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Harville EW, Hakala JO, Rovio SP, Pahkala K, Raitakari O, Lehtimäki T. Trajectories of cardiovascular risk predict pregnancy outcomes: The Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study. Paediatr Perinat Epidemiol 2024; 38:168-179. [PMID: 37432549 PMCID: PMC10782826 DOI: 10.1111/ppe.12995] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Life course patterns of change in risk-trajectories-affect health. OBJECTIVES To examine how trajectories of cardiovascular risk factors are associated with pregnancy and birth outcomes. METHODS Data from two cohort studies participating in the International Childhood Cardiovascular Consortium-The Bogalusa Heart Study (BHS; started in 1973, N = 903 for this analysis) and the Cardiovascular Risk in Young Finns Study (YFS; started in 1980, N = 499) were used. Both followed children into adulthood and measured cardiovascular risk factors, including body mass index (BMI), systolic and diastolic blood pressure (SBP/DBP), total, lipoprotein (LDL)- and high density lipoprotein (HDL)-cholesterol and serum triglycerides. Discrete mixture modelling was used to divide each cohort into distinct trajectories according to these risk factors from childhood to early adulthood, and these groups were then used to predict pregnancy outcomes including small for gestational age (SGA; <10th study-specific percentile of gestational age by sex), preterm birth (PTB; <37 weeks' gestation), hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), with control for age at baseline and at first birth, parity, socioeconomic status, BMI and smoking. RESULTS The models created more trajectories for BMI, SBP and HDL-cholesterol in the YFS than in BHS, for which three classes generally seemed to be sufficient to represent the groups in the population across risk factors. In BHS, the association between the higher and flatter DBP trajectory and PTB was aRR 1.77, 95% confidence interval [CI] 1.06, 2.96. In BHS the association between consistent total cholesterol and PTB was aRR 2.16, 95% CI 1.22, 3.85 and in YFS the association between elevated high trajectory and PTB was aRR 3.35, 95% CI 1.28, 8.79. Elevated-increasing SBP was associated with a higher risk of GH in BHS and increasing or persistent-obese BMI trajectories were associated with GDM in both cohorts (BHS: aRR 3.51, 95% CI 1.95, 6.30; YFS: aRR 2.61, 95% CI 0.96, 7.08). CONCLUSIONS Trajectories of cardiovascular risk, particularly those that represent a consistent or more rapid worsening of cardiovascular health, are associated with a higher risk of pregnancy complications.
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Affiliation(s)
- Emily W. Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Juuso O. Hakala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Suvi P. Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere 33520 Finland
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Chen J, Wu F, Magnussen CG, Pahkala K, Juonala M, Hakala JO, Männistö S, Hutri-Kähönen N, Viikari JSA, Raitakari OT, Rovio SP. Dietary patterns from youth to adulthood and cognitive function in midlife: The cardiovascular risk in Young Finns Study. Nutrition 2023; 112:112063. [PMID: 37269718 DOI: 10.1016/j.nut.2023.112063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 04/04/2023] [Accepted: 04/24/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Diet plays an important role in cognitive health, but the long-term association of diet early in life with cognitive function in adulthood has not, to our knowledge, been rigorously studied. The aim of this study was to examine the association of youth, adulthood, and long-term dietary patterns from youth to adulthood with cognitive function in midlife. METHODS This was a population-based cohort study that assessed dietary intake in 1980 (baseline, participants 3-18 y of age), 1986, 2001, 2007, and 2011 and cognitive function in 2011. Six dietary patterns were derived from 48-h food recall or food frequency questionnaires using factor analysis. The dietary patterns were traditional Finnish, high-carbohydrate, vegetables and dairy products, traditional Finnish and high-carbohydrate, red meat, and healthy. Scores of long-term dietary patterns were calculated as the average between youth and adulthood. Cognitive function outcomes assessed included episodic memory and associative learning, short-term working memory and problem solving, reaction and movement time, and visual processing and sustained attention. Standardized z-scores of exposures and outcomes were used for analyses. RESULTS Participants (n = 790, mean age 11.2 y) were followed up for 31 y. Multivariable models showed that both youth and long-term vegetable and dairy products and healthy patterns were positively associated with episodic memory and associative learning scores (β = 0.080-0.111, P < 0.05 for all). Both youth and long-term traditional Finnish patterns were negatively associated with spatial working memory and problem solving (β = -0.085 and -0.097, respectively; P < 0.05 for both). Long-term high-carbohydrate and traditional Finnish and high-carbohydrate patterns were inversely associated with visual processing and sustained attention, whereas the vegetable and dairy products pattern was positively associated with this cognitive domain (β = -0.117 to 0.073, P < 0.05 for all). Adulthood high-carbohydrate and traditional Finnish and high-carbohydrate patterns were inversely associated with all cognitive domains except for reaction and movement time (β = -0.072 to -0.161, P < 0.05 for all). Both long-term and adulthood red meat pattern were positively associated with visual processing and sustained attention (β = 0.079 and 0.104, respectively; P < 0.05 for both). These effect sizes correspond to approximately 1.6 to 16.1 y of cognitive aging on these cognitive domains. CONCLUSIONS Higher adherence to traditional Finnish, high-carbohydrate, and traditional Finnish and high-carbohydrate patterns across the early life course was associated with poorer cognitive function in midlife, whereas higher adherence to healthy and vegetable and dairy product patterns was associated with better cognitive function. The findings, if causative, highlight the importance of maintaining a healthy dietary pattern from early life to adulthood in an attempt to promote cognitive health.
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Affiliation(s)
- Jing Chen
- Department of Geriatrics, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-chemical Injury Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Feitong Wu
- Baker Heart and Diabetes Institute, Melbourne, Australia; Baker Department of Cardiometabolic Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia.
| | - Costan G Magnussen
- Baker Heart and Diabetes Institute, Melbourne, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Juuso O Hakala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Satu Männistö
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Nina Hutri-Kähönen
- Tampere Centre for Skills Training and Simulation, Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Koskinen JS, Kytö V, Juonala M, Viikari JSA, Nevalainen J, Kähönen M, Lehtimäki T, Hutri‐Kähönen N, Laitinen TP, Tossavainen P, Jokinen E, Magnussen CG, Raitakari OT. Childhood Dyslipidemia and Carotid Atherosclerotic Plaque in Adulthood: The Cardiovascular Risk in Young Finns Study. J Am Heart Assoc 2023; 12:e027586. [PMID: 36927037 PMCID: PMC10122878 DOI: 10.1161/jaha.122.027586] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/12/2023] [Indexed: 03/18/2023]
Abstract
Background Childhood exposure to dyslipidemia is associated with adult atherosclerosis, but it is unclear whether the long-term risk associated with dyslipidemia is attenuated on its resolution by adulthood. We aimed to address this question by examining the links between childhood and adult dyslipidemia on carotid atherosclerotic plaques in adulthood. Methods and Results The Cardiovascular Risk in Young Finns Study is a prospective follow-up of children that began in 1980. Since then, follow-up studies have been conducted regularly. In 2001 and 2007, carotid ultrasounds were performed on 2643 participants at the mean age of 36 years to identify carotid plaques and plaque areas. For childhood lipids, we exploited several risk factor measurements to determine the individual cumulative burden for each lipid during childhood. Participants were categorized into the following 4 groups based on their childhood and adult dyslipidemia status: no dyslipidemia (reference), incident, resolved, and persistent. Among individuals with carotid plaque, linear regression models were used to study the association of serum lipids with plaque area. The prevalence of plaque was 3.3% (N=88). In models adjusted for age, sex, and nonlipid cardiovascular risk factors, the relative risk for carotid plaque was 2.34 (95% CI, 0.91-6.00) for incident adult dyslipidemia, 3.00 (95% CI, 1.42-6.34) for dyslipidemia resolved by adulthood, and 5.23 (95% CI, 2.57-10.66) for persistent dyslipidemia. Carotid plaque area correlated with childhood total, low-density lipoprotein, and non-high-density lipoprotein cholesterol levels. Conclusions Childhood dyslipidemia, even if resolved by adulthood, is a risk factor for adult carotid plaque. Furthermore, among individuals with carotid plaque, childhood lipids associate with plaque size. These findings highlight the importance of primordial prevention of dyslipidemia in childhood to reduce atherosclerosis development.
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Affiliation(s)
- Juhani S. Koskinen
- Research Centre of Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland
- Centre for Population Health ResearchUniversity of Turku and Turku University HospitalTurkuFinland
- Division of MedicineTurku University HospitalTurkuFinland
- Department of MedicineSatakunta Central HospitalPoriFinland
| | - Ville Kytö
- Research Centre of Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland
- Centre for Population Health ResearchUniversity of Turku and Turku University HospitalTurkuFinland
- Heart CentreTurku University Hospital and University of TurkuTurkuFinland
| | - Markus Juonala
- Research Centre of Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland
- Centre for Population Health ResearchUniversity of Turku and Turku University HospitalTurkuFinland
- Division of MedicineTurku University HospitalTurkuFinland
- Department of MedicineUniversity of TurkuTurkuFinland
| | - Jorma S. A. Viikari
- Division of MedicineTurku University HospitalTurkuFinland
- Department of MedicineUniversity of TurkuTurkuFinland
| | | | - Mika Kähönen
- Department of Clinical PhysiologyTampere University HospitalTampereFinland
- Faculty of Medicine and Health Technology and Finnish Cardiovascular Research Center TampereTampere UniversityTampereFinland
| | - Terho Lehtimäki
- Faculty of Medicine and Health Technology and Finnish Cardiovascular Research Center TampereTampere UniversityTampereFinland
- Department of Clinical ChemistryFimlab LaboratoriesTampereFinland
| | - Nina Hutri‐Kähönen
- Tampere Centre for Skills Training and SimulationTampere University, Faculty of Medicine and Health TechnologyTampereFinland
| | - Tomi P. Laitinen
- Department of Clinical Physiology and Nuclear MedicineKuopio University HospitalKuopioFinland
- Institute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
| | - Päivi Tossavainen
- Department of Pediatrics and Adolescent MedicineOulu University HospitalOuluFinland
- PEDEGO Research UnitUniversity of OuluOuluFinland
| | - Eero Jokinen
- Department of PediatricsUniversity of HelsinkiFinland
- Hospital for Children and AdolescentsHelsinki University HospitalHelsinkiFinland
| | - Costan G. Magnussen
- Research Centre of Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland
- Centre for Population Health ResearchUniversity of Turku and Turku University HospitalTurkuFinland
- Baker Heart and Diabetes InstituteMelbourneVictoriaAustralia
| | - Olli T. Raitakari
- Research Centre of Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland
- Centre for Population Health ResearchUniversity of Turku and Turku University HospitalTurkuFinland
- Department of Clinical Physiology and Nuclear MedicineTurku University HospitalTurkuFinland
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IDO activity forecasts obesity in males and premenopausal females in a 10-year follow-up study:The Cardiovascular Risk in Young Finns Study. Atherosclerosis 2021; 336:32-38. [PMID: 34628102 DOI: 10.1016/j.atherosclerosis.2021.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/12/2021] [Accepted: 09/16/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Indoleamine 2,3-dioxygenase (IDO) is an intracellular enzyme associated with artery wall inflammation. Previous studies have verified correlation between IDO activity and early signs of atherosclerosis especially in females. We aimed to elucidate the relationship between an estimate of IDO activity and atherosclerotic risk factors related to non-alchohol-fatty liver (NAFLD) in a 6- and 10-year follow-up. METHODS Estimates of IDO activity along with complete risk factor data were measured from females (n = 506; age 24-39) and males (n = 421; age 24-39) in 2001. Risk factor measurements were conducted again in 2007 and 2011. Statistical examinations were carried out by Pearson correlation and risk ratio analysis. RESULTS In females, age-adjusted IDO correlated with body mass index (BMI) (p = 0.0008), waist (p = 0.0009), C-reactive protein (CRP) (p = 0.0014) and logarithmically modified triglycerides (p = 0.0488) in 2007. Correlation remained significant with BMI (p = 0.0007) and waist (p = 0.0063) in 2011. In males, age-adjusted IDO correlated with waist (p = 0.0367) and high-density lipoprotein cholesterol (HDL-C) (p = 0.0489) in 2007. Correlation remained significant with HDL-C (p = 0.0348) in 2011. In risk ratio analysis, relationship between IDO and obesity was confirmed in females after 10 years (RR = 1.026, p = 0.0147, 95% CI) and in males after 6 and 10 years (RR = 1.019, p = 0.0091, 95% CI and RR = 1.015, p = 0.0404, 95% CI, respectively) when the data was adjusted for age and BMI. CONCLUSIONS IDO activity correlated with obesity and factors related to NAFLD, namely obesity of visceral type, hypertriglyceridemia and CRP (in females), well-characterized risk factors for diabetes and atherosclerosis in 6- and 10-year follow-up in males and premenopausal females.
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Rovio SP, Pihlman J, Pahkala K, Juonala M, Magnussen CG, Pitkänen N, Ahola-Olli A, Salo P, Kähönen M, Hutri-Kähönen N, Lehtimäki T, Jokinen E, Laitinen T, Taittonen L, Tossavainen P, Viikari JSA, Raitakari OT. Childhood Exposure to Parental Smoking and Midlife Cognitive Function. Am J Epidemiol 2020; 189:1280-1291. [PMID: 32242223 DOI: 10.1093/aje/kwaa052] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 03/23/2020] [Indexed: 11/14/2022] Open
Abstract
We studied whether exposure to parental smoking in childhood/adolescence is associated with midlife cognitive function, leveraging data from the Cardiovascular Risk in Young Finns Study. A population-based cohort of 3,596 children/adolescents aged 3-18 years was followed between 1980 and 2011. In 2011, cognitive testing was performed on 2,026 participants aged 34-49 years using computerized testing. Measures of secondhand smoke exposure in childhood/adolescence consisted of parental self-reports of smoking and participants' serum cotinine levels. Participants were classified into 3 exposure groups: 1) no exposure (nonsmoking parents, cotinine <1.0 ng/mL); 2) hygienic parental smoking (1-2 smoking parents, cotinine <1.0 ng/mL); and 3) nonhygienic parental smoking (1-2 smoking parents, cotinine ≥1.0 ng/mL). Analyses adjusted for sex, age, family socioeconomic status, polygenic risk score for cognitive function, adolescent/adult smoking, blood pressure, and serum total cholesterol level. Compared with the nonexposed, participants exposed to nonhygienic parental smoking were at higher risk of poor (lowest quartile) midlife episodic memory and associative learning (relative risk (RR) = 1.38, 95% confidence interval (CI): 1.08, 1.75), and a weak association was found for short-term and spatial working memory (RR = 1.25, 95% CI: 0.98, 1.58). Associations for those exposed to hygienic parental smoking were nonsignificant (episodic memory and associative learning: RR = 1.19, 95% CI: 0.92, 1.54; short-term and spatial working memory: RR = 1.10, 95% CI: 0.85, 1.34). We conclude that avoiding childhood/adolescence secondhand smoke exposure promotes adulthood cognitive function.
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Pussinen PJ, Paju S, Viikari J, Salminen A, Taittonen L, Laitinen T, Burgner D, Kähönen M, Lehtimäki T, Hutri-Kähönen N, Raitakari O, Juonala M. Childhood Oral Infections Associate with Adulthood Metabolic Syndrome: A Longitudinal Cohort Study. J Dent Res 2020; 99:1165-1173. [PMID: 32479136 PMCID: PMC7443963 DOI: 10.1177/0022034520929271] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Chronic oral infection/inflammation is cross-sectionally associated with metabolic syndrome (MetS) in adults, but there are few longitudinal studies and studies on childhood oral infections and adult MetS risk. We investigated whether childhood clinical parameters indicative of oral infection/inflammation were associated with adulthood MetS and its components. A total of 755 children aged 6, 9, and 12 y underwent a clinical oral examination in 1980 as part of the Cardiovascular Risk in Young Finns Study. Oral health measures included bleeding on probing (BOP), periodontal probing pocket depth, caries, fillings, and visible plaque. Metabolic parameters were determined at baseline and during follow-up. MetS was diagnosed (n = 588, 77.9%) in the adulthood at 21 y (in 2001), 27 y (in 2007), and 31 y (in 2011) after the oral assessment, when the participants were 27 to 43 y old. Regression analyses were adjusted for childhood age, sex, body mass index, and family income, as well as adulthood smoking and education level. In adulthood, MetS was diagnosed in 11.9% (2001), 18.7% (2007), and 20.7% (2011) of participants at the 3 follow-ups. Childhood caries and fillings were associated with increased risk of adult MetS (risk ratio [95% CI], 1.25 [0.90 to 2.45] and 1.27 [1.02 to 1.99]) and with increased systolic blood pressure (1.78 [1.01 to 4.26] and 2.48 [1.11 to 4.12]) and waist circumference (2.25 [1.02 to 4.99] and 1.56 [1.01 to 3.25]), whereas BOP and visible plaque were associated with plasma glucose (1.97 [1.08 to 3.60] and 1.88 [1.00 to 3.53]). Severity of BOP (P = 0.015) and caries (P = 0.005) and teeth with plaque (P = 0.027) were associated with number of MetS components. No such trends were seen with probing pocket depth. Childhood oral infection/inflammation was associated with adverse metabolic parameters and MetS in adulthood.
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Affiliation(s)
- P J Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - S Paju
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - J Viikari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - A Salminen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | | | - T Laitinen
- University of Eastern Finland, Kuopio, Finland
| | - D Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - M Kähönen
- University of Tampere, Tampere, Finland
| | - T Lehtimäki
- Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | | | - O Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - M Juonala
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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Childhood risk factors and carotid atherosclerotic plaque in adulthood: The Cardiovascular Risk in Young Finns Study. Atherosclerosis 2020; 293:18-25. [DOI: 10.1016/j.atherosclerosis.2019.11.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/18/2019] [Accepted: 11/27/2019] [Indexed: 12/28/2022]
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Increase in adiposity from childhood to adulthood predicts a metabolically obese phenotype in normal-weight adults. Int J Obes (Lond) 2019; 44:848-851. [PMID: 31745257 DOI: 10.1038/s41366-019-0479-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 10/03/2019] [Accepted: 10/31/2019] [Indexed: 12/22/2022]
Abstract
Normal weight is associated with a favorable cardiometabolic risk profile and low risk of type 2 diabetes and cardiovascular disease. However, some normal-weight individuals-the "metabolically obese normal weight" (MONW)-show a cardiometabolic risk profile similar to the obese. Previous studies have shown that older age, central body fat distribution, and unfavorable lifestyle increase the risk of MONW. However, the role of early-life factors in MONW remains unknown. We examined the associations of early-life factors with adult MONW in 1178 individuals from the Cardiovascular Risk in Young Finns study who were followed up from childhood to adulthood. The strongest early predictor for adult MONW was an increase in BMI from childhood to adulthood (p = 3.1 × 10-11); each 1 SD increase in BMI z-score from childhood to adulthood led to a 2.56-fold increase in the risk of adult MONW (CI 95% = 1.94-3.38). Other significant predictors of adult MONW were male sex (OR = 2.38, 95% = 1.63-3.47, p = 7.0 × 10-6), higher childhood LDL cholesterol (OR = 1.41 per 1 SD increase in LDL cholesterol, CI 95% = 1.14-1.73, p = 0.001), and lower HDL cholesterol (OR = 1.51 per 1 SD decrease in HDL cholesterol, CI 95% = 1.23-1.85, p = 5.4 × 10-5). Our results suggest that an increase in adiposity from childhood to adulthood is detrimental to cardiometabolic health, even among individuals remaining normal weight.
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Cuthbertson DJ, Brown E, Koskinen J, Magnussen CG, Hutri-Kähönen N, Sabin M, Tossavainen P, Jokinen E, Laitinen T, Viikari J, Raitakari OT, Juonala M. Longitudinal analysis of risk of non-alcoholic fatty liver disease in adulthood. Liver Int 2019; 39:1147-1154. [PMID: 30347485 DOI: 10.1111/liv.13993] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/10/2018] [Accepted: 10/11/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS We aimed to determine how childhood body mass index and metabolic health, along with the change in body mass index between childhood and adulthood, determine the risk of adult non-alcoholic fatty liver disease. METHODS Data from 2020 participants aged 3-18 years at baseline, followed up 31 years later, were examined to assess the utility of four childhood metabolic phenotypes (Metabolic Groups I: normal body mass index, no metabolic disturbances; II: normal body mass index, one or more metabolic disturbances; III: overweight/obese, no metabolic disturbances; IV: overweight/obese, one or more metabolic disturbances) and four life-course adiposity phenotypes (Adiposity Group 1: normal child and adult body mass index; 2, high child, normal adult body mass index; 3, normal child body mass index, high adult body mass index; 4, high child and adult body mass index) in predicting adult non-alcoholic fatty liver disease. RESULTS The risk for adult non-alcoholic fatty liver disease was similar across all four groups after adjustment for age, sex, lifestyle factors and adult body mass index. Risk of adult non-alcoholic fatty liver disease was not increased among individuals overweight/obese in childhood but non-obese in adulthood. In contrast, overweight or obese adults, irrespective of their youth body mass index status, had ~eight-fold to 10-fold increased risk (P < 0.001). CONCLUSIONS Childhood overweight/obesity, not metabolic health, is associated with increased risk for adult non-alcoholic fatty liver disease. However, the increased risk associated with childhood overweight/obesity can be largely removed by obtaining a normal body mass index by adulthood.
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Affiliation(s)
- Daniel J Cuthbertson
- Obesity and Endocrinology Research Group, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Emily Brown
- Obesity and Endocrinology Research Group, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Juha Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Heart Center, Kymenlaakson keskussairaala, Kotka, Finland
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Matthew Sabin
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,The Royal Children's Hospital and University of Melbourne, Melbourne, Victoria, Australia
| | - Päivi Tossavainen
- Department of Pediatrics, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Eero Jokinen
- Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Jorma Viikari
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Markus Juonala
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
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Balder J, Lansberg P, Hof M, Wiegman A, Hutten B, Kuivenhoven J. Pediatric lipid reference values in the general population: The Dutch lifelines cohort study. J Clin Lipidol 2018; 12:1208-1216. [DOI: 10.1016/j.jacl.2018.05.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 05/12/2018] [Accepted: 05/16/2018] [Indexed: 01/19/2023]
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11
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Harville EW, Juonala M, Viikari JSA, Kähönen M, Raitakari OT. Pregnancy complications and later vascular ultrasound measures: A cohort study. Pregnancy Hypertens 2017; 10:171-176. [PMID: 29153673 DOI: 10.1016/j.preghy.2017.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 07/28/2017] [Accepted: 08/03/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Pregnancy complications predict or even predispose to later cardiovascular disease in the mother. We examined whether pregnancy complications are associated with post-pregnancy measures of endothelial dysfunction and arterial stiffness. STUDY DESIGN Prospective cohort; Data for 847 women female participants in the Cardiovascular Risk in Young Finns study were linked with the national birth registry. Preterm birth (<37weeks), low birthweight (<2500g), small-for-gestational-age (weight <10th percentile for gestational age), and hypertensive disorders of pregnancy were examined as predictors of later vascular measures. MAIN OUTCOME MEASURES Flow-mediated dilatation (FMD), carotid intima-media thickness (IMT), Young's elastic modulus (YEM), and carotid artery distensibility. RESULTS In some analyses, gestational hypertension and pre-eclampsia were associated with increased YEM. Low birthweight was also associated with an increase in IMT, and this increased risk was present prior to the pregnancy. CONCLUSIONS The increased cardiovascular risk in the mother observed after low birthweight and hypertensive disorders may be due to vascular changes, and some of this increased risk may be present before pregnancy.
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Affiliation(s)
- Emily W Harville
- Department of Epidemiology, Tulane University School of Public Health, USA.
| | - Markus Juonala
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland; Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Jorma S A Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Psychology, Tampere University Hospital and University of Tampere, Finland
| | - Olli T Raitakari
- The Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku and Department of Clinical Physiology, Turku University Hospital, Finland
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12
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Böckerman P, Bryson A, Viinikainen J, Hakulinen C, Hintsanen M, Pehkonen J, Viikari J, Raitakari O. The biometric antecedents to happiness. PLoS One 2017; 12:e0184887. [PMID: 28915269 PMCID: PMC5600384 DOI: 10.1371/journal.pone.0184887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 09/03/2017] [Indexed: 12/19/2022] Open
Abstract
It has been suggested that biological markers are associated with human happiness. We contribute to the empirical literature by examining the independent association between various aspects of biometric wellbeing measured in childhood and happiness in adulthood. Using Young Finns Study data (n = 1905) and nationally representative linked data we examine whether eight biomarkers measured in childhood (1980) are associated with happiness in adulthood (2001). Using linked data we account for a very rich set of confounders including age, sex, body size, family background, nutritional intake, physical activity, income, education and labour market experiences. We find that there is a negative relationship between triglycerides and subjective well-being but it is both gender- and age-specific and the relationship does not prevail using the later measurements (1983/1986) on triglycerides. In summary, we conclude that none of the eight biomarkers measured in childhood predict happiness robustly in adulthood.
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Affiliation(s)
- Petri Böckerman
- Turku School of Economics, Turku, Finland
- Labour Institute for Economic Research, Helsinki, Finland
- IZA, Bonn, Germany
- * E-mail:
| | - Alex Bryson
- IZA, Bonn, Germany
- UCL Department of Social Science, London, United Kingdom
- NIESR, London, United Kingdom
| | - Jutta Viinikainen
- Jyväskylä University School of Business and Economics, Jyväskylä, Finland
| | - Christian Hakulinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Jaakko Pehkonen
- Jyväskylä University School of Business and Economics, Jyväskylä, Finland
| | - Jorma Viikari
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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13
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Corder K, Winpenny E, Love R, Brown HE, White M, Sluijs EV. Change in physical activity from adolescence to early adulthood: a systematic review and meta-analysis of longitudinal cohort studies. Br J Sports Med 2017; 53:496-503. [PMID: 28739834 PMCID: PMC6250429 DOI: 10.1136/bjsports-2016-097330] [Citation(s) in RCA: 160] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2017] [Indexed: 12/29/2022]
Abstract
Objective To systematically review and meta-analyse how physical activity (PA) changes from adolescence to early adulthood (13–30 years). Data sources Seven electronic databases were searched: Medline, Embase, PsycInfo, SCOPUS, ASSIA, SPORTdiscus and Web of Science. Eligibility criteria for selecting studies English-language, longitudinal studies (from 01/1980 to 01/2017) assessing PA ≥twice, with the mean age of ≥1 measurement in adolescence (13–19 years) and ≥1 in young adulthood (16–30 years) were included. Where possible, data were converted to moderate-to-vigorous physical activity (MVPA) min/day, and meta-analyses were conducted between weighted mean differences (WMDs) in adolescence and adulthood. Heterogeneity was explored using meta-regression. Results Of 67 included studies, 49 were eligible for meta-analysis. PA was lower during adulthood than adolescence WMD (95% CI) −5.2 (−7.3 to –3.1) min/day MVPA over mean (SD) 3.4 (2.6) years; heterogeneity was high (I2 >99.0%), and no predictors explained this variation (all p>0.05). When we restricted analysis to studies with data for males (n=29) and females (n=30) separately, there were slightly larger declines in WMD (−6.5 (−10.6 to –2.3) and −5.5 (−8.4 to −2.6) min/day MVPA) (both I2 >99.0%). For studies with accelerometer data (n=9), the decline was −7.4 (−11.6 to –3.1) and longer follow-up indicated more of a decline in WMD (95% CI) (−1.9 (−3.6 to –0.2) min/day MVPA), explaining 27.0% of between-study variation. Of 18 studies not eligible for meta-analysis, nine statistically tested change over time: seven showed a decline and two showed no change. Conclusion PA declines modestly between adolescence and young adulthood. More objective longitudinal PA data (eg, accelerometry) over this transition would be valuable, as would investigating how PA change is associated with contemporaneous social transitions to better inform PA promotion interventions. Registration PROSPERO ref:CRD42015030114.
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Affiliation(s)
- Kirsten Corder
- UKCRC Centre for Diet and Activity Research (CEDAR) at the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Eleanor Winpenny
- UKCRC Centre for Diet and Activity Research (CEDAR) at the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Rebecca Love
- UKCRC Centre for Diet and Activity Research (CEDAR) at the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Helen Elizabeth Brown
- UKCRC Centre for Diet and Activity Research (CEDAR) at the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Martin White
- UKCRC Centre for Diet and Activity Research (CEDAR) at the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Esther van Sluijs
- UKCRC Centre for Diet and Activity Research (CEDAR) at the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
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14
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Cardiovascular Risk Factors From Childhood and Midlife Cognitive Performance. J Am Coll Cardiol 2017; 69:2279-2289. [DOI: 10.1016/j.jacc.2017.02.060] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/13/2017] [Accepted: 02/28/2017] [Indexed: 01/08/2023]
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15
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Latsuzbaia A, Jaddoe VWV, Hofman A, Franco OH, Felix JF. Associations of genetic variants for adult lipid levels with lipid levels in children. The Generation R Study. J Lipid Res 2016; 57:2185-2192. [PMID: 27777320 DOI: 10.1194/jlr.p066902] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 10/19/2016] [Indexed: 01/14/2023] Open
Abstract
Lipid concentrations are heritable traits. Recently, the number of known genetic loci associated with lipid levels in adults increased from 95 to 157. The effects of these 157 loci have not been tested in children. Considering that lipid levels track from childhood to adulthood, we studied to determine whether these variants already affected lipid concentrations in a large group of 2,645 children with a median age of 6.0 years (95% range 5.7-7.3 years) from the population-based Generation R Study. Twenty-eight SNPs associated with TGs, 39 SNPs associated with total cholesterol (TC), 28 SNPs associated with LDL cholesterol (LDL-C), and 56 SNPs associated with HDL cholesterol (HDL-C) were analyzed individually and combined into genetic risk scores (GRSs). All risk scores were associated with their specific outcomes. The differences in mean absolute lipid and lipoprotein values between the 10% of children with the highest lipid or lipoprotein GRS versus the 10% with the lowest score were 0.28, 0.25, 0.32, and 0.30 mmol/l for TGs, TC, LDL-C, and HDL-C, respectively. In conclusion, we show for the first time that GRSs based on 157 SNPs associated with adult lipid concentrations are associated with lipid levels in children. The genetic background of these phenotypes at least partly overlaps between children and adults.
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Affiliation(s)
- Ardashel Latsuzbaia
- The Generation R Study Group Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Departments of Epidemiology Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Albert Hofman
- Departments of Epidemiology Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Oscar H Franco
- Departments of Epidemiology Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Janine F Felix
- The Generation R Study Group Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands .,Departments of Epidemiology Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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16
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Suomela E, Oikonen M, Pitkänen N, Ahola-Olli A, Virtanen J, Parkkola R, Jokinen E, Laitinen T, Hutri-Kähönen N, Kähönen M, Lehtimäki T, Taittonen L, Tossavainen P, Jula A, Loo BM, Mikkilä V, Telama R, Viikari JSA, Juonala M, Raitakari OT. Childhood predictors of adult fatty liver. The Cardiovascular Risk in Young Finns Study. J Hepatol 2016; 65:784-790. [PMID: 27235307 DOI: 10.1016/j.jhep.2016.05.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 04/28/2016] [Accepted: 05/09/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Fatty liver is a potentially preventable cause of serious liver diseases. This longitudinal study aimed to identify childhood risk factors of fatty liver in adulthood in a population-based group of Finnish adults. METHODS Study cohort included 2,042 individuals from the Cardiovascular Risk in Young Finns Study aged 3-18years at baseline in 1980. During the latest follow-up in 2011, the liver was scanned by ultrasound. In addition to physical and environmental factors related to fatty liver, we examined whether the genetic risk posed by a single nucleotide polymorphism in the patatin-like phospholipase domain-containing protein 3 gene (PNPLA3) (rs738409) strengthens prediction of adult fatty liver. RESULTS Independent childhood predictors of adult fatty liver were small for gestational age, (odds ratio=1.71, 95% confidence interval=1.07-2.72), variant in PNPLA3 (1.63, 1.29-2.07 per one risk allele), variant in the transmembrane 6 superfamily 2 gene (TM6SF2) (1.57, 1.08-2.30), BMI (1.30, 1.07-1.59 per standard deviation) and insulin (1.25, 1.05-1.49 per standard deviation). Childhood blood pressure, physical activity, C-reactive protein, smoking, serum lipid levels or parental lifestyle factors did not predict fatty liver. Risk assessment based on childhood age, sex, BMI, insulin levels, birth weight, TM6SF2 and PNPLA3 was superior in predicting fatty liver compared with the approach using only age, sex, BMI and insulin levels (C statistics, 0.725 vs. 0.749; p=0.002). CONCLUSIONS Childhood risk factors on the development of fatty liver were small for gestational age, high insulin and high BMI. Prediction of adult fatty liver was enhanced by taking into account genetic variants in PNPLA3 and TM6SF2 genes. LAY SUMMARY The increase in pediatric obesity emphasizes the importance of identification of children and adolescents at high risk of fatty liver in adulthood. We used data from the longitudinal Cardiovascular Risk in Young Finns Study to examine the associations of childhood (3-18years) risk variables with fatty liver assessed in adulthood at the age of 34-49years. The findings suggest that a multifactorial approach with both lifestyle and genetic factors included would improve early identification of children with a high risk of adult fatty liver.
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Affiliation(s)
- Emmi Suomela
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
| | - Mervi Oikonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Niina Pitkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Ari Ahola-Olli
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Johanna Virtanen
- Department of Radiology, Turku University Central Hospital, Medical Imaging Centre of Southwest Finland, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, Turku University Central Hospital, Medical Imaging Centre of Southwest Finland, Turku, Finland
| | - Eero Jokinen
- Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Terho Lehtimäki
- Fimlab Laboratories and Department of Clinical Chemistry, School of Medicine, University of Tampere, Tampere, Finland
| | - Leena Taittonen
- Vaasa Central Hospital, Vaasa, Finland and Department of Pediatrics, University of Oulu, Oulu, Finland
| | - Päivi Tossavainen
- Department of Children and Adolescents, Oulu University Hospital, PEDEGO Research Unit and Medical Research Centre Oulu, University of Oulu, Oulu, Finland
| | - Antti Jula
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland
| | - Britt-Marie Loo
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland
| | - Vera Mikkilä
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Division of Nutrition, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland
| | - Risto Telama
- LIKES-Research Centre for Sport and Health Sciences, Jyväskylä, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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17
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Pitkänen N, Juonala M, Rönnemaa T, Sabin MA, Hutri-Kähönen N, Kähönen M, Lehtimäki T, Viikari JSA, Raitakari OT. Role of Conventional Childhood Risk Factors Versus Genetic Risk in the Development of Type 2 Diabetes and Impaired Fasting Glucose in Adulthood: The Cardiovascular Risk in Young Finns Study. Diabetes Care 2016; 39:1393-9. [PMID: 27298332 DOI: 10.2337/dc16-0167] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/06/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We examined whether the addition of novel genetic risk variant data to conventional childhood risk factors improves risk assessment of impaired fasting glucose (IFG) and type 2 diabetes in adulthood. RESEARCH DESIGN AND METHODS An association of a weighted genetic risk score (wGRS) based on 73 risk variants with IFG and type 2 diabetes was analyzed in 2,298 participants of the Cardiovascular Risk in Young Finns Study who were followed for 24-31 years from childhood to adulthood. In addition, the value of the wGRS in pediatric prediction of type 2 diabetes was examined. RESULTS Of the 2,298 participants, 484 (21.8%) and 79 (3.4%) had IFG or type 2 diabetes in adulthood, respectively. Adjusting for age, sex, baseline BMI, parental diabetes, mother's BMI, fasting insulin concentration, systolic blood pressure, and smoking status, wGRS was associated with an increased risk of IFG (odds ratio 1.64 [95% CI 1.33-2.01] per unit increase in the wGRS) and type 2 diabetes (2.22 [1.43-3.44]). Incorporating wGRS into pediatric risk models improved model discrimination and reclassification properties. Area under the receiver operating curve improved for IFG (from 0.678 to 0.691, P = 0.015), combined IFG and type 2 diabetes outcome (from 0.678 to 0.692, P = 0.007), and type 2 diabetes (from 0.728 to 0.749, P = 0.158). The net reclassification improvement and integrated discrimination improvement were significant for all outcomes. CONCLUSIONS A multifactorial approach combining genetic and clinical risk factors may be useful in identifying children at high risk for adult IFG and type 2 diabetes.
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Affiliation(s)
- Niina Pitkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Markus Juonala
- Division of Medicine, Turku University Hospital, Turku, Finland Department of Medicine, University of Turku, Turku, Finland
| | - Tapani Rönnemaa
- Division of Medicine, Turku University Hospital, Turku, Finland Department of Medicine, University of Turku, Turku, Finland
| | - Matthew A Sabin
- Murdoch Childrens Research Institute, Royal Children's Hospital, Australia, and Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere, and Tampere University Hospital, Tampere, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, University of Tampere, and Tampere University Hospital, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, and School of Medicine, University of Tampere, Tampere, Finland
| | - Jorma S A Viikari
- Division of Medicine, Turku University Hospital, Turku, Finland Department of Medicine, University of Turku, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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18
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Majid HA, Amiri M, Mohd Azmi N, Su TT, Jalaludin MY, Al-Sadat N. Physical activity, body composition and lipids changes in adolescents: analysis from the MyHeART Study. Sci Rep 2016; 6:30544. [PMID: 27465116 PMCID: PMC4964611 DOI: 10.1038/srep30544] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 07/06/2016] [Indexed: 12/22/2022] Open
Abstract
Insufficient physical activity and growing obesity levels among Malaysian adolescents are becoming a public health concern. Our study is to identify the trends of self-reported physical activity (PA) levels, blood lipid profiles, and body composition (BC) indices from a cohort of 820 adolescents. The self-reported PA was assessed using a validated Malay version of the PA Questionnaire for Older Children (PAQ-C). Fasting blood samples were collected to investigate their lipid profiles. Height, weight, waist and hip circumferences as well as body fat percentage were measured. The baseline and the first follow-up were conducted in 2012 and 2014, respectively. A downward trend in the PA level was seen in all categories with a significant reduction among all rural adolescents (P = 0.013) and more specifically, PA among girls residing in rural areas dropped significantly (P = 0.006). Either a significant reduction in high-density lipoprotein (HDL) or a significant increment in BC indices (i.e., body mass index [BMI], waist circumference [WC], hip circumference, and body fat percentage [BF %]) were seen in this group. Female adolescents experienced more body fat increment with the reduction of physical activity. If not intervened early, adolescents from rural areas may increase their risk of developing cardiovascular diseases earlier.
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Affiliation(s)
- Hazreen Abdul Majid
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mohammadreza Amiri
- Department of Development Studies, Faculty of Economics and Administration, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Nahar Mohd Azmi
- Dean's Office, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Tin Tin Su
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.,Centre for Population Health, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Muhammad Yazid Jalaludin
- Department of Paediatrics, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Nabilla Al-Sadat
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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19
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Magnussen CG, Cheriyan S, Sabin MA, Juonala M, Koskinen J, Thomson R, Skilton MR, Kähönen M, Laitinen T, Taittonen L, Hutri-Kähönen N, Viikari JSA, Raitakari OT. Continuous and Dichotomous Metabolic Syndrome Definitions in Youth Predict Adult Type 2 Diabetes and Carotid Artery Intima Media Thickness: The Cardiovascular Risk in Young Finns Study. J Pediatr 2016; 171:97-103.e1-3. [PMID: 26681473 DOI: 10.1016/j.jpeds.2015.10.093] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 10/02/2015] [Accepted: 10/29/2015] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To examine the utility of continuous metabolic syndrome (cMetS) scores vs a dichotomous metabolic syndrome (MetS) definition in youth to predict adult type 2 diabetes mellitus (T2DM) and carotid intima-media thickness (IMT). STUDY DESIGN Participants (n = 1453) from the population-based, prospective, observational Cardiovascular Risk in Young Finns Study who were examined in youth (when aged 9-18 years) and re-examined 15-25 years later. Four cMetS scores were constructed according to procedures most often used in the literature that comprised the youth risk factor inputs of body mass index, blood pressure, glucose, insulin, high-density lipoprotein-cholesterol, and triglycerides. Adult outcomes included T2DM and high carotid IMT (≥ 90 th percentile). RESULTS For a 1 SD increase in cMetS scores in youth, participants had a 30%-78% increased risk of T2DM and 12%-61% increased risk of high carotid IMT. Prediction of adult T2DM and high carotid IMT using cMetS scores in youth was essentially no different to a dichotomous MetS definition with area under the receiver-operating characteristic curve ranging from 0.54-0.60 (continuous definitions) and 0.55-0.59 (dichotomous) with 95% CIs often including 0.5, and integrated discrimination improvement from -0.2% to -0.6%. CONCLUSIONS cMetS scores in youth are predictive of cardiometabolic outcomes in adulthood. However, they do not have increased predictive utility over a dichotomous definition of MetS.
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Affiliation(s)
- Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
| | - Sanith Cheriyan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Matthew A Sabin
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia; Department of Pediatrics, University of Melbourne, Parkville, Australia
| | - Markus Juonala
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia; Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Juha Koskinen
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Russell Thomson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Michael R Skilton
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, Australia
| | - Mika Kähönen
- Department of Clinical Physiology, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Leena Taittonen
- Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, University of Turku, Turku, Finland
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20
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Buscot MJ, Magnussen CG, Juonala M, Pitkänen N, Lehtimäki T, Viikari JSA, Kähönen M, Hutri-Kähönen N, Schork NJ, Raitakari OT, Thomson RJ. The Combined Effect of Common Genetic Risk Variants on Circulating Lipoproteins Is Evident in Childhood: A Longitudinal Analysis of the Cardiovascular Risk in Young Finns Study. PLoS One 2016; 11:e0146081. [PMID: 26731281 PMCID: PMC4701181 DOI: 10.1371/journal.pone.0146081] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 12/11/2015] [Indexed: 12/22/2022] Open
Abstract
Low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) are modifiable risk factors for cardiovascular disease. Several genetic loci for predisposition to abnormal LDL-C, HDL-C and TG have been identified. However, it remains unclear whether these loci are consistently associated with serum lipid levels at each age or with unique developmental trajectories. Therefore, we assessed the association between genome wide association studies (GWAS) derived polygenic genetic risk scores and LDL-C, HDL-C, and triglyceride trajectories from childhood to adulthood using data available from the 27-year European ‘Cardiovascular Risk in Young Finns’ Study. For 2,442 participants, three weighted genetic risk scores (wGRSs) for HDL-C (38 SNPs), LDL-C (14 SNPs) and triglycerides (24 SNPs) were computed and tested for association with serum lipoprotein levels measured up to 8 times between 1980 and 2011. The categorical analyses revealed no clear divergence of blood lipid trajectories over time between wGRSs categories, with participants in the lower wGRS quartiles tending to have average lipoprotein concentrations 30 to 45% lower than those in the upper-quartile wGRS beginning at age 3 years and continuing through to age 49 years (where the upper-quartile wGRS have 4–7 more risk alleles than the lower wGRS group). Continuous analyses, however, revealed a significant but moderate time-dependent genetic interaction for HDL-C levels, with the association between HDL-C and the continuous HDL-C risk score weakening slightly with age. Conversely, in males, the association between the continuous TG genetic risk score and triglycerides levels tended to be lower in childhood and become more pronounced after the age of 25 years. Although the influence of genetic factors on age-specific lipoprotein values and developmental trajectories is complex, our data show that wGRSs are highly predictive of HDL-C, LDL-C, and triglyceride levels at all ages.
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Affiliation(s)
- Marie-jeanne Buscot
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- * E-mail:
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Markus Juonala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
- Murdoch Children Research Institute, Parkville, Australia
| | - Niina Pitkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Terho Lehtimäki
- Fimlab Ltd, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Jorma S. A. Viikari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital, Finland
| | - Nicholas J. Schork
- Human Biology, The J. Craig Venter Institute, La Jolla, CA, United States of America
| | - Olli T. Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Russell J. Thomson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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Nuotio J, Oikonen M, Magnussen CG, Viikari JSA, Hutri-Kähönen N, Jula A, Thomson R, Sabin MA, Daniels SR, Raitakari OT, Juonala M. Adult dyslipidemia prediction is improved by repeated measurements in childhood and young adulthood. The Cardiovascular Risk in Young Finns Study. Atherosclerosis 2015; 239:350-7. [PMID: 25682034 DOI: 10.1016/j.atherosclerosis.2015.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 01/14/2015] [Accepted: 02/03/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Prediction of adult dyslipidemia has been suggested to improve with multiple measurements in childhood or young adulthood, but there is paucity of specific data from longitudinal studies. METHODS AND RESULTS The sample comprised 1912 subjects (54% women) from the Cardiovascular Risk in Young Finns Study who had fasting lipid and lipoprotein measurements collected at three time-points in childhood/young adulthood and had at least one follow-up in later adulthood. Childhood/young adult dyslipidemia was defined as total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C) or triglycerides (TG) in the highest quintile, or high-density lipoprotein cholesterol (HDL-C) in the lowest quintile. Adult dyslipidemia was defined according to European cut-points (TC > 5.0 mmol/L, LDL-C >3 mmol/L, Non-HDL-C >3.8 mmol/L, HDL-C <1.0 mmol/L (in men)/<1.2 mmol/L (in women) and TG > 1.7 mmol/L). With the exception of triglycerides, Pearson correlation coefficients for predicting adult levels significantly improved when two lipid or lipoprotein measurements in childhood/young adulthood were compared with one measurement (all P < 0.01). For triglycerides, there was significant improvement only when three measurements were considered (P = 0.004). Two measurements significantly improved prediction of dyslipidemia levels in adulthood for non-HDL-C, LDL-C, HDL-C and TG compared with one measurement (P < 0.05 for improved area-under the receiver-operating characteristic curve). Risk of dyslipidemia in adulthood grew according to the number of times a person had been at risk in childhood. CONCLUSIONS Based on these results, it seems that compared to a single measurement two lipid measures in childhood/early adulthood significantly improve prediction of adult dyslipidemia. A lack of dyslipidemia in childhood does not strongly exclude later development of dyslipidemia. Multiple measurements increase the prediction accuracy, but the incremental prognostic/diagnostic accuracy of especially third measurement is modest.
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Affiliation(s)
- Joel Nuotio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
| | - Mervi Oikonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - Jorma S A Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Antti Jula
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland
| | - Russell Thomson
- Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - Matthew A Sabin
- Murdoch Childrens Research Institute, Melbourne, Australia; Royal Children's Hospital and University of Melbourne, Melbourne, Australia
| | - Stephen R Daniels
- Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, USA
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; The Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland; Murdoch Childrens Research Institute, Melbourne, Australia
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Harville EW, Juonala M, Viikari JSA, Raitakari OT. Preconception metabolic indicators predict gestational diabetes and offspring birthweight. Gynecol Endocrinol 2014; 30:840-4. [PMID: 25007009 DOI: 10.3109/09513590.2014.937336] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Pregnancy conditions such as gestational diabetes (GDM) and macrosomia lead to an increased risk of diabetes and cardiovascular disease in the offspring, perpetuating a cycle of poor health. We hypothesized that (1) pre-pregnancy indicators of metabolism would be associated with GDM and birthweight; and (2) the lipid accumulation product (LAP; incorporating waist circumference and triglycerides) and visceral adiposity index (VAI; incorporating waist circumference, triglycerides, and HDL-c) would be better predictors of GDM and birthweight than other indicators. Data from the Cardiovascular Risk in Young Finns Study were linked to the Finnish birth registry for 349 women. BMI, triglycerides, waist circumference, insulin, HOMA-IR, LAP, and VAI at the visit prior to the pregnancy were examined as predictors of GDM and large-for-gestational-age (LGA) using logistic regression with adjustment for age, parity, and smoking. Waist circumference was the strongest predictor of GDM (adjusted odds ratio [aOR] 1.66, 95% confidence interval 1.16-2.38) and LGA (aOR 1.41, 1.00-1.99). For GDM, all markers had similar discrimination; for LGA, the area under the receiver operating curve for waist circumference was significantly higher than for BMI (p < 0.01). This analysis suggests that pregnancy and even offspring health is affected by risk factors outside the immediate time period of pregnancy.
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Affiliation(s)
- Emily W Harville
- Tulane School of Public Health and Tropical Medicine , New Orleans , LA
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Pälve KS, Pahkala K, Magnussen CG, Koivistoinen T, Juonala M, Kähönen M, Lehtimäki T, Rönnemaa T, Viikari JSA, Raitakari OT. Association of physical activity in childhood and early adulthood with carotid artery elasticity 21 years later: the cardiovascular risk in Young Finns Study. J Am Heart Assoc 2014; 3:e000594. [PMID: 24755150 PMCID: PMC4187482 DOI: 10.1161/jaha.113.000594] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Decreased arterial elasticity is a risk factor for several cardiovascular outcomes. Longitudinal data on the effect of physical activity in youth on adult arterial elasticity are limited. The aim of this study was to determine the long-term effects of physical activity in children and young adults on carotid artery elasticity after 21 years of follow-up. METHODS AND RESULTS Participants were 1417 children (aged 9 to 15 years) and 999 young adults (aged 18 to 24 years) from the prospective Cardiovascular Risk in Young Finns Study. Participants had questionnaire measures of leisure-time physical activity available from 1986 and ultrasound-derived indices of carotid artery elasticity measured in 2007. Carotid artery elasticity indices were distensibility (%/10 mm Hg), Young's elastic modulus (kPa), and stiffness index (unitless). Physical activity at age 18 to 24 years was directly associated with distensibility (β=0.068, P=0.014) and inversely with Young's elastic modulus (β=-0.057, P=0.0037) and indirectly with stiffness index (β=-0.050, P=0.0028) 21 years later in males and females. The associations remained after adjustment for age, sex, body mass index, smoking, systolic blood pressure, serum lipids and insulin, and 21-year change in physical activity. At age 9 to 15 years, the favorable association, remaining after adjustment, was found in males (distensibility [β=0.097, P=0.010], Young's elastic modulus [β=-0.060, P=0.028], and stiffness index [β=-0.062, P=0.007]) but not in females (P=0.70, P=0.85, and P=0.91, respectively). CONCLUSIONS Leisure-time physical activity in boys and young adults is associated with carotid artery elasticity later in life, suggesting that higher levels of physical activity in youth may benefit future cardiovascular health.
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Affiliation(s)
- Kristiina S Pälve
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Chumaeva N, Hintsanen M, Pulkki-Råback L, Jokela M, Juonala M, Lehtimäki T, Raitakari OT, Keltikangas-Järvinen L. Interleukin-6 gene polymorphism, chronic stress and atherosclerosis: interleukin-6-174G>C polymorphism, chronic stress and risk of early atherosclerosis in the Cardiovascular Risk in Young Finns Study. J Psychosom Res 2014; 76:333-8. [PMID: 24630186 DOI: 10.1016/j.jpsychores.2014.01.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 01/14/2014] [Accepted: 01/21/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Interleukin-6 protein has been suggested as a mediator connecting chronic stress and cardiovascular diseases. We investigated whether the functional G174C polymorphism (rs1800795) of interleukin-6 gene is associated with vital exhaustion, a measure of chronic stress, or with preclinical atherosclerosis. METHODS Associations between the interleukin-6-174G>C polymorphism, preclinical atherosclerosis, and vital exhaustion were examined in 1673 women and men aged 24-39years participating in the Cardiovascular Risk in Young Finns study. Vital exhaustion was measured using Maastricht Questionnaire. Preclinical atherosclerosis was assessed by carotid intima-media thickness using ultrasound techniques. DNA was genotyped for the interleukin-6-174G>C polymorphism (rs1800795). RESULTS The GG genotype of the interleukin-6-174G>C polymorphism was associated with higher vital exhaustion. Moreover, higher vital exhaustion was associated with greater intima-media thickness in men carrying G alleles, adjusted for cardiovascular risk factors. CONCLUSION Our findings support a role for the interleukin-6-174G>C polymorphism in increased risk of atherosclerosis in individuals with chronic stress. In addition, individuals carrying the G allele of the interleukin-6-174G>C polymorphism may be more prone to adverse effects of psychosocial stress.
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Affiliation(s)
- Nadja Chumaeva
- Institute of Behavioural Sciences, University of Helsinki, Finland
| | - Mirka Hintsanen
- Institute of Behavioural Sciences, University of Helsinki, Finland; Helsinki Collegium for Advanced Studies, University of Helsinki, Finland.
| | - Laura Pulkki-Råback
- Institute of Behavioural Sciences, University of Helsinki, Finland; Finnish Institute of Occupational Health, Helsinki, Finland
| | - Markus Jokela
- Institute of Behavioural Sciences, University of Helsinki, Finland
| | - Markus Juonala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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Lilly CL, Gebremariam YD, Cottrell L, John C, Neal W. Trends in serum lipids among 5th grade CARDIAC participants, 2002-2012. J Epidemiol Community Health 2013; 68:218-23. [PMID: 24218074 DOI: 10.1136/jech-2013-203253] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Studies have shown that serum low-density lipoprotein (LDL-C) and non-high-density lipoprotein (non-HDL-C) have recently declined in the U.S.A. among adult and child populations despite high obesity prevalence rates. The purpose of this study was to assess whether there was a significant linear decrease in LDL-C and non-HDL-C, but not Body Mass Index (BMI) percentile among a cross-sectional, large, homogenous cohort with consistent methodology over the past decade. METHODS A total of 47,198 children, mostly between 10 and 11 years old, participating between 2002 and 2012 were examined to assess trends in serum lipid concentration and BMI percentile. RESULTS For LDL-C, year of screening was significant (p<0.0001) even with the inclusion of gender, age and BMI (all p<0.0001). For non-HDL-C, year of screening was also significant (p<0.0001), even with the inclusion of gender (p=0.0445), age (p<0.0001), BMI (p<0.0001) and systolic blood pressure (p=0.0021). Although some non-linear trends were also significant (e.g., a quartic trend, p<0.001), the linear trend provided the best fit for both cholesterol models. By comparison, we noted general maintenance of BMI percentile over time. CONCLUSIONS Between 2002 and 2012, among 5th grade Appalachian children, there was a consistent linear decrease in LDL-C and non-HDL-C despite continued high prevalence rates of obesity, diabetes and hypertension. The improvement in LDL-C and non-HDL-C could be due to multifactorial causes.
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Affiliation(s)
- Christa L Lilly
- Department of Biostatistics, School of Public Health, West Virginia University, , Morgantown, West Virginia, USA
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26
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Kaikkonen JE, Jula A, Mikkilä V, Juonala M, Viikari JSA, Moilanen T, Nikkari T, Kähönen M, Lehtimäki T, Raitakari OT. Childhood serum fatty acid quality is associated with adult carotid artery intima media thickness in women but not in men. J Nutr 2013; 143:682-9. [PMID: 23486978 DOI: 10.3945/jn.112.172866] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Childhood nutrition may play a role in the development of cardiovascular disease risk in adulthood. We examined the links between childhood dietary fatty acid quality and adult subclinical atherosclerosis in a cohort of 374 males and 449 females, aged 3-18 y at baseline in 1980, followed for 27 y. Serum cholesterol ester fatty acid (CEFA) percentages were analyzed as markers of dietary fatty acid intake. Adulthood carotid artery intima media thickness (cIMT, μm), adjusted for childhood and adulthood lipid and nonlipid risk markers, was used as the outcome. In women, after adjustment for age and childhood nonlipid risk markers, the childhood saturated CEFA (B = 11.3; P = 0.011), monounsaturated CEFA (B = 2.5; P = 0.025), and n3 (ω3) polyunsaturated CEFA (B = 16.2; P = 0.035) percentages were directly associated with adult cIMT. In contrast, the n6 (ω6) polyunsaturated CEFA percentage was negatively associated with cIMT (B = -2.3; P = 0.008). Similar relationships were observed between childhood dietary intake data and adult cIMT. In men, these associations were generally weak and nonsignificant (P > 0.05) after controlling for confounders. These longitudinal data suggest that fat quality as reflected in the serum cholesterol ester fraction in childhood is associated with adult cIMT in women.
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Affiliation(s)
- Jari E Kaikkonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Juonala M, Viikari JSA, Raitakari OT. Main findings from the prospective Cardiovascular Risk in Young Finns Study. Curr Opin Lipidol 2013; 24:57-64. [PMID: 23069987 DOI: 10.1097/mol.0b013e32835a7ed4] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW To provide a comprehensive overview on the main findings from the Cardiovascular Risk in Young Finns Study. This prospective multicenter study initiated in 1980 (N = 3596, baseline age 3-18 years) has followed up study participants over 30 years to investigate childhood risk factors for cardiometabolic outcomes in adulthood. RECENT FINDINGS Childhood BMI, socioeconomic status, parental risk factor status, as well as genetic polymorphisms are independent predictors of adult obesity, hypertension, and dyslipidemia. Results from the Young Finns Study and other follow-up studies have shown that conventional childhood risk factors, such as dyslipidemia, obesity, elevated blood pressure and smoking, are predictive of subclinical atherosclerosis in young adults. Recent findings suggest that childhood lifestyle (diet, physical activity) is associated with subclinical atherosclerosis and its progression in adulthood. Concerning the timing of risk factor measurements, they seem to be predictive of adult atherosclerosis from the age of 9 onwards. From a clinical point of view, a recent observation suggesting that the adverse cardiometabolic effects of childhood overweight/obesity are reversed among those who become nonobese adults, provides optimism during the days of obesity epidemic. SUMMARY Current data suggest that childhood risk factors are associated with higher risk of subclinical atherosclerosis in adulthood. Future studies among aging cohorts followed since childhood will provide data on their influence on clinical cardiovascular outcomes.
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Affiliation(s)
- Markus Juonala
- University of Turku and Turku University Hospital, Cardiovascular Research Center, Turku, Finland.
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Nielsen TRH, Gamborg M, Fonvig CE, Kloppenborg J, Hvidt KN, Ibsen H, Holm JC. Changes in lipidemia during chronic care treatment of childhood obesity. Child Obes 2012. [PMID: 23181919 DOI: 10.1089/chi.2011.0098] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Childhood obesity and related co-morbidities are increasing. This intervention study assessed the associations between weight changes and lipidemia in obese children and adolescents. METHODS A total of 240 obese children and adolescents (median age, 11.3 years; range, 3.9-20.9) were enrolled in a best-practice multidisciplinary chronic care treatment program. The concentrations of total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TGs) and anthropometric data comprising height and weight were collected at baseline and after up to 39 months of continuous treatment. RESULTS The BMI standard deviation score (SDS) decreased in 51% of patients and maintained unchanged in 32% of patients during the treatment. At baseline, 65 (27.1%) of the patients exhibited dyslipidemia defined as increased concentrations of total cholesterol (>200 mg/dL), LDL (>130 mg/dL), or TGs (>150 mg/dL), or decreased HDL concentration (<35 mg/dL). Dyslipidemia improved with weight loss; the odds ratio (OR) was 0.37 per BMI SDS (p = 0.014) after adjusting for age, sex, and baseline BMI SDS. Baseline TG concentration correlated positively and HDL concentration correlated negatively with baseline BMI SDS. Weight loss was associated with a decrease in the concentrations of total cholesterol (p = 0.0005), LDL (p < 0.0001), non-HDL (p < 0.0001), and TGs (p < 0.0001), and with an increase in HDL concentration (p < 0.0001). CONCLUSION High lipid concentrations were associated with childhood obesity. The lipid profile improved during weight loss independently of the baseline BMI SDS and baseline lipid concentration.
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Mansikkaniemi K, Juonala M, Taimela S, Hirvensalo M, Telama R, Huupponen R, Saarikoski L, Hurme M, Mallat Z, Benessiano J, Jula A, Taittonen L, Marniemi J, Kähönen M, Lehtimäki T, Rönnemaa T, Viikari J, Raitakari OT. Cross-sectional associations between physical activity and selected coronary heart disease risk factors in young adults. The Cardiovascular Risk in Young Finns Study. Ann Med 2012; 44:733-44. [PMID: 21721849 DOI: 10.3109/07853890.2011.590146] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Physical activity (PA) may reduce the risk of coronary heart disease (CHD) by inducing beneficial changes in several risk factors. We studied the associations between PA and a range of risk markers of CHD in young adults. METHODS AND RESULTS We measured serum lipoproteins, oxidized LDL, adipokines, inflammatory markers, metabolic markers, and arginine metabolites in 2,268 individuals (age 24-39 y). Participants were asked frequency, duration, and intensity of PA in leisure time. In addition, commuting to work was assessed. In both sexes, PA was inversely associated with waist circumference (all P < 0.0001). After controlling for sex, age, and waist circumference, PA was directly associated with HDL-cholesterol and apolipoprotein A1, and inversely with heart rate, smoking, oxidized LDL, apolipoprotein B, insulin, glucose, C-reactive protein, leptin, L-arginine, and phospholipase A2 activity (all P < 0.05). CONCLUSION These population-based data are consistent with the idea that the beneficial effects of PA on CHD risk are mediated by favorable influences on several risk factors, as judged by independent relations to markers of lipoprotein metabolism, glucose metabolism, and inflammation. These associations reflect beneficial effects on cardiovascular health in both sexes and may offer mechanistic insights for the inverse association between PA and CHD.
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Affiliation(s)
- Kristiina Mansikkaniemi
- The Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Adolescence risk factors are predictive of coronary artery calcification at middle age: the cardiovascular risk in young Finns study. J Am Coll Cardiol 2012; 60:1364-70. [PMID: 22981553 DOI: 10.1016/j.jacc.2012.05.045] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Revised: 04/26/2012] [Accepted: 05/15/2012] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The purpose of this study was to examine the roles of adolescence risk factors in predicting coronary artery calcium (CAC). BACKGROUND Elevated coronary heart disease risk factor levels in adolescence may predict subsequent CAC independently of change in risk factor levels from adolescence to adulthood. METHODS CAC was assessed in 589 subjects 40 to 46 years of age from the Cardiovascular Risk in Young Finns Study. Risk factor levels were measured in 1980 (12 to 18 years) and in 2007. RESULTS The prevalence of any CAC was 19.2% (27.9% in men and 12.2% in women). Age, levels of systolic blood pressure (BP), total cholesterol, and low-density lipoprotein cholesterol (LDL-C) in adolescence, as well as systolic BP, total cholesterol, diastolic BP, and pack-years of smoking in adulthood were higher among subjects with CAC than those without CAC. Adolescence LDL-C and systolic BP levels predicted CAC in adulthood independently of 27-year changes in these risk factors. The multivariable odds ratios were 1.34 (95% confidence interval: 1.05 to 1.70; p=0.02) and 1.38 (95% confidence interval: 1.08 to 1.77; p=0.01), for 1-SD increase in adolescence LDL-C and systolic BP, respectively. Exposure to both of these risk factors in adolescence (defined as values at or above the age- and sex-specific 75th percentile) substantially increased the risk of CAC (multivariable odds ratio: 3.5 [95% confidence interval: 1.7 to 7.2; p=0.007]) between groups with no versus both risk factors. CONCLUSIONS Elevated adolescence LDL-C and systolic BP levels are independent predictors of adulthood CAC, indicating that adolescence risk factor levels play an important role in the pathogenesis of coronary heart disease.
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Abstract
BACKGROUND Pregnancy-related cardiovascular conditions are associated with both poorer pregnancy outcomes and cardiovascular disease later in life. Little is known about the relationship between preconception cardiovascular risk factor levels and pregnancy complications. METHODS Data from the Cardiovascular Risk in Young Finns Study were linked with birth registry data for 1142 primiparous women. Age-standardized levels of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, blood pressure, insulin, and glucose from the study visit prior to last menstrual period were calculated. These factors were examined as predictors of gestational age, preterm birth (<37 weeks), birthweight, low birthweight (<2500 g), small-for-gestational-age (weight <10th percentile for gestational age), hypertensive disorders of pregnancy, and gestational diabetes, using linear and Poisson regression with adjustment for age, body mass index, smoking, and socioeconomic status. RESULTS Higher triglycerides were associated with a higher risk of hypertensive disorders (adjusted risk ratio [aRR] = 1.42 [95% confidence interval (CI) = 0.90-2.23]), preeclampsia (1.70 [1.08-2.65]), and gestational diabetes (1.68 [1.25-2.25]). After removing women with pregnancy complications (n = 30), the estimated aRR for the association between systolic blood pressure and preterm birth was 1.23 (95% CI = 0.99-1.54); for HDL-c and low birthweight, 0.97 (0.73-1.28); for diastolic blood pressure and small-for-gestational-age, 0.98 (0.81-1.20); and for systolic blood pressure and small-for-gestational-age, 1.18 (0.97-1.45). CONCLUSIONS High lipid levels before pregnancy predict an increased risk of preeclampsia and gestational diabetes. Reported associations between these pregnancy complications and later cardiovascular disease of the mother are probably explained, at least in part, by maternal conditions that precede pregnancy. Interventions to improve cardiovascular health before pregnancy may reduce risk of pregnancy complications.
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Niinikoski H, Pahkala K, Ala-Korpela M, Viikari J, Rönnemaa T, Lagström H, Jokinen E, Jula A, Savolainen MJ, Simell O, Raitakari OT. Effect of repeated dietary counseling on serum lipoproteins from infancy to adulthood. Pediatrics 2012; 129:e704-13. [PMID: 22331346 DOI: 10.1542/peds.2011-1503] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE As atherosclerosis is a lifelong process, prevention of exposure to its risk factors should start at an early age. Our aim was to study the influences of repeated low saturated fat dietary counseling on dietary intakes and lipoprotein measures from infancy to adulthood. METHODS Dietary intakes (food records) and serum lipid profile were studied annually from 7 months to 19 years of age in an atherosclerosis prevention study (Special Turku Coronary Risk Factor Intervention Project), comprising 540 children in the intervention group and 522 children in the control group. Serum total and high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured and used to estimate very low-density lipoprotein-TG, intermediate-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and HDL(2)-C, as well as apolipoproteins A-1 and B. RESULTS Compared with controls, the intervention children had a lower saturated fat intake (mean daily difference [95% confidence interval] between groups: -2.1 [-2.3, -1.9] percentage of total energy intake in boys; -1.9 [-2.1, -1.7] percentage of total energy intake in girls, both P < .001) and LDL-C concentration (difference [95% confidence interval] between groups: -0.18 [-0.26, -0.10] mmol/L, P < .001 in boys; -0.10 [-0.19, -0.01] mmol/L, P = .037 in girls), whereas HDL-C and apolipoprotein A-1 did not differ between the study groups. In boys, total cholesterol and intermediate-density lipoprotein cholesterol, very low-density lipoprotein-TG, apolipoprotein B, and TG concentrations were also lower in the intervention than in the control group, whereas no differences were found in girls. CONCLUSIONS Repeated dietary counseling is effective in decreasing saturated fat intake and serum LDL-C values from infancy until 19 years of age in both genders. In boys, significant intervention effects are evident in various lipoprotein measures, indicating a more favorable lipid profile in the counseling group.
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Affiliation(s)
- Harri Niinikoski
- Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
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Tikkanen E, Tuovinen T, Widén E, Lehtimäki T, Viikari J, Kähönen M, Peltonen L, Raitakari OT, Ripatti S. Association of Known Loci With Lipid Levels Among Children and Prediction of Dyslipidemia in Adults. ACTA ACUST UNITED AC 2011; 4:673-80. [DOI: 10.1161/circgenetics.111.960369] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Recent genome-wide association studies have found 95 distinct genetic loci associated with high-density (HDL-C) and low-density (LDL-C) lipoprotein cholesterol, total cholesterol (TC), and triglycerides (TG), using adult samples. It is not known if these variants are associated with lipid levels in children and adolescents and if the genetic risk score (GRS), based on these variants, could improve adulthood dyslipidemia prediction over the childhood lipid measurements.
Methods and Results—
We used 2443 participants of the Cardiovascular Risk in Young Finns study cohort with up to 5 measurements of serum lipids taken between ages 3 and 45 years to estimate the effect of individual single-nucleotide polymorphisms and the GRS on lipids. The GRSs were strongly associated with lipids in all age groups (1.5×10
−20
<
P
<8.7×10
−12
for HDL-C, 3.5×10
−27
<
P
<5.6×10
−09
for LDL-C, 2.0×10
−25
<
P
<5.2×10
−09
for TC, and 4.1×10
−20
<
P
<8.4×10
−05
for TG). Jointly, the lipid loci explained 11.8–26.7% of the total variance in lipids among 3- to 6-year-old children, and the proportion dropped over age, except for TG. The discrimination of adult hypertriglyceridemia improved when GRS was added to childhood lipid measurement (
C
statistic=0.04,
P
=0.01).
Conclusions—
Previously identified lipid loci are associated with lipid levels in children and adolescents and explain up to more than 2 times of the lipid variation in children compared with adults. The TG-GRS improves the risk discrimination over childhood lipid measurement for adult hypertriglyceridemia.
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Affiliation(s)
- Emmi Tikkanen
- From the Institute for Molecular Medicine, Finland FIMM, University of Helsinki, Helsinki, Finland (E.T., T.T., E.W., L.P., S.R.); National Institute for Health and Welfare, Helsinki, Finland (E.T., T.T., L.P., S.R.); the Department of Clinical Chemistry, Tampere University Hospital and University of Tampere, Tampere, Finland (T.L.); the Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland (J.V.); the Department of Clinical Physiology, Tampere University Hospital
| | - Tarja Tuovinen
- From the Institute for Molecular Medicine, Finland FIMM, University of Helsinki, Helsinki, Finland (E.T., T.T., E.W., L.P., S.R.); National Institute for Health and Welfare, Helsinki, Finland (E.T., T.T., L.P., S.R.); the Department of Clinical Chemistry, Tampere University Hospital and University of Tampere, Tampere, Finland (T.L.); the Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland (J.V.); the Department of Clinical Physiology, Tampere University Hospital
| | - Elisabeth Widén
- From the Institute for Molecular Medicine, Finland FIMM, University of Helsinki, Helsinki, Finland (E.T., T.T., E.W., L.P., S.R.); National Institute for Health and Welfare, Helsinki, Finland (E.T., T.T., L.P., S.R.); the Department of Clinical Chemistry, Tampere University Hospital and University of Tampere, Tampere, Finland (T.L.); the Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland (J.V.); the Department of Clinical Physiology, Tampere University Hospital
| | - Terho Lehtimäki
- From the Institute for Molecular Medicine, Finland FIMM, University of Helsinki, Helsinki, Finland (E.T., T.T., E.W., L.P., S.R.); National Institute for Health and Welfare, Helsinki, Finland (E.T., T.T., L.P., S.R.); the Department of Clinical Chemistry, Tampere University Hospital and University of Tampere, Tampere, Finland (T.L.); the Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland (J.V.); the Department of Clinical Physiology, Tampere University Hospital
| | - Jorma Viikari
- From the Institute for Molecular Medicine, Finland FIMM, University of Helsinki, Helsinki, Finland (E.T., T.T., E.W., L.P., S.R.); National Institute for Health and Welfare, Helsinki, Finland (E.T., T.T., L.P., S.R.); the Department of Clinical Chemistry, Tampere University Hospital and University of Tampere, Tampere, Finland (T.L.); the Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland (J.V.); the Department of Clinical Physiology, Tampere University Hospital
| | - Mika Kähönen
- From the Institute for Molecular Medicine, Finland FIMM, University of Helsinki, Helsinki, Finland (E.T., T.T., E.W., L.P., S.R.); National Institute for Health and Welfare, Helsinki, Finland (E.T., T.T., L.P., S.R.); the Department of Clinical Chemistry, Tampere University Hospital and University of Tampere, Tampere, Finland (T.L.); the Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland (J.V.); the Department of Clinical Physiology, Tampere University Hospital
| | - Leena Peltonen
- From the Institute for Molecular Medicine, Finland FIMM, University of Helsinki, Helsinki, Finland (E.T., T.T., E.W., L.P., S.R.); National Institute for Health and Welfare, Helsinki, Finland (E.T., T.T., L.P., S.R.); the Department of Clinical Chemistry, Tampere University Hospital and University of Tampere, Tampere, Finland (T.L.); the Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland (J.V.); the Department of Clinical Physiology, Tampere University Hospital
| | - Olli T. Raitakari
- From the Institute for Molecular Medicine, Finland FIMM, University of Helsinki, Helsinki, Finland (E.T., T.T., E.W., L.P., S.R.); National Institute for Health and Welfare, Helsinki, Finland (E.T., T.T., L.P., S.R.); the Department of Clinical Chemistry, Tampere University Hospital and University of Tampere, Tampere, Finland (T.L.); the Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland (J.V.); the Department of Clinical Physiology, Tampere University Hospital
| | - Samuli Ripatti
- From the Institute for Molecular Medicine, Finland FIMM, University of Helsinki, Helsinki, Finland (E.T., T.T., E.W., L.P., S.R.); National Institute for Health and Welfare, Helsinki, Finland (E.T., T.T., L.P., S.R.); the Department of Clinical Chemistry, Tampere University Hospital and University of Tampere, Tampere, Finland (T.L.); the Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland (J.V.); the Department of Clinical Physiology, Tampere University Hospital
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34
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Koivistoinen T, Hutri-Kähönen N, Juonala M, Aatola H, Kööbi T, Lehtimäki T, Viikari JSA, Raitakari OT, Kähönen M. Metabolic syndrome in childhood and increased arterial stiffness in adulthood: the Cardiovascular Risk In Young Finns Study. Ann Med 2011; 43:312-9. [PMID: 21284533 DOI: 10.3109/07853890.2010.549145] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE. We conducted the present study to examine the associations of two different paediatric metabolic syndrome (MetS) definitions and recovery from childhood MetS with arterial pulse wave velocity (PWV), an index of arterial stiffness, measured in adulthood. METHODS. A total of 945 subjects participated in the base-line study in 1986 (then aged 9-18 years) and the adult follow-up in 2007 (then aged 30-39 years). Cardiovascular risk factor data were available at both base-line and follow-up. In the follow-up study, arterial PWV was measured using a whole-body impedance cardiography device. RESULTS. Subjects suffering from MetS in childhood (prevalence 11.1%-14.1%) had higher arterial PWV after 21-year follow-up when compared with those not afflicted by the syndrome in childhood (P < 0.007). An increasing number of the MetS components in childhood were associated with increased PWV in adulthood (P for trend = 0.005). Subjects who recovered from the MetS during the 21-year follow-up period had lower PWV than those with persistent MetS (P < 0.001). CONCLUSION. MetS in childhood predicted increased arterial stiffness in adulthood, and recovery from childhood MetS was associated with decreased arterial PWV in adulthood. The current results emphasize the importance of the prevention and controlling of MetS risk factors both in childhood and adulthood.
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Affiliation(s)
- Teemu Koivistoinen
- Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Finland.
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35
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Vuorela N, Saha MT, Salo MK. Change in prevalence of overweight and obesity in Finnish children - comparison between 1974 and 2001. Acta Paediatr 2011; 100:109-15. [PMID: 20712840 DOI: 10.1111/j.1651-2227.2010.01980.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To analyse the possible changes in the prevalence of overweight and obesity comparing birth cohorts from four different decades in Finland. DESIGN A retrospective longitudinal growth study. METHODS The subjects representing five birth cohorts: 1974 (n = 1109), 1981 (n = 987), 1991 (n = 586), 1995 (n = 856) and 2001 (n = 766) in the city of Tampere and three rural municipalities in Finland. Data included five consecutive height and weight measurements from 2 to 15 years of age. Normal weight, overweight and obesity at the time points were classified by body mass index (BMI, kg/m(2) ) according to international age- and gender-specific BMI cut-off points. The chi-square test was used to analyse the differences in the between birth cohorts. RESULTS The combined prevalence of overweight and obesity decreased significantly in 2-year-old boys (p = 0.009) and girls (p = 0.002) from 1974 to 2001. Insignificant fluctuation was seen in 5- and 7-year-old children. Both the prevalence of obesity and the combined prevalence of overweight and obesity showed a significant increase in 12- (p = 0.031 and p < 0.001) and 15-year-old boys (p < 0.001 in both) from the 1970s to 2000s. In girls, the prevalence of obesity as well as the combined prevalence of overweight and obesity increased significantly in the age group of 12 years (p = 0.023), but not in that of 15 years. CONCLUSIONS During the last three decades, overweight and obesity have become clearly more prevalent in Finnish young adolescents. This trend has been more obvious in boys than in girls. At the same time, 2-year-old children have shown an opposite trend.
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Affiliation(s)
- Nina Vuorela
- Paediatric Research Centre, University of Tampere, Finland.
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36
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Wallner A, Hirz A, Schober E, Harbich H, Waldhoer T. Evolution of cardiovascular risk factors among 18-year-old males in Austria between 1986 and 2005. Wien Klin Wochenschr 2010; 122:152-8. [PMID: 20361378 DOI: 10.1007/s00508-010-1305-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2009] [Accepted: 12/21/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aims of the study were to determine time trends in cardiovascular risk factors among young Austrian males between 1986 and 2005 and to examine socioeconomic and geographic differences. METHODS Data on Austrian conscripts were derived from the nationwide compulsory medical investigations held at military induction at 18 years of age. Four cohorts (1986-1990: n = 252,799; 1991-1995: n = 209,266; 1996-2000: n = 208,427; 2001-2005: n = 209,168) were examined with respect to their place of residence and level of education. Height, weight, waist circumference, blood pressure, serum total-cholesterol and triglycerides were measured. Mean body mass index (BMI) was calculated: overweight was defined as BMI between 25 and <30 and obesity as BMI >or= 30. The Chi-squared test and ANOVA were used to test group differences. RESULTS During the 20-year observation period the prevalence of overweight increased from 13.3% to 15.7% (p < 0.001) and that of obesity from 2.6% to 5.4% (p < 0.001); in accordance, mean BMI and waist circumference increased significantly. Blood pressure and serum total-cholesterol level decreased (p < 0.001) during the period studied, although triglyceride levels (p < 0.001) increased. A significant east-west gradient was identified for the prevalence of overweight and obesity, waist circumference and mean BMI, with lower values in the urban population compared with those of rural inhabitants. Mean BMI and the prevalence of overweight and obesity were higher in conscripts belonging to lower socioeconomic strata. CONCLUSION Our study demonstrates a clear increase of mean BMI, waist circumference and the prevalence of overweight and obesity in Austrian male adolescents during the past 20 years. Conscripts from rural regions and with lower levels of education showed the highest values. The investigation of conscript health appears to be a useful tool for risk surveillance in the male population.
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Affiliation(s)
- Astrid Wallner
- Department of Epidemiology and Public Health, Medical University of Vienna, Vienna, Austria
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37
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Chumaeva N, Hintsanen M, Juonala M, Raitakari OT, Keltikangas-Järvinen L. Sex differences in the combined effect of chronic stress with impaired vascular endothelium functioning and the development of early atherosclerosis: the Cardiovascular Risk in Young Finns study. BMC Cardiovasc Disord 2010; 10:34. [PMID: 20624297 PMCID: PMC2912787 DOI: 10.1186/1471-2261-10-34] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Accepted: 07/12/2010] [Indexed: 11/25/2022] Open
Abstract
Background The syndrome of vital exhaustion (VE), characterized by fatigue and irritability, may contribute to an increased risk of atherosclerosis. The aim of the study was to explore sex differences in the interactions of VE with endothelial dysfunction and VE with reduced carotid elasticity, the important contributors to the development of early atherosclerosis, on preclinical atherosclerosis. Methods The participants were 1002 women and 719 men aged 24-39 examined in the Cardiovascular Risk in Young Finns study. Vital exhaustion was measured using the Maastricht Questionnaire. Preclinical atherosclerosis was assessed by carotid intima-media thickness (IMT), endothelial function was measured by brachial flow-mediated dilatation (FMD), and arterial elasticity by carotid artery compliance (CAC) using ultrasound techniques. Results We found a significant CAC x VE interaction for IMT only for the men. Our results imply that high VE level significantly related to high IMT levels among the men with low CAC, but not among the women with low CAC or among the women or men with high CAC. No significant FMD x VE interactions for IMT for the women or men were found. Conclusions High VE may exert an effect on IMT for men with impaired arterial elasticity. The results suggest that high vitally exhausted men with reduced arterial elasticity are at increased risk of atherosclerosis in early life and imply men's decreased stress coping in relation to stressful psychological coronary risk factors.
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Affiliation(s)
- Nadja Chumaeva
- Institute of Behavioral Sciences, University of Helsinki, PO Box 9, 00014 Helsinki, Finland
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38
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Thomas NE, Jasper M, Williams DRR, Rowe DA, Malina RM, Davies B, Siegel SR, Baker JS. Secular trends in established and novel cardiovascular risk factors in Welsh 12-13 year olds: a comparison between 2002 and 2007. Ann Hum Biol 2010; 38:22-7. [PMID: 20450386 DOI: 10.3109/03014460.2010.482540] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study examines CVD risk factors trends in Welsh adolescents between 2002 and 2007. PARTICIPANTS AND METHODS CVD risk factor data was examined from two cross-sectional studies. The first study (73 participants; aged 12.9 ± 0.3 years) was completed in 2002. The second study (90 participants; aged 12.9 ± 0.4 years) was conducted in 2007. Measurements included body mass index (BMI), waist circumference (WC), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, fibrinogen (Fg) and high-sensitivity C-reactive protein (hs-CRP). RESULTS In boys, mean BMI and WC were lower in 2007, although not significantly (p ≥ 0.05). In 2007, there were improvements in mean lipid, Fg and hs-CRP concentrations in both sexes (p < 0.05). In 2002, 42.8% of boys and 34.2% of girls were overweight or obese; in 2007, this was 23.7% and 28.9% for boys and girls, respectively. More adolescents in 2002 exceeded the recommended levels for lipids, Fg and hs-CRP. CONCLUSION This is the only study to examine CVD risk factor trends in Welsh adolescents. Although overweight continues to be widespread in 12-13 year olds, this study did not identify significant mean changes in overweight and obesity between 2002 and 2007. Overall, the data presented a positive trend in lipid profile and inflammatory factors.
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Affiliation(s)
- N E Thomas
- Centre for Children and Young Peoples' Health and Well-Being, School of Medicine, Swansea University, Singleton Park, Swansea, Wales, UK.
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39
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Salonen M, Tenhola S, Laitinen T, Lyyra-Laitinen T, Romppanen J, Jääskeläinen J, Voutilainen R. Tracking Serum Lipid Levels and the Association of Cholesterol Concentrations, Blood Pressure and Cigarette Smoking With Carotid Artery Intima-Media Thickness in Young Adults Born Small for Gestational Age. Circ J 2010; 74:2419-25. [DOI: 10.1253/circj.cj-10-0398] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Maria Salonen
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland
- Department of Pediatrics, Kymenlaakso Central Hospital
| | - Sirpa Tenhola
- Department of Pediatrics, Kymenlaakso Central Hospital
| | - Tomi Laitinen
- Department of Clinical Physiology, Kuopio University Hospital
| | | | - Jarkko Romppanen
- Eastern Finland Laboratory Centre and University of Eastern Finland
| | - Jarmo Jääskeläinen
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland
| | - Raimo Voutilainen
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland
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40
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Abstract
OBJECTIVE to explore the effect of organized youth sport on metabolic syndrome (MetS) in adulthood. DESIGN Longitudinal study data from the cardiovascular risk in young Finns study. SUBJECTS A total of 1493 males (n=704) and females (n=789) aged 3, 6, 9, 12, 15 and 18 years were randomly selected from five university towns and their rural surroundings in 1980. They were followed up for 21 years. In 2001 they were 24, 27, 30, 33, 36 and 39 years old. MEASUREMENTS Youth sports participation data (participation in sport-club training and competitions) were assessed in 1980 and 1983 using a self-report questionnaire completed in connection with a medical examination. Participants were divided into athletes and non-athletes at each measurement point, and then classified into four groups: Persistent athlete, Starter, Leaver and Non-athlete. A mean score of youth sport was assessed by calculating the average of four consecutive measurements (1980-1989). MetS risk in 2001 was defined as a categorical variable based on the guidelines of the European Group for the Study of Insulin Resistance (EGIR) and as a continuous MetS-score variable by summing the z-scores of individual metabolic variables. RESULTS In males and females, intense participation in youth sports over 3 years was inversely and significantly associated with clustered MetS score and prevalence of MetS defined by EGIR in adulthood (P<0.05). The association remained significant after adjustment for age, baseline clustered MetS score, smoking and total caloric intake and after additional adjustments for adult leisure-time physical activity. Starters during 3 years were less likely to have MetS than non-athletes. Leavers were at a higher risk for MetS than persistent athletes. These associations were attenuated in males by adjustment for all potential confounders. Similar associations were found using EGIR MetS as an outcome. CONCLUSIONS Sustained participation in organized sport lasting at least 3 years in youth is associated with reduced risk for developing MetS in adulthood.
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41
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Hintsanen M, Pulkki-Råback L, Juonala M, Viikari JSA, Raitakari OT, Keltikangas-Järvinen L. Cloninger's temperament traits and preclinical atherosclerosis: the Cardiovascular Risk in Young Finns Study. J Psychosom Res 2009; 67:77-84. [PMID: 19539821 DOI: 10.1016/j.jpsychores.2009.01.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2008] [Revised: 12/22/2008] [Accepted: 01/13/2009] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Cloninger's psychobiological model of temperament has recently raised interest as a risk factor for CHD. However, there are no studies that have examined the associations of Cloninger's temperament traits with atherosclerosis. METHODS The subjects were 398 men and 657 women (mean age 31.7 years) participating in the Cardiovascular Risk in Young Finns Study. Linear regression analyses were used to examine the cross-sectional associations between temperament traits and preclinical atherosclerosis. Preclinical atherosclerosis was measured with carotid intima-media thickness ultrasound. RESULTS Higher novelty seeking (NS) and reward dependence (RD) and lower harm avoidance (HA) were associated with preclinical atherosclerosis. In NS and RD, associations remained significant after adjustments for various risk factors. The effect sizes of these associations were comparable to those of traditional risk factors of coronary heart disease, which is a major finding. No association for persistence (P) was found. CONCLUSIONS The present findings imply that examining a wider range of temperament and personality factors may offer new information that can help in explaining the between-individual variation in atherosclerosis and CHD morbidity.
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Affiliation(s)
- Mirka Hintsanen
- Department of Psychology, University of Helsinki, Helsinki, Finland
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42
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Jartti T, Saarikoski L, Jartti L, Lisinen I, Jula A, Huupponen R, Viikari J, Raitakari OT. Obesity, adipokines and asthma. Allergy 2009; 64:770-7. [PMID: 19210351 DOI: 10.1111/j.1398-9995.2008.01872.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The prevalence of asthma and obesity is increasing concomitantly, but many aspects of this link are unclear. Our objective was to examine whether obesity is associated with asthma in three time points of life, and whether immunomodulatory adipokines, leptin and adiponectin are linked to overweight-associated asthma. METHODS We studied the association between obesity and asthma at ages 3-18 years [mean (SD), 10 years (5), n = 3582, year 1980], 9-24 years [16 years (5), n = 2764, 1986] and 24-39 years [32 years (5), n = 2620, 2001] in a prospective cohort study and further tested for associations with serum leptin and adiponectin concentrations. Data on allergy status, smoking and other laboratory values (serum insulin, plasma C-reactive protein and serum lipid values) were also analyzed. RESULTS Allergy and parental asthma were significantly associated with asthma at all ages. At ages 24-39 years, but not earlier, body mass index (BMI) (odds ratio, OR 1.05; P = 0.019) and female gender (OR 1.56; P = 0.031) were independently associated with asthma. Increase in BMI was also associated with incident asthma during adulthood (OR 1.08; P = 0.030). Levels of leptin, adiponectin or any other obesity-related biomarker were not independently associated with asthma. CONCLUSIONS Asthma is linked with obesity in adults, but our results do not support a significant role for leptin, adiponectin or any other obesity-related biomarker studied in this association. Other factors should be sought for better understanding the connection between obesity and asthma.
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Affiliation(s)
- T Jartti
- The Department of Pediatrics, Turku University Hospital, PO Box 52, FIN-20520 Turku, Finland
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43
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Raitakari OT, Blom-Nyholm J, Koskinen TA, Kähönen M, Viikari JSA, Lehtimäki T. Common variation in NOS1AP and KCNH2 genes and QT interval duration in young adults. The Cardiovascular Risk in Young Finns Study. Ann Med 2009; 41:144-51. [PMID: 18785031 DOI: 10.1080/07853890802392529] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Common genetic variants in the nitric oxide synthase 1 adaptor protein gene (NOS1AP) and in the HERG potassium channel gene (KCNH2) have been associated with cardiac repolarization in middle-aged and elderly subjects. AIM We examined the relation between these variants and QT interval duration in a population of healthy young adults. METHODS We measured QT interval duration and genotyped rs10494366 T>G (NOS1AP gene, n=1,842) and rs1805123 A>C (KCNH2 gene, n=1,894) in subjects aged 24-39 years. RESULTS The NOS1AP variant was significantly related with heart rate-corrected QT interval duration (QTc). Additive regression model adjusting for age, sex, systolic blood pressure, body mass index, alcohol use, and smoking indicated that the G allele was associated with a 3.2 ms (95% confidence interval (CI) 1.7-4.6 ms, P<0.0001) increase in QTc interval duration for each additional copy. The KCNH2 variant was not significantly related with QTc interval duration in the study sample. CONCLUSION These findings provide evidence from a population of healthy young adults that a common variation in the NOS1AP gene influences cardiac repolarization within the normal physiological range. Further studies are warranted to investigate the effects of this variant on sudden cardiac death and ventricular arrhythmias.
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Affiliation(s)
- Olli T Raitakari
- Department of Clinical Physiology, University of Turku, Finland.
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44
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Yang X, Telama R, Hirvensalo M, Mattsson N, Viikari JSA, Raitakari OT. The longitudinal effects of physical activity history on metabolic syndrome. Med Sci Sports Exerc 2008; 40:1424-31. [PMID: 18614950 DOI: 10.1249/mss.0b013e318172ced4] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To examine the relationship of physical activity and its changes over a 9-yr follow-up to the prevalence of metabolic syndrome (MetS) in 2060 young adults (24-39 yr) enrolled in the Cardiovascular Risk in Young Finns Study. METHODS Leisure-time physical activity (LTPA) was assessed using a self-report questionnaire completed in connection with a medical examination at two consecutive measurements in 1992 and 2001. By summing the LTPA items, a physical activity index (PAI) was formed for both measurement points according to which the participants were divided into tracking groups: persistently active, increasingly active, decreasingly active, and persistently inactive. MetS in 2001 was defined by the guidelines of the European Group for the Study of Insulin Resistance (EGIR), the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), and the International Diabetes Federation (IDF). A continuous metabolic risk score was also calculated by summing the z-scores for the metabolic risk factors. RESULTS There was a significant linear relationship between MetS and LTPA at baseline in men and at follow-up in both sexes according to all three definitions. Persistent physical activity during 9 yr was associated with a lower prevalence of MetS than persistent physical inactivity on all definitions (all P < 0.05). Similar results were found for increasingly active women (all P < 0.05). All of these associations remained significant after adjustment for potential confounders. In both men and women, the 9-yr change in LTPA was related to the metabolic risk score after adjustments for baseline LTPA, age, smoking, and education. CONCLUSIONS A physically active lifestyle across the lifespan may prevent or delay the onset of metabolic syndrome in young male and female adults.
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Affiliation(s)
- Xiaolin Yang
- LIKES Research Center for Sport and Health Sciences, Jyväskylä, Finland.
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Kivimäki M, Lawlor DA, Smith GD, Elovainio M, Jokela M, Keltikangas-Järvinen L, Vahtera J, Taittonen L, Juonala M, Viikari JSA, Raitakari OT. Association of age at menarche with cardiovascular risk factors, vascular structure, and function in adulthood: the Cardiovascular Risk in Young Finns study. Am J Clin Nutr 2008; 87:1876-82. [PMID: 18541580 DOI: 10.1093/ajcn/87.6.1876] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is unclear whether age at menarche is an independent determinant of future cardiovascular risk. OBJECTIVE We aimed to determine whether menarcheal age is an independent predictor of body mass index (BMI) and a wide range of cardiovascular risk factors in adolescence and adulthood. DESIGN We examined the associations of menarcheal age with BMI (in kg/m(2)) and other cardiovascular risk factors in adolescence and adulthood in a population-based sample of 794 female adolescents aged 9-18 y at baseline. Their age at first menstruation was requested at baseline and again 3 and 6 y later. Cardiovascular risk factors were assessed at baseline and at age 30-39 y. RESULTS A 1-y decrease in menarcheal age was associated with 0.81 (95% CI: 0.53, 1.08) higher adult BMI as well as greater waist circumference and waist-to-hip ratio, elevated systolic blood pressure, higher insulin resistance, and greater risk of metabolic syndrome (P < 0.05 for all). In multivariable analysis in which these adult risk factors were mutually adjusted for, only the inverse association between age at menarche and adult BMI remained. However, this inverse association was lost after adjustment for premenarcheal BMI (beta: -0.16; 95% CI -0.55, 0.23; P = 0.42). Higher premenarcheal BMI predicted earlier menarche, and the strong association between premenarcheal BMI and adult BMI was robust to adjustment for age at menarche. CONCLUSIONS These findings suggest that early menarche is only a risk marker. Greater childhood BMI seems to contribute to earlier age at menarche and, because of tracking, greater adult BMI and associated cardiovascular risk. An independent effect of early menarche on adult adiposity cannot be excluded, but it is likely to be small at best.
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Affiliation(s)
- Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom.
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Miettinen TA, Gylling H, Raitakari OT, Hallikainen M, Viikari J. Adolescent cholesterol metabolism predicts coronary risk factors at middle age: the Cardiovascular Risk in Young Finns Study. Transl Res 2008; 151:260-6. [PMID: 18433708 DOI: 10.1016/j.trsl.2008.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Revised: 02/14/2008] [Accepted: 02/27/2008] [Indexed: 10/22/2022]
Abstract
Atherosclerosis develops at an early age. We studied whether cholesterol metabolism in adolescence is related to coronary risk factors later during the adult years. A random population sample of 12-year-old (n=162), 15-year-old (n=158), and 18-year-old (n=148) boys who participated in the Cardiovascular Risk in Young Finns Study was studied for major coronary risk factors in 1980 and 2001. These values were related to noncholesterol sterols and their quartiles in 1980 (ie, markers of cholesterol absorption and synthesis). In 1980, serum triglycerides, body mass index (BMI), and systolic blood pressure were lower and high-density lipoprotein (HDL) cholesterol was higher in high absorbers versus low absorbers. This difference, except HDL cholesterol, was maintained after follow-up (eg, in 2001, systolic blood pressure was 123+/-1 mm Hg in low absorbers vs 119+/-1 mm Hg in high absorbers, P<0.01). Cholesterol synthesis (r = up to 0.470, P<0.001) and absorption (r = down to -0.347, P<0.001) were related to BMI at baseline and after follow-up. Significant associations were also found between cholesterol metabolism and serum triglycerides, blood pressure, and HDL cholesterol after follow-up. Cholesterol absorption was related to LDL cholesterol only in low absorbers (r=0.251, P<0.01). In conclusion, synthesis and absorption of cholesterol measured with serum noncholesterol sterols in adolescence were related to coronary risk factors later in adult life. High synthesis and low absorption of cholesterol are related to risk factors that determine the characteristics of the metabolic syndrome.
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Affiliation(s)
- Tatu A Miettinen
- Department of Medicine, Division of Internal Medicine, University of Helsinki, Helsinki, Finland.
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Chen H, Jin X, Zhou J, Chen B, Zhuang H, Han Q. Trends in serum lipid levels of healthy Chinese in Shanghai from 1973 to 1999. ACTA ACUST UNITED AC 2008. [DOI: 10.1007/s11684-008-0002-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Juonala M, Viikari JSA, Rönnemaa T, Marniemi J, Jula A, Loo BM, Raitakari OT. Associations of dyslipidemias from childhood to adulthood with carotid intima-media thickness, elasticity, and brachial flow-mediated dilatation in adulthood: the Cardiovascular Risk in Young Finns Study. Arterioscler Thromb Vasc Biol 2008; 28:1012-7. [PMID: 18309111 DOI: 10.1161/atvbaha.108.163329] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dyslipidemias are the major cause for atherosclerosis. They may act synergistically with nonlipid risk factors to increase atherogenesis. In the present study, we examined the effects of dyslipidemias from childhood to adulthood and their interaction with nonlipid risk factors on markers of subclinical atherosclerosis. METHODS AND RESULTS Study subjects were participants of the longitudinal Cardiovascular Risk in Young Finns Study started in 1980 (n=2265, age 3 to 18 years). To phenotype type IIa, IIb, and IV dyslipidemias and hypoHDL-cholesterolemia, we calculated age and sex-specific z scores for lipid values for each subject in 1980, 1983, 1986, and 2001. Subjects with mean z score over 90th percentile for LDL-cholesterol or triglycerides were considered having type IIa or IV dyslipidemia. Subjects with mean z score over 90th percentile for LDL-cholesterol and triglycerides had type IIb dyslipidemia, and those with mean z score below 10th percentile for HDL-cholesterol had hypoHDL-cholesterolemia. Compared to controls, subjects with type IIb dyslipidemia had increased carotid IMT (P<0.01). This difference remained significant when adjusted with other risk factors (P<0.05). Carotid IMT also increased significantly more with increasing number of nonlipid risk factors (P<0.001) or presence of the metabolic syndrome (P<0.05) in subjects with type IIb than in controls. Subjects with type IIb or type IV dyslipidemia had decreased carotid elasticity (P<0.05), but these differences became nonsignificant (P>0.3) when adjusted with blood pressure. CONCLUSIONS Our findings suggest that type IIb dyslipidemia has deleterious effects on vasculature already since childhood. Subjects with type IIb dyslipidemia are more vulnerable to the effects of cardiovascular risk factors and metabolic syndrome.
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Affiliation(s)
- Markus Juonala
- Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland
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Raitakari OT, Juonala M, Ronnemaa T, Keltikangas-Jarvinen L, Rasanen L, Pietikainen M, Hutri-Kahonen N, Taittonen L, Jokinen E, Marniemi J, Jula A, Telama R, Kahonen M, Lehtimaki T, Akerblom HK, Viikari JS. Cohort Profile: The Cardiovascular Risk in Young Finns Study. Int J Epidemiol 2008; 37:1220-6. [DOI: 10.1093/ije/dym225] [Citation(s) in RCA: 536] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Utility of Currently Recommended Pediatric Dyslipidemia Classifications in Predicting Dyslipidemia in Adulthood. Circulation 2008; 117:32-42. [DOI: 10.1161/circulationaha.107.718981] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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