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Thomsen CF, Goharian TS, Larsen KT, Goetze JP, Andersen LB, Jeppesen JL. Intensive Lifestyle Intervention Increases Plasma Midregional Proatrial Natriuretic Peptide Concentrations in Overweight Children. J Am Heart Assoc 2021; 10:e020676. [PMID: 34180245 PMCID: PMC8403313 DOI: 10.1161/jaha.121.020676] [Citation(s) in RCA: 1] [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: 12/12/2022]
Abstract
Background Overweight adults have low circulating concentrations of ANP (atrial natriuretic peptide) and proANP fragments. We tested the hypothesis that an intensive lifestyle intervention with an intended weight loss would increase plasma concentrations of a proANP fragment in overweight children. Methods and Results We measured MR‐proANP (midregional proANP) concentrations in plasma from overweight children who participated in the OOIS (Odense Overweight Intervention Study). OOIS randomized 115 overweight children (11–13 years, 55% girls) to an intensive day‐camp intervention arm with increased physical activity and healthy diet or to a less intensive standard intervention arm for 6 weeks. We used linear mixed‐effects modeling for repeated measures to estimate the difference in the mean change with 95% CIs in fasting plasma MR‐proANP concentrations between the 2 arms, and we used partial least squares regression analysis to identify candidate mediators. Differences in weight, fitness, and metabolic factors were also analyzed. At baseline, fasting plasma MR‐proANP concentrations were (median [interquartile range]) 35.0 pmol/L (26.8–42.0) in the day‐camp intervention arm and 37.2 pmol/L (31.7–44.7) in standard intervention arm participants, respectively. After 6 weeks intervention, children in the day‐camp intervention arm had increased their MR‐proANP (5.4 pmol/L [0.8–10.0], P=0.022) and their fitness (2.33 mL O2/min per kg [0.52–4.14], P=0.012) and they had deceased their body mass index (−2.12 kg/m2 [−2.59 to −1.65], P<0.001) as compared with children in standard intervention arm. In the partial least squares analysis, decreases in fasting insulin and in estimated insulin resistance were associated with the observed increase in MR‐proANP concentrations. Conclusions An intensive lifestyle intervention increases plasma MR‐proANP among overweight children. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01574352.
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Affiliation(s)
- Camilla F Thomsen
- Department of Medicine Amager Hvidovre Hospital in GlostrupUniversity of Copenhagen Glostrup Denmark
| | - Tina S Goharian
- Department of Clinical Biochemistry Nordsjællands Hospital HillerødUniversity of Copenhagen Hillerød Denmark
| | - Kristian T Larsen
- Center of Research in Childhood Health (RICH) Department of Sports Science and Clinical Biomechanics University of Southern Denmark Odense Denmark
| | - Jens P Goetze
- Department of Clinical Biochemistry Rigshospitalet BlegdamsvejUniversity of Copenhagen Denmark.,Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen Denmark
| | - Lars B Andersen
- Department of Sport, Food, and Natural Sciences Campus SogndalWestern Norway University of Applied Sciences, Sogndal Norway
| | - Jørgen L Jeppesen
- Department of Medicine Amager Hvidovre Hospital in GlostrupUniversity of Copenhagen Glostrup Denmark.,Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Denmark
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2
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Saha-Chaudhuri P, Juwara L. Survival analysis under the Cox proportional hazards model with pooled covariates. Stat Med 2020; 40:998-1020. [PMID: 33210315 DOI: 10.1002/sim.8816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 10/23/2020] [Accepted: 10/29/2020] [Indexed: 11/09/2022]
Abstract
For a continuous time-to-event outcome and an expensive-to-measure exposure, we develop a pooling design and propose a likelihood-based approach to estimate the hazard ratios (HRs) of a Cox proportional hazards (PH) model. Our proposed approach fits a PH model based on pooled exposures with individually observed time-to-event outcomes. The design and estimation exploits the equivalence of the conditional logistic likelihood functions arising from a matched case-control study and the partial likelihood function of a riskset-matched, nested case-control (NCC) subset of a cohort study. To create the pools, we first focus on an NCC subcohort. Pools are formed at random while keeping the matching intact. Pool-level exposure and confounders are then evaluated and used in the likelihood to estimate the HR and the standard error of the estimates. The estimators are MLEs, provide consistent estimates of the individual-level HRs, and are asymptotically normal. Our simulation results indicate that the pooled estimates are comparable to the estimates obtained from the NCC subcohort. The units of analysis for the pooled design are the pools and not the individual participants. Hence the effective sample size is reduced. Therefore, the variance of the HR estimate increases with increasing poolsize. However, this variance inflation in small samples can be offset by including more matched controls per case within the NCC subcohort. An application is demonstrated with the Second Manifestations of ARTerial disease (SMART) study.
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Affiliation(s)
| | - Lamin Juwara
- Quantitative Life Sciences Program, McGill University, Montreal, Quebec, Canada
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3
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Kou S, Zhang M, Ji B, Zhao Q, Li Y, Pan H, Ban B, Li P. Association between systolic blood pressure and uric acid in Chinese children and adolescents with idiopathic short stature: a cross-sectional study. J Hum Hypertens 2020; 35:472-478. [PMID: 32518302 PMCID: PMC8134047 DOI: 10.1038/s41371-020-0362-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 05/22/2020] [Accepted: 05/29/2020] [Indexed: 01/21/2023]
Abstract
The purpose of this study was to investigate the relationship between systolic blood pressure (SBP) and uric acid (UA) in patients with idiopathic short stature (ISS). The present study was a cross-sectional study. A total of 210 Chinese children and adolescents with ISS were included, and their anthropometrics and biochemical parameters were measured. Growth hormone peak levels were assessed after provocation tests with L-dopa and insulin. The univariate analysis results showed a significant positive association between UA and SBP levels (P < 0.001). Furthermore, a non-linear relationship was detected between UA and SBP. In multivariate piecewise linear regression, the inflection point of UA was 4.13 mg/dl (95% CI 3.28, 6.65; P = 0.03), the levels of SBP increased with the increase in UA when the UA level was >4.13 mg/dl (β 2.63, 95% CI: 0.94, 4.31; P = 0.002). However, we did not observe a significant relationship between UA and SBP when the UA level was <4.13 mg/dl (β −2.72, 95% CI −6.89, 1.45; P = 0.202). Our study found a nonlinear relationship between UA and SBP in Chinese children and adolescents with ISS and showed that SBP levels were associated positively with the rise of UA levels when the UA levels reached the inflection point.
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Affiliation(s)
- Shuang Kou
- Department of Clinical Medicine, Jining Medical University, 16 Hehua Road, Beihu New District, Jining, 272067, Shandong, China
| | - Mei Zhang
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, 272029, Shandong, China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, 272029, Shandong, China
| | - Baolan Ji
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, 272029, Shandong, China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, 272029, Shandong, China
| | - Qianqian Zhao
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, 272029, Shandong, China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, 272029, Shandong, China
| | - Yanying Li
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, 272029, Shandong, China.,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, 272029, Shandong, China
| | - Hui Pan
- Chinese Research Center for Behavior Medicine in Growth and Development, Jining, 272029, Shandong, China.,Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Bo Ban
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, 272029, Shandong, China. .,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, 272029, Shandong, China.
| | - Ping Li
- Department of Endocrinology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, 272029, Shandong, China. .,Chinese Research Center for Behavior Medicine in Growth and Development, Jining, 272029, Shandong, China.
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Thomsen CF, Dreier R, Goharian TS, Goetze JP, Andersen LB, Faber J, Ried-Larsen M, Grøntved A, Jeppesen JL. Association of copeptin, a surrogate marker for arginine vasopressin secretion, with insulin resistance: Influence of adolescence and psychological stress. Peptides 2019; 115:8-14. [PMID: 30779927 DOI: 10.1016/j.peptides.2019.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 02/11/2019] [Accepted: 02/14/2019] [Indexed: 02/08/2023]
Abstract
In middle-aged and elderly individuals, circulating copeptin concentrations, a surrogate marker for arginine vasopressin (AVP) secretion, associates with insulin resistance (IR). Whether this association is present in adolescents and young adults is unclear. Because psychological stress associates with higher circulating copeptin concentrations and IR, it has been speculated that increased AVP secretion could be a link between psychological stress and IR. We measured plasma copeptin concentrations in 351 14-16-year-old adolescents and 617 20-28-year-old young adults from the Danish site of the European Youth Heart Study, a population-based cardiovascular risk factor study in adolescents and young adults. IR was determined by the homeostatic model assessment method. Among the young adults, we used symptoms of depression, evaluated by means of the Major Depression Inventory (MDI) scale, as a measure of psychological stress. We applied linear regressions to examine associations, expressed as unstandardized regression coefficients (B) with 95% confidence intervals (CIs), between variables of interest, stratified by age group and adjusting for age, sex and Tanner stages. Copeptin and IR were log-transformed. Among the young adults, copeptin associated with IR (B (95%CI) = 0.19 (0.11 to 0.27), P < 0.001). This association was not found among the adolescents (B=-0.01 (-0.12 to 0.09), P = 0.78). MDI score associated with IR (B = 0.010 (0.004 to 0.016), P < 0.001) and copeptin (B=0.010 (0.004 to 0.015); P<0.002) in the young adults. Adjusted for copeptin, the strength of the association between MDI score and IR somewhat diminished (to B=0.008). In conclusion, adolescence and psychological stress appear to influence the association between copeptin and IR.
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Affiliation(s)
- Camilla F Thomsen
- Department of Medicine, Amager and Hvidovre Hospital in Glostrup, University of Copenhagen, Glostrup, Denmark.
| | - Rasmus Dreier
- Department of Medicine, Amager and Hvidovre Hospital in Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Tina S Goharian
- Department of Medicine, Amager and Hvidovre Hospital in Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Jens P Goetze
- Department of Clinical Biochemistry, Rigshospitalet Blegdamsvej, University of Copenhagen, Copenhagen, Denmark
| | - Lars B Andersen
- Faculty of Education, Arts and Sport, Western Norway University of Applied Sciences, Campus Sogndal, Norway; Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Jens Faber
- Department of Medicine O, Endocrine Unit, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mathias Ried-Larsen
- Research Unit for Exercise Epidemiology, Department of Sport Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Anders Grøntved
- Research Unit for Exercise Epidemiology, Department of Sport Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Jørgen L Jeppesen
- Department of Medicine, Amager and Hvidovre Hospital in Glostrup, University of Copenhagen, Glostrup, Denmark; Department of Medicine O, Endocrine Unit, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
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Perng W, Rifas-Shiman SL, Hivert MF, Chavarro JE, Sordillo J, Oken E. Metabolic trajectories across early adolescence: differences by sex, weight, pubertal status and race/ethnicity. Ann Hum Biol 2019; 46:205-214. [PMID: 31264447 PMCID: PMC6960375 DOI: 10.1080/03014460.2019.1638967] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/21/2019] [Accepted: 06/12/2019] [Indexed: 12/22/2022]
Abstract
Background: Biomarkers of cardiovascular and metabolic risk track from adolescence into adulthood, therefore characterising the direction and magnitude of these changes is an important first step to identifying health trajectories that presage future disease risk.Aim: To characterise changes in metabolic biomarkers across early adolescence in a multi-ethnic cohort.Subjects and methods: Among 891 participants in Project Viva we estimated changes in insulin resistance (HOMA-IR), adipokines, lipids, and SBP between ages 6-10 years and 11-16 years. Next, we used multivariable linear regression to examine associations of sex, baseline overweight/obesity, baseline pubertal status and race/ethnicity with change in the biomarkers during follow-up.Results: Boys exhibited a larger decrement in adiponectin (-0.66 [95% CI = -1.14, -0.18)] ng/mL) and a greater increase in SBP (3.20 [2.10, 4.30] mmHg) than girls. Overweight/obese participants experienced larger increases in HOMA-IR, leptin, and triglycerides; and a steeper decrement in HDL. Pubertal youth showed larger decrements in total and LDL cholesterol than their pre-pubertal counterparts. In comparison to White participants, Black youth experienced a larger magnitude of increase in HOMA-IR, and Hispanic youth exhibited larger decrements in adiponectin and HDL.Conclusions: Change in metabolic biomarkers across early adolescence differed by sex, weight status, pubertal status and race/ethnicity. Some of the metabolic changes may reflect normal physiological changes of puberty, while others may presage future disease risk. Future studies are warranted to link metabolic changes during adolescence to long-term health.
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Affiliation(s)
- Wei Perng
- Department of Epidemiology, Colorado School of Public Health, Anschutz Medical Center, Aurora, CO
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joanne Sordillo
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Verboven K, Hansen D, Jocken JWE, Blaak EE. Natriuretic peptides in the control of lipid metabolism and insulin sensitivity. Obes Rev 2017; 18:1243-1259. [PMID: 28901677 DOI: 10.1111/obr.12598] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 07/08/2017] [Accepted: 07/20/2017] [Indexed: 12/24/2022]
Abstract
Natriuretic peptides have long been known for their cardiovascular function. However, a growing body of evidence emphasizes the role of natriuretic peptides in human substrate and energy metabolism, thereby connecting the heart with several insulin-sensitive organs like adipose tissue, skeletal muscle and liver. Obesity may be associated with an impaired regulation of the natriuretic peptide system, also indicated as a natriuretic handicap. Evidence points towards a contribution of this natriuretic handicap to the development of obesity, type 2 diabetes mellitus and cardiometabolic complications, although the causal relationship is not fully understood. Nevertheless, targeting the natriuretic peptide pathway may improve metabolic health in obesity and type 2 diabetes mellitus. This review will focus on current literature regarding the metabolic roles of natriuretic peptides with emphasis on lipid metabolism and insulin sensitivity. Furthermore, it will be discussed how exercise and lifestyle intervention may modulate the natriuretic peptide-related metabolic effects.
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Affiliation(s)
- K Verboven
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.,REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - D Hansen
- REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | - J W E Jocken
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - E E Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands
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Goharian TS, Goetze JP, Faber J, Andersen LB, Grøntved A, Jeppesen JL. Associations of Proatrial Natriuretic Peptide with Components of the Metabolic Syndrome in Adolescents and Young Adults from the General Population. Am J Hypertens 2017; 30:561-568. [PMID: 28338810 DOI: 10.1093/ajh/hpx026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 02/02/2017] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND In middle-aged and elderly populations, circulating natriuretic peptide concentrations are negatively associated with several components of the metabolic syndrome. Whether these negative associations are also present in healthy adolescents and young adults from the general population are unknown. METHODS In a cross-sectional setting, we measured plasma concentrations of mid-regional proatrial natriuretic peptide (MR-proANP) in 343 adolescents (age 14-16 years) and 616 young adults (age 20-28 years) from the Danish site of the European Youth Heart Study, which is a population-based study of cardiovascular disease risk factors in children, adolescents and young adults. We used linear regression analysis to examine the associations, expressed as standardized regression coefficients, of various variables of interest with MR-proANP stratified according to age group, adjusting for age and gender. RESULTS Among the young adults, MR-proANP was negatively associated with body mass index (BMI) (β = -0.10, P = 0.02), waist circumference (WC) (β = -0.14, P < 0.001), systolic blood pressure (BP) (β = -0.08, P = 0.03), diastolic BP (β = -0.23, P < 0.001), insulin (β = -0.15, P < 0.001), and triglycerides (β = -0.14, P < 0.001). Among the adolescents a somehow different pattern was observed since MR-proANP was not significantly associated with BMI (β = -0.00, P = 0.98), WC (β = -0.01, P = 0.90) and insulin (β = -0.02, P = 0.69). Nevertheless, among the adolescents, MR-proANP was negatively associated with triglycerides (β = -0.13, P = 0.01), diastolic BP (β = -0.12, P = 0.01) and systolic BP (β = -0.10, P = 0.10), although the latter association was of borderline significance. CONCLUSIONS The young adults displayed significant negative associations between MR-proANP and several components of the metabolic syndrome, whereas such associations were not found among the adolescents besides triglycerides and diastolic BP.
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Affiliation(s)
- Tina S Goharian
- Department of Medicine, Amager Hvidovre Hospital Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Jens P Goetze
- Department of Clinical Chemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jens Faber
- Department of Medicine O, Endocrine Unit, Herlev Hospital, University of Copenhagen, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars B Andersen
- Faculty of Teacher Education and Sport, Sogn and Fjordane University College, Sogndal, Norway
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Anders Grøntved
- Research Unit for Exercise Epidemiology, Department of Sport Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Jørgen L Jeppesen
- Department of Medicine, Amager Hvidovre Hospital Glostrup, University of Copenhagen, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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