vasoconstrictor effect. Other possible factors (i.e. excretion of neuroendocrine compounds) may also be implicated. The aim of this paper was to review all possible mechanisms involved in the observed increase in blood pressure in individuals who had been born preterm and/or with intrauterine growth restriction. The outlook for new and promising laboratory techniques capable of identifying alterations in the metabolic pathways regulating blood pressure levels, such as metabolomics, is also provided.
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Affiliation(s)
- Antonio Crisafulli
- Department of Medical Sciences and Public Health, Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | | | - Sean Kelleher
- Our Lady's Children's Hospital Crumlin, Dublin, Ireland
| | | | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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14
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Abstract
PURPOSE OF REVIEW Cardiovascular disease (CVD) can begin in youth. Prevention is essential to reducing the burden of CVD-related risk factors in childhood and disease development in adulthood. This review addresses the clinical scope of CVD prevention, including a review of conditions encountered, proposed diagnostic criteria, and management strategies. We also highlight the impact of the intrauterine environment on the development of CVD risk. Finally, we highlight the potential role of telehealth in the management of pediatric patients with risk factors for premature CVD. RECENT FINDINGS Growing evidence suggests that maternal obesity, diabetes, and preeclampsia may play an important role in the development of CVD risk among offspring contributing to the development of known traditional CVD risk factors among offspring. As the prevalence of CVD continues to rise, knowledge as well as appropriate diagnosis and management of primordial and traditional risk factors for CVD is needed. The diagnosis and management of CVD risk factors is a central role of the preventive pediatric cardiologist, but it is imperative that the general physician and other pediatric subspecialists be aware of these risk factors, diagnoses, and management strategies. Finally, telehealth may offer an additional method for providing preventive care, including screening and counseling of at risk children and adolescents for traditional risk factors and for providing education regarding risk factors in cases of long distance care and/or during periods of social distancing.
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15
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Mild maternal sleep-disordered breathing during pregnancy and offspring growth and adiposity in the first 3 years of life. Sci Rep 2020; 10:13979. [PMID: 32814798 PMCID: PMC7438510 DOI: 10.1038/s41598-020-70911-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/06/2020] [Indexed: 01/06/2023] Open
Abstract
Sleep-disordered breathing (SDB) during pregnancy has been linked to adverse fetal outcomes. Since the intrauterine milieu plays a critical role in childhood growth, we explored the interactions between maternal SDB and offspring growth and adiposity patterns during infancy. Fifty-eight healthy women with uncomplicated pregnancies underwent an objective sleep study and laboratory evaluation during the third trimester, their offspring underwent a 3-year growth surveillance. The 14 (24.1%) women with SDB had a higher body mass index (BMI) (P = 0.003), elevated C-reactive protein levels (P = 0.003), and decreased HDL-cholesterol levels (P = 0.009) than the women without SDB. A general linear model evaluated the interactions between maternal SDB and offspring growth and adiposity measurements after controlling for gestational age and maternal and paternal BMIs. The offspring of mothers with SDB had a significantly smaller head circumference at birth (P = 0.004), with a distinctive pattern of catchup growth by the end of the first year of life (P = 0.018). Their growth pattern was distinguished by compromised birth weight-to-length, rapid catch-up growth, and an increase in both weight-to-length and triceps thickness by the age of three (P < 0.001 and P = 0.001, respectively). Our findings suggest that maternal SDB during pregnancy affects head circumference growth and adiposity acquisition from birth through infancy.
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16
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Oliveira HR, de Oliveira Toso BRG, Guimarães ATB, Viera CS, Grassiolli S, Frizon BJZ, Barreto GMS, Conterno JR, Minosso KC. Glycemia and Lipidemia in Term Newborns Correlate With Maternal Metabolism. Glob Pediatr Health 2019; 6:2333794X19889243. [PMID: 31799338 PMCID: PMC6868571 DOI: 10.1177/2333794x19889243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 11/21/2022] Open
Abstract
The present study characterized the plasma glycemic and lipid profiles in full-term newborn babies at birth and correlated these variables with growth markers and maternal clinical and metabolic conditions, to observe if maternal pregnancy conditions can influence metabolic programming in these newborn babies. Anthropometric and biochemical data were collected from 162 mother/newborn binomials at birth and at 6 months at a public hospital in Western Paraná State, Brazil. Samples of blood tests for glucose, insulin, total cholesterol, and triglycerides were obtained. Two classes of mothers/babies were statistically defined. The glycemic profiles in Class 1, at birth, were 63.0 ± 19.6 mg/dL and at 6 months 80.4 ± 10.6 mg/dL; in Class 2, at birth, they were 66.1 ± 20.8 mg/dL and at 6 months 78.2 ± 9.4 mg/dL. The triglycerides levels in Class 1 and Class 2, at birth, were 124.5 ± 47.8 mg/dL and 132.6 ± 60.2 mg/dL, respectively, and at 6 months they were 139.0 ± 51.5 mg/dL and 115.2 ± 39.9 mg/dL, respectively. Even though most of the pregnant women were overweight at the end of the gestation period, the anthropometric patterns found for babies followed the desirable standards. Furthermore, the average glycemic profile values were between the cutoff standards at birth and at 6 months; however, the triglycerides were above the expected values.
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17
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Guttier MC, Barcelos RS, Ferreira RW, Bortolotto CC, Dartora WJ, Schmidt MI, Matijasevich A, Tovo-Rodrigues L, Santos IS. Repeated high blood pressure at 6 and 11 years at the Pelotas 2004 birth cohort study. BMC Public Health 2019; 19:1260. [PMID: 31510953 PMCID: PMC6739988 DOI: 10.1186/s12889-019-7544-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 08/25/2019] [Indexed: 12/05/2022] Open
Abstract
Background We evaluated the prevalence and the factors associated with repeated high systolic (SBP) and diastolic blood pressure (DBP) at 6- and 11-year follow-ups of children from the Pelotas (Brazil) 2004 Birth Cohort. Methods All live births to mothers living in the urban area of Pelotas were enrolled in the cohort. Blood pressure (BP) values were transformed into Z-scores by sex, age, and height. High SBP and DBP were defined as repeated systolic and diastolic BP Z-scores on the ≥95th percentile at the two follow-ups. Prevalence (95% confidence interval) of repeated high SBP, DBP, and both (SDBP) were calculated. Associations with maternal and child characteristics were explored in crude and adjusted logistic regression analyses. Results A total of 3182 cohort participants were analyzed. Prevalence of repeated high SBP, DBP and SDBP was 1.7% (1.2–2.1%), 2.3% (1.8–2.9%) and 1.2% (0.9–1.6%), respectively. Repeated high SBP was associated with males, gestational diabetes mellitus (2.92; 1.13–7.58) and obesity at 11 years (2.44; 1.29–4.59); while repeated high DBP was associated with females, family history of hypertension from both sides (3.95; 1.59–9.85) and gestational age < 34 weeks (4.08; 1.52–10.96). Repeated high SDBP was not associated with any of the characteristics investigated. Conclusion Prevalence of repeated high SBP, DBP, and SDBP were within the expected distribution at the population level. Nonetheless, gestational diabetes mellitus, obesity, family history of hypertension, and prematurity increased the risk of repeated high blood pressure measured at two occasions 5 years apart.
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