1
|
Mosorin ME, Haverinen A, Ollila MM, Nordström T, Jokelainen J, Keinänen-Kiukaanniemi S, Puukka K, Ruokonen A, Auvinen J, Piltonen T, Morin-Papunen L, Tapanainen JS. Current use of combined hormonal contraception is associated with glucose metabolism disorders in perimenopausal women. Eur J Endocrinol 2020; 183:619-626. [PMID: 33105101 DOI: 10.1530/eje-20-0406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 09/28/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The use of combined hormonal contraceptives (CHCs) worsens glucose tolerance, but the risk for glucose metabolism disorders remains controversial. DESIGN The study is a prospective longitudinal population-based cohort study. METHODS The study was based on a cohort population that comprised 1879 women born in 1966. At age 46, the women answered a questionnaire on contraceptive use and underwent an oral glucose tolerance test. Glucose metabolism indices were evaluated in current CHC (n = 153), progestin-only contraceptive (POC, n = 842), and non-hormonal contraceptive users (n = 884). RESULTS In the entire study population, current CHC use was significantly associated with prediabetes (OR: 2.0, 95% CI: 1.3-3.2) and type 2 diabetes (OR: 3.3, 95% CI: 1.1-9.7) compared to non-hormonal contraceptive use. After 5 years of use, the prediabetes risk increased 2.2-fold (95% CI: 1.3-3.7) and type 2 diabetes risk increased 4.5-fold (95% CI: 1.5-13.5). Compared with the current POC use, current CHC use was significantly associated with prediabetes (OR: 1.9, 95% CI: 1.2-3.0). Current POC use was not associated with any glucose metabolism disorders. The results prevailed after adjusting for BMI and socioeconomic status. CONCLUSIONS CHC use in perimenopausal women was associated with a significantly increased risk of glucose metabolism disorders. This association should be considered in women with increased metabolic risk.
Collapse
Affiliation(s)
- Maria-Elina Mosorin
- Department of Obstetrics and Gynecology, Oulu University Hospital, University of Oulu and Medical Research Center, and PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Oulu, Finland
| | - Annina Haverinen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Meri-Maija Ollila
- Department of Obstetrics and Gynecology, Oulu University Hospital, University of Oulu and Medical Research Center, and PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Oulu, Finland
| | - Tanja Nordström
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Jari Jokelainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Unit of General Practice, Oulu University Hospital, Oulu, Finland
| | - Katri Puukka
- Nordlab Oulu, Medical Research Center Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland
| | - Aimo Ruokonen
- Nordlab Oulu, Medical Research Center Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Unit of General Practice, Oulu University Hospital, Oulu, Finland
| | - Terhi Piltonen
- Department of Obstetrics and Gynecology, Oulu University Hospital, University of Oulu and Medical Research Center, and PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Oulu, Finland
| | - Laure Morin-Papunen
- Department of Obstetrics and Gynecology, Oulu University Hospital, University of Oulu and Medical Research Center, and PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Oulu, Finland
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology, Oulu University Hospital, University of Oulu and Medical Research Center, and PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Oulu, Finland
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
2
|
West S, Ollila M, Franks S, Piltonen T, Jokelainen J, Nevalainen J, Puukka K, Ruokonen A, Järvelin M, Auvinen J, Tapanainen JS, Morin‐Papunen L. Overweight, obesity and hyperandrogenemia are associated with gestational diabetes mellitus: A follow‐up cohort study. Acta Obstet Gynecol Scand 2020; 99:1311-1319. [DOI: 10.1111/aogs.13883] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/07/2020] [Accepted: 04/09/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Sammeli West
- Department of Obstetrics and Gynecology Medical Research Center Oulu and PEDEGO Research Unit (Research Unit for Pediatrics Dermatology, Clinical Genetics, Obstetrics and Gynecology University Hospital of OuluUniversity of Oulu Oulu Finland
| | - Meri‐Maija Ollila
- Department of Obstetrics and Gynecology Medical Research Center Oulu and PEDEGO Research Unit (Research Unit for Pediatrics Dermatology, Clinical Genetics, Obstetrics and Gynecology University Hospital of OuluUniversity of Oulu Oulu Finland
| | - Stephen Franks
- Institute of Reproductive and Developmental Biology Imperial College London London UK
| | - Terhi Piltonen
- Department of Obstetrics and Gynecology Medical Research Center Oulu and PEDEGO Research Unit (Research Unit for Pediatrics Dermatology, Clinical Genetics, Obstetrics and Gynecology University Hospital of OuluUniversity of Oulu Oulu Finland
| | - Jari Jokelainen
- Center for Life Course Health Research Faculty of Medicine University of Oulu Oulu Finland
- Unit of General Practice Oulu University Hospital Oulu Finland
| | - Jaana Nevalainen
- Department of Obstetrics and Gynecology Medical Research Center Oulu and PEDEGO Research Unit (Research Unit for Pediatrics Dermatology, Clinical Genetics, Obstetrics and Gynecology University Hospital of OuluUniversity of Oulu Oulu Finland
| | - Katri Puukka
- Department of Clinical Chemistry NordLab Oulu Oulu University HospitalUniversity of Oulu Oulu Finland
| | - Aimo Ruokonen
- Department of Clinical Chemistry NordLab Oulu Oulu University HospitalUniversity of Oulu Oulu Finland
| | - Marjo‐Riitta Järvelin
- Department of Children, Young People and Families National Institute for Health and Welfare Oulu Finland
- Department of Epidemiology and Biostatistics MRC Health Protection Agency (HPA) Center for Environment and Health School of Public HealthImperial College London London UK
| | - Juha Auvinen
- Center for Life Course Health Research Faculty of Medicine University of Oulu Oulu Finland
- Unit of General Practice Oulu University Hospital Oulu Finland
| | - Juha S. Tapanainen
- Department of Obstetrics and Gynecology Medical Research Center Oulu and PEDEGO Research Unit (Research Unit for Pediatrics Dermatology, Clinical Genetics, Obstetrics and Gynecology University Hospital of OuluUniversity of Oulu Oulu Finland
- Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Laure Morin‐Papunen
- Department of Obstetrics and Gynecology Medical Research Center Oulu and PEDEGO Research Unit (Research Unit for Pediatrics Dermatology, Clinical Genetics, Obstetrics and Gynecology University Hospital of OuluUniversity of Oulu Oulu Finland
| |
Collapse
|
3
|
Kaseva N, Vääräsmäki M, Sundvall J, Matinolli HM, Sipola M, Tikanmäki M, Heinonen K, Lano A, Wehkalampi K, Wolke D, Ruokonen A, Andersson S, Järvelin MR, Räikkönen K, Eriksson JG, Kajantie E. Gestational Diabetes But Not Prepregnancy Overweight Predicts for Cardiometabolic Markers in Offspring Twenty Years Later. J Clin Endocrinol Metab 2019; 104:2785-2795. [PMID: 30835282 DOI: 10.1210/jc.2018-02743] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/25/2019] [Indexed: 02/06/2023]
Abstract
CONTEXT Maternal gestational diabetes mellitus (GDM) and prepregnancy overweight/obesity [body mass index (BMI) ≥25 kg/m2] might adversely affect offspring cardiometabolic health. OBJECTIVE To assess the associations between maternal GDM and prepregnancy overweight/obesity with adult offspring cardiometabolic risk factors. DESIGN Longitudinal cohort study (ESTER Maternal Pregnancy Disorders Study and the Arvo Ylppö Longitudinal Study). SETTING Province of Uusimaa and Northern Finland. PARTICIPANTS At a mean age of 24.1 ± 1.3 years, we classified offspring as offspring of mothers with GDM regardless of the prepregnancy BMI (OGDM; n = 193); normoglycemic mothers with prepregnancy overweight/obesity (ONO; n = 157); and normoglycemic mothers with prepregnancy BMI <25 kg/m2 (controls; n = 556). MAIN OUTCOME MEASURES We assessed the cardiometabolic biomarkers from blood and measured the blood pressure at rest and heart rate. RESULTS Compared with the controls, the OGDM and ONO groups had greater fasting glucose (1.6%; 95% CI, 0.1% to 3.1%; and 2.3%; 95% CI, 0.5% to 4.3%, respectively) and insulin (12.7%; 95% CI, 4.4% to 21.9%; and 8.7%; 95% CI, 0.2% to 17.8%). These differences attenuated to nonsignificance when adjusted for confounders and/or current offspring characteristics, including BMI or body fat percentage. The OGDM group had lower SHBG (men, -12.4%; 95% CI, -20.2% to -3.9%; women, -33.2%; 95% CI, -46.3% to -16.8%), high-density lipoprotein (-6.6%; 95% CI, -10.9% to -2.2%), and apolipoprotein A1 (-4.5%; 95% CI, -7.5% to -1.4%). These differences survived the adjustments. The heart rate and other biomarkers were similar among the groups. CONCLUSIONS Adult offspring of mothers with GDM have increased markers of insulin resistance and a more atherogenic lipid profile. These were only partly explained by confounders or current offspring adiposity. Maternal prepregnancy overweight/obesity was associated with impaired offspring glucose regulation, which was explained by confounders and/or current adiposity.
Collapse
Affiliation(s)
- Nina Kaseva
- National Institute for Health and Welfare, Helsinki, Finland
| | - Marja Vääräsmäki
- National Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jouko Sundvall
- National Institute for Health and Welfare, Helsinki, Finland
| | - Hanna-Maria Matinolli
- National Institute for Health and Welfare, Helsinki, Finland
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Marika Sipola
- National Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Marjaana Tikanmäki
- National Institute for Health and Welfare, Helsinki, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Kati Heinonen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Aulikki Lano
- Children's Hospital, Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karoliina Wehkalampi
- Children's Hospital, Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Warwick, United Kingdom
| | - Aimo Ruokonen
- NordLab Oulu, Oulu University Hospital, Oulu, Finland
- Department of Clinical Chemistry, University of Oulu, Oulu, Finland
| | - Sture Andersson
- Children's Hospital, Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, United Kingdom
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Johan G Eriksson
- National Institute for Health and Welfare, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland
- PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology), Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Children's Hospital, Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
4
|
Nedelec R, Jokelainen J, Miettunen J, Ruokonen A, Herzig KH, Männikkö M, Järvelin MR, Sebert S. Early determinants of metabolically healthy obesity in young adults: study of the Northern Finland Birth Cohort 1966. Int J Obes (Lond) 2018; 42:1704-1714. [PMID: 29795454 DOI: 10.1038/s41366-018-0115-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 04/06/2018] [Accepted: 04/17/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND A body of literature suggests a metabolically healthy phenotype in individuals with obesity. Despite important clinical implications, the early origins of metabolically healthy obesity (MHO) have received little attention. OBJECTIVE To assess the prevalence of MHO among the Northern Finland Birth Cohort 1966 (NFBC1966) at 31 years of age, examine its determinants in early life taking into account the sex specificity. METHODS We studied 3205 term-born cohort participants with data available for cardio-metabolic health outcomes at 31 years, and longitudinal height and weight data. After stratifying the population by sex, adult BMI and a strict definition of metabolic health (i.e., no risk factors meaning metabolic health), we obtained six groups. Repeated childhood height and weight measures were used to model early growth and early adiposity phenotypes. We employed marginal means adjusted for mother and child covariates including socio-economic status, birth weight and gestational-age, to compare differences between the groups. RESULTS The prevalence of adult MHO was 6% in men and 13.5% in women. Differences in adult metabolic status were linked to alterations in BMI and age at adiposity peak in infancy (p < 0.0003 in men and p = 0.027 in women), and BMI and age at adiposity rebound (AR) (p < 0.0001 irrespective of sex). Compared to MHO, metabolically unhealthy obese (MUO) women were five and a half months younger at AR (p = 0.007) with a higher BMI while MUO men were four months older (p = 0.036) with no difference in BMI at AR. CONCLUSION At the time of AR, MHO women appeared to be older than their MUO counterparts while MHO men were younger. These original results support potential risk factors at the time of adiposity rebound linked to metabolic health in adulthood. These variations by sex warrant independent replication.
Collapse
Affiliation(s)
- Rozenn Nedelec
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Jari Jokelainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University, Oulu, Finland
| | - Aimo Ruokonen
- NordLab Oulu, Department of Clinical Chemistry, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Karl-Heinz Herzig
- Biocenter Oulu, University of Oulu, Oulu, Finland.,Unit of Primary Care, Oulu University Hospital, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University, Oulu, Finland.,Research Unit of Biomedicine, Department of Physiology, University of Oulu, Oulu, Finland.,Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland
| | - Minna Männikkö
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, University of Oulu, Oulu, Finland. .,Biocenter Oulu, University of Oulu, Oulu, Finland. .,Unit of Primary Care, Oulu University Hospital, Oulu, Finland. .,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK. .,MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, London, UK. .,Department of Life Sciences, College of Health and Life Sciences, Brunel University, London, UK.
| | - Sylvain Sebert
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Biocenter Oulu, University of Oulu, Oulu, Finland.,Department of Genomics of Complex Diseases, School of Public Health, Imperial College, London, UK
| |
Collapse
|
5
|
Sinikumpu SP, Huilaja L, Auvinen J, Jokelainen J, Puukka K, Ruokonen A, Timonen M, Tasanen K. The Association Between Low Grade Systemic Inflammation and Skin Diseases: A Cross-sectional Survey in the Northern Finland Birth Cohort 1966. Acta Derm Venereol 2018; 98:65-69. [PMID: 28902946 DOI: 10.2340/00015555-2795] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Low grade inflammation is associated with many noncommunicable diseases. The association between skin diseases in general and systemic inflammation has not previously been studied at the population level. A whole-body investigation on 1,930 adults belonging to Northern Finland Birth Cohort 1966 was performed and high sensitive C-reactive protein (CRP) level was measured as a marker of low grade inflammation in order to determine the association between low grade inflammation and skin diseases in an unselected adult population. After adjustment for confounding factors the following skin disorders were associated with low grade inflammation in multinomial logistic regression analysis: atopic eczema (OR 2.2, 95% CI 1.2-3.9), onychomycosis (OR 2.0, 1.2-3.2) and rosacea (OR 1.7, 1.1-2.5). After additionally adjusting for body mass index and systemic diseases, the risks for atopic eczema (OR 2.4, 1.3-4.6) and onychomycosis (OR 1.9, 1.1-3.1) remained statistically significant. In conclusion, low grade inflammation is present in several skin diseases.
Collapse
Affiliation(s)
- Suvi-Päivikki Sinikumpu
- Department of Dermatology, Medical Research Center, PEDEGO Research Group, University of Oulu and Oulu University Hospital, FIN-90029 OYS Oulu, Finland.
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Kiviniemi AM, Perkiömäki N, Auvinen J, Niemelä M, Tammelin T, Puukka K, Ruokonen A, Keinänen-Kiukaanniemi S, Tulppo MP, Järvelin MR, Jämsä T, Huikuri HV, Korpelainen R. Fitness, Fatness, Physical Activity, and Autonomic Function in Midlife. Med Sci Sports Exerc 2018; 49:2459-2468. [PMID: 29135784 DOI: 10.1249/mss.0000000000001387] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE Although low cardiorespiratory fitness (CRF), physical inactivity, and obesity are associated with impaired autonomic function, they are also extensively interrelated. The present study aimed to assess the extent to which they contribute to autonomic function independently of each other. METHODS At the age of 46 yr, 1383 men and 1761 women without cardiorespiratory diseases and diabetes underwent assessments of vagally mediated heart rate (HR) variability (root mean square of successive differences in R-R interval (rMMSD)), peak HR during a submaximal step test (CRF), and 60-s HR recovery (HRR). Moderate-to-vigorous physical activity (MVPA; ≥3.5 METs, 2 wk) was measured by wrist-worn accelerometer and body fat percentage (Fat%) by bioimpedance. RESULTS In men, CRF and Fat% were significantly associated with higher rMSSD (standardized β = 0.31 and -0.16) and HRR (β = 0.19 and -0.18), whereas higher MVPA was linked with higher HRR (β = 0.13) when including CRF, MVPA, and Fat% in the initial regression. After adjustments for other lifestyle and cardiometabolic factors, CRF remained significantly associated with rMMSD (β = 0.24) and HRR (β = 0.14), as did MVPA with HRR (β = 0.11). In women, CRF was associated with rMSSD (β = 0.23) and HRR (β = 0.15), and MVPA (β = 0.17) and Fat% (β = -0.07) with HRR, when CRF, MVPA, and Fat% were adjusted for each other. After further adjustments, CRF remained a significant determinant of rMSSD (β = 0.20) and HRR (β = 0.13), as did MVPA with HRR (β = 0.15). The final models explained 23% and 21% of variation in rMSSD and HRR in men, and 10% and 12% in women, respectively. CONCLUSIONS CRF was a more important determinant of cardiac autonomic function than MVPA and body fat. Furthermore, MVPA but not body fat was independently associated with cardiac autonomic function in both men and women.
Collapse
Affiliation(s)
- Antti M Kiviniemi
- 1Research Unit of Internal Medicine, University of Oulu, Oulu, FINLAND; 2Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, FINLAND; 3Center for Life Course Health Research, University of Oulu, Oulu, FINLAND; 4Unit of Primary Care, University of Oulu, Oulu, FINLAND; 5Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FINLAND; 6LIKES Research Centre for Physical Activity and Health, Jyväskylä, FINLAND; 7NordLab Oulu, Medical Research Center Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, FINLAND; 8Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UNITED KINGDOM; 9Biocenter Oulu, University of Oulu, Oulu, FINLAND; 10Diagnostic Imaging, Oulu University Hospital, Oulu, FINLAND; and 11Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Oulu, FINLAND
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Sinikumpu S, Huilaja L, Jokalainen J, Auvinen J, Puukka K, Ruokonen A, Timonen M, Tasanen K. 510 The association between low grade inflammation and skin diseases. A cross-sectional survey in the Northern Finland Birth Cohort 1966. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
8
|
Karjula S, Morin-Papunen L, Auvinen J, Ruokonen A, Puukka K, Franks S, Järvelin MR, Tapanainen JS, Jokelainen J, Miettunen J, Piltonen TT. Psychological Distress Is More Prevalent in Fertile Age and Premenopausal Women With PCOS Symptoms: 15-Year Follow-Up. J Clin Endocrinol Metab 2017; 102:1861-1869. [PMID: 28323926 PMCID: PMC5470769 DOI: 10.1210/jc.2016-3863] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 02/22/2017] [Indexed: 01/30/2023]
Abstract
Context Polycystic ovary syndrome (PCOS) is associated with increased psychological distress, obesity and hyperandrogenism being suggested as key promoters. Objectives To investigate the prevalence of anxiety/depression and their coexistence in women with PCOS/PCOS-related symptoms at ages 31 and 46. The roles of obesity, hyperandrogenism, and awareness of PCOS on psychological distress were also assessed. Design Population-based follow-up. Setting Northern Finland Birth Cohort 1966 with 15-year follow-up. Participants At age 31, a questionnaire-based screening for oligoamenorrhea (OA) and hirsutism (H): 2188 asymptomatic (controls), 331 OA, 323 H, and 125 OA plus H (PCOS). Follow-up at age 46: 1576 controls, 239 OA, 231 H, and 85 PCOS. Interventions Questionnaire-based screening for anxiety and depression symptoms (Hopkins Symptom Checklist-25) and previously diagnosed/treated depression at ages 31 and 46. Body mass index (BMI), serum testosterone/free androgen index, and awareness of polycystic ovaries/PCOS on psychological distress were also assessed. Main Outcomes Population-based prevalence of anxiety and/or depression in women with PCOS/PCOS-related symptoms at ages 31 and 46. Results Anxiety and/or depression symptoms, their coexistence, and rate of depression were increased at ages 31 and 46 in women with PCOS or isolated H compared with controls. High BMI or hyperandrogenism did not associate with increased anxiety or depression symptoms. The awareness of PCOS was associated with increased anxiety. Conclusions Women with PCOS or isolated H present more often with anxiety and/or depression symptoms and their coexistence compared with controls. High BMI or hyperandrogenism did not provoke psychological distress in PCOS. The awareness of PCOS increased anxiety but did not associate with severe anxiety or depression.
Collapse
Affiliation(s)
- Salla Karjula
- Department of Obstetrics and Gynecology, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- Medical Research Center, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- PEDEGO Research Unit, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
| | - Laure Morin-Papunen
- Department of Obstetrics and Gynecology, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- Medical Research Center, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- PEDEGO Research Unit, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
| | - Juha Auvinen
- Medical Research Center, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- Center for Life Course Health Research, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
| | - Aimo Ruokonen
- Medical Research Center, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- NordLab Oulu, Department of Clinical Chemistry, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
| | - Katri Puukka
- Medical Research Center, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- NordLab Oulu, Department of Clinical Chemistry, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
| | - Stephen Franks
- Institute of Reproductive and Developmental Biology, Imperial College London, London W12 ONN, United Kingdom
| | - Marjo-Riitta Järvelin
- Center for Life Course Epidemiology, Faculty of Medicine, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- Department of Epidemiology and Biostatistics, Medical Research Council-Public Health England Centre for Environment and Health, School of Public Health, Imperial College London, London W2 1PG, United Kingdom
| | - Juha S. Tapanainen
- Department of Obstetrics and Gynecology, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- Medical Research Center, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- PEDEGO Research Unit, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital, FI-00014 Helsinki, Finland
| | - Jari Jokelainen
- Faculty of Medicine, University of Oulu, FI-90014 Oulu, Finland
| | - Jouko Miettunen
- Medical Research Center, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- Center for Life Course Health Research, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
| | - Terhi T. Piltonen
- Department of Obstetrics and Gynecology, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- Medical Research Center, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
- PEDEGO Research Unit, University Hospital of Oulu, University of Oulu, FI-90014 Oulu, Finland
| |
Collapse
|
9
|
Ollila MM, West S, Keinänen-Kiukaaniemi S, Jokelainen J, Auvinen J, Puukka K, Ruokonen A, Järvelin MR, Tapanainen JS, Franks S, Piltonen TT, Morin-Papunen LC. Overweight and obese but not normal weight women with PCOS are at increased risk of Type 2 diabetes mellitus-a prospective population-based cohort study. Hum Reprod 2017; 32:968. [PMID: 28333219 DOI: 10.1093/humrep/dex030] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M M Ollila
- Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Medical Research Center Oulu and PEDEGO Research Unit, FI, OYS, Oulu, Finland
| | - S West
- Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Medical Research Center Oulu and PEDEGO Research Unit, FI, OYS, Oulu, Finland
| | - S Keinänen-Kiukaaniemi
- Center for Life Course Health Research, University of Oulu, FI, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, FI, Oulu, Finland
| | - J Jokelainen
- Center for Life Course Health Research, University of Oulu, FI, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, FI, Oulu, Finland
| | - J Auvinen
- Center for Life Course Health Research, University of Oulu, FI, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, FI, Oulu, Finland
| | - K Puukka
- NordLab Oulu, Department of Clinical Chemistry, Oulu University Hospital, University of Oulu and Medical Research Center, FI, Oulu, Finland
| | - A Ruokonen
- NordLab Oulu, Department of Clinical Chemistry, Oulu University Hospital, University of Oulu and Medical Research Center, FI, Oulu, Finland
| | - M-R Järvelin
- Center for Life Course Health Research, University of Oulu, FI, Oulu, Finland.,Department of Children, Young People and Families, National Institute for Health and Welfare, FI, Oulu, Finland.,Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College London,London, UK
| | - J S Tapanainen
- Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Medical Research Center Oulu and PEDEGO Research Unit, FI, OYS, Oulu, Finland.,Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, FI, Helsinki, Finland
| | - S Franks
- Institute of Reproductive and Developmental Biology, Imperial College London, Hammersmith Hospital, London, UK
| | - T T Piltonen
- Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Medical Research Center Oulu and PEDEGO Research Unit, FI, OYS, Oulu, Finland
| | - L C Morin-Papunen
- Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Medical Research Center Oulu and PEDEGO Research Unit, FI, OYS, Oulu, Finland
| |
Collapse
|
10
|
Eskola PJ, Auvinen JP, Jokelainen J, Liukkonen T, Sebert S, Ruokonen A, Puukka K, Timonen M, Keinänen-Kiukaanniemi S. Depressive symptom profiles and glucose tolerance status. World Psychiatry 2017; 16:112. [PMID: 28127921 PMCID: PMC5269695 DOI: 10.1002/wps.20391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Pasi J Eskola
- Center for Life Course Health Research, University of Oulu, Finland
- Kontinkangas Wellness Centre, Oulu, Finland
| | - Juha P Auvinen
- Center for Life Course Health Research, University of Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Jari Jokelainen
- Center for Life Course Health Research, University of Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Timo Liukkonen
- Center for Life Course Health Research, University of Oulu, Finland
- Mikkeli Central Hospital, Mikkeli, Finland
| | - Sylvain Sebert
- Center for Life Course Health Research, University of Oulu, Finland
- Biocenter Oulu, University of Oulu, Finland
- Department of Genomics of Complex Diseases, Imperial College London, London, UK
| | - Aimo Ruokonen
- NordLab Oulu, Oulu University Hospital, Oulu, Finland
- Department of Clinical Chemistry, University of Oulu, Finland
| | - Katri Puukka
- NordLab Oulu, Oulu University Hospital, Oulu, Finland
- Department of Clinical Chemistry, University of Oulu, Finland
| | - Markku Timonen
- Center for Life Course Health Research, University of Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, Finland
- Kontinkangas Wellness Centre, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| |
Collapse
|
11
|
Ollila MM, West S, Keinänen-Kiukaanniemi S, Jokelainen J, Auvinen J, Puukka K, Ruokonen A, Järvelin MR, Tapanainen JS, Franks S, Piltonen TT, Morin-Papunen LC. Overweight and obese but not normal weight women with PCOS are at increased risk of Type 2 diabetes mellitus-a prospective, population-based cohort study. Hum Reprod 2016; 32:423-431. [PMID: 28031324 DOI: 10.1093/humrep/dew329] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 11/29/2016] [Accepted: 12/16/2016] [Indexed: 12/15/2022] Open
Abstract
STUDY QUESTION What are the respective roles of polycystic ovary syndrome (PCOS), long-term weight gain and obesity for the development of prediabetes or Type 2 diabetes mellitus (T2DM) by age 46 years? SUMMARY ANSWER The risk of T2DM in women with PCOS is mainly due to overweight and obesity, although these two factors have a synergistic effect on the development of T2DM. WHAT IS KNOWN ALREADY PCOS is associated with an increased risk of prediabetes and T2DM. However, the respective roles of PCOS per se and BMI for the development of T2DM have remained unclear. STUDY DESIGN, SIZE, DURATION In a prospective, general population-based follow-up birth cohort 1966 (n = 5889), postal questionnaires were sent at ages 14 (95% answered), 31 (80% answered) and 46 years (72% answered). Questions about oligoamenorrhoea and hirsutism were asked at age 31 years, and a question about PCOS diagnosis at 46 years. Clinical examination and blood sampling were performed at 31 years in 3127 women, and at 46 years in 3280 women. A 2-h oral glucose tolerance test (OGTT) was performed at 46 years of age in 2780 women. PARTICIPANTS/MATERIALS, SETTING, METHODS Women reporting both oligoamenorrhoea and hirsutism at age 31 years and/or diagnosis of PCOS by 46 years were considered as women with PCOS (n = 279). Women without any symptoms at 31 years and without PCOS diagnosis by 46 years were considered as controls (n = 1577). The level of glucose metabolism was classified according to the results of the OGTT and previous information of glucose metabolism status from the national drug and hospital discharge registers. MAIN RESULTS AND THE ROLE OF CHANCE PCOS per se significantly increased the risk of T2DM in overweight/obese (BMI ≥ 25.0 kg/m2) women with PCOS when compared to overweight/obese controls (odds ratio: 2.45, 95% CI: 1.28-4.67). Normal weight women with PCOS did not present with an increased risk of prediabetes or T2DM. The increase in weight between ages 14, 31 and 46 years was significantly greater in women with PCOS developing T2DM than in women with PCOS and normal glucose tolerance, with the most significant increase occurring in early adulthood (between 14 and 31 years: median with [25%; 75% quartiles]: 27.25 kg [20.43; 34.78] versus 13.80 kg [8.55; 20.20], P < 0.001). LIMITATIONS, REASONS FOR CAUTION The diagnosis of PCOS was based on self-reporting, and the questionnaire at 46 years did not distinguish between polycystic ovaries only in ultrasonography and the syndrome. Ovarian ultrasonography was not available to aid the diagnosis of PCOS. WIDER IMPLICATIONS OF THE FINDINGS These results emphasize weight management already during adolescence and early adulthood to prevent the development of T2DM in women with PCOS, as the period between 14 and 31 years seems to be a crucial time-window during which the women with PCOS who are destined to develop T2DM by 46 years of age experience a dramatic weight gain. Furthermore, our results support the view that, particularly in times of limited sources of healthcare systems, OGTT screening should be targeted to overweight/obese women with PCOS rather than to all women with PCOS. STUDY FUNDING/COMPETING INTERESTS Finnish Medical Foundation; North Ostrobothnia Regional Fund; Academy of Finland (project grants 104781, 120315, 129269, 1114194, 24300796, Center of Excellence in Complex Disease Genetics and SALVE); Sigrid Juselius Foundation; Biocenter Oulu; University Hospital Oulu and University of Oulu (75617); Medical Research Center Oulu; National Institute for Health Research (UK); National Heart, Lung, and Blood Institute (grant 5R01HL087679-02) through the STAMPEED program (1RL1MH083268-01); National Institute of Health/National Institute of Mental Health (5R01MH63706:02); ENGAGE project and grant agreement HEALTH-F4-2007-201413; EU FP7 EurHEALTHAgeing-277849 European Commission and Medical Research Council, UK (G0500539, G0600705, G1002319, PrevMetSyn/SALVE) and Medical Research Center, Centenary Early Career Award. The authors have no conflicts of interests. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- M M Ollila
- Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Medical Research Center Oulu and PEDEGO Research Unit, FI-90029, OYS, Oulu, Finland
| | - S West
- Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Medical Research Center Oulu and PEDEGO Research Unit, FI-90029, OYS, Oulu, Finland
| | - S Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, FI-90014, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, FI-90220, Oulu, Finland
| | - J Jokelainen
- Center for Life Course Health Research, University of Oulu, FI-90014, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, FI-90220, Oulu, Finland
| | - J Auvinen
- Center for Life Course Health Research, University of Oulu, FI-90014, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, FI-90220, Oulu, Finland
| | - K Puukka
- NordLab Oulu, Department of Clinical Chemistry, Oulu University Hospital, University of Oulu and Medical Research Center Oulu, FI-90220, Oulu, Finland
| | - A Ruokonen
- NordLab Oulu, Department of Clinical Chemistry, Oulu University Hospital, University of Oulu and Medical Research Center Oulu, FI-90220, Oulu, Finland
| | - M-R Järvelin
- Center for Life Course Health Research, University of Oulu, FI-90014, Oulu, Finland.,Department of Children, Young People and Families, National Institute for Health and Welfare, FI-90101, Oulu, Finland.,Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment & Health, School of Public Health, Imperial College London, W2 1PG, London, UK
| | - J S Tapanainen
- Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Medical Research Center Oulu and PEDEGO Research Unit, FI-90029, OYS, Oulu, Finland.,Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, FI-00014, Helsinki, Finland
| | - S Franks
- Institute of Reproductive and Developmental Biology, Imperial College London, Hammersmith Hospital, W12 0NN, London, UK
| | - T T Piltonen
- Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Medical Research Center Oulu and PEDEGO Research Unit, FI-90029, OYS, Oulu, Finland
| | - L C Morin-Papunen
- Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu, Medical Research Center Oulu and PEDEGO Research Unit, FI-90029, OYS, Oulu, Finland
| |
Collapse
|
12
|
Uimari O, Auvinen J, Jokelainen J, Puukka K, Ruokonen A, Järvelin MR, Piltonen T, Keinänen-Kiukaanniemi S, Zondervan K, Järvelä I, Ryynänen M, Martikainen H. Uterine fibroids and cardiovascular risk. Hum Reprod 2016; 31:2689-2703. [PMID: 27733532 DOI: 10.1093/humrep/dew249] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 08/13/2016] [Accepted: 08/23/2016] [Indexed: 01/19/2023] Open
Abstract
STUDY QUESTION Are uterine fibroids associated with increased cardiovascular risk? SUMMARY ANSWER This study reports an association between increased serum lipids and metabolic syndrome with an increased risk of uterine fibroids. WHAT IS KNOWN ALREADY Recent studies suggest similarities in biological disease mechanisms and risk factors for fibroids and atherosclerosis: obesity, hypertension and abnormal serum lipids. These findings are awaiting confirmation that a population-based follow-up study could offer with extensive health examination data collection linked with a national hospital discharge register. STUDY DESIGN, SIZE, DURATION The Northern Finland Birth Cohort (NFBC1966) is a population-based long-term follow-up study including all children with estimated date of delivery in 1966 in the Northern Finland area. The data were collected from national registries, postal questionnaires and clinical health examinations. The study population for this study comprised all females included in the NFBC1966 that underwent an extensive clinical health examination at age 46 years (n = 3635). PARTICIPANTS/MATERIALS, SETTING, METHODS All females included in the NFBC1966 who were alive and traceable (n = 5118) were invited for the 46-year follow-up study; 3268 (63.9%) responded, returned the postal questionnaire and attended the clinical examination. Uterine fibroid cases were identified through the national hospital discharge register that has data on disease diagnoses based on WHO ICD-codes. Uterine fibroid codes, ICD-9: 218 and ICD-10: D25 were used for case identification. Self-reported fibroid cases were identified through the postal questionnaire. MAIN RESULTS AND THE ROLE OF CHANCE A total of 729 fibroid cases were identified, including 293 based on hospital discharge registries. With adjustment for BMI, parity, education and current use of exogenous hormones the risk of prevalent fibroids rose significantly for every 1 mmol/l increase in LDL (OR = 1.13, 95% CI: 1.02-1.26 for all cases) and triglycerides (OR = 1.27, 95% CI: 1.09-1.49 for all cases). Metabolic syndrome associated with hospital discharge-based fibroid diagnosis (OR = 1.48, 95% CI: 1.09-2.01). Additionally every 1 unit increase in waist-hip ratio associated with fibroids (OR = 1.32, 95% CI: 1.10-1.57). LIMITATIONS, REASONS FOR CAUTION The case ascertainment may present some limitations. There was likely an under-identification of cases and misclassification of some cases as controls; this would have diluted the effects of reported associations. The data analysed were cross-sectional and therefore cause and effect for the associations observed cannot be distinguished. WIDER IMPLICATIONS OF THE FINDINGS Increased serum lipids and metabolic syndrome are associated with increased risk of uterine fibroids. Along with central obesity these findings add to an increased risk for cardiovascular disease among women with fibroids. These observations may suggest that there are shared predisposing factors underlying both uterine fibroids and adverse metabolic and cardiac disease risk, or that metabolic factors have a role in biological mechanisms underlying fibroid development. STUDY FUNDING/COMPETING INTERESTS This study was supported by the Academy of Finland, University Hospital Oulu, University of Oulu, Finland, Northern Finland Health Care Foundation, Duodecim Foundation, ERDF European Regional Development Fund-Well-being and health: Research in the Northern Finland Birth Cohort 1966. The authors declare no conflict of interest.
Collapse
Affiliation(s)
- Outi Uimari
- Department of Obstetrics and Gynaecology, Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland .,PEDEGO Research Unit, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland.,Endometriosis CaRe Centre, Nuffield Department of Obstetrics and Gyneacology, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK.,Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, PO Box 8000, 90014 Oulu, Finland.,Unit of Primary Care, Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Jari Jokelainen
- Center for Life Course Health Research, University of Oulu, PO Box 8000, 90014 Oulu, Finland.,Unit of Primary Care, Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Katri Puukka
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland.,NordLab Oulu, Department of Clinical Chemistry, University Hospital of Oulu, University of Oulu, PO Box 5000, 90014 Oulu, Finland
| | - Aimo Ruokonen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland.,NordLab Oulu, Department of Clinical Chemistry, University Hospital of Oulu, University of Oulu, PO Box 5000, 90014 Oulu, Finland
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, University of Oulu, PO Box 8000, 90014 Oulu, Finland.,Unit of Primary Care, Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Terhi Piltonen
- Department of Obstetrics and Gynaecology, Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland.,PEDEGO Research Unit, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, PO Box 8000, 90014 Oulu, Finland.,Unit of Primary Care, Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Krina Zondervan
- Endometriosis CaRe Centre, Nuffield Department of Obstetrics and Gyneacology, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK.,Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Ilkka Järvelä
- Department of Obstetrics and Gynaecology, Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland.,PEDEGO Research Unit, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Markku Ryynänen
- Department of Obstetrics and Gynaecology, Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland.,PEDEGO Research Unit, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| | - Hannu Martikainen
- Department of Obstetrics and Gynaecology, Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland.,PEDEGO Research Unit, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, PO Box 5000, 90014 Oulu, Finland
| |
Collapse
|
13
|
Perkiömäki N, Auvinen J, Tulppo MP, Hautala AJ, Perkiömäki J, Karhunen V, Keinänen-Kiukaanniemi S, Puukka K, Ruokonen A, Järvelin MR, Huikuri HV, Kiviniemi AM. Association between Birth Characteristics and Cardiovascular Autonomic Function at Mid-Life. PLoS One 2016; 11:e0161604. [PMID: 27552091 PMCID: PMC4994955 DOI: 10.1371/journal.pone.0161604] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 08/08/2016] [Indexed: 12/19/2022] Open
Abstract
Background Low birth weight is associated with an increased risk of cardiovascular diseases in adulthood. As abnormal cardiac autonomic function is a common feature in cardiovascular diseases, we tested the hypothesis that low birth weight may also be associated with poorer cardiac autonomic function in middle-aged subjects. Methods At the age of 46, the subjects of the Northern Finland Birth Cohort 1966 were invited to examinations including questionnaires about health status and life style and measurement of vagally-mediated heart rate variability (rMSSD) from R-R intervals (RRi) and spontaneous baroreflex sensitivity (BRS) in both seated and standing positions. Maternal parameters had been collected in 1965–1966 since the 16th gestational week and birth variables immediately after delivery. For rMSSD, 1,799 men and 2,279 women without cardiorespiratory diseases and diabetes were included and 902 men and 1,020 women for BRS. The analyses were adjusted for maternal (age, anthropometry, socioeconomics, parity, gestational smoking) and adult variables (life style, anthropometry, blood pressure, glycemic and lipid status) potentially confounding the relationship between birth weight and autonomic function. Results In men, birth weight correlated negatively with seated (r = -0.058, p = 0.014) and standing rMSSD (r = -0.090, p<0.001), as well as with standing BRS (r = -0.092, p = 0.006). These observations were verified using relevant birth weight categories (<2,500 g; 2,500–3,999 g; ≥4,000 g). In women, birth weight was positively correlated with seated BRS (r = 0.081, p = 0.010), but none of the other measures of cardiovascular autonomic function. These correlations remained significant after adjustment for potential confounders (p<0.05 for all). Conclusions In men, higher birth weight was independently associated with poorer cardiac autonomic function at mid-life. Same association was not observed in women. Our findings suggest that higher, not lower, birth weight in males may contribute to less favourable cardiovascular autonomic regulation and potentially to an elevated cardiovascular risk in later life.
Collapse
Affiliation(s)
- Nelli Perkiömäki
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
| | - Mikko P. Tulppo
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Arto J. Hautala
- Physiological Signal Analysis Team, Center for Machine Vision and Signal Analysis, University of Oulu, Oulu, Finland
| | - Juha Perkiömäki
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Ville Karhunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
| | - Katri Puukka
- NordLab Oulu, Medical Research Center Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Finland
| | - Aimo Ruokonen
- NordLab Oulu, Medical Research Center Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Finland
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC–PHE Centre for Environment & Health, School of Public Health, Imperial College London, London, United Kingdom
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Heikki V. Huikuri
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Antti M. Kiviniemi
- Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- * E-mail:
| |
Collapse
|
14
|
Ollila MME, Piltonen T, Puukka K, Ruokonen A, Järvelin MR, Tapanainen JS, Franks S, Morin-Papunen L. Weight Gain and Dyslipidemia in Early Adulthood Associate With Polycystic Ovary Syndrome: Prospective Cohort Study. J Clin Endocrinol Metab 2016; 101:739-47. [PMID: 26652764 DOI: 10.1210/jc.2015-3543] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Obesity affects the majority of women with polycystic ovary syndrome (PCOS), but previous studies are inconsistent about the prevalence of obesity and the importance of weight gain in the development of the syndrome. OBJECTIVE Our objective was to explore the association between weight, weight gain, hyperandrogenism, and PCOS from adolescence to late adulthood. DESIGN The study includes a prospective Northern Finland Birth Cohort 1966 study including 5889 females born in 1966 and followed at the ages of 14, 31, and 46 years. SETTING The setting was the general community. PARTICIPANTS Women presenting both oligo/amenorrhea (OA) and hirsutism (H) at age 31 (N = 125) or with formally diagnosed PCOS by age 46 (N = 181) were compared with women without PCOS symptoms or diagnosis (n = 1577). INTERVENTIONS None. MAIN OUTCOME MEASURES Body mass index (BMI), weight change through life, waist circumference, Free Androgen Index, lipids, glucose, insulin, high-sensitivity C-reactive protein, homeostatic model assessment for insulin resistance, and PCOS. RESULTS Women with OA+H at age 31 or diagnosis of PCOS by age 46 had the highest BMI at all ages compared with the controls. Increase of BMI between ages 14 and 31, but not between 31 and 46, was greater in women with isolated OA (P = .006), OA+H (P = .001), and diagnosis of PCOS (P = .001) compared with controls. In the multivariate analysis, PCOS was significantly associated with BMI at all ages (BMI at age 31: odds ratio [OR] = 1.05 [95% confidence interval (CI), 1.00-1.10], Free Androgen Index (OR = 1.08 [95% CI, 1.03-1.14]), serum levels of insulin (OR = 1.05 [95% CI, 1.00-1.09]), and triglycerides (OR = 1.48 [95% CI, 1.08-2.03]). CONCLUSIONS Symptoms or diagnosis of PCOS are associated with dyslipidemia, hyperandrogenemia, and significantly increased weight gain, especially in early adulthood. This observation is important because it may identify a sensitive time period when weight gain plays a crucial role in the emergence of PCOS and when preventive actions against metabolic and cardiovascular diseases should be implemented.
Collapse
Affiliation(s)
- Meri-Maija E Ollila
- Department of Obstetrics and Gynecology (M.-M.E.O., T.P., J.S.T., L.M.-P.), University Hospital of Oulu, University of Oulu, Medical Research Center Oulu and PEDEGO (Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology) Research Unit, Oulu, FI-90029, Finland; NordLab Oulu (K.P., A.R.), Department of Clinical Chemistry, University Hospital of Oulu, University of Oulu and Medical Research Center Oulu, Oulu, FI-90029, Finland; Department of Epidemiology and Biostatistics (M.-R.J.), Medical Research Council-PHE (Public Health England) Centre for Environment & Health, School of Public Health, Imperial College London, United Kingdom W2 1PG; Center for Life Course Epidemiology (M.-R.J.), Faculty of Medicine, University of Oulu, Oulu, FI-90014, Finland; Biocenter Oulu (M.-R.J.), University of Oulu, Oulu, FI-90014, Finland; Unit of Primary Care (M.-R.J.), University Hospital of Oulu, Oulu, FI-90220, Finland; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Hospital, Helsinki, FI-00014, Finland; Institute of Reproductive and Developmental Biology (S.F.), Imperial College London, United Kingdom W12 ONN
| | - Terhi Piltonen
- Department of Obstetrics and Gynecology (M.-M.E.O., T.P., J.S.T., L.M.-P.), University Hospital of Oulu, University of Oulu, Medical Research Center Oulu and PEDEGO (Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology) Research Unit, Oulu, FI-90029, Finland; NordLab Oulu (K.P., A.R.), Department of Clinical Chemistry, University Hospital of Oulu, University of Oulu and Medical Research Center Oulu, Oulu, FI-90029, Finland; Department of Epidemiology and Biostatistics (M.-R.J.), Medical Research Council-PHE (Public Health England) Centre for Environment & Health, School of Public Health, Imperial College London, United Kingdom W2 1PG; Center for Life Course Epidemiology (M.-R.J.), Faculty of Medicine, University of Oulu, Oulu, FI-90014, Finland; Biocenter Oulu (M.-R.J.), University of Oulu, Oulu, FI-90014, Finland; Unit of Primary Care (M.-R.J.), University Hospital of Oulu, Oulu, FI-90220, Finland; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Hospital, Helsinki, FI-00014, Finland; Institute of Reproductive and Developmental Biology (S.F.), Imperial College London, United Kingdom W12 ONN
| | - Katri Puukka
- Department of Obstetrics and Gynecology (M.-M.E.O., T.P., J.S.T., L.M.-P.), University Hospital of Oulu, University of Oulu, Medical Research Center Oulu and PEDEGO (Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology) Research Unit, Oulu, FI-90029, Finland; NordLab Oulu (K.P., A.R.), Department of Clinical Chemistry, University Hospital of Oulu, University of Oulu and Medical Research Center Oulu, Oulu, FI-90029, Finland; Department of Epidemiology and Biostatistics (M.-R.J.), Medical Research Council-PHE (Public Health England) Centre for Environment & Health, School of Public Health, Imperial College London, United Kingdom W2 1PG; Center for Life Course Epidemiology (M.-R.J.), Faculty of Medicine, University of Oulu, Oulu, FI-90014, Finland; Biocenter Oulu (M.-R.J.), University of Oulu, Oulu, FI-90014, Finland; Unit of Primary Care (M.-R.J.), University Hospital of Oulu, Oulu, FI-90220, Finland; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Hospital, Helsinki, FI-00014, Finland; Institute of Reproductive and Developmental Biology (S.F.), Imperial College London, United Kingdom W12 ONN
| | - Aimo Ruokonen
- Department of Obstetrics and Gynecology (M.-M.E.O., T.P., J.S.T., L.M.-P.), University Hospital of Oulu, University of Oulu, Medical Research Center Oulu and PEDEGO (Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology) Research Unit, Oulu, FI-90029, Finland; NordLab Oulu (K.P., A.R.), Department of Clinical Chemistry, University Hospital of Oulu, University of Oulu and Medical Research Center Oulu, Oulu, FI-90029, Finland; Department of Epidemiology and Biostatistics (M.-R.J.), Medical Research Council-PHE (Public Health England) Centre for Environment & Health, School of Public Health, Imperial College London, United Kingdom W2 1PG; Center for Life Course Epidemiology (M.-R.J.), Faculty of Medicine, University of Oulu, Oulu, FI-90014, Finland; Biocenter Oulu (M.-R.J.), University of Oulu, Oulu, FI-90014, Finland; Unit of Primary Care (M.-R.J.), University Hospital of Oulu, Oulu, FI-90220, Finland; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Hospital, Helsinki, FI-00014, Finland; Institute of Reproductive and Developmental Biology (S.F.), Imperial College London, United Kingdom W12 ONN
| | - Marjo-Riitta Järvelin
- Department of Obstetrics and Gynecology (M.-M.E.O., T.P., J.S.T., L.M.-P.), University Hospital of Oulu, University of Oulu, Medical Research Center Oulu and PEDEGO (Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology) Research Unit, Oulu, FI-90029, Finland; NordLab Oulu (K.P., A.R.), Department of Clinical Chemistry, University Hospital of Oulu, University of Oulu and Medical Research Center Oulu, Oulu, FI-90029, Finland; Department of Epidemiology and Biostatistics (M.-R.J.), Medical Research Council-PHE (Public Health England) Centre for Environment & Health, School of Public Health, Imperial College London, United Kingdom W2 1PG; Center for Life Course Epidemiology (M.-R.J.), Faculty of Medicine, University of Oulu, Oulu, FI-90014, Finland; Biocenter Oulu (M.-R.J.), University of Oulu, Oulu, FI-90014, Finland; Unit of Primary Care (M.-R.J.), University Hospital of Oulu, Oulu, FI-90220, Finland; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Hospital, Helsinki, FI-00014, Finland; Institute of Reproductive and Developmental Biology (S.F.), Imperial College London, United Kingdom W12 ONN
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology (M.-M.E.O., T.P., J.S.T., L.M.-P.), University Hospital of Oulu, University of Oulu, Medical Research Center Oulu and PEDEGO (Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology) Research Unit, Oulu, FI-90029, Finland; NordLab Oulu (K.P., A.R.), Department of Clinical Chemistry, University Hospital of Oulu, University of Oulu and Medical Research Center Oulu, Oulu, FI-90029, Finland; Department of Epidemiology and Biostatistics (M.-R.J.), Medical Research Council-PHE (Public Health England) Centre for Environment & Health, School of Public Health, Imperial College London, United Kingdom W2 1PG; Center for Life Course Epidemiology (M.-R.J.), Faculty of Medicine, University of Oulu, Oulu, FI-90014, Finland; Biocenter Oulu (M.-R.J.), University of Oulu, Oulu, FI-90014, Finland; Unit of Primary Care (M.-R.J.), University Hospital of Oulu, Oulu, FI-90220, Finland; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Hospital, Helsinki, FI-00014, Finland; Institute of Reproductive and Developmental Biology (S.F.), Imperial College London, United Kingdom W12 ONN
| | - Stephen Franks
- Department of Obstetrics and Gynecology (M.-M.E.O., T.P., J.S.T., L.M.-P.), University Hospital of Oulu, University of Oulu, Medical Research Center Oulu and PEDEGO (Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology) Research Unit, Oulu, FI-90029, Finland; NordLab Oulu (K.P., A.R.), Department of Clinical Chemistry, University Hospital of Oulu, University of Oulu and Medical Research Center Oulu, Oulu, FI-90029, Finland; Department of Epidemiology and Biostatistics (M.-R.J.), Medical Research Council-PHE (Public Health England) Centre for Environment & Health, School of Public Health, Imperial College London, United Kingdom W2 1PG; Center for Life Course Epidemiology (M.-R.J.), Faculty of Medicine, University of Oulu, Oulu, FI-90014, Finland; Biocenter Oulu (M.-R.J.), University of Oulu, Oulu, FI-90014, Finland; Unit of Primary Care (M.-R.J.), University Hospital of Oulu, Oulu, FI-90220, Finland; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Hospital, Helsinki, FI-00014, Finland; Institute of Reproductive and Developmental Biology (S.F.), Imperial College London, United Kingdom W12 ONN
| | - Laure Morin-Papunen
- Department of Obstetrics and Gynecology (M.-M.E.O., T.P., J.S.T., L.M.-P.), University Hospital of Oulu, University of Oulu, Medical Research Center Oulu and PEDEGO (Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology) Research Unit, Oulu, FI-90029, Finland; NordLab Oulu (K.P., A.R.), Department of Clinical Chemistry, University Hospital of Oulu, University of Oulu and Medical Research Center Oulu, Oulu, FI-90029, Finland; Department of Epidemiology and Biostatistics (M.-R.J.), Medical Research Council-PHE (Public Health England) Centre for Environment & Health, School of Public Health, Imperial College London, United Kingdom W2 1PG; Center for Life Course Epidemiology (M.-R.J.), Faculty of Medicine, University of Oulu, Oulu, FI-90014, Finland; Biocenter Oulu (M.-R.J.), University of Oulu, Oulu, FI-90014, Finland; Unit of Primary Care (M.-R.J.), University Hospital of Oulu, Oulu, FI-90220, Finland; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Hospital, Helsinki, FI-00014, Finland; Institute of Reproductive and Developmental Biology (S.F.), Imperial College London, United Kingdom W12 ONN
| |
Collapse
|
15
|
Päkkilä F, Männistö T, Hartikainen AL, Ruokonen A, Surcel HM, Bloigu A, Vääräsmäki M, Järvelin MR, Moilanen I, Suvanto E. Maternal and Child's Thyroid Function and Child's Intellect and Scholastic Performance. Thyroid 2015; 25:1363-74. [PMID: 26438036 PMCID: PMC4684651 DOI: 10.1089/thy.2015.0197] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Maternal hypothyroidism and/or hypothyroxinemia have been associated with child's poor neuropsychological development, but the results have been inconsistent. METHODS The Northern Finland Birth Cohort 1986 included all expected births within a year (9362 women, 9479 children) from the two northernmost provinces of Finland. Maternal serum samples (n = 5791) were obtained in early pregnancy (M ± SD = 10.7 ± 2.8 weeks' gestation), and serum samples from their children were obtained at 16 years of age (n = 5829). All samples were analyzed for thyrotropin, free thyroxine (fT4), and thyroid peroxidase antibodies. The children's school performance was evaluated by their main teachers at eight years of age, as well as by the adolescents themselves at 16 years of age. Data on possible severe intellectual deficiency and mild cognitive limitation were collected from healthcare records and registries for all children. Logistic regression estimated the odds of poor school performance or severe intellectual deficiency/mild cognitive limitation associated with exposure to maternal thyroid dysfunction. The odds of poor school performance associated with the adolescents' own thyroid function at age 16 were also estimated. Results are presented as odds ratios (OR) with confidence intervals (CI), adjusted for maternal/family covariates and child's sex. RESULTS Girls of mothers with subclinical hypothyroidism had more self-evaluated difficulties in mathematics than did girls of euthyroid mothers (OR 1.62 [CI 1.06-2.49]). Boys of hypothyroxinemic mothers repeated a school class more often than did boys of euthyroid mothers (OR 5.46 [CI 1.19-25.06]). Adolescents of hyperthyroid mothers had increased odds of poor self-evaluated performance in mathematics (OR 1.61 [CI 1.01-2.49]). Maternal thyroid dysfunction did not increase the odds of a child having severe intellectual deficiency/mild cognitive limitation. At 16 years of age, girls with hyperthyroidism by laboratory measurements had more difficulties in Finnish language (OR 2.82 [CI 1.42-5.61]) than did euthyroid girls. Boys with hypothyroxinemia by laboratory measurement had higher odds of having difficulties in Finnish and/or mathematics (OR 2.13 [CI 1.26-3.62]) than did euthyroid boys. CONCLUSIONS Maternal thyroid dysfunction during early pregnancy was associated with poorer scholastic performance of the adolescent. Additionally, adolescents' own thyroid dysfunction was associated with difficulties in school performance assessed by self-evaluation.
Collapse
Affiliation(s)
- Fanni Päkkilä
- Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland
- Clinic of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland
| | - Tuija Männistö
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu, Finland
- Northern Finland Laboratory Centre Nordlab, Oulu University Hospital, Oulu, Finland
- Department of Clinical Chemistry, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Anna-Liisa Hartikainen
- Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland
- Clinic of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Aimo Ruokonen
- Northern Finland Laboratory Centre Nordlab, Oulu University Hospital, Oulu, Finland
| | - Heljä-Marja Surcel
- Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland
| | - Aini Bloigu
- Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland
| | - Marja Vääräsmäki
- Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland
- Clinic of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Department of Children, Young People, and Families, National Institute for Health and Welfare, Oulu, Finland
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom
| | - Irma Moilanen
- PEDEGO Research Unit, Department of Child Psychiatry, University of Oulu, Oulu, Finland
- Department of Child Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Eila Suvanto
- Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland
- Clinic of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| |
Collapse
|
16
|
Pinola P, Piltonen TT, Puurunen J, Vanky E, Sundström-Poromaa I, Stener-Victorin E, Ruokonen A, Puukka K, Tapanainen JS, Morin-Papunen LC. Androgen Profile Through Life in Women With Polycystic Ovary Syndrome: A Nordic Multicenter Collaboration Study. J Clin Endocrinol Metab 2015; 100:3400-7. [PMID: 26192874 DOI: 10.1210/jc.2015-2123] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
CONTEXT Women with polycystic ovary syndrome (PCOS) have increased androgen secretion throughout fertile life; however, the data on the effect of menopause on hyperandrogenemia in these women are scarce. Nevertheless, large comprehensive comparative studies on age-related androgen levels in women with PCOS are lacking. OBJECTIVE The objective of the study was to investigate the effect of age on serum androgen levels in women with PCOS and to determine cutoff values for androgens and SHBG associated with a PCOS diagnosis. DESIGN This was a case-control study. SETTING The study was conducted in five university sites in the Nordic countries. PATIENTS In all, 681 women with PCOS and 230 referent women were grouped according to age into seven age groups (18 to > 50 y). INTERVENTIONS There were no interventions. MAIN OUTCOME MEASURES T, SHBG, free androgen index (FAI), calculated free T (cFT), androstenedione (A4), and dehydroepiandrosterone sulfate were measured. RESULTS Androgen levels in women with PCOS decreased with age toward menopause. The difference between women with PCOS and the referent women narrowed and individual variation increased as they approached menopause. T levels, FAI, and cFT were significantly higher in women with PCOS aged 18-44 years (P < .001, adjusted for body mass index). The best predictive factors for having PCOS were cFT (≥0.40 ng/dL, odds ratio [OR] 7.90), FAI (≥2.0, OR 6.71), and A4 (≥277.94 ng/dL, OR 6.16). CONCLUSIONS Women with PCOS had elevated serum androgen levels also after menopause. The parameters that best predicted PCOS at all ages were cFT, A4, and FAI.
Collapse
Affiliation(s)
- Pekka Pinola
- Department of Obstetrics and Gynecology (P.P., T.T.P., J.P., J.S.T., L.C.M.-P.), Oulu University Hospital, 90029 Oulu, Finland; University of Oulu and Medical Research Center (J.S.T., L.C.M.-P.) and Department of Clinical Chemistry (A.R., K.P.), University of Oulu, 90220 Oulu, Finland; Institute of Laboratory Medicine (E.V.), Children's and Women's Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Department of Obstetrics and Gynecology (E.V.), St Olav's University Hospital Trondheim, 7006 Trondheim, Norway; Department of Women's and Children's Health (I.S.-P.), Uppsala University, SE-751 05 Uppsala, Sweden; Department of Physiology and Pharmacology (E.S.-V.), Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Central Hospital, 00290 Helsinki, Finland
| | - Terhi T Piltonen
- Department of Obstetrics and Gynecology (P.P., T.T.P., J.P., J.S.T., L.C.M.-P.), Oulu University Hospital, 90029 Oulu, Finland; University of Oulu and Medical Research Center (J.S.T., L.C.M.-P.) and Department of Clinical Chemistry (A.R., K.P.), University of Oulu, 90220 Oulu, Finland; Institute of Laboratory Medicine (E.V.), Children's and Women's Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Department of Obstetrics and Gynecology (E.V.), St Olav's University Hospital Trondheim, 7006 Trondheim, Norway; Department of Women's and Children's Health (I.S.-P.), Uppsala University, SE-751 05 Uppsala, Sweden; Department of Physiology and Pharmacology (E.S.-V.), Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Central Hospital, 00290 Helsinki, Finland
| | - Johanna Puurunen
- Department of Obstetrics and Gynecology (P.P., T.T.P., J.P., J.S.T., L.C.M.-P.), Oulu University Hospital, 90029 Oulu, Finland; University of Oulu and Medical Research Center (J.S.T., L.C.M.-P.) and Department of Clinical Chemistry (A.R., K.P.), University of Oulu, 90220 Oulu, Finland; Institute of Laboratory Medicine (E.V.), Children's and Women's Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Department of Obstetrics and Gynecology (E.V.), St Olav's University Hospital Trondheim, 7006 Trondheim, Norway; Department of Women's and Children's Health (I.S.-P.), Uppsala University, SE-751 05 Uppsala, Sweden; Department of Physiology and Pharmacology (E.S.-V.), Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Central Hospital, 00290 Helsinki, Finland
| | - Eszter Vanky
- Department of Obstetrics and Gynecology (P.P., T.T.P., J.P., J.S.T., L.C.M.-P.), Oulu University Hospital, 90029 Oulu, Finland; University of Oulu and Medical Research Center (J.S.T., L.C.M.-P.) and Department of Clinical Chemistry (A.R., K.P.), University of Oulu, 90220 Oulu, Finland; Institute of Laboratory Medicine (E.V.), Children's and Women's Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Department of Obstetrics and Gynecology (E.V.), St Olav's University Hospital Trondheim, 7006 Trondheim, Norway; Department of Women's and Children's Health (I.S.-P.), Uppsala University, SE-751 05 Uppsala, Sweden; Department of Physiology and Pharmacology (E.S.-V.), Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Central Hospital, 00290 Helsinki, Finland
| | - Inger Sundström-Poromaa
- Department of Obstetrics and Gynecology (P.P., T.T.P., J.P., J.S.T., L.C.M.-P.), Oulu University Hospital, 90029 Oulu, Finland; University of Oulu and Medical Research Center (J.S.T., L.C.M.-P.) and Department of Clinical Chemistry (A.R., K.P.), University of Oulu, 90220 Oulu, Finland; Institute of Laboratory Medicine (E.V.), Children's and Women's Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Department of Obstetrics and Gynecology (E.V.), St Olav's University Hospital Trondheim, 7006 Trondheim, Norway; Department of Women's and Children's Health (I.S.-P.), Uppsala University, SE-751 05 Uppsala, Sweden; Department of Physiology and Pharmacology (E.S.-V.), Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Central Hospital, 00290 Helsinki, Finland
| | - Elisabet Stener-Victorin
- Department of Obstetrics and Gynecology (P.P., T.T.P., J.P., J.S.T., L.C.M.-P.), Oulu University Hospital, 90029 Oulu, Finland; University of Oulu and Medical Research Center (J.S.T., L.C.M.-P.) and Department of Clinical Chemistry (A.R., K.P.), University of Oulu, 90220 Oulu, Finland; Institute of Laboratory Medicine (E.V.), Children's and Women's Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Department of Obstetrics and Gynecology (E.V.), St Olav's University Hospital Trondheim, 7006 Trondheim, Norway; Department of Women's and Children's Health (I.S.-P.), Uppsala University, SE-751 05 Uppsala, Sweden; Department of Physiology and Pharmacology (E.S.-V.), Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Central Hospital, 00290 Helsinki, Finland
| | - Aimo Ruokonen
- Department of Obstetrics and Gynecology (P.P., T.T.P., J.P., J.S.T., L.C.M.-P.), Oulu University Hospital, 90029 Oulu, Finland; University of Oulu and Medical Research Center (J.S.T., L.C.M.-P.) and Department of Clinical Chemistry (A.R., K.P.), University of Oulu, 90220 Oulu, Finland; Institute of Laboratory Medicine (E.V.), Children's and Women's Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Department of Obstetrics and Gynecology (E.V.), St Olav's University Hospital Trondheim, 7006 Trondheim, Norway; Department of Women's and Children's Health (I.S.-P.), Uppsala University, SE-751 05 Uppsala, Sweden; Department of Physiology and Pharmacology (E.S.-V.), Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Central Hospital, 00290 Helsinki, Finland
| | - Katri Puukka
- Department of Obstetrics and Gynecology (P.P., T.T.P., J.P., J.S.T., L.C.M.-P.), Oulu University Hospital, 90029 Oulu, Finland; University of Oulu and Medical Research Center (J.S.T., L.C.M.-P.) and Department of Clinical Chemistry (A.R., K.P.), University of Oulu, 90220 Oulu, Finland; Institute of Laboratory Medicine (E.V.), Children's and Women's Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Department of Obstetrics and Gynecology (E.V.), St Olav's University Hospital Trondheim, 7006 Trondheim, Norway; Department of Women's and Children's Health (I.S.-P.), Uppsala University, SE-751 05 Uppsala, Sweden; Department of Physiology and Pharmacology (E.S.-V.), Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Central Hospital, 00290 Helsinki, Finland
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology (P.P., T.T.P., J.P., J.S.T., L.C.M.-P.), Oulu University Hospital, 90029 Oulu, Finland; University of Oulu and Medical Research Center (J.S.T., L.C.M.-P.) and Department of Clinical Chemistry (A.R., K.P.), University of Oulu, 90220 Oulu, Finland; Institute of Laboratory Medicine (E.V.), Children's and Women's Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Department of Obstetrics and Gynecology (E.V.), St Olav's University Hospital Trondheim, 7006 Trondheim, Norway; Department of Women's and Children's Health (I.S.-P.), Uppsala University, SE-751 05 Uppsala, Sweden; Department of Physiology and Pharmacology (E.S.-V.), Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Central Hospital, 00290 Helsinki, Finland
| | - Laure C Morin-Papunen
- Department of Obstetrics and Gynecology (P.P., T.T.P., J.P., J.S.T., L.C.M.-P.), Oulu University Hospital, 90029 Oulu, Finland; University of Oulu and Medical Research Center (J.S.T., L.C.M.-P.) and Department of Clinical Chemistry (A.R., K.P.), University of Oulu, 90220 Oulu, Finland; Institute of Laboratory Medicine (E.V.), Children's and Women's Health, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Department of Obstetrics and Gynecology (E.V.), St Olav's University Hospital Trondheim, 7006 Trondheim, Norway; Department of Women's and Children's Health (I.S.-P.), Uppsala University, SE-751 05 Uppsala, Sweden; Department of Physiology and Pharmacology (E.S.-V.), Karolinska Institutet, SE-171 77 Stockholm, Sweden; Department of Obstetrics and Gynecology (J.S.T.), University of Helsinki and Helsinki University Central Hospital, 00290 Helsinki, Finland
| |
Collapse
|
17
|
Eskola PJ, Jokelainen J, Järvelin MR, Keinänen-Kiukaanniemi S, Ruokonen A, Puukka K, Timonen M, Auvinen JP. Depression and Insulin Resistance: Additional Support for the Novel Heuristic Model in Perimenopausal Depression. Am J Psychiatry 2015; 172:796-7. [PMID: 26234605 DOI: 10.1176/appi.ajp.2015.15030377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Pasi J Eskola
- From the Center for Life Course Epidemiology and Systems Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland; the Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom; Biocenter Oulu and Department of Clinical Chemistry, University of Oulu, Oulu, Finland; and Unit of Primary Care and NordLab Oulu, Oulu University Hospital, Oulu, Finland
| | - Jari Jokelainen
- From the Center for Life Course Epidemiology and Systems Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland; the Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom; Biocenter Oulu and Department of Clinical Chemistry, University of Oulu, Oulu, Finland; and Unit of Primary Care and NordLab Oulu, Oulu University Hospital, Oulu, Finland
| | - Marjo-Riitta Järvelin
- From the Center for Life Course Epidemiology and Systems Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland; the Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom; Biocenter Oulu and Department of Clinical Chemistry, University of Oulu, Oulu, Finland; and Unit of Primary Care and NordLab Oulu, Oulu University Hospital, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- From the Center for Life Course Epidemiology and Systems Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland; the Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom; Biocenter Oulu and Department of Clinical Chemistry, University of Oulu, Oulu, Finland; and Unit of Primary Care and NordLab Oulu, Oulu University Hospital, Oulu, Finland
| | - Aimo Ruokonen
- From the Center for Life Course Epidemiology and Systems Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland; the Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom; Biocenter Oulu and Department of Clinical Chemistry, University of Oulu, Oulu, Finland; and Unit of Primary Care and NordLab Oulu, Oulu University Hospital, Oulu, Finland
| | - Katri Puukka
- From the Center for Life Course Epidemiology and Systems Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland; the Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom; Biocenter Oulu and Department of Clinical Chemistry, University of Oulu, Oulu, Finland; and Unit of Primary Care and NordLab Oulu, Oulu University Hospital, Oulu, Finland
| | - Markku Timonen
- From the Center for Life Course Epidemiology and Systems Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland; the Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom; Biocenter Oulu and Department of Clinical Chemistry, University of Oulu, Oulu, Finland; and Unit of Primary Care and NordLab Oulu, Oulu University Hospital, Oulu, Finland
| | - Juha P Auvinen
- From the Center for Life Course Epidemiology and Systems Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland; the Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom; Biocenter Oulu and Department of Clinical Chemistry, University of Oulu, Oulu, Finland; and Unit of Primary Care and NordLab Oulu, Oulu University Hospital, Oulu, Finland
| |
Collapse
|
18
|
Hukkanen J, Puurunen J, Hyötyläinen T, Savolainen MJ, Ruokonen A, Morin-Papunen L, Orešič M, Piltonen T, Tapanainen JS. The effect of atorvastatin treatment on serum oxysterol concentrations and cytochrome P450 3A4 activity. Br J Clin Pharmacol 2015; 80:473-9. [PMID: 26095142 DOI: 10.1111/bcp.12701] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 06/07/2015] [Accepted: 06/14/2015] [Indexed: 01/14/2023] Open
Abstract
AIMS Atorvastatin is known to both inhibit and induce the cytochrome P450 3A4 (CYP3A4) enzyme in vitro. Some clinical studies indicate that atorvastatin inhibits CYP3A4 but there are no well-controlled longer term studies that could evaluate the inducing effect of atorvastatin. We aimed to determine if atorvastatin induces or inhibits CYP3A4 activity as measured by the 4β-hydroxycholesterol to cholesterol ratio (4βHC : C). METHODS In this randomized, double-blind, placebo-controlled 6 month study we evaluated the effects of atorvastatin 20 mg day(-1) (n = 15) and placebo (n = 14) on oxysterol concentrations and determined if atorvastatin induces or inhibits CYP3A4 activity as assessed by the 4βHC : C index. The respective 25-hydroxycholesterol and 5α,6α-epoxycholesterol ratios were used as negative controls. RESULTS Treatment with atorvastatin decreased 4βHC and 5α,6α-epoxycholesterol concentrations by 40% and 23%, respectively. The mean 4βHC : C ratio decreased by 13% (0.214 ± 0.04 to 0.182 ± 0.04, P = 0.024, 95% confidence interval (CI) of the difference -0.0595, -0.00483) in the atorvastatin group while no significant change occurred in the placebo group. The difference in change of 4βHC : C between study arms was statistically significant (atorvastatin -0.032, placebo 0.0055, P = 0.020, 95% CI of the difference -0.069, -0.0067). The ratios of 25-hydroxycholesterol and 5α,6α-epoxycholesterol to cholesterol did not change. CONCLUSIONS The results establish atorvastatin as an inhibitor of CYP3A4 activity. Furthermore, 4βHC : C is a useful index of CYP3A4 activity, including the conditions with altered cholesterol concentrations.
Collapse
Affiliation(s)
- Janne Hukkanen
- Research Center for Internal Medicine, University of Oulu, Oulu.,Department of Internal Medicine, Oulu University Hospital, Oulu.,Biocenter Oulu, Oulu.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulo
| | - Johanna Puurunen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulo.,Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Oulu, Oulu.,Department of Obstetrics and Gynaecology, Oulu University Hospital, Oulo, Finland
| | | | - Markku J Savolainen
- Research Center for Internal Medicine, University of Oulu, Oulu.,Department of Internal Medicine, Oulu University Hospital, Oulu.,Biocenter Oulu, Oulu.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulo
| | - Aimo Ruokonen
- Department of Clinical Chemistry, Institute of Diagnostics, University of Oulu, Oulu.,NordLab Oulu, Oulu University Hospital, Oulu
| | - Laure Morin-Papunen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulo.,Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Oulu, Oulu.,Department of Obstetrics and Gynaecology, Oulu University Hospital, Oulo, Finland
| | | | - Terhi Piltonen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulo.,Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Oulu, Oulu.,Department of Obstetrics and Gynaecology, Oulu University Hospital, Oulo, Finland
| | - Juha S Tapanainen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulo.,Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Oulu, Oulu.,Department of Obstetrics and Gynaecology, Oulu University Hospital, Oulo, Finland.,Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
19
|
Wang Q, Kangas AJ, Soininen P, Tiainen M, Tynkkynen T, Puukka K, Ruokonen A, Viikari J, Kähönen M, Lehtimäki T, Salomaa V, Perola M, Davey Smith G, Raitakari OT, Järvelin MR, Würtz P, Kettunen J, Ala-Korpela M. Sex hormone-binding globulin associations with circulating lipids and metabolites and the risk for type 2 diabetes: observational and causal effect estimates. Int J Epidemiol 2015; 44:623-37. [PMID: 26050255 DOI: 10.1093/ije/dyv093] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The causal role of circulating sex hormone-binding globulin (SHBG) for type 2 diabetes is controversial. Information on the relations between SHBG and new biomarkers of cardiometabolic risk is scarce. METHODS We applied quantitative nuclear magnetic resonance metabolomics in three Finnish population-based cohorts to comprehensively profile circulating lipids and metabolites and study their associations with SHBG. Mendelian randomization was used to examine potential causality of SHBG on the metabolic measures and insulin resistance. Prospective associations and causal effect estimates of SHBG on type 2 diabetes were assessed via meta-analysis including summary statistics from the DIAGRAM consortium. RESULTS In cross-sectional analysis in 6475 young adults (mean age 31, 57% men), higher SHBG was linked with a more favourable cardiometabolic risk profile, including associations with lipoprotein subclasses, fatty acid composition, amino acids, ketone bodies and inflammation-linked glycoproteins. Prospective analysis of 1377 young adults with 6-year follow-up indicated that SHBG is also associated with future insulin resistance. Mendelian randomization suggested only minor, if any, causal effects of SHBG on lipid and metabolite measures and insulin resistance(n = 10,895).Causal effect estimates on type 2 diabetes for 41,439 cases and 103,870 controls indicated a causative protective role of SHBG (OR = 0.83 per 1-SD, 95% CI: 0.76, 0.91); however, effects were considerably weaker than observed in meta-analysis of prospective studies [hazard ratio (HR) = 0.47 per 1-SD, 95% CI: 0.41, 0.53]. CONCLUSION Circulating SHBG is strongly associated with systemic metabolism and predictive for insulin resistance and diabetes. The weaker causal estimates suggest that the observational associations are partly confounded rather than conferred directly via circulating SHBG.
Collapse
Affiliation(s)
- Qin Wang
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland. Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, F
| | - Antti J Kangas
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland
| | - Pasi Soininen
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland. Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, F
| | - Mika Tiainen
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland. Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, F
| | - Tuulia Tynkkynen
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland. Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, F
| | - Katri Puukka
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland
| | - Aimo Ruokonen
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland
| | - Jorma Viikari
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland
| | - Mika Kähönen
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland
| | - Terho Lehtimäki
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland
| | - Veikko Salomaa
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland
| | - Markus Perola
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland. Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, F
| | - George Davey Smith
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland
| | - Olli T Raitakari
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland. Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, F
| | - Marjo-Riitta Järvelin
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland. Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, F
| | - Peter Würtz
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland
| | - Johannes Kettunen
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland. Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, F
| | - Mika Ala-Korpela
- Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland, NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland, Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland, Department of Clinical Physiology, University of Tampere and Tampere University Hospital, Tampere, Finland, Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere, School of Medicine, Tampere, Finland, National Institute for Health and Welfare, Helsinki, Finland, Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland, Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland, Estonian Genome Center, University of Tartu, Tartu, Estonia, Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland, Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK, Institute of Health Sciences & Biocenter Oulu, University of Oulu, Oulu, Finland, Unit of Primary Care, Oulu University Hospital, Oulu, Finland, Department of Children and Young People and Families, National Institute for Health and Welfare, Oulu, Finland, Computational Medicine, School of Social and Community Medicine, University of Bristol, Bristol, UK and Computational Medicine, Oulu University Hospital, Oulu, Finland. Computational Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland, NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, F
| |
Collapse
|
20
|
Sipola-Leppänen M, Vääräsmäki M, Tikanmäki M, Matinolli HM, Miettola S, Hovi P, Wehkalampi K, Ruokonen A, Sundvall J, Pouta A, Eriksson JG, Järvelin MR, Kajantie E. Cardiometabolic risk factors in young adults who were born preterm. Am J Epidemiol 2015; 181:861-73. [PMID: 25947956 PMCID: PMC4445394 DOI: 10.1093/aje/kwu443] [Citation(s) in RCA: 154] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/09/2014] [Indexed: 11/16/2022] Open
Abstract
Adults who were born preterm with a very low birth weight have higher blood pressure and impaired glucose regulation later in life compared with those born at term. We investigated cardiometabolic risk factors in young adults who were born at any degree of prematurity in the Preterm Birth and Early Life Programming of Adult Health and Disease (ESTER) Study, a population-based cohort study of individuals born in 1985–1989 in Northern Finland. In 2009–2011, 3 groups underwent clinical examination: 134 participants born at less than 34 gestational weeks (early preterm), 242 born at 34–36 weeks (late preterm), and 344 born at 37 weeks or later (controls). Compared with controls, adults who were born preterm had higher body fat percentages (after adjustment for sex, age, and cohort (1985–1986 or 1987–1989), for those born early preterm, difference = 6.2%, 95% confidence interval (CI): 0.4, 13.2; for those born late preterm, difference = 8.0%, 95% CI: 2.4, 13.8), waist circumferences, blood pressure (for those born early preterm, difference = 3.0 mm Hg, 95% CI: 0.9, 5.1; for those born late preterm, difference = 1.7, 95% CI: −0.1, 3.4), plasma uric acid levels (for those born early preterm, difference = 20.1%, 95% CI: 7.9, 32.3; for those born late preterm, difference = 20.2%, 95% CI: 10.7, 30.5), alanine aminotransferase levels, and aspartate transaminase levels. They were also more likely to have metabolic syndrome (for those born early preterm, odds ratio = 3.7, 95% CI: 1.6, 8.2; for those born late preterm, odds ratio = 2.5, 95% CI: 1.2, 5.3). Elevated levels of conventional and emerging risk factors suggest a higher risk of cardiometabolic disease later in life. These risk factors are also present in the large group of adults born late preterm.
Collapse
Affiliation(s)
- Marika Sipola-Leppänen
- Correspondence to Dr. Marika Sipola-Leppänen, National Institute for Health and Welfare, P.O. Box 310, 90101 Oulu, Finland (e-mail: )
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Sipola-Leppänen M, Vääräsmäki M, Tikanmäki M, Hovi P, Miettola S, Ruokonen A, Pouta A, Järvelin MR, Kajantie E. Cardiovascular risk factors in adolescents born preterm. Pediatrics 2014; 134:e1072-81. [PMID: 25180275 DOI: 10.1542/peds.2013-4186] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Adolescents and adults born as small preterm infants show more pronounced risk factors of cardiovascular disease. Whether similar risks apply across all degrees of preterm birth is poorly known. METHODS We studied the association between preterm birth and cardiovascular risk factors in 6642 16-year-old adolescents of the population-based Northern Finland Birth Cohort 1986. Of these, 79 (1.2%) were born at <34 gestational weeks (early preterm), 238 (3.6%) at 34 to 36 weeks (late preterm), and 6325 at term (controls). RESULTS Girls born early preterm had 6.7 mm Hg (95% confidence interval: 3.1-10.2) higher systolic blood pressure (BP) and 3.5 mm Hg (1.1-5.8) higher diastolic BP, but no difference in serum lipid levels compared with control girls. Boys showed no differences in BP, but boys born early preterm had 6.7% (0.2%-13.7%) higher total cholesterol, 11.7% (2.1%-22.3%) higher low-density lipoprotein cholesterol, and 12.3% (3.1%-22.4%) higher apolipoprotein B concentrations. The differences were similar (BP) or stronger (lipids) when adjusted for maternal smoking, birth weight SD score, parental education, pubertal stage, BMI, and lifestyle. There were similar associations with length of gestation as a continuous variable. Accordingly, mean differences between late preterm and controls were in the same direction but weaker, although most were not statistically significant. CONCLUSIONS Preterm birth was associated with elevated BP in adolescent girls and an atherogenic lipid profile in boys. Because these associations were strongest among those born early preterm, our findings are consistent with a dose-response relationship between shorter length of gestation and cardiovascular risk factors.
Collapse
Affiliation(s)
- Marika Sipola-Leppänen
- Departments of Chronic Disease Prevention, Diabetes Prevention Unit and Institute of Health Sciences, and Department of Pediatrics and Adolescence,
| | - Marja Vääräsmäki
- Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland
| | - Marjaana Tikanmäki
- Departments of Chronic Disease Prevention, Diabetes Prevention Unit and Institute of Health Sciences, and
| | - Petteri Hovi
- Departments of Chronic Disease Prevention, Diabetes Prevention Unit and Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland; and
| | - Satu Miettola
- Departments of Chronic Disease Prevention, Diabetes Prevention Unit and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Aimo Ruokonen
- NordLab Oulu, Oulu University Hospital, Oulu, Finland; Department of Clinical Chemistry
| | - Anneli Pouta
- Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Institute of Health Sciences, and Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland; Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom Biocenter Oulu, University of Oulu, Oulu, Finland; Unit of Primary Care, and
| | - Eero Kajantie
- Departments of Chronic Disease Prevention, Diabetes Prevention Unit and Department of Obstetrics and Gynecology, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland; and
| |
Collapse
|
22
|
Jarvela IY, Pelkonen S, Uimari O, Makikallio K, Puukka K, Ruokonen A, Tekay A, Martikainen H. Controlled ovarian hyperstimulation leads to high progesterone and estradiol levels during early pregnancy. Hum Reprod 2014; 29:2393-401. [DOI: 10.1093/humrep/deu223] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
|
23
|
West S, Lashen H, Bloigu A, Franks S, Puukka K, Ruokonen A, Järvelin MR, Tapanainen JS, Morin-Papunen L. Irregular menstruation and hyperandrogenaemia in adolescence are associated with polycystic ovary syndrome and infertility in later life: Northern Finland Birth Cohort 1986 study. Hum Reprod 2014; 29:2339-51. [PMID: 25085801 DOI: 10.1093/humrep/deu200] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Do teenage girls with a history of menstrual irregularity and/or elevated androgen levels in adolescence exhibit an increased risk of polycystic ovary syndrome (PCOS) and/or infertility later on in adulthood? SUMMARY ANSWER Our results suggest that menstrual irregularity and/or elevated androgen levels at 16 years are still associated with symptoms of PCOS at 26 years as well as infertility problems at 26 years but not with decreased pregnancy or delivery rates at 26 years. WHAT IS KNOWN ALREADY Hyperandrogenaemia is associated with menstrual irregularity, hirsutism, acne and potentially higher risk for PCOS, but there are few follow-up studies investigating whether adolescent hyperandrogenaemia and/or menstrual irregularity are an early sign of PCOS. STUDY DESIGN, SIZE, DURATION A prospective population-based cohort study was conducted using two postal questionnaires targeting girls in the Northern Finland Birth Cohort 1986 (NFBC1986, n = 4567). The NFBC1986 comprises all expected births from the year 1986 in the two northernmost provinces of Finland. Collection of the database was performed at the age of 16 and 26. The 16-year and 26-year questionnaires included one question about the regularity and length of the menstrual cycle. The 26-year questionnaire also included questions about symptoms of PCOS, reproduction and infertility problems. PARTICIPANTS, SETTING, METHODS The response rates for the questionnaires were 80% (n = 3669) at 16 years and 50% (n = 2270) at 26 years. At 15-16 years, of 2448 girls, 709 (29%) girls reported menstrual irregularity (symptomatic girls) and 1739 (71%) had regular periods (non-symptomatic girls). After combining data from the two questionnaires a total of 2033 girls were included in the analyses. The χ(2) and Student's t-test was used to compare reproductive outcome and prevalence of clinical hyperandrogenaemia, PCOS and infertility at 26 years between the study groups. Univariate and multivariate logistic regression models were employed to estimate the association of menstrual irregularity at 16 years with clinical hyperandrogenaemia, PCOS and infertility at 26 years. MAIN RESULTS AND THE ROLE OF CHANCE At follow-up, the proportion of symptomatic girls who had conceived at least once (68.0 versus 67.9%) and had delivered at least one child (25.7 versus 28.1%) was similar to the non-symptomatic women and the groups had similar miscarriage rates (11.6 versus 12.1%). Logistic regression analyses indicated that menstrual irregularity at 16 years was associated with an increased risk of menstrual irregularity [adjusted odds ratio (OR) 1.37, 95% confidence interval (CI) 1.00-1.88, P = 0.050], PCOS (adjusted OR 2.91, 95% CI 1.74-4.84, P < 0.001) and infertility problems (adjusted OR 2.07, 95% CI 1.16-3.76, P = 0.013) at 26 years. At 26 years, women with PCOS (P = 0.013), hirsutism (P = 0.001) and acne (P < 0.001) exhibited significantly higher values of free androgen index (FAI) at 16 years than control women. There was a significant linear trend in the higher FAI quartiles at 16 years towards higher prevalence of PCOS (P = 0.005), hirsutism (P < 0.001) and acne (P < 0.001) at 26 years. Only 10.5% of the girls with menstrual irregularity at 16 years had PCOS at 26 years. LIMITATIONS, REASONS FOR CAUTION The diagnosis of menstrual irregularity was based on a self-reported questionnaire, thus introducing a risk of information bias in reporting the symptoms. Moreover, ovarian ultrasonography was not available to aid the diagnosis of PCOS and there was no clinical evaluation of hyperandrogenism. The relatively low rate of participation to the questionnaire at 26 years may also have biased the results. WIDER IMPLICATIONS OF THE FINDINGS Our findings confirm that menstrual irregularity and/or elevated androgen levels are already present in adolescence in women with PCOS and infertility in later life, which strengthens the importance of early identification of menstrual irregularity. STUDY FUNDING/COMPETING INTERESTS This work was supported by grants from the Finnish Medical Society Duodecim, the North Ostrobothnia Regional Fund, the Academy of Finland, the Sigrid Juselius Foundation, University Hospital Oulu and University of Oulu, the European Commission and the Medical Research Council, UK, Welcome Trust (089549/Z/09/Z). None of the authors have any conflict of interest.
Collapse
Affiliation(s)
- S West
- Department of Obstetrics and Gynaecology, University Hospital of Oulu, University of Oulu, Oulu, Finland
| | - H Lashen
- Department of Human Metabolism, University of Sheffield, Jessop Wing, Sheffield S10 2SF, UK
| | - A Bloigu
- Department of Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland
| | - S Franks
- Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - K Puukka
- NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland
| | - A Ruokonen
- NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland
| | - M-R Järvelin
- Department of Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, London, UK Institute of Health Sciences, University of Oulu, Oulu, Finland Biocenter Oulu, University of Oulu, Oulu, Finland Unit of Primary Care, University Hospital of Oulu, University of Oulu, Oulu, Finland
| | - J S Tapanainen
- Department of Obstetrics and Gynaecology, University Hospital of Oulu, University of Oulu, Oulu, Finland Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - L Morin-Papunen
- Department of Obstetrics and Gynaecology, University Hospital of Oulu, University of Oulu, Oulu, Finland
| |
Collapse
|
24
|
Pinola P, Morin-Papunen LC, Bloigu A, Puukka K, Ruokonen A, Järvelin MR, Franks S, Tapanainen JS, Lashen H. Anti-Müllerian hormone: correlation with testosterone and oligo- or amenorrhoea in female adolescence in a population-based cohort study. Hum Reprod 2014; 29:2317-25. [PMID: 25056088 PMCID: PMC4164146 DOI: 10.1093/humrep/deu182] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
STUDY QUESTIONS Can serum anti-Müllerian hormone (AMH) levels measured in female adolescents predict polycystic ovary syndrome (PCOS)-associated features in adolescence and early adulthood? SUMMARY ANSWER AMH levels associated well with PCOS-associated features (such as testosterone levels and oligoamenorrhoea) in adolescence, but was not an ideal marker to predict PCOS-associated features in early adulthood. WHAT IS KNOWN ALREADY Several studies have reported that there is a strong correlation between antral follicle count and serum AMH levels and that women with PCOS/PCO have significantly higher serum AMH levels than women with normal ovaries. Other studies have reported an association between AMH serum levels and hyperandrogenism in adolescence, but none has prospectively assessed AMH as a risk predictor for developing features of PCOS during adulthood. STUDY DESIGN, SIZE, DURATION A subset of 400 girls was selected from the prospective population-based Northern Finland Birth Cohort 1986 (n = 4567 at age 16 and n = 4503 at age 26). The population has been followed from 1986 to the present. PARTICIPANTS/MATERIAL, SETTING, METHODS At age 16, 400 girls (100 from each testosterone quartile: 50 with oligo- or amenorrhoea and 50 with a normal menstrual cycle) were selected at random from the cohort for AMH measurement. Metabolic parameters were also assessed at age 16 in all participants. Postal questionnaires enquired about oligo- or amenorrhoea, hirsutism, contraceptive use and reproductive health at ages 16 and 26. MAIN RESULTS AND ROLE OF CHANCE There was a significant correlation between AMH and testosterone at age 16 (r = 0.36, P < 0.001). AMH levels at age 16 were significantly higher among girls with oligo- or amenorrhoea compared with girls with normal menstrual cycles (35.9 pmol/l [95% CI: 33.2;38.6] versus 27.7 pmol/l [95% CI: 25.0;30.4], P < 0.001). AMH at age 16 was higher in girls who developed hirsutism at age 26 compared with the non-hirsute group (31.4 pmol/l [95% CI 27.1;36.5] versus 25.8 pmol/l [95% CI 23.3;28.6], P = 0.036). AMH at age 16 was also higher in women with PCOS at age 26 compared with the non-PCOS subjects (38.1 pmol/l [95% CI 29.1;48.4] versus 30.2 pmol/l [95% CI 27.9;32.4], P = 0.044). The sensitivity and specificity of the AMH (cut-off 22.5 pmol/l) for predicting PCOS at age 26 was 85.7 and 37.5%, respectively. The addition of testosterone did not significantly improve the accuracy of the test. There was no significant correlation between AMH levels and metabolic indices at age 16. IMPLICATIONS, REASONS FOR CAUTION AMH is related to oligo- or amenorrhoea in adolescence, but it is not a good marker for metabolic factors. The relatively low rate of participation in the questionnaire at age 26 may also have affected the results. AMH was measured in a subset of the whole cohort. AMH measurement is lacking international standardization and therefore the concentrations and cut-off points are method dependent. WIDER IMPLICATIONS FOR THE FINDINGS Using a high enough cut-off value of AMH to predict which adolescents are likely to develop PCOS in adulthood could help to manage the condition from an early age due to a good sensitivity. However, because of its low specificity, it is not an ideal diagnostic marker, and its routine use in clinical practice cannot, at present, be recommended. STUDY FUNDINGS AND COMPETING INTERESTS The study was funded by a grant from Wellcome Trust (089549/Z/09/Z) to H.L., S.F. and M.-R.J. Study funding was also received from Oulu University Hospital Research Funds, Sigrid Juselius Foundation and the Academy of Finland. None of the authors have any competing interest to declare.
Collapse
Affiliation(s)
- P Pinola
- Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu and Medical Research Center Oulu, Oulu, Finland
| | - L C Morin-Papunen
- Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu and Medical Research Center Oulu, Oulu, Finland
| | - A Bloigu
- Department of Children and Young People and Families, National Institute for Health and Welfare, Aapistie 1, Box 310, FI-90101 Oulu, Finland
| | - K Puukka
- NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland
| | - A Ruokonen
- NordLab Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland
| | - M-R Järvelin
- Department of Children and Young People and Families, National Institute for Health and Welfare, Aapistie 1, Box 310, FI-90101 Oulu, Finland Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, London, UK Institute of Health Sciences, University of Oulu, PO Box 5000, FI-90014 Oulu, Finland Biocenter Oulu, University of Oulu, Aapistie 5A, PO Box 5000, FI-90014 Oulu, Finland Unit of Primary Care, Oulu University Hospital, Kajaanintie 50, PO Box 20, FI-90220 Oulu, 90029 OYS, Finland
| | - S Franks
- Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
| | - J S Tapanainen
- Department of Obstetrics and Gynaecology, Oulu University Hospital, University of Oulu and Medical Research Center Oulu, Oulu, Finland Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - H Lashen
- Department of Human Metabolism, University of Sheffield, Jessop Wing, Sheffield, UK
| |
Collapse
|
25
|
Canoy D, Barber TM, Pouta A, Hartikainen AL, McCarthy MI, Franks S, Järvelin MR, Tapanainen JS, Ruokonen A, Huhtaniemi IT, Martikainen H. Serum sex hormone-binding globulin and testosterone in relation to cardiovascular disease risk factors in young men: a population-based study. Eur J Endocrinol 2014; 170:863-72. [PMID: 24670886 DOI: 10.1530/eje-13-1046] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Reduced sex hormone-binding globulin (SHBG) concentration predicts insulin resistance and type 2 diabetes, but its association with cardiovascular disease (CVD) risk is unclear. We examined the association between SHBG and cardiovascular risk factors, independently of total testosterone (TT), in young men. DESIGN Observational, cross-sectional study. SETTING General community. PARTICIPANTS The study included 2716 men aged 31 years in the Northern Finland Birth Cohort in 1996 with clinical examination data and fasting blood samples. OUTCOME VARIABLES Blood pressure (BP), lipids and C-reactive protein (CRP) as biological CVD risk markers. RESULTS SHBG concentration was significantly and inversely related to systolic and diastolic BP, triglycerides and CRP, but positively to HDL cholesterol after adjusting for insulin, BMI, waist circumference, smoking, education and physical activity (all P<0.05). These linearly graded associations persisted with additional adjustment for TT. SHBG was significantly associated with total cholesterol only with adjustment for covariates and TT (P<0.05). The direction and magnitude of associations between TT and risk factors were variable, but further adjustment for insulin, adiposity and SHBG showed positive associations between TT and BP, total and LDL-cholesterol and triglycerides and an inverse association with CRP (all P<0.05), but its relation with HDL-cholesterol was no longer significant. CONCLUSIONS In this cohort of young adult men, higher SHBG concentration was associated with a more favourable CVD risk profile, independently of TT. SHBG concentration modified the associations of TT with CVD risk factors.
Collapse
Affiliation(s)
- D Canoy
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - T M Barber
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - A Pouta
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - A L Hartikainen
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - M I McCarthy
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, FinlandCancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of
| | - S Franks
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - M R Järvelin
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, FinlandCancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of
| | - J S Tapanainen
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, FinlandCancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of
| | - A Ruokonen
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, FinlandCancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of
| | - I T Huhtaniemi
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| | - H Martikainen
- Cancer Epidemiology UnitNuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford OX3 7LF, UKDepartment of Metabolic and Vascular HealthWarwick Medical School, University of Warwick, Coventry, UKDepartment of Children and Young People and FamiliesNational Institute for Health and Welfare, Oulu, FinlandDepartment of Obstetrics and GynaecologyOulu University Hospital and University of Oulu, Oulu, FinlandOxford Centre for DiabetesEndocrinology and Metabolism, University of Oxford, Oxford, UKWellcome Trust Centre for Human GeneticsUniversity of Oxford, Oxford, UKDepartment of Surgery and CancerImperial College London, Institute of Reproductive and Developmental Biology, London, UKDepartment of Epidemiology and BiostatisticsImperial College London, MRC-Health Protection Agency Centre for Environment and Health, and School of Public Health, London, UKInstitute of Health SciencesUniversity of Oulu, Oulu, FinlandBiocenter OuluUniversity of Oulu, Oulu, FinlandUnit of Primary CareOulu University Hospital, Oulu, FinlandDepartment of Obstetrics and GynecologyHelsinki University Central Hospital and University of Helsinki, Helsinki, FinlandDepartment of Clinical ChemistryUniversity of Oulu, Oulu, FinlandNorLab OuluOulu University Hospital, Oulu, Finland
| |
Collapse
|
26
|
Päkkilä F, Männistö T, Pouta A, Hartikainen AL, Ruokonen A, Surcel HM, Bloigu A, Vääräsmäki M, Järvelin MR, Moilanen I, Suvanto E. The impact of gestational thyroid hormone concentrations on ADHD symptoms of the child. J Clin Endocrinol Metab 2014; 99:E1-8. [PMID: 24384024 PMCID: PMC3879664 DOI: 10.1210/jc.2013-2943] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
CONTEXT Maternal hypothyroidism during pregnancy is associated with adverse neuropsychological development in the offspring. OBJECTIVE The objective of the study was to evaluate the effect of maternal thyroid dysfunction during pregnancy on a child's attention-deficit/hyperactivity disorder (ADHD) symptoms. DESIGN, SETTINGS, AND PARTICIPANTS The prospective, population-based Northern Finland Birth Cohort 1986 (9362 pregnancies; 9479 infants) included analysis of maternal TSH, free T4, and thyroid-peroxidase antibodies (TPO-Abs) from early pregnancy samples (5791 women). Teachers evaluated the children's ADHD symptoms at 8 years using the Rutter B2 scale (5131 mother-child pairs), in which a high score indicated probable psychiatric disorders and three questions focused directly on ADHD. MAIN OUTCOME MEASURES The odds ratios (ORs) and 95% confidence intervals (95% CIs) of child having ADHD symptoms and/or a high Rutter B2 score after exposure to increases in maternal TSH levels (after logarithmic transformation), low free T4 levels, and TPO-Ab positivity was tested with logistic regression, adjusting for maternal/family covariates. Data were stratified by the child's gender due to interaction. RESULTS Among girls the odds of inattention (OR 1.18, 95% CI 1.02-1.37), high Rutter B2 total score (OR 1.23, 95% CI 1.03-1.48), and combined ADHD symptoms (OR 1.39, 95% CI 1.07-1.80) significantly increased with every natural log increase in maternal TSH concentrations. Such findings were not evident in boys. No associations were seen between ADHD symptoms and low maternal free T4 levels or TPO-Ab positivity. CONCLUSIONS Increases in maternal TSH in early pregnancy showed weak but significant association with girls' ADHD symptoms.
Collapse
Affiliation(s)
- Fanni Päkkilä
- Departments of Obstetrics and Gynecology (F.P., A.-L.H., M.V., E.S.) and Clinical Chemistry (A.R.), and Clinic of Child Psychiatry (I.M.), University of Oulu and Oulu University Hospital, 90029 OYS, Oulu, Finland; Institute of Health Sciences (F.P., M.-R.J.), University of Oulu, 90220 Oulu, Finland; Department of Children, Young People, and Families (F.P., A.P., H.-M.S., A.B., M.-R.J.), National Institute for Health and Welfare, 00271 Helsinki, Finland; Epidemiology Branch (T.M.), Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892; and Department of Epidemiology and Biostatistics (M.-R.J.), Imperial College London, London SW7 2AZ, United Kingdom
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Puurunen J, Piltonen T, Puukka K, Ruokonen A, Savolainen MJ, Bloigu R, Morin-Papunen L, Tapanainen JS. Statin therapy worsens insulin sensitivity in women with polycystic ovary syndrome (PCOS): a prospective, randomized, double-blind, placebo-controlled study. J Clin Endocrinol Metab 2013; 98:4798-807. [PMID: 24152688 DOI: 10.1210/jc.2013-2674] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Statins have been shown to improve hyperandrogenism in women with polycystic ovary syndrome (PCOS). However, their use has also been associated with impairment of glucose metabolism and an increased risk of type 2 diabetes mellitus. Because women with PCOS are prone to disturbances in glucose metabolism, statin therapy could also have negative effects. OBJECTIVE Our objective was to explore the effects of atorvastatin therapy on hormonal and metabolic parameters in women with PCOS. DESIGN AND SETTING We conducted a randomized, double-blind, placebo-controlled 6-month follow-up study conducted at Oulu University Hospital, Finland. PATIENTS Women with PCOS (Rotterdam criteria) were treated with atorvastatin (20 mg/d, n = 15) or placebo (n = 13) for 6 months. INTERVENTIONS Fasting serum samples were collected at baseline and at 3 and 6 months. Oral and iv glucose tolerance tests were performed at 0 and 6 months. MAIN OUTCOME MEASURES Androgen secretion and glucose metabolism were measured. RESULTS Fasting levels and area under the curve of insulin increased significantly and insulin sensitivity (insulinogenic and Matsuda indexes) decreased during 6 months of atorvastatin therapy. Serum levels of dehydroepiandrosterone sulfate decreased in the atorvastatin group, whereas no change was observed in serum testosterone levels. Levels of C-reactive protein, total and low-density lipoprotein-cholesterol, and triglycerides decreased significantly during statin therapy. CONCLUSIONS Atorvastatin therapy improves chronic inflammation and lipid profile, but it impairs insulin sensitivity in women with PCOS. Because women with PCOS have an increased risk of developing type 2 diabetes mellitus, the results suggest that statin therapy should be initiated on the basis of generally accepted criteria and individual risk assessment of cardiovascular disease, and not only because of PCOS.
Collapse
Affiliation(s)
- Johanna Puurunen
- Department of Obstetrics and Gynecology, Helsinki University Central Hospital and Helsinki University, P.O. Box 140, 00029 HUS, Finland.
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Ijäs H, Morin-Papunen L, Keränen AK, Bloigu R, Ruokonen A, Puukka K, Ebeling T, Raudaskoski T, Vääräsmäki M. Pre-pregnancy overweight overtakes gestational diabetes as a risk factor for subsequent metabolic syndrome. Eur J Endocrinol 2013; 169:605-11. [PMID: 23959786 DOI: 10.1530/eje-13-0412] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Gestational diabetes mellitus (GDM) is associated with an increased risk of subsequent diabetes and metabolic syndrome (MS). The independent significance of overweight, often associated with GDM, is controversial. This study was aimed to investigate the prevalence of MS and carotid intima-media thickness (CIMT) values in normal and overweight women with previous insulin-treated GDM and control without GDM 19 years after the index pregnancy. METHODS The study group consisted of 61 women with prior GDM and 55 controls who gave birth in Oulu University Hospital between 1988 and 1993. These women were further divided into subgroups according to pre-pregnancy BMI (<25 or ≥25 kg/m(2)). In 2008-2010, anthropometrics and blood pressure were measured, blood samples were taken, and an oral glucose tolerance test was performed to investigate the components of MS. CIMT was measured by Doppler ultrasound. RESULTS Total prevalence of MS was 62% in the GDM group and 31% in the control group (P=0.001); it was highest (86%) in GDM women with pre-pregnancy overweight. CIMT was significantly thicker (0.67 vs 0.56 mm, P=0.007) and more often abnormal (71.7 vs 45.3%, P=0.004) in the GDM group compared with the controls. In logistic regression analysis, the strongest factor predicting MS in the whole study population was pre-pregnancy overweight. CONCLUSIONS Pre-pregnancy overweight was the strongest predictive factor for later MS, whereas GDM indicated increased risk of subsequent diabetes and subclinical atherosclerosis. The risk of MS was highest when both of these factors were present.
Collapse
Affiliation(s)
- H Ijäs
- Departments of Obstetrics and Gynecology Radiology, Oulu University Hospital, PO Box 23, FIN-90029 OYS Oulu, Finland
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Willer CJ, Schmidt EM, Sengupta S, Peloso GM, Gustafsson S, Kanoni S, Ganna A, Chen J, Buchkovich ML, Mora S, Beckmann JS, Bragg-Gresham JL, Chang HY, Demirkan A, Den Hertog HM, Do R, Donnelly LA, Ehret GB, Esko T, Feitosa MF, Ferreira T, Fischer K, Fontanillas P, Fraser RM, Freitag DF, Gurdasani D, Heikkilä K, Hyppönen E, Isaacs A, Jackson AU, Johansson Å, Johnson T, Kaakinen M, Kettunen J, Kleber ME, Li X, Luan J, Lyytikäinen LP, Magnusson PK, Mangino M, Mihailov E, Montasser ME, Müller-Nurasyid M, Nolte IM, O’Connell JR, Palmer CD, Perola M, Petersen AK, Sanna S, Saxena R, Service SK, Shah S, Shungin D, Sidore C, Song C, Strawbridge RJ, Surakka I, Tanaka T, Teslovich TM, Thorleifsson G, Van den Herik EG, Voight BF, Volcik KA, Waite LL, Wong A, Wu Y, Zhang W, Absher D, Asiki G, Barroso I, Been LF, Bolton JL, Bonnycastle LL, Brambilla P, Burnett MS, Cesana G, Dimitriou M, Doney AS, Döring A, Elliott P, Epstein SE, Ingi Eyjolfsson G, Gigante B, Goodarzi MO, Grallert H, Gravito ML, Groves CJ, Hallmans G, Hartikainen AL, Hayward C, Hernandez D, Hicks AA, Holm H, Hung YJ, Illig T, Jones MR, Kaleebu P, Kastelein JJ, Khaw KT, Kim E, Klopp N, Komulainen P, Kumari M, Langenberg C, Lehtimäki T, Lin SY, Lindström J, Loos RJ, Mach F, McArdle WL, Meisinger C, Mitchell BD, Müller G, Nagaraja R, Narisu N, Nieminen TV, Nsubuga RN, Olafsson I, Ong KK, Palotie A, Papamarkou T, Pomilla C, Pouta A, Rader DJ, Reilly MP, Ridker PM, Rivadeneira F, Rudan I, Ruokonen A, Samani N, Scharnagl H, Seeley J, Silander K, Stančáková A, Stirrups K, Swift AJ, Tiret L, Uitterlinden AG, van Pelt LJ, Vedantam S, Wainwright N, Wijmenga C, Wild SH, Willemsen G, Wilsgaard T, Wilson JF, Young EH, Zhao JH, Adair LS, Arveiler D, Assimes TL, Bandinelli S, Bennett F, Bochud M, Boehm BO, Boomsma DI, Borecki IB, Bornstein SR, Bovet P, Burnier M, Campbell H, Chakravarti A, Chambers JC, Chen YDI, Collins FS, Cooper RS, Danesh J, Dedoussis G, de Faire U, Feranil AB, Ferrières J, Ferrucci L, Freimer NB, Gieger C, Groop LC, Gudnason V, Gyllensten U, Hamsten A, Harris TB, Hingorani A, Hirschhorn JN, Hofman A, Hovingh GK, Hsiung CA, Humphries SE, Hunt SC, Hveem K, Iribarren C, Järvelin MR, Jula A, Kähönen M, Kaprio J, Kesäniemi A, Kivimaki M, Kooner JS, Koudstaal PJ, Krauss RM, Kuh D, Kuusisto J, Kyvik KO, Laakso M, Lakka TA, Lind L, Lindgren CM, Martin NG, März W, McCarthy MI, McKenzie CA, Meneton P, Metspalu A, Moilanen L, Morris AD, Munroe PB, Njølstad I, Pedersen NL, Power C, Pramstaller PP, Price JF, Psaty BM, Quertermous T, Rauramaa R, Saleheen D, Salomaa V, Sanghera DK, Saramies J, Schwarz PE, Sheu WHH, Shuldiner AR, Siegbahn A, Spector TD, Stefansson K, Strachan DP, Tayo BO, Tremoli E, Tuomilehto J, Uusitupa M, van Duijn CM, Vollenweider P, Wallentin L, Wareham NJ, Whitfield JB, Wolffenbuttel BH, Ordovas JM, Boerwinkle E, Palmer CN, Thorsteinsdottir U, Chasman DI, Rotter JI, Franks PW, Ripatti S, Cupples LA, Sandhu MS, Rich SS, Boehnke M, Deloukas P, Kathiresan S, Mohlke KL, Ingelsson E, Abecasis GR. Discovery and refinement of loci associated with lipid levels. Nat Genet 2013; 45:1274-1283. [PMID: 24097068 PMCID: PMC3838666 DOI: 10.1038/ng.2797] [Citation(s) in RCA: 2104] [Impact Index Per Article: 191.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 09/13/2013] [Indexed: 11/16/2022]
Abstract
Levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and total cholesterol are heritable, modifiable risk factors for coronary artery disease. To identify new loci and refine known loci influencing these lipids, we examined 188,577 individuals using genome-wide and custom genotyping arrays. We identify and annotate 157 loci associated with lipid levels at P < 5 × 10(-8), including 62 loci not previously associated with lipid levels in humans. Using dense genotyping in individuals of European, East Asian, South Asian and African ancestry, we narrow association signals in 12 loci. We find that loci associated with blood lipid levels are often associated with cardiovascular and metabolic traits, including coronary artery disease, type 2 diabetes, blood pressure, waist-hip ratio and body mass index. Our results demonstrate the value of using genetic data from individuals of diverse ancestry and provide insights into the biological mechanisms regulating blood lipids to guide future genetic, biological and therapeutic research.
Collapse
Affiliation(s)
- Cristen J. Willer
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan 48109, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, Michigan 48109, USA
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Ellen M. Schmidt
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Sebanti Sengupta
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Gina M. Peloso
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts 02118, USA
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Broad Institute, Program in Medical and Population Genetics, Cambridge, Massachusetts 02142, USA
| | - Stefan Gustafsson
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Stavroula Kanoni
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, CB10 1SA, Hinxton, United Kingdom
| | - Andrea Ganna
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jin Chen
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | | | - Samia Mora
- Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave., Boston MA 02215, USA
- Harvard Medical School, Boston MA 02115, USA
| | - Jacques S. Beckmann
- Service of Medical Genetics, Lausanne University Hospital, Lausanne, Switzerland
- Department of Medical Genetics, University of Lausanne, Lausanne, Switzerland
| | - Jennifer L. Bragg-Gresham
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Hsing-Yi Chang
- Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Ayşe Demirkan
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Ron Do
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
| | - Louise A. Donnelly
- Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School. Dundee, DD1 9SY, United Kingdom
| | - Georg B. Ehret
- Cardiology, Department of Specialities of Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland
- Center for Complex Disease Genomics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Tõnu Esko
- Broad Institute, Program in Medical and Population Genetics, Cambridge, Massachusetts 02142, USA
- Estonian Genome Center of the University of Tartu, Tartu, Estonia
- Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Mary F. Feitosa
- Department of Genetics, Washington University School of Medicine, USA
| | - Teresa Ferreira
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN, United Kingdom
| | - Krista Fischer
- Estonian Genome Center of the University of Tartu, Tartu, Estonia
| | - Pierre Fontanillas
- Broad Institute, Program in Medical and Population Genetics, Cambridge, Massachusetts 02142, USA
| | - Ross M. Fraser
- Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, United Kingdom
| | - Daniel F. Freitag
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Deepti Gurdasani
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, CB10 1SA, Hinxton, United Kingdom
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Kauko Heikkilä
- Hjelt Institute, Department of Public Health, University of Helsinki, Finland
| | - Elina Hyppönen
- Centre For Paediatric Epidemiology and Biostatistics/MRC Centre of Epidemiology for Child Health, University College of London Institute of Child Health, London, United Kingdom
| | - Aaron Isaacs
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Centre for Medical Systems Biology, Leiden, the Netherlands
| | - Anne U. Jackson
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Åsa Johansson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Toby Johnson
- Genome Centre, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Clinical Pharmacology, NIHR Cardiovascular Biomedical Research Unit, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry Queen Mary University of London, London, UK
| | - Marika Kaakinen
- Biocenter Oulu, University of Oulu, Oulu, Finland
- Institute of Health Sciences, University of Oulu, Finland
| | - Johannes Kettunen
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Finland
- Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Marcus E. Kleber
- Department of Internal Medicine II – Cardiology, University of Ulm Medical Centre, Ulm, Germany
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty of Mannheim, University of Heidelberg, Ludolf-Krehl-Strasse 7-11, 68167 Mannheim, Germany
| | - Xiaohui Li
- Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jian’an Luan
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere 33520, Finland
- Department of Clinical Chemistry, University of Tampere School of Medicine, Tampere 33014, Finland
| | - Patrik K.E. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Evelin Mihailov
- Estonian Genome Center of the University of Tartu, Tartu, Estonia
- Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - May E. Montasser
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland, School of Medicine, Baltimore, Maryland
| | - Martina Müller-Nurasyid
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, Neuherberg 85764, Germany
- Department of Medicine I, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Germany
- Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Ilja M. Nolte
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Jeffrey R. O’Connell
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland, School of Medicine, Baltimore, Maryland
| | - Cameron D. Palmer
- Broad Institute, Program in Medical and Population Genetics, Cambridge, Massachusetts 02142, USA
- Division of Endocrinology, Children’s Hospital Boston, Massachusetts 02115, USA
- Division of Genetics, Program in Genomics, Children’s Hospital, Boston, Massachusetts 02115, USA
| | - Markus Perola
- Estonian Genome Center of the University of Tartu, Tartu, Estonia
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Finland
- Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Ann-Kristin Petersen
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, Neuherberg 85764, Germany
| | - Serena Sanna
- Istituto di Ricerca Genetica e Biomedica, CNR, Monserrato, 09042, Italy
| | - Richa Saxena
- Massachusetts General Hospital/Broad Institute, Harvard University, Cambridge, MA, USA
| | - Susan K. Service
- Center for Neurobehavioral Genetics, The Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
| | - Sonia Shah
- Genetic Epidemiology Group, Deparment of Epidemiology and Public Health, UCL, London WC1E 6BT, United Kingdom
| | - Dmitry Shungin
- Department of Clinical Sciences, Genetic & Molecular Epidemiology Unit, Lund University Diabetes Center, Scania University Hosptial, Malmö, Sweden
- Department of Odontology, Umeå University, Umeå, Sweden
- Department of Public Health and Primary Care, Unit of Medicine, Umeå University, Umeå, Sweden
| | - Carlo Sidore
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan 48109, USA
- Istituto di Ricerca Genetica e Biomedica, CNR, Monserrato, 09042, Italy
- Dipartimento di Scienze Biomediche, Universita di Sassari, 07100 SS, Italy
| | - Ci Song
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Rona J. Strawbridge
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ida Surakka
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Finland
- Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Toshiko Tanaka
- Clinical Research Branch, National Institute Health, Baltimore, MD, USA
| | - Tanya M. Teslovich
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | | | | | - Benjamin F. Voight
- Department of Genetics, University of Pennsylvania - School of Medicine, Philadelphia PA, 19104, USA
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania - School of Medicine, Philadelphia PA, 19104, USA
| | - Kelly A. Volcik
- Human Genetics Center, University of Texas Health Science Center - School of Public Health, Houston, TX 77030, USA
| | | | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London, WC1B 5JU, United Kingdom
| | - Ying Wu
- Department of Genetics, University of North Carolina, Chapel Hill, NC 27599 USA
| | - Weihua Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Ealing Hospital, Southall, Middlesex UB1 3HW, United Kingdom
| | - Devin Absher
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
| | - Gershim Asiki
- MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda
| | - Inês Barroso
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, CB10 1SA, Hinxton, United Kingdom
- University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Level 4, Institute of Metabolic Science Box 289 Addenbrooke’s Hospital Cambridge CB2 OQQ, UK
| | - Latonya F. Been
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jennifer L. Bolton
- Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, United Kingdom
| | - Lori L Bonnycastle
- Genome Technology Branch, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Paolo Brambilla
- Department of Experimental Medicine, University of Milano Bicocca, Italy
| | - Mary S. Burnett
- MedStar Health Research Institute, 6525 Belcrest Road, Suite 700, Hyattsville, MD 20782, USA
| | - Giancarlo Cesana
- Research Centre on Public Health, University of Milano Bicocca, Italy
| | - Maria Dimitriou
- Department of Dietetics-Nutrition, Harokopio University, 70 El. Venizelou Str, Athens, Greece
| | - Alex S.F. Doney
- Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School. Dundee, DD1 9SY, United Kingdom
| | - Angela Döring
- Institute of Epidemiology I, Helmholtz Zentrum München, Neuherberg 85764, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg 85764, Germany
| | - Paul Elliott
- Institute of Health Sciences, University of Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, UK
| | - Stephen E. Epstein
- MedStar Health Research Institute, 6525 Belcrest Road, Suite 700, Hyattsville, MD 20782, USA
| | | | - Bruna Gigante
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mark O. Goodarzi
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Harald Grallert
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, Neuherberg 85764, Germany
| | - Martha L. Gravito
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Christopher J. Groves
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, OX3 7LJ, United Kingdom
| | - Göran Hallmans
- Department of Public Health and Clinical Medicine, Nutritional research, Umeå University, Umeå, Sweden
| | - Anna-Liisa Hartikainen
- Department of Clinical Sciences/Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, Scotland, United Kingdom
| | - Dena Hernandez
- Laboratory of Neurogenetics, National Institute on Aging, Bethesda, MD 20892, USA
| | - Andrew A. Hicks
- Center for Biomedicine, European Academy Bozen/Bolzano (EURAC), Bolzano, Italy - Affiliated Institute of the University of Lübeck, Lübeck, Germany
| | - Hilma Holm
- deCODE Genetics/Amgen, 101 Reykjavik, Iceland
| | - Yi-Jen Hung
- Division of Endocrinology & Metabolism, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Thomas Illig
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, Neuherberg 85764, Germany
- Hannover Unified Biobank, Hannover Medical School, Hannover 30625, Germany
| | - Michelle R. Jones
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | | | - John J.P. Kastelein
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Kay-Tee Khaw
- Clinical Gerontology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Eric Kim
- Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Norman Klopp
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, Neuherberg 85764, Germany
- Hannover Unified Biobank, Hannover Medical School, Hannover 30625, Germany
| | | | - Meena Kumari
- Genetic Epidemiology Group, Deparment of Epidemiology and Public Health, UCL, London WC1E 6BT, United Kingdom
| | - Claudia Langenberg
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere 33520, Finland
- Department of Clinical Chemistry, University of Tampere School of Medicine, Tampere 33014, Finland
| | - Shih-Yi Lin
- Division of Endocrine and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jaana Lindström
- Diabetes Prevention Unit, National Institute for Health and Welfare, 00271 Helsinki, Finland
| | - Ruth J.F. Loos
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0QQ, United Kingdom
- The Genetics of Obesity and Related Metabolic Traits Program, The Icahn School of Medicine at Mount Sinai, New York, USA
- The Charles Bronfman Institute for Personalized Medicine, The Icahn School of Medicine at ount Sinai, New York, USA
- The Mindich Child Health and Development Institute, The Icahn School of Medicine at Mount Sinai, New York
| | - François Mach
- Cardiology, Department of Specialities of Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland
| | - Wendy L McArdle
- School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom
| | - Christa Meisinger
- Institute of Epidemiology I, Helmholtz Zentrum München, Neuherberg 85764, Germany
| | - Braxton D. Mitchell
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland, School of Medicine, Baltimore, Maryland
| | - Gabrielle Müller
- Institute for Medical Informatics and Biometrics, University of Dresden, Medical Faculty Carl Gustav Carus, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Ramaiah Nagaraja
- Laboratory of Genetics, National Institute on Aging, Baltimore, MD21224, USA
| | - Narisu Narisu
- Genome Technology Branch, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Tuomo V.M. Nieminen
- Department of Clinical Pharmacology, University of Tampere School of Medicine, Tamperew 33014, Finland
- Department of Internal Medicine, Päijät-Häme Central Hospital, Lahti, Finland
- Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Isleifur Olafsson
- Department of Clinical Biochemistry, Landspitali University Hospital, 101 Reykjavik, Iceland
| | - Ken K. Ong
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0QQ, United Kingdom
- MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London, WC1B 5JU, United Kingdom
| | - Aarno Palotie
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Finland
- Department of Medical Genetics, Haartman Institute, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Genetic Epidemiology Group, Wellcome Trust Sanger Institute, Hinxton, Cambridge, United ingdom
| | - Theodore Papamarkou
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, CB10 1SA, Hinxton, United Kingdom
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Department of Statistical Sciences, University College of London, London, United Kingdom
| | - Cristina Pomilla
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, CB10 1SA, Hinxton, United Kingdom
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Anneli Pouta
- Department of Clinical Sciences/Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland
- National Institute for Health and Welfare, Oulu, Finland
| | - Daniel J. Rader
- Cardiovascular Institute, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Building 421, Translational Research Center, Philadelphia, PA 19104-5158, USA
- Division of Translational Medicine and Human Genetics, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Building 421, Translational Research Center, Philadelphia, PA 19104-5158, USA
| | - Muredach P. Reilly
- Cardiovascular Institute, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Building 421, Translational Research Center, Philadelphia, PA 19104-5158, USA
- Division of Translational Medicine and Human Genetics, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Building 421, Translational Research Center, Philadelphia, PA 19104-5158, USA
| | - Paul M. Ridker
- Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave., Boston MA 02215, USA
- Harvard Medical School, Boston MA 02115, USA
| | - Fernando Rivadeneira
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging NCHA), Leiden, The Netherlands
| | - Igor Rudan
- Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, United Kingdom
| | - Aimo Ruokonen
- Department of Clinical Sciences/Clinical Chemistry, University of Oulu, Oulu, Finland
| | - Nilesh Samani
- National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester LE3 9QP, UK
- Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Hubert Scharnagl
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
| | - Janet Seeley
- MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda
- School of International Development, University of East Anglia, Norwich NR4 7TJ, United Kingdom
| | - Kaisa Silander
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Finland
- Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Alena Stančáková
- University of Eastern Finland and Kuopio University Hospital, 70210 Kuopio, Finland
| | - Kathleen Stirrups
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, CB10 1SA, Hinxton, United Kingdom
| | - Amy J. Swift
- Genome Technology Branch, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Laurence Tiret
- INSERM UMRS 937, Pierre and Marie Curie University, Paris, France
| | - Andre G. Uitterlinden
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging NCHA), Leiden, The Netherlands
| | - L. Joost van Pelt
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, The Netherlands
- LifeLines Cohort Study, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Sailaja Vedantam
- Broad Institute, Program in Medical and Population Genetics, Cambridge, Massachusetts 02142, USA
- Division of Endocrinology, Children’s Hospital Boston, Massachusetts 02115, USA
- Division of Genetics, Program in Genomics, Children’s Hospital, Boston, Massachusetts 02115, USA
| | - Nicholas Wainwright
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, CB10 1SA, Hinxton, United Kingdom
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Cisca Wijmenga
- LifeLines Cohort Study, University of Groningen, University Medical Center Groningen, The Netherlands
- Department of Genetics, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Sarah H. Wild
- Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, United Kingdom
| | - Gonneke Willemsen
- Department of Biological Psychology, VU Univ, Amsterdam, The Netherlands
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - James F. Wilson
- Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, United Kingdom
| | - Elizabeth H. Young
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, CB10 1SA, Hinxton, United Kingdom
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Jing Hua Zhao
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - Linda S. Adair
- Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA
| | - Dominique Arveiler
- Department of Epidemiology and Public Health, EA 3430, University of Strasbourg, Faculty of Medicine, Strasbourg, France
| | | | | | - Franklyn Bennett
- Chemical Pathology, Department of Pathology, University of the West Indies, Mona, Kingston 7, Jamaica
| | - Murielle Bochud
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Route de la Corniche 10, 1010 Lausanne, Switzerland
| | - Bernhard O. Boehm
- Division of Endocrinology and Diabetes, Department of Internal Medicine, Ulm University Medical Centre, Ulm, Germany
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Dorret I. Boomsma
- Department of Biological Psychology, VU Univ, Amsterdam, The Netherlands
| | - Ingrid B. Borecki
- Department of Genetics, Washington University School of Medicine, USA
| | - Stefan R. Bornstein
- Department of Medicine III, University of Dresden, Medical Faculty Carl Gustav Carus, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Pascal Bovet
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Route de la Corniche 10, 1010 Lausanne, Switzerland
- Ministry of Health, Victoria, Republic of Seychelles
| | - Michel Burnier
- Service of Nephrology, Lausanne University Hospital, Lausanne, Switzerland
| | - Harry Campbell
- Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, United Kingdom
| | - Aravinda Chakravarti
- Center for Complex Disease Genomics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - John C. Chambers
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Ealing Hospital, Southall, Middlesex UB1 3HW, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Yii-Der Ida Chen
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Francis S. Collins
- Genome Technology Branch, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Richard S. Cooper
- Department of Preventive Medicine and Epidemiology, Loyola University Medical School, Maywood, Illinois 60153, USA
| | - John Danesh
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - George Dedoussis
- Department of Dietetics-Nutrition, Harokopio University, 70 El. Venizelou Str, Athens, Greece
| | - Ulf de Faire
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alan B. Feranil
- Office of Population Studies Foundation, University of San Carlos, Talamban, Cebu City, Philippines
| | - Jean Ferrières
- Department of Cardiology, Toulouse University School of Medicine, Rangueil Hospital, Toulouse, France
| | - Luigi Ferrucci
- Clinical Research Branch, National Institute Health, Baltimore, MD, USA
| | - Nelson B. Freimer
- Center for Neurobehavioral Genetics, The Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
- Department of Psychiatry, University of California, Los Angeles, USA
| | - Christian Gieger
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, Neuherberg 85764, Germany
| | - Leif C. Groop
- Department of Clinical Sciences, Lund University, SE-20502, Malmö, Sweden
- Department of Medicine, Helsinki University Hospital, FI-00029 Helsinki, Finland
| | | | - Ulf Gyllensten
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Anders Hamsten
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - Tamara B. Harris
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Ageing, Bethesda, MD, USA
| | - Aroon Hingorani
- Genetic Epidemiology Group, Deparment of Epidemiology and Public Health, UCL, London WC1E 6BT, United Kingdom
| | - Joel N. Hirschhorn
- Broad Institute, Program in Medical and Population Genetics, Cambridge, Massachusetts 02142, USA
- Division of Endocrinology, Children’s Hospital Boston, Massachusetts 02115, USA
- Division of Genetics, Program in Genomics, Children’s Hospital, Boston, Massachusetts 02115, USA
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging NCHA), Leiden, The Netherlands
| | - G. Kees Hovingh
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Chao Agnes Hsiung
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Steve E. Humphries
- Cardiovascular Genetics, BHF Laboratories, Institute Cardiovascular Science, University College London, London, United Kingdom
| | - Steven C. Hunt
- Cardiovascular Genetics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Kristian Hveem
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway
| | | | - Marjo-Riitta Järvelin
- Biocenter Oulu, University of Oulu, Oulu, Finland
- Institute of Health Sciences, University of Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Centre for Environment and Health, School of Public Health, Imperial College London, UK
- National Institute for Health and Welfare, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Antti Jula
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, University of Tampere School of Medicine, Tampere 33014, Finland
| | - Jaakko Kaprio
- Hjelt Institute, Department of Public Health, University of Helsinki, Finland
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Finland
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland
| | - Antero Kesäniemi
- Institute of Clinical Medicine, Department of Medicine, University of Oulu and Clinical Research Center, Oulu University Hospital, Oulu, Finland
| | - Mika Kivimaki
- Genetic Epidemiology Group, Deparment of Epidemiology and Public Health, UCL, London WC1E 6BT, United Kingdom
| | - Jaspal S. Kooner
- Ealing Hospital, Southall, Middlesex UB1 3HW, United Kingdom
- Imperial College Healthcare NHS Trust, London, United Kingdom
- National Heart & Lung Institute, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Peter J. Koudstaal
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Ronald M. Krauss
- Children’s Hospital Oakland Research Institute, 5700 Martin Luther King Junior Way, Oakland, CA 94609, USA
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, 33 Bedford Place, London, WC1B 5JU, United Kingdom
| | - Johanna Kuusisto
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, 70210 Kuopio, Finland
| | - Kirsten O. Kyvik
- Institute of Regional Health Services Research, University of Southern Denmark, Odense, Denmark
- Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Markku Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, 70210 Kuopio, Finland
| | - Timo A. Lakka
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Finland
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Cecilia M. Lindgren
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN, United Kingdom
| | - Nicholas G. Martin
- Queensland Institute of Medical Research, Locked Bag 2000, Royal Brisbane Hospital, Queensland 4029, Australia
| | - Winfried März
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty of Mannheim, University of Heidelberg, Ludolf-Krehl-Strasse 7-11, 68167 Mannheim, Germany
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
- Synlab Academy, Synlab Services GmbH,Gottlieb-Daimler-Straße 25, 68165 Mannheim, Germany
| | - Mark I. McCarthy
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN, United Kingdom
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, OX3 7LJ, United Kingdom
| | - Colin A. McKenzie
- Tropical Metabolism Research Unit, Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston 7, Jamaica
| | - Pierre Meneton
- U872 Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, 75006 Paris, France
| | - Andres Metspalu
- Estonian Genome Center of the University of Tartu, Tartu, Estonia
- Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Leena Moilanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Andrew D. Morris
- Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School. Dundee, DD1 9SY, United Kingdom
| | - Patricia B. Munroe
- Genome Centre, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Clinical Pharmacology, NIHR Cardiovascular Biomedical Research Unit, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry Queen Mary University of London, London, UK
| | - Inger Njølstad
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Chris Power
- Centre For Paediatric Epidemiology and Biostatistics/MRC Centre of Epidemiology for Child Health, University College of London Institute of Child Health, London, United Kingdom
| | - Peter P. Pramstaller
- Center for Biomedicine, European Academy Bozen/Bolzano (EURAC), Bolzano, Italy - Affiliated Institute of the University of Lübeck, Lübeck, Germany
- Department of Neurology, General Central Hospital, Bolzano, Italy
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Jackie F. Price
- Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, Scotland, United Kingdom
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle, WA, USA
- Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA
| | - Thomas Quertermous
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Rainer Rauramaa
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Danish Saleheen
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Center for Non-Communicable Diseases, Karachi, Pakistan
- Department of Medicine, University of Pennsylvania, USA
| | - Veikko Salomaa
- Unit of Chronic Disease Epidemiology and Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Dharambir K. Sanghera
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | - Peter E.H. Schwarz
- Department of Medicine III, University of Dresden, Medical Faculty Carl Gustav Carus, Fetscherstrasse 74, 01307 Dresden, Germany
- Paul Langerhans Institute Dresden, German Center for Diabetes Research (DZD), Dresden, Germany
| | - Wayne H-H Sheu
- Division of Endocrine and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Alan R. Shuldiner
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland, School of Medicine, Baltimore, Maryland
- Geriatric Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, Maryland
| | - Agneta Siegbahn
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Tim D. Spector
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | - Kari Stefansson
- deCODE Genetics/Amgen, 101 Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, 101 Reykjavík, Iceland
| | - David P. Strachan
- Division of Population Health Sciences and Education, St George’s, University of London, Cranmer Terrace, London SW17 0RE, United Kingdom
| | - Bamidele O. Tayo
- Department of Preventive Medicine and Epidemiology, Loyola University Medical School, Maywood, Illinois 60153, USA
| | - Elena Tremoli
- Department of Pharmacological Sciences, University of Milan, Monzino Cardiology Center, IRCCS, Milan, Italy
| | - Jaakko Tuomilehto
- Diabetes Prevention Unit, National Institute for Health and Welfare, 00271 Helsinki, Finland
- Centre for Vascular Prevention, Danube-University Krems, 3500 Krems, Austria
- King Abdulaziz University, Faculty of Medicine, Jeddah 21589, Saudi Arabia
- Red RECAVA Grupo RD06/0014/0015, Hospital Universitario La Paz, 28046
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
- Research Unit, Kuopio University Hospital, Kuopio, Finland
| | - Cornelia M. van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Centre for Medical Systems Biology, Leiden, the Netherlands
| | | | - Lars Wallentin
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0QQ, United Kingdom
| | - John B. Whitfield
- Queensland Institute of Medical Research, Locked Bag 2000, Royal Brisbane Hospital, Queensland 4029, Australia
| | - Bruce H.R. Wolffenbuttel
- LifeLines Cohort Study, University of Groningen, University Medical Center Groningen, The Netherlands
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Jose M. Ordovas
- Department of Cardiovascular Epidemiology and Population Genetics, National Center for rdiovascular Investigation, Madrid, Spain
- IMDEA-Alimentacion, Madrid, Spain
- Nutrition and Genomics Laboratory, Jean Mayer-USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Eric Boerwinkle
- Human Genetics Center, University of Texas Health Science Center - School of Public Health, Houston, TX 77030, USA
| | - Colin N.A. Palmer
- Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School. Dundee, DD1 9SY, United Kingdom
| | - Unnur Thorsteinsdottir
- deCODE Genetics/Amgen, 101 Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, 101 Reykjavík, Iceland
| | - Daniel I. Chasman
- Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave., Boston MA 02215, USA
- Harvard Medical School, Boston MA 02115, USA
| | - Jerome I. Rotter
- Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Paul W. Franks
- Department of Clinical Sciences, Genetic & Molecular Epidemiology Unit, Lund University Diabetes Center, Scania University Hosptial, Malmö, Sweden
- Department of Public Health and Primary Care, Unit of Medicine, Umeå University, Umeå, Sweden
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - Samuli Ripatti
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, CB10 1SA, Hinxton, United Kingdom
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Finland
- Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - L. Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts 02118, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Manjinder S. Sandhu
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, CB10 1SA, Hinxton, United Kingdom
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA 22908, USA
| | - Michael Boehnke
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Panos Deloukas
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, CB10 1SA, Hinxton, United Kingdom
| | - Sekar Kathiresan
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Broad Institute, Program in Medical and Population Genetics, Cambridge, Massachusetts 02142, USA
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Karen L. Mohlke
- Department of Genetics, University of North Carolina, Chapel Hill, NC 27599 USA
| | - Erik Ingelsson
- Department of Medical Sciences, Molecular Epidemiology, Uppsala University, Uppsala, Sweden
- Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN, United Kingdom
| | - Gonçalo R. Abecasis
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, Michigan 48109, USA
| | | |
Collapse
|
30
|
Do R, Willer CJ, Schmidt EM, Sengupta S, Gao C, Peloso GM, Gustafsson S, Kanoni S, Ganna A, Chen J, Buchkovich ML, Mora S, Beckmann JS, Bragg-Gresham JL, Chang HY, Demirkan A, Den Hertog HM, Donnelly LA, Ehret GB, Esko T, Feitosa MF, Ferreira T, Fischer K, Fontanillas P, Fraser RM, Freitag DF, Gurdasani D, Heikkilä K, Hyppönen E, Isaacs A, Jackson AU, Johansson A, Johnson T, Kaakinen M, Kettunen J, Kleber ME, Li X, Luan J, Lyytikäinen LP, Magnusson PKE, Mangino M, Mihailov E, Montasser ME, Müller-Nurasyid M, Nolte IM, O'Connell JR, Palmer CD, Perola M, Petersen AK, Sanna S, Saxena R, Service SK, Shah S, Shungin D, Sidore C, Song C, Strawbridge RJ, Surakka I, Tanaka T, Teslovich TM, Thorleifsson G, Van den Herik EG, Voight BF, Volcik KA, Waite LL, Wong A, Wu Y, Zhang W, Absher D, Asiki G, Barroso I, Been LF, Bolton JL, Bonnycastle LL, Brambilla P, Burnett MS, Cesana G, Dimitriou M, Doney ASF, Döring A, Elliott P, Epstein SE, Eyjolfsson GI, Gigante B, Goodarzi MO, Grallert H, Gravito ML, Groves CJ, Hallmans G, Hartikainen AL, Hayward C, Hernandez D, Hicks AA, Holm H, Hung YJ, Illig T, Jones MR, Kaleebu P, Kastelein JJP, Khaw KT, Kim E, Klopp N, Komulainen P, Kumari M, Langenberg C, Lehtimäki T, Lin SY, Lindström J, Loos RJF, Mach F, McArdle WL, Meisinger C, Mitchell BD, Müller G, Nagaraja R, Narisu N, Nieminen TVM, Nsubuga RN, Olafsson I, Ong KK, Palotie A, Papamarkou T, Pomilla C, Pouta A, Rader DJ, Reilly MP, Ridker PM, Rivadeneira F, Rudan I, Ruokonen A, Samani N, Scharnagl H, Seeley J, Silander K, Stančáková A, Stirrups K, Swift AJ, Tiret L, Uitterlinden AG, van Pelt LJ, Vedantam S, Wainwright N, Wijmenga C, Wild SH, Willemsen G, Wilsgaard T, Wilson JF, Young EH, Zhao JH, Adair LS, Arveiler D, Assimes TL, Bandinelli S, Bennett F, Bochud M, Boehm BO, Boomsma DI, Borecki IB, Bornstein SR, Bovet P, Burnier M, Campbell H, Chakravarti A, Chambers JC, Chen YDI, Collins FS, Cooper RS, Danesh J, Dedoussis G, de Faire U, Feranil AB, Ferrières J, Ferrucci L, Freimer NB, Gieger C, Groop LC, Gudnason V, Gyllensten U, Hamsten A, Harris TB, Hingorani A, Hirschhorn JN, Hofman A, Hovingh GK, Hsiung CA, Humphries SE, Hunt SC, Hveem K, Iribarren C, Järvelin MR, Jula A, Kähönen M, Kaprio J, Kesäniemi A, Kivimaki M, Kooner JS, Koudstaal PJ, Krauss RM, Kuh D, Kuusisto J, Kyvik KO, Laakso M, Lakka TA, Lind L, Lindgren CM, Martin NG, März W, McCarthy MI, McKenzie CA, Meneton P, Metspalu A, Moilanen L, Morris AD, Munroe PB, Njølstad I, Pedersen NL, Power C, Pramstaller PP, Price JF, Psaty BM, Quertermous T, Rauramaa R, Saleheen D, Salomaa V, Sanghera DK, Saramies J, Schwarz PEH, Sheu WHH, Shuldiner AR, Siegbahn A, Spector TD, Stefansson K, Strachan DP, Tayo BO, Tremoli E, Tuomilehto J, Uusitupa M, van Duijn CM, Vollenweider P, Wallentin L, Wareham NJ, Whitfield JB, Wolffenbuttel BHR, Altshuler D, Ordovas JM, Boerwinkle E, Palmer CNA, Thorsteinsdottir U, Chasman DI, Rotter JI, Franks PW, Ripatti S, Cupples LA, Sandhu MS, Rich SS, Boehnke M, Deloukas P, Mohlke KL, Ingelsson E, Abecasis GR, Daly MJ, Neale BM, Kathiresan S. Common variants associated with plasma triglycerides and risk for coronary artery disease. Nat Genet 2013; 45:1345-52. [PMID: 24097064 PMCID: PMC3904346 DOI: 10.1038/ng.2795] [Citation(s) in RCA: 628] [Impact Index Per Article: 57.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 09/13/2013] [Indexed: 12/20/2022]
Abstract
Triglycerides are transported in plasma by specific triglyceride-rich lipoproteins; in epidemiologic studies, increased triglyceride levels correlate with higher risk for coronary artery disease (CAD). However, it is unclear whether this association reflects causal processes. We used 185 common variants recently mapped for plasma lipids (P<5×10−8 for each) to examine the role of triglycerides on risk for CAD. First, we highlight loci associated with both low-density lipoprotein cholesterol (LDL-C) and triglycerides, and show that the direction and magnitude of both are factors in determining CAD risk. Second, we consider loci with only a strong magnitude of association with triglycerides and show that these loci are also associated with CAD. Finally, in a model accounting for effects on LDL-C and/or high-density lipoprotein cholesterol, a polymorphism's strength of effect on triglycerides is correlated with the magnitude of its effect on CAD risk. These results suggest that triglyceride-rich lipoproteins causally influence risk for CAD.
Collapse
Affiliation(s)
- Ron Do
- 1] Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA. [2] Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, USA. [3] Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA. [4] Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Sovio U, Kaakinen M, Tzoulaki I, Das S, Ruokonen A, Pouta A, Hartikainen AL, Molitor J, Järvelin MR. How do changes in body mass index in infancy and childhood associate with cardiometabolic profile in adulthood? Findings from the Northern Finland Birth Cohort 1966 Study. Int J Obes (Lond) 2013; 38:53-9. [PMID: 24080793 DOI: 10.1038/ijo.2013.165] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 08/09/2013] [Accepted: 08/27/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND/OBJECTIVE Postnatal growth patterns leading to obesity may have adverse influences on future cardiometabolic health. This study evaluated age and body mass index (BMI) at infant BMI peak (BMIP) and childhood BMI rebound (BMIR) in relation to adult cardiometabolic outcomes in the Northern Finland Birth Cohort 1966. METHODS BMI at various ages was calculated from frequent height and weight measurements obtained from child health and welfare clinical records. Age and BMI at BMIP and BMIR were derived from random effect models fitted at >0-1.5 years (N=3 265) and >1.5-13 years (N=4 121). Cardiometabolic outcomes were obtained from a clinical examination at age 31 years. Multiple regression models were used to analyse associations between the derived growth parameters and cardiometabolic outcomes. RESULTS Age and BMI at BMIP were positively associated with adult BMI and waist circumference (WC), independently of birth weight and infant height growth (P<0.05). Later BMIR was associated with a better cardiometabolic profile: adult BMI and insulin were 14% lower, WC and triglycerides were 10% lower and the odds of metabolic syndrome (MetS) were 74% lower per 2 s.d. (1.86 years) higher age at BMIR (P<0.0001). BMI at rebound had generally weaker associations with cardiometabolic outcomes, which attenuated after adjustment for age at BMIR. CONCLUSIONS Age and BMI at infant BMIP were associated with adult adiposity but not with other cardiometabolic outcomes. Earlier timing of BMIR was a risk factor of an adverse cardiometabolic profile, independently of early growth or BMI at rebound. Identifying growth patterns harmful to cardiovascular health will give opportunities for early interventions.
Collapse
Affiliation(s)
- U Sovio
- 1] Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK [2] Department of Epidemiology and Biostatistics, MRC-HPA Centre, School of Public Health, Imperial College London, Norfolk Place, London, UK
| | - M Kaakinen
- 1] Institute of Health Sciences, University of Oulu, Oulu, Finland [2] Biocenter Oulu, University of Oulu, Oulu, Finland
| | - I Tzoulaki
- 1] Department of Epidemiology and Biostatistics, MRC-HPA Centre, School of Public Health, Imperial College London, Norfolk Place, London, UK [2] Department of Hygiene and Epidemiology, Medical School University of Ioannina, Ioannina, Greece
| | - S Das
- Department of Epidemiology and Biostatistics, MRC-HPA Centre, School of Public Health, Imperial College London, Norfolk Place, London, UK
| | - A Ruokonen
- Institute of Diagnostics, Clinical Chemistry, University of Oulu, Oulu, Finland
| | - A Pouta
- 1] Department of Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland [2] Department of Clinical Sciences/Obstetrics and Gynecology, University of Oulu, Oulu, Finland
| | - A-L Hartikainen
- Department of Clinical Sciences/Obstetrics and Gynecology, University of Oulu, Oulu, Finland
| | - J Molitor
- 1] Department of Epidemiology and Biostatistics, MRC-HPA Centre, School of Public Health, Imperial College London, Norfolk Place, London, UK [2] College of Public Health & Human Sciences, Oregon State University, Corvallis, OR, USA
| | - M-R Järvelin
- 1] Department of Epidemiology and Biostatistics, MRC-HPA Centre, School of Public Health, Imperial College London, Norfolk Place, London, UK [2] Institute of Health Sciences, University of Oulu, Oulu, Finland [3] Biocenter Oulu, University of Oulu, Oulu, Finland [4] Department of Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland
| |
Collapse
|
32
|
Kallio S, Puurunen J, Ruokonen A, Vaskivuo T, Piltonen T, Tapanainen JS. Antimüllerian hormone levels decrease in women using combined contraception independently of administration route. Fertil Steril 2013; 99:1305-10. [DOI: 10.1016/j.fertnstert.2012.11.034] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 11/02/2012] [Accepted: 11/20/2012] [Indexed: 02/08/2023]
|
33
|
Laurila PP, Surakka I, Sarin AP, Yetukuri L, Hyötyläinen T, Söderlund S, Naukkarinen J, Tang J, Kettunen J, Mirel DB, Soronen J, Lehtimäki T, Ruokonen A, Ehnholm C, Eriksson JG, Salomaa V, Jula A, Raitakari OT, Järvelin MR, Palotie A, Peltonen L, Orešič M, Jauhiainen M, Taskinen MR, Ripatti S. Genomic, Transcriptomic, and Lipidomic Profiling Highlights the Role of Inflammation in Individuals With Low High-density Lipoprotein Cholesterol. Arterioscler Thromb Vasc Biol 2013; 33:847-57. [DOI: 10.1161/atvbaha.112.300733] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective—
Low high-density lipoprotein cholesterol (HDL-C) is associated with cardiometabolic pathologies. In this study, we investigate the biological pathways and individual genes behind low HDL-C by integrating results from 3 high-throughput data sources: adipose tissue transcriptomics, HDL lipidomics, and dense marker genotypes from Finnish individuals with low or high HDL-C (n=450).
Approach and Results—
In the pathway analysis of genetic data, we demonstrate that genetic variants within inflammatory pathways were enriched among low HDL-C associated single-nucleotide polymorphisms, and the expression of these pathways upregulated in the adipose tissue of low HDL-C subjects. The lipidomic analysis highlighted the change in HDL particle quality toward putatively more inflammatory and less vasoprotective state in subjects with low HDL-C, as evidenced by their decreased antioxidative plasmalogen contents. We show that the focal point of these inflammatory pathways seems to be the
HLA
region with its low HDL-associated alleles also associating with more abundant local transcript levels in adipose tissue, increased plasma vascular cell adhesion molecule 1 (VCAM1) levels, and decreased HDL particle plasmalogen contents, markers of adipose tissue inflammation, vascular inflammation, and HDL antioxidative potential, respectively. In a population-based look-up of the inflammatory pathway single-nucleotide polymorphisms in a large Finnish cohorts (n=11 211), no association of the
HLA
region was detected for HDL-C as quantitative trait, but with extreme HDL-C phenotypes, implying the presence of low or high HDL genes in addition to the population-genomewide association studies–identified HDL genes.
Conclusions—
Our study highlights the role of inflammation with a genetic component in subjects with low HDL-C and identifies novel
cis
-expression quantitative trait loci (
cis
-eQTL) variants in
HLA
region to be associated with low HDL-C.
Collapse
Affiliation(s)
- Pirkka-Pekka Laurila
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Ida Surakka
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Antti-Pekka Sarin
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Laxman Yetukuri
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Tuulia Hyötyläinen
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Sanni Söderlund
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Jussi Naukkarinen
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Jing Tang
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Johannes Kettunen
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Daniel B. Mirel
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Jarkko Soronen
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Terho Lehtimäki
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Aimo Ruokonen
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Christian Ehnholm
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Johan G. Eriksson
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Veikko Salomaa
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Antti Jula
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Olli T. Raitakari
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Marjo-Riitta Järvelin
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Aarno Palotie
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Leena Peltonen
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Matej Orešič
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Matti Jauhiainen
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Marja-Riitta Taskinen
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| | - Samuli Ripatti
- From the Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Finland (P-P.L., I.S., A-P.S., J.K., A.P., S.R.); Public Health Genomics Unit, National Institute for Health and Welfare, Helsinki, Finland (P-P.L., I.S., A-P.S., J.N., J.K., J.S., C.E., M.J., S.R.); Department of Medical Genetics, University of Helsinki, Helsinki, Finland (P-P.L., A.P.); VTT Technical Research Centre of Finland, Espoo, Finland (L.Y., T.H., J.T., M.O.); Department of Medicine, Helsinki University
| |
Collapse
|
34
|
Walters RG, Coin LJM, Ruokonen A, de Smith AJ, El-Sayed Moustafa JS, Jacquemont S, Elliott P, Esko T, Hartikainen AL, Laitinen J, Männik K, Martinet D, Meyre D, Nauck M, Schurmann C, Sladek R, Thorleifsson G, Thorsteinsdóttir U, Valsesia A, Waeber G, Zufferey F, Balkau B, Pattou F, Metspalu A, Völzke H, Vollenweider P, Stefansson K, Järvelin MR, Beckmann JS, Froguel P, Blakemore AIF. Rare genomic structural variants in complex disease: lessons from the replication of associations with obesity. PLoS One 2013; 8:e58048. [PMID: 23554873 PMCID: PMC3595275 DOI: 10.1371/journal.pone.0058048] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 01/30/2013] [Indexed: 01/19/2023] Open
Abstract
The limited ability of common variants to account for the genetic contribution to complex disease has prompted searches for rare variants of large effect, to partly explain the ‘missing heritability’. Analyses of genome-wide genotyping data have identified genomic structural variants (GSVs) as a source of such rare causal variants. Recent studies have reported multiple GSV loci associated with risk of obesity. We attempted to replicate these associations by similar analysis of two familial-obesity case-control cohorts and a population cohort, and detected GSVs at 11 out of 18 loci, at frequencies similar to those previously reported. Based on their reported frequencies and effect sizes (OR≥25), we had sufficient statistical power to detect the large majority (80%) of genuine associations at these loci. However, only one obesity association was replicated. Deletion of a 220 kb region on chromosome 16p11.2 has a carrier population frequency of 2×10−4 (95% confidence interval [9.6×10−5–3.1×10−4]); accounts overall for 0.5% [0.19%–0.82%] of severe childhood obesity cases (P = 3.8×10−10; odds ratio = 25.0 [9.9–60.6]); and results in a mean body mass index (BMI) increase of 5.8 kg.m−2 [1.8–10.3] in adults from the general population. We also attempted replication using BMI as a quantitative trait in our population cohort; associations with BMI at or near nominal significance were detected at two further loci near KIF2B and within FOXP2, but these did not survive correction for multiple testing. These findings emphasise several issues of importance when conducting rare GSV association, including the need for careful cohort selection and replication strategy, accurate GSV identification, and appropriate correction for multiple testing and/or control of false discovery rate. Moreover, they highlight the potential difficulty in replicating rare CNV associations across different populations. Nevertheless, we show that such studies are potentially valuable for the identification of variants making an appreciable contribution to complex disease.
Collapse
Affiliation(s)
- Robin G. Walters
- Department of Genomics of Common Disease, Imperial College London, London, United Kingdom
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, United Kingdom
| | - Lachlan J. M. Coin
- Department of Genomics of Common Disease, Imperial College London, London, United Kingdom
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Aimo Ruokonen
- Institute of Diagnostics, Clinical Chemistry, University of Oulu, Oulu, Finland
- Oulu University Hospital, Oulu, Finland
| | - Adam J. de Smith
- Department of Genomics of Common Disease, Imperial College London, London, United Kingdom
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | | | - Sebastien Jacquemont
- Service of Medical Genetics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- MRC Health Protection Agency (HPA) Centre for Environment and Health, Imperial College London, London, United Kingdom
| | - Tõnu Esko
- Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Anna-Liisa Hartikainen
- Institute of Clinical Sciences/Obstetrics and Gynecology, University of Oulu, Oulu, Finland
| | | | - Katrin Männik
- Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
- The Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - Danielle Martinet
- Service of Medical Genetics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - David Meyre
- CNRS 8199-Institute of Biology, Pasteur Institute, Lille, France
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany
| | - Claudia Schurmann
- Interfaculty Institute for Genetics and Functional Genomics, Ernst-Moritz-Arndt-University, Greifswald, Germany
| | - Rob Sladek
- McGill University and Genome Quebec Innovation Centre, Montreal, Canada
- Department of Medicine and Human Genetics, McGill University, Montreal, Canada
| | | | - Unnur Thorsteinsdóttir
- deCODE Genetics, Reykjavík, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Armand Valsesia
- Department of Medical Genetics, University of Lausanne, Lausanne, Switzerland
- Swiss Institute of Bioinformatics, University of Lausanne, Lausanne, Switzerland
- Ludwig Institute for Cancer Research, University of Lausanne, Lausanne, Switzerland
| | - Gerard Waeber
- Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Flore Zufferey
- Service of Medical Genetics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Beverley Balkau
- INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Villejuif, France
- University Paris Sud 11, UMRS 1018, Villejuif, France
| | - François Pattou
- INSERM U859, Lille, France
- Université Lille Nord de France, Centre Hospitalier Universitaire Lille, Lille, France
| | - Andres Metspalu
- Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Henry Völzke
- Institute for Community Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany
| | - Peter Vollenweider
- Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Kári Stefansson
- deCODE Genetics, Reykjavík, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- MRC Health Protection Agency (HPA) Centre for Environment and Health, Imperial College London, London, United Kingdom
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
- Department of Lifecourse and Services, National Institute for Health and Welfare, Oulu, Finland
| | - Jacques S. Beckmann
- Service of Medical Genetics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
- Department of Medical Genetics, University of Lausanne, Lausanne, Switzerland
| | - Philippe Froguel
- Department of Genomics of Common Disease, Imperial College London, London, United Kingdom
- CNRS 8199-Institute of Biology, Pasteur Institute, Lille, France
- * E-mail: (AIFB); (PF)
| | - Alexandra I. F. Blakemore
- Department of Genomics of Common Disease, Imperial College London, London, United Kingdom
- Section of Investigative Medicine, Imperial College London, London, United Kingdom
- * E-mail: (AIFB); (PF)
| |
Collapse
|
35
|
Päkkilä F, Männistö T, Surcel HM, Ruokonen A, Bloigu A, Pouta A, Hartikainen AL, Vääräsmäki M, Järvelin MR, Suvanto E. Maternal thyroid dysfunction during pregnancy and thyroid function of her child in adolescence. J Clin Endocrinol Metab 2013; 98:965-72. [PMID: 23408571 PMCID: PMC3590485 DOI: 10.1210/jc.2012-2028] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT Normal maternal thyroid function is important for fetal development. No knowledge exists on how maternal thyroid function and thyroid antibodies during early pregnancy affect thyroid function of the offspring. OBJECTIVE The aim of this study was to investigate the relationship between maternal and adolescent thyroid function parameters. DESIGN, SETTING, AND PARTICIPANTS A total of 3673 mother-child pairs from the prospective, population-based Northern Finland Birth Cohort 1986 participated in the study. Maternal serum samples were drawn in early pregnancy (<20th gestational week), and children's samples were drawn at the age of 16 years and analyzed for TSH, free T4 (fT4), and thyroid peroxidase antibodies (TPO-Abs). MAIN OUTCOME MEASURES TSH, fT4, and TPO-Ab concentrations were measured at the age of 16 years. Children of mothers with thyroid dysfunction (hypothyroidism, hyperthyroidism, or hypothyroxinemia) or TPO-Ab positivity were compared to those of euthyroid or TPO-Ab-negative mothers. The distributions are expressed as medians with 5th to 95th percentiles. RESULTS Boys of hypothyroid mothers had higher TSH concentrations than those of euthyroid mothers: 2.0 (0.9-4.0) vs 1.7 (0.8-3.3) mU/L; P = .001. Children of hyperthyroid mothers had lower TSH concentrations than those of euthyroid mothers: 1.3 (0.6-4.2) vs 1.7 (0.8-3.3) mU/L, P = .013, for boys; and 1.3 (0.5-3.5) vs 1.6 (0.7-3.4) mU/L, P = .034, for girls. There were no differences in TSH or fT4 concentrations between children of hypothyroxinemic and euthyroid mothers. TPO-Ab-positive mothers more often had TPO-Ab-positive children (prevalence, 9.0 vs 3.7% among boys, and 22.7 vs 7.5% among girls). CONCLUSIONS Maternal thyroid dysfunction and TPO-Ab positivity during pregnancy seem to modify thyroid function parameters of offspring even in adolescence. Whether this increases the thyroid disease risk of the children is still unknown.
Collapse
Affiliation(s)
- Fanni Päkkilä
- Department of Obstetrics and Gynecology, Oulu University and Oulu University Hospital, Oulu 90029, Finland
| | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Miettola S, Hartikainen AL, Vääräsmäki M, Bloigu A, Ruokonen A, Järvelin MR, Pouta A. Offspring's blood pressure and metabolic phenotype after exposure to gestational hypertension in utero. Eur J Epidemiol 2013; 28:87-98. [PMID: 23354981 DOI: 10.1007/s10654-013-9763-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 01/07/2013] [Indexed: 12/13/2022]
Abstract
The aim of the study was to investigate the impact of de novo hypertension in pregnancy, i.e. gestational (non-proteinuric) hypertension (GH) and preeclampsia (PE), on the long-term metabolic outcome of the offspring. Data was obtained from the Northern Finland Birth Cohort 1986 (NFBC 1986), including 9,362 pregnancies and subsequent births between 1985 and 1986. Pregnancies were categorised into three groups: (1) GH with blood pressure (BP) ≥ 140/90 mmHg, (2) PE with BP ≥ 140/90 mmHg and proteinuria, and (3) reference group with normal BP. The final study population included 331 offspring of mothers with GH, 197 with PE and 5,045 offspring of normotensive mothers. The main outcome measures were systolic and diastolic blood pressure (SBP, DBP), mean arterial pressure (MAP), body mass index (BMI), and serum lipid, glucose and insulin levels of the 16 year-old offspring. The children of mothers with GH had higher BP compared to the reference group (SBP percentage difference 2.7 (95% CI 1.6, 3.8); DBP 3.4 (2.1, 4.6); MAP 3.1 (2.0, 4.1), P < 0.001 for all) and a tendency towards higher cholesterol and apolipoprotein B values. The offspring of mothers with PE had higher DBP and MAP, however after the adjustments this difference disappeared. Maternal de novo hypertension during pregnancy is associated with offspring's elevated blood pressure level already in adolescence. GH may also be associated with unfavourable lipid profile of the offspring.
Collapse
Affiliation(s)
- Satu Miettola
- National Institute for Health and Welfare, Oulu, Finland.
| | | | | | | | | | | | | |
Collapse
|
37
|
van der Harst P, Zhang W, Mateo Leach I, Rendon A, Verweij N, Sehmi J, Paul DS, Elling U, Allayee H, Li X, Radhakrishnan A, Tan ST, Voss K, Weichenberger CX, Albers CA, Al-Hussani A, Asselbergs FW, Ciullo M, Danjou F, Dina C, Esko T, Evans DM, Franke L, Gögele M, Hartiala J, Hersch M, Holm H, Hottenga JJ, Kanoni S, Kleber ME, Lagou V, Langenberg C, Lopez LM, Lyytikäinen LP, Melander O, Murgia F, Nolte IM, O'Reilly PF, Padmanabhan S, Parsa A, Pirastu N, Porcu E, Portas L, Prokopenko I, Ried JS, Shin SY, Tang CS, Teumer A, Traglia M, Ulivi S, Westra HJ, Yang J, Zhao JH, Anni F, Abdellaoui A, Attwood A, Balkau B, Bandinelli S, Bastardot F, Benyamin B, Boehm BO, Cookson WO, Das D, de Bakker PIW, de Boer RA, de Geus EJC, de Moor MH, Dimitriou M, Domingues FS, Döring A, Engström G, Eyjolfsson GI, Ferrucci L, Fischer K, Galanello R, Garner SF, Genser B, Gibson QD, Girotto G, Gudbjartsson DF, Harris SE, Hartikainen AL, Hastie CE, Hedblad B, Illig T, Jolley J, Kähönen M, Kema IP, Kemp JP, Liang L, Lloyd-Jones H, Loos RJF, Meacham S, Medland SE, Meisinger C, Memari Y, Mihailov E, Miller K, Moffatt MF, Nauck M, Novatchkova M, Nutile T, Olafsson I, Onundarson PT, Parracciani D, Penninx BW, Perseu L, Piga A, Pistis G, Pouta A, Puc U, Raitakari O, Ring SM, Robino A, Ruggiero D, Ruokonen A, Saint-Pierre A, Sala C, Salumets A, Sambrook J, Schepers H, Schmidt CO, Silljé HHW, Sladek R, Smit JH, Starr JM, Stephens J, Sulem P, Tanaka T, Thorsteinsdottir U, Tragante V, van Gilst WH, van Pelt LJ, van Veldhuisen DJ, Völker U, Whitfield JB, Willemsen G, Winkelmann BR, Wirnsberger G, Algra A, Cucca F, d'Adamo AP, Danesh J, Deary IJ, Dominiczak AF, Elliott P, Fortina P, Froguel P, Gasparini P, Greinacher A, Hazen SL, Jarvelin MR, Khaw KT, Lehtimäki T, Maerz W, Martin NG, Metspalu A, Mitchell BD, Montgomery GW, Moore C, Navis G, Pirastu M, Pramstaller PP, Ramirez-Solis R, Schadt E, Scott J, Shuldiner AR, Smith GD, Smith JG, Snieder H, Sorice R, Spector TD, Stefansson K, Stumvoll M, Tang WHW, Toniolo D, Tönjes A, Visscher PM, Vollenweider P, Wareham NJ, Wolffenbuttel BHR, Boomsma DI, Beckmann JS, Dedoussis GV, Deloukas P, Ferreira MA, Sanna S, Uda M, Hicks AA, Penninger JM, Gieger C, Kooner JS, Ouwehand WH, Soranzo N, Chambers JC. Seventy-five genetic loci influencing the human red blood cell. Nature 2012; 492:369-75. [PMID: 23222517 DOI: 10.1038/nature11677] [Citation(s) in RCA: 245] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 10/15/2012] [Indexed: 11/09/2022]
Abstract
Anaemia is a chief determinant of global ill health, contributing to cognitive impairment, growth retardation and impaired physical capacity. To understand further the genetic factors influencing red blood cells, we carried out a genome-wide association study of haemoglobin concentration and related parameters in up to 135,367 individuals. Here we identify 75 independent genetic loci associated with one or more red blood cell phenotypes at P < 10(-8), which together explain 4-9% of the phenotypic variance per trait. Using expression quantitative trait loci and bioinformatic strategies, we identify 121 candidate genes enriched in functions relevant to red blood cell biology. The candidate genes are expressed preferentially in red blood cell precursors, and 43 have haematopoietic phenotypes in Mus musculus or Drosophila melanogaster. Through open-chromatin and coding-variant analyses we identify potential causal genetic variants at 41 loci. Our findings provide extensive new insights into genetic mechanisms and biological pathways controlling red blood cell formation and function.
Collapse
Affiliation(s)
- Pim van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Morandi A, Meyre D, Lobbens S, Kleinman K, Kaakinen M, Rifas-Shiman SL, Vatin V, Gaget S, Pouta A, Hartikainen AL, Laitinen J, Ruokonen A, Das S, Khan AA, Elliott P, Maffeis C, Gillman MW, Järvelin MR, Froguel P. Estimation of newborn risk for child or adolescent obesity: lessons from longitudinal birth cohorts. PLoS One 2012; 7:e49919. [PMID: 23209618 PMCID: PMC3509134 DOI: 10.1371/journal.pone.0049919] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 10/15/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Prevention of obesity should start as early as possible after birth. We aimed to build clinically useful equations estimating the risk of later obesity in newborns, as a first step towards focused early prevention against the global obesity epidemic. METHODS We analyzed the lifetime Northern Finland Birth Cohort 1986 (NFBC1986) (N = 4,032) to draw predictive equations for childhood and adolescent obesity from traditional risk factors (parental BMI, birth weight, maternal gestational weight gain, behaviour and social indicators), and a genetic score built from 39 BMI/obesity-associated polymorphisms. We performed validation analyses in a retrospective cohort of 1,503 Italian children and in a prospective cohort of 1,032 U.S. children. RESULTS In the NFBC1986, the cumulative accuracy of traditional risk factors predicting childhood obesity, adolescent obesity, and childhood obesity persistent into adolescence was good: AUROC = 0·78[0·74-0.82], 0·75[0·71-0·79] and 0·85[0·80-0·90] respectively (all p<0·001). Adding the genetic score produced discrimination improvements ≤1%. The NFBC1986 equation for childhood obesity remained acceptably accurate when applied to the Italian and the U.S. cohort (AUROC = 0·70[0·63-0·77] and 0·73[0·67-0·80] respectively) and the two additional equations for childhood obesity newly drawn from the Italian and the U.S. datasets showed good accuracy in respective cohorts (AUROC = 0·74[0·69-0·79] and 0·79[0·73-0·84]) (all p<0·001). The three equations for childhood obesity were converted into simple Excel risk calculators for potential clinical use. CONCLUSION This study provides the first example of handy tools for predicting childhood obesity in newborns by means of easily recorded information, while it shows that currently known genetic variants have very little usefulness for such prediction.
Collapse
Affiliation(s)
- Anita Morandi
- Unité Mixte de Recherche 8199, Centre National de Recherche Scientifique (CNRS) and Pasteur Institute, Lille, France
- Regional Centre for Juvenile Diabetes, Obesity and Clinical Nutrition, University of Verona, Verona, Italy
| | - David Meyre
- Unité Mixte de Recherche 8199, Centre National de Recherche Scientifique (CNRS) and Pasteur Institute, Lille, France
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| | - Stéphane Lobbens
- Unité Mixte de Recherche 8199, Centre National de Recherche Scientifique (CNRS) and Pasteur Institute, Lille, France
| | - Ken Kleinman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
| | - Marika Kaakinen
- Institute of Health Sciences and Biocenter, University of Oulu, Oulu, Finland
| | - Sheryl L. Rifas-Shiman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
| | - Vincent Vatin
- Unité Mixte de Recherche 8199, Centre National de Recherche Scientifique (CNRS) and Pasteur Institute, Lille, France
| | - Stefan Gaget
- Unité Mixte de Recherche 8199, Centre National de Recherche Scientifique (CNRS) and Pasteur Institute, Lille, France
| | - Anneli Pouta
- Department of Children, Young People and Families, National Institute for Health and Welfare, Helsinki, Finland
- Institute of Clinical Medicine/Obstetrics and Gynecology, University of Oulu, Oulu, Finland
| | - Anna-Liisa Hartikainen
- Institute of Clinical Medicine/Obstetrics and Gynecology, University of Oulu, Oulu, Finland
| | - Jaana Laitinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Aimo Ruokonen
- Department of Clinical Sciences and Clinical Chemistry, University of Oulu, Oulu, Finland
| | - Shikta Das
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Anokhi Ali Khan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
- Centre for Environment and Health, School of Public Health, Imperial College, London, United Kingdom
| | - Claudio Maffeis
- Regional Centre for Juvenile Diabetes, Obesity and Clinical Nutrition, University of Verona, Verona, Italy
| | - Matthew W. Gillman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
| | - Marjo-Riitta Järvelin
- Institute of Health Sciences and Biocenter, University of Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
- Centre for Environment and Health, School of Public Health, Imperial College, London, United Kingdom
- Department of Life Course and Services, National Institute for Health and Welfare, Oulu, Finland
| | - Philippe Froguel
- Unité Mixte de Recherche 8199, Centre National de Recherche Scientifique (CNRS) and Pasteur Institute, Lille, France
- Department of Genomics of Common Disease, School of Public Health, Imperial College, London, United Kingdom
| |
Collapse
|
39
|
Costelloe SJ, El-Sayed Moustafa JS, Drenos F, Palmen J, Li Q, Qiao L, Whiting S, Thomas M, Kivimaki M, Kumari M, Hingorani AD, Tzoulaki I, Järvelin MR, Marjo-Riitta J, Ruokonen A, Aimo R, Hartikainen AL, Pouta A, Walters RG, Blakemore AIF, Humphries SE, Coin LJM, Talmud PJ. Gene-targeted analysis of copy number variants identifies 3 novel associations with coronary heart disease traits. Circ Cardiovasc Genet 2012; 5:555-60. [PMID: 22972876 DOI: 10.1161/circgenetics.111.961037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Copy number variants (CNVs) are a major form of genomic variation, which may be implicated in complex disease phenotypes. However, investigation of the role of CNVs in coronary heart disease (CHD) traits has been limited. METHODS AND RESULTS We examined the use of the cnvHap algorithm for CNV detection, using data for 2500 men from the Second Northwick Park Heart Study (NPHS-II). An Illumina custom chip, including 722 single-nucleotide polymorphisms covering 76 coronary heart disease-trait genes, was used. Common CNVs were significantly associated (at P<0.05, after correction) with coronary heart disease phenotypes in 5 genes. Novel associations of CNVs in toll-like receptor-4 with apolipoprotein AI were replicated (P<0.05) in the Whitehall II cohort (4887 subjects), whereas newly described associations of CNVs in sterol regulatory element-binding protein with apolipoprotein AI and associations of interleukin-6 signal transducer with apolipoprotein B were replicated in the data from 3546 subjects from the North Finnish Birth Cohort 1966 (P<0.05). CONCLUSIONS This study supports the use of CNV detection algorithms such as cnvHap as potential tools for the identification of novel CNVs, some of which show significant association and replication with coronary heart disease risk phenotypes. However, the functional basis for these associations requires further substantiation.
Collapse
Affiliation(s)
- Seán J Costelloe
- Center for Cardiovascular Genetics, Institute of Cardiovascular Science, The Royal Free London NHS Foundation Trust, Pond St, London, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Männistö T, Karumanchi SA, Pouta A, Vääräsmäki M, Mendola P, Miettola S, Surcel HM, Bloigu A, Ruokonen A, Järvelin MR, Hartikainen AL, Suvanto E. Preeclampsia, gestational hypertension and subsequent hypothyroidism. Pregnancy Hypertens 2012; 3:21-27. [PMID: 23439671 DOI: 10.1016/j.preghy.2012.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES: To evaluate the effect of preeclampsia (PE) and gestational hypertension (GH) on subsequent hypothyroidism. Recent studies suggest that women with PE have increased risk for reduced thyroid function, but the association between PE and GH with overt hypothyroidism has not been examined. STUDY DESIGN: Two prospective population-based cohort studies, the Northern Finland Birth Cohorts 1966 and 1986, followed women who had PE (N=955), GH (N=1449) or were normotensive (N=13531) during pregnancy. Finnish national registers were used to confirm subsequent hypothyroidism. Adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) estimated hypothyroidism risk when comparing women with PE or GH with normotensive women. MAIN OUTCOME MEASURES: Primary hypothyroidism during follow-up of 20-40 years. RESULTS: The subsequent prevalence of hypothyroidism was higher among women with PE (4.0%) and GH (4.5%) compared with normotensive women (3.5%), but the risk increase was not significant (aHR for PE 1.13, 95%CI 0.80-1.59 and aHR for GH 1.11, 95%CI 0.85-1.45). Subgroup analysis among nulliparous women revealed a significant association between late PE and subsequent hypothyroidism (aHR 1.82, 95%CI 1.04-3.19). Early or recurrent PE were not associated with hypothyroidism (aHR 0.93, 95%CI 0.46-1.81 and aHR 1.35, 95%CI 0.63-2.88, respectively). CONCLUSIONS: Overall, PE or GH during pregnancy was not significantly associated with subsequent hypothyroidism in Finnish women after 20-40 years of follow-up. However, late PE in nulliparous women was associated with a 1.8-fold increased risk of subsequent hypothyroidism, a finding that merits further study in other populations.
Collapse
Affiliation(s)
- Tuija Männistö
- Epidemiology Branch, Department of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD-20852, USA ; Department of Clinical Chemistry, University of Oulu, Oulu-90014, Finland
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Kallio S, Puurunen J, Ruokonen A, Piltonen T, Tapanainen J. Anti-müllerian hormone as a marker of follicular inhibition by combined contraception – a randomized study. Fertil Steril 2012. [DOI: 10.1016/j.fertnstert.2012.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
42
|
Männistö T, Hartikainen AL, Vääräsmäki M, Bloigu A, Surcel HM, Pouta A, Järvelin MR, Ruokonen A, Suvanto E. Smoking and early pregnancy thyroid hormone and anti-thyroid antibody levels in euthyroid mothers of the Northern Finland Birth Cohort 1986. Thyroid 2012; 22:944-50. [PMID: 22873201 PMCID: PMC3429279 DOI: 10.1089/thy.2011.0377] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Smokers in the general population have lower thyrotropin (TSH) and higher free triiodothyronine (fT3) and free thyroxine (fT4) concentrations, but the results in pregnant population vary from no effect to a decrease in TSH and fT4 concentrations and an increase in fT3 levels. Our objective was to further evaluate the question of whether there is an association between smoking, before and during pregnancy, with maternal thyroid function during pregnancy and with the risk for subsequent hypothyroidism. METHODS Our study population was a prospective population-based cohort (N=9362), the Northern Finland Birth Cohort 1986, with extensive data throughout gestation. The mothers underwent serum sampling in early pregnancy. The samples were assayed for TSH, fT3, fT4, thyroid-peroxidase antibodies (TPO-Ab), and thyroglobulin antibodies (TG-Abs) (n=5805). Mothers with thyroid dysfunction diagnosed before or during pregnancy were excluded, leaving 4837 euthyroid mothers. The smoking status of mothers and fathers were requested by questionnaires during pregnancy. Subsequent maternal morbidity relating to hypothyroidism 20 years after the index pregnancy was evaluated using national registers. RESULTS Euthyroid mothers who smoked before, or continued smoking during first trimester of pregnancy, had higher serum fT3 (p<0.001) and lower fT4 (p=0.023) concentrations than nonsmokers. Smoking in the second trimester was associated with higher fT3 (p<0.001) concentrations, but no difference in fT4 concentrations compared with nonsmokers. TG-Abs were less common among smoking than nonsmoking mothers (2.5% vs. 4.7%, p<0.001), but the prevalence of TPO-Ab was similar. Paternal smoking had no independent effect on maternal early pregnancy thyroid hormone or antibody concentrations. The risk of subsequent maternal hypothyroidism after follow-up of 20 years was similar among prepregnancy smokers and nonsmokers. CONCLUSIONS In euthyroid women, smoking during pregnancy was associated with higher fT3 levels and lower fT4 levels; possibly reflecting smoking-induced changes in peripheral metabolism of thyroid hormones. No differences were found in TSH concentrations between smokers and nonsmokers. Our results differ from those of the general population, which usually have shown smoking-induced thyroidal stimulation. This is possibly due to pregnancy-induced changes in thyroid function. Decreases in fT4 levels among smokers might predispose to hypothyroidism or hypothyroxinemia during pregnancy. Despite these changes in thyroid function, smoking did not increase the woman's risk of subsequent hypothyroidism.
Collapse
Affiliation(s)
- Tuija Männistö
- Department of Clinical Chemistry, University of Oulu, Oulu, Finland
- Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland
| | | | - Marja Vääräsmäki
- Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland
| | - Aini Bloigu
- National Institute for Health and Welfare, Oulu, Finland
| | | | - Anneli Pouta
- National Institute for Health and Welfare, Oulu, Finland
| | - Marjo-Riitta Järvelin
- National Institute for Health and Welfare, Oulu, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Aimo Ruokonen
- Department of Clinical Chemistry, University of Oulu, Oulu, Finland
| | - Eila Suvanto
- Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland
| |
Collapse
|
43
|
Pinola P, Lashen H, Bloigu A, Puukka K, Ulmanen M, Ruokonen A, Martikainen H, Pouta A, Franks S, Hartikainen AL, Järvelin MR, Morin-Papunen L. Menstrual disorders in adolescence: a marker for hyperandrogenaemia and increased metabolic risks in later life? Finnish general population-based birth cohort study. Hum Reprod 2012; 27:3279-86. [PMID: 22933528 DOI: 10.1093/humrep/des309] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Are self-reported menstrual disorders associated with hyperandrogenaemia and metabolic disturbances as early as in adolescence? SUMMARY ANSWER Menstrual disorders at the age 16 are a good marker of hyperandrogenaemia, and an adverse lipid profile was associated with higher androgen levels. WHAT IS KNOWN AND WHAT THIS PAPER ADDS Hyperandrogenism per se has been suggested to be a significant metabolic risk factor in women and a cause of physical and psychological morbidity in adolescent girls. A weak positive correlation has been described between hyperandrogenaemia and obesity in adolescent girls, but the clinical consequences are still poorly understood. Hyperandrogenism and insulin resistance are also key features of polycystic ovary syndrome (PCOS), and women with PCOS are consequently at an increased risk of developing type 2 diabetes mellitus and/or metabolic syndrome, and may have increased cardiovascular morbidity. Our findings confirm that the association between menstrual disorders, hyperandrogenism, obesity and metabolic risks is already evident in adolescence. STUDY DESIGN This population-based, cross-sectional study used postal questionnaires to targeting 15-16-year-old girls in the Northern Finland Birth Cohort 1986 (n= 4567). PARTICIPANTS AND SETTING There were 3669 girls who answered the postal questionnaire and out of 3373 girls who also underwent clinical examinations and blood tests, 2448 were included in the analyses. The questionnaire included one question about the regularity and length of the menstrual cycle: 'Is your menstrual cycle (the interval from the beginning of one menstrual period to the beginning of the next period) often (more than twice a year) longer than 35 days?' The girls who answered 'yes' to this question were considered to be suffering from menstrual disorders and were classified as 'symptomatic'. The girls who answered 'no' were defined as 'non-symptomatic'. MAIN RESULTS AND THE ROLE OF CHANCE There were 709 (29%) girls who reported menstrual disorders (symptomatic girls) and 1739 who had regular periods (non-symptomatic girls). In the whole population and in both study groups, there were significant correlations between body mass index (BMI) (and waist-to-hip ratio), hyperandrogenaemia and metabolic parameters. Symptomatic girls exhibited significantly higher serum concentrations of testosterone (P= 0.010), lower levels of sex hormone-binding globulin (P =0.042) and higher free androgen indices [FAIs; geometric mean 3.38 (interquartile range (IQR): 2.27, 5.18) versus 3.08 (IQR: 2.15, 4.74), P= 0.002]. The two groups had comparable BMI and insulin sensitivity, and serum levels of glucose, insulin and lipids. There was a significant linear trend towards higher FAI values in the higher BMI quartiles in both symptomatic and non-symptomatic girls. In the whole population, there was a statistically significant linear decrease in high-density lipoprotein concentrations (P < 0.001) and higher triglyceride concentrations (P =0.004) in the upper FAI quartile. IMPLICATIONS Information regarding menstrual disorders in adolescence is a good marker of hyperandrogenaemia and may be an early risk factor for the development of PCOS in adulthood. The association between obesity, hyperandrogenism and metabolic risks is already evident in adolescence, which strengthens the importance of noting menstrual disorders at an early stage. BIAS, LIMITATIONS, GENERALIZABILITY: The cross-sectional nature of the study does not allow us to draw conclusions concerning the metabolic risks of this population in later life. The diagnosis of menstrual disorders was based on a questionnaire, suggesting a risk of information bias in reporting the symptoms. This study was not designed to diagnose PCOS, as ultrasonography was not available and there was no clinical evaluation of hyperandrogenism (i.e. hirsutism). However, we were able to take into account potential confounding factors in the analyses. STUDY FUNDING/COMPETING INTERESTS This work was supported by grants from the Finnish Medical Society Duodecim, the North Ostrobothnia Regional Fund, the Academy of Finland (project grants 104781, 120315, 129269, 1114194, SALVE), University Hospital Oulu, Biocenter, University of Oulu, Finland (75617), the European Commission (EURO-BLCS, Framework 5 award QLG1-CT-2000-01643) and the Medical Research Council, UK (PrevMetSyn/SALVE). None of the authors have any conflict of interest to declare.
Collapse
Affiliation(s)
- P Pinola
- Department of Obstetrics and Gynaecology, University Hospital of Oulu, PL 23 90029 OYS, Oulu, Finland
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Coviello AD, Haring R, Wellons M, Vaidya D, Lehtimäki T, Keildson S, Lunetta KL, He C, Fornage M, Lagou V, Mangino M, Onland-Moret NC, Chen B, Eriksson J, Garcia M, Liu YM, Koster A, Lohman K, Lyytikäinen LP, Petersen AK, Prescott J, Stolk L, Vandenput L, Wood AR, Zhuang WV, Ruokonen A, Hartikainen AL, Pouta A, Bandinelli S, Biffar R, Brabant G, Cox DG, Chen Y, Cummings S, Ferrucci L, Gunter MJ, Hankinson SE, Martikainen H, Hofman A, Homuth G, Illig T, Jansson JO, Johnson AD, Karasik D, Karlsson M, Kettunen J, Kiel DP, Kraft P, Liu J, Ljunggren Ö, Lorentzon M, Maggio M, Markus MRP, Mellström D, Miljkovic I, Mirel D, Nelson S, Morin Papunen L, Peeters PHM, Prokopenko I, Raffel L, Reincke M, Reiner AP, Rexrode K, Rivadeneira F, Schwartz SM, Siscovick D, Soranzo N, Stöckl D, Tworoger S, Uitterlinden AG, van Gils CH, Vasan RS, Wichmann HE, Zhai G, Bhasin S, Bidlingmaier M, Chanock SJ, De Vivo I, Harris TB, Hunter DJ, Kähönen M, Liu S, Ouyang P, Spector TD, van der Schouw YT, Viikari J, Wallaschofski H, McCarthy MI, Frayling TM, Murray A, Franks S, Järvelin MR, de Jong FH, Raitakari O, Teumer A, Ohlsson C, Murabito JM, Perry JRB. A genome-wide association meta-analysis of circulating sex hormone-binding globulin reveals multiple Loci implicated in sex steroid hormone regulation. PLoS Genet 2012; 8:e1002805. [PMID: 22829776 PMCID: PMC3400553 DOI: 10.1371/journal.pgen.1002805] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 05/19/2012] [Indexed: 01/28/2023] Open
Abstract
Sex hormone-binding globulin (SHBG) is a glycoprotein responsible for the transport and biologic availability of sex steroid hormones, primarily testosterone and estradiol. SHBG has been associated with chronic diseases including type 2 diabetes (T2D) and with hormone-sensitive cancers such as breast and prostate cancer. We performed a genome-wide association study (GWAS) meta-analysis of 21,791 individuals from 10 epidemiologic studies and validated these findings in 7,046 individuals in an additional six studies. We identified twelve genomic regions (SNPs) associated with circulating SHBG concentrations. Loci near the identified SNPs included SHBG (rs12150660, 17p13.1, p = 1.8 × 10(-106)), PRMT6 (rs17496332, 1p13.3, p = 1.4 × 10(-11)), GCKR (rs780093, 2p23.3, p = 2.2 × 10(-16)), ZBTB10 (rs440837, 8q21.13, p = 3.4 × 10(-09)), JMJD1C (rs7910927, 10q21.3, p = 6.1 × 10(-35)), SLCO1B1 (rs4149056, 12p12.1, p = 1.9 × 10(-08)), NR2F2 (rs8023580, 15q26.2, p = 8.3 × 10(-12)), ZNF652 (rs2411984, 17q21.32, p = 3.5 × 10(-14)), TDGF3 (rs1573036, Xq22.3, p = 4.1 × 10(-14)), LHCGR (rs10454142, 2p16.3, p = 1.3 × 10(-07)), BAIAP2L1 (rs3779195, 7q21.3, p = 2.7 × 10(-08)), and UGT2B15 (rs293428, 4q13.2, p = 5.5 × 10(-06)). These genes encompass multiple biologic pathways, including hepatic function, lipid metabolism, carbohydrate metabolism and T2D, androgen and estrogen receptor function, epigenetic effects, and the biology of sex steroid hormone-responsive cancers including breast and prostate cancer. We found evidence of sex-differentiated genetic influences on SHBG. In a sex-specific GWAS, the loci 4q13.2-UGT2B15 was significant in men only (men p = 2.5 × 10(-08), women p = 0.66, heterogeneity p = 0.003). Additionally, three loci showed strong sex-differentiated effects: 17p13.1-SHBG and Xq22.3-TDGF3 were stronger in men, whereas 8q21.12-ZBTB10 was stronger in women. Conditional analyses identified additional signals at the SHBG gene that together almost double the proportion of variance explained at the locus. Using an independent study of 1,129 individuals, all SNPs identified in the overall or sex-differentiated or conditional analyses explained ~15.6% and ~8.4% of the genetic variation of SHBG concentrations in men and women, respectively. The evidence for sex-differentiated effects and allelic heterogeneity highlight the importance of considering these features when estimating complex trait variance.
Collapse
Affiliation(s)
- Andrea D. Coviello
- Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts, United States of America
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, Massachusetts, United States of America
- National Heart, Lung, and Blood Institute's The Framingham Heart Study, Framingham, Massachusetts, United States of America
| | - Robin Haring
- Institute for Clinical Chemistry and Laboratory Medicine, University Medicine, Ernst-Moritz-Arndt University of Greifswald, Greifswald, Germany
| | - Melissa Wellons
- Department of Medicine and Department of Obstetrics and Gynecology, The University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Dhananjay Vaidya
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere University Hospital and University of Tampere School of Medicine, Tampere, Finland
| | - Sarah Keildson
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Kathryn L. Lunetta
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Chunyan He
- Department of Public Health, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
- Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana, United States of America
| | - Myriam Fornage
- University of Texas Health Sciences Center at Houston, Houston, Texas, United States of America
| | - Vasiliki Lagou
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - N. Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Brian Chen
- Program on Genomics and Nutrition and the Center for Metabolic Disease Prevention, School of Public Health, University of California Los Angeles, Los Angeles, California, United States of America
| | - Joel Eriksson
- Center for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Melissa Garcia
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland, United States of America
| | - Yong Mei Liu
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, North Carolina, United States of America
| | - Annemarie Koster
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland, United States of America
| | - Kurt Lohman
- Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere University Hospital and University of Tampere School of Medicine, Tampere, Finland
| | - Ann-Kristin Petersen
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Jennifer Prescott
- Program in Molecular and Genetic Epidemiology, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Lisette Stolk
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Consortium of Healthy Aging, Rotterdam, The Netherlands
| | - Liesbeth Vandenput
- Center for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andrew R. Wood
- Genetics of Complex Traits, Peninsula Medical School, University of Exeter, Exeter, United Kingdom
| | - Wei Vivian Zhuang
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Aimo Ruokonen
- Institute of Diagnostics, University of Oulu, Oulu, Finland
| | | | - Anneli Pouta
- National Institute for Health and Welfare and Institute of Health Sciences, University of Oulu, Oulu, Finland
| | | | - Reiner Biffar
- Department of Prosthetic Dentistry, Gerostomatology, and Dental Materials, University of Greifswald, Greifswald, Germany
| | - Georg Brabant
- Experimental and Clinical Endocrinology, University of Lübeck, Lübeck, Germany
| | - David G. Cox
- Cancer Research Center of Lyon, INSERM U1052, Lyon, France
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Yuhui Chen
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
| | - Steven Cummings
- California Pacific Medical Center, San Francisco, California, United States of America
| | - Luigi Ferrucci
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, United States of America
| | - Marc J. Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Susan E. Hankinson
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, United States of America
- Division of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Massachusetts, United States of America
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Hannu Martikainen
- Department of Obstetrics and Gynecology, University Hospital of Oulu, Oulu, Finland
| | - Albert Hofman
- Netherlands Consortium of Healthy Aging, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, Germany
| | - Thomas Illig
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - John-Olov Jansson
- Center for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andrew D. Johnson
- National Heart, Lung, and Blood Institute's The Framingham Heart Study, Framingham, Massachusetts, United States of America
| | - David Karasik
- Hebrew SeniorLife Institute for Aging Research and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Magnus Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Department of Orthopaedics, Lund University, Malmö, Sweden
| | - Johannes Kettunen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Douglas P. Kiel
- Hebrew SeniorLife Institute for Aging Research and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Peter Kraft
- Program in Molecular and Genetic Epidemiology, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Jingmin Liu
- Women's Health Initiative Clinical Coordinating Center, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Östen Ljunggren
- Department of Medical Sciences, University of Uppsala, Uppsala, Sweden
| | - Mattias Lorentzon
- Center for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marcello Maggio
- Department of Internal Medicine and Biomedical Sciences, Section of Geriatrics, University of Parma, Parma, Italy
| | | | - Dan Mellström
- Center for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Iva Miljkovic
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Daniel Mirel
- Gene Environment Initiative, Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Boston, Massachusetts, United States of America
| | - Sarah Nelson
- Department of Biostatistics, University of Washington, Seattle, Washington, United States of America
| | - Laure Morin Papunen
- Department of Obstetrics and Gynecology, University Hospital of Oulu, Oulu, Finland
| | - Petra H. M. Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Inga Prokopenko
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, United Kingdom
| | - Leslie Raffel
- Medical Genetics Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
| | - Martin Reincke
- Medizinische Klinik and Poliklinik IV, Ludwig-Maximilians University, Munich, Germany
| | - Alex P. Reiner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Kathryn Rexrode
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Consortium of Healthy Aging, Rotterdam, The Netherlands
| | - Stephen M. Schwartz
- Cardiovascular Health Research Unit, Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - David Siscovick
- Cardiovascular Health Research Unit, Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Nicole Soranzo
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Human Genetics, Wellcome Trust Sanger Institute, Hinxton, United Kingdom
| | - Doris Stöckl
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany
- Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University, Munich, Germany
| | - Shelley Tworoger
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - André G. Uitterlinden
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Consortium of Healthy Aging, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Carla H. van Gils
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ramachandran S. Vasan
- Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, Massachusetts, United States of America
- National Heart, Lung, and Blood Institute's The Framingham Heart Study, Framingham, Massachusetts, United States of America
| | - H.-Erich Wichmann
- Institute of Epidemiology I, Helmholtz Zentrum München, Neuherberg, Germany
- Institute of Medical Informatics, Biometry, and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany
- Klinikum Großhadern, Munich, Germany
| | - Guangju Zhai
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Discipline of Genetics, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Shalender Bhasin
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Martin Bidlingmaier
- Medizinische Klinik and Poliklinik IV, Ludwig-Maximilians University, Munich, Germany
| | - Stephen J. Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Immaculata De Vivo
- Program in Molecular and Genetic Epidemiology, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Tamara B. Harris
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland, United States of America
| | - David J. Hunter
- Program in Molecular and Genetic Epidemiology, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and University of Tampere School of Medicine, Tampere, Finland
| | - Simin Liu
- Program on Genomics and Nutrition, Department of Epidemiology, University of California Los Angeles, Los Angeles, California, United States of America
| | - Pamela Ouyang
- Division of Cardiology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, United States of America
| | - Tim D. Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jorma Viikari
- Department of Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Henri Wallaschofski
- Institute for Clinical Chemistry and Laboratory Medicine, University Medicine, Ernst-Moritz-Arndt University of Greifswald, Greifswald, Germany
| | - Mark I. McCarthy
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Churchill Hospital, Oxford, United Kingdom
- Oxford NIHR Biomedical Research Centre, Churchill Hospital, Oxford, United Kingdom
| | - Timothy M. Frayling
- Genetics of Complex Traits, Peninsula Medical School, University of Exeter, Exeter, United Kingdom
| | - Anna Murray
- Genetics of Complex Traits, Peninsula Medical School, University of Exeter, Exeter, United Kingdom
| | - Steve Franks
- Institute of Reproductive and Developmental Biology, Imperial College London, London, United Kingdom
| | - Marjo-Riitta Järvelin
- Department of Biostatistics and Epidemiology, School of Public Health, MRC-HPA Centre for Environment and Health, Faculty of Medicine, Imperial College London, London, United Kingdom
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
- National Institute of Health and Welfare, University of Oulu, Oulu, Finland
| | - Frank H. de Jong
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Olli Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital and Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Alexander Teumer
- Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Greifswald, Germany
| | - Claes Ohlsson
- Center for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Joanne M. Murabito
- National Heart, Lung, and Blood Institute's The Framingham Heart Study, Framingham, Massachusetts, United States of America
- Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
- * E-mail: (JM Murabito); (JRB Perry)
| | - John R. B. Perry
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Genetics of Complex Traits, Peninsula Medical School, University of Exeter, Exeter, United Kingdom
- * E-mail: (JM Murabito); (JRB Perry)
| |
Collapse
|
45
|
Piltonen T, Puurunen J, Hedberg P, Ruokonen A, Mutt SJ, Herzig KH, Nissinen A, Morin-Papunen L, Tapanainen JS. Oral, transdermal and vaginal combined contraceptives induce an increase in markers of chronic inflammation and impair insulin sensitivity in young healthy normal-weight women: a randomized study. Hum Reprod 2012; 27:3046-56. [PMID: 22811306 DOI: 10.1093/humrep/des225] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
STUDY QUESTION What is the effect of alternative administration routes of combined contraceptives (CCs) on androgen secretion, chronic inflammation, glucose tolerance and lipid profile? SUMMARY ANSWER The use of oral, transdermal and vaginal CCs impairs glucose tolerance and induces chronic inflammation. WHAT IS KNOWN AND WHAT THIS PAPER ADDS Oral CCs worsen insulin sensitivity and are associated with increased levels of circulating inflammatory markers, whereas the metabolic effects of transdermal and vaginal CCs have been reported to be minimal. This is the first study comparing three different administration routes of CCs on metabolic variables. STUDY DESIGN, SIZE AND DURATION This randomized (computer-generated) open-label 9-week follow-up study was conducted at the Oulu University Hospital, Finland. Fasting blood samples were collected at baseline and thereafter at 5 and 9 weeks of treatment, and serum levels of 17-hydroxyprogesterone, androstenedione, testosterone, C-reactive protein (CRP), sex hormone-binding globulin (SHBG), glucose, insulin, C-peptide, total, low-density lipoprotein and high-density lipoprotein cholesterol and triglycerides were measured. Oral glucose tolerance tests were performed and plasma levels of pentraxin 3 (PTX-3) were measured at 0 and 9 weeks. The randomization list, with an allocation ratio of 1:1:1 and block size of six, was computer generated and constructed by a pharmacist at the Oulu University Hospital. The research nurse controlled the randomization list and assigned participants to their groups at the first visit. PARTICIPANTS AND SETTING Forty-two of 54 healthy women who entered the study used oral contraceptive pills (n = 13), transdermal contraceptive patches (n = 15) or contraceptive vaginal rings (n = 14) continuously for 9 weeks. Inclusion criteria were regular menstrual cycles, at least a 2-month washout as regards hormonal contraceptives and no medication. MAIN RESULTS AND THE ROLE OF CHANCE Serum levels of SHBG increased and consequently the free androgen index (FAI) decreased in all study groups from baseline to 9 weeks of treatment [FAI, oral: 1.3 (95% confidence interval, CI: 0.94; 1.62) to 0.40 (0.25; 0.54); transdermal: 1.2 (0.96; 1.4) to 0.36 (0.30; 0.43); vaginal: 1.6 (1.1; 2.1) to 0.43 (0.29; 0.58), P < 0.001 in all groups]. Insulin sensitivity was reduced at 9 weeks in all three groups according to the Matsuda index [oral: 7.3 (5.5; 9.0) to 5.6 (3.9; 7.3); transdermal: 9.1 (6.7; 11.4) to 6.6 (4.5; 8.8); vaginal: 7.7 (5.9; 9.5) to 5.4 (3.9; 7.0), P= 0.004-0.024]. Levels of HDL cholesterol, triglycerides and CRP rose in all three groups [CRP, oral: 0.70 (0.38; 1.0) to 5.4 (1.0; 9.9) mg/l; transdermal: 0.77 (0.45; 1.1) to 2.9 (1.4;4.4) mg/l; vaginal: 0.98 (0.52; 1.4) to 3.7 (-0.25; 7.7, a negative value due to skewed distribution to right) mg/l, P≤ 0.002 in all groups] and PTX-3 levels increased in the oral and transdermal study groups (P = 0.007 and P = 0.002). WIDER IMPLICATIONS OF THE FINDINGS Although the long-term consequences of the present results remain undetermined, these findings emphasize the importance of monitoring glucose metabolism during the use of CCs, especially in women with known risks of type 2 diabetes or cardiovascular diseases. BIAS, LIMITATIONS, GENERALIZABILITY: The number of subjects was relatively low. Moreover, the 9-week exposure to CCs is too short to draw conclusions about the long-term health consequences. However, as the subjects were healthy, normal-weight young women, the possible alterations in the glucose and inflammatory profiles among women with known metabolic risks might be even greater. STUDY FUNDING/COMPETING INTERESTS This work was supported by grants from the Academy of Finland, the Sigrid Jusélius Foundation, the Finnish Medical Foundation, the Research Foundation of Obstetrics and Gynecology, Oulu University Scholarship Foundation, the North Ostrobothnia Regional Fund of the Finnish Cultural Foundation, the Tyyni Tani Foundation of the University of Oulu and the Finnish-Norwegian Medical Foundation. No competing interests. TRIAL REGISTRATION NUMBER NCT01087879.
Collapse
Affiliation(s)
- T Piltonen
- Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu FIN-90029, Finland
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Manning AK, Hivert MF, Scott RA, Grimsby JL, Bouatia-Naji N, Chen H, Rybin D, Liu CT, Bielak LF, Prokopenko I, Amin N, Barnes D, Cadby G, Hottenga JJ, Ingelsson E, Jackson AU, Johnson T, Kanoni S, Ladenvall C, Lagou V, Lahti J, Lecoeur C, Liu Y, Martinez-Larrad MT, Montasser ME, Navarro P, Perry JRB, Rasmussen-Torvik LJ, Salo P, Sattar N, Shungin D, Strawbridge RJ, Tanaka T, van Duijn CM, An P, de Andrade M, Andrews JS, Aspelund T, Atalay M, Aulchenko Y, Balkau B, Bandinelli S, Beckmann JS, Beilby JP, Bellis C, Bergman RN, Blangero J, Boban M, Boehnke M, Boerwinkle E, Bonnycastle LL, Boomsma DI, Borecki IB, Böttcher Y, Bouchard C, Brunner E, Budimir D, Campbell H, Carlson O, Chines PS, Clarke R, Collins FS, Corbatón-Anchuelo A, Couper D, de Faire U, Dedoussis GV, Deloukas P, Dimitriou M, Egan JM, Eiriksdottir G, Erdos MR, Eriksson JG, Eury E, Ferrucci L, Ford I, Forouhi NG, Fox CS, Franzosi MG, Franks PW, Frayling TM, Froguel P, Galan P, de Geus E, Gigante B, Glazer NL, Goel A, Groop L, Gudnason V, Hallmans G, Hamsten A, Hansson O, Harris TB, Hayward C, Heath S, Hercberg S, Hicks AA, Hingorani A, Hofman A, Hui J, Hung J, Jarvelin MR, Jhun MA, Johnson PC, Jukema JW, Jula A, Kao W, Kaprio J, Kardia SLR, Keinanen-Kiukaanniemi S, Kivimaki M, Kolcic I, Kovacs P, Kumari M, Kuusisto J, Kyvik KO, Laakso M, Lakka T, Lannfelt L, Lathrop GM, Launer LJ, Leander K, Li G, Lind L, Lindstrom J, Lobbens S, Loos RJF, Luan J, Lyssenko V, Mägi R, Magnusson PKE, Marmot M, Meneton P, Mohlke KL, Mooser V, Morken MA, Miljkovic I, Narisu N, O’Connell J, Ong KK, Oostra BA, Palmer LJ, Palotie A, Pankow JS, Peden JF, Pedersen NL, Pehlic M, Peltonen L, Penninx B, Pericic M, Perola M, Perusse L, Peyser PA, Polasek O, Pramstaller PP, Province MA, Räikkönen K, Rauramaa R, Rehnberg E, Rice K, Rotter JI, Rudan I, Ruokonen A, Saaristo T, Sabater-Lleal M, Salomaa V, Savage DB, Saxena R, Schwarz P, Seedorf U, Sennblad B, Serrano-Rios M, Shuldiner AR, Sijbrands EJ, Siscovick DS, Smit JH, Small KS, Smith NL, Smith AV, Stančáková A, Stirrups K, Stumvoll M, Sun YV, Swift AJ, Tönjes A, Tuomilehto J, Trompet S, Uitterlinden AG, Uusitupa M, Vikström M, Vitart V, Vohl MC, Voight BF, Vollenweider P, Waeber G, Waterworth DM, Watkins H, Wheeler E, Widen E, Wild SH, Willems SM, Willemsen G, Wilson JF, Witteman JC, Wright AF, Yaghootkar H, Zelenika D, Zemunik T, Zgaga L, Wareham NJ, McCarthy MI, Barroso I, Watanabe RM, Florez JC, Dupuis J, Meigs JB, Langenberg C. A genome-wide approach accounting for body mass index identifies genetic variants influencing fasting glycemic traits and insulin resistance. Nat Genet 2012; 44:659-69. [PMID: 22581228 PMCID: PMC3613127 DOI: 10.1038/ng.2274] [Citation(s) in RCA: 593] [Impact Index Per Article: 49.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 04/13/2012] [Indexed: 12/15/2022]
Abstract
Recent genome-wide association studies have described many loci implicated in type 2 diabetes (T2D) pathophysiology and β-cell dysfunction but have contributed little to the understanding of the genetic basis of insulin resistance. We hypothesized that genes implicated in insulin resistance pathways might be uncovered by accounting for differences in body mass index (BMI) and potential interactions between BMI and genetic variants. We applied a joint meta-analysis approach to test associations with fasting insulin and glucose on a genome-wide scale. We present six previously unknown loci associated with fasting insulin at P < 5 × 10(-8) in combined discovery and follow-up analyses of 52 studies comprising up to 96,496 non-diabetic individuals. Risk variants were associated with higher triglyceride and lower high-density lipoprotein (HDL) cholesterol levels, suggesting a role for these loci in insulin resistance pathways. The discovery of these loci will aid further characterization of the role of insulin resistance in T2D pathophysiology.
Collapse
Affiliation(s)
- Alisa K. Manning
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA
- Department of Molecular Biology, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts
| | - Marie-France Hivert
- General Medicine Division, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Universite de Sherbrooke, Sherbrooke, Québec, Canada
| | - Robert A. Scott
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Jonna L. Grimsby
- General Medicine Division, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Nabila Bouatia-Naji
- Institut Pasteur de Lille, Lille, France
- Lille Nord de France University, Lille, France
| | - Han Chen
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Denis Rybin
- Boston University Data Coordinating Center, Boston, Massachusetts, USA
| | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Lawrence F. Bielak
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Inga Prokopenko
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Najaf Amin
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Daniel Barnes
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Gemma Cadby
- Genetic Epidemiology and Biostatistics Platform, Ontario Institute for Cancer Research. Toronto, Canada
- Prosserman Centre for Health Research, Samuel Lunenfeld Research Institute, Toronto, Canada
| | - Jouke-Jan Hottenga
- Netherlands Twin Register, Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Erik Ingelsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anne U. Jackson
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Toby Johnson
- Clinical Pharmacology and The Genome Centre, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Stavroula Kanoni
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hixton, Cambridge, UK
| | - Claes Ladenvall
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University, Malmö, Sweden
- Lund University Diabetes Centre, Malmö, Sweden
| | - Vasiliki Lagou
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Jari Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Cecile Lecoeur
- Institut Pasteur de Lille, Lille, France
- Lille Nord de France University, Lille, France
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Maria Teresa Martinez-Larrad
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - May E. Montasser
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland, School of Medicine, Baltimore, Maryland, USA
| | - Pau Navarro
- MRC Human Genetics Unit, MRC IGMM, University of Edinburgh, Edinburgh, UK
| | - John R. B. Perry
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Genetics of Complex Traits, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, UK
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
| | - Laura J. Rasmussen-Torvik
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Perttu Salo
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | - Dmitry Shungin
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University, Malmö, Sweden
- Lund University Diabetes Centre, Malmö, Sweden
- Department of Public Health & Clinical Medicine, Genetic Epidemiology & Clinical Research Group, Umeå University Hospital, Umeå, Sweden
- Department of Odontology, Umeå University, Sweden
| | - Rona J. Strawbridge
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Toshiko Tanaka
- Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, USA
| | - Cornelia M. van Duijn
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Centre for medical systems biology, Netherlands Genomics Initiative, The Hague
- Netherlands Genomics Initiative and the Netherlands Consortium for Healthy Aging, Rotterdam, The Netherlands
| | - Ping An
- Department of Genetics Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Mariza de Andrade
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Jeanette S. Andrews
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Thor Aspelund
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | - Mustafa Atalay
- Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
| | - Yurii Aulchenko
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Beverley Balkau
- Inserm, CESP Centre for research in Epidemiology and Population Health, Villejuif, France
- University Paris Sud 11, Villejuif, France
| | | | - Jacques S. Beckmann
- Department of Medical Genetics, University of Lausanne, Lausanne, Switzerland
- Service of Medical Genetics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - John P. Beilby
- PathWest Laboratory Medicine of WA, J Block, QEII Medical Centre, Nedlands, Australia
- School of Pathology and Laboratory Medicine, The University of Western Australia, Nedlands, Australia
- Busselton Population Medical Research Foundation, B Block, QEII Medical Centre, Nedlands, Australia
| | - Claire Bellis
- Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Richard N. Bergman
- Department of Physiology & Biophysics, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - John Blangero
- Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Mladen Boban
- Department of Pharmacology, Faculty of Medicine, University of Split, Croatia
| | - Michael Boehnke
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Eric Boerwinkle
- Human Genetics Center, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Lori L. Bonnycastle
- Genome Technology Branch, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Dorret I. Boomsma
- Netherlands Twin Register, Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Ingrid B. Borecki
- Department of Genetics Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Yvonne Böttcher
- IFB Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - Claude Bouchard
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Eric Brunner
- University College London, Department of Epidemiology & Public Health, London, UK
| | - Danijela Budimir
- Department of Pharmacology, Faculty of Medicine, University of Split, Croatia
| | - Harry Campbell
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Olga Carlson
- Laboratory of Clinical Investigation, National Institute of Aging, Baltimore, Maryland, USA
| | - Peter S. Chines
- Genome Technology Branch, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Robert Clarke
- Clinical Trial Service Unit, University of Oxford, Oxford, UK
| | - Francis S. Collins
- Genome Technology Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Arturo Corbatón-Anchuelo
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - David Couper
- Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Ulf de Faire
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - George V Dedoussis
- Department of Nutrition - Dietetics, Harokopio University, Athens, Greece
| | - Panos Deloukas
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hixton, Cambridge, UK
| | - Maria Dimitriou
- Department of Nutrition - Dietetics, Harokopio University, Athens, Greece
| | - Josephine M Egan
- Laboratory of Clinical Investigation, National Institute of Aging, Baltimore, Maryland, USA
| | | | - Michael R. Erdos
- Genome Technology Branch, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Johan G. Eriksson
- Department of General Practice and Primary health Care, University of Helsinki, Finland
- Helsinki University Central Hospital, Unit of General Practice, Helsinki, Finland
- Folkhalsan Research Centre, Helsinki, Finland
- Vaasa Central Hospital, Vaasa, Finland
- National Institute for Health and Welfare, Helsinki, Finland
| | - Elodie Eury
- Institut Pasteur de Lille, Lille, France
- Lille Nord de France University, Lille, France
| | - Luigi Ferrucci
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland, USA
| | - Ian Ford
- Robertson Centre for Biostatistics, University of Glasgow, UK
| | - Nita G. Forouhi
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Caroline S Fox
- National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, Massachusetts, USA
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Maria Grazia Franzosi
- Department of Cardiovascular Research, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Paul W Franks
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University, Malmö, Sweden
- Lund University Diabetes Centre, Malmö, Sweden
- Department of Public Health & Clinical Medicine, Genetic Epidemiology & Clinical Research Group, Umeå University Hospital, Umeå, Sweden
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
- Institut National de la Recherche Agronomique, Université Paris, Bobigny Cedex, France
| | - Timothy M Frayling
- Genetics of Complex Traits, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, UK
| | - Philippe Froguel
- Institut Pasteur de Lille, Lille, France
- Lille Nord de France University, Lille, France
- Genomic Medicine, Hammersmith Hospital, Imperial College London, London, UK
| | - Pilar Galan
- Institut National de la Santé et de la Recherche Médicale, Université Paris, Bobigny Cedex, France
| | - Eco de Geus
- Netherlands Twin Register, Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Bruna Gigante
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nicole L. Glazer
- Department of Medicine, Section of Preventive Medicine and Epidemiology, BU School of Medicine, Boston, Massachusetts, USA
- Department of Epidemiology, BU School of Public Health, Boston, Massachusetts, USA
| | - Anuj Goel
- Department of Cardiovascular Medicine and Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Leif Groop
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University, Malmö, Sweden
- Lund University Diabetes Centre, Malmö, Sweden
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | - Göran Hallmans
- Department of Public Health & Clinical Medicine, Nutrition Research, Umeå University, Sweden
| | - Anders Hamsten
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Ola Hansson
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University, Malmö, Sweden
- Lund University Diabetes Centre, Malmö, Sweden
| | - Tamara B. Harris
- Intramural Research Program, Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland, USA
| | - Caroline Hayward
- MRC Human Genetics Unit, MRC IGMM, University of Edinburgh, Edinburgh, UK
| | - Simon Heath
- Centre National de Génotypage, Commissariat à L’Energie Atomique, Institut de Génomique, Evry, France
| | - Serge Hercberg
- Institut National de la Santé et de la Recherche Médicale, Université Paris, Bobigny Cedex, France
| | - Andrew A. Hicks
- Center for Biomedicine, European Academy Bozen/Bolzano, Bolzano, Italy - Affiliated Institute of the University of Lübeck, Lübeck, Germany
| | - Aroon Hingorani
- Genetic epidemiology group, University College London, Department of Epidemiology & Public Health, London, UK
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Genomics Initiative and the Netherlands Consortium for Healthy Aging, Rotterdam, The Netherlands
| | - Jennie Hui
- PathWest Laboratory Medicine of WA, J Block, QEII Medical Centre, Nedlands, Australia
- School of Pathology and Laboratory Medicine, The University of Western Australia, Nedlands, Australia
- Busselton Population Medical Research Foundation, B Block, QEII Medical Centre, Nedlands, Australia
- School of Population Health, The University of Western Australia, Nedlands, Australia
| | - Joseph Hung
- Busselton Population Medical Research Foundation, B Block, QEII Medical Centre, Nedlands, Australia
- Sir Charles Gairdner Hospital Unit, School of Medicine & Pharmacology, University of Western Australia, Australia
| | - Marjo Riitta Jarvelin
- Department of Epidemiology and Biostatistics, School of Public Health, MRC-HPA Centre for Environment and Health, Faculty of Medicine, Imperial College London, UK
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
- National Institute of Health and Welfare, Oulu, Finland
| | - Min A. Jhun
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - J Wouter Jukema
- Department of Cardiology C5-P, Leiden University Medical Center, Leiden, the Netherlands
- Durrer Center for Cardiogenetic Research, Amsterdam, The Netherlands
| | - Antti Jula
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - W.H. Kao
- Division of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Jaakko Kaprio
- National Institute for Health and Welfare, Helsinki, Finland
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Hjelt Institute, Dept of Public Health, University of Helsinki, Finland
| | - Sharon L. R. Kardia
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Sirkka Keinanen-Kiukaanniemi
- Faculty of Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland
- Unit of General Practice, Oulu University Hospital, Oulu, Finland
| | - Mika Kivimaki
- University College London, Department of Epidemiology & Public Health, London, UK
| | - Ivana Kolcic
- Department of Public Health, Faculty of Medicine, University of Split, Croatia
| | - Peter Kovacs
- Interdisciplinary Centre for Clinical Research, University of Leipzig, Leipzig, Germany
| | - Meena Kumari
- Genetic epidemiology group, University College London, Department of Epidemiology & Public Health, London, UK
| | - Johanna Kuusisto
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Kirsten Ohm Kyvik
- Institute of Regional Health Services Research and Professor Odense Patient data Explorative Network (OPEN)
| | - Markku Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Timo Lakka
- Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio Campus, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Lars Lannfelt
- Department of Public Health and Caring Sciences, Uppsala University, Rudbecklaboratoriet, Uppsala, Sweden
| | - G Mark Lathrop
- Centre National de Génotypage, Commissariat à L’Energie Atomique, Institut de Génomique, Evry, France
| | - Lenore J. Launer
- Intramural Research Program, Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland, USA
| | - Karin Leander
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Guo Li
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA
| | - Lars Lind
- Department of Medical Sciences, University Hospital, Uppsala University, Uppsala, Sweden
| | - Jaana Lindstrom
- Diabetes Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Stéphane Lobbens
- Institut Pasteur de Lille, Lille, France
- Lille Nord de France University, Lille, France
| | - Ruth J. F. Loos
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Jian’an Luan
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Valeriya Lyssenko
- Department of Clinical Sciences, Diabetes and Endocrinology, Lund University, Malmö, Sweden
- Lund University Diabetes Centre, Malmö, Sweden
| | - Reedik Mägi
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Patrik K. E. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Michael Marmot
- University College London, Department of Epidemiology & Public Health, London, UK
| | - Pierre Meneton
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Paris, France
| | - Karen L. Mohlke
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Vincent Mooser
- Division of Genetics, GlaxoSmithKline, Philadelphia, Pennsylvania, USA
| | - Mario A. Morken
- Genome Technology Branch, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Iva Miljkovic
- Department of Epidemiology, Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Narisu Narisu
- Genome Technology Branch, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Jeff O’Connell
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland, School of Medicine, Baltimore, Maryland, USA
| | - Ken K. Ong
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Ben A. Oostra
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - Lyle J. Palmer
- Genetic Epidemiology and Biostatistics Platform, Ontario Institute for Cancer Research. Toronto, Canada
- Prosserman Centre for Health Research, Samuel Lunenfeld Research Institute, Toronto, Canada
| | - Aarno Palotie
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hixton, Cambridge, UK
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Department of Medical Genetics, University of Helsinki and Helsinki University Central Hospital, Finland
| | - James S. Pankow
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - John F. Peden
- Department of Cardiovascular Medicine and Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Marina Pehlic
- Department of Biology, Faculty of Medicine, University of Split, Croatia
| | - Leena Peltonen
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hixton, Cambridge, UK
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Brenda Penninx
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department Psychiatry, EMGO Institute for Health and Care Research and Institute for Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Markus Perola
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Louis Perusse
- Department of Preventive Medicine, Laval University, Quebec, Canada
| | - Patricia A Peyser
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ozren Polasek
- Department of Public Health, Faculty of Medicine, University of Split, Croatia
| | - Peter P. Pramstaller
- Center for Biomedicine, European Academy Bozen/Bolzano, Bolzano, Italy - Affiliated Institute of the University of Lübeck, Lübeck, Germany
| | - Michael A. Province
- Department of Genetics Division of Statistical Genomics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Rainer Rauramaa
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Emil Rehnberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ken Rice
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | | | - Igor Rudan
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
- Centre for Global Health, University of Split, Croatia
| | - Aimo Ruokonen
- Institute of Clinical Medicine, University of Oulu, Finland
| | - Timo Saaristo
- Finnish Diabetes Association, Tampere, Finland
- Pirkanmaa Hospital District, Tampere, Finland
| | - Maria Sabater-Lleal
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Veikko Salomaa
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - David B. Savage
- Metabolic Research Laboratories, Institute of Metabolic Science, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
| | - Richa Saxena
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Peter Schwarz
- Department of Medicine, Division Prevention and Care of Diabetes, University of Dresden, Dresden, Germany
| | - Udo Seedorf
- Leibniz Institute for Arteriosclerosis Research, University of Munster, Germany
| | - Bengt Sennblad
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Manuel Serrano-Rios
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Alan R. Shuldiner
- Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland, School of Medicine, Baltimore, Maryland, USA
- Geriatric Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, Maryland, USA
| | | | - David S. Siscovick
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Johannes H. Smit
- Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - Kerrin S. Small
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, UK
| | - Nicholas L. Smith
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Group Health Research Institute, Group Health Cooperative, Seattle, Washington, USA
- Seattle Epidemiologic Research and Information Center, Veterans Affairs Office of Research and Development, Seattle, WA, USA
| | - Albert Vernon Smith
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | - Alena Stančáková
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Kathleen Stirrups
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hixton, Cambridge, UK
| | - Michael Stumvoll
- IFB Adiposity Diseases, University of Leipzig, Leipzig, Germany
- Department of Medicine, University of Leipzig, Division of Endocrinology and Diabetes, Leipzig, Germany
| | - Yan V. Sun
- Department of Epidemiology, Emory University, Atlanta, Georgia, US
| | - Amy J. Swift
- Genome Technology Branch, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Anke Tönjes
- IFB Adiposity Diseases, University of Leipzig, Leipzig, Germany
- Department of Medicine, University of Leipzig, Division of Endocrinology and Diabetes, Leipzig, Germany
| | - Jaakko Tuomilehto
- Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- South Ostrobothnia Central Hospital, Seinäjoki, Finland
- Hospital Universitario La Paz, Madrid, Spain
- Centre for Vascular Prevention, Danube-University Krems, Krems, Austria
| | - Stella Trompet
- Department of Cardiology C5-P, Leiden University Medical Center, Leiden, the Netherlands
| | - Andre G. Uitterlinden
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Genomics Initiative and the Netherlands Consortium for Healthy Aging, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, University of Easten Finland, Kuopio, Finland
- Research Unit, Kuopio University Hospital, Kuopio, Finland
| | - Max Vikström
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Veronique Vitart
- MRC Human Genetics Unit, MRC IGMM, University of Edinburgh, Edinburgh, UK
| | - Marie-Claude Vohl
- Department of Food Science and Nutrition, Laval University, Quebec, Canada
| | - Benjamin F. Voight
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA
| | - Peter Vollenweider
- Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Gerard Waeber
- Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Dawn M Waterworth
- Division of Genetics, GlaxoSmithKline, Philadelphia, Pennsylvania, USA
| | - Hugh Watkins
- Department of Cardiovascular Medicine and Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Eleanor Wheeler
- Metabolic Disease Group, Wellcome Trust Sanger Institute, Hinxton, UK
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland, University of Helsinki, Finland
| | - Sarah H. Wild
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Sara M. Willems
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Gonneke Willemsen
- Netherlands Twin Register, Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - James F. Wilson
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Jacqueline C.M. Witteman
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Netherlands Genomics Initiative and the Netherlands Consortium for Healthy Aging, Rotterdam, The Netherlands
| | - Alan F. Wright
- MRC Human Genetics Unit, MRC IGMM, University of Edinburgh, Edinburgh, UK
| | - Hanieh Yaghootkar
- Genetics of Complex Traits, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, UK
| | - Diana Zelenika
- Centre National de Génotypage, Commissariat à L’Energie Atomique, Institut de Génomique, Evry, France
| | - Tatijana Zemunik
- Department of Biology, Faculty of Medicine, University of Split, Croatia
| | - Lina Zgaga
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
- Department of medical statistics, epidemiology and medical informatics, University of Zagreb, Zagreb, Croatia
| | | | | | - Nicholas J. Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Mark I. McCarthy
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Ines Barroso
- Metabolic Disease Group, Wellcome Trust Sanger Institute, Hinxton, UK
- University of Cambridge, Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| | - Richard M. Watanabe
- Department of Physiology & Biophysics, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Jose C. Florez
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, USA
- Diabetes Research Center, Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
- National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, Massachusetts, USA
| | - James B. Meigs
- General Medicine Division, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Claudia Langenberg
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital, Cambridge, UK
| |
Collapse
|
47
|
Morin-Papunen L, Rantala AS, Unkila-Kallio L, Tiitinen A, Hippeläinen M, Perheentupa A, Tinkanen H, Bloigu R, Puukka K, Ruokonen A, Tapanainen JS. Metformin improves pregnancy and live-birth rates in women with polycystic ovary syndrome (PCOS): a multicenter, double-blind, placebo-controlled randomized trial. J Clin Endocrinol Metab 2012; 97:1492-500. [PMID: 22419702 DOI: 10.1210/jc.2011-3061] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The role of metformin in the treatment of infertility in women with polycystic ovary syndrome (PCOS) is still controversial. OBJECTIVE AND OUTCOMES: We investigated whether metformin decreases the early miscarriage rate and improves the pregnancy rates (PR) and live-birth rates (LBR) in PCOS. METHODS This was a multicenter, randomized (1:1), double-blind, placebo-controlled study. Three hundred twenty women with PCOS and anovulatory infertility were randomized to metformin (n = 160, Diformin; obese women, 1000 mg two times daily; nonobese subjects, 500 mg + 1000 mg daily) or identical doses of placebo (n = 160). After 3 months' treatment, another appropriate infertility treatment was combined if necessary. If pregnancy occurred, metformin/placebo was continued up to the 12th week. RESULTS Miscarriage rates were low and similar in the two groups (metformin 15.2% vs. placebo 17.9%, P = 0.8). Intent-to-treat analysis showed that metformin significantly improved PR and LBR (vs. placebo) in the whole study population (PR: 53.6 vs. 40.4%, P = 0.006; LBR: 41.9 vs. 28.8%, P = 0.014) and PR in obese women (49.0 vs. 31.4%, P = 0.04), and there was a similar trend in nonobese (PR: 58.6 vs. 47.6%, P = 0.09; LBR: 46.7 vs. 34.5%, P = 0.09) and in obese women with regard to LBR (35.7 vs. 21.9%, P = 0.07). Cox regression analysis showed that metformin plus standard infertility treatment increased the chance of pregnancy 1.6 times (hazard rate 1.6, 95% confidence interval 1.13-2.27). CONCLUSION Obese women especially seem to benefit from 3 months' pretreatment with metformin and its combination thereafter with routine ovulation induction in anovulatory infertility.
Collapse
Affiliation(s)
- Laure Morin-Papunen
- Department of Obstetrics and Gynaecology, University Hospital of Oulu PL 23, FIN-90029 Oys, Finland.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Kristiansson K, Perola M, Tikkanen E, Kettunen J, Surakka I, Havulinna AS, Stancáková A, Barnes C, Widen E, Kajantie E, Eriksson JG, Viikari J, Kähönen M, Lehtimäki T, Raitakari OT, Hartikainen AL, Ruokonen A, Pouta A, Jula A, Kangas AJ, Soininen P, Ala-Korpela M, Männistö S, Jousilahti P, Bonnycastle LL, Järvelin MR, Kuusisto J, Collins FS, Laakso M, Hurles ME, Palotie A, Peltonen L, Ripatti S, Salomaa V. Genome-wide screen for metabolic syndrome susceptibility Loci reveals strong lipid gene contribution but no evidence for common genetic basis for clustering of metabolic syndrome traits. ACTA ACUST UNITED AC 2012; 5:242-9. [PMID: 22399527 DOI: 10.1161/circgenetics.111.961482] [Citation(s) in RCA: 152] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Genome-wide association (GWA) studies have identified several susceptibility loci for metabolic syndrome (MetS) component traits, but have had variable success in identifying susceptibility loci to the syndrome as an entity. We conducted a GWA study on MetS and its component traits in 4 Finnish cohorts consisting of 2637 MetS cases and 7927 controls, both free of diabetes, and followed the top loci in an independent sample with transcriptome and nuclear magnetic resonance-based metabonomics data. Furthermore, we tested for loci associated with multiple MetS component traits using factor analysis, and built a genetic risk score for MetS. METHODS AND RESULTS A previously known lipid locus, APOA1/C3/A4/A5 gene cluster region (SNP rs964184), was associated with MetS in all 4 study samples (P=7.23×10(-9) in meta-analysis). The association was further supported by serum metabolite analysis, where rs964184 was associated with various very low density lipoprotein, triglyceride, and high-density lipoprotein metabolites (P=0.024-1.88×10(-5)). Twenty-two previously identified susceptibility loci for individual MetS component traits were replicated in our GWA and factor analysis. Most of these were associated with lipid phenotypes, and none with 2 or more uncorrelated MetS components. A genetic risk score, calculated as the number of risk alleles in loci associated with individual MetS traits, was strongly associated with MetS status. CONCLUSIONS Our findings suggest that genes from lipid metabolism pathways have the key role in the genetic background of MetS. We found little evidence for pleiotropy linking dyslipidemia and obesity to the other MetS component traits, such as hypertension and glucose intolerance.
Collapse
Affiliation(s)
- Kati Kristiansson
- National Institute for Health and Welfare, University of Helsinki, Biomedicum, Helsinki, Finland.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Lajunen TK, Purhonen AK, Haapea M, Ruokonen A, Puukka K, Hartikainen AL, Savolainen MJ, Morin-Papunen L, Tapanainen JS, Franks S, Järvelin MR, Herzig KH. Full-length visfatin levels are associated with inflammation in women with polycystic ovary syndrome. Eur J Clin Invest 2012; 42:321-8. [PMID: 21913913 DOI: 10.1111/j.1365-2362.2011.02586.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common gynaecological endocrinopathy characterized by oligomenorrhea, amenorrhoea, clinical and/or biochemical hyperandrogenism and polycystic ovaries. Abdominal deposition of excess body fat and metabolic diseases like insulin resistance and compensatory hyperinsulinemia are commonly observed in PCOS subjects. It has been suggested that visfatin is an adipokine secreted from the abdominal fat influencing glucose metabolism and might therefore contribute to the metabolic disturbances in PCOS. MATERIALS AND METHODS We measured circulating full-length visfatin levels with a specific enzyme immunoassay (AdipoGen Inc, Incheon, South-Korea) in 57 women with self-reported symptoms of PCOS (hirsutism and/or oligomenorrhea) and ultrasound confirmed polycystic ovaries, and in 57 controls from the Northern Finland 1966 Birth Cohort and explored its association with metabolic and inflammatory parameters. RESULTS Polycystic ovary syndrome cases had higher body mass index (BMI) (25·7 vs. 24·1 kg/m(2)) and waist circumference (83·2 vs. 78·8 cm) compared to controls, yet there was no difference in plasma visfatin levels between them. In contrast, visfatin significantly correlated with C-reactive protein (CRP) in the control group and with white blood cell count (WBC) in both groups. In linear regression analysis, adjusted for PCOS, smoking, socioeconomic status, BMI or waist circumference, serum lipids and markers of glucose metabolism and hormone status, only WBC remained significantly associated with plasma visfatin levels. CONCLUSION Our results suggest that circulating visfatin levels correlate with WBC and CRP but are not associated with PCOS, obesity or metabolic markers, suggesting that visfatin may act as a proinflammatory cytokine.
Collapse
Affiliation(s)
- Taina K Lajunen
- Deparment of Physiology Biocenter Oulu, University of Oulu, Oulu, Finland
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Palmer ND, McDonough CW, Hicks PJ, Roh BH, Wing MR, An SS, Hester JM, Cooke JN, Bostrom MA, Rudock ME, Talbert ME, Lewis JP, Ferrara A, Lu L, Ziegler JT, Sale MM, Divers J, Shriner D, Adeyemo A, Rotimi CN, Ng MCY, Langefeld CD, Freedman BI, Bowden DW, Voight BF, Scott LJ, Steinthorsdottir V, Morris AP, Dina C, Welch RP, Zeggini E, Huth C, Aulchenko YS, Thorleifsson G, McCulloch LJ, Ferreira T, Grallert H, Amin N, Wu G, Willer CJ, Raychaudhuri S, McCarroll SA, Langenberg C, Hofmann OM, Dupuis J, Qi L, Segrè AV, van Hoek M, Navarro P, Ardlie K, Balkau B, Benediktsson R, Bennett AJ, Blagieva R, Boerwinkle E, Bonnycastle LL, Boström KB, Bravenboer B, Bumpstead S, Burtt NP, Charpentier G, Chines PS, Cornelis M, Couper DJ, Crawford G, Doney ASF, Elliott KS, Elliott AL, Erdos MR, Fox CS, Franklin CS, Ganser M, Gieger C, Grarup N, Green T, Griffin S, Groves CJ, Guiducci C, Hadjadj S, Hassanali N, Herder C, Isomaa B, Jackson AU, Johnson PRV, Jørgensen T, Kao WHL, Klopp N, Kong A, Kraft P, Kuusisto J, Lauritzen T, Li M, Lieverse A, Lindgren CM, Lyssenko V, Marre M, Meitinger T, Midthjell K, Morken MA, Narisu N, Nilsson P, Owen KR, Payne F, Perry JRB, Petersen AK, Platou C, Proença C, Prokopenko I, Rathmann W, Rayner NW, Robertson NR, Rocheleau G, Roden M, Sampson MJ, Saxena R, Shields BM, Shrader P, Sigurdsson G, Sparsø T, Strassburger K, Stringham HM, Sun Q, Swift AJ, Thorand B, Tichet J, Tuomi T, van Dam RM, van Haeften TW, van Herpt T, van Vliet-Ostaptchouk JV, Walters GB, Weedon MN, Wijmenga C, Witteman J, Bergman RN, Cauchi S, Collins FS, Gloyn AL, Gyllensten U, Hansen T, Hide WA, Hitman GA, Hofman A, Hunter DJ, Hveem K, Laakso M, Mohlke KL, Morris AD, Palmer CNA, Pramstaller PP, Rudan I, Sijbrands E, Stein LD, Tuomilehto J, Uitterlinden A, Walker M, Wareham NJ, Watanabe RM, Abecasis GR, Boehm BO, Campbell H, Daly MJ, Hattersley AT, Hu FB, Meigs JB, Pankow JS, Pedersen O, Wichmann HE, Barroso I, Florez JC, Frayling TM, Groop L, Sladek R, Thorsteinsdottir U, Wilson JF, Illig T, Froguel P, van Duijn CM, Stefansson K, Altshuler D, Boehnke M, McCarthy MI, Soranzo N, Wheeler E, Glazer NL, Bouatia-Naji N, Mägi R, Randall J, Johnson T, Elliott P, Rybin D, Henneman P, Dehghan A, Hottenga JJ, Song K, Goel A, Egan JM, Lajunen T, Doney A, Kanoni S, Cavalcanti-Proença C, Kumari M, Timpson NJ, Zabena C, Ingelsson E, An P, O'Connell J, Luan J, Elliott A, McCarroll SA, Roccasecca RM, Pattou F, Sethupathy P, Ariyurek Y, Barter P, Beilby JP, Ben-Shlomo Y, Bergmann S, Bochud M, Bonnefond A, Borch-Johnsen K, Böttcher Y, Brunner E, Bumpstead SJ, Chen YDI, Chines P, Clarke R, Coin LJM, Cooper MN, Crisponi L, Day INM, de Geus EJC, Delplanque J, Fedson AC, Fischer-Rosinsky A, Forouhi NG, Frants R, Franzosi MG, Galan P, Goodarzi MO, Graessler J, Grundy S, Gwilliam R, Hallmans G, Hammond N, Han X, Hartikainen AL, Hayward C, Heath SC, Hercberg S, Hicks AA, Hillman DR, Hingorani AD, Hui J, Hung J, Jula A, Kaakinen M, Kaprio J, Kesaniemi YA, Kivimaki M, Knight B, Koskinen S, Kovacs P, Kyvik KO, Lathrop GM, Lawlor DA, Le Bacquer O, Lecoeur C, Li Y, Mahley R, Mangino M, Manning AK, Martínez-Larrad MT, McAteer JB, McPherson R, Meisinger C, Melzer D, Meyre D, Mitchell BD, Mukherjee S, Naitza S, Neville MJ, Oostra BA, Orrù M, Pakyz R, Paolisso G, Pattaro C, Pearson D, Peden JF, Pedersen NL, Perola M, Pfeiffer AFH, Pichler I, Polasek O, Posthuma D, Potter SC, Pouta A, Province MA, Psaty BM, Rayner NW, Rice K, Ripatti S, Rivadeneira F, Rolandsson O, Sandbaek A, Sandhu M, Sanna S, Sayer AA, Scheet P, Seedorf U, Sharp SJ, Shields B, Sijbrands EJG, Silveira A, Simpson L, Singleton A, Smith NL, Sovio U, Swift A, Syddall H, Syvänen AC, Tanaka T, Tönjes A, Uitterlinden AG, van Dijk KW, Varma D, Visvikis-Siest S, Vitart V, Vogelzangs N, Waeber G, Wagner PJ, Walley A, Ward KL, Watkins H, Wild SH, Willemsen G, Witteman JCM, Yarnell JWG, Zelenika D, Zethelius B, Zhai G, Zhao JH, Zillikens MC, Borecki IB, Loos RJF, Meneton P, Magnusson PKE, Nathan DM, Williams GH, Silander K, Salomaa V, Smith GD, Bornstein SR, Schwarz P, Spranger J, Karpe F, Shuldiner AR, Cooper C, Dedoussis GV, Serrano-Ríos M, Lind L, Palmer LJ, Franks PW, Ebrahim S, Marmot M, Kao WHL, Pramstaller PP, Wright AF, Stumvoll M, Hamsten A, Buchanan TA, Valle TT, Rotter JI, Siscovick DS, Penninx BWJH, Boomsma DI, Deloukas P, Spector TD, Ferrucci L, Cao A, Scuteri A, Schlessinger D, Uda M, Ruokonen A, Jarvelin MR, Waterworth DM, Vollenweider P, Peltonen L, Mooser V, Sladek R. A genome-wide association search for type 2 diabetes genes in African Americans. PLoS One 2012; 7:e29202. [PMID: 22238593 PMCID: PMC3251563 DOI: 10.1371/journal.pone.0029202] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 11/22/2011] [Indexed: 12/16/2022] Open
Abstract
African Americans are disproportionately affected by type 2 diabetes (T2DM) yet few studies have examined T2DM using genome-wide association approaches in this ethnicity. The aim of this study was to identify genes associated with T2DM in the African American population. We performed a Genome Wide Association Study (GWAS) using the Affymetrix 6.0 array in 965 African-American cases with T2DM and end-stage renal disease (T2DM-ESRD) and 1029 population-based controls. The most significant SNPs (n = 550 independent loci) were genotyped in a replication cohort and 122 SNPs (n = 98 independent loci) were further tested through genotyping three additional validation cohorts followed by meta-analysis in all five cohorts totaling 3,132 cases and 3,317 controls. Twelve SNPs had evidence of association in the GWAS (P<0.0071), were directionally consistent in the Replication cohort and were associated with T2DM in subjects without nephropathy (P<0.05). Meta-analysis in all cases and controls revealed a single SNP reaching genome-wide significance (P<2.5×10(-8)). SNP rs7560163 (P = 7.0×10(-9), OR (95% CI) = 0.75 (0.67-0.84)) is located intergenically between RND3 and RBM43. Four additional loci (rs7542900, rs4659485, rs2722769 and rs7107217) were associated with T2DM (P<0.05) and reached more nominal levels of significance (P<2.5×10(-5)) in the overall analysis and may represent novel loci that contribute to T2DM. We have identified novel T2DM-susceptibility variants in the African-American population. Notably, T2DM risk was associated with the major allele and implies an interesting genetic architecture in this population. These results suggest that multiple loci underlie T2DM susceptibility in the African-American population and that these loci are distinct from those identified in other ethnic populations.
Collapse
Affiliation(s)
- Nicholette D Palmer
- Department of Biochemistry, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|