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Ilonen J, Laine A, Kiviniemi M, Härkönen T, Lempainen J, Knip M, Groop P, Ilonen J, Otonkoski T, Veijola R, Abram A, Aito H, Arkhipov I, Blanco‐Sequeiros E, Bondestam J, Granholm M, Haapalehto‐Ikonen M, Horn T, Huopio H, Janer J, Johansson C, Kalliokoski L, Keskinen P, Kinnala A, Korteniemi M, Laakkonen H, Lähde J, Miettinen P, Nykänen P, Popov E, Pulkkinen M, Salonen M, Salonen P, Sankala J, Sidoroff V, Suomi A, Tiainen T, Veijola R. Associations between deduced first islet specific autoantibody with sex, age at diagnosis and genetic risk factors in young children with type 1 diabetes. Pediatr Diabetes 2022; 23:693-702. [PMID: 35403376 PMCID: PMC9541564 DOI: 10.1111/pedi.13340] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/25/2022] [Accepted: 04/04/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES We aimed to further characterize demography and genetic associations of type 1 diabetes "endotypes" defined by the first appearing islet specific autoantibodies. RESEARCH DESIGN AND METHODS We analyzed 3277 children diagnosed before the age of 10 years from the Finnish Pediatric Diabetes Register. The most likely first autoantibody could be deduced in 1636 cases (49.9%) based on autoantibody combinations at diagnosis. Distribution of age, sex, HLA genotypes and allele frequencies of 18 single nucleotide polymorphisms (SNPs) in non-HLA risk genes were compared between the endotypes. RESULTS Two major groups with either glutamic acid decarboxylase (GADA) or insulin autoantibodies (IAA) as the deduced first autoantibody showed significant differences in their demographic and genetic features. Boys and children diagnosed at young age had more often IAA-initiated autoimmunity whereas GADA-initiated autoimmunity was observed more frequently in girls and in subjects diagnosed at an older age. IAA as the first autoantibody was also most common in HLA genotype groups conferring high-disease risk while GADA first was seen more evenly and frequently in HLA groups associated with lower type 1 diabetes risk. The risk alleles in IKZF4 and ERBB3 genes were associated with GADA-initiated whereas those in PTPN22, INS and PTPN2 genes were associated with IAA-initiated autoimmunity. CONCLUSIONS The results support the assumption that in around half of the young children the first autoantibody can be deduced based on islet autoantibody combinations at disease diagnosis. Strong differences in sex and age distributions as well as in genetic associations could be observed between GADA- and IAA-initiated autoimmunity.
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Affiliation(s)
- Jorma Ilonen
- Immunogenetics Laboratory, Institute of BiomedicineUniversity of TurkuTurkuFinland
| | - Antti‐Pekka Laine
- Immunogenetics Laboratory, Institute of BiomedicineUniversity of TurkuTurkuFinland
| | - Minna Kiviniemi
- Immunogenetics Laboratory, Institute of BiomedicineUniversity of TurkuTurkuFinland
| | - Taina Härkönen
- Pediatric Research Center, Children's HospitalUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland,Research Program for Clinical and Molecular Metabolism, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | - Johanna Lempainen
- Immunogenetics Laboratory, Institute of BiomedicineUniversity of TurkuTurkuFinland,Departments of PediatricsTurku University HospitalTurkuFinland,Clinical MicrobiologyTurku University HospitalTurkuFinland
| | - Mikael Knip
- Pediatric Research Center, Children's HospitalUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland,Research Program for Clinical and Molecular Metabolism, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland,Tampere Center for Child Health ResearchTampere University HospitalTampereFinland
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2
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Vieira P, Nagy II, Rahikkala E, Väisänen ML, Latva K, Kaunisto K, Valmari P, Keski-Filppula R, Haanpää MK, Sidoroff V, Miettinen PJ, Arkkola T, Ojaniemi M, Nuutinen M, Uusimaa J, Myllynen P. Cytosolic phosphoenolpyruvate carboxykinase deficiency: Expanding the clinical phenotype and novel laboratory findings. J Inherit Metab Dis 2022; 45:223-234. [PMID: 34622459 DOI: 10.1002/jimd.12446] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 11/11/2022]
Abstract
Cytosolic phosphoenolpyruvate carboxykinase (PEPCK-C) deficiency due to the homozygous PCK1 variant has recently been associated with childhood-onset hypoglycemia with a recognizable pattern of abnormal urine organic acids. In this study, 21 children and 3 adult patients with genetically confirmed PEPCK-C deficiency were diagnosed during the years 2016 to 2019 and the available biochemical and clinical data were collected. All patients were ethnic Finns. Most patients (22 out of 24) had a previously published homozygous PCK1 variant c.925G>A. Two patients had a novel compound heterozygous PCK1 variant c.925G>A and c.716C>T. The laboratory results showed abnormal urine organic acid profile with increased tricarboxylic acid cycle intermediates and inadequate ketone body production during hypoglycemia. The hypoglycemic episodes manifested predominantly in the morning. Infections, fasting or poor food intake, heavy exercise, alcohol consumption, and breastfeeding were identified as triggering factors. Five patients presented with neonatal hypoglycemia. Hypoglycemic seizures occurred in half of the patients (12 out of 24). The first hypoglycemic episode often occurred at the age of 1-2 years, but it sometimes presented at a later age, and could re-occur during school age or adulthood. This study adds to the laboratory data on PEPCK-C deficiency, confirming the recognizable urine organic acid pattern and identifying deficient ketogenesis as a novel laboratory finding. The phenotype is expanded suggesting that the risk of hypoglycemia may continue into adulthood if predisposing factors are present.
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Affiliation(s)
- Päivi Vieira
- Clinic for Children and Adolescents, Oulu University Hospital, Oulu, Finland
- PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Irina I Nagy
- Department of Clinical Chemistry, Cancer and Translational Medicine Research Unit, Medical Research Center, University of Oulu and Northern Finland Laboratory Centre NordLab, Oulu University Hospital, Oulu, Finland
| | - Elisa Rahikkala
- PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Clinical Genetics, Oulu University Hospital, Oulu, Finland
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Marja-Leena Väisänen
- Department of Clinical Chemistry, Cancer and Translational Medicine Research Unit, Medical Research Center, University of Oulu and Northern Finland Laboratory Centre NordLab, Oulu University Hospital, Oulu, Finland
| | - Katariina Latva
- Department of Pediatrics, Päijät-Häme Central Hospital, Lahti, Finland
| | - Kari Kaunisto
- Clinic for Children and Adolescents, Oulu University Hospital, Oulu, Finland
- PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Pekka Valmari
- Department of Pediatrics, Lapland Central Hospital, Rovaniemi, Finland
| | - Riikka Keski-Filppula
- PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Clinical Genetics, Oulu University Hospital, Oulu, Finland
| | - Maria K Haanpää
- Institute of Biomedicine, University of Turku, Turku, Finland
- Department of Clinical Genetics, Turku University Hospital and University of Turku, Turku, Finland
| | - Virpi Sidoroff
- Department of Pediatrics, North Karelia Central Hospital, Joensuu, Finland
| | - Päivi J Miettinen
- New Children's Hospital, Helsinki University Hospital, Pediatric Research Center, Helsinki, Finland
| | - Tuula Arkkola
- Clinic for Children and Adolescents, Oulu University Hospital, Oulu, Finland
| | - Marja Ojaniemi
- Clinic for Children and Adolescents, Oulu University Hospital, Oulu, Finland
- PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Matti Nuutinen
- Clinic for Children and Adolescents, Oulu University Hospital, Oulu, Finland
- PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Johanna Uusimaa
- Clinic for Children and Adolescents, Oulu University Hospital, Oulu, Finland
- PEDEGO Research Unit and Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Päivi Myllynen
- Department of Clinical Chemistry, Cancer and Translational Medicine Research Unit, Medical Research Center, University of Oulu and Northern Finland Laboratory Centre NordLab, Oulu University Hospital, Oulu, Finland
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Iivonen AP, Kärkinen J, Yellapragada V, Sidoroff V, Almusa H, Vaaralahti K, Raivio T. Kallmann syndrome in a patient with Weiss-Kruszka syndrome and a de novo deletion in 9q31.2. Eur J Endocrinol 2021; 185:57-66. [PMID: 33909591 PMCID: PMC8183635 DOI: 10.1530/eje-20-1387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/28/2021] [Indexed: 12/21/2022]
Abstract
Patients with deletions on chromosome 9q31.2 may exhibit delayed puberty, craniofacial phenotype including cleft lip/palate, and olfactory bulb hypoplasia. We report a patient with congenital HH with anosmia (Kallmann syndrome, KS) and a de novo 2.38 Mb heterozygous deletion in 9q31.2. The deletion breakpoints (determined with whole-genome linked-read sequencing) were in the FKTN gene (9:108,331,353) and in a non-coding area (9:110,707,332) (hg19). The deletion encompassed six protein-coding genes (FKTN, ZNF462, TAL2, TMEM38B, RAD23B, and KLF4). ZNF462 haploinsufficiency was consistent with the patient's Weiss-Kruszka syndrome (craniofacial phenotype, developmental delay, and sensorineural hearing loss), but did not explain his KS. In further analyses, he did not carry rare sequence variants in 32 known KS genes in whole-exome sequencing and displayed no aberrant splicing of 15 KS genes that were expressed in peripheral blood leukocyte transcriptome. The deletion was 1.8 Mb upstream of a KS candidate gene locus (PALM2AKAP2) but did not suppress its expression. In conclusion, this is the first report of a patient with Weiss-Kruszka syndrome and KS. We suggest that patients carrying a microdeletion in 9q31.2 should be evaluated for the presence of KS and KS-related features.
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Affiliation(s)
- Anna-Pauliina Iivonen
- Department of Physiology, Stem Cells and Metabolism Research Program, Faculty of Medicine, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | - Juho Kärkinen
- Pediatric Research Center, New Children’s Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Venkatram Yellapragada
- Department of Physiology, Stem Cells and Metabolism Research Program, Faculty of Medicine, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | | | - Henrikki Almusa
- Institute for Molecular Medicine Finland, FIMM, University of Helsinki, Helsinki, Finland
| | - Kirsi Vaaralahti
- Department of Physiology, Stem Cells and Metabolism Research Program, Faculty of Medicine, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | - Taneli Raivio
- Department of Physiology, Stem Cells and Metabolism Research Program, Faculty of Medicine, Research Programs Unit, University of Helsinki, Helsinki, Finland
- Pediatric Research Center, New Children’s Hospital, Helsinki University Hospital, Helsinki, Finland
- Correspondence should be addressed to T Raivio;
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Kohva E, Huopio H, Hero M, Miettinen PJ, Vaaralahti K, Sidoroff V, Toppari J, Raivio T. Recombinant Human FSH Treatment Outcomes in Five Boys With Severe Congenital Hypogonadotropic Hypogonadism. J Endocr Soc 2018; 2:1345-1356. [PMID: 30519672 PMCID: PMC6270974 DOI: 10.1210/js.2018-00225] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/10/2018] [Indexed: 11/19/2022] Open
Abstract
Context Recombinant human FSH (r-hFSH), given to prepubertal boys with hypogonadotropic hypogonadism (HH), may induce Sertoli cell proliferation and thereby increase sperm-producing capacity later in life. Objective To evaluate the effects of r-hFSH, human chorionic gonadotropin (hCG), and testosterone (T) in such patients. Design and Setting Retrospective review in three tertiary centers in Finland between 2006 and 2016. Patients Five boys: ANOS1 mutation in two, homozygous PROKR2 mutation in one, FGFR1 mutation in one, and homozygous GNRHR mutation in one. Prepubertal testicular volume (TV) varied between 0.3 and 2.3 mL; three boys had micropenis, three had undergone orchidopexy. Interventions Two boys received r-hFSH (6 to 7 months) followed by r-hFSH plus hCG (33 to 34 months); one received T (6 months), then r-hFSH plus T (29 months) followed by hCG (25 months); two received T (3 months) followed by r-hFSH (7 months) or r-hFSH plus T (8 months). Main Outcome Measures TV, inhibin B, anti-Müllerian hormone, T, puberty, sperm count. Results r-hFSH doubled TV (from a mean ± SD of 0.9 ± 0.9 mL to 1.9 ± 1.7 mL; P < 0.05) and increased serum inhibin B (from 15 ± 5 ng/L to 85 ± 40 ng/L; P < 0.05). hCG further increased TV (from 2.1 ± 2.3 mL to 8.6 ± 1.7 mL). Two boys with initially extremely small testis size (0.3 mL) developed sperm (maximal sperm count range, 2.8 to 13.8 million/mL), which was cryopreserved. Conclusions Spermatogenesis can be induced with gonadotropins even in boys with HH who have extremely small testes, and despite low-dose T treatment given in early puberty. Induction of puberty with gonadotropins allows preservation of fertility.
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Affiliation(s)
- Ella Kohva
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Huopio
- University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Matti Hero
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Päivi J Miettinen
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kirsi Vaaralahti
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Jorma Toppari
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, University of Turku and Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Taneli Raivio
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Soininen S, Eloranta AM, Viitasalo A, Dion G, Erkkilä A, Sidoroff V, Lindi V, Mahonen A, Lakka TA. Serum 25-Hydroxyvitamin D, Plasma Lipids, and Associated Gene Variants in Prepubertal Children. J Clin Endocrinol Metab 2018; 103:2670-2679. [PMID: 29750416 DOI: 10.1210/jc.2018-00335] [Citation(s) in RCA: 3] [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: 02/10/2018] [Accepted: 05/04/2018] [Indexed: 02/09/2023]
Abstract
CONTEXT The associations of serum 25-hydroxyvitamin D [25(OH)D] with plasma lipids remain controversial in children. OBJECTIVE To examine the associations and interactions of 25(OH)D and related gene variants with lipids in children. DESIGN Cross-sectional. SETTING Kuopio, Finland. PARTICIPANTS Population sample of 419 prepubertal white children aged 6 to 8 years. MAIN OUTCOME MEASURES 25(OH)D, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides. RESULTS Serum 25(OH)D was negatively associated with total cholesterol (β = -0.141, P = 0.004), LDL cholesterol (β = -0.112, P = 0.023), HDL cholesterol (β = -0.150, P = 0.002), and triglycerides (β = -0.104, P = 0.035) adjusted for age and sex. Associations of 25(OH)D with total cholesterol, LDL cholesterol, and HDL cholesterol remained after adjustment for adiposity, physical activity, sedentary behavior, diet, daylight time, and parental education. Children in the highest quartile of 25(OH)D had the lowest total cholesterol (P = 0.022) and LDL cholesterol (P = 0.026) adjusted for age and sex. Cytochrome P450 family 2 subfamily R member 1 (CYP2R1) rs12794714, CYP2R1 rs10741657, and vitamin D binding protein (DBP) rs2282679 were associated with 25(OH)D adjusted for age and sex. CYP2R1 rs12794714 was associated with total cholesterol and LDL cholesterol and C10orf88 rs6599638 with HDL cholesterol adjusted for age, sex, and 25(OH)D. The gene variants did not explain or modify the associations of 25(OH)D with lipids. CONCLUSIONS 25(OH)D was independently and inversely associated with total cholesterol, LDL cholesterol, and HDL cholesterol. CYP2R1 rs12794714, CYP2R1 rs10741657, and DBP rs2282679 were associated with 25(OH)D. CYP2R1 rs12794714 was associated with total cholesterol and LDL cholesterol and chromosome 10 open reading frame 88 (C10orf88) rs6599638 with HDL cholesterol independent of 25(OH)D. None of the gene variants modified the associations of 25(OH)D with lipids. Further studies are needed to detect the mechanisms for the associations of 25(OH)D with lipids.
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Affiliation(s)
- Sonja Soininen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Social and Health Center, City of Varkaus, Varkaus, Finland
| | - Aino-Maija Eloranta
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Anna Viitasalo
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Geneviève Dion
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Arja Erkkilä
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Virpi Sidoroff
- Department of Pediatrics, North Karelia Central Hospital, Joensuu, Finland
| | - Virpi Lindi
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- University of Eastern Finland Library Kuopio, Kuopio, Finland
| | - Anitta Mahonen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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Soininen S, Sidoroff V, Lindi V, Mahonen A, Kröger L, Kröger H, Jääskeläinen J, Atalay M, Laaksonen DE, Laitinen T, Lakka TA. Body fat mass, lean body mass and associated biomarkers as determinants of bone mineral density in children 6-8years of age - The Physical Activity and Nutrition in Children (PANIC) study. Bone 2018; 108:106-114. [PMID: 29307776 DOI: 10.1016/j.bone.2018.01.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 11/24/2017] [Accepted: 01/03/2018] [Indexed: 11/23/2022]
Abstract
Lean body mass (LM) has been positively associated with bone mineral density (BMD) in children and adolescents, but the relationship between body fat mass (FM) and BMD remains controversial. Several biomarkers secreted by adipose tissue, skeletal muscle, or bone may affect bone metabolism and BMD. We investigated the associations of LM, FM, and such biomarkers with BMD in children. We studied a population sample of 472 prepubertal Finnish children (227 girls, 245 boys) aged 6-8years. We assessed BMD, LM, and FM using whole-body dual-energy x-ray absorptiometry and analysed several biomarkers from fasting blood samples. We studied the associations of LM, FM, and the biomarkers with BMD of the whole body excluding the head using linear regression analysis. LM (standardized regression coefficient β=0.708, p<0.001), FM (β=0.358, p<0.001), and irisin (β=0.079, p=0.048) were positive correlates for BMD adjusted for age, sex, and height in all children. These associations remained statistically significant after further adjustment for LM or FM. The positive associations of dehydroepiandrosterone sulphate (DHEAS), insulin, homeostatic model assessment for insulin resistance (HOMA-IR), leptin, free leptin index, and high-sensitivity C-reactive protein and the negative association of leptin receptor with BMD were explained by FM. The positive associations of DHEAS and HOMA-IR with BMD were also explained by LM. Serum 25-hydroxyvitamin D was a positive correlate for BMD adjusted for age, sex, and height and after further adjustment for FM but not for LM. LM and FM were positive correlates for BMD also in girls and boys separately. In girls, insulin, HOMA-IR, leptin, and free leptin index were positively and leptin receptor was negatively associated with BMD adjusted for age, height, and LM. After adjustment for age, height, and FM, none of the biomarkers was associated with BMD. In boys, leptin and free leptin index were positively and leptin receptor was negatively associated with BMD adjusted for age, height, and LM. After adjustment for age, height and FM, 25(OH)D was positively and IGF-1 and leptin were negatively associated with BMD. FM strongly modified the association between leptin and BMD. LM but also FM were strong, independent positive correlates for BMD in all children, girls, and boys. Irisin was positively and independently associated with BMD in all children. The associations of other biomarkers with BMD were explained by LM or FM.
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Affiliation(s)
- Sonja Soininen
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Institute of Dentistry, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Social and Health Center, City of Varkaus, Savontie 55, 78300 Varkaus, Finland.
| | - Virpi Sidoroff
- Department of Pediatrics, North-Karelia Central Hospital, Tikkamäentie 16, 80210 Joensuu, Finland.
| | - Virpi Lindi
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland.
| | - Anitta Mahonen
- Institute of Biomedicine, Medical Biochemistry, School of Medicine, University of Eastern Finland, PO Box 1627, Kuopio, Finland.
| | - Liisa Kröger
- Department of Pediatrics, Kuopio University Hospital, University of Eastern Finland, PO Box 100, 70029 Kuopio, Finland.
| | - Heikki Kröger
- Department of Orthopedics and Traumatology, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland; Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland.
| | - Jarmo Jääskeläinen
- Department of Pediatrics, Kuopio University Hospital, University of Eastern Finland, PO Box 100, 70029 Kuopio, Finland.
| | - Mustafa Atalay
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland.
| | - David E Laaksonen
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Department of Internal Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland.
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland.
| | - Timo A Lakka
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland; Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 Kuopio, Finland.
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Sidoroff V, Hyvärinen MK, Piippo-Savolainen E, Korppi M. Overweight does not increase asthma risk but may decrease allergy risk at school age after infantile bronchiolitis. Acta Paediatr 2012; 101:43-7. [PMID: 21824194 DOI: 10.1111/j.1651-2227.2011.02439.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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: 01/24/2023]
Abstract
AIM Increasing evidence suggests that overweight children are at increased risk of asthma. The association between weight gain and allergy is more complex. The aim was to evaluate the association between overweight or obesity and asthma, allergy, bronchial reactivity or atopic sensitization at school age in children with bronchiolitis in infancy. SUBJECTS AND METHODS Eighty-one children hospitalized for bronchiolitis at <24 months of age attended control visits at 7.2 and 12.3 years of ages. The visits consisted of medical examinations, weight and height measurements, body mass index (BMI) calculations, skin prick tests and exercise challenge tests. BMI >1.3 SD from age- and gender-specific references meant overweight and BMI >2.0 SD obesity. RESULTS Current or previous overweight or obesity did not increase the risk of asthma, allergy, bronchial reactivity or atopic sensitization at 7.2 or 12.3 years of age. Previous and current obesity decreased the risk of atopic dermatitis, and current overweight and obesity decreased the risk of sensitization to outdoor allergens at 12.3 years of age. CONCLUSION Previous or current overweight does not increase asthma or allergy risk but current obesity may decrease allergy risk at school age after bronchiolitis in infancy.
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Affiliation(s)
- Virpi Sidoroff
- Department of Pediatrics, University of Eastern Finland, Kuopio, Finland
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Sidoroff V, Hyvärinen M, Piippo-Savolainen E, Korppi M. Lung function and overweight in school aged children after early childhood wheezing. Pediatr Pulmonol 2011; 46:435-41. [PMID: 21194138 DOI: 10.1002/ppul.21386] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [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] [Received: 05/25/2010] [Revised: 11/01/2010] [Accepted: 11/04/2010] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Recently, obesity has been connected with wheezing, asthma and reduced lung function. Most previous studies have been cross-sectional. The aim of the present follow-up study was to evaluate the association of preceding or current overweight or obesity with lung function at early and late school age after early childhood wheezing. MATERIAL AND METHODS From the 100 children hospitalized for infection associated wheezing at <24 months of age, 83 attended the control visit at 4.0 years, 82 at 7.2 years and 81 at 12.3 years of age. Flow-volume spirometry was performed in 79 children at 7.2 years and in 80 children at 12.3 years of age. The weight status was assessed by calculating body mass index (BMI) at all visits. Age- and gender-specific BMI standard deviation scores (BMI-SDS) of >1.3 SD and >2.0 SD were defined to mean overweight and obesity, respectively. RESULTS Overweight at both 7.2 and 12.3 years of age was associated with decreased FEV1 /FVC (forced expiratory volume in 1 sec/forced vital capacity). Overweight and obesity at 7.2 years of age were associated with decreased FEV1 /FVC and MEF50 (maximal expiratory flow at 50% of FVC) at 12.3 years of age. The results were similar by continuous and categorized analyses, being robust to adjustments for viral findings during early childhood wheezing and asthma maintenance medication at school age. CONCLUSION Overweight and obesity are significant risk factors for reduced lung function at school age after early childhood wheezing. Thus, early-life wheezers should avoid excessive weight gain during childhood.
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Affiliation(s)
- Virpi Sidoroff
- Department of Pediatrics, School of Medicine, University of Eastern Finland, Kuopio, Finland.
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