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Long SE, Sood S, Kanesa-Thasan A, Kahn LG, Urbina EM, Barrett ES, Nguyen RH, Bush NR, Swan SH, Sathyanarayana S, Trasande L. Longitudinal study of birthweight, blood pressure, and markers of arterial stiffness in children age six among the TIDES cohort. J Hypertens 2024:00004872-990000000-00458. [PMID: 38690915 DOI: 10.1097/hjh.0000000000003745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
OBJECTIVE Although some studies have observed an association between birthweight and cardiovascular disease in adulthood, fewer have investigated whether birthweight is linked to cardiovascular health in early childhood. This study assesses the association between birthweight and cardiovascular outcomes in children 6 years of age. STUDY DESIGN Birthweight, blood pressure (BP), and markers of arterial stiffness in children, including brachial artery distensibility and carotid-femoral pulse wave velocity (cfPWV), were obtained from 324 participants in The Infant Development and the Environment Study, a prospective multisite pregnancy cohort. Birthweight was converted into sex-specific birthweight-for-gestational-age (bw/ga) z-scores based on the INTERGROWTH-21st standard. Following 2017 American Academy of Pediatrics guidelines, SBP and DBP were transformed into sex, age, and height-specific z-scores. Associations between birthweight and cardiovascular outcomes were assessed using nested multivariable linear regression models among the overall and sex-stratified samples. RESULTS Among the overall sample, bw/ga z-score was positively associated with cfPWV [b = 0.11 m/s, 95% confidence interval (CI): 0.01 m/s, 0.21 m/s] in crude and adjusted models. No associations between birthweight and cardiovascular outcomes were detected among the sex-stratified analyses. CONCLUSION Overall, birthweight was not related to cardiovascular outcomes in children 6 years old. However, infants born with a higher birthweight may be at risk for higher cfPWV in childhood. Early intervention in pregnant people at risk of delivering high birthweight infants may be warranted if results are replicated.
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Affiliation(s)
- Sara E Long
- Department of Pediatrics, NYU School of Medicine, New York, New York
| | - Shefali Sood
- Department of Ophthalmology, Georgetown University, Washington, District of Columbia
| | | | - Linda G Kahn
- Department of Pediatrics, NYU School of Medicine, New York, New York
- Department of Population Health, NYU School of Medicine, New York, New York
| | - Elaine M Urbina
- Heart Institute, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute; Piscataway, New Jersey
| | - Ruby H Nguyen
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (UCSF)
- Department of Pediatrics, UCSF, San Francisco, California
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sheela Sathyanarayana
- Department of Pediatrics, Seattle Children's Research Institute
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington
| | - Leonardo Trasande
- Department of Pediatrics, NYU School of Medicine, New York, New York
- Department of Population Health, NYU School of Medicine, New York, New York
- Department of Environmental Medicine, NYU School of Medicine
- NYU Wagner School of Public Service, New York, New York, USA
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Gonçalves R, Wiertsema CJ, Silva CCV, Monasso GS, Gaillard R, Steegers EAP, Santos S, Jaddoe VWV. Associations of Fetal and Infant Growth Patterns With Early Markers of Arterial Health in School-Aged Children. JAMA Netw Open 2022; 5:e2219225. [PMID: 35767260 PMCID: PMC9244605 DOI: 10.1001/jamanetworkopen.2022.19225] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Fetal life and infancy might be critical periods for predisposing individuals to develop cardiovascular disease in adulthood. OBJECTIVE To examine the associations of fetal and infant weight growth patterns with early markers of arterial health. DESIGN, SETTING, AND PARTICIPANTS This population-based prospective cohort study was conducted from early fetal life onward among 4484 offspring of women in Rotterdam, the Netherlands, delivering between April 1, 2002, and January 31, 2006. Statistical analysis was performed between January 1 and August 31, 2021. EXPOSURES Estimated fetal weight was measured in the second and third trimester. Data on weight and gestational age at birth were collected from midwives. Infant weight was measured at 6, 12, and 24 months. MAIN OUTCOMES AND MEASURES The common carotid intima-media thickness (cIMT) and carotid distensibility were measured as early markers of arterial health. RESULTS Follow-up measurements were available for 4484 children (2260 girls [50.4%]; median age, 9.7 years [95% range, 9.3-10.5 years]; and 2578 [57.5%] of Dutch ethnicity). Gestational age at birth was not associated with markers of arterial health. A 500-g-higher birth weight was associated with increased cIMT (standard deviation score [SDS], 0.08 mm [95% CI, 0.05-0.10 mm]) and a lower carotid distensibility (SDS, -0.05 × 10-3 kPa-1; [95% CI, -0.08 to -0.03 × 10-3 kPa-1]). Compared with children with a birth weight of 2500 to 4500 g, those weighing more than 4500 g had the lowest carotid distensibility (difference in SDS, -0.22 × 10-3 kPa-1 [95% CI, -0.42 to -0.02 × 10-3 kPa-1]). Conditional regression analyses showed that higher third-trimester fetal weight and birth weight were associated with increased cIMT (difference in SDS: third-trimester fetal weight, 0.08 mm [95% CI, 0.04-0.12 mm]; birth weight, 0.05 mm [95% CI, 0.01-0.09 mm]) and that higher weight at 6, 12, and 24 months was associated with increased cIMT (difference in SDS: 6 months, 0.05 mm [95% CI, 0.01-0.10 mm]; 12 months, 0.06 mm [95% CI, 0.02-0.10 mm]; and 24 months, 0.07 mm [95% CI, 0.03-0.11 mm]) and lower carotid distensibility (difference in SDS: 6 months, -0.04 × 10-3 kPa-1 [95% CI, -0.09 to -0.001 × 10-3 kPa-1]; 12 months, -0.05 × 10-3 kPa-1 [95% CI, -0.09 to -0.01 × 10-3 kPa-1]; and 24 months, -0.10 × 10-3 kPa-1 [95% CI, -0.15 to -0.06 × 10-3 kPa-1]). Compared with children with normal fetal and infant growth, children with normal fetal growth that was followed by accelerated infant growth had the highest cIMT (SDS, 0.19 mm [95% CI, 0.07-0.31 mm]) and lowest carotid distensibility (SDS, -0.16 × 10-3 kPa-1 [95% CI, -0.28 to -0.03 × 10-3 kPa-1]). The observed associations were largely explained by childhood body mass index. CONCLUSIONS AND RELEVANCE In this cohort study of 4484 children aged approximately 10 years, higher fetal and infant weight growth patterns were associated with early markers of impaired arterial health. Childhood body mass index seemed to be involved in the underlying pathways of the observed associations.
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Affiliation(s)
- Romy Gonçalves
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Sophia’s Children’s Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Clarissa J. Wiertsema
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Sophia’s Children’s Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Carolina C. V. Silva
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Sophia’s Children’s Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Giulietta S. Monasso
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Sophia’s Children’s Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Romy Gaillard
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Sophia’s Children’s Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Eric A. P. Steegers
- Department of Obstetrics and Gynaecology, Sophia’s Children’s Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Sophia’s Children’s Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Sophia’s Children’s Hospital, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
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Sinicropi MS, Iacopetta D, Ceramella J, Catalano A, Mariconda A, Pellegrino M, Saturnino C, Longo P, Aquaro S. Triclosan: A Small Molecule with Controversial Roles. Antibiotics (Basel) 2022; 11:antibiotics11060735. [PMID: 35740142 PMCID: PMC9220381 DOI: 10.3390/antibiotics11060735] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 12/23/2022] Open
Abstract
Triclosan (TCS), a broad-spectrum antimicrobial agent, has been widely used in personal care products, medical products, plastic cutting boards, and food storage containers. Colgate Total® toothpaste, containing 10 mM TCS, is effective in controlling biofilm formation and maintaining gingival health. Given its broad usage, TCS is present ubiquitously in the environment. Given its strong lipophilicity and accumulation ability in organisms, it is potentially harmful to biohealth. Several reports suggest the toxicity of this compound, which is inserted in the class of endocrine disrupting chemicals (EDCs). In September 2016, TCS was banned by the U.S. Food and Drug Administration (FDA) and the European Union in soap products. Despite these problems, its application in personal care products within certain limits is still allowed. Today, it is still unclear whether TCS is truly toxic to mammals and the adverse effects of continuous, long-term, and low concentration exposure remain unknown. Indeed, some recent reports suggest the use of TCS as a repositioned drug for cancer treatment and cutaneous leishmaniasis. In this scenario it is necessary to investigate the advantages and disadvantages of TCS, to understand whether its use is advisable or not. This review intends to highlight the pros and cons that are associated with the use of TCS in humans.
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Affiliation(s)
- Maria Stefania Sinicropi
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy; (M.S.S.); (D.I.); (J.C.); (M.P.); (S.A.)
| | - Domenico Iacopetta
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy; (M.S.S.); (D.I.); (J.C.); (M.P.); (S.A.)
| | - Jessica Ceramella
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy; (M.S.S.); (D.I.); (J.C.); (M.P.); (S.A.)
| | - Alessia Catalano
- Department of Pharmacy-Drug Sciences, University of Bari Aldo Moro, 70126 Bari, Italy
- Correspondence: ; Tel.: +39-080-544-2746
| | - Annaluisa Mariconda
- Department of Science, University of Basilicata, 85100 Potenza, Italy; (A.M.); (C.S.)
| | - Michele Pellegrino
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy; (M.S.S.); (D.I.); (J.C.); (M.P.); (S.A.)
| | - Carmela Saturnino
- Department of Science, University of Basilicata, 85100 Potenza, Italy; (A.M.); (C.S.)
| | - Pasquale Longo
- Department of Chemistry and Biology, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Italy;
| | - Stefano Aquaro
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy; (M.S.S.); (D.I.); (J.C.); (M.P.); (S.A.)
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Monasso GS, Silva CCV, Santos S, Goncalvez R, Gaillard R, Felix JF, Jaddoe VWV. Infant weight growth patterns, childhood BMI, and arterial health at age 10 years. Obesity (Silver Spring) 2022; 30:770-778. [PMID: 35142077 PMCID: PMC9302666 DOI: 10.1002/oby.23376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/26/2021] [Accepted: 12/14/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Associations of obesity with cardiovascular disease may originate in childhood. This study examined critical periods for BMI in relation to arterial health at school age. METHODS Among 4,731 children from a prospective cohort study, associations of infant peak weight velocity, both age and BMI at adiposity peak, and BMI trajectories with carotid artery intima-media thickness and carotid artery distensibility at 10 years were examined. RESULTS A 1-standard deviation score (SDS) higher peak weight velocity and BMI at adiposity peak were associated with higher intima-media thickness (0.10 SDS; 95% CI: 0.06 to 0.13 and 0.08 SDS; 95% CI: 0.05 to 0.12) and lower distensibility (-0.07 SDS; 95% CI: -0.10 to -0.03 and -0.07 SDS; 95% CI: -0.11 to -0.03) at 10 years. For distensibility, current BMI explained these associations. Children within the highest BMI tertile at ages 2 and 10 years had the lowest distensibility (p < 0.05), but similar intima-media thickness, compared with children constantly within the middle tertile. CONCLUSIONS Infant weight growth patterns and childhood BMI are associated with subtle differences in carotid intima-media thickness and carotid distensibility at school age. For distensibility, current BMI seems critical. Follow-up is needed to determine whether these associations lead to adult cardiovascular disease.
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Affiliation(s)
- Giulietta S. Monasso
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Carolina C. V. Silva
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Susana Santos
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Romy Goncalvez
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of Obstetrics and GynaecologyErasmus University Medical CenterRotterdamthe Netherlands
| | - Romy Gaillard
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Janine F. Felix
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
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Patti MA, Henderson NB, Gajjar P, Eliot M, Jackson-Browne M, Braun JM. Gestational triclosan exposure and infant birth weight: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2021; 157:106854. [PMID: 34560323 PMCID: PMC8576608 DOI: 10.1016/j.envint.2021.106854] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/02/2021] [Accepted: 08/30/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Exposure to triclosan, an antimicrobial chemical used in some personal care and cleaning products, has been associated with reduced birth weight in some, but not all epidemiological studies. OBJECTIVES We conducted a systematic review and meta-analysis to characterize the relation of gestational triclosan exposure with infant birth weight and identify sources of heterogeneity between studies. METHODS We identified original studies measuring urinary triclosan concentrations during pregnancy and reporting their association with infant birth weight, gestational age (GA) adjusted birth weight (g), or GA-standardized birth weight z-scores. Using a random effects model, we estimated differences in these outcomes per 10-fold increase in triclosan concentrations and considered triclosan levels and infant sex as sources of heterogeneity. Using Navigation Guide Methods, we evaluated risk of bias within individual studies and across the body of evidence. RESULTS Among thirteen studies, median triclosan concentrations varied by almost 2-orders of magnitude (0.6-29 ng/mL), with higher concentrations in North American and some European studies compared to Asian ones. Associations between triclosan and birth weight (β:-20 g; 95% CI:-65, 26; n = 6) were stronger than those for GA-adjusted birth weight (β:-12 g; 95% CI:-29, 5; n = 9). Triclosan was not associated with GA-standardized birth weight z-scores (β:-0.04; 95% CI:-0.16, 0.07; n = 5). The association between triclosan and GA-adjusted birth weight was stronger in studies with median triclosan values ≥10 ng/mL compared to studies with median values < 10 ng/mL (β:-27 g; 95% CI:-61, 7; n = 4 vs. β:6g; 95% CI:-20, 31; n = 5). With a limited number of studies, we observed suggestive evidence that inverse associations were more apparent in studies with ≥ 2 prospective triclosan measures compared to those with one measure. DISCUSSION Available evidence, with "low" risk of bias, provides limited evidence that triclosan exposure and reduces infant birth weight. We observed stronger inverse associations between triclosan concentrations and birth weight in populations with higher triclosan exposure.
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Affiliation(s)
- Marisa A Patti
- Brown University School of Public Health, 121 S. Main Street, Providence, RI 02912, United States.
| | - Noelle B Henderson
- Brown University School of Public Health, 121 S. Main Street, Providence, RI 02912, United States.
| | - Priya Gajjar
- Brown University School of Public Health, 121 S. Main Street, Providence, RI 02912, United States.
| | - Melissa Eliot
- Brown University School of Public Health, 121 S. Main Street, Providence, RI 02912, United States.
| | | | - Joseph M Braun
- Brown University School of Public Health, 121 S. Main Street, Providence, RI 02912, United States.
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Silva CCV, El Marroun H, Sammallahti S, Vernooij MW, Muetzel RL, Santos S, Jaddoe VWV. Patterns of Fetal and Infant Growth and Brain Morphology at Age 10 Years. JAMA Netw Open 2021; 4:e2138214. [PMID: 34882181 PMCID: PMC8662367 DOI: 10.1001/jamanetworkopen.2021.38214] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
IMPORTANCE Preterm birth and low birth weight are associated with brain developmental and neurocognitive outcomes in childhood; however, not much is known about the specific critical periods in fetal life and infancy for these outcomes. OBJECTIVE To examine the associations of fetal and infant growth patterns with brain morphology in children at school age. DESIGN, SETTING, AND PARTICIPANTS This population-based, prospective cohort study was conducted from February 1 to April 16, 2021, as a part of the Generation R Study in Rotterdam, the Netherlands. The study included 3098 singleton children born between April 1, 2002, and January 31, 2006. EXPOSURES Fetal weight was estimated in the second and third trimesters of pregnancy by ultrasonography. Infant weight was measured at birth and at 6, 12, and 24 months. Fetal and infant weight acceleration or deceleration were defined as a change in SD scores greater than 0.67 between time points. Infant measurements also included peak weight velocity, and age and body mass index reached at adiposity peak. MAIN OUTCOMES AND MEASURES Brain structure, including global and regional brain volumes, was quantified by magnetic resonance imaging at age 10 years. RESULTS The study evaluated 3098 children (mean [SD] age at follow-up, 10.1 [0.6] years; 1557 girls [50.3%]; and 1753 Dutch [57.8%]). One SD score-higher weight gain until the second and third trimesters, birth, and 6, 12, and 24 months was associated with larger total brain volume independently of growth during any other age windows (second trimester: 5.7 cm3; 95% CI, 1.2-10.2 cm3; third trimester: 15.3 cm3; 95% CI, 11.0-19.6 cm3; birth: 20.8 cm3; 95% CI, 16.4-25.1 cm3; 6 months: 15.6 cm3; 95% CI, 11.2-19.9 cm3; 12 months: 11.3 cm3; 95% CI, 7.0-15.6 cm3; and 24 months: 11.1 cm3; 95% CI, 6.8-15.4 cm3). Compared with children with normal fetal and infant growth, those with fetal and infant growth deceleration had the smallest total brain volume (-32.5 cm3; 95% CI, -53.2 to -11.9 cm3). Children with fetal weight deceleration followed by infant catch-up growth had similar brain volumes as children with normal growth. Higher peak weight velocity and body mass index reached at adiposity peak were associated with larger brain volumes. Similar results were observed for cerebral and cerebellar gray and white matter volumes. CONCLUSIONS AND RELEVANCE This cohort study's findings suggest that both fetal and infant weight growth might be critical for cerebral and cerebellar brain volumes during childhood. Whether these associations link to neurocognitive outcomes should be further studied.
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Affiliation(s)
- Carolina C. V. Silva
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC–Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Hanan El Marroun
- Department of Pediatrics, Erasmus MC–Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Sara Sammallahti
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Meike W. Vernooij
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Ryan L. Muetzel
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC–Sophia Children’s Hospital, 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
- Department of Pediatrics, Erasmus MC–Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Childhood vascular phenotypes have differing associations with prenatal and postnatal growth. J Hypertens 2021; 39:1884-1892. [PMID: 33853103 PMCID: PMC8373454 DOI: 10.1097/hjh.0000000000002870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE In children aged 8--9 years, we examined the associations of linear and abdominal circumference growth during critical stages of prenatal and postnatal development with six vascular measurements commonly used as early markers of atherosclerosis and later cardiovascular disease (CVD) risk. METHODS In 724 children from the UK Southampton Women's Survey mother--offspring cohort, offspring length/height and abdominal circumference measurements were collected at 10 ages between 11 weeks' gestation and age 8--9 years. Using residual growth modelling and linear regression, we examined the independent associations between growth and detailed vascular measures made at 8--9 years. RESULTS Postnatal linear and abdominal circumference growth were associated with higher childhood SBP and carotid--femoral pulse wave velocity, whereas prenatal growth was not. For example, 1SD faster abdominal circumference gain between ages 3 and 6 years was associated with 2.27 [95% confidence interval (CI): 1.56--2.98] mmHg higher SBP. In contrast, faster abdominal circumference gain before 19 weeks' gestation was associated with greater carotid intima--media thickness [0.009 mm (0.004--0.015) per 1SD larger 19-week abdominal circumference), whereas later growth was not. We found no strong associations between prenatal or postnatal growth and DBP or measures of endothelial function. CONCLUSION Higher postnatal linear growth and adiposity gain are related to higher SBP and carotid--femoral pulse wave velocity in childhood. In contrast, faster growth in early gestation is associated with greater childhood carotid intima--media thickness, perhaps resulting from subtle changes in vascular structure that reflect physiological adaptations rather than subclinical atherosclerosis.
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Early-childhood BMI trajectories in relation to preclinical cardiovascular measurements in adolescence. J Dev Orig Health Dis 2021; 13:322-329. [PMID: 34308826 DOI: 10.1017/s2040174421000441] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cardiovascular diseases are the leading causes of morbidity and mortality. Overweight, obesity, and accelerated growth during early childhood have been associated with adverse cardiovascular outcomes in later life. Few studies have assessed whether trajectories of accelerated growth in early childhood are associated with preclinical cardiovascular measurements. We aimed to evaluate the associations between childhood body mass index (BMI) growth trajectories and measures of macro- and microvascular function in early adolescence. Measurements of macrovascular function (systolic and diastolic blood pressure (SBP and DBP), pulse wave velocity (PWV), and microvascular function (central retinal arteriolar/veinular equivalent) were assessed at 11 years old in a Spanish birth cohort study (n = 489). BMI trajectories from birth to 9 years were identified using latent class growth analysis. Multiple linear regression assessed the associations between the BMI trajectories and macro- and microvascular function. Compared to children with average birth size and slower BMI gain (reference), children with a lower birth size and accelerated BMI gain had increased SBP [β = 6.57; (95% CI 4.00, 9.15)], DBP [β = 3.65; (95% CI 1.45, 5.86)], and PWV [β = 0.14; (95% CI 0.01, 0.27)]. Children with higher birth size and accelerated BMI gain had increased SBP [β = 4.75; (95% CI 1.79, 7.71) compared to the reference. No significant associations between BMI trajectories and the microvascular measurements were observed. In conclusion, we found that childhood BMI trajectories characterized by accelerated growth are associated with preclinical macrovascular measurements in young adolescents.
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Wiertsema CJ, Erkamp JS, Mulders AGMGJ, Steegers EAP, Duijts L, Koning AHJ, Gaillard R, Jaddoe VWV. First trimester fetal proportion volumetric measurements using a Virtual Reality approach. Prenat Diagn 2021; 41:868-876. [PMID: 33811672 PMCID: PMC8251560 DOI: 10.1002/pd.5947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/15/2021] [Accepted: 03/27/2021] [Indexed: 12/02/2022]
Abstract
OBJECTIVE To establish feasibility and reproducibility of fetal proportion volumetric measurements, using three-dimensional (3D) ultrasound and a Virtual Reality (VR) system. METHODS Within a population-based prospective birth cohort, 3D ultrasound datasets of 50 fetuses in the late first trimester were collected by three ultrasonographers in a single research center. V-scope software was used for volumetric measurements of total fetus, extremities, head-trunk, head, trunk, thorax, and abdomen. All measurements were performed independently by two researchers. Intraobserver and interobserver reproducibility were analyzed using Bland and Altman methods. RESULTS Intraobserver and interobserver analyses of volumetric measurements of total fetus, head-trunk, head, trunk, thorax and abdomen showed intraclass correlation coefficients above 0.979, coefficients of variation below 7.51% and mean difference below 3.44%. The interobserver limits of agreement were within the ±10% range for volumetric measurements of total fetus, head-trunk, head and trunk. The interobserver limits of agreement for extremities, thorax and abdomen were -26.09% to 4.77%, -14.14% to 10.00% and -14.47% to 8.83%, respectively. CONCLUSION First trimester fetal proportion volumetric measurements using 3D ultrasound and VR are feasible and reproducible, except volumetric measurements of the fetal extremities. These novel volumetric measurements may be used in future research to enable detailed studies on first trimester fetal development and growth.
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Affiliation(s)
- Clarissa J. Wiertsema
- The Generation R Study GroupErasmus University Medical CenterRotterdamThe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamThe Netherlands
| | - Jan S. Erkamp
- The Generation R Study GroupErasmus University Medical CenterRotterdamThe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamThe Netherlands
| | | | - Eric A. P. Steegers
- Departments of Obstetrics and GynecologyErasmus University Medical CenterRotterdamThe Netherlands
| | - Liesbeth Duijts
- Department of PediatricsErasmus University Medical CenterRotterdamThe Netherlands
- Department of PediatricsDivision of Respiratory Medicine and AllergologyErasmus University Medical CenterRotterdamThe Netherlands
| | - Anton H. J. Koning
- The Generation R Study GroupErasmus University Medical CenterRotterdamThe Netherlands
- Clinical Bioinformatics UnitDepartment of PathologyErasmus MC University Medical CenterRotterdamThe Netherlands
| | - Romy Gaillard
- The Generation R Study GroupErasmus University Medical CenterRotterdamThe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamThe Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study GroupErasmus University Medical CenterRotterdamThe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamThe Netherlands
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10
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Castro JM, Marin M, Zinoveev A, García-Espinosa V, Chiesa P, Bia D, Zócalo Y. Changes in Body Size during Early Growth Are Independently Associated with Arterial Properties in Early Childhood. J Cardiovasc Dev Dis 2021; 8:jcdd8020020. [PMID: 33671380 PMCID: PMC7921917 DOI: 10.3390/jcdd8020020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/13/2021] [Accepted: 02/09/2021] [Indexed: 11/29/2022] Open
Abstract
Nutritional status in early life stages has been associated with arterial parameters in childhood. However, it is still controversial whether changes in standardized body weight (z-BW), height (z-BH), BW for height (z-BWH) and/or body mass index (z-BMI) in the first three years of life are independently associated with variations in arterial structure, stiffness and hemodynamics in early childhood. In addition, it is unknown if the strength of the associations vary depending on the growth period, nutritional characteristics and/or arterial parameters analyzed. Aims: First, to compare the strength of association between body size changes (Δz-BW, Δz-BH, Δz-BWH, Δz-BMI) in different time intervals (growth periods: 0–6, 0–12, 0–24, 0–36, 12–24, 12–36, 24–36 months (m)) and variations in arterial structure, stiffness and hemodynamics at age 6 years. Second, to determine whether the associations depend on exposure to cardiovascular risk factors, body size at birth and/or on body size at the time of the evaluation (cofactors). Anthropometric (at birth, 6, 12, 24, 36 m and at age 6 years), hemodynamic (peripheral and central (aortic)) and arterial (elastic (carotid) and muscular (femoral) arteries; both hemi-bodies) parameters were assessed in a child cohort (6 years; n =632). The association between arterial parameters and body size changes (Δz-BW, Δz-BH, Δz-BWH, Δz-BMI) in the different growth periods was compared, before and after adjustment by cofactors. Results: Δz-BW 0–24 m and Δz-BWH 0–24 m allowed us to explain inter-individual variations in structural arterial properties at age 6 years, with independence of cofactors. When the third year of life was included in the analysis (0–36, 12–36, 24–36 m), Δz-BW explained hemodynamic (peripheral and central) variations at age 6 years. Δz-BH and Δz-BMI showed limited associations with arterial properties. Conclusion: Δz-BW and Δz-BWH are the anthropometric variables with the greatest association with arterial structure and hemodynamics in early childhood, with independence of cofactors.
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Affiliation(s)
- Juan M. Castro
- Departamento de Fisiología, Facultad de Medicina, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Universidad de la República, General Flores 2125, 11800 Montevideo, Uruguay; (J.M.C.); (M.M.); (A.Z.); (V.G.-E.)
| | - Mariana Marin
- Departamento de Fisiología, Facultad de Medicina, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Universidad de la República, General Flores 2125, 11800 Montevideo, Uruguay; (J.M.C.); (M.M.); (A.Z.); (V.G.-E.)
| | - Agustina Zinoveev
- Departamento de Fisiología, Facultad de Medicina, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Universidad de la República, General Flores 2125, 11800 Montevideo, Uruguay; (J.M.C.); (M.M.); (A.Z.); (V.G.-E.)
| | - Victoria García-Espinosa
- Departamento de Fisiología, Facultad de Medicina, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Universidad de la República, General Flores 2125, 11800 Montevideo, Uruguay; (J.M.C.); (M.M.); (A.Z.); (V.G.-E.)
| | - Pedro Chiesa
- Servicio de Cardiología Pediátrica, Centro Hospitalario Pereira-Rossell, ASSE-Facultad de Medicina, Universidad de la República, Bulevar Artigas 1550, 11600 Montevideo, Uruguay;
| | - Daniel Bia
- Departamento de Fisiología, Facultad de Medicina, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Universidad de la República, General Flores 2125, 11800 Montevideo, Uruguay; (J.M.C.); (M.M.); (A.Z.); (V.G.-E.)
- Correspondence: or (D.B.); (Y.Z.); Tel.: +598-924-3414-3313 (D.B. & Y.Z.)
| | - Yanina Zócalo
- Departamento de Fisiología, Facultad de Medicina, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Universidad de la República, General Flores 2125, 11800 Montevideo, Uruguay; (J.M.C.); (M.M.); (A.Z.); (V.G.-E.)
- Correspondence: or (D.B.); (Y.Z.); Tel.: +598-924-3414-3313 (D.B. & Y.Z.)
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11
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Norris T, Crozier SR, Cameron N, Godfrey KM, Inskip H, Johnson W. Fetal growth does not modify the relationship of infant weight gain with childhood adiposity and blood pressure in the Southampton women's survey. Ann Hum Biol 2020; 47:150-158. [PMID: 32429761 PMCID: PMC7261399 DOI: 10.1080/03014460.2020.1717616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background: Rapid infant weight gain is a risk factor for childhood obesity. This relationship may depend on whether infant weight gain is preceded by in-utero growth restriction. Aim: Examine whether fetal growth modifies the relationship between infant weight gain and childhood adiposity and blood pressure. Subjects and methods: 786 children in the Southampton Women’s Survey. We related infant weight gain (weight at 2 years-birth weight) to body mass index (BMI), %body fat, trunk fat (kg), systolic (SBP) and diastolic blood pressure (DBP) at age 6–7 years. Mean estimated fetal weight (EFW) between 19–34 weeks and change in EFW (19–34 weeks) were added to models as effect modifiers. Results: Infant weight gain was positively associated with all childhood outcomes. We found no evidence that these effects were modified by fetal growth (p > .1 for all interaction terms). For example, a 1 standard deviation (SD) increase in infant weight gain was associated with an increase in BMI z-score of 0.51 (95% CI 0.37;0.64) when EFW-change was set at -2 SD-scores compared with an increase of 0.41 (95% CI 0.27;0.54, p(interaction)=.48) when set at 2 SD-scores. Conclusion: The documented adverse consequences of rapid infant weight gain may occur regardless of whether growth was constrained in-utero.
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Affiliation(s)
- Tom Norris
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Noël Cameron
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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12
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Ong YY, Sadananthan SA, Aris IM, Tint MT, Yuan WL, Huang JY, Chan YH, Ng S, Loy SL, Velan SS, Fortier MV, Godfrey KM, Shek L, Tan KH, Gluckman PD, Yap F, Choo JTL, Ling LH, Tan K, Chen L, Karnani N, Chong YS, Eriksson JG, Wlodek ME, Chan SY, Lee YS, Michael N. Mismatch between poor fetal growth and rapid postnatal weight gain in the first 2 years of life is associated with higher blood pressure and insulin resistance without increased adiposity in childhood: the GUSTO cohort study. Int J Epidemiol 2020; 49:1591-1603. [PMID: 32851407 PMCID: PMC7116531 DOI: 10.1093/ije/dyaa143] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Using longitudinal ultrasounds as an improved fetal growth marker, we aimed to investigate if fetal growth deceleration followed by rapid postnatal weight gain is associated with childhood cardiometabolic risk biomarkers in a contemporary well-nourished population. METHODS We defined fetal growth deceleration (FGD) as ultrasound-measured 2nd-3rd-trimester abdominal circumference decrease by ≥0.67 standard deviation score (SDS) and rapid postnatal weight gain (RPWG) as 0-2-year-old weight increase by ≥0.67 SDS. In the GUSTO mother-offspring cohort, we grouped 797 children into four groups of FGD-only (14.2%), RPWG-only (23.3%), both (mismatch, 10.7%) or neither (reference, 51.8%). Adjusting for confounders and comparing with the reference group, we tested associations of these growth groups with childhood cardiometabolic biomarkers: magnetic resonance imaging (MRI)-measured abdominal fat (n = 262), liver fat (n = 216), intramyocellular lipids (n = 227), quantitative magnetic resonance-measured overall body fat % (BF%) (n = 310), homeostasis model assessment of insulin resistance (HOMA-IR) (n = 323), arterial wall thickness (n = 422) and stiffness (n = 443), and blood pressure trajectories (ages 3-6 years). RESULTS Mean±SD birthweights were: FGD-only (3.11 ± 0.38 kg), RPWG-only (3.03 ± 0.37 kg), mismatch (2.87 ± 0.31 kg), reference (3.30 ± 0.36 kg). FGD-only children had elevated blood pressure trajectories without correspondingly increased BF%. RPWG-only children had altered body fat partitioning, higher BF% [BF = 4.26%, 95% confidence interval (CI) (2.34, 6.19)], HOMA-IR 0.28 units (0.11, 0.45)] and elevated blood pressure trajectories. Mismatch children did not have increased adiposity, but had elevated ectopic fat, elevated HOMA-IR [0.29 units (0.04,0.55)] and the highest blood pressure trajectories. Associations remained even after excluding small-for-gestational-age infants from analyses. CONCLUSIONS Fetal growth deceleration coupled with rapid postnatal weight gain was associated with elevated childhood cardiometabolic risk biomarkers without correspondingly increased BF%.
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Affiliation(s)
- Yi Ying Ong
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wen Lun Yuan
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jonathan Y Huang
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sharon Ng
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - See Ling Loy
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Sendhil S Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore, Singapore
| | - Marielle V Fortier
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lynette Shek
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Pediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore, Singapore
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fabian Yap
- Duke-NUS Medical School, Singapore, Singapore
- Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | | | - Lieng Hsi Ling
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Karen Tan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Molecular Diagnosis Centre, Department of Laboratory Medicine, National University Health System, Singapore, Singapore
| | - Li Chen
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mary E Wlodek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Physiology, University of Melbourne, Melbourne, VIC, Australia
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yung Seng Lee
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Pediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
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13
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Bernhardsen GP, Stensrud T, Hansen BH, Steene-Johannesen J, Kolle E, Nystad W, Anderssen SA, Hallal PC, Janz KF, Kriemler S, Andersen LB, Northstone K, Resaland GK, Sardinha LB, van Sluijs EMF, Ried-Larsen M, Ekelund U. Birth weight, cardiometabolic risk factors and effect modification of physical activity in children and adolescents: pooled data from 12 international studies. Int J Obes (Lond) 2020; 44:2052-2063. [PMID: 32494037 PMCID: PMC7508671 DOI: 10.1038/s41366-020-0612-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 05/20/2020] [Indexed: 01/06/2023]
Abstract
Objectives Low and high birth weight is associated with higher levels of cardiometabolic risk factors and adiposity in children and adolescents, and increases the risk of cardiovascular diseases, obesity, and early mortality later in life. Moderate-to-vigorous physical activity (MVPA) is associated with lower cardiometabolic risk factors and may mitigate the detrimental consequences of high or low birth weight. Thus, we examined whether MVPA modified the associations between birth weight and cardiometabolic risk factors in children and adolescents. Methods We used pooled individual data from 12 cohort- or cross-sectional studies including 9,100 children and adolescents. Birth weight was measured at birth or maternally reported retrospectively. Device-measured physical activity (PA) and cardiometabolic risk factors were measured in childhood or adolescence. We tested for associations between birth weight, MVPA, and cardiometabolic risk factors using multilevel linear regression, including study as a random factor. We tested for interaction between birth weight and MVPA by introducing the interaction term in the models (birth weight x MVPA). Results Most of the associations between birth weight (kg) and cardiometabolic risk factors were not modified by MVPA (min/day), except between birth weight and waist circumference (cm) in children (p = 0.005) and HDL-cholesterol (mmol/l) in adolescents (p = 0.040). Sensitivity analyses suggested that some of the associations were modified by VPA, i.e., the associations between birth weight and diastolic blood pressure (mmHg) in children (p = 0.009) and LDL- cholesterol (mmol/l) (p = 0.009) and triglycerides (mmol/l) in adolescents (p = 0.028). Conclusion MVPA appears not to consistently modify the associations between low birth weight and cardiometabolic risk. In contrast, MVPA may mitigate the association between higher birth weight and higher waist circumference in children. MVPA is consistently associated with a lower cardiometabolic risk across the birth weight spectrum. Optimal prenatal growth and subsequent PA are both important in relation to cardiometabolic health in children and adolescents.
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Affiliation(s)
| | - Trine Stensrud
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Bjørge Herman Hansen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | | | - Elin Kolle
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Wenche Nystad
- Chronic Diseases and Aging, Norwegian Institute of Public Health, Oslo, Norway
| | | | | | - Kathleen F Janz
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa, USA
| | - Susi Kriemler
- Epidemiology, Biostatistics and Public Health Institute, University of Zürich, Zürich, Switzerland
| | - Lars Bo Andersen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Sport, Food and Natural Sciences, Campus Sogndal, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Geir Kåre Resaland
- Center for Physically Active Learning, Faculty of Education, Arts and Sports, Campus Sogndal, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, Universidade de Lisboa, Lisbon, Portugal
| | - Esther M F van Sluijs
- Centre for Diet and Activity Research (CEDAR) & MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Mathias Ried-Larsen
- Centre for Physical Activity Research, Rigshospitalet Copenhagen, Capital Region of Denmark, Copenhagen, Denmark
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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14
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Toemen L, Gaillard R, Roest AA, van der Geest RJ, Steegers EA, van der Lugt A, Helbing WA, Jaddoe VW. Fetal and infant growth patterns and left and right ventricular measures in childhood assessed by cardiac MRI. Eur J Prev Cardiol 2019; 27:63-74. [PMID: 31357885 DOI: 10.1177/2047487319866022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Early life is critical for cardiac development. We examined the associations of longitudinal fetal and childhood growth patterns with childhood right and left ventricular structures measured by cardiac magnetic resonance imaging. METHODS In a population-based prospective cohort study among 2827 children, we measured growth at 20 and 30 weeks of pregnancy, at birth, 0.5, 1, 2, 6 and 10 years. At 10 years, we measured right ventricular end-diastolic volume, left ventricular end-diastolic volume, left ventricular mass and left ventricular mass-to-volume ratio by cardiac magnetic resonance imaging. RESULTS Small size for gestational age at birth was associated with smaller right and left ventricular end-diastolic volume relative to current body surface area, but with larger left ventricular mass-to-volume ratio (P < 0.05). Children in the upper 25% of right and left ventricular end-diastolic volume and left ventricular mass at age 10 years were larger at birth and became taller and leaner in childhood (P < 0.05). In contrast, children in the lower 25% of right and left ventricular end-diastolic volume and left ventricular mass were smaller at birth and became shorter and heavier in childhood (P < 0.05). Both fetal and childhood growth were independently of each other associated with childhood right and left ventricular end-diastolic volume and left ventricular mass. CONCLUSION Children who are larger at birth and grow taller and leaner in childhood have larger hearts relative to body surface area. Small size at birth children, who grow shorter and heavier in childhood, have relatively smaller hearts with larger left ventricular mass-to-volume ratio. Both fetal and childhood growth are important for the development of cardiac dimensions.
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Affiliation(s)
- Liza Toemen
- The Generation R Study Group, Erasmus University Medical Center, The Netherlands.,Department of Pediatrics, Erasmus University Medical Center, The Netherlands
| | - Romy Gaillard
- The Generation R Study Group, Erasmus University Medical Center, The Netherlands.,Department of Pediatrics, Erasmus University Medical Center, The Netherlands
| | - Arno A Roest
- Department of Pediatrics, Leiden University Medical Center, The Netherlands
| | | | - Eric Ap Steegers
- Department of Obstetrics and Gynecology, Erasmus University Medical Center, The Netherlands
| | - Aad van der Lugt
- Department of Radiology, Erasmus University Medical Center, The Netherlands
| | - Willem A Helbing
- Department of Pediatrics, Erasmus University Medical Center, The Netherlands
| | - Vincent Wv Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, The Netherlands.,Department of Pediatrics, Erasmus University Medical Center, The Netherlands
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15
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Vogelezang S, Santos S, Toemen L, Oei EHG, Felix JF, Jaddoe VWV. Associations of Fetal and Infant Weight Change With General, Visceral, and Organ Adiposity at School Age. JAMA Netw Open 2019; 2:e192843. [PMID: 31026028 PMCID: PMC6487630 DOI: 10.1001/jamanetworkopen.2019.2843] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
IMPORTANCE Both fetal and infant growth influence obesity later in life. The association of longitudinal fetal and infant growth patterns with organ fat is unknown. OBJECTIVE To examine the associations of fetal and infant weight change with general, visceral, and organ adiposity at school age. DESIGN, SETTING, AND PARTICIPANTS This cohort study was embedded in the Generation R Study, a population-based prospective cohort study in Rotterdam, the Netherlands. Pregnant women with a delivery date between April 2002 and January 2006 were eligible to participate. Follow-up measurements were performed for 3205 children. Data analysis of this population was performed from July 26, 2018, to February 7, 2019. EXPOSURES Fetal weight was estimated in the second and third trimester of pregnancy. Infant weight was measured at 6, 12, and 24 months. Fetal and infant weight acceleration or deceleration were defined as a change in standard deviation scores greater than 0.67 between 2 ages. MAIN OUTCOMES AND MEASURES Visceral fat index, pericardial fat index, and liver fat fraction were measured by magnetic resonance imaging. RESULTS The sample consisted of 3205 children (1632 girls [50.9%]; mean [SD] age, 9.8 [0.3] years). Children born small for gestational age had the lowest median body mass index compared with children born appropriate for gestational age and large for gestational age (16.4 [90% range, 14.1-23.6] vs 16.9 [90% range, 14.4-22.8] vs 17.4 [90% range, 14.9-22.7]). Compared with children with normal fetal and infant growth (533 of 2370 [22.5%]), those with fetal weight deceleration followed by infant weight acceleration (263 of 2370 [11.1%]) had the highest visceral fat index (standard deviation scores, 0.18; 95% CI, 0.03-0.33; P = .02) and liver fat fraction (standard deviation scores, 0.34; 95% CI, 0.20-0.48; P < .001). CONCLUSIONS AND RELEVANCE Fetal and infant weight change patterns were both associated with childhood body fat, but weight change patterns in infancy tended to have larger effects. Fetal growth restriction followed by infant growth acceleration was associated with increased visceral and liver fat.
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Affiliation(s)
- Suzanne Vogelezang
- The Generation R Study Group, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
- Department of Paediatrics, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
- Department of Paediatrics, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
| | - Liza Toemen
- The Generation R Study Group, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
- Department of Paediatrics, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
| | - Edwin H. G. Oei
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
| | - Janine F. Felix
- The Generation R Study Group, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
- Department of Paediatrics, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
- Department of Paediatrics, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
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16
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Ferguson DP, Monroe TO, Heredia CP, Fleischmann R, Rodney GG, Taffet GE, Fiorotto ML. Postnatal undernutrition alters adult female mouse cardiac structure and function leading to limited exercise capacity. J Physiol 2019; 597:1855-1872. [PMID: 30730556 DOI: 10.1113/jp277637] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 02/01/2019] [Indexed: 12/11/2022] Open
Abstract
KEY POINTS Impaired growth during fetal life can reprogramme heart development and increase the risk for long-term cardiovascular dysfunction. It is uncertain if the developmental window during which the heart is vulnerable to reprogramming as a result of inadequate nutrition extends into the postnatal period. We found that adult female mice that had been undernourished only from birth to 3 weeks of age had disproportionately smaller hearts compared to males, with thinner ventricle walls and more mononucleated cardiomyocytes. In females, but not males, cardiac diastolic function, and heart rate responsiveness to adrenergic stimulation were limited and maximal exercise capacity was compromised. These data suggest that the developmental window during which the heart is vulnerable to reprogramming by inadequacies in nutrient intake may extend into postnatal life and such individuals could be at increased risk for a cardiac event as a result of strenuous exercise. ABSTRACT Adults who experienced undernutrition during critical windows of development are at increased risk for cardiovascular disease. The contribution of cardiac function to this increased disease risk is uncertain. We evaluated the effect of a short episode of postnatal undernutrition on cardiovascular function in mice at the whole animal, organ, and cellular levels. Pups born to control mouse dams were suckled from birth to postnatal day (PN) 21 on dams fed either a control (20% protein) or a low protein (8% protein) isocaloric diet. After PN21 offspring were fed the same control diet until adulthood. At PN70 V ̇ O 2 , max was measured by treadmill test. At PN80 cardiac function was evaluated by echocardiography and Doppler analysis at rest and following β-adrenergic stimulation. Isolated cardiomyocyte nucleation and Ca2+ transients (with and without β-adrenergic stimulation) were measured at PN90. Female mice that were undernourished and then refed (PUN), unlike male mice, had disproportionately smaller hearts and their exercise capacity, cardiac diastolic function, and heart rate responsiveness to adrenergic stimulation were limited. A reduced left ventricular end diastolic volume, impaired early filling, and decreased stored energy at the beginning of diastole contributed to these impairments. Female PUN mice had more mononucleated cardiomyocytes; under resting conditions binucleated cells had a functional profile suggestive of increased basal adrenergic activation. Thus, a brief episode of early postnatal undernutrition in the mouse can produce persistent changes to cardiac structure and function that limit exercise/functional capacity and thereby increase the risk for the development of a wide variety of cardiovascular morbidities.
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Affiliation(s)
- David P Ferguson
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, 77030, USA.,Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX, 77030, USA.,Department of Kinesiology, Michigan State University, East Lansing, MI, 48824, USA
| | - Tanner O Monroe
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Celia Pena Heredia
- Section of Geriatrics, Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Ryan Fleischmann
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - George G Rodney
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX, 77030, USA
| | - George E Taffet
- Section of Geriatrics, Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Marta L Fiorotto
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, 77030, USA.,Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX, 77030, USA
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17
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Koletzko B, Godfrey KM, Poston L, Szajewska H, van Goudoever JB, de Waard M, Brands B, Grivell RM, Deussen AR, Dodd JM, Patro-Golab B, Zalewski BM. Nutrition During Pregnancy, Lactation and Early Childhood and its Implications for Maternal and Long-Term Child Health: The Early Nutrition Project Recommendations. ANNALS OF NUTRITION AND METABOLISM 2019; 74:93-106. [PMID: 30673669 DOI: 10.1159/000496471] [Citation(s) in RCA: 156] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 12/28/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND A considerable body of evidence accumulated especially during the last decade, demonstrating that early nutrition and lifestyle have long-term effects on later health and disease ("developmental or metabolic programming"). METHODS Researchers involved in the European Union funded international EarlyNutrition research project consolidated the scientific evidence base and existing recommendations to formulate consensus recommendations on nutrition and lifestyle before and during pregnancy, during infancy and early childhood that take long-term health impact into account. Systematic reviews were performed on published dietary guidelines, standards and recommendations, with special attention to long-term health consequences. In addition, systematic reviews of published systematic reviews on nutritional interventions or exposures in pregnancy and in infants and young children aged up to 3 years that describe effects on subsequent overweight, obesity and body composition were performed. Experts developed consensus recommendations incorporating the wide-ranging expertise from additional 33 stakeholders. FINDINGS Most current recommendations for pregnant women, particularly obese women, and for young children do not take long-term health consequences of early nutrition into account, although the available evidence for relevant consequences of lifestyle, diet and growth patterns in early life on later health and disease risk is strong. INTERPRETATION We present updated recommendations for optimized nutrition before and during pregnancy, during lactation, infancy and toddlerhood, with special reference to later health outcomes. These recommendations are developed for affluent populations, such as women and children in Europe, and should contribute to the primary prevention of obesity and associated non-communicable diseases.
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Affiliation(s)
- Berthold Koletzko
- LMU, Ludwig-Maximilians-University of Munich, Dr. von Hauner Children's Hospital, Medical Centre of LMU Munich, München, Germany,
| | - K M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Lucilla Poston
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Hania Szajewska
- Medical University of Warsaw, Department of Paediatrics, Warsaw, Poland
| | | | - Marita de Waard
- Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands
| | - Brigitte Brands
- LMU, Ludwig-Maximilians-University of Munich, Dr. von Hauner Children's Hospital, Medical Centre of LMU Munich, München, Germany
| | - Rosalie M Grivell
- Discipline of Obstetrics and Gynaecology, The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Andrea R Deussen
- Discipline of Obstetrics and Gynaecology, The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jodie M Dodd
- Discipline of Obstetrics and Gynaecology, The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
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18
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Sletner L, Mahon P, Crozier SR, Inskip HM, Godfrey KM, Chiesa S, Bhowruth DJ, Charakida M, Deanfield J, Cooper C, Hanson M. Childhood Fat and Lean Mass: Differing Relations to Vascular Structure and Function at Age 8 to 9 Years. Arterioscler Thromb Vasc Biol 2018; 38:2528-2537. [PMID: 30354210 PMCID: PMC6248304 DOI: 10.1161/atvbaha.118.311455] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective- Childhood body mass index (BMI) has been related to vascular structure and function. However, little is known about the differing contributions of fat and lean mass to this relationship. Our objectives were to relate the fat and lean mass (bone excluded) components of BMI (fat mass index and lean mass index; mass [kg]/height [m]2) to vascular measures in prepubertal children. Approach and Results- In the UK Southampton Women's Survey mother-offspring cohort, 983 children had dual x-ray absorptiometry and vascular measurements at 8 to 9 years. Using linear regression analyses, we found that most vascular measures were related to BMI, but fat and lean mass contributed differently. Systolic blood pressure was positively associated with both fat mass index (β=0.91 [95% CI, 0.52-1.30] mm Hg) and lean mass index (β=2.16 [95% CI, 1.47-2.85] mm Hg), whereas pulse rate was positively associated with fat mass index (β=0.93 [95% CI, 0.48-1.38] b/min) but negatively associated with lean mass index (β=-1.79 [95% CI, -2.59 to -0.99] b/min). The positive relation between BMI and carotid intima-media thickness was mainly due to a positive association with lean mass index (β=0.013 [95% CI, 0.008-0.019] mm). Carotid-femoral pulse wave velocity, but not carotid-radial pulse wave velocity, was positively associated with fat mass index (β=0.06 [95% CI, 0.03-0.09] m/s). For systolic blood pressure, carotid-femoral pulse wave velocity and reactive hyperemia significant interactions indicated that the association with fat mass depended on the amount of lean mass. Conclusions- In prepubertal children, differences in vascular structure and function in relation to BMI probably represent combinations of adverse effects of fat mass, adaptive effects of body size, and relatively protective effects of lean mass.
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Affiliation(s)
- Line Sletner
- Dept. of Pediatric and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Pamela Mahon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Sarah R. Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Scott Chiesa
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - Devina J. Bhowruth
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - Marietta Charakida
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - John Deanfield
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mark Hanson
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
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19
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Arnold KF, Ellison G, Gadd SC, Textor J, Tennant P, Heppenstall A, Gilthorpe MS. Adjustment for time-invariant and time-varying confounders in 'unexplained residuals' models for longitudinal data within a causal framework and associated challenges. Stat Methods Med Res 2018; 28:1347-1364. [PMID: 29451093 PMCID: PMC6484949 DOI: 10.1177/0962280218756158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
‘Unexplained residuals’ models have been used within lifecourse epidemiology to
model an exposure measured longitudinally at several time points in relation to
a distal outcome. It has been claimed that these models have several advantages,
including: the ability to estimate multiple total causal effects in a single
model, and additional insight into the effect on the outcome of
greater-than-expected increases in the exposure compared to traditional
regression methods. We evaluate these properties and prove mathematically how
adjustment for confounding variables must be made within this modelling
framework. Importantly, we explicitly place unexplained residual models in a
causal framework using directed acyclic graphs. This allows for theoretical
justification of appropriate confounder adjustment and provides a framework for
extending our results to more complex scenarios than those examined in this
paper. We also discuss several interpretational issues relating to unexplained
residual models within a causal framework. We argue that unexplained residual
models offer no additional insights compared to traditional regression methods,
and, in fact, are more challenging to implement; moreover, they artificially
reduce estimated standard errors. Consequently, we conclude that unexplained
residual models, if used, must be implemented with great care.
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Affiliation(s)
- K F Arnold
- 1 Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,2 School of Medicine, University of Leeds, Leeds, UK
| | - Gth Ellison
- 1 Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,2 School of Medicine, University of Leeds, Leeds, UK
| | - S C Gadd
- 2 School of Medicine, University of Leeds, Leeds, UK
| | - J Textor
- 3 Tumor Immunology Lab, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Pwg Tennant
- 1 Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,4 School of Healthcare, University of Leeds, Leeds, UK
| | - A Heppenstall
- 1 Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,5 School of Geography, University of Leeds, Leeds, UK
| | - M S Gilthorpe
- 1 Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,2 School of Medicine, University of Leeds, Leeds, UK
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20
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Marinkovic T, Toemen L, Kruithof CJ, Reiss I, van Osch-Gevers L, Hofman A, Franco OH, Jaddoe VWV. Early Infant Growth Velocity Patterns and Cardiovascular and Metabolic Outcomes in Childhood. J Pediatr 2017; 186:57-63.e4. [PMID: 28256212 PMCID: PMC5489080 DOI: 10.1016/j.jpeds.2017.02.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 01/05/2017] [Accepted: 02/01/2017] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate the impact of infant growth on childhood health by examining the associations of detailed longitudinal infant weight velocity patterns with childhood cardiovascular and metabolic outcomes. STUDY DESIGN In a population-based prospective cohort study of 4649 children, we used repeated growth measurements at age 0-3 years to derive peak weight velocity (PWV), age at adiposity peak (AGEAP), and body mass index at adiposity peak (BMIAP). At age 6 years, we measured blood pressure, left ventricular mass, and cholesterol, triglyceride, and insulin concentrations and defined children with clusters of risk factors. We assessed associations using 2 multivariable linear regression models. RESULTS A 1-SDS-higher infant PWV was associated with higher diastolic blood pressure (0.05 SDS; 95% CI, 0.02-0.09) and lower left ventricular mass (-0.05 SDS; 95% CI, -0.09 to -0.01), independent of body size. A 1-SDS-higher BMIAP was associated with higher systolic (0.12; 95% CI, 0.09-0.16) and diastolic (0.05; 95% CI, 0.01-0.08) blood pressure, but these associations were explained by childhood BMI. We did not observe any associations of PWV, BMIAP, and AGEAP with cholesterol and insulin concentrations. Higher PWV and AGEAP were associated with elevated risk of clustering of cardiovascular risk factors in childhood (P < .05). CONCLUSION Infant weight velocity patterns are associated with cardiovascular outcomes. Further studies are needed to explore the associations with metabolic outcomes and long-term consequences.
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Affiliation(s)
- Tamara Marinkovic
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Liza Toemen
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Claudia J Kruithof
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Irwin Reiss
- Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Lennie van Osch-Gevers
- Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
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21
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22
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Arabin B, Baschat AA. Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health-An Appeal for Continuous Family Care and Interdisciplinary Communication. Front Pediatr 2017; 5:69. [PMID: 28451583 PMCID: PMC5389980 DOI: 10.3389/fped.2017.00069] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 03/20/2017] [Indexed: 12/21/2022] Open
Abstract
Physiologic adaptations during pregnancy unmask a woman's predisposition to diseases. Complications are increasingly predicted by first-trimester algorithms, amplify a pre-existing maternal phenotype and accelerate risks for chronic diseases in the offspring up to adulthood (Barker hypothesis). Recent evidence suggests that vice versa, pregnancy diseases also indicate maternal and even grandparent's risks for chronic diseases (reverse Barker hypothesis). Pub-Med and Embase were reviewed for Mesh terms "fetal programming" and "pregnancy complications combined with maternal disease" until January 2017. Studies linking pregnancy complications to future cardiovascular, metabolic, and thrombotic risks for mother and offspring were reviewed. Women with a history of miscarriage, fetal growth restriction, preeclampsia, preterm delivery, obesity, excessive gestational weight gain, gestational diabetes, subfertility, and thrombophilia more frequently demonstrate with echocardiographic abnormalities, higher fasting insulin, deviating lipids or clotting factors and show defective endothelial function. Thrombophilia hints to thrombotic risks in later life. Pregnancy abnormalities correlate with future cardiovascular and metabolic complications and earlier mortality. Conversely, women with a normal pregnancy have lower rates of subsequent diseases than the general female population creating the term: "Pregnancy as a window for future health." Although the placenta works as a gatekeeper, many pregnancy complications may lead to sickness and earlier death in later life when the child becomes an adult. The epigenetic mechanisms and the mismatch between pre- and postnatal life have created the term "fetal origin of adult disease." Up to now, the impact of cardiovascular, metabolic, or thrombotic risk profiles has been investigated separately for mother and child. In this manuscript, we strive to illustrate the consequences for both, fetus and mother within a cohesive perspective and thus try to demonstrate the complex interrelationship of genetics and epigenetics for long-term health of societies and future generations. Maternal-fetal medicine specialists should have a key role in the prevention of non-communicable diseases by implementing a framework for patient consultation and interdisciplinary networks. Health-care providers and policy makers should increasingly invest in a stratified primary prevention and follow-up to reduce the increasing number of manifest cardiovascular and metabolic diseases and to prevent waste of health-care resources.
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Affiliation(s)
- Birgit Arabin
- Center for Mother and Child, Philipps University, Marburg, Germany
- Clara Angela Foundation, Witten, Germany
| | - Ahmet A. Baschat
- Clara Angela Foundation, Witten, Germany
- Center for Fetal Therapy, Johns Hopkins University, Baltimore, MD, USA
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