1
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Chen LW, Ng S, Tint MT, Michael N, Sadananthan SA, Ong YY, Yuan WL, Chen ZY, Chen CY, Godfrey KM, Tan KH, Gluckman PD, Chong YS, Eriksson JG, Yap F, Lee YS, Fortier MV, Velan SS, Chan SY. Associations of cord plasma per- and polyfluoroakyl substances (PFAS) with neonatal and child body composition and adiposity: The GUSTO study. ENVIRONMENT INTERNATIONAL 2024; 183:108340. [PMID: 38043321 DOI: 10.1016/j.envint.2023.108340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/26/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The influence of prenatal exposure to per- and poly- fluoroalkyl substances (PFAS) on birth size and offspring adiposity is unclear, especially for the newer, shorter-chained replacement PFAS. METHODS In the GUSTO multi-ethnic Singaporean mother-offspring cohort, 12 PFAS were measured in 783 cord plasma samples using ultra-performance-liquid chromatography-tandem-mass-spectrometer (UPLC-MS/MS). Outcomes included offspring anthropometry, other indicators of body composition/metabolic health, and MRI-derived abdominal adiposity (subset) at birth and 6 years of age. PFAS were modeled individually, in categories of long-chain and short-chain PFAS, and as scores of three principal components (PC) derived using PC analysis (PC1, PC2, and PC3 reflect predominant exposure patterns to "very-long-PFAS", "long-PFAS", and "short-PFAS", respectively). Associations with outcomes were assessed using multivariable linear regressions, adjusted for important covariates such as maternal sociodemographic and lifestyle factors. RESULTS Overall, cord PFAS levels showed either no or positive associations (mostly for long-chain PFAS) with birth weight, length and head circumference. In general, PFAS were associated with higher neonatal abdominal adiposity, driven by shorter-chain PFAS. Perfluoroheptanoic acid (PFHpA) was associated with higher volumes of superficial subcutaneous adipose tissue (sSAT) (3.75 [1.13, 6.37] mL per SD increase in PFAS) and internal adipose tissue (IAT) (1.39 [0.41, 2.38] mL). Higher levels of perfluorobutanesulfonic acid (PFBS), short-chain PFAS, and PC3 were associated with higher IAT volume (β range 1.22-1.41 mL/SD, all P < 0.02), especially in girls. Higher PC3 score was additionally associated with higher sSAT (3.12 [0.45, 5.80] mL) volume. At age 6 years, most observed associations did not persist. No consistent associations were observed between PFAS and whole-body adiposity measures. CONCLUSIONS Fetal exposure to emerging short-chain PFAS was associated with higher abdominal adiposity at birth but not at age 6 years. Further research is needed to replicate the findings and to determine if these effects may reappear beyond early childhood. Population exposure to newer PFAS and consequent health impact must be monitored.
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Affiliation(s)
- Ling-Wei Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 10055, Taiwan; Master of Public Health Program, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 10055, Taiwan; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - Sharon Ng
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - Yi Ying Ong
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, 119228, Singapore; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Wen Lun Yuan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
| | - Ze-Ying Chen
- Institute of Food Safety and Health, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 10055, Taiwan
| | - Chia-Yang Chen
- Institute of Food Safety and Health, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 10055, Taiwan
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Tremona Road, SO16 6YD Southampton, UK
| | - Kok Hian Tan
- Duke-NUS Medical School, 8 College Road, 169857, Singapore; Department of Reproductive Medicine, KK Women's and Children Hospital, Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland 1023, New Zealand
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, 119228, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, 119228, Singapore; Department of General Practice and Primary Health Care, University of Helsinki, Haartmaninkatu 8, 00290 Helsinki, Finland; Folkhälsan Research Center, Topeliusgatan 20, 00250 Helsinki, Finland
| | - Fabian Yap
- Duke-NUS Medical School, 8 College Road, 169857, Singapore; Department of Pediatric Endocrinology, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, 119228, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System, 1E Kent Ridge Road, 119228, Singapore
| | - Marielle V Fortier
- Department of Diagnostic & Interventional Imaging, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
| | - Sendhil S Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609, Singapore; Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, 119228, Singapore.
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2
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Kway YM, Thirumurugan K, Michael N, Tan KH, Godfrey KM, Gluckman P, Chong YS, Venkataraman K, Khoo EYH, Khoo CM, Leow MKS, Tai ES, Chan JK, Chan SY, Eriksson JG, Fortier MV, Lee YS, Velan SS, Feng M, Sadananthan SA. A fully convolutional neural network for comprehensive compartmentalization of abdominal adipose tissue compartments in MRI. Comput Biol Med 2023; 167:107608. [PMID: 37897959 DOI: 10.1016/j.compbiomed.2023.107608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/18/2023] [Accepted: 10/17/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Existing literature has highlighted structural, physiological, and pathological disparities among abdominal adipose tissue (AAT) sub-depots. Accurate separation and quantification of these sub-depots are crucial for advancing our understanding of obesity and its comorbidities. However, the absence of clear boundaries between the sub-depots in medical imaging data has challenged their separation, particularly for internal adipose tissue (IAT) sub-depots. To date, the quantification of AAT sub-depots remains challenging, marked by a time-consuming, costly, and complex process. PURPOSE To implement and evaluate a convolutional neural network to enable granular assessment of AAT by compartmentalization of subcutaneous adipose tissue (SAT) into superficial subcutaneous (SSAT) and deep subcutaneous (DSAT) adipose tissue, and IAT into intraperitoneal (IPAT), retroperitoneal (RPAT), and paraspinal (PSAT) adipose tissue. MATERIAL AND METHODS MRI datasets were retrospectively collected from Singapore Preconception Study for Long-Term Maternal and Child Outcomes (S-PRESTO: 389 women aged 31.4 ± 3.9 years) and Singapore Adult Metabolism Study (SAMS: 50 men aged 28.7 ± 5.7 years). For all datasets, ground truth segmentation masks were created through manual segmentation. A Res-Net based 3D-UNet was trained and evaluated via 5-fold cross-validation on S-PRESTO data (N = 300). The model's final performance was assessed on a hold-out (N = 89) and an external test set (N = 50, SAMS). RESULTS The proposed method enabled reliable segmentation of individual AAT sub-depots in 3D MRI volumes with high mean Dice similarity scores of 98.3%, 97.2%, 96.5%, 96.3%, and 95.9% for SSAT, DSAT, IPAT, RPAT, and PSAT respectively. CONCLUSION Convolutional neural networks can accurately sub-divide abdominal SAT into SSAT and DSAT, and abdominal IAT into IPAT, RPAT, and PSAT with high accuracy. The presented method has the potential to significantly contribute to advancements in the field of obesity imaging and precision medicine.
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Affiliation(s)
- Yeshe M Kway
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kashthuri Thirumurugan
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore
| | - Kok Hian Tan
- Duke-National University of Singapore Graduate Medical School, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kavita Venkataraman
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore
| | - Eric Yin Hao Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chin Meng Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Medicine, National University Health System, Singapore
| | - Melvin Khee-Shing Leow
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University (NTU), Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital (TTSH), Singapore
| | - E Shyong Tai
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Endocrinology, University Medicine Cluster, National University Health System, Singapore
| | - Jerry Ky Chan
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore; Experimental Fetal Medicine Group, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University Health System, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Marielle V Fortier
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore
| | - Mengling Feng
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore; Institute of Data Science, National University of Singapore, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore.
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3
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Michael N, Gupta V, Fogel A, Huang J, Chen L, Sadananthan SA, Ong YY, Aris IM, Pang WW, Yuan WL, Loy SL, Thway Tint M, Tan KH, Chan JK, Chan SY, Shek LPC, Yap F, Godfrey K, Chong YS, Gluckman P, Velan SS, Forde CG, Lee YS, Eriksson JG, Karnani N. Longitudinal characterization of determinants associated with obesogenic growth patterns in early childhood. Int J Epidemiol 2022; 52:426-439. [PMID: 36087338 PMCID: PMC10114026 DOI: 10.1093/ije/dyac177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 08/29/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Longitudinal assessment of the determinants of obesogenic growth trajectories in childhood can suggest appropriate developmental windows for intervention. METHODS Latent class growth mixture modelling was used to identify body mass index (BMI) z-score trajectories from birth to age 6 years in 994 children from a prospective mother-offspring cohort (Chinese, Indian and Malay ethnicities) based in Singapore. We evaluated the early-life determinants of the trajectories as well as their associations with cardiometabolic risk markers at age 6 years. RESULTS Five BMI z-score trajectory patterns were identified, three within the healthy weight range, alongside early-acceleration and late-acceleration obesogenic trajectories. The early-acceleration pattern was characterized by elevated fetal abdominal circumference growth velocity, BMI acceleration immediately after birth and crossing of the obesity threshold by age 2 years. The late-acceleration pattern had normal fetal growth and BMI acceleration after infancy, and approached the obesity threshold by age 6 years. Abdominal fat, liver fat, insulin resistance and odds of pre-hypertension/hypertension were elevated in both groups. Indian ethnicity, high pre-pregnancy BMI, high polygenic risk scores for obesity and shorter breastfeeding duration were common risk factors for both groups. Malay ethnicity and low maternal educational attainment were uniquely associated with early BMI acceleration, whereas nulliparity and obesogenic eating behaviours in early childhood were uniquely associated with late BMI acceleration. CONCLUSION BMI acceleration starting immediately after birth or after infancy were both linked to early cardiometabolic alterations. The determinants of these trajectories may be useful for developing early risk stratification and intervention approaches to counteract metabolic adversities linked to childhood obesity.
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Affiliation(s)
- Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Varsha Gupta
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Anna Fogel
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Jonathan Huang
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Li Chen
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Yi Ying Ong
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA
| | - Wei Wei Pang
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wen Lun Yuan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Université de Paris, CRESS, Inserm, INRAE, Paris, France
| | - See Ling Loy
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore.,Academic Medicine, Duke-National University of Singapore Graduate Medical School, Singapore
| | - Jerry Ky Chan
- Duke-NUS Medical School, Singapore.,Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Fabian Yap
- Duke-NUS Medical School, Singapore.,Department of Pediatrics, KK Women's and Children's Hospital, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Keith Godfrey
- MRC Lifecourse Epidemiology Centre and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Institute of Bioengineering & Bioimaging, Agency for Science Technology and Research, Singapore
| | - Ciarán G Forde
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Bioinformatics Institute, Agency for Science Technology and Research, Singapore
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4
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Demashkieh M, Dalan R, Burns SF. Cardiorespiratory fitness and fat oxidation during exercise in Chinese, Indian, Malay men with elevated body mass index. Appl Physiol Nutr Metab 2022; 47:888-892. [PMID: 35679614 DOI: 10.1139/apnm-2022-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A cross-sectional pilot investigation in Chinese, Indian and Malay men (15 each) with elevated BMI to compare: (i) cardiorespiratory fitness (CRF); and (ii) fat oxidation at rest and maximal fat oxidation during exercise. Predicted CRF (Chinese: 37.0 (5.1) mL/kg/min; Indian: 34.8 (5.6) mL/kg/min; Malay: 33.0 (7.1) mL/kg/min; P = 0.208) and resting fat oxidation were similar among groups. Maximal fat oxidation during exercise was lower in Indian (3.81 (1.02) mg/kg/min, P = 0.004) and Malay (Malay: 3.36 (0.95) mg/kg/min, P < 0.001) than Chinese (5.17 (1.23) mg/kg/min) men. Fat oxidation during exercise may contribute toward obesity risk in Asian populations. ClinicalTrials.gov Identifier: NCT05337111.
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Affiliation(s)
- Mayada Demashkieh
- Nanyang Technological University National Institute of Education, 63238, Singapore, Singapore, Singapore;
| | - Rinkoo Dalan
- Nanyang Technological University, 54761, Singapore, Singapore, Singapore.,Tan Tock Seng Hospital, 63703, Department of Endocrinology, Singapore, Singapore;
| | - Stephen Francis Burns
- Nanyang Technological University National Institute of Education, 63238, Singapore, Singapore, Singapore;
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5
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Tan KML, Tint MT, Kothandaraman N, Michael N, Sadananthan SA, Velan SS, Fortier MV, Yap F, Tan KH, Gluckman PD, Chong YS, Chong MFF, Lee YS, Godfrey KM, Eriksson JG, Cameron-Smith D. The Kynurenine Pathway Metabolites in Cord Blood Positively Correlate With Early Childhood Adiposity. J Clin Endocrinol Metab 2022; 107:e2464-e2473. [PMID: 35150259 PMCID: PMC9113811 DOI: 10.1210/clinem/dgac078] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT The kynurenine pathway generates metabolites integral to energy metabolism, neurotransmission, and immune function. Circulating kynurenine metabolites positively correlate with adiposity in children and adults, yet it is not known whether this relationship is present already at birth. OBJECTIVE In this prospective longitudinal study, we investigate the relationship between cord blood kynurenine metabolites and measures of adiposity from birth to 4.5 years. METHODS Liquid chromatography-tandem mass spectrometry was used to quantify cord blood kynurenine metabolites in 812 neonates from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study. Fat percentage was measured by air displacement plethysmography and abdominal adipose tissue compartment volumes; superficial (sSAT) and deep subcutaneous (dSAT) and internal adipose tissue were quantified by magnetic resonance imaging at early infancy in a smaller subset of neonates, and again at 4 to 4.5 years of age. RESULTS Cord blood kynurenine metabolites appeared to be higher in female newborns, higher in Indian newborns compared with Chinese newborns, and higher in infants born by cesarean section compared with vaginal delivery. Kynurenine, xanthurenic acid, and quinolinic acid were positively associated with birthweight, but not with subsequent weight during infancy and childhood. Quinolinic acid was positively associated with sSAT at birth. Kynurenic acid and quinolinic acid were positively associated with fat percentage at 4 years. CONCLUSION Several cord blood kynurenine metabolite concentrations were positively associated with birthweight, with higher kynurenic acid and quinolinic acid correlating to higher percentage body fat in childhood, suggesting these cord blood metabolites as biomarkers of early childhood adiposity.
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Affiliation(s)
- Karen Mei-Ling Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Department of Laboratory Medicine, National University Hospital, 119074, Singapore
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Department of Obstetrics and Gynaecology, Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, 119228, Singapore
| | - Narasimhan Kothandaraman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Institute of Bioengineering and Bioimaging (IBB), Agency for Science Technology and Research, 138669, Singapore
| | - Marielle V Fortier
- Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, 229899, Singapore
| | - Fabian Yap
- Duke-National University of Singapore (NUS) Medical School, 169857, Singapore
- Department of Pediatric Endocrinology, KK Women’s and Children’s Hospital, 229899, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, 636921, Singapore
| | - Kok Hian Tan
- Duke-National University of Singapore (NUS) Medical School, 169857, Singapore
- Perinatal Audit and Epidemiology, Department of Maternal Fetal Medicine, KK Women’s and Children’s Hospital, 119228, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Department of Obstetrics and Gynaecology, Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, 119228, Singapore
- Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, 117597, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 117549, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 119228, Singapore
- Khoo Teck Puat – National University Children’s Medical Institute, National University Health System, 119074, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton SO16 6YD, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton Hospital, Southampton SO16 6YD, United Kingdom
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Department of Obstetrics and Gynaecology, Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, 119228, Singapore
- Folkhälsan Research Center, 00250 Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, 00290 Helsinki, Finland
| | - David Cameron-Smith
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), 117609, Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, 117596, Singapore
- Correspondence: Professor David Cameron Smith, Singapore Institute for Clinical Sciences, Brenner Centre for Molecular Medicine, Agency for Science, Technology and Research, 30 Medical Drive 117609, Singapore.
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6
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Slapnicar C, Lear SA, Dehghan M, Gupta M, Rangarajan S, Punthakee Z. Relationship of parental feeding practices and diet with children's diet among South Asians in Canada. Appetite 2022; 173:105991. [PMID: 35271940 DOI: 10.1016/j.appet.2022.105991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/17/2022] [Accepted: 02/27/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND South Asian children's diets are considered unhealthy, yet the relationship with food parenting among South Asians is understudied. METHODS In a cross-sectional study, questionnaires were administered to dyads of Canadian South Asian elementary and high school children and a parent. Relationships between parental factors (perceived responsibility, restriction, pressure to eat, monitoring, home food environment, nutrition knowledge and intake of fruits and vegetables (FV), sugary beverages (SB) and sweets and fast foods (SWFF) and children's intake of FV, SB and SWFF were assessed by linear regression adjusted for sociodemographics. Subgroup differences by children's age and acculturation were explored by interaction analysis. RESULTS 291 children (age 9.8 ± 3.2 years) had mean daily intake frequencies of 3.1 ± 2.0 FV, 1.0 ± 0.9 SB and 2.1 ± 1.5 SWFF. Positive associations were found between parent and child intake of FV (standardized beta (ß) = 0.230, [95%CI 0.115, 0.345], p < 0.001), SB (β = 0.136 [0.019, 0.252], p = 0.02), and SWFF (β = 0.167 [0.052, 0.282], p = 0.005). Parental monitoring was associated with lower children's SWFF intake (ß = -0.131 [-0.248, -0.015], p = 0.03). Among those expressing less Western culture, parental SWFF intake was associated with child's SB intake (β = 0.255 [0.085, 0.425], p = 0.004). Among those expressing less traditional culture, positive home food environment was associated with lower child SWFF intake (β = -0.208 [-0.374, -0.042], p = 0.015). CONCLUSION South Asian children's diets have stronger relationships with their parents' diets than with food parenting practices or nutrition knowledge, though parental monitoring was associated with lower unhealthy food intake. However, with greater acculturation, the home food environment was more important for unhealthy food intake.
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Affiliation(s)
- Calum Slapnicar
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada; Population Health Research Institute, Hamilton, ON, Canada
| | | | - Milan Gupta
- Canadian Collaborative Research Network, Brampton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Zubin Punthakee
- Population Health Research Institute, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.
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Moya M, Pérez-Fernandez V. Estimating trunk fat in children according to sex using basic somatic readings: an opportunity for improving evaluation among girls. BMC Pediatr 2021; 21:446. [PMID: 34629070 PMCID: PMC8504037 DOI: 10.1186/s12887-021-02918-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 09/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The fat mass estimators waist-to-height ratio (WHtR) and relative fat mass-pediatric (RFMp) complement the widely accepted body mass index (BMI) in obesity evaluation. AIMS OF THE STUDY Conduct an easy appraisal of trunk fat and the cardiometabolic risk associated with pediatric obesity. METHODS A total of 472 children (39% boys in the total sample) were classified as underweight, normal weight, overweight or obese (nutritional groups, NGs) according to BMI Z-score after initial anthropometric data were obtained and ad hoc exclusion criteria were applied. WHtR and RFMp (% of total fat) were calculated for each group, associations were assessed through multiple linear regression (MLR), and differences between sexes were evaluated (medians, IQR). RESULTS The mean age (mean (95% CI)) was 10.8 y (10.1-11.1). The values in the total sample were as follows: WHtR, 0.5 (0.49-0.51) and RFMp%, 32.3 (31.7-33.0). In the overweight group, the values were as follows: WHtR, 0.51 (0.50-0.52) and RFMp(%), 34.2 (33.3-35.1). In the obese group, the values were as follows: WHtR, 0.56 (0.55-0.57) and RFMp(%), 37.8 (36.9-38.6). The associations were as follows (NG; independent variables): In the NG, adjusted R2 values were between 0.74 and 0.78. In the total sample, the beta coefficient was 3.36 (P < 0.001) for RFMp for girls; for waist circumference (WC), the beta coefficient was 2.97 (P < 0.001), and for WHtR the beta coefficients were - 0.01 (p < 0.001) and 0.03 (p < 0.001),for girls and for WC respectively. The sex differences were as follows: BMI exhibited no differences in the NG (Mann-Whitney U). WHtR (median (IQR)) differed (M vs. F) in the total sample (0.49 (0.45-0.54) vs. 0.52 (0.45-0.56), p < 0.004); in the overweight group (0.51 (0.48-0.53) vs. 0.54 (0.51-0.55), p < 0.001); and in the obese group (0.55 (0.52-0.57) vs. 0.57 (0.54-0.60), p < 0.004). RFMp (%) differed in the total group (29.21 (24.27-32.92) vs. 36.63 (30.2-39.51), p < 0.001); in the overweight group (31.24 (28.35-32.35) vs. 37.95 (35.75-38.82), p < 0.001) and in the obese group (35.89 (32.05-36.15) vs. 40.63 (38.27-42.42), p < 0.001). CONCLUSIONS WHtR and RFMp are simple and reliable indices that do not require centile charts. Their values, including waist circumference, can be used to estimate the different trunk fat components in boys and girls better than BMI, especially if individuals are overweight or obese. RFMp proved to be more reliable as it considers sex. Both should be included in routine anthropometric readings.
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Affiliation(s)
- Manuel Moya
- Universidad Miguel Hernández, Health Sciences Campus of S. Juan, UMH Campus de S. Juan, Edificio Balmis, room S01 P002; Av Ramón y Cajal s/n. 03550 San Juan, Alicante, Spain
| | - Virginia Pérez-Fernandez
- Department of Surgery, Pediatrics and Obs & Gynecology, Facultad de Medicina, Universidad de Murcia, LAIB Building, Av. Buenavista s/n 30120 El Palmar, Murcia, Spain
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8
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Kway YM, Thirumurugan K, Tint MT, Michael N, Shek LPC, Yap FKP, Tan KH, Godfrey KM, Chong YS, Fortier MV, Marx UC, Eriksson JG, Lee YS, Velan SS, Feng M, Sadananthan SA. Automated Segmentation of Visceral, Deep Subcutaneous, and Superficial Subcutaneous Adipose Tissue Volumes in MRI of Neonates and Young Children. Radiol Artif Intell 2021; 3:e200304. [PMID: 34617030 DOI: 10.1148/ryai.2021200304] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 06/01/2021] [Accepted: 07/12/2021] [Indexed: 11/11/2022]
Abstract
Purpose To develop and evaluate an automated segmentation method for accurate quantification of abdominal adipose tissue (AAT) depots (superficial subcutaneous adipose tissue [SSAT], deep subcutaneous adipose tissue [DSAT], and visceral adipose tissue [VAT]) in neonates and young children. Materials and Methods This was a secondary analysis of prospectively collected data, which used abdominal MRI data from Growing Up in Singapore Towards healthy Outcomes, or GUSTO, a longitudinal mother-offspring cohort, to train and evaluate a convolutional neural network for volumetric AAT segmentation. The data comprised imaging volumes of 333 neonates obtained at early infancy (age ≤2 weeks, 180 male neonates) and 755 children aged either 4.5 years (n = 316, 150 male children) or 6 years (n = 439, 219 male children). The network was trained on images of 761 randomly selected volumes (neonates and children combined) and evaluated on 100 neonatal volumes and 227 child volumes by using 10-fold validation. Automated segmentations were compared with expert-generated manual segmentation. Segmentation performance was assessed using Dice scores. Results When the model was tested on the test datasets across the 10 folds, the model had strong agreement with the ground truth for all testing sets, with mean Dice similarity scores for SSAT, DSAT, and VAT, respectively, of 0.960, 0.909, and 0.872 in neonates and 0.944, 0.851, and 0.960 in children. The model generalized well to different body sizes and ages and to all abdominal levels. Conclusion The proposed segmentation approach provided accurate automated volumetric assessment of AAT compartments on MR images of neonates and children.Keywords Pediatrics, Deep Learning, Convolutional Neural Networks, Water-Fat MRI, Image Segmentation, Deep and Superficial Subcutaneous Adipose Tissue, Visceral Adipose TissueClinical trial registration no. NCT01174875 Supplemental material is available for this article. © RSNA, 2021.
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Affiliation(s)
- Yeshe Manuel Kway
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Kashthuri Thirumurugan
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Navin Michael
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Fabian Kok Peng Yap
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Kok Hian Tan
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Keith M Godfrey
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Marielle Valerie Fortier
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Ute C Marx
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Mengling Feng
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences (Y.M.K., K.T., M.T.T., N.M., L.P.C.S., Y.S.C., M.V.F., J.G.E., Y.S.L., S.S.V., S.A.S.) and Institute of Bioengineering and Bioimaging (S.S.V.), Agency for Science Technology and Research, 30 Medical Dr, Singapore 117609; Departments of Medicine (Y.M.K., J.G.E.), Obstetrics and Gynaecology (M.T.T., Y.S.C.), and Pediatrics (L.P.C.S., Y.S.L.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore (L.P.C.S., Y.S.L.); Departments of Pediatric Endocrinology (F.K.P.Y.), Obstetrics and Gynaecology (K.H.T.), and Diagnostic and Interventional Imaging (M.V.F.), KK Women's and Children's Hospital, Singapore; Pediatrics Academic Clinical Programme (F.K.P.Y.), Academic Medicine (K.H.T.), Duke-National University of Singapore Medical School, Singapore (F.K.P.Y., K.H.T.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (F.K.P.Y.); Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, England (K.M.G.); School of Engineering, Pforzheim University, Pforzheim, Germany (U.C.M.); Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (J.G.E.); Folkhälsan Research Center, Helsinki, Finland (J.G.E.); and Saw Swee Hock School of Public Health, National University Health System and National University of Singapore, Singapore (M.F.); Institute of Data Science, National University of Singapore, Singapore (M.F.)
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9
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Tint MT, Michael N, Sadananthan SA, Huang JY, Khoo CM, Godfrey KM, Shek LPC, Lek N, Tan KH, Yap F, Velan SS, Gluckman PD, Chong YS, Karnani N, Chan SY, Leow MKS, Lee KJ, Lee YS, Hu HH, Zhang C, Fortier MV, Eriksson JG. Brown Adipose Tissue, Adiposity, and Metabolic Profile in Preschool Children. J Clin Endocrinol Metab 2021; 106:2901-2914. [PMID: 34143868 PMCID: PMC8475202 DOI: 10.1210/clinem/dgab447] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Indexed: 02/08/2023]
Abstract
CONTEXT An inverse relationship between brown adipose tissue (BAT) and obesity has previously been reported in older children and adults but is unknown in young children. OBJECTIVE We investigated the influence of BAT in thermoneutral condition on adiposity and metabolic profile in Asian preschool children. DESIGN, SETTING, AND PARTICIPANTS A total of 198 children aged 4.5 years from a prospective birth cohort study, Growing Up in Singapore Towards Healthy Outcomes (GUSTO) were successfully studied with water-fat magnetic resonance imaging of the supraclavicular and axillary fat depot (FDSA). Regions within FDSA with fat-signal-fraction between 20% and 80% were considered BAT, and percentage BAT (%BAT; 100*BAT volume/ FDSA volume) was calculated. MAIN OUTCOME MEASURES Abdominal adipose tissue compartment volumes, ectopic fat in the soleus muscle and liver, fatty liver index, metabolic syndrome scores, and markers of insulin sensitivity. RESULTS A 1% unit increase in %BAT was associated with lower body mass index, difference (95% CI), -0.08 (-0.10, -0.06) kg/m2 and smaller abdominal adipose tissue compartment volumes. Ethnicity and sex modified these associations. In addition, each unit increase in %BAT was associated with lower ectopic fat at 4.5 years in the liver, -0.008% (-0.013%, -0.003%); soleus muscle, -0.003% (-0.006%, -0.001%) of water content and lower fatty liver index at 6 years. CONCLUSIONS Higher %BAT is associated with a more favorable metabolic profile. BAT may thus play a role in the pathophysiology of obesity and related metabolic disorders. The observed ethnic and sex differences imply that the protective effect of BAT may vary among different groups.
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Affiliation(s)
- Mya Thway Tint
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Jonathan Yinhao Huang
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Chin Meng Khoo
- Division of Endocrinology, Department of Medicine, National University Health System, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation Trust, Southampton, UK
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ngee Lek
- Department of Pediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore
| | - Kok Hian Tan
- Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore
| | - Fabian Yap
- Department of Pediatric Endocrinology, KK Women’s and Children’s Hospital, Singapore
- Duke-NUS Graduate Medical School, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Singapore Bioimaging Consortium (SBIC), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Melvin Khee-Shing Leow
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore
- Metabolic Disorders Research Programme, Lee Kong Chian School of Medicine, Singapore
- Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore
| | - Kuan Jin Lee
- Singapore Bioimaging Consortium (SBIC), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Yung-Seng Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat–National University Children’s Medical Institute, National University Health System, Singapore
| | - Houchun Harry Hu
- Department of Radiology, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD, USA
| | - Marielle V Fortier
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Correspondence: Johan G. Eriksson, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, MD1, Tahir Foundation Building, Level 12, #12-02/03, 12 Science Drive 2, Singapore 117549, Singapore. ;
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10
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Padmapriya N, Tint MT, Sadananthan SA, Michael N, Chen B, Cai S, Toh JY, Lanca C, Tan KH, Saw SM, Shek LPC, Chong YS, Gluckman PD, Lee YS, Yap F, Fortier MV, Chong MFF, Godfrey KM, Eriksson JG, Velan SS, Kramer MS, Bernard JY, Müller-Riemenschneider F. The longitudinal association between early-life screen viewing and abdominal adiposity-findings from a multiethnic birth cohort study. Int J Obes (Lond) 2021; 45:1995-2005. [PMID: 34108642 PMCID: PMC7611569 DOI: 10.1038/s41366-021-00864-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 05/02/2021] [Accepted: 05/18/2021] [Indexed: 02/05/2023]
Abstract
IMPORTANCE Screen viewing in adults has been associated with greater abdominal adiposity, with the magnitude of associations varying by sex and ethnicity, but the evidence is lacking at younger ages. We aimed to investigate sex- and ethnic-specific associations of screen-viewing time at ages 2 and 3 years with abdominal adiposity measured by magnetic resonance imaging at age 4.5 years. METHODS The Growing Up in Singapore Towards healthy Outcomes is an ongoing prospective mother-offspring cohort study. Parents/caregivers reported the time their child spent viewing television, handheld devices, and computer screens at ages 2 and 3 years. Superficial and deep subcutaneous and visceral abdominal adipose tissue volumes were quantified from magnetic resonance images acquired at age 4.5 years. Associations between screen-viewing time and abdominal adipose tissue volumes were examined by multivariable linear regression adjusting for confounding factors. RESULTS In the overall sample (n = 307), greater total screen-viewing time and handheld device times were associated with higher superficial and deep subcutaneous adipose tissue volumes, but not with visceral adipose tissue volumes. Interactions with child sex were found, with significant associations with superficial and deep subcutaneous and visceral adipose tissue volumes in boys, but not in girls. Among boys, the increases in mean (95% CI) superficial and deep subcutaneous and visceral adipose tissue volumes were 24.3 (9.9, 38.7), 17.6 (7.4, 27.8), and 7.8 (2.1, 13.6) mL per hour increase in daily total screen-viewing time, respectively. Ethnicity-specific analyses showed associations of total screen-viewing time with abdominal adiposity only in Malay children. Television viewing time was not associated with abdominal adiposity. CONCLUSION Greater total screen-viewing time (and in particular, handheld device viewing time) was associated with higher abdominal adiposity in boys and Malay children. Additional studies are necessary to confirm these associations and to examine screen-viewing interventions for preventing excessive abdominal adiposity and its adverse cardiometabolic consequences.
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Affiliation(s)
- Natarajan Padmapriya
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| | - Mya-Thway Tint
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Bozhi Chen
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Shirong Cai
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Carla Lanca
- Singapore Eye Research Institute, Singapore, Singapore
| | - Kok Hian Tan
- KK Women's and Children's Hospital, Singapore, Singapore
- Duke-National University of Singapore, Singapore, Singapore
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Singapore Eye Research Institute, Singapore, Singapore
- Duke-National University of Singapore, Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Yap Seng Chong
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Fabian Yap
- KK Women's and Children's Hospital, Singapore, Singapore
- Duke-National University of Singapore, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | | | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Johan G Eriksson
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Institute for Bioengineering and Bioimaging, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Michael S Kramer
- Department of Obstetrics & Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Pediatrics, McGill University Faculty of Medicine, Montreal, QC, Canada
- Department of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, QC, Canada
| | - Jonathan Y Bernard
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Centre for Research in Epidemiology and Statistics (CRESS), Université de Paris, Inserm, INRAE, Paris, France
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Berlin Institute of Health, Charite University Medical Centre, Berlin, Germany
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11
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Yuan WL, Kramer MS, Michael N, Sadananthan SA, Tint MT, Chen LW, Pang WW, Velan SS, Godfrey KM, Chong YS, Chong MFF, Choo JTL, Ling LH, Eriksson JG, Lee YS. Trajectories of Systolic Blood Pressure in Children: Risk Factors and Cardiometabolic Correlates. J Pediatr 2021; 236:86-94.e6. [PMID: 34019883 PMCID: PMC7611585 DOI: 10.1016/j.jpeds.2021.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify systolic blood pressure (SBP) percentile trajectories in children and to describe the early-life risk factors and cardiometabolic correlates of those trajectories. STUDY DESIGN Using age-, sex-, and height-specific SBP percentiles based on the American Academy of Pediatrics reference, we examined SBP trajectories using latent class mixed models from ages 3 to 8 years (n = 844) from the Growing Up in Singapore Towards healthy Outcomes-study, a Singaporean mother-offspring cohort study. We analyzed associations between SBP trajectories and early-life risk factors using multinomial logistic regression and differences across trajectories in cardiometabolic outcomes using multiple linear regression. RESULTS Children were classified into 1 of 4 SBP percentile trajectories: "low increasing" (15%), "high stable" (47%), "high decreasing" (20%), and "low stable" (18%). Maternal hypertension during early pregnancy was a predictor of the "high stable" and "low increasing" SBP trajectories. Rapid child weight gain in the first 2 years of life was only associated with the "high stable" trajectory. Compared with children in the "low stable" trajectory, children in the "high stable" SBP trajectory had greater body mass index z scores, sum of skinfold thicknesses, waist circumference from ages 3 to 8 years, and abdominal adipose tissue (milliliters) at 4.5 years (adjusted mean difference [95% CI]: superficial and deep subcutaneous abdominal adipose tissue: 115.2 [48.1-182.3] and 85.5 [35.2-135.8]). Their fat mass (kilograms) (1.3 [0.6-2.0]), triglyceride levels (mmol/L) (0.10 [0.02-0.18]), and homeostasis model assessment of insulin resistance (0.28 [0.11 0.46]) at age 6 years were also greater but not their arterial thickness and stiffness. CONCLUSIONS Reducing maternal blood pressure during pregnancy and infant weight gain in the first 2 years of life might help to prevent the development of high SBP.
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Affiliation(s)
- Wen Lun Yuan
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Michael S Kramer
- Department of Paediatrics, Faculty of Medicine, McGill University, Montreal, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, Canada
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Suresh A Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Mya T Tint
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Ling-Wei Chen
- HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Wei Wei Pang
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sendhil S Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
- Singapore Bioimaging Consortium, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Mary FF Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Lieng Hsi Ling
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Johan G Eriksson
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
- Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
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12
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CAFT: a deep learning-based comprehensive abdominal fat analysis tool for large cohort studies. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2021; 35:205-220. [PMID: 34338926 DOI: 10.1007/s10334-021-00946-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/24/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND There is increasing appreciation of the association of obesity beyond co-morbidities, such as cancers, Type 2 diabetes, hypertension, and stroke to also impact upon the muscle to give rise to sarcopenic obesity. Phenotypic knowledge of obesity is crucial for profiling and management of obesity, as different fat-subcutaneous adipose tissue depots (SAT) and visceral adipose tissue depots (VAT) have various degrees of influence on metabolic syndrome and morbidities. Manual segmentation is time consuming and laborious. Study focuses on the development of a deep learning-based, complete data processing pipeline for MRI-based fat analysis, for large cohort studies which include (1) data augmentation and preprocessing (2) model zoo (3) visualization dashboard, and (4) correction tool, for automated quantification of fat compartments SAT and VAT. METHODS Our sample comprised 190 healthy community-dwelling older adults from the Geri-LABS study with mean age of 67.85 ± 7.90 years, BMI 23.75 ± 3.65 kg/m2, 132 (69.5%) female, and mainly Chinese ethnicity. 3D-modified Dixon T1-weighted gradient-echo MR images were acquired. Residual global aggregation-based 3D U-Net (RGA-U-Net) and standard 3D U-Net were trained to segment SAT, VAT, superficial and deep subcutaneous adipose tissue depots (SSAT and DSAT). Manual segmentation from 26 subjects was used as ground truth during training. Data augmentations, random bias, noise and ghosting were carried out to increase the number of training datasets to 130. Segmentation accuracy was evaluated using Dice and Hausdorff metrics. RESULTS The accuracy of segmentation was SSAT:0.92, DSAT:0.88 and VAT:0.9. Average Hausdorff distance was less than 5 mm. Automated segmentation significantly correlated R2 > 0.99 (p < 0.001) with ground truth for all 3-fat compartments. Predicted volumes were within ± 1.96SD from Bland-Altman analysis. CONCLUSIONS DL-based, comprehensive SSAT, DSAT, and VAT analysis tool showed high accuracy and reproducibility and provided a comprehensive fat compartment composition analysis and visualization in less than 10 s.
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13
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Morrison JL, Ayonrinde OT, Care AS, Clarke GD, Darby JRT, David AL, Dean JM, Hooper SB, Kitchen MJ, Macgowan CK, Melbourne A, McGillick EV, McKenzie CA, Michael N, Mohammed N, Sadananthan SA, Schrauben E, Regnault TRH, Velan SS. Seeing the fetus from a DOHaD perspective: discussion paper from the advanced imaging techniques of DOHaD applications workshop held at the 2019 DOHaD World Congress. J Dev Orig Health Dis 2021; 12:153-167. [PMID: 32955011 DOI: 10.1017/s2040174420000884] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Advanced imaging techniques are enhancing research capacity focussed on the developmental origins of adult health and disease (DOHaD) hypothesis, and consequently increasing awareness of future health risks across various subareas of DOHaD research themes. Understanding how these advanced imaging techniques in animal models and human population studies can be both additively and synergistically used alongside traditional techniques in DOHaD-focussed laboratories is therefore of great interest. Global experts in advanced imaging techniques congregated at the advanced imaging workshop at the 2019 DOHaD World Congress in Melbourne, Australia. This review summarizes the presentations of new imaging modalities and novel applications to DOHaD research and discussions had by DOHaD researchers that are currently utilizing advanced imaging techniques including MRI, hyperpolarized MRI, ultrasound, and synchrotron-based techniques to aid their DOHaD research focus.
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Affiliation(s)
- Janna L Morrison
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Oyekoya T Ayonrinde
- Fiona Stanley Hospital, Murdoch, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Alison S Care
- The Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Geoffrey D Clarke
- Department of Radiology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Jack R T Darby
- Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Anna L David
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Justin M Dean
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Stuart B Hooper
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia
- The Department of Obstetrics and Gynecology, Monash University, Melbourne, Victoria, Australia
| | - Marcus J Kitchen
- School of Physics and Astronomy, Monash University, Melbourne, Victoria, Australia
| | | | - Andrew Melbourne
- School of Biomedical Engineering and Imaging Sciences, Kings College London, London, UK
| | - Erin V McGillick
- The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia
- The Department of Obstetrics and Gynecology, Monash University, Melbourne, Victoria, Australia
| | - Charles A McKenzie
- Department of Medical Biophysics, Western University, London, ON, Canada
- Lawson Health Research Institute and Children's Health Research Institute, London, ON, Canada
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Nuruddin Mohammed
- Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, Aga Khan University Hospital, Karachi, Pakistan
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Eric Schrauben
- Translational Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Timothy R H Regnault
- Lawson Health Research Institute and Children's Health Research Institute, London, ON, Canada
- Department of Obstetrics and Gynecology, Western University, London, ON, Canada
- Department of Physiology and Pharmacology, Western University, London, ON, Canada
| | - S Sendhil Velan
- Singapore Bioimaging Consortium, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
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14
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Ong YY, Sadananthan SA, Aris IM, Tint MT, Yuan WL, Huang JY, Chan YH, Ng S, Loy SL, Velan SS, Fortier MV, Godfrey KM, Shek L, Tan KH, Gluckman PD, Yap F, Choo JTL, Ling LH, Tan K, Chen L, Karnani N, Chong YS, Eriksson JG, Wlodek ME, Chan SY, Lee YS, Michael N. Mismatch between poor fetal growth and rapid postnatal weight gain in the first 2 years of life is associated with higher blood pressure and insulin resistance without increased adiposity in childhood: the GUSTO cohort study. Int J Epidemiol 2020; 49:1591-1603. [PMID: 32851407 PMCID: PMC7116531 DOI: 10.1093/ije/dyaa143] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Using longitudinal ultrasounds as an improved fetal growth marker, we aimed to investigate if fetal growth deceleration followed by rapid postnatal weight gain is associated with childhood cardiometabolic risk biomarkers in a contemporary well-nourished population. METHODS We defined fetal growth deceleration (FGD) as ultrasound-measured 2nd-3rd-trimester abdominal circumference decrease by ≥0.67 standard deviation score (SDS) and rapid postnatal weight gain (RPWG) as 0-2-year-old weight increase by ≥0.67 SDS. In the GUSTO mother-offspring cohort, we grouped 797 children into four groups of FGD-only (14.2%), RPWG-only (23.3%), both (mismatch, 10.7%) or neither (reference, 51.8%). Adjusting for confounders and comparing with the reference group, we tested associations of these growth groups with childhood cardiometabolic biomarkers: magnetic resonance imaging (MRI)-measured abdominal fat (n = 262), liver fat (n = 216), intramyocellular lipids (n = 227), quantitative magnetic resonance-measured overall body fat % (BF%) (n = 310), homeostasis model assessment of insulin resistance (HOMA-IR) (n = 323), arterial wall thickness (n = 422) and stiffness (n = 443), and blood pressure trajectories (ages 3-6 years). RESULTS Mean±SD birthweights were: FGD-only (3.11 ± 0.38 kg), RPWG-only (3.03 ± 0.37 kg), mismatch (2.87 ± 0.31 kg), reference (3.30 ± 0.36 kg). FGD-only children had elevated blood pressure trajectories without correspondingly increased BF%. RPWG-only children had altered body fat partitioning, higher BF% [BF = 4.26%, 95% confidence interval (CI) (2.34, 6.19)], HOMA-IR 0.28 units (0.11, 0.45)] and elevated blood pressure trajectories. Mismatch children did not have increased adiposity, but had elevated ectopic fat, elevated HOMA-IR [0.29 units (0.04,0.55)] and the highest blood pressure trajectories. Associations remained even after excluding small-for-gestational-age infants from analyses. CONCLUSIONS Fetal growth deceleration coupled with rapid postnatal weight gain was associated with elevated childhood cardiometabolic risk biomarkers without correspondingly increased BF%.
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Affiliation(s)
- Yi Ying Ong
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wen Lun Yuan
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jonathan Y Huang
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sharon Ng
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - See Ling Loy
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Sendhil S Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Singapore Bioimaging Consortium, Agency for Science Technology and Research, Singapore, Singapore
| | - Marielle V Fortier
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lynette Shek
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Pediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore, Singapore
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fabian Yap
- Duke-NUS Medical School, Singapore, Singapore
- Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | | | - Lieng Hsi Ling
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Karen Tan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Molecular Diagnosis Centre, Department of Laboratory Medicine, National University Health System, Singapore, Singapore
| | - Li Chen
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mary E Wlodek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Physiology, University of Melbourne, Melbourne, VIC, Australia
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yung Seng Lee
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Pediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
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15
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Tint MT, Sadananthan SA, Soh SE, Aris IM, Michael N, Tan KH, Shek LPC, Yap F, Gluckman PD, Chong YS, Godfrey KM, Velan SS, Chan SY, Eriksson JG, Fortier MV, Zhang C, Lee YS. Maternal glycemia during pregnancy and offspring abdominal adiposity measured by MRI in the neonatal period and preschool years: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) prospective mother-offspring birth cohort study. Am J Clin Nutr 2020; 112:39-47. [PMID: 32219421 PMCID: PMC7351532 DOI: 10.1093/ajcn/nqaa055] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 02/26/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Gestational diabetes is associated with unfavorable body fat distribution in offspring. However, less is known about the effects across the range of maternal gestational glycemia on offspring abdominal adiposity (AA) in infancy and early childhood. OBJECTIVES This study determined the association between gestational glycemia and offspring AA measured by MRI in the neonatal period and during the preschool years. METHODS Participants were mother-offspring pairs from the GUSTO (Growing Up in Singapore Towards healthy Outcomes) prospective cohort study. Children who underwent MRI within 2 wk postdelivery (n = 305) and/or at preschool age, 4.5 y (n = 273), and whose mothers had a 2-h 75-g oral-glucose-tolerance test (OGTT) at 26-28 weeks of gestation were included. AA measured by adipose tissue compartment volumes-abdominal superficial (sSAT), deep subcutaneous (dSAT), and internal (IAT) adipose tissue-was quantified from MRI images. RESULTS Adjusting for potential confounders including maternal prepregnancy BMI, each 1-mmol/L increase in maternal fasting glucose was associated with higher SD scores for sSAT (0.66; 95% CI: 0.45, 0.86), dSAT (0.65; 95% CI: 0.44, 0.87), and IAT (0.64; 95% CI: 0.42, 0.86) in neonates. Similarly, each 1-mmol/L increase in 2-h OGTT glucose was associated with higher neonatal sSAT (0.11; 95% CI: 0.03, 0.19) and dSAT (0.09; 95% CI: 0.00, 0.17). These associations were stronger in female neonates but only persisted in girls between fasting glucose, and sSAT and dSAT at 4.5 y. CONCLUSIONS A positive association between maternal glycemia and neonatal AA was observed across the whole range of maternal mid-gestation glucose concentrations. These findings may lend further support to efforts toward optimizing maternal hyperglycemia during pregnancy. The study also provides suggestive evidence on sex differences in the impact of maternal glycemia, which merits further confirmation in other studies.This trial was registered at clinicaltrials.gov as NCT01174875.
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Affiliation(s)
- Mya-Thway Tint
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore
| | - Suresh A Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore
| | - Shu-E Soh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore
| | - Kok H Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
- Academic Medicine, Duke–National University of Singapore Graduate Medical School, Singapore
| | - Lynette P C Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Fabian Yap
- Department of Pediatric Endocrinology, KK Women's and Children's Hospital, Singapore
- Duke–National University of Singapore Graduate Medical School, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yap-Seng Chong
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, Univeristyof Southhampton, Southampton, United Kingdom
- National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton, NHS Foundation Trust, Southhampton, United Kingdom
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore
- Singapore Bioimaging Consortium, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Shiao-Yng Chan
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore
| | - Johan G Eriksson
- Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Marielle V Fortier
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore
| | - Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Rockville, MD, USA
| | - Yung S Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Pediatric Endocrinology, Department of Pediatrics, Khoo Teck Puat—National University Children's Medical Institute, National University Health System, Singapore
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16
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Grunnet LG, Lund ASQ, Laigaard KK, Alibegovic AC, Jensen RT, Henriksen NS, Astrup A, Vaag A, Brøns C. Abdominal fat distribution measured by ultrasound and aerobic fitness in young Danish men born with low and normal birth weight. Obes Res Clin Pract 2019; 13:529-532. [PMID: 31757746 DOI: 10.1016/j.orcp.2019.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/17/2019] [Accepted: 10/29/2019] [Indexed: 12/14/2022]
Abstract
Abdominal subcutaneous and visceral adipose tissue thickness was examined by ultrasound in 17 men with low birth weight (LBW) and 26 with normal BW control individuals to determine if abdominal obesity in LBW individuals is due to increased visceral or subcutaneous fat mass/thickness, or both. Men born with LBW had an increased waist-to-hip ratio (P = 0.04), greater abdominal fat thickness (P = 0.05) and increased visceral (VAT) and subcutaneous adipose tissue (SAT) thickness compared with controls, however the latter not statistically significant (P = 0.08, P = 0.10). A significant difference between birth weight groups in both SAT (P = 0.04) and VAT (P = 0.03) was found after adjustment for weight, whereas no significant difference in either SAT (P = 0.93) or VAT (P = 0.30) was found after adjustment for BMI. Increased waist-to-hip ratio in LBW individuals is due to increased total abdominal fat including both subcutaneous and visceral fat.
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Affiliation(s)
- Louise G Grunnet
- Steno Diabetes Center, Gentofte, Denmark; Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark
| | - Anne-Sofie Q Lund
- Steno Diabetes Center, Gentofte, Denmark; Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Denmark
| | - Klaus K Laigaard
- Steno Diabetes Center, Gentofte, Denmark; Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Denmark
| | | | - Rasmus T Jensen
- Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark
| | | | - Arne Astrup
- Department of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Denmark
| | - Allan Vaag
- Cardiovascular and Metabolic Disease (CVMD) Translational Medicine Unit, Early Clinical Development, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Charlotte Brøns
- Steno Diabetes Center, Gentofte, Denmark; Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.
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