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Aris IM, Rifas-Shiman SL, Li LJ, Yang S, Belfort MB, Thompson J, Hivert MF, Patel R, Martin RM, Kramer MS, Oken E. Association of Weight for Length vs Body Mass Index During the First 2 Years of Life With Cardiometabolic Risk in Early Adolescence. JAMA Netw Open 2018; 1:e182460. [PMID: 30646168 PMCID: PMC6324504 DOI: 10.1001/jamanetworkopen.2018.2460] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 07/11/2018] [Indexed: 12/17/2022] Open
Abstract
Importance The American Academy of Pediatrics currently recommends weight for length (WFL) for assessment of weight status in children younger than 2 years but body mass index (BMI) for children older than 2 years. However, the clinical implications of using WFL vs BMI in children younger than 2 years as an indicator of future health outcomes remains understudied. Objective To compare associations of overweight based on WFL vs BMI in children younger than 2 years with cardiometabolic outcomes during early adolescence. Design, Setting, and Participants This prospective study of birth cohorts in the United States (Project Viva) and Belarus (Promotion of Breastfeeding Intervention Trial [PROBIT]) performed from June 1, 1996, to November 31, 2002, included 13 666 children younger than 2 years. Main Exposures Overweight defined as Centers for Disease Control and Prevention (CDC) WFL in the 95th percentile or greater, World Health Organization (WHO) WFL in the 97.7th percentile or greater, or WHO BMI in the 97.7th percentile or greater at 6, 12, 18, or 24 months of age. Main Outcomes and Measures Primary outcomes were fat mass index, insulin resistance, metabolic risk score, and obesity during early adolescence. Secondary outcomes were height and BMI z scores, sum of skinfolds, waist circumference, and systolic blood pressure during early adolescence. Results The study included 919 children (mean [SD] age, 12.9 [0.9] years; 460 [50.1%] male; and 598 [65.1%] white) from Project Viva and 12 747 children (mean [SD] age, 11.5 [0.5] years; 6204 [48.7%] male; and 12 747 [100%] white) from PROBIT. During 6 to 24 months of age, in Project Viva, 206 children (22.4%) were overweight at any of the 4 times points according to the CDC WFL, 160 (17.4%) according to WHO WFL, and 161 (17.5%) according to WHO BMI cut points. In PROBIT, 3715 children (29.1%) were overweight at any of the 4 time points according to the CDC WFL, 3069 (24.1%) according to WHO WFL, and 3125 (24.5%) according to WHO BMI cut points. After maternal and child characteristics were adjusted for, being ever overweight (vs never overweight) during 6 to 24 months of age was associated with higher likelihood of adverse cardiometabolic risk markers during early adolescence, but associations did not differ substantially across WFL and BMI cut points in either cohort. For example, for fat mass index in Project Viva, β = 0.9 (95% CI, 0.5-1.4) for the CDC WFL, β = 1.1 (95% CI, 0.6-1.6) for WHO WFL, and β = 1.4 (95% CI, 0.9-1.9) for WHO BMI. For PROBIT, β = 0.5 (95% CI, 0.4-0.6) for the CDC WFL, β = 0.6 (95% CI, 0.5-0.7) for WHO WFL, and β = 0.6 (95% CI, 0.5-0.6) for WHO BMI. Neither growth metric in infancy was superior over the others based on F statistics (Project Viva: 17.1-17.8; PROBIT: 87.1-88.7). Findings were similar for insulin resistance, metabolic risk score, obesity, and secondary outcomes. Conclusions and Relevance Choice of WFL vs BMI to define overweight during the first 2 years of life may not greatly affect the association with cardiometabolic outcomes during early adolescence. The findings appear to have important implications for investigators seeking to use BMI as a growth metric for epidemiologic research and for practitioners monitoring the weight status of children younger than 2 years.
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Affiliation(s)
- Izzuddin M. Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Ling-Jun Li
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Division of Obstetrics and Gynecology, KK Women’s and Children’s Hospital, Singapore, Singapore
- Obstetrics and Gynecology Academic Clinical Programme, Duke–National University of Singapore Graduate Medical School, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Seungmi Yang
- Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine McGill University, Montreal, Quebec, Canada
| | - Mandy B. Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jennifer Thompson
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Diabetes Unit, Massachusetts General Hospital, Boston
| | - Rita Patel
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Richard M. Martin
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Michael S. Kramer
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine McGill University, Montreal, Quebec, Canada
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Patel N, Dalrymple KV, Briley AL, Pasupathy D, Seed PT, Flynn AC, Poston L. Mode of infant feeding, eating behaviour and anthropometry in infants at 6-months of age born to obese women - a secondary analysis of the UPBEAT trial. BMC Pregnancy Childbirth 2018; 18:355. [PMID: 30176807 PMCID: PMC6122563 DOI: 10.1186/s12884-018-1995-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 08/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal obesity and rapid infant weight gain have been associated with increased risk of obesity in childhood. Breastfeeding is suggested to be protective against childhood obesity, but no previous study has addressed the potential benefit of breastfeeding as a preventive method of childhood obesity amongst obese women. The primary aim of this study was to assess the relationship between mode of feeding and body composition, growth and eating behaviours in 6-month-old infants of obese women who participated in UPBEAT; a multi-centre randomised controlled trial comparing a lifestyle intervention of diet and physical activity to standard care during pregnancy. METHODS Three hundred and fifty-three mother and infant pairs attended a 6-months postpartum follow-up visit, during which they completed the Baby-Eating Behaviour Questionnaire, a parent-reported psychometric measure of appetite traits. Measures of infant body composition were also undertaken. As there was no effect of the antenatal intervention on infant feeding and appetite the study was treated as a cohort. Using regression analyses, we examined relationships between: 1) mode of feeding and body composition and growth; 2) mode of feeding and eating behaviour and 3) eating behaviour and body composition. RESULTS Formula fed infants of obese women in comparison to those exclusively breastfed, demonstrated higher weight z-scores (mean difference 0.26; 95% confidence interval 0.01 to 0.52), higher rate of weight gain (0.04; 0.00 to 0.07) and greater catch-up growth (2.48; 1.31 to 4.71). There was also a lower enjoyment of food (p = 0.002) amongst formula fed infants, following adjustment for confounders. Independent of the mode of feeding, a measure of infant appetite was associated with sum of skinfold thicknesses (β 0.66; 95% CI 0.12 to 1.21), calculated body fat percentage (0.83; 0.15 to 1.52), weight z-scores (0.21; 0.06 to 0.36) and catch-up growth (odds ratio 1.98; 1.21 to 3.21). CONCLUSIONS In obese women, exclusive breastfeeding was protective against increasing weight z-scores and trajectories of weight gain in their 6-month old infants. Measures of general appetite in early infancy were associated with measures of adiposity, weight and catch up growth independent of cord blood leptin concentrations and mode of early feeding.
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Affiliation(s)
- Nashita Patel
- Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Kathryn V. Dalrymple
- Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Annette L. Briley
- Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Dharmintra Pasupathy
- Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Paul T. Seed
- Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Angela C. Flynn
- Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Lucilla Poston
- Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - on behalf of the UPBEAT Consortium
- Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK
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Effect of early postnatal nutrition on chronic kidney disease and arterial hypertension in adulthood: a narrative review. J Dev Orig Health Dis 2018; 9:598-614. [PMID: 30078383 DOI: 10.1017/s2040174418000454] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Intrauterine growth restriction (IUGR) has been identified as a risk factor for adult chronic kidney disease (CKD), including hypertension (HTN). Accelerated postnatal catch-up growth superimposed to IUGR has been shown to further increase the risk of CKD and HTN. Although the impact of excessive postnatal growth without previous IUGR is less clear, excessive postnatal overfeeding in experimental animals shows a strong impact on the risk of CKD and HTN in adulthood. On the other hand, food restriction in the postnatal period seems to have a protective effect on CKD programming. All these effects are mediated at least partially by the activation of the renin-angiotensin system, leptin and neuropeptide Y (NPY) signaling and profibrotic pathways. Early nutrition, especially in the postnatal period has a significant impact on the risk of CKD and HTN at adulthood and should receive specific attention in the prevention of CKD and HTN.
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Perng W, Baek J, Zhou CW, Cantoral A, Tellez-Rojo MM, Song PX, Peterson KE. Associations of the infancy body mass index peak with anthropometry and cardiometabolic risk in Mexican adolescents. Ann Hum Biol 2018; 45:386-394. [PMID: 30328713 PMCID: PMC6377326 DOI: 10.1080/03014460.2018.1506048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 06/15/2018] [Accepted: 07/15/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Early-life growth dynamics are associated with future health. Little is known regarding timing and magnitude of the infancy body mass index (BMI) peak with adiposity and metabolic biomarkers during adolescence. AIM To examine associations of the infancy BMI peak with anthropometry and cardiometabolic risk during peripuberty. METHODS Among 163 ELEMENT participants, this study estimated age and magnitude of the infancy BMI peak from eight anthropometric measurements from birth-36 months using Newton's Growth Models, an acceleration-based process model. Associations were examined of the infancy milestones with anthropometry and cardiometabolic risk at 8-14 years using linear regression models that accounted for maternal calcium supplementation and age; child's birthweight, sex, and age; and the other infancy milestone. RESULTS Median age at the infancy BMI peak was 9.6 months, and median peak BMI was 16.5 kg/m2. Later age and larger magnitude of the peak predicted higher BMI z-score, waist circumference, and skinfold thicknesses; i.e. each 1 month of age at peak and each 1 kg/m2 of peak BMI corresponded with 0.04 (0.01-0.07) and 0.33 (0.17-0.48) units of higher BMI z-score, respectively. Later age at peak was also a determinant of worse glycaemia and higher blood pressure. CONCLUSION Later age and larger magnitude of the infancy BMI peak are associated with higher adiposity at 8-14 years of age. Later age but not magnitude of the BMI peak are related to a worse cardiometabolic profile during peripuberty.
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Affiliation(s)
- Wei Perng
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Jonggyu Baek
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Christina W. Zhou
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Alejandra Cantoral
- Center for Nutrition and Health Research, National Institute of Public Health, Mexico City, MX
- CONACYT, National Institute of Public Health, Center for Research on Nutrition and Health, MX
| | | | - Peter X.K. Song
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Karen E. Peterson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Ramirez-Silva I, Rivera JA, Trejo-Valdivia B, Stein AD, Martorell R, Romieu I, Barraza-Villarreal A, Avila-Jiménez L, Ramakrishnan U. Relative Weight Gain Through Age 4 Years Is Associated with Increased Adiposity, and Higher Blood Pressure and Insulinemia at 4-5 Years of Age in Mexican Children. J Nutr 2018; 148:1135-1143. [PMID: 29924321 PMCID: PMC6669951 DOI: 10.1093/jn/nxy068] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 11/10/2017] [Accepted: 03/12/2018] [Indexed: 12/25/2022] Open
Abstract
Background Rapid early weight gain has been associated with increased risk of obesity and cardiometabolic alterations, but evidence in low and middle-income countries is inconclusive. Objective We evaluated the relation between relative weight gain from 1 to 48 mo with adiposity and cardiometabolic risk factors at 4-5 y of age, and determined if adiposity is a mediator for cardiometabolic alterations. Methods We studied 428 Mexican children with anthropometric and blood pressure (BP) information from birth to 5 y of age from POSGRAD (Prenatal Omega-3 fatty acid Supplementation and child GRowth And Development), of whom 334 provided measures of adiposity and cardiometabolic risk markers at 4 y. We estimated relative weight gain by means of conditional weight-for-height z scores for the age intervals 1-6, 6-12, 12-24, and 24-48 mo. Associations between relative weight gain and adiposity and cardiometabolic risk markers (lipid profile, triglycerides, insulin, glucose, and BP) were analyzed by multivariate multiple linear models and path analysis. Results A 1-unit increase in conditional weight-for-height z score within each age interval was positively associated with adiposity at 5 y, with coefficients of 0.43-0.89 for body mass index (BMI) z score, 1.08-3.65 mm for sum of skinfolds, and 1.21-3.87 cm for abdominal circumference (all P < 0.01). Positive associations were documented from ages 6 to 48 mo with systolic BP (coefficient ranges: 1.19-1.78 mm Hg; all P < 0.05) and from ages 12 to 48 mo with diastolic BP (1.28-0.94 mm Hg; P < 0.05) at 5 y. Conditional weight-for-height z scores at 12-24 and 24-48 mo of age were more strongly associated with adiposity and BP relative to younger ages. A unit increase in conditional weight-for-height z scores from 12 to 24 mo was associated with 14% higher insulin levels (P < 0.05) at 4 y. Path analyses documented that the associations of conditional weight gain with BP were mediated by BMI and sum of skinfolds. Conclusion Relative weight gain at most periods during the first 4 y of life was associated with greater adiposity and higher systolic and diastolic BP at 5 y. These associations with BP were mediated by adiposity. Relative weight gain from 12 to 24 mo was associated with increased serum insulin concentrations at 4 y, but there were no associations with lipid profiles or glucose concentration.
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Affiliation(s)
| | | | | | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Isabelle Romieu
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | | | | | - Usha Ramakrishnan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
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Is birth weight associated with blood pressure among African children and adolescents? A systematic review. J Dev Orig Health Dis 2018; 9:270-280. [PMID: 29353561 DOI: 10.1017/s2040174417001039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
There is substantial evidence of an inverse association between birth weight and later blood pressure (BP) in populations from high-income countries, but whether this applies in low-income countries, where causes of low birth weight are different, is not certain. OBJECTIVE We conducted a review of the evidence on the relationship between birth weight and BP among African children and adolescents. Medline, EMBASE, Global Health and Web of Science databases were searched for publications to October 2016. Papers reporting the relationship between birth weight and BP among African children and adolescents were assessed. Bibliographies were searched for further relevant publications. Selected papers were summarized following the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. In total, 16 papers from 13 studies conducted in nine African countries (Nigeria, Republic of Seychelles, Gambia, Democratic Republic of Congo, Cameroon, South Africa, Algeria, Zimbabwe and Angola) were reviewed. Eight studies were cohorts, while five were cross-sectional. The relationship between birth weight and later BP varied with age of the participants. Studies in neonates showed a consistently positive association, while predominantly inverse associations were seen among children, and studies in adolescents were inconsistent. Based on the limited number of studies identified, the relationship between birth weight and later BP may vary with age in African children and adolescents. Not all studies adequately controlled for confounding, notably gender or age. Whether the inverse relationship between birth weight and BP in later life observed in Western settings is also seen in Africa remains unclear.
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Arima Y, Nishiyama K, Izumiya Y, Kaikita K, Hokimoto S, Tsujita K. Fetal Origins of Hypertension. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1012:41-48. [PMID: 29956193 DOI: 10.1007/978-981-10-5526-3_5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Hypertension is a common noncommunicable disease. According to the World Health Organization, 1.13 billion people were suffering from hypertension in the year 2015. High blood pressure, hypertension, has a multifactorial etiology. Arterial atherosclerotic changes, systolic or diastolic dysfunction of the heart, and other noncardiac factors are involved. Epidemiological evidence has revealed that perinatal growth disturbance elevates the prevalence of hypertension. However, the specific effects of developmental disturbances on the pathological process of hypertension are poorly understood. Recently, it has become apparent that the perinatal period plays many essential roles in cardiovascular development. In this chapter, we focus on the perinatal development of the cardiovascular system, especially in murine models. Individual organs, blood, blood vessels, and the heart show unique growth characteristics during this period. We also introduce evidence from related clinical studies regarding the developmental origins of hypertension. Finally, evidence from several animal models is presented to reveal the effects of developmental disturbance or stress on arterial pathology. Improving our understanding of both developmental events and the results of clinical studies will give fresh insight into the fetal origins of hypertension.
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Affiliation(s)
- Yuichiro Arima
- Department of Cardiovascular Medicine, Kumamoto University, Kumamoto, Japan. .,International Research Center for Medical Science, Kumamoto University, Kumamoto, Japan.
| | - Koichi Nishiyama
- International Research Center for Medical Science, Kumamoto University, Kumamoto, Japan
| | - Yasuhiro Izumiya
- Department of Cardiovascular Medicine, Kumamoto University, Kumamoto, Japan
| | - Koichi Kaikita
- Department of Cardiovascular Medicine, Kumamoto University, Kumamoto, Japan
| | - Seiji Hokimoto
- Department of Cardiovascular Medicine, Kumamoto University, Kumamoto, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Kumamoto University, Kumamoto, Japan
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Munthali RJ, Kagura J, Lombard Z, Norris SA. Early Life Growth Predictors of Childhood Adiposity Trajectories and Future Risk for Obesity: Birth to Twenty Cohort. Child Obes 2017; 13:384-391. [PMID: 28520476 DOI: 10.1089/chi.2016.0310] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is growing evidence of variations in adiposity trajectories among individuals, but the influence of early life growth patterns on these trajectories is underresearched in low- and middle-income countries. Therefore, our aim was to examine the association between early life conditional weight gain and childhood adiposity trajectories. METHODS We previously identified distinct adiposity trajectories (four for girls and three for boys) in black South African children (boys = 877; girls = 947). The association between the trajectories and early life growth patterns, and future obesity risk was assessed by multivariate linear and multinomial logistic and logistic regressions. Conditional weight gain independent of height was computed for infancy (0-2 years) and early childhood (2-4 years). RESULTS Conditional weight gain before 5 years of age was significantly associated with early onset of obesity or overweight (excess weight) BMI trajectories in both boys and girls. In girls, greater conditional weight gain in infancy was associated with increased relative risk of being in the early-onset obese to morbid obese trajectory, with relative risk ratios of 2.03 (95% confidence interval: 1.17-3.52) compared to belonging to a BMI trajectory in the normal range. Boys and girls in the early-onset obesity or overweight BMI trajectories were more likely to be overweight or obese in early adulthood. CONCLUSIONS Excessive weight gain in infancy and early childhood, independent of linear growth, predicts childhood and adolescent BMI trajectories toward obesity. These results underscore the importance of early life factors in the development of obesity and other NCDs in later life.
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Affiliation(s)
- Richard J Munthali
- 1 Faculty of Science, School of Molecular and Cell Biology, University of the Witwatersrand , Johannesburg, South Africa .,2 Sydney Brenner Institute for Molecular Bioscience (SBIMB), University of the Witwatersrand , Johannesburg, South Africa .,3 MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand , Johannesburg, South Africa
| | - Juliana Kagura
- 3 MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand , Johannesburg, South Africa
| | - Zané Lombard
- 1 Faculty of Science, School of Molecular and Cell Biology, University of the Witwatersrand , Johannesburg, South Africa .,4 Division of Human Genetics, Faculty of Health Sciences, School of Pathology, University of the Witwatersrand and National Health Laboratory Service , Johannesburg, South Africa
| | - Shane A Norris
- 3 MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand , Johannesburg, South Africa
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Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, de Ferranti SD, Dionne JM, Falkner B, Flinn SK, Gidding SS, Goodwin C, Leu MG, Powers ME, Rea C, Samuels J, Simasek M, Thaker VV, Urbina EM. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics 2017; 140:peds.2017-1904. [PMID: 28827377 DOI: 10.1542/peds.2017-1904] [Citation(s) in RCA: 1912] [Impact Index Per Article: 273.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
These pediatric hypertension guidelines are an update to the 2004 "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents." Significant changes in these guidelines include (1) the replacement of the term "prehypertension" with the term "elevated blood pressure," (2) new normative pediatric blood pressure (BP) tables based on normal-weight children, (3) a simplified screening table for identifying BPs needing further evaluation, (4) a simplified BP classification in adolescents ≥13 years of age that aligns with the forthcoming American Heart Association and American College of Cardiology adult BP guidelines, (5) a more limited recommendation to perform screening BP measurements only at preventive care visits, (6) streamlined recommendations on the initial evaluation and management of abnormal BPs, (7) an expanded role for ambulatory BP monitoring in the diagnosis and management of pediatric hypertension, and (8) revised recommendations on when to perform echocardiography in the evaluation of newly diagnosed hypertensive pediatric patients (generally only before medication initiation), along with a revised definition of left ventricular hypertrophy. These guidelines include 30 Key Action Statements and 27 additional recommendations derived from a comprehensive review of almost 15 000 published articles between January 2004 and July 2016. Each Key Action Statement includes level of evidence, benefit-harm relationship, and strength of recommendation. This clinical practice guideline, endorsed by the American Heart Association, is intended to foster a patient- and family-centered approach to care, reduce unnecessary and costly medical interventions, improve patient diagnoses and outcomes, support implementation, and provide direction for future research.
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Affiliation(s)
- Joseph T Flynn
- Dr. Robert O. Hickman Endowed Chair in Pediatric Nephrology, Division of Nephrology, Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington;
| | - David C Kaelber
- Departments of Pediatrics, Internal Medicine, Population and Quantitative Health Sciences, Center for Clinical Informatics Research and Education, Case Western Reserve University and MetroHealth System, Cleveland, Ohio
| | - Carissa M Baker-Smith
- Division of Pediatric Cardiology, School of Medicine, University of Maryland, Baltimore, Maryland
| | - Douglas Blowey
- Children's Mercy Hospital, University of Missouri-Kansas City and Children's Mercy Integrated Care Solutions, Kansas City, Missouri
| | - Aaron E Carroll
- Department of Pediatrics, School of Medicine, Indiana University, Bloomington, Indiana
| | - Stephen R Daniels
- Department of Pediatrics, School of Medicine, University of Colorado-Denver and Pediatrician in Chief, Children's Hospital Colorado, Aurora, Colorado
| | - Sarah D de Ferranti
- Director, Preventive Cardiology Clinic, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Janis M Dionne
- Division of Nephrology, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Bonita Falkner
- Departments of Medicine and Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Susan K Flinn
- Consultant, American Academy of Pediatrics, Washington, District of Columbia
| | - Samuel S Gidding
- Cardiology Division Head, Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, Delaware
| | - Celeste Goodwin
- National Pediatric Blood Pressure Awareness Foundation, Prairieville, Louisiana
| | - Michael G Leu
- Departments of Pediatrics and Biomedical Informatics and Medical Education, University of Washington, University of Washington Medicine and Information Technology Services, and Seattle Children's Hospital, Seattle, Washington
| | - Makia E Powers
- Department of Pediatrics, School of Medicine, Morehouse College, Atlanta, Georgia
| | - Corinna Rea
- Associate Director, General Academic Pediatric Fellowship, Staff Physician, Boston's Children's Hospital Primary Care at Longwood, Instructor, Harvard Medical School, Boston, Massachusetts
| | - Joshua Samuels
- Departments of Pediatrics and Internal Medicine, McGovern Medical School, University of Texas, Houston, Texas
| | - Madeline Simasek
- Pediatric Education, University of Pittsburgh Medical Center Shadyside Family Medicine Residency, Clinical Associate Professor of Pediatrics, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, and School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Vidhu V Thaker
- Division of Molecular Genetics, Department of Pediatrics, Columbia University Medical Center, New York, New York; and
| | - Elaine M Urbina
- Preventive Cardiology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
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Van Hulst A, Barnett TA, Paradis G, Roy-Gagnon MH, Gomez-Lopez L, Henderson M. Birth Weight, Postnatal Weight Gain, and Childhood Adiposity in Relation to Lipid Profile and Blood Pressure During Early Adolescence. J Am Heart Assoc 2017; 6:JAHA.117.006302. [PMID: 28778942 PMCID: PMC5586463 DOI: 10.1161/jaha.117.006302] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background Different pathways likely underlie the association between early weight gain and cardiovascular disease risk. We examined whether birth weight for length relationship and weight gain up to 2 years of age are associated with lipid profiles and blood pressure (BP) in early adolescence and determined whether childhood adiposity mediates these associations. Methods and Results Data from QUALITY (Quebec Adipose and Lifestyle Investigation in Youth), a cohort of white children with parental history of obesity, were analyzed (n=395). Sex‐specific weight for length z scores from birth to 2 years were computed. Rate of postnatal weight gain was estimated using individual slopes of weight for length z‐score measurements. Percentage of body fat was measured at 8 to 10 years. Fasting lipids and BP were measured at 10 to 12 years. Using path analysis, we found indirect effects of postnatal weight gain, through childhood adiposity, on all outcomes: Rate of postnatal weight for length gain was positively associated with childhood adiposity, which in turn was associated with unfavorable lipid and BP levels in early adolescence. In contrast, small beneficial direct effects on diastolic BP z scores, independent of weight at other time points, were found for birth weight for length (β=−0.05, 95% CI, −0.09 to −0.002) and for postnatal weight gain (β=−0.02, 95% CI, −0.03 to −0.002). Conclusions Among children with at least 1 obese parent, faster postnatal weight gain leads to cardiovascular risk factors in early adolescence through its effect on childhood adiposity. Although heavier newborns may have lower BP in early adolescence, this protective direct effect could be offset by a deleterious indirect effect linking birth weight to later adiposity.
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Affiliation(s)
- Andraea Van Hulst
- Department of Epidemiology Biostatistics and Occupational Health, McGill University, Montreal, Canada.,Centre de recherche du CHU Sainte-Justine, Montreal, Canada
| | - Tracie A Barnett
- Centre de recherche du CHU Sainte-Justine, Montreal, Canada.,INRS-Armand-Frappier Institute, Laval, Canada
| | - Gilles Paradis
- Department of Epidemiology Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | | | - Lilianne Gomez-Lopez
- Centre de recherche du CHU Sainte-Justine, Montreal, Canada.,Division of medical genetics, CHU Sainte-Justine, Montreal, Canada
| | - Mélanie Henderson
- Centre de recherche du CHU Sainte-Justine, Montreal, Canada .,Department of Pediatrics, University of Montreal, Canada
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Perng W, Ringham BM, Glueck DH, Sauder KA, Starling AP, Belfort MB, Dabelea D. An observational cohort study of weight- and length-derived anthropometric indicators with body composition at birth and 5 mo: the Healthy Start study. Am J Clin Nutr 2017; 106:559-567. [PMID: 28659296 PMCID: PMC5525117 DOI: 10.3945/ajcn.116.149617] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 05/24/2017] [Indexed: 12/30/2022] Open
Abstract
Background: Despite widespread use of weight- and length-based anthropometric indexes as proxies for adiposity, little is known regarding the extent to which they correspond with fat mass (FM) or fat-free mass (FFM) during infancy.Objective: This study aimed to examine associations of 3 derived indicators-weight-for-age z score (WFAZ), weight-for-length score (WFLZ), and body mass index z score (BMIZ)-with FM, percentage of FM, and FFM measured by air-displacement plethysmography during the first 5 mo of life.Design: Applying prospectively collected data from 1027 infants in a Colorado prebirth cohort, we used multivariate regression to evaluate associations between the derived indicators and body composition at birth and at 5 mo, and with change (Δ) during follow-up.Results: At birth, all 3 derived indicators were more strongly associated with FFM than with FM. Each unit of WFAZ corresponded with 0.342 kg FFM (95% CI: 0.331, 0.351 kg FFM), compared with 0.121 kg FM (95% CI: 0.114, 0.128 kg FM) (P < 0.0001); similar trends were observed for WFLZ and BMIZ. By 5 mo, WFLZ and BMIZ were more strongly associated with FM than with FFM, whereas WFAZ correlated similarly with the 2 components of body composition. ΔWFLZ and ΔBMIZ were both more strongly related to ΔFM than to ΔFFM; however, a direct comparison of the 2 indexes with respect to change in the percentage of FM indicated that ΔBMIZ was the optimal proxy of adiposity gain (P < 0.0001, pairwise difference).Conclusions: Weight- and length-based indexes are poor surrogates for newborn adiposity. However, at 5 mo, WFLZ and BMIZ are suitable proxies of FM. When assessing adiposity gain, ΔBMIZ is the best indicator of fat accrual during the first 5 postnatal months. This trial was registered at clinicaltrials.gov as NCT02273297.
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Affiliation(s)
- Wei Perng
- Departments of Nutritional Sciences and dana.dabelea@ucdenver
- Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
| | - Brandy M Ringham
- Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, CO
| | - Deborah H Glueck
- Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, CO
| | - Katherine A Sauder
- Department of Pediatrics, School of Medicine, University of Colorado Denver - Anschutz Medical Campus, Denver, CO
| | - Anne P Starling
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO; and
| | - Mandy B Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA
| | - Dana Dabelea
- Department of Pediatrics, School of Medicine, University of Colorado Denver - Anschutz Medical Campus, Denver, CO
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO; and
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Feldman-Winter L, Burnham L, Grossman X, Matlak S, Chen N, Merewood A. Weight gain in the first week of life predicts overweight at 2 years: A prospective cohort study. MATERNAL AND CHILD NUTRITION 2017. [PMID: 28636245 DOI: 10.1111/mcn.12472] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
In formula-fed infants, rapid weight gain during the first week of life is associated with later obesity. To examine the association between weight gain during the first week and overweight at age 2 among infants with various feeding practices and the relationship between exclusive breastfeeding in early infancy and overweight, we enrolled a prospective cohort of healthy mother-infant dyads and followed them for 2 years. We enrolled 450 mother/infant pairs and obtained information on 306 infants at year 2. Weight change during the first week of life and detailed feeding information were collected during the first month of life. Anthropometric measures were collected at 2 years. Overweight was defined as body mass index (BMI) ≥85th percentile for age. At 2 years, 81% had normal weights and 19% were overweight. Maternal pre-pregnancy BMI; infant birth weight; maternal education; and Women, Infants, and Children status were associated with the risk of overweight at age 2. Children who gained more than 100 g during the first week were 2.3 times as likely after adjustment (p = .02) to be overweight at age 2 compared to infants who lost weight. There was no association between feeding type and BMI, but feeding type was significantly associated with change in weight at week 1 and anthropometric measurements at age 2. Infant weight gain in the first week of life is related to overweight at age 2, and exclusively breastfed infants are least likely to gain ≥100 g.
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Affiliation(s)
- Lori Feldman-Winter
- Department of Pediatrics, The Children's Regional Hospital at Cooper, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Laura Burnham
- Division of General Pediatrics, Boston Medical Center, Boston, Massachusetts, USA
| | - Xena Grossman
- Division of General Pediatrics, Boston Medical Center, Boston, Massachusetts, USA
| | - Stephanie Matlak
- Division of General Pediatrics, Boston Medical Center, Boston, Massachusetts, USA
| | - Ning Chen
- Division of General Pediatrics, Boston Medical Center, Boston, Massachusetts, USA
| | - Anne Merewood
- Division of General Pediatrics, Boston Medical Center, Boston, Massachusetts, USA
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Hawkes CP, Zemel BS, Kiely M, Irvine AD, Kenny LC, O'B Hourihane J, Murray DM. Body Composition within the First 3 Months: Optimized Correction for Length and Correlation with BMI at 2 Years. Horm Res Paediatr 2017; 86:178-187. [PMID: 27560149 DOI: 10.1159/000448659] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 07/21/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Although early infant growth has implications for future health, body composition reference data in infancy are limited. The aim of this study was to describe reference data for fat mass (FM) and fat-free mass (FFM) corrected for length (L) within the first 3 months and to evaluate if these measures predict the body mass index (BMI) at 2 years. METHODS Term infants had air displacement plethysmography performed at birth (n = 1,063) and approximately 2 months later (n = 922, between 49 and 86 days). Age- and sex-specific reference data were generated for FM, FFM, FM/L3 and FFM/L2 and compared with BMI at 2 years. RESULTS FM/L3 and FFM/L2 were the optimal indices independent of length. In the first 3 months, mean FM/L3 increased (males, from 2.7 to 5.9 kg/m3; females, from 3.2 to 6.1 kg/m3), whereas FFM/L2 remained relatively stable (males, from 11.8 to 12.7 kg/m2; females, from 12.8 to 12.1 kg/m2). The odds of a BMI Z-score ≥2 at 2 years increased with increasing FM (OR 2.7, 95% CI 1.97-3.7) and weight (OR 2.27, 95% CI 1.64-3.13) Z-scores at 2 months. CONCLUSIONS FM/L3 and FFM/L2 provide length-independent measures of FM and FFM in infancy. During the first 3 months, there is an increase in FM/L3, but not in FFM/L2. The weight Z-score at 2 months is as good at predicting BMI at 2 years as body composition parameters. © 2016 S. Karger AG, Basel.
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Affiliation(s)
- Colin P Hawkes
- Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, Pa., USA
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Postnatal height and adiposity gain, childhood blood pressure and prehypertension risk in an Asian birth cohort. Int J Obes (Lond) 2017; 41:1011-1017. [PMID: 28186098 DOI: 10.1038/ijo.2017.40] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 01/06/2017] [Accepted: 01/31/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE There have been hypotheses that early life adiposity gain may influence blood pressure (BP) later in life. We examined associations between timing of height, body mass index (BMI) and adiposity gains in early life with BP at 48 months in an Asian pregnancy-birth cohort. METHODS In 719 children, velocities for height, BMI and abdominal circumference (AC) were calculated at five intervals [0-3, 3-12, 12-24, 24-36 and 36-48 months]. Triceps (TS) and subscapular skinfold (SS) velocities were calculated between 0-18, 18-36 and 36-48 months. Systolic (SBP) and diastolic blood pressure (DBP) was measured at 48 months. Growth velocities at later periods were adjusted for growth velocities in preceding intervals, as well as measurements at birth. RESULTS After adjusting for confounders and child height at BP measurement, each unit z-score gain in BMI, AC, TS and SS velocities at 36-48 months were associated with 2.3 (95% CI:1.6, 3.1), 2.1 (1.3, 2.8), 1.4 (0.6, 2.2) and 1.8 (1, 2.6) mmHg higher SBP respectively, and 0.9 (0.4, 1.4), 0.9 (0.4, 1.3), 0.6 (0.1, 1.1) and 0.8 (0.3, 1.3) mmHg higher DBP respectively. BMI and adiposity velocities (AC, TS or SS) at various intervals in the first 36 months however, were not associated with BP. Faster BMI, AC, TS and SS velocities, but not height, at 36-48 months were associated with 0.22 (0.15, 0.29), 0.17 (0.10, 0.24), 0.11 (0.04, 0.19) and 0.15 (0.08, 0.23) units higher SBP z-score respectively, and OR=1.46 (95% CI: 1.13-1.90), 1.49 (1.17-1.92), 1.45 (1.09-1.92) and 1.43 (1.09, 1.88) times higher risk of prehypertension/hypertension respectively at 48 months. CONCLUSIONS Our results indicated that faster BMI and adiposity (AC, TS or SS) velocities only at the preceding interval before 48 months (36-48 months), but not at earlier intervals in the first 36 months, are predictive of BP and prehypertension/hypertension at 48 months.
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Taine M, Stengel B, Forhan A, Carles S, Botton J, Charles MA, Heude B. Rapid Early Growth May Modulate the Association Between Birth Weight and Blood Pressure at 5 Years in the EDEN Cohort Study. Hypertension 2016; 68:859-65. [PMID: 27550918 DOI: 10.1161/hypertensionaha.116.07529] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 07/27/2016] [Indexed: 12/30/2022]
Abstract
Physiological evidence suggests that birth weight (BW) and postnatal growth affect blood pressure (BP) level, independently or in interaction. Their respective roles are difficult to disentangle in epidemiological studies, however, especially when adjusting for final weight. We assessed the portion of the effect of BW on BP at 5 years that was not attributable to postnatal growth and investigated potential interactions between BW and postnatal growth velocity at different time points in the EDEN mother-child study. Collecting a median of 19 weight measurements for each of the 1119 children who completed follow-up enabled us to model instantaneous growth velocity at any age. After computing a BP SD-score at 5 years, adjusted for age, sex, current body mass index, and height, we used multiple linear regression to study its association with age- and sex-specific BW z score, adjusting for several maternal and pregnancy risk factors. We tested interactions between BW categories (small-, appropriate-, and large-for-gestational-age) and weight growth velocities at different ages. The BW z score was negatively and significantly correlated with the systolic BP SD-score at the age of 5 years (r=-0.07, P=0.02). Interactions were found between BW categories and weight growth velocities from 1 to 4 months (P from 0.002 to 0.08) but not at older ages; specifically, children born small for gestational age with a fast weight growth velocity in their first few months of life had the highest absolute systolic BP and SD score values at 5 years. They may need monitoring for cardiovascular risks.
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Affiliation(s)
- Marion Taine
- From the Inserm UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early Determinants of Children's Health and Development Team (ORCHAD), Villejuif, France (M.T., A.F., S.C., J.B., M.-A.C., B.H.); Paris Descartes University, Paris, France (M.T., A.F., S.C., M.-A.C., B.H.); Inserm UMRS 1018, Center for Research in Epidemiology and Population Health (CESP), Paris-Sud University, Versailles-Saint-Quentin en Yvelines University, Paris-Saclay University, Villejuif, France (B.S.); Paris Sud University, Villejuif, France (S.C.); and Paris Sud University, Paris-Saclay University, Faculty of Pharmacy, Châtenay-Malabry, France (J.B.).
| | - Bénédicte Stengel
- From the Inserm UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early Determinants of Children's Health and Development Team (ORCHAD), Villejuif, France (M.T., A.F., S.C., J.B., M.-A.C., B.H.); Paris Descartes University, Paris, France (M.T., A.F., S.C., M.-A.C., B.H.); Inserm UMRS 1018, Center for Research in Epidemiology and Population Health (CESP), Paris-Sud University, Versailles-Saint-Quentin en Yvelines University, Paris-Saclay University, Villejuif, France (B.S.); Paris Sud University, Villejuif, France (S.C.); and Paris Sud University, Paris-Saclay University, Faculty of Pharmacy, Châtenay-Malabry, France (J.B.)
| | - Anne Forhan
- From the Inserm UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early Determinants of Children's Health and Development Team (ORCHAD), Villejuif, France (M.T., A.F., S.C., J.B., M.-A.C., B.H.); Paris Descartes University, Paris, France (M.T., A.F., S.C., M.-A.C., B.H.); Inserm UMRS 1018, Center for Research in Epidemiology and Population Health (CESP), Paris-Sud University, Versailles-Saint-Quentin en Yvelines University, Paris-Saclay University, Villejuif, France (B.S.); Paris Sud University, Villejuif, France (S.C.); and Paris Sud University, Paris-Saclay University, Faculty of Pharmacy, Châtenay-Malabry, France (J.B.)
| | - Sophie Carles
- From the Inserm UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early Determinants of Children's Health and Development Team (ORCHAD), Villejuif, France (M.T., A.F., S.C., J.B., M.-A.C., B.H.); Paris Descartes University, Paris, France (M.T., A.F., S.C., M.-A.C., B.H.); Inserm UMRS 1018, Center for Research in Epidemiology and Population Health (CESP), Paris-Sud University, Versailles-Saint-Quentin en Yvelines University, Paris-Saclay University, Villejuif, France (B.S.); Paris Sud University, Villejuif, France (S.C.); and Paris Sud University, Paris-Saclay University, Faculty of Pharmacy, Châtenay-Malabry, France (J.B.)
| | - Jérémie Botton
- From the Inserm UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early Determinants of Children's Health and Development Team (ORCHAD), Villejuif, France (M.T., A.F., S.C., J.B., M.-A.C., B.H.); Paris Descartes University, Paris, France (M.T., A.F., S.C., M.-A.C., B.H.); Inserm UMRS 1018, Center for Research in Epidemiology and Population Health (CESP), Paris-Sud University, Versailles-Saint-Quentin en Yvelines University, Paris-Saclay University, Villejuif, France (B.S.); Paris Sud University, Villejuif, France (S.C.); and Paris Sud University, Paris-Saclay University, Faculty of Pharmacy, Châtenay-Malabry, France (J.B.)
| | - Marie-Aline Charles
- From the Inserm UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early Determinants of Children's Health and Development Team (ORCHAD), Villejuif, France (M.T., A.F., S.C., J.B., M.-A.C., B.H.); Paris Descartes University, Paris, France (M.T., A.F., S.C., M.-A.C., B.H.); Inserm UMRS 1018, Center for Research in Epidemiology and Population Health (CESP), Paris-Sud University, Versailles-Saint-Quentin en Yvelines University, Paris-Saclay University, Villejuif, France (B.S.); Paris Sud University, Villejuif, France (S.C.); and Paris Sud University, Paris-Saclay University, Faculty of Pharmacy, Châtenay-Malabry, France (J.B.)
| | - Barbara Heude
- From the Inserm UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Early Determinants of Children's Health and Development Team (ORCHAD), Villejuif, France (M.T., A.F., S.C., J.B., M.-A.C., B.H.); Paris Descartes University, Paris, France (M.T., A.F., S.C., M.-A.C., B.H.); Inserm UMRS 1018, Center for Research in Epidemiology and Population Health (CESP), Paris-Sud University, Versailles-Saint-Quentin en Yvelines University, Paris-Saclay University, Villejuif, France (B.S.); Paris Sud University, Villejuif, France (S.C.); and Paris Sud University, Paris-Saclay University, Faculty of Pharmacy, Châtenay-Malabry, France (J.B.)
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Sharma D, Shastri S, Sharma P. Intrauterine Growth Restriction: Antenatal and Postnatal Aspects. Clin Med Insights Pediatr 2016; 10:67-83. [PMID: 27441006 PMCID: PMC4946587 DOI: 10.4137/cmped.s40070] [Citation(s) in RCA: 437] [Impact Index Per Article: 54.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 06/07/2016] [Accepted: 06/13/2016] [Indexed: 12/14/2022] Open
Abstract
Intrauterine growth restriction (IUGR), a condition that occurs due to various reasons, is an important cause of fetal and neonatal morbidity and mortality. It has been defined as a rate of fetal growth that is less than normal in light of the growth potential of that specific infant. Usually, IUGR and small for gestational age (SGA) are used interchangeably in literature, even though there exist minute differences between them. SGA has been defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycemia, and polycythemia. The likely long-term complications that are prone to develop when IUGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps, and developmental origin of health and disease. In this review, we have covered various antenatal and postnatal aspects of IUGR.
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Affiliation(s)
- Deepak Sharma
- Department of Neonatology, NEOCLINIC, TN Mishra Marg, Everest Vihar, Nirman Nagar, Jaipur, Rajasthan, India
| | - Sweta Shastri
- Department of Pathology, N.K.P Salve Medical College, Nagpur, Maharashtra, India
| | - Pradeep Sharma
- Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Jaipur, Rajasthan, India
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Won JC, Hong JW, Noh JH, Kim DJ. Association Between Age at Menarche and Risk Factors for Cardiovascular Diseases in Korean Women: The 2010 to 2013 Korea National Health and Nutrition Examination Survey. Medicine (Baltimore) 2016; 95:e3580. [PMID: 27149485 PMCID: PMC4863802 DOI: 10.1097/md.0000000000003580] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Early menarche is strongly associated with adulthood obesity; however, the relationship between age at menarche and cardiovascular disease (CVD) in Korean women remains poorly understood. Here, we investigated the association between early menarche and risk factors for developing CVD during adulthood using a nationwide population database.In total, 12,336 women (weighted n = 17,483,406; weighted age, 45.7 years) who participated in the Korean National Health and Nutrition Examination Survey 2010 to 2013 were included in this study. Participants were scored using the National Cholesterol Education Program Adult Treatment Panel III criteria for metabolic syndrome. Risk of CVD was estimated using the 10-year Framingham Coronary Heart Disease Risk Point Scale (10-year FRS).Early menarche (≤11 years) was reported in 5.2% (weighted n = 917,493) of subjects. The weighted prevalences of metabolic syndrome and ≥20% 10-year FRS were 23.6% [95% confidence interval (95% CI), 22.7-24.6] and 7.7% (7.1-8.3), respectively. Women with early menarche reported a significantly higher body mass index and waist circumference, along with a higher prevalence of hypertension, diabetes, and metabolic syndrome than those with later menarche (≥13 years). Furthermore, the prevalence of women with a ≥10% or ≥20% 10-year FRS was higher in those with early menarche than in other groups after adjusting for age, smoking, education level, and menstruation. Logistic regression analyses controlling for these and other confounding factors revealed odds ratios of 2.29 (95% CI = 1.25-4.19) and 1.78 (0.96-3.30) for ≥10% and ≥20% 10-year FRS in women with early menarche, respectively, compared with those in the latest menarche group (≥17 years).Taken together, this nationwide study revealed that women with early menarche are at increased risks of metabolic syndrome and CVD. Early menarche may therefore represent an important marker for early preventive interventions.
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Affiliation(s)
- Jong Chul Won
- From the Department of Internal Medicine (JCW), Sanggye Paik Hospital, Cardiovascular and Metabolic Disease Center, College of Medicine, Inje University, Seoul, and Department of Internal Medicine (JWH, JHN, D-JK), Ilsan-Paik Hospital, College of Medicine, Inje University, Koyang, Republic of Korea
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Barton M, Husmann M, Meyer MR. Accelerated Vascular Aging as a Paradigm for Hypertensive Vascular Disease: Prevention and Therapy. Can J Cardiol 2016; 32:680-686.e4. [PMID: 27118295 DOI: 10.1016/j.cjca.2016.02.062] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 02/22/2016] [Accepted: 02/23/2016] [Indexed: 12/21/2022] Open
Abstract
Aging is considered the most important nonmodifiable risk factor for cardiovascular disease and death after age 28 years. Because of demographic changes the world population is expected to increase to 9 billion by the year 2050 and up to 12 billion by 2100, with several-fold increases among those 65 years of age and older. Healthy aging and prevention of aging-related diseases and associated health costs have become part of political agendas of governments around the world. Atherosclerotic vascular burden increases with age; accordingly, patients with progeria (premature aging) syndromes die from myocardial infarctions or stroke as teenagers or young adults. The incidence and prevalence of arterial hypertension also increases with age. Arterial hypertension-like diabetes and chronic renal failure-shares numerous pathologies and underlying mechanisms with the vascular aging process. In this article, we review how arterial hypertension resembles premature vascular aging, including the mechanisms by which arterial hypertension (as well as other risk factors such as diabetes mellitus, dyslipidemia, or chronic renal failure) accelerates the vascular aging process. We will also address the importance of cardiovascular risk factor control-including antihypertensive therapy-as a powerful intervention to interfere with premature vascular aging to reduce the age-associated prevalence of diseases such as myocardial infarction, heart failure, hypertensive nephropathy, and vascular dementia due to cerebrovascular disease. Finally, we will discuss the implementation of endothelial therapy, which aims at active patient participation to improve primary and secondary prevention of cardiovascular disease.
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Affiliation(s)
- Matthias Barton
- Molecular Internal Medicine, University of Zürich, Zürich, Switzerland.
| | - Marc Husmann
- Division of Angiology, University Hospital Zürich, Zürich, Switzerland
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