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Shook LL, Castro VM, Herzberg EM, Fourman LT, Kaimal AJ, Perlis RH, Edlow AG. Offspring cardiometabolic outcomes and postnatal growth trajectories after exposure to maternal SARS-CoV-2 infection. Obesity (Silver Spring) 2024; 32:969-978. [PMID: 38351665 PMCID: PMC11039385 DOI: 10.1002/oby.23998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/12/2023] [Accepted: 01/06/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVE The objective of this study is to determine whether in utero exposure to SARS-CoV-2 is associated with increased risk for a cardiometabolic diagnosis by 18 months of age. METHODS This retrospective electronic health record (EHR)-based cohort study included the live-born offspring of all individuals who delivered during the COVID-19 pandemic (April 1, 2020-December 31, 2021) at eight hospitals in Massachusetts. Offspring exposure was defined as a positive maternal SARS-CoV-2 polymerase chain reaction test during pregnancy. The primary outcome was presence of an ICD-10 code for a cardiometabolic disorder in offspring EHR by 18 months. Weight-, length-, and BMI-for-age z scores were calculated and compared at 6-month intervals from birth to 18 months. RESULTS A total of 29,510 offspring (1599 exposed and 27,911 unexposed) were included. By 18 months, 6.7% of exposed and 4.4% of unexposed offspring had received a cardiometabolic diagnosis (crude odds ratio [OR] 1.47 [95% CI: 1.10 to 1.94], p = 0.007; adjusted OR 1.38 [1.06 to 1.77], p = 0.01). Exposed offspring had a significantly greater mean BMI-for-age z score versus unexposed offspring at 6 months (z score difference 0.19 [95% CI: 0.10 to 0.29], p < 0.001; adjusted difference 0.04 [-0.06 to 0.13], p = 0.4). CONCLUSIONS Exposure to maternal SARS-CoV-2 infection was associated with an increased risk of receiving a cardiometabolic diagnosis by 18 months preceded by greater BMI-for-age at 6 months.
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Affiliation(s)
- Lydia L. Shook
- Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Victor M. Castro
- Center for Quantitative Health and Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Research Information Science and Computing, Mass General Brigham, Somerville, MA
| | - Emily M. Herzberg
- Division of Neonatology and Newborn Medicine, Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School
| | - Lindsay T. Fourman
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Anjali J. Kaimal
- Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, FL
| | - Roy H. Perlis
- Center for Quantitative Health and Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Andrea G. Edlow
- Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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Habib M, Croyal M, Kaeffer B, Grit I, Castellano B, Gourdel M, Le May C, Thorin C, Nazih H, Ouguerram K. Gestational cholestyramine treatment protects adult offspring of ApoE-deficient mice against maternal-hypercholesterolemia-induced atherosclerosis. Acta Physiol (Oxf) 2024; 240:e14133. [PMID: 38546340 DOI: 10.1111/apha.14133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 03/04/2024] [Indexed: 04/24/2024]
Abstract
AIM Perinatal hypercholesterolemia exacerbates the development of atherosclerotic plaques in adult offspring. Here, we aimed to study the effect of maternal treatment with cholestyramine, a lipid-lowering drug, on atherosclerosis development in adult offspring of hypercholesterolemic ApoE-deficient (ApoE-/-) mice. METHODS ApoE-/- mice were treated with 3% cholestyramine (CTY) during gestation (G). After weaning, offspring (CTY-G) were fed control diet until sacrificed at 25weeks of age. Atherosclerosis development in the aortic root of offspring was assessed after oil-red-o staining, along with some of predefined atherosclerosis regulators such as LDL and HDL by high-performance liquid chromatography (HPLC), and bile acids (BA) and trimethylamine N-oxide (TMAO) by liquid chromatography-mass spectrometry (LC-MS/MS). RESULTS In pregnant dams, cholestyramine treatment resulted in significantly lower plasma total- and LDL-cholesterol as well as gallbladder total BA levels. In offspring, both males and females born to treated dams displayed reduced atherosclerotic plaques areas along with less lipid deposition in the aortic root. No significant change in plasma total cholesterol or triglycerides was measured in offspring, but CTY-G males had increased HDL-cholesterol and decreased apolipoproteins B100 to A-I ratio. This latter group also showed reduced gallbladder total and specifically tauro-conjugated bile acid pools, whereas for CTY-G females, hydrophilic plasma tauro-conjugated BA pool was significantly higher. They also benefited from lower plasma TMAO. CONCLUSION Prenatal cholestyramine treatment reduces atherosclerosis development in adult offspring of ApoE-/- mice along with modulating the plaques' composition as well as some related biomarkers such as HDL-C, bile acids and TMAO.
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Affiliation(s)
- Marina Habib
- UMR1280 Pathophysiology of Nutritional Adaptations, Nantes Université, INRAE, Nantes, France
| | - Mikael Croyal
- Mass Spectrometry Core Facility, CRNH-Ouest, Nantes, France
- Institut du thorax, Nantes Université, CNRS, INSERM, Nantes, France
- UMS 016, UMS 3556, Nantes Université, Inserm, CNRS, Nantes, France
| | - Bertrand Kaeffer
- UMR1280 Pathophysiology of Nutritional Adaptations, Nantes Université, INRAE, Nantes, France
| | - Isabelle Grit
- UMR1280 Pathophysiology of Nutritional Adaptations, Nantes Université, INRAE, Nantes, France
| | - Blandine Castellano
- UMR1280 Pathophysiology of Nutritional Adaptations, Nantes Université, INRAE, Nantes, France
| | - Mathilde Gourdel
- Institut du thorax, Nantes Université, CNRS, INSERM, Nantes, France
| | - Cédric Le May
- UMS 016, UMS 3556, Nantes Université, Inserm, CNRS, Nantes, France
| | - Chantal Thorin
- UMR0703 PAnTher, École Nationale Vétérinaire, Agroalimentaire et de l'Alimentation, Nantes, France
| | - Hassan Nazih
- UR2160 ISOMer, Nantes Université, Nantes, France
| | - Khadija Ouguerram
- UMR1280 Pathophysiology of Nutritional Adaptations, Nantes Université, INRAE, Nantes, France
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Ventura AK, Phelan S, Alarcon N, Quintana Diaz A, Sklar JC, Hart CN. A Pilot Feasibility Randomized Controlled Trial of Effects of Opaque Bottles on Maternal Sensitivity, Infant Intake, and Infant Weight Status. J Acad Nutr Diet 2024:S2212-2672(24)00055-8. [PMID: 38331187 DOI: 10.1016/j.jand.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Conventional clear infant feeding bottles provide visual cues about the amount of milk consumed, which may decrease caregivers' sensitivity to infant cues, increase infant intake, and lead to greater infant weight gain. OBJECTIVE This study examined feasibility, adherence, acceptability, and preliminary effectiveness of an intervention in which families received clear vs opaque bottles. DESIGN A pilot feasibility randomized controlled trial was conducted. PARTICIPANTS/SETTING Participants included mothers (N = 76) with young infants (2.9 ± 1.4 months old). Data collection occurred between December 2018 and July 2022 and within San Luis Obispo and Santa Barbara Counties, California. All assessments occurred within participants' homes. INTERVENTION Participants were randomized to use clear (Clear group, n = 38) or opaque (Opaque group, n = 38) bottles for 12 weeks. MAIN OUTCOME MEASURES We assessed feasibility of recruitment and retention, participant perceptions of study bottles, participant adherence to the intervention, maternal sensitivity to cues, infant intake (mL and mL/kg), and infant weight-for-length z-scores (WLZ). STATISTICAL ANALYSES PERFORMED Data were analyzed using linear regression, χ2 analysis, and repeated-measures analysis of variance (ANOVA). RESULTS Of 842 potential participants, 295 (35%) could not be reached after initial contact, 166 (20%) declined to participate, and 305 (36%) were ineligible. Of those who declined, 16 (10%) declined because they did not want to use study bottles. No differences were observed for loss to follow-up for Clear (8 of 38; 21%) vs Opaque (5 of 38; 13%) groups (P = 0.36) or for reported use of assigned bottles for Clear (89.8% ± 24.5% of daily feedings) vs Opaque (90.1% ± 22.1%) groups (P = 0.96). No group differences were observed for sensitivity to cues (P = 0.52) or intake (mL, P = 0.53 or mL/kg, P = 0.56) at follow-up. Opaque group infants had lower WLZ at follow-up compared with Clear group infants (mean difference, 0.47; 95% confidence interval, 0.08, 0.86; ηp2 = 0.17), adjusting for baseline WLZ. CONCLUSIONS Relative to providing clear bottles, providing families with opaque bottles appeared feasible and acceptable, with good adherence. Although preliminary, study findings suggest the potential of opaque bottles to support healthier weight outcomes for bottle-fed infants.
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Affiliation(s)
- Alison K Ventura
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, CA.
| | - Suzanne Phelan
- Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, CA
| | - Noemi Alarcon
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA
| | - Adilene Quintana Diaz
- Center for Health Research, California Polytechnic State University, San Luis Obispo, CA
| | - Jeffrey C Sklar
- Department of Statistics, California Polytechnic State University, San Luis Obispo, CA
| | - Chantelle N Hart
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA
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Ockene MW, Russo SC, Lee H, Monthé-Drèze C, Stanley TL, Ma IL, Toribio M, Shook LL, Grinspoon SK, Edlow AG, Fourman LT. Accelerated Longitudinal Weight Gain Among Infants With In Utero COVID-19 Exposure. J Clin Endocrinol Metab 2023; 108:2579-2588. [PMID: 36988326 PMCID: PMC10505544 DOI: 10.1210/clinem/dgad130] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Indexed: 03/30/2023]
Abstract
CONTEXT Since the initial outbreak of coronavirus disease 2019 (COVID-19), a novel population of children with in utero exposure to maternal infection has emerged whose health outcomes are largely unknown. OBJECTIVE To compare longitudinal growth trajectories among infants with vs without in utero COVID-19 exposure. METHODS We conducted a longitudinal cohort study leveraging a prospectively enrolled perinatal biorepository among 149 infants with in utero COVID-19 exposure and 127 unexposed controls. Weight, length, and body mass index (BMI) were abstracted from health records at 0, 2, 6, and 12 months and standardized using World Health Organization growth charts. Analyses were adjusted for maternal age, ethnicity, parity, insurance, and BMI as well as infant sex, birthdate, and breastfeeding. RESULTS Infants with in utero COVID-19 exposure vs controls exhibited differential trajectories of weight and BMI, but not length, z-score over the first year of life (study group × time interaction, P < .0001 for weight and BMI). Infants born to mothers with prenatal COVID-19 had lower BMI z-score at birth (effect size: -0.35, 95% CI -0.66 to -0.03) and greater gain in BMI z-score from birth to 12 months (effect size: 0.53, 95% CI 0.06 to 0.99). Birth weight z-score mediated a significant proportion of the relationship between COVID-19 exposure and postnatal growth (estimate ± SE, 32 ± 14%, P = .02). CONCLUSION Infants with in utero COVID-19 exposure exhibited lower birth weight and accelerated weight gain in the first year of life, which may be harbingers of downstream cardiometabolic pathology. Further studies are needed to delineate cardiometabolic sequelae among this emerging global population.
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Affiliation(s)
- Mollie W Ockene
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Samuel C Russo
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Hang Lee
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Carmen Monthé-Drèze
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Takara L Stanley
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Ingrid L Ma
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Mabel Toribio
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Lydia L Shook
- Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Steven K Grinspoon
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Andrea G Edlow
- Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Lindsay T Fourman
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
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Iyengar A, Bonilla-Félix M. Effects of Prematurity and Growth Restriction on Adult Blood Pressure and Kidney Volume. Adv Chronic Kidney Dis 2022; 29:243-250. [PMID: 36084971 DOI: 10.1053/j.ackd.2022.02.002] [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: 07/09/2021] [Revised: 01/11/2022] [Accepted: 02/15/2022] [Indexed: 11/11/2022]
Abstract
Gaining insight into the complex cycle of renal programming and its early-life clinical associations is essential to understand the origins of kidney disease. Prematurity and intrauterine growth restriction are associated with low nephron endowment. This increases the risk of developing hypertension and chronic kidney disease later in life. There is appreciable evidence to support mechanistic links between low nephron endowment secondary to intrauterine events and kidney size, kidney function, and blood pressure in postnatal life. A clear understanding of the cycle of developmental programming and consequences of fetal insults on the kidney is critical. In addition, the impact of events in the early postnatal period (accelerated postnatal growth, development of obesity, exposure to nephrotoxins) on the cardiovascular system and blood pressure of individuals born prematurely or with low birth weight is discussed. In summary, this review draws attention to the concepts of renal programming and nephron endowment and underscores the associations between intrauterine growth restriction, prematurity, and its clinical consequences in adult life.
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Affiliation(s)
- Arpana Iyengar
- Department of Pediatric Nephrology, St John's Medical College Hospital, Bangalore, India
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Semmler L, Weberruß H, Baumgartner L, Pirzer R, Oberhoffer-Fritz R. Vascular diameter and intima-media thickness to diameter ratio values of the carotid artery in 642 healthy children. Eur J Pediatr 2021; 180:851-860. [PMID: 32945911 PMCID: PMC7886737 DOI: 10.1007/s00431-020-03785-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 08/11/2020] [Accepted: 08/18/2020] [Indexed: 12/20/2022]
Abstract
In children, arterial alterations occur with increased intima-media thickness as well as vascular diameter enlargement. Both conditions correlate with higher cardiovascular risk in adults, and both the array and proportion of these alterations are important hemodynamic parameters. In terms of functional adaptation processes, they influence several arterial wall properties as for example the shear and tensile stress of the vessel. There are no reference values for the vascular diameter and intima-media thickness/diameter ratio of the carotid artery in children. Therefore, this study aimed to assess vascular diameter, intima-media thickness/diameter ratio and related tensile stress values in children and to further investigate the influence of sex, age, body mass index, and blood pressure. The parameters were measured with high-resolution semi-automated ultrasound. Sex- and age-dependent values were calculated with the LMS method for a cross-sectional sample of 642 healthy, non-obese children aged 8-17 years. The mean vascular diameter was 5.45 ± 0.46 mm; the median intima-media thickness/diameter ratio was 0.085 (0.079-0.092); the median tensile stress was 105.4 (95.2-116.4) kPa. The vascular diameter and the tensile stress were higher, and the intima-media thickness/diameter ratio was lower in boys than in girls. In comparison to the normal weight study population the excludedobese children had a significantly higher diameter, a lower intima-media thickness/diameter ratio, and a higher tensile stress. In multiple regression analyses of diameter, intima-media thickness/diameter ratio, and tensile stress, all parameters were influenced by sex and body mass index. Furthermore, systolic and diastolic blood pressure significantly influenced the vascular diameter, and systolic blood pressure significantly influenced the intima-media thickness/diameter ratio. Conclusion: This study is the first to report values for the diameter, the intima-media thickness/diameter ratio of the carotid artery, and the related tensile stress allowing a more differentiated view of cardiovascular adaptations as it combines structural and functional vascular parameters. What is known: • Intima-media thickness and vascular diameter are related to a higher cardiovascular risk in adults • The intima-media thickness/diameter ratio gives information about hemodynamic and functional vessel adaptation What is new: • Values for vascular diameter, intima-media thickness/diameter ratio, and tensile stress of the carotid artery in children are presented in this study • Intima-media thickness as a surrogate marker for arterial health in children should be complemented by intima-media thickness/diameter ratio measurement.
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Affiliation(s)
- Luisa Semmler
- Institute of Preventive Pediatrics, Technical University, Munich, Germany
| | - Heidi Weberruß
- Institute of Preventive Pediatrics, Technical University, Munich, Germany
| | - Lisa Baumgartner
- Institute of Preventive Pediatrics, Technical University, Munich, Germany
| | - Raphael Pirzer
- Department of Anaesthesiology and Operative Intensive Care, University Hospital, Augsburg, Germany
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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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Risk factors during first 1,000 days of life for carotid intima-media thickness in infants, children, and adolescents: A systematic review with meta-analyses. PLoS Med 2020; 17:e1003414. [PMID: 33226997 PMCID: PMC7682901 DOI: 10.1371/journal.pmed.1003414] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/19/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The first 1,000 days of life, i.e., from conception to age 2 years, could be a critical period for cardiovascular health. Increased carotid intima-media thickness (CIMT) is a surrogate marker of atherosclerosis. We performed a systematic review with meta-analyses to assess (1) the relationship between exposures or interventions in the first 1,000 days of life and CIMT in infants, children, and adolescents; and (2) the CIMT measurement methods. METHODS AND FINDINGS Systematic searches of Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), and Cochrane Central Register of Controlled Trials (CENTRAL) were performed from inception to March 2019. Observational and interventional studies evaluating factors at the individual, familial, or environmental levels, for instance, size at birth, gestational age, breastfeeding, mode of conception, gestational diabetes, or smoking, were included. Quality was evaluated based on study methodological validity (adjusted Newcastle-Ottawa Scale if observational; Cochrane collaboration risk of bias tool if interventional) and CIMT measurement reliability. Estimates from bivariate or partial associations that were least adjusted for sex were used for pooling data across studies, when appropriate, using random-effects meta-analyses. The research protocol was published and registered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD42017075169). Of 6,221 reports screened, 50 full-text articles from 36 studies (34 observational, 2 interventional) totaling 7,977 participants (0 to 18 years at CIMT assessment) were retained. Children born small for gestational age had increased CIMT (16 studies, 2,570 participants, pooled standardized mean difference (SMD): 0.40 (95% confidence interval (CI): 0.15 to 0.64, p: 0.001), I2: 83%). When restricted to studies of higher quality of CIMT measurement, this relationship was stronger (3 studies, 461 participants, pooled SMD: 0.64 (95% CI: 0.09 to 1.19, p: 0.024), I2: 86%). Only 1 study evaluating small size for gestational age was rated as high quality for all methodological domains. Children conceived through assisted reproductive technologies (ART) (3 studies, 323 participants, pooled SMD: 0.78 (95% CI: -0.20 to 1.75, p: 0.120), I2: 94%) or exposed to maternal smoking during pregnancy (3 studies, 909 participants, pooled SMD: 0.12 (95% CI: -0.06 to 0.30, p: 0.205), I2: 0%) had increased CIMT, but the imprecision around the estimates was high. None of the studies evaluating these 2 factors was rated as high quality for all methodological domains. Two studies evaluating the effect of nutritional interventions starting at birth did not show an effect on CIMT. Only 12 (33%) studies were at higher quality across all domains of CIMT reliability. The degree of confidence in results is limited by the low number of high-quality studies, the relatively small sample sizes, and the high between-study heterogeneity. CONCLUSIONS In our meta-analyses, we found several risk factors in the first 1,000 days of life that may be associated with increased CIMT during childhood. Small size for gestational age had the most consistent relationship with increased CIMT. The associations with conception through ART or with smoking during pregnancy were not statistically significant, with a high imprecision around the estimates. Due to the large uncertainty in effect sizes and the limited quality of CIMT measurements, further high-quality studies are needed to justify intervention for primordial prevention of cardiovascular disease (CVD).
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Check J, Jensen ET, Skelton JA, Ambrosius WT, O'Shea TM. Early growth outcomes in very low birth weight infants with bronchopulmonary dysplasia or fetal growth restriction. Pediatr Res 2020; 88:601-604. [PMID: 32061195 DOI: 10.1038/s41390-020-0808-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/29/2020] [Accepted: 02/07/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND To assess the growth outcomes at 18 months corrected age in very low birth weight (VLBW) infants compared to standardized norms, and in VLBW infants with and without bronchopulmonary dysplasia (BPD) or fetal growth restriction (FGR). METHODS In all, 1149 VLBW infants completed anthropometrics at 18 months corrected age. To derive weight, height, and body mass index (BMI) percentiles and z-scores at 18 months, we used the SAS macro from the Centers for Disease Control and Prevention (CDC). z-scores for a child's sex and age are based on the World Health Organization's growth charts for children <24 months of age. RESULTS Female and male VLBW infants had higher body-mass-index (BMI)-for-age z-scores compared to normative data (0.82 and 1.77 respectively). No significant difference was found in BMI-for-age z-scores in BPD and non-BPD (1.76 vs. 2.3; p = 0.4), nor in FGR and non-FGR (1.24 vs. 2.16; p = 0.2). CONCLUSIONS At 18 months corrected age, VLBW infants, including those with BPD or FGR, had BMI-for-age z-scores higher than reference standards. No significant difference was seen comparing BMI-for-age z-scores in the BPD/non-BPD and FGR/non-FGR groups.
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Affiliation(s)
- Jennifer Check
- Department of Pediatrics, Wake Forest University School of Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA.
| | - Elizabeth T Jensen
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Joseph A Skelton
- Department of Pediatrics, Wake Forest University School of Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Walter T Ambrosius
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest University School of Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - T Michael O'Shea
- Department of Pediatrics, University of North Carolina at Chapel Hill, UNC Hospitals, Chapel Hill, NC, USA
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10
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Soesanti F, Idris NS, Klipstein-Grobusch K, Hendarto A, Grobbee DE, Uiterwaal CSPM. The effect of non-organophosphate household pesticides exposure during pregnancy on infants birth sizes and growth rate: a cohort study. BMC Pregnancy Childbirth 2020; 20:476. [PMID: 32819320 PMCID: PMC7441723 DOI: 10.1186/s12884-020-03162-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 08/10/2020] [Indexed: 12/17/2022] Open
Abstract
Background To date, there is limited evidence on the effect of antenatal exposure to non-organophosphate household pesticides on infant health. Our hypothesis is that antenatal exposure to non-organophosphate household pesticides will be associated with birth sizes and infant growth rate. Methods In this prospective cohort study, 284 mother-infant pairs were studied. Mothers were recruited at the third trimester in two primary care centers and one private hospital in Jakarta, Indonesia. Mothers filled out questionnaires about exposure to non-organophosphate household pesticides at the 3rd trimester of pregnancy. Birth weight and length were measured at birth. Afterwards, the weight, height, and head circumference (HC) were measured at 7 days, 1, 2, 4, and 6 months of age. Linear mixed modeling and linear regression was performed to calculate growth rate of each infant. Multivariable linear regression adjusted for confounders was used to assess the association between household pesticides exposure and birth sizes and infant growth rate. Results Based on self-report questionnaires, 133 (46.8%) mothers were exposed to household pesticides during pregnancy. The mean HC at day 7 in the exposed group was − 7.1 mm (95%CI -13.1;-1.2) lower than in the non-exposed group. The difference was more prominent in the non-mosquito pesticide group (linear regression coefficient: − 22.1 mm, 95%CI -36.5;-7.6). No material associations were found between antenatal exposure to household pesticides with other growth measures, including weight gain, length gain, HC increment and weight-to-length gain rates. No modification of effects by breastfeeding was found. Conclusions Our findings suggest that antenatal exposure to household non-organophosphate pesticides is associated with smaller head circumference at birth.
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Affiliation(s)
- Frida Soesanti
- Department of Child Health, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. .,Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, The Netherlands.
| | - Nikmah S Idris
- Department of Child Health, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.,Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, The Netherlands.,Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Aryono Hendarto
- Department of Child Health, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Diederick E Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - Cuno S P M Uiterwaal
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, The Netherlands
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11
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Relationship between prenatal and postnatal conditions and accelerated postnatal growth. Impact on the rigidity of the arterial wall and obesity in childhood. J Dev Orig Health Dis 2020; 10:436-446. [PMID: 31347487 DOI: 10.1017/s2040174418001058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Restricted growth in utero and accelerated postnatal growth (APG) in the postnatal period have been associated with the development of overweight, obesity and an increased cardiovascular risk in childhood. The objectives of this study were to evaluate the influence of prenatal and perinatal conditions on APG and to evaluate the influence of this APG on different cardiovascular risk factors such as body mass index (BMI), body fat mass index (FMI), blood pressure (BP) and arterial wall stiffness [carotid to femoral pulse wave velocity (cf-PWV)]. All measurements were performed in 355 children (185 boys and 170 girls; 8-11 years). Data on mother weight before and during pregnancy, gestational age (weeks), birth weight (g) and breastfeeding of children were obtained through interviews with families. Children who presented APG were born of mothers with lower BMIs before pregnancy and who gained less weight during the second trimester of pregnancy. They also have a lower gestational age and birth weight, a shorter duration of breastfeeding and a longer duration of artificial feeding (AF). Later in childhood, they had higher values of cf-PWV, BMI, FMI and higher prevalence of hypertension. Low maternal gestational weight gain, inadequate fetal development (low birth weight, shorter gestational age) and reduced breastfeeding duration favor APG. Infants with such APG had higher values of cf-PWV, BP, BMI and FMI later in childhood, along with a higher risk of hypertension and obesity. The interaction between APG and a longer duration of AF had a negative effect on cf-PWV (arterial stiffness) and FMI.
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12
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Arterial Structural and Functional Characteristics at End of Early Childhood and Beginning of Adulthood: Impact of Body Size Gain during Early, Intermediate, Late and Global Growth. J Cardiovasc Dev Dis 2019; 6:jcdd6030033. [PMID: 31489955 PMCID: PMC6787690 DOI: 10.3390/jcdd6030033] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 12/17/2022] Open
Abstract
An association between nutritional characteristics in theearlylife stages and the state of the cardiovascular (CV) system in early childhood itself and/or at the beginning of adulthood has been postulated. It is still controversial whether changes in weight, height and/or body mass index (BMI) during childhood or adolescence are independently associated with hemodynamics and/or arterial properties in early childhood and adulthood. Aims: First, to evaluate and compare the strength of association between CVproperties (at 6 and 18 years (y)) and (a) anthropometric data at specific growth stages (e.g., birth, 6 y, 18 y) and (b) anthropometric changes during early (0–2 y), intermediate (0–6 y), late (6–18 y) and global (0–18 y) growth. Second, to determine whether the associations between CVproperties and growth-related body changes depend on size at birth and/or at the time of CVstudy. Third, to analyze the capacity of growth-related body size changes to explain hemodynamic and arterial properties in early childhood and adulthood before and after adjusting for exposure to CV risk factors. Anthropometric, hemodynamic (central, peripheral) and arterial parameters (structural, functional; elastic, transitional and muscular arteries) were assessed in two cohorts (children, n = 682; adolescents, n = 340). Data wereobtained and analyzed following identical protocols. Results: Body-size changes in infancy (0–2 y) and childhood (0–6 y) showed similar strength of association with CV properties at 6 y. Conversely, 0–6, 6-18 or 0–18 ychanges were not associated with CV parameters at 18 y. The association between CV properties at 6 yand body-size changes during growth showed: equal or greater strength than the observed for body-size at birth, and lower strength compared to that obtained for current z-BMI. Conversely, only z-BMI at 18 y showed associations with CV z-scores at 18 y. Body size at birth showed almost no association with CVproperties at 6 or 18 y. Conclusion: current z-BMI showed the greatest capacity to explain variations in CV properties at 6 and 18 y. Variations in some CV parameters were mainly explained by growth-related anthropometric changes and/or by their interaction with current z-BMI. Body size at birth showed almost no association with arterial properties at 6 or 18 y.
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13
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Soesanti F, Uiterwaal CSPM, Grobbee DE, Hendarto A, Dalmeijer GW, Idris NS. Antenatal exposure to second hand smoke of non-smoking mothers and growth rate of their infants. PLoS One 2019; 14:e0218577. [PMID: 31220162 PMCID: PMC6586334 DOI: 10.1371/journal.pone.0218577] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 06/04/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives There is limited evidence on the effect of exposure to second hand smoke (SHS) in non-smoking pregnant mothers and infant health. We assessed the effects of maternal antenatal exposure to SHS on infant growth rate, and secondarily, on birth weight, birth length and head circumference at birth. Methods In this prospective cohort, 305 mother-infant pairs were studied. Mothers filled out questionnaires about exposure to SHS in pregnancy at the 3rd trimester of pregnancy. Infant anthropometry was performed at birth, day 7, and months 1, 2, 4, and 6, postnatally. Linear mixed modeling and linear regression were used to calculate growth rates over the first 6 months. The association between SHS-exposure with growth rate and birth sizes was assessed using multivariate linear regression adjusted for confounders, with SHS as both number of cigarettes and as groups (no exposure, SHS < 23 cigarettes, SHS ≥ 23 cigarettes). Results Seventy-three mothers were not exposed and 232 were exposed. SHS exposure (per cigarette) was not related to gain in weight, length, head circumference, and weight for length. However, infants born to mothers exposed to ≥ 23 cigarettes/d had lower head circumference gain (-0.32 mm/m, 95% CI -0.60, -0.03) than those born to non-exposed mothers. SHS exposure (per cigarette) was not related to birth weight, length, and head circumference, but exposure to ≥ 23 cigarettes was related to lower head circumference at birth (-11.09 mm, -20.03, -2.16). Conclusions Heavy antenatal exposure to SHS in non-smoking mothers results in reduced neonatal head circumference at birth and head circumference gain over the first 6 months of life. Our findings show no clear relations between exposure to SHS during pregnancy and other markers of neonatal growth and birth size.
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Affiliation(s)
- Frida Soesanti
- Department of Child Health, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center, Utrecht, the Netherlands
- * E-mail:
| | - Cuno S. P. M. Uiterwaal
- Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center, Utrecht, the Netherlands
| | - Diederick E. Grobbee
- Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center, Utrecht, the Netherlands
| | - Aryono Hendarto
- Department of Child Health, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Geertje W. Dalmeijer
- Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center, Utrecht, the Netherlands
| | - Nikmah Salamia Idris
- Department of Child Health, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center, Utrecht, the Netherlands
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14
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Abstract
Blood pressure (BP) tracks from childhood to adulthood, and early BP trajectories predict cardiovascular disease risk later in life. Excess postnatal weight gain is associated with vascular changes early in life. However, to what extent it is associated with children's BP is largely unknown. In 853 healthy 5-year-old children of the Wheezing-Illnesses-Study-Leidsche-Rijn (WHISTLER) birth cohort, systolic (SBP) and diastolic BP (DBP) were measured, and z scores of individual weight gain rates adjusted for length gain rates were calculated using at least two weight and length measurements from birth until 3 months of age. Linear regression analyses were conducted to investigate the association between weight gain rates adjusted for length gain rates and BP adjusted for sex and ethnicity. Each standard deviation increase in weight gain rates adjusted for length gain rates was associated with 0.9 mmHg (95% CI 0.3, 1.5) higher sitting SBP after adjustment for confounders. Particularly in children in the lowest birth size decile, high excess weight gain was associated with higher sitting SBP values compared to children with low weight gain rates adjusted for length gain rates. BMI and visceral adipose tissue partly explained the association between excess weight gain and sitting SBP (β 0.5 mmHg, 95% CI -0.3, 1.3). Weight gain rates adjusted for length gain rates were not associated with supine SBP or DBP. Children with excess weight gain, properly adjusted for length gain, in the first three months of life, particularly those with a small birth size, showed higher sitting systolic BP at the age of 5 years.
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15
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Associations between bottle-feeding intensity and maternal encouragement of bottle-emptying. Public Health Nutr 2017; 20:3090-3098. [DOI: 10.1017/s1368980017002166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AbstractObjectiveTo explore longitudinal associations between bottle-feeding and maternal encouragement of infant bottle-emptying during the first 6 months of infancy.DesignMothers completed questionnaires during the third trimester of pregnancy, then monthly during the first 6 months postpartum. Questionnaires assessed family demographics, maternal and infant weight status, infant feeding patterns and maternal encouragement of infant bottle-emptying.SettingThe Infant Feeding Practices Study 2, conducted by the US Centers for Disease Control and Prevention and the Food and Drug Administration.SubjectsMothers (n 1776).ResultsRepeated-measures regression was used to explore associations between bottle-feeding intensity (BFI; defined as the percentage of daily feedings that were from a bottle) and encouragement of bottle-emptying. Mothers who reported consistently high or consistently low BFI also exhibited consistently higher or lower frequency of encouraging their infants to empty the bottle (respectively) across the first 6 months of infancy, whereas mothers who reported increases in their BFI also exhibited concomitant increases in the frequency to which they encouraged their infants to finish the bottle. More frequent encouragement of bottle-emptying was also associated with feeding expressed breast milk (P<0·001), and lower parity (P=0·01), pre-pregnancy BMI (P=0·002) and infant birth weight (P=0·001).ConclusionsMore frequent use of bottles for infant feeding was significantly associated with more frequent encouragement of bottle-emptying. Further research using causal designs is needed to better understand whether the use of bottles promotes this controlling feeding practice or whether mothers with more controlling feeding practices opt to bottle-feed.
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16
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Ventura AK. Associations between Breastfeeding and Maternal Responsiveness: A Systematic Review of the Literature. Adv Nutr 2017; 8:495-510. [PMID: 28507014 PMCID: PMC5421127 DOI: 10.3945/an.116.014753] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Recent recommendations and prevention programs have focused on the promotion of responsive feeding during infancy, but more research is needed to understand best practices for fostering responsive feeding during early life. The objective of this systematic review was to synthesize the accumulating bodies of evidence aimed at understanding associations between mothers' feeding experiences and responsive feeding in an attempt to clarify the nature of associations between feeding mode and responsive feeding. A literature search was conducted between January and October 2016; articles were collected from PsychINFO, Medline, and CINAHL, as well as from references in published research and reviews. Article inclusion criteria were as follows: 1) empirical research, 2) included a measure of infant feeding, 3) included a measure of maternal responsiveness, 4) study conducted in human participants, 5) available in English, and 6) study conducted in a developed and/or high-income country. Forty-three studies were identified. Cross-sectional observational studies consistently reported greater responsiveness among breastfeeding mothers than among formula-/bottle-feeding mothers. In addition, longitudinal studies showed that longer breastfeeding durations predicted lower use of nonresponsive feeding practices during later childhood, and some, but not all, found that breastfeeding mothers showed greater increases in responsiveness across infancy than did formula-/bottle-feeding mothers. However, a limited number of longitudinal studies also reported that greater responsiveness during early infancy predicted longer breastfeeding durations. A common limitation among these studies is the correlational nature of their designs and lack of prenatal measures of maternal responsiveness, which hinders our understanding of causal mechanisms. Although 2 randomized clinical trials aimed at promoting maternal responsiveness did not find effects of the intervention on breastfeeding outcomes, these findings were limited by the way in which breastfeeding outcomes were assessed. In sum, although there is consistent evidence for an association between breastfeeding and responsive feeding, more research is needed to better understand the mechanisms underlying this association.
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Affiliation(s)
- Alison K Ventura
- Department of Kinesiology, California Polytechnic State University, San Luis Obispo, CA
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17
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Ventura AK, Mennella JA. An Experimental Approach to Study Individual Differences in Infants' Intake and Satiation Behaviors during Bottle-Feeding. Child Obes 2017; 13:44-52. [PMID: 27788024 PMCID: PMC5278825 DOI: 10.1089/chi.2016.0122] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND As a group, bottle-fed infants are at higher risk for rapid weight gain compared with breast-fed infants. However, little is known about individual differences in feeding behaviors of bottle-feeding infants, as well as maternal and infant characteristics associated with bottle-feeding outcomes. METHODS We conducted a 2-day, within-subject study of 21 formula-feeding dyads; the within-subject factor was feeding condition: mother-led (ML; mothers were given the instruction to feed their infants as they typically would) vs. infant-led (IL; the experimenter ensured feeding began when infants signaled hunger and ended when they rejected the bottle on three consecutive occasions). Intake was determined by bottle weight; feedings were video-recorded and later analyzed to determine feeding duration and types of satiation behaviors displayed. Percent difference scores were calculated for each outcome as [((ML - IL)/IL) × 100] to standardize differences among dyads. Mothers completed questionnaires of feeding styles and infant temperament. RESULTS On average, infants consumed ∼42% more formula during the ML- than IL-condition (p = 0.03). However, notable variation existed in difference scores for intake (range = -52.8% to 268.9%; higher scores reflect greater intake during ML than IL). Stepwise regression illustrated that greater intakes during the ML-condition were predicted by the combination of: (1) higher infant age; (2) lower levels of infant rhythmicity and adaptability; (3) higher levels of infant positive mood; and (4) lower levels of maternal restrictive and responsive feeding styles. CONCLUSIONS This objective, experimental approach illustrated that variation in bottle-feeding outcomes is associated with characteristics of both members of the dyad.
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Affiliation(s)
- Alison K. Ventura
- Monell Chemical Senses Center, Philadelphia, PA.,Department of Kinesiology, California Polytechnic State University, San Luis Obispo, CA
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18
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Mispireta ML, Caulfield LE, Zavaleta N, Merialdi M, Putnick DL, Bornstein MH, DiPietro JA. Effect of maternal zinc supplementation on the cardiometabolic profile of Peruvian children: results from a randomized clinical trial. J Dev Orig Health Dis 2017; 8:56-64. [PMID: 27748235 PMCID: PMC5822716 DOI: 10.1017/s2040174416000568] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Zinc is an essential micronutrient for the development of the fetal renal, cardiovascular and metabolic systems; however, there is limited evidence of its effects on the postnatal cardiometabolic function. In this study, we evaluated the effect of maternal zinc supplementation during pregnancy on the cardiometabolic profile of the offspring in childhood. A total of 242 pregnant women were randomly assigned to receive a daily supplement containing iron+folic acid with or without zinc. A follow-up study was conducted when children of participating mothers were 4.5 years of age to evaluate their cardiometabolic profile, including anthropometric measures of body size and composition, blood pressure, lipid profile and insulin resistance. No difference in measures of child cardiometabolic risk depending on whether mothers received supplemental zinc during pregnancy. Our results do not support the hypothesis that maternal zinc supplementation reduces the risk of offspring cardiometabolic disease.
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Affiliation(s)
- M L Mispireta
- 1Kasiska School of Health Professions,Idaho State University,Pocatello,ID,USA
| | - L E Caulfield
- 2Department of International Health,Center for Human Nutrition,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA
| | - N Zavaleta
- 4Instituto de Investigación Nutricional,Lima,Peru
| | - M Merialdi
- 5Global Health Division,Becton Dickinson, Franklin Lakes,NJ,USA
| | - D L Putnick
- 6Eunice Kennedy ShriverNational Institute of Child Health and Human Development,National Institutes of Health,Bethesda,MD,USA
| | - M H Bornstein
- 6Eunice Kennedy ShriverNational Institute of Child Health and Human Development,National Institutes of Health,Bethesda,MD,USA
| | - J A DiPietro
- 3Department of Population, Family and Reproductive Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA
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19
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Uesugi KH, Dattilo AM, Black MM, Saavedra JM. Design of a Digital-Based, Multicomponent Nutrition Guidance System for Prevention of Early Childhood Obesity. J Obes 2016; 2016:5067421. [PMID: 27635257 PMCID: PMC5007363 DOI: 10.1155/2016/5067421] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 06/21/2016] [Accepted: 07/17/2016] [Indexed: 12/02/2022] Open
Abstract
Interventions targeting parenting focused modifiable factors to prevent obesity and promote healthy growth in the first 1000 days of life are needed. Scale-up of interventions to global populations is necessary to reverse trends in weight status among infants and toddlers, and large scale dissemination will require understanding of effective strategies. Utilizing nutrition education theories, this paper describes the design of a digital-based nutrition guidance system targeted to first-time mothers to prevent obesity during the first two years. The multicomponent system consists of scientifically substantiated content, tools, and telephone-based professional support delivered in an anticipatory and sequential manner via the internet, email, and text messages, focusing on educational modules addressing the modifiable factors associated with childhood obesity. Digital delivery formats leverage consumer media trends and provide the opportunity for scale-up, unavailable to previous interventions reliant on resource heavy clinic and home-based counseling. Designed initially for use in the United States, this system's core features are applicable to all contexts and constitute an approach fostering healthy growth, not just obesity prevention. The multicomponent features, combined with a global concern for optimal growth and positive trends in mobile internet use, represent this system's future potential to affect change in nutrition practice in developing countries.
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Affiliation(s)
| | - Anne M. Dattilo
- Nestlé Nutrition, 12 Vreeland Road, Florham Park, NJ 07932, USA
| | - Maureen M. Black
- Department of Pediatrics, University of Maryland School of Medicine, 737 W Lombard Street No. 161, Baltimore, MD 21201, USA
- RTI International, East Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA
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20
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Sebastiani G, Díaz M, Bassols J, Aragonés G, López-Bermejo A, de Zegher F, Ibáñez L. The sequence of prenatal growth restraint and post-natal catch-up growth leads to a thicker intima-media and more pre-peritoneal and hepatic fat by age 3-6 years. Pediatr Obes 2016; 11:251-7. [PMID: 26132470 DOI: 10.1111/ijpo.12053] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 05/04/2015] [Accepted: 05/29/2015] [Indexed: 01/15/2023]
Abstract
BACKGROUND Infants born small-for-gestational-age (SGA) who develop post-natal weight catch-up are at risk for insulin resistance, central adiposity and cardiovascular disease in later life, even in the absence of overweight. OBJECTIVE In young (age 3-6 years) non-obese SGA children, we assessed arterial health (as judged by intima-media thickness [IMT]) and abdominal fat distribution (subcutaneous, visceral, preperitoneal and hepatic components by magnetic resonance imaging [MRI] and/or ultrasound [US]) besides a selection of endocrine markers. METHODS Comparisons of measures in SGA (n = 27) vs. appropriate-for-GA (AGA) children (n = 19) of similar height, weight and body mass index. Longitudinal outcomes (age 3-6 years) were carotid IMT (cIMT); fasting glucose, circulating insulin, IGF-I and high-molecular-weight (HMW) adiponectin; abdominal fat partitioning by US. Cross-sectional outcomes (age 6 years) were aortic IMT (aIMT) and abdominal fat partitioning by MRI. RESULTS At 3 and 6 years, cIMT and IGF-I results were higher and HMW adiponectin lower in SGA than AGA children; at 6 years, SGA subjects had also a thicker aIMT and more pre-peritoneal and hepatic fat, and were less insulin sensitive (all P values between <0.05 and <0.0001). cIMT correlated positively with pre-peritoneal fat, particularly at 6 years. Post-SGA status and weight gain in early childhood (between 3 and 6 years) were independent predictors of cIMT at 6 years, explaining 48 % of its variance. CONCLUSION SGA children aged 3-6 years were found to have a thicker intima- media and more pre-peritoneal and hepatic fat than AGA children of comparable size.
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Affiliation(s)
- G Sebastiani
- Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| | - M Díaz
- Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| | - J Bassols
- Department of Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
| | - G Aragonés
- Grupo de Estudio de Enfermedades Metabólicas Asociadas a Resistencia a la Insulina (GEMMAIR), Department of Medicine and Surgery, Universitat Rovira i Virgili (URV), Tarragona, Spain
| | - A López-Bermejo
- Department of Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
| | - F de Zegher
- Pediatric Endocrinology, University of Leuven, Leuven, Belgium
| | - L Ibáñez
- Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
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21
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Accelerated growth during childhood is associated with increased arterial stiffness in prepubertal children. Int J Cardiol 2016; 204:83-5. [DOI: 10.1016/j.ijcard.2015.11.149] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 11/22/2015] [Indexed: 11/19/2022]
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Eikendal ALM, Evelein AMV, Uiterwaal CSPM, van der Ent CK, Visseren FLJ, Bots ML, Hoefer IE, den Ruijter HM, Dalmeijer GW. Relation Between Circulating Inflammatory Chemokines and Vascular Characteristics in Healthy, Young Children. J Am Heart Assoc 2015; 4:e002346. [PMID: 26675251 PMCID: PMC4845277 DOI: 10.1161/jaha.115.002346] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/07/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Atherosclerosis begins in childhood with the occurrence of inflammatory vascular wall alterations that are detectable with B-mode ultrasound. Chemokines appear to be involved in the development of these alterations given that they occur early in the atherosclerotic pathway as mediators of vascular inflammation. However, this has not extensively been investigated. Therefore, we studied in healthy young children whether chemokines monocyte chemotactic protein 1 (MCP-1), regulated on activation normal T-cell expressed and secreted (RANTES), and vascular and intercellular adhesion molecules (VCAM and ICAM) related to vascular characteristics of the carotid artery. METHODS AND RESULTS We obtained demography, anthropometry, and overnight fasting plasma of 139 eight-year-old children of the Wheezing Illnesses Study Leidsche Rijn birth cohort. Carotid intima-media thickness (CIMT), distensibility, and Young's Elastic Modulus (YEM) of the common carotid artery were measured sonographically. Chemokine plasma levels were assessed using a multiplex assay. We studied the relation between the chemokines and vascular characteristics using multivariable linear regression analyses with adjustments for sex, systolic blood pressure, homeostasis model assessment of insulin resistance, triglycerides, low-density lipoprotein- and high-density lipoprotein-cholesterol. Of the studied chemokines, RANTES related to common carotid distensibility and YEM. One standard deviation increase in RANTES level related to a 5.45-MPA(-1) (95% confidence interval [CI], -9.43, -1.39; P=0.01) decrease in distensibility and to a 5.55-kPa increase in YEM (95% CI, 0.40, 10.85; P=0.03). RANTES did not relate to CIMT. MCP-1, VCAM, and ICAM did not relate to any of the studied vascular characteristics. CONCLUSION RANTES appears to be involved in the development of preatherosclerotic inflammatory vascular alterations already in healthy, young children. This may provide further insight into the early-life origins of atherosclerosis.
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Affiliation(s)
| | - Annemieke M. V. Evelein
- Department of PediatricsWilhelmina Children's HospitalUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Cuno S. P. M. Uiterwaal
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Cornelis K. van der Ent
- Department of PediatricsWilhelmina Children's HospitalUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Frank L. J. Visseren
- Department of Vascular MedicineUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Michiel L. Bots
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Imo E. Hoefer
- Laboratory of Experimental CardiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Hester M. den Ruijter
- Laboratory of Experimental CardiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Geertje W. Dalmeijer
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrechtThe Netherlands
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McCrindle BW. Cardiovascular Consequences of Childhood Obesity. Can J Cardiol 2015; 31:124-30. [DOI: 10.1016/j.cjca.2014.08.017] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 08/22/2014] [Accepted: 08/22/2014] [Indexed: 12/11/2022] Open
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Linhares RDS, Gigante DP, de Barros FCLF, Horta BL. Carotid intima-media thickness at age 30, birth weight, accelerated growth during infancy and breastfeeding: a birth cohort study in Southern Brazil. PLoS One 2015; 10:e0115166. [PMID: 25611747 PMCID: PMC4303430 DOI: 10.1371/journal.pone.0115166] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 11/19/2014] [Indexed: 12/11/2022] Open
Abstract
Objective To examine the relationship between carotid intima-media thickness (IMT) at age 30 and birth characteristics, growth during infancy, and breastfeeding duration, among subjects who have been prospectively followed since birth. Methods and Results In 1982, all births in the city of Pelotas, southern Brazil, were identified and those children (n = 5,914) whose families lived in the urban area of the city have been followed and evaluated at several time points. The cohort participants were evaluated in 2012–13, and IMT was measured at the posterior wall of the right and left common carotid arteries in longitudinal planes using ultrasound imaging. We obtained valid IMT measurements for 3,188 individuals. Weight-for-age z-score (WAZ) at age 2 years, weight-for-height z-score (WHZ) at age 4, height-for-age z-score (HAZ) at 4 years, WAZ at age 4 and relative conditional weight at 4 years were positively associated with IMT, even after controlling for confounding variables. The beta-coefficient associated with ≥1 s.d. WAZ at age 2 (compared to those with a <–1 s.d.) was 3.62 μm (95% CI 0.86 to 6.38). The beta-coefficient associated with ≥1 s.d. WHZ at 4 (in relation to <–1 s.d) was 3.83 μm (95% CI 0.24 to 7.42). For HAZ at 4, the beta-coefficient for ≥1 s.d. in relation to <–1 s.d. was 4.19 μm (95% CI 1.14 to 7.25). For WAZ at 4, the beta-coefficient associated with ≥1 s.d. in relation to <–1 s.d. was 4.28 μm (95% CI 1.59 to 6.97). The beta-coefficient associated with conditional weight gain at age 2–4 was 1.26 μm (95% CI 0.49 to 2.02). Conclusion IMT at age 30 was positively associated with WAZ at age 2 years, WHZ at age 4, HAZ at age 4, WAZ at age 4 and conditional weight gain at age 4 years.
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Affiliation(s)
- Rogério da Silva Linhares
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
- * E-mail:
| | - Denise Petrucci Gigante
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Bernardo Lessa Horta
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
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Gruszfeld D, Weber M, Nowakowska-Rysz M, Janas R, Kozlik-Feldmann R, Xhonneux A, Carlier C, Riva E, Verduci E, Closa-Monasterolo R, Escribano J, Dobrzanska A, Koletzko B. Protein intake in infancy and carotid intima media thickness at 5 years--a secondary analysis from a randomized trial. ANNALS OF NUTRITION AND METABOLISM 2015; 66:51-9. [PMID: 25572773 DOI: 10.1159/000369980] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 11/15/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Nutrition in childhood has an influence on the cardiovascular function later on in life. European Childhood Obesity Project is a multicenter, randomized clinical intervention trial examining the effect of early protein intake on later health outcomes, particularly adiposity and related disorders. The aim of the study was to examine the effect of nutritional intervention--different protein intake in infancy on carotid intima-media thickness (cIMT) at 5 years. The association of cardiovascular risk factors with cIMT was also assessed. METHODS Healthy term formula-fed infants in five European countries were enrolled either to the higher (HP) or to the lower (LP) protein group. Observational group consisted of breastfed infants. Plasma insulin, glucose, lipid profile, IGF-1, apolipoprotein A1 and B were measured as well as anthropometric parameters of parents and a child, blood pressure and physical activity. RESULTS No difference in cIMT between HP and LP group was observed. Insulin, HOMA-IR index and total IGF-1 were positively associated with cIMT but after adjustment for confounders only an inverse association between ApoA1 and positive between ApoB/ApoA1 and cIMT were significant. CONCLUSION High versus low protein intake in infancy does not influence cIMT at 5 years. cIMT in healthy children at 5 years is associated with their apolipoprotein profile.
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Abstract
BACKGROUND In the past decades, the obesity epidemic in children of all ages has been an important research field for detecting the metabolic causes and consequences of obesity, the major focus being on insulin and adipocytokine levels. Metabolic work-up in obese children is recommended in the age group as young as 2-6 years. There is evidence that birth weight can be a factor causing obesity later in life accompanied by metabolic complications. METHODS Insulin, leptin, and adiponectin levels were analyzed in 269 obese children and 60 controls, as well as 110 newborn children with different birth weight and different length of gestation, using standard methods. RESULTS In 53.6% of the obese children, complications of obesity such as diabetes mellitus, obesity, hyperlipidemia, heart attack or stroke were found in family members. The peak insulinemia on OGTT was significantly higher in the pubertal compared to the prepubertal group (110.5± 75.9 μU/mL versus 72.2±62.7 μU/mL) (p<0.005). Glucose intolerance was confirmed in 24%. The leptin level was significantly higher and the adiponectin level was lower in pubertal obese children compared to the prepubertal children and controls (p<0.05). In newborns the leptin and adiponectin levels were in correlation with anthropometric parameters: body weight (BW), body length (BL), BW/BL, BMI, and the pondered index (p<0.05). CONCLUSION Obese children have high insulinemia in all ages, reaching its peak towards puberty. The leptin and adiponectin levels might be indicators of the metabolic syndrome. Our findings in newborns might influence the nutritional approach in the future in order to prevent complications of obesity.
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Kramer CK, Hamilton JK, Ye C, Hanley AJ, Connelly PW, Sermer M, Zinman B, Retnakaran R. Antepartum determinants of rapid early-life weight gain in term infants born to women with and without gestational diabetes. Clin Endocrinol (Oxf) 2014; 81:387-94. [PMID: 24612153 DOI: 10.1111/cen.12437] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 12/21/2013] [Accepted: 02/18/2014] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Rapid weight gain in the first 3 months of life has been associated with an unfavourable cardio-metabolic phenotype in adulthood. However, little is known about the antepartum determinants of this rapid weight gain, which may reflect key developmental exposures that program metabolic pathways. Thus, we sought to characterize the antepartum determinants of rapid weight gain in the first 3 months of life in infants exposed to gestational diabetes mellitus (GDM), a patient population at risk for early cardio-metabolic disease. DESIGN Prospective observational cohort study. PATIENTS Pregnant women with (n = 90) and without GDM (n = 250) underwent detailed antepartum metabolic characterization, followed by assessment of their term offspring at age 3 months. MEASUREMENTS Rapid infant weight gain in the first 3 months was defined as weight gain ≥ 0·5 SD. RESULTS No features of maternal metabolic function in pregnancy (including insulin sensitivity, lipid profile, adiponectin, leptin and C-reactive protein) were associated with infant weight gain in either the GDM or non-GDM group. Interestingly, although all infants were born at term (≥37 weeks), length of gestation was inversely associated with weight gain at 3 months in the infants of women with GDM (β = -148·5, P = 0·01). In these infants, length of gestation <39 weeks was an independent predictor of rapid weight gain (OR = 7·9, 95%CI 1·7-38, P = 0·009) in the fully adjusted model. These associations were not observed in infants of women without GDM. CONCLUSIONS Delivery before 39 weeks is independently associated with rapid weight gain in the first 3 months of life in term infants of women with GDM and hence may be an antepartum marker of future cardio-metabolic risk.
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Affiliation(s)
- Caroline K Kramer
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON, Canada; Division of Endocrinology, University of Toronto, Toronto, ON, Canada
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Eikendal ALM, den Ruijter HM, Uiterwaal CSPM, Pasterkamp G, Hoefer IE, de Kleijn DPV, Schoneveld AH, Leiner T, Bots ML, Visseren FLJ, Evelein AMV. Extracellular vesicle protein CD14 relates to common carotid intima-media thickness in eight-year-old children. Atherosclerosis 2014; 236:270-6. [PMID: 25108076 DOI: 10.1016/j.atherosclerosis.2014.07.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 07/03/2014] [Accepted: 07/16/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Atherosclerosis is a process that begins in childhood, develops over decades and underlies the majority of cardiovascular events in adulthood. Previously, we demonstrated in adults with cardiovascular disease that levels of extracellular vesicle (EV) proteins CD14, Serpin F2 and cystatin C predict vascular outcome. Here, we study for the first time whether these EV proteins are related to vascular characteristics in healthy, young children. METHODS AND RESULTS In 141 eight-year old children of the Wheezing-Illnesses-Studie-LEidsche-Rijn birth cohort, anthropometrics and blood pressure were measured. In addition, common carotid intima-media thickness, carotid distensibility and carotid Young's elastic modulus were obtained non-invasively using ultrasound imaging. A fasting lipid spectrum was obtained and EVs were isolated from plasma. Levels of EV proteins CD14, Serpin F2 and cystatin C were measured using a multiplex assay. In a multivariable linear regression model we assessed the relation between these EV proteins and the selected vascular characteristics. Of the studied EV proteins, CD14 levels were positively related to common carotid intima-media thickness (log transformed, beta = 7.31 ln(mm)/(ng/mg) (1.24, 13.38), p = 0.02). EV proteins Serpin F2 and cystatin C were not related to common carotid intima-media thickness. In addition, we found no relation between all three EV proteins and carotid distensibility or carotid Young's elastic modulus. CONCLUSION In healthy eight-year old children, extracellular vesicle protein CD14 levels seem positively related to common carotid intima-media thickness. This would point towards inflammatory vascular alterations inflicted by extracellular vesicle protein CD14 already in early life and warrants further investigation.
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Affiliation(s)
- Anouk L M Eikendal
- Department of Radiology, E.01.132, University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - Hester M den Ruijter
- Julius Center for Health Sciences and Primary Care, University Medical Center, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands; Laboratory of Experimental Cardiology, G02.523, University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - Cuno S P M Uiterwaal
- Julius Center for Health Sciences and Primary Care, University Medical Center, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands.
| | - Gerard Pasterkamp
- Laboratory of Experimental Cardiology, G02.523, University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - Imo E Hoefer
- Laboratory of Experimental Cardiology, G02.523, University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - Dominique P V de Kleijn
- Laboratory of Experimental Cardiology, G02.523, University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; Department of Surgery, National University Singapore & Cardiovascular Research Institute, National University Health System, Singapore.
| | - Arjan H Schoneveld
- Laboratory of Experimental Cardiology, G02.523, University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - Tim Leiner
- Department of Radiology, E.01.132, University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands.
| | - Frank L J Visseren
- Julius Center for Health Sciences and Primary Care, University Medical Center, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands; Department of Internal Medicine, University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - Annemieke M V Evelein
- Julius Center for Health Sciences and Primary Care, University Medical Center, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands.
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Idris NS, Evelein AMV, Geerts CC, Sastroasmoro S, Grobbee DE, Uiterwaal CSPM. Effect of physical activity on vascular characteristics in young children. Eur J Prev Cardiol 2014; 22:656-64. [PMID: 24526797 DOI: 10.1177/2047487314524869] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 01/31/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Physical activity has long been proposed as an important modifiable cardiovascular risk factor in adults. We assessed whether physical activity already has an effect on childhood vasculature. METHODS In the Wheezing-Illnesses-Study-in-Leidsche-Rijn birth cohort, we performed vascular ultrasound to measure carotid intima-media thickness (cIMT) and functional properties (distensibility, elastic modulus) at 5 and 8 years of age. Child typical physical activities were inquired using a questionnaire completed by parents. Linear regression was used with physical activity level, expressed as a standardized value of time-weighted metabolic equivalent (MET) as the independent variable and vascular properties as dependent variables with further confounder adjustment and evaluation for possible body mass index and sex effect modifications. RESULTS In 595 5-year-old children and in 237 of those who had reached the age of 8 years, we did not find statistically significant associations between total time-weighted MET and each vascular parameter, neither in pooled nor stratified analysis. However, sport activities were associated with thinner cIMT (-3.20 µm/SD, 95% CI -6.34, -0.22, p = 0.04) at 5 years of age; a similar pattern was seen for organized sport. This effect was strongest in children in the highest body mass index tertile (-5.38 µm/SD, 95% CI -10.54, -0.19, p = 0.04). At the age of 8 years, higher sport level tended to be associated with higher vascular distensibility (2.64 × 10(3) kPa/SD, 95% CI -0.18, 5.45, p = 0.07) although this was not statistically significant. CONCLUSIONS Sport activity may have beneficial effects on arteries of young children, particularly those with higher relative body weight.
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Affiliation(s)
- Nikmah S Idris
- University Medical Center Utrecht, Utrecht, The Netherlands University of Indonesia, Jakarta, Indonesia
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Johnson W, Kuh D, Tikhonoff V, Charakida M, Woodside J, Whincup P, Hughes AD, Deanfield JE, Hardy R. Body mass index and height from infancy to adulthood and carotid intima-media thickness at 60 to 64 years in the 1946 British Birth Cohort Study. Arterioscler Thromb Vasc Biol 2014; 34:654-60. [PMID: 24458709 DOI: 10.1161/atvbaha.113.302572] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Atherosclerosis begins early in life and obesity is a key determinant. We investigated the role of body mass index (BMI) and height from infancy to adulthood in presenting with high adulthood carotid intima-media thickness. APPROACH AND RESULTS Odds ratios of BMI, and height Z scores at 2, 4, 6, 7, 11, 15, and 20 years, and changes between 2 and 4, 4 and 7, 7 and 15, and 15 and 20 years, for carotid intima-media thickness at 60 to 64 years in the upper quartile were estimated for 604 men and 669 women. Confounding by early-life environments, mediating by body size and cardiometabolic measures at 60 to 64 years, and effect modification were investigated. In men, there was positive association of BMI at 4 years (odds ratio, 1.256; 95% confidence interval, 1.026-1.538) and 20 years (1.282; 1.022-1.609), negative association of height at 4 years (0.780; 0.631-0.964), and negative association of height growth between 2 and 4 years (0.698; 0.534-0.913) with high carotid intima-media thickness. The childhood estimates were robust, but the estimate for BMI at 20 years was attenuated by adjustment for BMI at 60 to 64 years. The protective influence of greater early childhood height was strongest in those with the lowest systolic blood pressure at 60 to 64 years. In women, there was no pattern of association and all confidence intervals crossed 1. CONCLUSIONS Early childhood in men might be a sensitive developmental period for atherosclerosis, in which changes in BMI and height represent 2 distinct biological mechanisms. The maintenance of healthy weight in men from adolescence onward may be a useful strategy to avoid the atherosclerotic complications of adiposity tracking.
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Affiliation(s)
- William Johnson
- From the MRC Unit for Lifelong Health and Ageing at UCL (W.J., D.K., V.T., R.H.) and National Centre for Cardiovascular Prevention and Outcomes, Institute of Cardiovascular Science (M.C., J.W., J.E.D.), University College London, London, United Kingdom; Population Health Research Centre, Division of Population Health Sciences and Education, St George's University of London, London, United Kingdom (P.W.); and International Centre for Circulatory Health, National Heart & Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom (A.D.H.)
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Idris NS, Uiterwaal CSPM, van der Schouw YT, van Abeelen AFM, Roseboom TJ, de Jong PA, Rutten A, Grobbee DE, Elias SG. Famine in childhood and postmenopausal coronary artery calcification: a cohort study. BMJ Open 2013; 3:e003818. [PMID: 24293207 PMCID: PMC3845053 DOI: 10.1136/bmjopen-2013-003818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To assess the effects of famine exposure during childhood on coronary calcium deposition and, secondarily, on cardiac valve and aortic calcifications. DESIGN Retrospective cohort. SETTING Community. PATIENTS 286 postmenopausal women with individual measurements of famine exposure during childhood in the Netherlands during World War II. INTERVENTION/EXPOSURE Famine exposure during childhood. MAIN OUTCOME MEASURES Coronary artery calcifications measured by CT scan and scored using the Agatston method; calcifications of the aorta and cardiac valves (mitral and/or aortic) measured semiquantitatively. Logistic regression was used for coronary Agatston score of >100 or ≤100, valve or aortic calcifications as the dependent variable and an indicator for famine exposure as the independent variable. These models were also used for confounder adjustment and stratification based on age groups of 0-9 and 10-17 years. RESULTS In the overall analysis, no statistically significant association was found between severe famine exposure in childhood and a high coronary calcium score (OR 1.80, 95% CI 0.87 to 3.78). However, when looking at specific risk periods, severe famine exposure during adolescence was related to a higher risk for a high coronary calcium score than non-exposure to famine, both in crude (OR 3.47, 95% CI 1.00 to 12.07) and adjusted analyses (OR 4.62, 95% CI 1.16 to 18.43). No statistically significant association was found between childhood famine exposure and valve or aortic calcification (OR 1.66, 95% CI 0.69 to 4.10). CONCLUSIONS Famine exposure in childhood, especially during adolescence, seems to be associated with a higher risk of coronary artery calcification in late adulthood. However, the association between childhood famine exposure and cardiac valve/aortic calcification is less clear.
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Affiliation(s)
- Nikmah S Idris
- Cardiology Division, Department of Child Health, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center,Utrecht, The Netherlands
| | - Cuno S P M Uiterwaal
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center,Utrecht, The Netherlands
| | - Yvonne T van der Schouw
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center,Utrecht, The Netherlands
| | - Annet F M van Abeelen
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center,Utrecht, The Netherlands
- Department of Clinical Epidemiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Tessa J Roseboom
- Department of Clinical Epidemiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Pim A de Jong
- Department of Radiology, University Medical Center, Utrecht, The Netherlands
| | - Annemarieke Rutten
- Department of Radiology, University Medical Center, Utrecht, The Netherlands
| | - Diederick E Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center,Utrecht, The Netherlands
| | - Sjoerd G Elias
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center,Utrecht, The Netherlands
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