Early growth, stress, and socioeconomic factors as predictors of the rate of multimorbidity accumulation across the life course: a longitudinal birth cohort study

Association of birthweight with all-cause and cause-specific premature mortality in the UK: A prospective cohort study

PURPOSE

We investigated the association between birthweight and all-cause and cause-specific premature mortality, and evaluated the effect modification by lifestyle factors.

METHODS

This prospective cohort study used data of participants aged 39-71 years from the UK Biobank in 2006-2010 and followed up till the end of 2022. Birthweight was classified into < 1.0 kg, 1.0-<1.5 kg, 1.5-<2.5 kg, 2.5-<4.0 kg, and ≥ 4.0 kg. Cox proportional-hazards models were used to estimate adjusted hazard ratios (aHR) and 95 % confidence intervals (CI) for premature mortality.

RESULTS

Of 221 848 participants, there were 6336 premature deaths (2148 cardiovascular, 624 respiratory, 3040 cancers, 524 other causes). Birthweight was nonlinearly associated with risks of all-cause, cardiovascular, and cancer-related mortality but the association was linear for respiratory and other-cause mortality. Compared to birthweight of 2.5-<4.0 kg, birthweight< 1.0 kg (aHR 1.36, 95 %CI 1.00-1.85) and ≥ 4.0 kg (1.10, 1.02-1.17) were associated with increased risks of all-cause mortality. A similar pattern was observed for cardiovascular mortality, with corresponding aHRs of 1.54 (1.02-2.49) and 1.16 (1.03-1.31) for birthweight of 2.5-<4.0 kg, and ≥ 4.0 kg, respectively. Birthweight≥ 4.0 kg was associated with increased risk of cancer-related mortality (1.11, 1.00-1.22). The mortality risks did not differ significantly across lifestyle scores (all P-interaction>0.05).

CONCLUSIONS

Both lower and higher birthweight were associated with increased risks of premature mortality from all causes and cardiovascular diseases, and higher birthweight was associated with increased risk of cancer-related mortality.

Epidemiological trends and risk factors of CKD-T1DM in children and adolescents across 204 countries and territories (1990-2021)

Background

Global T1DM incidence in children and adolescents is rising, leading to Chronic Kidney Disease due to Type 1 Diabetes Mellitus (CKD-T1DM), a critical public health concern. Severe cases evolve into end-stage kidney disease (ESKD), requiring dialysis or transplantation, severely impacting quality of life and imposing substantial burdens.

Methods

This study used Global Burden of Disease (GBD) data to analyze global and regional CKD-T1DM incidence, prevalence, mortality, and Disability-Adjusted Life Years (DALYs) rates in children and adolescents (1990-2021). It calculated age-standardized ratios and estimated annual percentage change (EAPC), presenting findings via maps and comparing age-specific burdens and mortality patterns.

Findings

From 1990 to 2021, CKD-T1DM prevalence and incidence in children and adolescents increased globally, while mortality and DALYs declined. Middle SDI (Socio-Demographic Index) nations saw a surge in new cases, contrasting with High SDI countries' success in reducing DALYs. Male incidence and DALYs were higher than those of females, with notable rises in Eastern Europe, Central Latin America, and Central Europe, and drops in East Asia. The 10-14 age group exhibited higher incidence, and the 15-19 age group higher DALYs.

Interpretation

Global CKD-T1DM management in children and adolescents faces challenges. Future research should focus on SDI-specific needs, resource allocation, public awareness, and community health education. Early detection and comprehensive health protection are crucial, especially in middle and low SDI countries and high-incidence areas.

Intergenerational Effects of Stress - A Focus on Learning and Memory

Stress is a ubiquitous facet of life. Ranging in form (e.g., psychosocial, physical, nutritional, economic) and longevity (e.g., acute, chronic), stressors affect the biology of those directly in their line of attack. As is becoming increasingly appreciated, the pernicious effects of stress echo across generations (Dias et al. 2015; Yehuda and Lehrner 2018; Jawaid et al. 2021; Dion et al. 2022; Zhou and Ryan 2023; Dias 2024). With a focus on learning and memory, this chapter addresses how stressors derail learning and memory in the generation directly exposed to them andin future generations. To do so, with a specific emphasis on associative fear conditioning in humans and rodents, we touch upon the relevance of extinction training in the aftermath of such conditioning and the recall of such extinction training as windows into normative and disrupted learning. Next, we briefly discuss underlying neuroanatomical substrates mediating these processes. We then draw attention to influences of postnatal, in utero, and pre-conceptional stress on learning and memory across generations. Finally, we briefly outline biological factors that underlie how learning and memory is derailed by these stressors.

Clusters and associations of adverse neonatal events with adult risk of multimorbidity: A secondary analysis of birth cohort data

OBJECTIVE

To investigate associations between clustered adverse neonatal events and later-life multimorbidity.

DESIGN

Secondary analysis of birth cohort data.

SETTING

Prospective birth cohort study of individuals born in Britain in one week of 1970.

POPULATION

Respondents provided data at birth (n = 17,196), age 34 (n = 11,261), age 38 (n = 9,665), age 42 (n = 9,840), and age 46 (n = 8,580).

METHODS

Mixed components analysis determined included factors, 'Birthweight'; 'Neonatal cyanosis'; 'Neonatal cerebral signs'; 'Neonatal illnesses'; 'Neonatal breathing difficulties'; and 'Prolonged duration to establishment of respiratory rate at birth', within the composite adverse neonatal event score. Log-binomial regression quantified the unadjusted and covariate-adjusted (paternal employment status and social class; maternal smoking status; maternal age; parity; cohort member smoking status and Body Mass Index) associations between the adverse neonatal event score and risk of multimorbidity in adulthood.

OUTCOME MEASURES

Multimorbidity at each adult data sweep, defined as the presence of two or more Long-Term Conditions (LTCs).

RESULTS

13.7% of respondents experienced one or more adverse neonatal event(s) at birth. The percentage reporting multimorbidity increased steadily from 14.6% at age 34 to 25.5% at age 46. A significant association was only observed at the 38 years sweep; those who had experienced two or more adverse neonatal events had a 41.0% (95% CI: 1.05 - 1.88) increased risk of multimorbidity, compared to those who had not suffered any adverse neonatal events at birth. This association was maintained following adjustment for parental confounders and adult smoking status.

CONCLUSIONS

Adverse neonatal events at birth may be independently associated with the development of midlife multimorbidity. Programmes and policies aimed at tackling the growing public health burden of multimorbidity may also need to consider interventions to reduce adverse neonatal events at birth.

Antenatal socioeconomic status of childhood family and the risk of pain spreading (ROPS) in early and mid-adulthood - a descriptive study from the northern Finland birth cohort 1966

OBJECTIVE

The Risk of Pain Spreading (ROPS) is a six-item tool capturing key data-driven prognostic factors for chronic pain and its spreading. Higher values on the ROPS indicate a higher risk. Early factors potentially associated with the ROPS are unknown. We aimed to examine the associations between antenatal socioeconomic status of childhood family (antenatal SES) and ROPS at ages 31 and 46 years.

METHODS

The study was based on the Northern Finland Birth Cohort 1966 and previously formulated latent clusters of antenatal family SES: Highest status (the reference), Small, Larger, Average wealth, and Rural families. The ROPS ranged from zero (the reference) to two or more points out of six. A multinomial regression model was used to identify antenatal SES clusters associated with ROPS.

RESULTS

At 31 years (n = 8252), only the Larger families cluster was associated with having accumulated points (two or more) (Odds ratio [OR]: 1.46, 95 % Confidence Interval [CI]: 1.14-1.87) on the ROPS compared to the Highest status families cluster. Corresponding finding was observed at 46 years (n = 6245), but the Small families and Average wealth families clusters were also associated with this outcome. The association of Larger families cluster was, however, the strongest (OR 1.48, 95 % CI 1.16-1.89).

CONCLUSIONS

Offspring born into families with ≥5 members are likely to accumulate higher sums of key data-driven prognostic factors for worse pain across the life course until middle age. In future, associations between antenatal SES and pain would be important to be examined in a light of the ROPS.

Tooth loss from the perspective of studies employing a life course approach: a systematic review

The life course approach scrutinizes factors that shape the development of diseases over time. Tooth loss, which is influenced by social, behavioral and biological factors, can occur at various stages of life and tends to become more prevalent in later years. This systematic review examined the influence of socioeconomic, psychosocial, biological and behavioral adversities in life on the likelihood of tooth loss. Searches were conducted in the Embase, PubMed, Web of Science, Ovid, PsycINFO, Scopus and LILACS databases. Reference management was performed using EndNote online. The risk of bias was appraised using the Newcastle-Ottawa Scale (NOS). The electronic searches yielded 1366 records, 17 of which (13 cohort and four cross-sectional studies) met the inclusion criteria. According to the NOS, all studies had a low risk of bias. Two studies found a link between a lower education and higher incidence of tooth loss and socioeconomic status exerted a significant influence in 47% of the studies. Disadvantaged socioeconomic trajectories and health-related factors, such as smoking, general health perception and oral health behaviors, increased the likelihood of tooth loss. Factors such as dental visits, a history of toothache and exposure to fluoridated water influenced the likelihood of tooth loss. Individuals who experienced adversities in socioeconomic, behavioral and biological aspects throughout their life course were more prone to tooth loss.

Early Life Interventions: Impact on Aging and Longevity

Across mammals, lifespans vary remarkably, spanning over a hundredfold difference. Comparative studies consistently reveal a strong inverse relationship between developmental pace and lifespan, hinting at the potential for early-life interventions (ELIs) to influence aging and lifespan trajectories. Focusing on postnatal interventions in mice, this review explores how ELIs influence development, lifespan, and the underlying mechanisms. Previous ELI studies have employed a diverse array of approaches, including dietary modifications, manipulations of the somatotropic axis, and various chemical treatments. Notably, these interventions have demonstrated significant impacts on aging and lifespan in mice. The underlying mechanisms likely involve pathways related to mitochondrial function, mTOR and AMPK signaling, cellular senescence, and epigenetic alterations. Interestingly, ELI studies may serve as valuable models for investigating the complex regulatory mechanisms of development and aging, particularly regarding the interplay among somatic growth, sexual maturation, and lifespan. In addition, prior research has highlighted the intricacies of experimental design and data interpretation. Factors such as timing, sex-specific effects, administration methods, and animal husbandry practices must be carefully considered to ensure the reliability and reproducibility of results, as well as rigorous interpretation. Addressing these factors is essential for advancing our understanding of how development, aging, and lifespan are regulated, potentially opening avenues for interventions that promote healthy aging.