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Augsburger P, Liimatta J, Flück CE. Update on Adrenarche-Still a Mystery. J Clin Endocrinol Metab 2024; 109:1403-1422. [PMID: 38181424 DOI: 10.1210/clinem/dgae008] [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: 09/11/2023] [Revised: 12/29/2023] [Accepted: 01/04/2024] [Indexed: 01/07/2024]
Abstract
CONTEXT Adrenarche marks the timepoint of human adrenal development when the cortex starts secreting androgens in increasing amounts, in healthy children at age 8-9 years, with premature adrenarche (PA) earlier. Because the molecular regulation and significance of adrenarche are unknown, this prepubertal event is characterized descriptively, and PA is a diagnosis by exclusion with unclear long-term consequences. EVIDENCE ACQUISITION We searched the literature of the past 5 years, including original articles, reviews, and meta-analyses from PubMed, ScienceDirect, Web of Science, Embase, and Scopus, using search terms adrenarche, pubarche, DHEAS, steroidogenesis, adrenal, and zona reticularis. EVIDENCE SYNTHESIS Numerous studies addressed different topics of adrenarche and PA. Although basic studies on human adrenal development, zonation, and zona reticularis function enhanced our knowledge, the exact mechanism leading to adrenarche remains unsolved. Many regulators seem involved. A promising marker of adrenarche (11-ketotestosterone) was found in the 11-oxy androgen pathway. By current definition, the prevalence of PA can be as high as 9% to 23% in girls and 2% to 10% in boys, but only a subset of these children might face related adverse health outcomes. CONCLUSION New criteria for defining adrenarche and PA are needed to identify children at risk for later disease and to spare children with a normal variation. Further research is therefore required to understand adrenarche. Prospective, long-term studies should characterize prenatal or early postnatal developmental pathways that modulate trajectories of birth size, early postnatal growth, childhood overweight/obesity, adrenarche and puberty onset, and lead to abnormal sexual maturation, fertility, and other adverse outcomes.
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Affiliation(s)
- Philipp Augsburger
- Pediatric Endocrinology, Diabetology, and Metabolism, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
| | - Jani Liimatta
- Pediatric Endocrinology, Diabetology, and Metabolism, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
- Kuopio Pediatric Research Unit (KuPRU), University of Eastern Finland and Kuopio University Hospital, 70029 Kuopio, Finland
| | - Christa E Flück
- Pediatric Endocrinology, Diabetology, and Metabolism, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
- Department of BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
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Burton JJN, Alonso LC. Overnutrition in the early postnatal period influences lifetime metabolic risk: Evidence for impact on pancreatic β-cell mass and function. J Diabetes Investig 2024; 15:263-274. [PMID: 38193815 PMCID: PMC10906026 DOI: 10.1111/jdi.14136] [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: 11/17/2023] [Accepted: 12/05/2023] [Indexed: 01/10/2024] Open
Abstract
Overconsumption of energy-rich foods that disrupt caloric balance is a fundamental cause of overweight, obesity and diabetes. Dysglycemia and the resulting cardiovascular disease cause substantial morbidity and mortality worldwide, as well as high societal cost. The prevalence of obesity in childhood and adolescence is increasing, leading to younger diabetes diagnosis, and higher severity of microvascular and macrovascular complications. An important goal is to identify early life conditions that increase future metabolic risk, toward the goal of preventing diabetes and cardiovascular disease. An ample body of evidence implicates prenatal and postnatal childhood growth trajectories in the programming of adult metabolic disease. Human epidemiological data show that accelerated childhood growth increases risk of type 2 diabetes in adulthood. Type 2 diabetes results from the combination of insulin resistance and pancreatic β-cell failure, but specific mechanisms by which accelerated postnatal growth impact one or both of these processes remain uncertain. This review explores the metabolic impact of overnutrition during postnatal life in humans and in rodent models, with specific attention to the connection between accelerated childhood growth and future adiposity, insulin resistance, β-cell mass and β-cell dysfunction. With improved knowledge in this area, we might one day be able to modulate nutrition and growth in the critical postnatal window to maximize lifelong metabolic health.
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Affiliation(s)
- Joshua JN Burton
- Division of Endocrinology, Diabetes and Metabolism and the Joan and Sanford I. Weill Center for Metabolic Health, Weill Cornell MedicineNew York CityNew YorkUSA
| | - Laura C Alonso
- Division of Endocrinology, Diabetes and Metabolism and the Joan and Sanford I. Weill Center for Metabolic Health, Weill Cornell MedicineNew York CityNew YorkUSA
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Lu C, Wolfs D, El ghormli L, Levitsky LL, Levitt Katz LE, Laffel LM, Patti ME, Isganaitis E. Growth Hormone Mediators and Glycemic Control in Youths With Type 2 Diabetes: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2024; 7:e240447. [PMID: 38421647 PMCID: PMC10905312 DOI: 10.1001/jamanetworkopen.2024.0447] [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: 10/17/2023] [Accepted: 01/06/2024] [Indexed: 03/02/2024] Open
Abstract
Importance Youth-onset type 2 diabetes (T2D) has a more aggressive phenotype than adult-onset T2D, including rapid loss of glycemic control and increased complication risk. Objective To identify associations of growth hormone mediators with glycemic failure, beta cell function, and insulin sensitivity in youth-onset T2D. Design, Setting, and Participants This post hoc secondary analysis of the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) randomized clinical trial, which enrolled participants from July 2004 to February 2009, included 398 participants from 15 university-affiliated medical centers with available plasma samples from baseline and 36 months. Participants were youths aged 10 to 17 years with a duration of T2D of less than 2 years who were randomized to metformin, metformin plus lifestyle intervention, or metformin plus rosiglitazone. Participants were followed up for a mean (SD) of 3.9 (1.5) years during the trial, ending in 2011. Statistical analysis was performed from August 2022 to November 2023. Exposure Plasma insulin-like growth factor-1 (IGF-1), growth hormone receptor (GHR), and insulin-like growth factor binding protein 1 (IGFBP-1). Main Outcomes and Measures Main outcomes were (1) loss of glycemic control during the TODAY study, defined as hemoglobin A1c (HbA1c) level of 8% or more for 6 months or inability to wean from insulin therapy, and (2) baseline and 36-month measures of glycemia (fasting glucose, HbA1c), insulin sensitivity (1/fasting C-peptide), high-molecular-weight adiponectin, and beta cell function (C-peptide index, C-peptide oral disposition index). Results This analysis included 398 participants (mean [SD] age, 13.9 [2.0] years; 248 girls [62%]; 166 Hispanic participants [42%]; 134 non-Hispanic Black participants [34%], and 84 non-Hispanic White participants [21%]). A greater increase in IGF-1 level between baseline and 36 months was associated with lower odds of glycemic failure (odds ratio [OR], 0.995 [95% CI, 0.991-0.997]; P < .001) and higher C-peptide index per 100-ng/mL increase in IGF-1 (β [SE], 0.015 [0.003]; P < .001). A greater increase in log2 GHR level between baseline and 36 months was associated with higher odds of glycemic failure (OR, 1.75 [95% CI, 1.05-2.99]; P = .04) and lower C-peptide index (β [SE], -0.02 [0.006]; P < .001). A greater increase in log2 IGFBP-1 level between baseline and 36 months was associated with higher odds of glycemic failure (OR, 1.37 [95% CI, 1.09-1.74]; P = .007) and higher high-molecular-weight adiponectin (β [SE], 431 [156]; P = .007). Conclusions and Relevance This study suggests that changes in plasma growth hormone mediators are associated with loss of glycemic control in youth-onset T2D, with IGF-1 associated with lower risk and GHR and IGFBP-1 associated with increased risk. Trial Registration ClinicalTrials.gov Identifier: NCT00081328.
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Affiliation(s)
- Chang Lu
- Division of Endocrinology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
| | - Danielle Wolfs
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
| | - Laure El ghormli
- The Biostatistics Center, George Washington University, Washington, DC
| | - Lynne L. Levitsky
- Division of Pediatric Endocrinology and Diabetes, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Lorraine E. Levitt Katz
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Lori M. Laffel
- Division of Endocrinology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
| | | | - Elvira Isganaitis
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
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Tamer G, Arets HGM, van der Ent CK, van Santen HM, van der Kamp HJ. BMI increase during early childhood in boys with cystic fibrosis and early adrenarche. Pediatr Pulmonol 2024. [PMID: 38270329 DOI: 10.1002/ppul.26861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 11/21/2023] [Accepted: 01/02/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Increase in body mass index (BMI) in early childhood (1-6 years) was found to be a contributing factor for impaired final height in boys with Cystic Fibrosis (CF). Early adrenarche (before age 9 years in boys) may contribute to an impaired final height by triggering an early acceleration of bone age resulting in a compromised growth spurt during puberty. We aimed to analyze the timing of adrenarche in boys with CF and to associate BMI increase in early childhood to timing of adrenarche. METHODS Boys with CF, aged 8-9 years, visiting the CF expertize center Utrecht were included. Since 2018, anthropomorphic, pubertal and endocrine data were collected. Early adrenarche in boys was defined as a dehydroepiandrosterone sulfate (DHEAS) ≥ 1 µmol/L before the age of 9 years. RESULTS Thirteen boys (mean age 8.55 ± 0.27 years) were enrolled. The median (IQR) DHEAS-level was 1.3 µmol/L (0.71-2.40). Eight boys (61.5%) had an early rise in DHEAS-levels ≥ 1 µmol/L. Mean increase in BMI Z-score between 1 and 6 years of age (ΔBMI1-6 ) was -0.07 ± 0.86. A significant correlation was found between ΔBMI1-6 and DHEAS-levels at the age of 8-9 years (r = 0.624, p = 0.040). In five boys with early rise in DHEAS, accelerated bone age was found (average 1.55 ± 0.96 years). CONCLUSION In this small cohort, 61.5% of boys with CF between 8 and 9 years had an early rise of DHEAS, which was correlated to ΔBMI1 -6 between 1 and 6 years. Early adrenarche may be caused by ΔBMI1 -6 .
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Affiliation(s)
- Gizem Tamer
- Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, the Netherlands
- Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, the Netherlands
| | - Hubertus Gerardus Maria Arets
- Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, the Netherlands
| | - Cornelis Kors van der Ent
- Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, the Netherlands
| | - Hanneke Margo van Santen
- Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, the Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Hetty Jacoba van der Kamp
- Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center, Utrecht, the Netherlands
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Wells JCK, Desoye G, Leon DA. Reconsidering the developmental origins of adult disease paradigm: The 'metabolic coordination of childbirth' hypothesis. Evol Med Public Health 2024; 12:50-66. [PMID: 38380130 PMCID: PMC10878253 DOI: 10.1093/emph/eoae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/18/2023] [Indexed: 02/22/2024] Open
Abstract
In uncomplicated pregnancies, birthweight is inversely associated with adult non-communicable disease (NCD) risk. One proposed mechanism is maternal malnutrition during pregnancy. Another explanation is that shared genes link birthweight with NCDs. Both hypotheses are supported, but evolutionary perspectives address only the environmental pathway. We propose that genetic and environmental associations of birthweight with NCD risk reflect coordinated regulatory systems between mother and foetus, that evolved to reduce risks of obstructed labour. First, the foetus must tailor its growth to maternal metabolic signals, as it cannot predict the size of the birth canal from its own genome. Second, we predict that maternal alleles that promote placental nutrient supply have been selected to constrain foetal growth and gestation length when fetally expressed. Conversely, maternal alleles that increase birth canal size have been selected to promote foetal growth and gestation when fetally expressed. Evidence supports these hypotheses. These regulatory mechanisms may have undergone powerful selection as hominin neonates evolved larger size and encephalisation, since every mother is at risk of gestating a baby excessively for her pelvis. Our perspective can explain the inverse association of birthweight with NCD risk across most of the birthweight range: any constraint of birthweight, through plastic or genetic mechanisms, may reduce the capacity for homeostasis and increase NCD susceptibility. However, maternal obesity and diabetes can overwhelm this coordination system, challenging vaginal delivery while increasing offspring NCD risk. We argue that selection on viable vaginal delivery played an over-arching role in shaping the association of birthweight with NCD risk.
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Affiliation(s)
- Jonathan C K Wells
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Gernot Desoye
- Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
| | - David A Leon
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Calcaterra V, Mannarino S, Garella V, Rossi V, Biganzoli EM, Zuccotti G. Cardiovascular Risk in Pediatrics: A Dynamic Process during the First 1000 Days of Life. Pediatr Rep 2023; 15:636-659. [PMID: 37987283 PMCID: PMC10661305 DOI: 10.3390/pediatric15040058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/08/2023] [Accepted: 10/24/2023] [Indexed: 11/22/2023] Open
Abstract
The early childhood period, encompassing prenatal and early stages, assumes a pivotal role in shaping cardiovascular risk factors. We conducted a narrative review, presenting a non-systematic summation and analysis of the available literature, focusing on cardiovascular risk from prenatal development to the first 1000 days of life. Elements such as maternal health, genetic predisposition, inadequate fetal nutrition, and rapid postnatal growth contribute to this risk. Specifically, maternal obesity and antibiotic use during pregnancy can influence transgenerational risk factors. Conditions at birth, such as fetal growth restriction and low birth weight, set the stage for potential cardiovascular challenges. To consider cardiovascular risk in early childhood as a dynamic process is useful when adopting a personalized prevention for future healthcare and providing recommendations for management throughout their journey from infancy to early adulthood. A comprehensive approach is paramount in addressing early childhood cardiovascular risks. By targeting critical periods and implementing preventive strategies, healthcare professionals and policymakers can pave the way for improved cardiovascular outcomes. Investing in children's health during their early years holds the key to alleviating the burden of cardiovascular diseases for future generations.
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Affiliation(s)
- Valeria Calcaterra
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy
| | - Savina Mannarino
- Pediatric Cardiology Unit, Buzzi Children's Hospital, 20154 Milan, Italy
| | - Vittoria Garella
- Pediatric Cardiology Unit, Buzzi Children's Hospital, 20154 Milan, Italy
| | - Virginia Rossi
- Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy
| | - Elia Mario Biganzoli
- Medical Statistics Unit, Department of Biomedical and Clinical Sciences, University Hospital, University of Milan, 20157 Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
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Cauzzo C, Chiavaroli V, Di Valerio S, Chiarelli F. Birth size, growth trajectory and later cardio-metabolic risk. Front Endocrinol (Lausanne) 2023; 14:1187261. [PMID: 37342257 PMCID: PMC10277632 DOI: 10.3389/fendo.2023.1187261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/19/2023] [Indexed: 06/22/2023] Open
Abstract
There is increasing evidence of a strong association between intrauterine growth and subsequent development of chronic disease in adult life. Birth size and growth trajectory have been demonstrated to have an impact on cardio-metabolic health, both in childhood and adult life. Hence, careful observation of the children's growth pattern, starting from the intrauterine period and the first years of life, should be emphasized to detect the possible onset of cardio-metabolic sequelae. This allows to intervene on them as soon as they are detected, first of all through lifestyle interventions, whose efficacy seems to be higher when they are started early. Recent papers suggest that prematurity may constitute an independent risk factor for the development of cardiovascular disease and metabolic syndrome, regardless of birth weight. The purpose of the present review is to examine and summarize the available knowledge about the dynamic association between intrauterine and postnatal growth and cardio-metabolic risk, from childhood to adulthood.
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Affiliation(s)
- Chiara Cauzzo
- Department of Pediatrics, University of Chieti, Chieti, Italy
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Fetal growth restriction followed by early catch-up growth impairs pancreatic islet morphology in male rats. Sci Rep 2023; 13:2732. [PMID: 36792668 PMCID: PMC9932152 DOI: 10.1038/s41598-023-28584-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 01/20/2023] [Indexed: 02/17/2023] Open
Abstract
Fetal growth restriction (FGR), followed by postnatal early catch-up growth, is associated with an increased risk of metabolic dysfunction, including type 2 diabetes in humans. This study aims to determine the effects of FGR and early catch-up growth after birth on the pathogenesis of type 2 diabetes, with particular attention to glucose tolerance, pancreatic islet morphology, and fibrosis, and to elucidate its mechanism using proteomics analysis. The FGR rat model was made by inducing mild intrauterine hypoperfusion using ameroid constrictors (ACs). On day 17 of pregnancy, ACs were affixed to the uterine and ovarian arteries bilaterally, causing a 20.9% reduction in birth weight compared to sham pups. On postnatal day 4 (P4), the pups were assigned to either the good nutrition (GN) groups with 5 pups per dam to ensure postnatal catch-up growth or poor nutrition groups with 15 pups per dam to maintain lower body weight. After weaning, all pups were fed regular chow food ad libitum (P21). Rats in both FGR groups developed glucose intolerance; however, male rats in the FGR good nutrition (FGR-GN) group also developed hypertriglyceridemia and dysmorphic pancreatic islets with fibrosis. A comprehensive and functional analysis of proteins expressed in the pancreas showed that FGR, followed by early catch-up growth, severely aggravated cell adhesion-related protein expression in male offspring. Thus, FGR and early catch-up growth caused pancreatic islet morphological abnormalities and fibrosis associated with the disturbance of cell adhesion-related protein expressions. These changes likely induce glucose intolerance and dyslipidemia in male rats.
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Northstone K, Ben Shlomo Y, Teyhan A, Hill A, Groom A, Mumme M, Timpson N, Golding J. The Avon Longitudinal Study of Parents and children ALSPAC G0 Partners: A cohort profile. Wellcome Open Res 2023. [DOI: 10.12688/wellcomeopenres.18782.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
ALSPAC is an ongoing population-based, observational study designed to investigate how genetic/environmental characteristics might influence the health/development of children and their parents. It has evolved to facilitate the measurement of many outcomes in the parental cohort. Pregnant women resident in Bristol, UK with expected dates of delivery between April 1991-December 1992 were eligible. 14,541 pregnancies were originally enrolled. Partners of the pregnant women were initially invited to take part by the women with formal enrolment of individuals since 2010. Data has been collected from 12,113 partners, with 3,807 formally enrolled. Data collected to date: 21 questionnaires, clinical follow up in 2012 (mean age: 53 years) and a family-based clinical follow-up currently ongoing (mean age: 63 years). Questionnaires asked about a wide range of environmental measures, physical/mental health and other phenotypic details including six questionnaires throughout the COVID-19 pandemic. Clinical measures include anthropometrics, blood pressure, body composition, cardiovascular health and a fasting blood sample. DNA has been extracted with genome-wide data available on >3,000 partners and exomes on ~1500 trios. The data contributes to one of the most deeply phenotyped birth cohorts in the world, providing trios of data and multi-generational information, and is fully accessible through a managed access process.
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Donnelly NA, Perry BI, Jones HJ, Khandaker GM. Childhood immuno-metabolic markers and risk of depression and psychosis in adulthood: A prospective birth cohort study. Psychoneuroendocrinology 2022; 139:105707. [PMID: 35286909 DOI: 10.1016/j.psyneuen.2022.105707] [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: 10/29/2021] [Revised: 02/25/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Metabolic and inflammatory disorders commonly co-occur with depression and psychosis, with emerging evidence implicating immuno-metabolic dysfunction in their aetiology. Previous studies have reported metabolic dysfunction and inflammation in adults with depression and psychosis. However, longitudinal studies testing the direction of association, and the effects of different dimensions of early-life immuno-metabolic dysfunction on adult psychopathology are limited. METHODS Using data from 3258 birth cohort participants we examined longitudinal associations of three metabolic hormones (leptin, adiponectin, insulin) at age 9 with risks for depression- and psychosis-spectrum outcomes at age 24. In addition, using nine immuno-metabolic biomarkers (leptin, adiponectin, insulin, interleukin-6, C-Reactive protein, low density lipoprotein, high density lipoprotein, triglycerides, and BMI), we constructed an exploratory bifactor model showing a general immuno-metabolic factor and three specific factors (adiposity, inflammation, and insulin resistance), which were also used as exposures. RESULTS Childhood leptin was associated with adult depressive episode (adjusted odds ratio (aOR)= 1.31; 95% CI, 1.02-1.71) and negative symptoms (aOR=1.15; 95% CI, 1.07-1.24), but not positive psychotic symptoms. The general immuno-metabolic factor was associated with atypical depressive symptoms (aOR=1.07; 95% CI, 1.01-1.14) and psychotic experiences (aOR=1.21; 95% CI, 1.02-1.44). The adiposity factor was associated with negative symptoms (aOR=1.07; 95% CI 1.02-1.12). Point estimates tended to be larger in women, though 95% credible intervals overlapped with those for men. In women, the inflammatory factor was associated with depressive episodes (aOR=1.27; 95% CI, 1.03-1.57). CONCLUSIONS While general immuno-metabolic dysfunction in childhood may contribute to risks for both psychotic and depressive symptoms in adulthood, childhood adiposity and inflammation appear to be particularly linked to affective (depressive and negative), but not positive psychotic symptoms.
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Affiliation(s)
- N A Donnelly
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Avon and Wiltshire Mental Health Partnership NHS Trust, UK.
| | - B I Perry
- Department of Psychiatry, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - H J Jones
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, UK
| | - G M Khandaker
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Avon and Wiltshire Mental Health Partnership NHS Trust, UK; Department of Psychiatry, University of Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, UK; NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK; MRC Integrative Epidemiology Unit, University of Bristol, UK
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Aydin BK, Kadioglu A, Kaya GA, Devecioglu E, Bas F, Poyrazoglu S, Gokcay G, Darendeliler F. Pelvic and breast ultrasound abnormalities and associated metabolic disturbances in girls with premature pubarche due to adrenarche. Clin Endocrinol (Oxf) 2022; 96:339-345. [PMID: 34918373 DOI: 10.1111/cen.14662] [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: 08/06/2021] [Revised: 12/12/2021] [Accepted: 12/14/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Premature adrenarche (PA) has been suggested as a risk factor for future health problems, such as metabolic syndrome and early menarche. However, not all girls with PA have these features and it is not certain who will develop them. We propose that these abnormalities might be identified earlier, even before they are visible. DESIGN Case-control study. SETTING Tertiary care hospital. PARTICIPANTS Forty-eight girls with premature pubarche due to PA and age (mean age 7.6 ± 1.0 years), weight, body mass index (BMI), birth weight and gestational age-matched 49 girls with no palpable breast tissue. MEASUREMENTS Early pubertal pelvic and breast ultrasonographic changes and their associations with obesity and metabolic parameters were evaluated. Blood samples were collected, breast and pelvic ultrasound examinations were performed and bone ages were assessed. RESULTS Girls with PA were taller and their bone ages were higher (p = .049 and p = .005). Fasting blood glucose, insulin, triglycerides, high-density lipoprotein and low-density lipoprotein cholesterol were not different between the groups. Luteinizing hormone (LH), follicle-stimulating hormone (FSH) and estradiol were not different either. Ultrasonography revealed breast gland tissue in 30% of girls with PA and 5% of controls (p = .006). Uterine volume and endometrial thickness were higher in girls with PA (p = .03 and p = .04). Endometrial thickness was positively associated with serum insulin levels in the whole study group and after adjusting for age, diagnosis, BMI, mean ovarian volume and LH, FSH, estradiol levels, this association remained with a borderline p-value (R2 = 0.486, p = .050). CONCLUSIONS We found early changes in uterus and breast glands of girls with PA and endometrial thickness was positively associated with insulin levels.
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Affiliation(s)
- Banu K Aydin
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alev Kadioglu
- ALKA Radiological Diagnosis Center, Istanbul, Turkey
| | - Gamze A Kaya
- Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Esra Devecioglu
- Department of Pediatrics, Institute of Child Health, Istanbul University, Istanbul, Turkey
| | - Firdevs Bas
- Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sukran Poyrazoglu
- Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gulbin Gokcay
- Department of Pediatrics, Institute of Child Health, Istanbul University, Istanbul, Turkey
| | - Feyza Darendeliler
- Department of Pediatrics, Pediatric Endocrinology Unit, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Carr TF, Granell R, Stern DA, Guerra S, Wright A, Halonen M, Henderson J, Martinez FD. High Insulin in Early Childhood Is Associated with Subsequent Asthma Risk Independent of Body Mass Index. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:785-792.e5. [PMID: 34656798 PMCID: PMC9059620 DOI: 10.1016/j.jaip.2021.09.047] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Asthma and obesity are major, interconnected public health challenges that usually have their origins in childhood, and for which the relationship is strengthened among those with insulin resistance. OBJECTIVE To determine whether high insulin in early life confers increased longitudinal risk for asthma independent of body mass index. METHODS The study used data from the Tucson Children's Respiratory Study (TCRS) and the Avon Longitudinal Study of Parents and Children (ALSPAC). Nonfasting insulin was measured in TCRS participants at age 6 years and fasting insulin in ALSPAC participants at age 8 years. Physician-diagnosed active asthma was determined at baseline and at subsequent assessments up to age 36 years in TCRS and 17 years in ALSPAC. RESULTS In TCRS, high insulin (upper quartile) at age 6 years was associated with increased odds of having active asthma from ages 8 to 36 years compared with low insulin (odds ratio,1.98; 95% CI, 1.28-3.05; P = .002). Similarly, in ALSPAC, high insulin was associated with a significantly higher risk of active asthma from ages 11 to 17 years compared with low insulin (odds ratio, 1.59; 95% CI, 1.12-2.27; P = .009). These findings were independent of baseline body mass index in both cohorts, and were not related to other demographic and asthma risk factors nor other tested markers of systemic inflammation and metabolic syndrome. CONCLUSIONS In 2 separate birth cohorts, higher blood insulin level in early childhood was associated with increased risk of active asthma through adolescence and adulthood, independent of body mass index. High insulin indicates a novel mechanism for asthma development, which may be a target for intervention.
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Affiliation(s)
- Tara F Carr
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz.
| | | | - Debra A Stern
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
| | - Stefano Guerra
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
| | - Anne Wright
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
| | - Marilyn Halonen
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
| | | | - Fernando D Martinez
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz
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13
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Olgun EG, Cetin SK, Siklar Z, Aycan Z, Ozsu E, Ceran A, Berberoglu M. Investigation of early puberty prevalence and time of addition thelarche to pubarche in girls with premature pubarche: two-year follow-up results. Clin Pediatr Endocrinol 2022; 31:25-32. [PMID: 35002065 PMCID: PMC8713059 DOI: 10.1297/cpe.2021-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/25/2021] [Indexed: 11/28/2022] Open
Abstract
We aimed to determine the prevalence of early puberty in girls with premature pubarche
and analyze the time interval between their pubarche and succeeding thelarche. This study
included 60 female children with premature pubarche. We retrospectively collected
clinical, laboratory, and radiological findings from all participants. We investigated the
time interval between pubarche and thelarche in cases wherein premature pubarche was
followed by thelarche. The mean age at onset of pubarche was 6.93 ± 0.79 yr old. Among the
participants, 16.7% were preterm, 20% were small for gestational age (SGA), and 55% were
overweight or obese. The mean time interval between pubarche and thelarche was 11.20 ±
7.41 mo. The mean serum DHEA-S level was higher in the preterm group (p = 0.016), and
DHEA-S levels were generally higher in the SGA group (p = 0.004). This study documented
the presence of being overweight or obese and having more advanced growth than their
genetic potential in half of the patients who had premature pubarche. In addition to these
identified risk factors, obesity-independent DHEA-S levels were observed to be higher in
patients who had early puberty with the first six months of their follow-up considered to
be the most critical time in predicting early puberty.
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Affiliation(s)
- Esin Gizem Olgun
- Department of Pediatrics, School of Medicine, Ankara University, Ankara, Turkey
| | - Sirmen Kizilcan Cetin
- Department of Pediatric Endocrinology, School of Medicine, Ankara University, Ankara, Turkey
| | - Zeynep Siklar
- Department of Pediatric Endocrinology, School of Medicine, Ankara University, Ankara, Turkey
| | - Zehra Aycan
- Department of Pediatric Endocrinology, School of Medicine, Ankara University, Ankara, Turkey
| | - Elif Ozsu
- Department of Pediatric Endocrinology, School of Medicine, Ankara University, Ankara, Turkey
| | - Aysegul Ceran
- Department of Pediatric Endocrinology, School of Medicine, Ankara University, Ankara, Turkey
| | - Merih Berberoglu
- Department of Pediatric Endocrinology, School of Medicine, Ankara University, Ankara, Turkey
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14
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Tagi VM, Samvelyan S, Chiarelli F. An update of the consensus statement on insulin resistance in children 2010. Front Endocrinol (Lausanne) 2022; 13:1061524. [PMID: 36465645 PMCID: PMC9709113 DOI: 10.3389/fendo.2022.1061524] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/14/2022] [Indexed: 11/17/2022] Open
Abstract
In our modern society, where highly palatable and calorie-rich foods are readily available, and sedentary lifestyle is common among children and adolescents, we face the pandemic of obesity, nonalcoholic fatty liver disease, hypertension, atherosclerosis, and T2D. Insulin resistance (IR) is known to be the main underlying mechanism of all these associated health consequences; therefore, the early detection of IR is fundamental for preventing them.A Consensus Statement, internationally supported by all the major scientific societies in pediatric endocrinology, was published in 2010, providing all the most recent reliable evidence to identify the definition of IR in children, its measurement, its risk factors, and the effective strategies to prevent and treat it. However, the 2010 Consensus concluded that further research was necessary to assess some of the discussed points, in particular the best way to measure insulin sensitivity, standardization of insulin measurements, identification of strong surrogate biomarkers of IR, and the effective role of lifestyle intervention and medications in the prevention and treatment of IR.The aim of this review is to update each point of the consensus with the most recent available studies, with the goal of giving a picture of the current state of the scientific literature regarding IR in children, with a particular regard for issues that are not yet fully clarified.
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Affiliation(s)
- Veronica Maria Tagi
- Department of Pediatrics, University of Chieti, Chieti, Italy
- *Correspondence: Veronica Maria Tagi,
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15
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Hicks ZM, Yates DT. Going Up Inflame: Reviewing the Underexplored Role of Inflammatory Programming in Stress-Induced Intrauterine Growth Restricted Livestock. FRONTIERS IN ANIMAL SCIENCE 2021; 2. [PMID: 34825243 PMCID: PMC8612632 DOI: 10.3389/fanim.2021.761421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The impact of intrauterine growth restriction (IUGR) on health in humans is well-recognized. It is the second leading cause of perinatal mortality worldwide, and it is associated with deficits in metabolism and muscle growth that increase lifelong risk for hypertension, obesity, hyperlipidemia, and type 2 diabetes. Comparatively, the barrier that IUGR imposes on livestock production is less recognized by the industry. Meat animals born with low birthweight due to IUGR are beset with greater early death loss, inefficient growth, and reduced carcass merit. These animals exhibit poor feed-to-gain ratios, less lean mass, and greater fat deposition, which increase production costs and decrease value. Ultimately, this reduces the amount of meat produced by each animal and threatens the economic sustainability of livestock industries. Intrauterine growth restriction is most commonly the result of fetal programming responses to placental insufficiency, but the exact mechanisms by which this occurs are not well-understood. In uncompromised pregnancies, inflammatory cytokines are produced at modest rates by placental and fetal tissues and play an important role in fetal development. However, unfavorable intrauterine conditions can cause cytokine activity to be excessive during critical windows of fetal development. Our recent evidence indicates that this impacts developmental programming of muscle growth and metabolism and contributes to the IUGR phenotype. In this review, we outline the role of inflammatory cytokine activity in the development of normal and IUGR phenotypes. We also highlight the contributions of sheep and other animal models in identifying mechanisms for IUGR pathologies.
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Affiliation(s)
- Zena M Hicks
- Stress Physiology Laboratory, Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Dustin T Yates
- Stress Physiology Laboratory, Department of Animal Science, University of Nebraska-Lincoln, Lincoln, NE, United States
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16
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Nordman H, Jääskeläinen J, Voutilainen R. Birth Size as a Determinant of Cardiometabolic Risk Factors in Children. Horm Res Paediatr 2021; 93:144-153. [PMID: 32846418 DOI: 10.1159/000509932] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 07/06/2020] [Indexed: 11/19/2022] Open
Abstract
The association between birth size and cardiometabolic disease risk may be U-shaped. Being born small for gestational age (SGA) has a definitive association with later cardiovascular risk, but the impact of being born large for gestational age (LGA) on cardiometabolic health is more controversial. In addition to birth size, early postnatal growth pattern and later weight gain affect cardiometabolic risk in adulthood. Most SGA-born children have catch-up and LGA-born children have catch-down growth during the first years of life. The extent of this early compensatory growth may contribute to the adverse health outcomes. Both SGA- and LGA-born children are at an increased risk for overweight and obesity. This may have a long-term impact on cardiometabolic health as overweight tends to track to adulthood. Other cardiometabolic risk factors, including alterations in glucose metabolism, dyslipidemia, hypertension, and low-grade inflammation are associated with birth weight. Many of these risk factors are related to overweight or adverse fat distribution. Since later cardiometabolic risk is often mediated by early growth pattern and later overweight in SGA and LGA children, it is important to focus on staying normal weight throughout life. Hence, effective interventions to reduce cardiometabolic risk in LGA and SGA children should be developed.
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Affiliation(s)
- Henrikki Nordman
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland,
| | - Jarmo Jääskeläinen
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Raimo Voutilainen
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
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17
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Gato-Moreno M, Martos-Lirio MF, Leiva-Gea I, Bernal-López MR, Vegas-Toro F, Fernández-Tenreiro MC, López-Siguero JP. Early Nutritional Education in the Prevention of Childhood Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126569. [PMID: 34207231 PMCID: PMC8296335 DOI: 10.3390/ijerph18126569] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/14/2022]
Abstract
Early childhood is a critical period for obesity prevention. This randomized controlled study evaluated the effectiveness of an educational intervention preventing obesity in preschool-age children. A nutritional education intervention, with a follow-up session one year later, was conducted with parents of children aged 3 to 4 years of public schools in the province of Málaga. The main outcome variable was the body mass index z-score (zBMI). The prevalence of overweight or obesity was the secondary outcome variable. The sample comprised 261 students (control group = 139). Initial BMI, weight, height-for-age and prevalence of overweight and obesity were similar for both groups. After the first year of the intervention, the zBMI of the intervention group decreased significantly from 0.23 to 0.10 (p = 0.002), and the subgroup of patients with baseline zBMI above the median decreased from 1 to 0.72 (p = 0.001), and in the second year from 1.01 to 0.73 (p = 0.002). The joint prevalence of overweight and obesity increased in the control group (12.2% to 20.1%; p = 0.027), while in the intervention group, there were no significant changes. This preschool educational intervention with parents improved their children’s BMI, especially those with a higher BMI for their age, and favored the prevention of overweight or obesity.
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Affiliation(s)
- Mario Gato-Moreno
- Department of Pediatric Endocrinology, Regional University Hospital of Málaga, 29011 Málaga, Spain; (M.G.-M.); (M.F.M.-L.); (F.V.-T.); (M.C.F.-T.); (J.P.L.-S.)
| | - María F. Martos-Lirio
- Department of Pediatric Endocrinology, Regional University Hospital of Málaga, 29011 Málaga, Spain; (M.G.-M.); (M.F.M.-L.); (F.V.-T.); (M.C.F.-T.); (J.P.L.-S.)
| | - Isabel Leiva-Gea
- Department of Pediatric Endocrinology, Regional University Hospital of Málaga, 29011 Málaga, Spain; (M.G.-M.); (M.F.M.-L.); (F.V.-T.); (M.C.F.-T.); (J.P.L.-S.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain;
- Department of Pharmacology and Pediatrics, Faculty of Medicine, University of Málaga, 29016 Málaga, Spain
- Correspondence:
| | - M. Rosa Bernal-López
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain;
- Department of Internal Medicine, Regional University Hospital of Málaga, 29009 Málaga, Spain
- CIBER Fisiopatologia de la Obesidad y la Nutricion (Ciber Obn), Carlos III Health Institute, 28029 Madrid, Spain
| | | | - María C. Fernández-Tenreiro
- Department of Pediatric Endocrinology, Regional University Hospital of Málaga, 29011 Málaga, Spain; (M.G.-M.); (M.F.M.-L.); (F.V.-T.); (M.C.F.-T.); (J.P.L.-S.)
| | - Juan P. López-Siguero
- Department of Pediatric Endocrinology, Regional University Hospital of Málaga, 29011 Málaga, Spain; (M.G.-M.); (M.F.M.-L.); (F.V.-T.); (M.C.F.-T.); (J.P.L.-S.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain;
- Department of Pharmacology and Pediatrics, Faculty of Medicine, University of Málaga, 29016 Málaga, Spain
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18
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Sauder KA, Perng W, Palumbo MP, Bloemsma LD, Carey J, Glueck DH, Dabelea D. Fat Mass Accretion from Birth to 5 Years and Metabolic Homeostasis in Childhood: the Healthy Start Study. J Clin Endocrinol Metab 2021; 106:1684-1691. [PMID: 33616653 PMCID: PMC8118576 DOI: 10.1210/clinem/dgab115] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT It is unclear how fat mass accretion in early life is related to glucose-insulin homeostasis. OBJECTIVE Examine associations of fat and fat-free mass accretion from birth to early childhood with glucose-insulin homeostasis in early childhood in a multi-ethnic cohort. METHODS Observational Healthy Start study with data collection from 2010 to 2020. Air displacement plethysmography at birth and 4.8 (SD 0.7) years estimated fat mass percent (FMP, %), fat mass index (FMI, kg/m2), and fat-free mass index (FFMI, kg/m2). General population recruited from academic obstetrics clinics in Denver, Colorado, consisting of 419 mother/offspring dyads. The main outcome measures were fasting glucose, insulin, homeostasis model assessment-2 insulin resistance (HOMA2-IR), and beta-cell function (HOMA2-B) at 4.8 years. RESULTS Greater fat mass accretion from birth to early childhood was associated with higher fasting glucose (ΔFMP β = 0.20 [95% CI 0.06-0.34], ΔFMI β = 0.90 [0.30-1.50]) in participants of Hispanic, Black, and Other races/ethnicities, while greater fat-free mass accretion was associated with higher fasting glucose in non-Hispanic White participants (ΔFFMI β = 0.76 [0.21-1.32]). Overall, greater fat, but not fat-free, mass accretion was also associated with higher insulin (ΔFMP β = 0.14 [0.09-0.18], ΔFMI 0.71 [0.51-0.92]), HOMA2-IR (FMP β = 0.02 [0.01-0.02], ΔFMI β = 0.09 [0.06-0.12]), and HOMA2-B (ΔFMP β = 0.92 [0.18-1.36], ΔFMI β = 4.76 [2.79-6.73]). CONCLUSION Greater fat mass accretion in infancy and childhood is associated with shifts in fasting glucose in children of Hispanic, Black, and Other races/ethnicities at 5 years of age. Body composition beginning in early life is relevant for metabolic health, and precise assessments of adiposity in pediatric research are needed.
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Affiliation(s)
- Katherine A Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
- Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
- Correspondence: Katherine Sauder, LEAD Center, University of Colorado Anschutz Medical Campus, 12474 E 19th Avenue – F426, Aurora CO, 80045, USA.
| | - Wei Perng
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Michaela P Palumbo
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Lizan D Bloemsma
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - John Carey
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Deborah H Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
- Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
- Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
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19
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Ramamurthy D, Lin chua SY, Saw S. A review of environmental risk factors for myopia during early life, childhood and adolescence. Clin Exp Optom 2021; 98:497-506. [DOI: 10.1111/cxo.12346] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 08/16/2015] [Accepted: 08/20/2015] [Indexed: 01/01/2023] Open
Affiliation(s)
- Dharani Ramamurthy
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,
| | | | - Seang‐mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,
- Myopia Unit, Singapore Eye Research Institute, Singapore,
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20
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Developmental programming of cardiovascular function: a translational perspective. Clin Sci (Lond) 2021; 134:3023-3046. [PMID: 33231619 DOI: 10.1042/cs20191210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/07/2020] [Accepted: 11/10/2020] [Indexed: 12/11/2022]
Abstract
The developmental origins of health and disease (DOHaD) is a concept linking pre- and early postnatal exposures to environmental influences with long-term health outcomes and susceptibility to disease. It has provided a new perspective on the etiology and evolution of chronic disease risk, and as such is a classic example of a paradigm shift. What first emerged as the 'fetal origins of disease', the evolution of the DOHaD conceptual framework is a storied one in which preclinical studies played an important role. With its potential clinical applications of DOHaD, there is increasing desire to leverage this growing body of preclinical work to improve health outcomes in populations all over the world. In this review, we provide a perspective on the values and limitations of preclinical research, and the challenges that impede its translation. The review focuses largely on the developmental programming of cardiovascular function and begins with a brief discussion on the emergence of the 'Barker hypothesis', and its subsequent evolution into the more-encompassing DOHaD framework. We then discuss some fundamental pathophysiological processes by which developmental programming may occur, and attempt to define these as 'instigator' and 'effector' mechanisms, according to their role in early adversity. We conclude with a brief discussion of some notable challenges that hinder the translation of this preclinical work.
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21
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Chiavaroli V, Derraik JGB, Jayasinghe TN, Rodrigues RO, Biggs JB, Battin M, Hofman PL, O'Sullivan JM, Cutfield WS. Lower insulin sensitivity remains a feature of children born very preterm. Pediatr Diabetes 2021; 22:161-167. [PMID: 33084185 DOI: 10.1111/pedi.13140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/24/2020] [Accepted: 10/15/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The first report of children born very preterm (<32 weeks of gestation) having insulin resistance was made 16 years ago. However, neonatal care has improved since. Thus, we aimed to assess whether children born very preterm still have lower insulin sensitivity than term controls. METHODS Participants were prepubertal children aged 5 to 11 years born very preterm (<32 weeks of gestation; n = 51; 61% boys) or at term (37-41 weeks; n = 50; 62% boys). Frequently sampled intravenous glucose tolerance tests were performed, and insulin sensitivity was calculated using Bergman's minimal model. Additional clinical assessments included anthropometry, body composition using whole-body dual-energy X-ray absorptiometry scans, clinic blood pressure, and 24-hour ambulatory blood pressure monitoring. RESULTS Children born very preterm were 0.69 standard deviation score (SDS) lighter (P < .001), 0.53 SDS shorter (P = .003), and had body mass index 0.57 SDS lower (P = .003) than children born at term. Notably, children born very preterm had insulin sensitivity that was 25% lower than term controls (9.4 vs 12.6 × 10-4 minutes-1 ·[mU/L]; P = .001). Other parameters of glucose metabolism, including fasting insulin levels, were similar in the two groups. The awake systolic blood pressure (from 24-hour monitoring) tended to be 3.1 mm Hg higher on average in children born very preterm (P = .054), while the clinic systolic blood pressure was 5.4 mm Hg higher (P = .002). CONCLUSIONS Lower insulin sensitivity remains a feature of children born very preterm, despite improvements in neonatal intensive care. As reported in our original study, our findings suggest the defect in insulin action in prepubertal children born very pretermis primarily peripheral and not hepatic.
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Affiliation(s)
- Valentina Chiavaroli
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Neonatal Intensive Care Unit, Pescara Public Hospital, Pescara, Italy
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Endocrinology Department, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | | | | | - Janene B Biggs
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Malcolm Battin
- Newborn Services, Auckland City Hospital, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
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22
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Millward DJ. Interactions between Growth of Muscle and Stature: Mechanisms Involved and Their Nutritional Sensitivity to Dietary Protein: The Protein-Stat Revisited. Nutrients 2021; 13:729. [PMID: 33668846 PMCID: PMC7996181 DOI: 10.3390/nu13030729] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/15/2021] [Accepted: 02/22/2021] [Indexed: 02/07/2023] Open
Abstract
Childhood growth and its sensitivity to dietary protein is reviewed within a Protein-Stat model of growth regulation. The coordination of growth of muscle and stature is a combination of genetic programming, and of two-way mechanical interactions involving the mechanotransduction of muscle growth through stretching by bone length growth, the core Protein-Stat feature, and the strengthening of bone through muscle contraction via the mechanostat. Thus, growth in bone length is the initiating event and this is always observed. Endocrine and cellular mechanisms of growth in stature are reviewed in terms of the growth hormone-insulin like growth factor-1 (GH-IGF-1) and thyroid axes and the sex hormones, which together mediate endochondral ossification in the growth plate and bone lengthening. Cellular mechanisms of muscle growth during development are then reviewed identifying (a) the difficulties posed by the need to maintain its ultrastructure during myofibre hypertrophy within the extracellular matrix and the concept of muscle as concentric "bags" allowing growth to be conceived as bag enlargement and filling, (b) the cellular and molecular mechanisms involved in the mechanotransduction of satellite and mesenchymal stromal cells, to enable both connective tissue remodelling and provision of new myonuclei to aid myofibre hypertrophy and (c) the implications of myofibre hypertrophy for protein turnover within the myonuclear domain. Experimental data from rodent and avian animal models illustrate likely changes in DNA domain size and protein turnover during developmental and stretch-induced muscle growth and between different muscle fibre types. Growth of muscle in male rats during adulthood suggests that "bag enlargement" is achieved mainly through the action of mesenchymal stromal cells. Current understanding of the nutritional regulation of protein deposition in muscle, deriving from experimental studies in animals and human adults, is reviewed, identifying regulation by amino acids, insulin and myofibre volume changes acting to increase both ribosomal capacity and efficiency of muscle protein synthesis via the mechanistic target of rapamycin complex 1 (mTORC1) and the phenomenon of a "bag-full" inhibitory signal has been identified in human skeletal muscle. The final section deals with the nutritional sensitivity of growth of muscle and stature to dietary protein in children. Growth in length/height as a function of dietary protein intake is described in the context of the breastfed child as the normative growth model, and the "Early Protein Hypothesis" linking high protein intakes in infancy to later adiposity. The extensive paediatric studies on serum IGF-1 and child growth are reviewed but their clinical relevance is of limited value for understanding growth regulation; a role in energy metabolism and homeostasis, acting with insulin to mediate adiposity, is probably more important. Information on the influence of dietary protein on muscle mass per se as opposed to lean body mass is limited but suggests that increased protein intake in children is unable to promote muscle growth in excess of that linked to genotypic growth in length/height. One possible exception is milk protein intake, which cohort and cross-cultural studies suggest can increase height and associated muscle growth, although such effects have yet to be demonstrated by randomised controlled trials.
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Affiliation(s)
- D Joe Millward
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
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Gross RS, Ghassabian A, Vandyousefi S, Messito MJ, Gao C, Kannan K, Trasande L. Persistent organic pollutants exposure in newborn dried blood spots and infant weight status: A case-control study of low-income Hispanic mother-infant pairs. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 267:115427. [PMID: 33254620 PMCID: PMC7708683 DOI: 10.1016/j.envpol.2020.115427] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/12/2020] [Accepted: 08/10/2020] [Indexed: 05/05/2023]
Abstract
Persistent organic pollutants (POPs) are believed to alter metabolic homeostasis during fetal development, leading to childhood obesity. However, limited studies have explored how fetal chemical exposures relate to birth and infant weight outcomes in low-income Hispanic families at the highest risk of obesity. Therefore, we sought to determine associations between neonatal POPs exposure measured in newborn dried blood spots (DBS) and prenatal diet quality, birth weight, and overweight status at 18 months old. We conducted a case-control study nested within the Starting Early Program randomized controlled trial comparing POPs concentrations in infants with healthy weight (n = 46) and overweight status (n = 52) at age 18 months. Three categories of POPs, organochlorine pesticides (OCPs), polybrominated diphenyl ethers (PBDEs) and perfluoroalkyl substances (PFASs) were measured in archived newborn DBS. We assessed correlations between prenatal diet quality and neonatal POPs concentrations. Multivariable regression analyses examined associations between POPs (dichotomized at the mean) and birth weight z-score and weight status at 18 months, controlling for confounders. Seven of eight chemicals had detectable levels in greater than 94% of the sample. Higher protein, sodium and refined grain intake during pregnancy were correlated with lower POPs in newborn DBS. We found that high concentrations of perfluorooctanesulfonate (unstandardized coefficient [B]: -0.62, 95% confidence interval [CI]: -0.96 to -0.29) and perfluorohexanesulfate (B: -0.65, 95% CI: -0.99 to -0.31) were related to lower birth weight z-scores compared to those with low concentrations. We did not find associations between PBDEs, OCPs, and the other PFASs with birth weight z-scores, or between any POPs and weight status at 18 months. In conclusion, two PFASs were associated with lower birth weight, an important indicator of child health and growth, although direct associations with infant overweight status were not found. Whether neonatal POPs exposures contribute to economic and ethnic disparities in early obesity remains unclear.
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Affiliation(s)
- Rachel S Gross
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
| | - Akhgar Ghassabian
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Sarvenaz Vandyousefi
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Mary Jo Messito
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Chongjing Gao
- Wadsworth Center, New York State Department of Health, Albany, NY, USA
| | - Kurunthachalam Kannan
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Wadsworth Center, New York State Department of Health, Albany, NY, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA; NYU Wagner School of Public Service, New York, NY, USA; NYU College of Global Public Health, New York, NY, USA
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24
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Norris T, Crozier SR, Cameron N, Godfrey KM, Inskip H, Johnson W. Fetal growth does not modify the relationship of infant weight gain with childhood adiposity and blood pressure in the Southampton women's survey. Ann Hum Biol 2020; 47:150-158. [PMID: 32429761 PMCID: PMC7261399 DOI: 10.1080/03014460.2020.1717616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background: Rapid infant weight gain is a risk factor for childhood obesity. This relationship may depend on whether infant weight gain is preceded by in-utero growth restriction. Aim: Examine whether fetal growth modifies the relationship between infant weight gain and childhood adiposity and blood pressure. Subjects and methods: 786 children in the Southampton Women’s Survey. We related infant weight gain (weight at 2 years-birth weight) to body mass index (BMI), %body fat, trunk fat (kg), systolic (SBP) and diastolic blood pressure (DBP) at age 6–7 years. Mean estimated fetal weight (EFW) between 19–34 weeks and change in EFW (19–34 weeks) were added to models as effect modifiers. Results: Infant weight gain was positively associated with all childhood outcomes. We found no evidence that these effects were modified by fetal growth (p > .1 for all interaction terms). For example, a 1 standard deviation (SD) increase in infant weight gain was associated with an increase in BMI z-score of 0.51 (95% CI 0.37;0.64) when EFW-change was set at -2 SD-scores compared with an increase of 0.41 (95% CI 0.27;0.54, p(interaction)=.48) when set at 2 SD-scores. Conclusion: The documented adverse consequences of rapid infant weight gain may occur regardless of whether growth was constrained in-utero.
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Affiliation(s)
- Tom Norris
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Noël Cameron
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Hazel Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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25
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Birth weight, childhood and adolescent growth and diabetes risk factors in 21-year-old Asian Indians: the Pune Children's Study. J Dev Orig Health Dis 2020; 12:474-483. [PMID: 32753090 DOI: 10.1017/s2040174420000707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Our objective was to investigate associations of body size (birth weight and body mass index (BMI)) and growth in height, body fat (adiposity) and lean mass during childhood and adolescence, with risk markers for diabetes in young South Asian adults. We studied 357 men and women aged 21 years from the Pune Children's Study birth cohort. Exposures were 1) birth weight, 21-year BMI, both of these mutually adjusted, and their interaction, and 2) uncorrelated conditional measures of growth in height and proxies for gain in adiposity and lean mass from birth to 8 years (childhood) and 8 to 21 years (adolescence) constructed from birth weight, and weight, height, and skinfolds at 8 and 21 years. Outcomes were plasma glucose and insulin concentrations during an oral glucose tolerance test and derived indices of insulin resistance and secretion. Higher 21-year BMI was associated with higher glucose and insulin concentrations and insulin resistance, and lower disposition index. After adjusting for 21-year BMI, higher birth weight was associated with lower 120-min glucose and insulin resistance, and higher disposition index. In the growth analysis, greater adiposity gain during childhood and adolescence was associated with higher glucose, insulin and insulin resistance, and lower disposition index, with stronger effects from adolescent gain. Greater childhood lean gain and adolescent height gain were associated with lower 120-min glucose and insulin. Consistent with other studies, lower birth weight and higher childhood weight gain increases diabetes risk. Disaggregation of weight gain showed that greater child/adolescent adiposity gain and lower lean and height gain may increase risk.
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26
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Evaluation of anthropometric measures for assessment of cardiometabolic risk in early childhood. Public Health Nutr 2020; 23:2100-2108. [PMID: 32301411 DOI: 10.1017/s1368980019004749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Waist-to-height ratio has been shown to be an important indicator of cardiometabolic risk. There are few studies evaluating this measure against existing measures of adiposity and cardiometabolic markers in early childhood. The objectives were: (i) to determine in young children the ability of waist-to-height ratio, BMI z-score, weight for length, and sum of skin fold thickness to predict cardiometabolic risk and (ii) to examine this association at ages 1, 3 and 5 years. DESIGN Prospective cohort study. SETTING A university hospital in Toronto, Ontario. PARTICIPANTS Infants at 1 (n 406), 3 (n 112) and 5 years of age (n 94) born to mothers with and without gestational diabetes mellitus. RESULTS Weight for length and BMI z-score demonstrated the strongest correlations with biochemical measures compared to waist-to-height ratio, including leptin (at 5 years, weight for length z-score: ρ = 0·65, P < 0·001; BMI z-score: ρ = 0·67, P < 0·001) and measures of insulin resistance (at 3 years, weight for length z-score: ρ = 0·25, P = 0·02; BMI z-score: ρ = 0·24, P = 0·02). The magnitude of associations between anthropometric measures and biochemical measures strengthened over time. Weight for length and BMI z-scores were moderately correlated with overall measures of fat mass as measured by dual-energy X-ray absorptiometry (ρ = 0·65, P = 0·00; ρ = 0·61, P = 0·01). CONCLUSIONS Waist-to-height ratio was not superior to existing measures in predicting cardiometabolic risk in young children. BMI z-score is a preferred measure of adiposity between birth and 5 years of age.
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Ong KK, Cheng TS, Olga L, Prentice PM, Petry CJ, Hughes IA, Dunger DB. Which infancy growth parameters are associated with later adiposity? The Cambridge Baby Growth Study. Ann Hum Biol 2020; 47:142-149. [PMID: 32429763 PMCID: PMC7261401 DOI: 10.1080/03014460.2020.1745887] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/28/2020] [Accepted: 03/09/2020] [Indexed: 12/12/2022]
Abstract
Background: Highly consistent positive associations are reported between infancy growth and later obesity risk. However, it is unclear whether infancy growth parameters beyond body weight add to the prediction of later obesity risk.Aim: To assess whether infancy length and skinfold thicknesses add to infancy weight in the prediction of childhood adiposity.Subjects and methods: This analysis included 254 children with available data on infant growth from birth to 24 months and childhood adiposity at age 6-11 years measured by DXA. Multilevel linear regression was used to examine the predictors of childhood percent body fat (%BF), with adjustment for sex and age at follow-up visit.Results: Birth weight and weight gain (modelled as changes in z-score) between 0-3 months and 3-24 months showed independent positive relationships with childhood %BF. The addition of gains in infant length and skinfolds between 0-3 months, but not 3-24 months, improved overall model prediction, from 18.7% to 20.7% of the variance in childhood %BF (likelihood ratio test, p < 0.0001), although their independent effect estimates were small (infant length gain: negative trend, partial R-square 0.6%, p = 0.2; skinfolds: positive trend, 1.3%, p = 0.09).Conclusion: Infancy length and skinfolds contribute significantly, but only modestly, to the prediction of childhood adiposity.
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Affiliation(s)
- Ken K. Ong
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Tuck Seng Cheng
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - L. Olga
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - P. M. Prentice
- Department of Paediatrics, University of Cambridge, Cambridge, UK
- North Middlesex University Hospital NHS Trust, London, UK
| | - C. J. Petry
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - I. A. Hughes
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - D. B. Dunger
- Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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28
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Perry BI, Khandaker GM, Marwaha S, Thompson A, Zammit S, Singh SP, Upthegrove R. Insulin resistance and obesity, and their association with depression in relatively young people: findings from a large UK birth cohort. Psychol Med 2020; 50:556-565. [PMID: 30854996 PMCID: PMC7093318 DOI: 10.1017/s0033291719000308] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/30/2018] [Accepted: 02/05/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Depression frequently co-occurs with disorders of glucose and insulin homeostasis (DGIH) and obesity. Low-grade systemic inflammation and lifestyle factors in childhood may predispose to DGIH, obesity and depression. We aim to investigate the cross-sectional and longitudinal associations among DGIH, obesity and depression, and to examine the effect of demographics, lifestyle factors and antecedent low-grade inflammation on such associations in young people. METHODS Using the Avon Longitudinal Study of Parents and Children birth cohort, we used regression analyses to examine: (1) cross-sectional and (2) longitudinal associations between measures of DGIH [insulin resistance (IR); impaired glucose tolerance] and body mass index (BMI) at ages 9 and 18 years, and depression (depressive symptoms and depressive episode) at age 18 years and (3) whether sociodemographics, lifestyle factors or inflammation [interleukin-6 (IL-6) at age 9 years] confounded any such associations. RESULTS We included 3208 participants. At age 18 years, IR and BMI were positively associated with depression. These associations may be explained by sociodemographic and lifestyle factors. There were no longitudinal associations between DGIH/BMI and depression, and adjustment for IL-6 and C-reactive protein did not attenuate associations between IR/BMI and depression; however, the longitudinal analyses may have been underpowered. CONCLUSIONS Young people with depression show evidence of DGIH and raised BMI, which may be related to sociodemographic and lifestyle effects such as deprivation, smoking, ethnicity and gender. In future, studies with larger samples are required to confirm this. Preventative strategies for the poorer physical health outcomes associated with depression should focus on malleable lifestyle factors.
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Affiliation(s)
- B. I. Perry
- Department of Psychiatry, University of Cambridge, Cambridge, England
- Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
| | - G. M. Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge, England
- Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, England
- National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge, England
| | - S. Marwaha
- Institute for Mental Health, University of Birmingham, Birmingham, England
- Birmingham and Solihull Mental Health Foundation NHS Trust, Birmingham, England
| | - A. Thompson
- Coventry and Warwickshire Partnership NHS Trust, Coventry, England
- Unit of Mental Health and Wellbeing, University of Warwick, Coventry, England
| | - S. Zammit
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, England
- Institute of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales
| | - S. P. Singh
- Coventry and Warwickshire Partnership NHS Trust, Coventry, England
- Unit of Mental Health and Wellbeing, University of Warwick, Coventry, England
| | - R. Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, England
- Early Intervention Service, Birmingham Women's and Children's NHS Trust, Birmingham, UK
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29
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Liu Q, Yin A, Wen S, Shi X, Fang L, Rao T, Liang J, Wu J. Analysis of amino acids and acylcarnitines profiles in small, appropriate, and large for gestational age neonates. J Matern Fetal Neonatal Med 2020; 35:439-446. [PMID: 32037923 DOI: 10.1080/14767058.2020.1720640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: To identify the amino acid (AA) and acylcarnitines (ACs) profiles in dry blood spot (DBS) of small, appropriate and large for gestational age neonates, and to investigate the difference AA and AC profiles in groups.Methods: Eight thousand nine hundred and fourteen healthy singleton newborns were divided into three groups: small for gestational age (SGA) (n = 713), appropriate for gestational age (AGA) (n = 7866), and LGA (n = 335). Electrospray ionization tandem mass spectrometry was taken to evaluate the concentrations of 11 AAs and 31 ACs in DBS specimens obtained from all enrolled neonates.Results: Compared with the AGA neonates, except propionylcarnitine, the concentrations of SGA neonatal most AAs and AC in the newborn were higher, while those of the newborns in the LGA group were lower.Conclusion: Different concentrations of AAs and ACs in the three groups suggest that SGA may be associated with under anabolic metabolism, while LGA may be associated with over anabolic metabolism.
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Affiliation(s)
- Qian Liu
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Aihua Yin
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Shen Wen
- Department of Reproductive Medicine, Guangdong Women and Children Hospital, Guangzhou, China
| | - Xiaomei Shi
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Liyuan Fang
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Tengzi Rao
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
| | - Jinqun Liang
- Department of Children Inherited Metabolism and Endocrine, Guangdong Women and Children Hospital, Guangzhou, China
| | - Jing Wu
- Department of Medical Genetics Center, Guangdong Women and Children Hospital, Guangzhou, China
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30
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Dunger D, Darendeliler F, Kandemir N, Harris M, Rabbani A, Kappelgaard AM. What is the evidence for beneficial effects of growth hormone treatment beyond height in short children born small for gestational age? A review of published literature. J Pediatr Endocrinol Metab 2020; 33:53-70. [PMID: 31860471 DOI: 10.1515/jpem-2019-0098] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 10/17/2019] [Indexed: 12/19/2022]
Abstract
Background An increasing body of evidence supports the view that both an adverse intrauterine milieu and rapid postnatal weight gain in children born small for gestational age (SGA) contribute towards the risk for the development of chronic diseases in adult life. Content The aim of this review was to identify and summarize the published evidence on metabolic and cardiovascular risk, as well as risk of impaired cardiac function, intellectual capacity, quality of life, pubertal development and bone strength among children born SGA. The review will then address whether growth hormone (GH) therapy, commonly prescribed to reduce the height deficit in children born SGA who do not catch up in height, increases or decreases these risks over time. Summary Overall, there are limited data in support of a modest beneficial effect of GH therapy on the adverse metabolic and cardiovascular risk observed in short children born SGA. Evidence to support a positive effect of GH on bone strength and psychosocial outcomes is less convincing. Outlook Further evaluation into the clinical relevance of any potential long-term benefits of GH therapy on metabolic and cardiovascular endpoints is warranted.
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Affiliation(s)
- David Dunger
- Department of Paediatrics, School of Clinical Medicine, University of Cambridge, Box 116, Level 8, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.,The Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Feyza Darendeliler
- Department of Pediatrics, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Nurgun Kandemir
- İhsan Doğramacı Children's Hospital, Hacettepe University, Ankara, Turkey
| | - Mark Harris
- Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Ali Rabbani
- Growth and Development Research Center, Children's Medical Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
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31
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Alonso-Larruscain IS, Ruibal Francisco JL, Granizo Martínez JJ, García-García ML, Fuentes Ferrer ME. Early markers of endocrinometabolic disease in newborns with delayed intrauterine growth. Clin Nutr ESPEN 2019; 34:37-44. [PMID: 31677709 DOI: 10.1016/j.clnesp.2019.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 07/05/2019] [Accepted: 09/06/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The adjustments to malnutrition in growth restricted fetus (GRF) that lead to obesity, insulin resistance, diabetes and cardiovascular disease in adulthood are not well known. The most feasible explanation for this association is the hypothesis of catch up. Some studies postulate a greater influence of catch up growth than the low birth weight itself in developing metabolic and cardiovascular disease. MATERIAL AND METHODS This is a prospective cohort study of newborns with intrauterine growth restriction (defined as weight percentile at birth less than 10th) born during a one-year period. Clinical data of patients were recorded (gender, gestational age, data about breastfeeding and anthropometry during follow-up every 3 months). Some details of pregnancy and characteristics of the mother were also registered. Serum biochemical parameters (IGF-1, IGF-BP3, insulin, glucose, total cholesterol, HDL cholesterol, DLD cholesterol, triglycerides, HOMA) were collected at birth from cord blood, 9 and 12 months. Two main comparative groups were established: those GRF who made a catch-up growth (increase in weight Z score higher than 0,67) during the follow-up and those who did not get it. RESULTS 126 GRF children were born in the study period. 125 accepted the inclusion in the study and 67 of them completed the full monitoring for a year; 47 of them made recovery growth and 20 did not. A significant difference between both groups was found in glucose in umbilical cord and triglycerides at 12 months: GRF children with catch up growth showed lower glucose levels (p = 0.03) and higher levels of triglycerides (p = 0.03). There were no statistically significant differences in the rest of laboratory parameters analyzed (IGF-1, IGF-BP3, insulin, glucose, total cholesterol, HDL cholesterol, DLD cholesterol, HOMA at 9 and 12 months or triglycerides at 9 months). CONCLUSIONS Those GRF with catch up growth during the first year of life have early changes in the triglycerides at the end of that period with higher levels than those GRF children without catch up growth. This finding could be useful to develop a tool for early detection of GRF children with higher metabolic risk in order to prevent future pathology.
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32
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Wibaek R, Girma T, Admassu B, Abera M, Abdissa A, Geto Z, Kæstel P, Vistisen D, Jørgensen ME, Wells JCK, Michaelsen KF, Friis H, Andersen GS. Higher Weight and Weight Gain after 4 Years of Age Rather than Weight at Birth Are Associated with Adiposity, Markers of Glucose Metabolism, and Blood Pressure in 5-Year-Old Ethiopian Children. J Nutr 2019; 149:1785-1796. [PMID: 31218356 DOI: 10.1093/jn/nxz121] [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: 03/20/2019] [Revised: 04/17/2019] [Accepted: 05/09/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Fetal and early life growth is associated with adult risk of obesity and cardiometabolic disease. However, little is known about the relative importance of birth weight and successive periods of weight gain on markers of cardiometabolic risk in childhood in low-income populations. OBJECTIVES The objective was to study associations of birth weight and weight gain velocities in selected age intervals from birth to 60 mo with height, fat-free mass (FFM), and markers of adiposity and cardiometabolic risk at 60 mo. METHODS In a prospective cohort study of 375 Ethiopian children aged 60 mo, we estimated individual weight gain velocities in the periods between birth and 3, 6, 24, 48, and 60 mo using linear-spline mixed-effects modeling. Subsequently, we analyzed associations of birth weight, weight gain velocities, and current weight with height, FFM, and markers of adiposity and cardiometabolic risk. RESULTS Weight gain from 48 to 60 mo and weight at 60 mo rather than birth weight were the strongest correlates of insulin, C-peptide, HOMA-IR, blood pressure, height, FFM, waist circumference, and fat mass at 60 mo. For instance, 1 SD higher (1 SD = 50 g/mo) weight accretion from 48 to 60 mo was associated with a higher insulin of 23.3% (95% CI: 9.6%, 38.8%), C-peptide of 11.4% (2.7%, 20.8%), systolic blood pressure of 1.4 mm Hg (0.6, 2.3 mm Hg), fat mass of 0.72 kg (0.59, 0.85 kg), and FFM of 0.70 kg (0.56, 0.85 kg). Weight gain from 0 to 3 mo was positively associated with LDL cholesterol, systolic blood pressure, height, and the body composition indices, and weight gain from 24 to 48 mo was inversely associated with blood glucose. CONCLUSIONS In 60-mo-old Ethiopian urban children, weight gain and weight after 48 mo rather than weight at birth may represent a sensitive period for variations in markers of adiposity and glucose metabolism. The birth cohort is registered at https://www.isrctn.com/ as ISRCTN46718296.
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Affiliation(s)
- Rasmus Wibaek
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark.,Clinical Epidemiology, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Tsinuel Girma
- Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia.,JUCAN Research Center, Jimma University, Jimma, Ethiopia
| | - Bitiya Admassu
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark.,JUCAN Research Center, Jimma University, Jimma, Ethiopia.,Department of Population and Family Health, Jimma University, Jimma, Ethiopia
| | - Mubarek Abera
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark.,JUCAN Research Center, Jimma University, Jimma, Ethiopia.,Department of Psychiatry, Jimma University, Jimma, Ethiopia
| | - Alemseged Abdissa
- JUCAN Research Center, Jimma University, Jimma, Ethiopia.,Department of Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Zeleke Geto
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Pernille Kæstel
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Dorte Vistisen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Marit E Jørgensen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Copenhagen, Denmark.,National Institute of Public Health, Southern Denmark University, Copenhagen, Denmark
| | - Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Kim F Michaelsen
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Friis
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Gregers S Andersen
- Clinical Epidemiology, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
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33
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Hak SF, Arets HGM, van der Ent CK, van der Kamp HJ. Rapid early increase in BMI is associated with impaired longitudinal growth in children with cystic fibrosis. Pediatr Pulmonol 2019; 54:1209-1215. [PMID: 31012271 PMCID: PMC6767779 DOI: 10.1002/ppul.24343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/28/2019] [Accepted: 03/21/2019] [Indexed: 12/02/2022]
Abstract
BACKGROUND We aimed to assess whether final height in children with cystic fibrosis (CF) is affected by body mass index (BMI), BMI increase, pulmonary function, and cystic fibrosis-related diabetes (CFRD). STUDY DESIGN A longitudinal, retrospective study was performed in a cohort of 57 patients with CF (30 boys, 27 girls) born between 1997 and 2001. Height and weight were recorded annually from ages 0.5 to 10 years and biannually up to the age of 18. Measurements were converted to height-for-age-adjusted-for-target-height (HFA-TH) and BMI-for-age z-scores. Analyses were performed using the independent t tests and the Pearson's correlation. RESULTS For both boys and girls, HFA-TH and BMI-for-age z-scores were significantly lower in the first year of life, these scores increased rapidly until the age of 11 and 8 years, respectively. In boys, HFA-TH z-scores declined during puberty, with subsequently significantly impaired final height (z-score, -0.56, n = 30, standard deviation [SD] = 0.81, P = 0.001). In girls, HFA-TH z-scores briefly declined after the age of 8 years, but then increased to a z-score of -0.21 (n = 27, SD = 0.87) at age 18, which is not significantly lower than the national average (P = 0.22). Pulmonary function and the presence of CFRD were not associated with final height. However, rapid BMI increase between ages 1 and 6 was negatively associated with final height in boys (n = 29, r =-0.420; P = 0.023) and girls (n = 25, r =-0.466; P = 0.019). CONCLUSIONS In boys and girls, early BMI increase was associated with impaired final height. We suggest that early childhood serves as a "window" in which nutritional variations may program subsequent growth. Further refinement of nutritional strategies could be needed.
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Affiliation(s)
- Sarah F Hak
- Department of Pediatric Endocrinology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hubertus G M Arets
- Department of Pediatric Pulmonology, Cystic Fibrosis Center Utrecht, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Cornelis K van der Ent
- Department of Pediatric Pulmonology, Cystic Fibrosis Center Utrecht, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Hetty J van der Kamp
- Department of Pediatric Endocrinology, University Medical Center Utrecht, Utrecht, The Netherlands
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Li C, Jenkins S, Huber HF, Nathanielsz PW. Effect of maternal baboon (Papio sp.) dietary mismatch in pregnancy and lactation on post-natal offspring early life phenotype. J Med Primatol 2019; 48:226-235. [PMID: 31025367 PMCID: PMC6610582 DOI: 10.1111/jmp.12415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/26/2019] [Accepted: 03/25/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Non-human primate models of developmental programing by maternal mismatch between pregnancy and lactation diets are needed for translation to human programing outcomes. We present baboon offspring morphometry from birth to 3 years, and blood cortisol and adrenocorticotropin (ACTH) from 2 to 24 months. METHODS Control mothers ate chow; mismatch mothers ate 30% less than controls during pregnancy and high-fat high-energy diet through lactation. RESULTS Mismatch mothers lost weight during pregnancy. At birth, there were trends toward lower weight in mismatch offspring of both sexes (P = 0.06). From 0-3 years, catch-up growth occurred. Mismatch offspring male and female body weight increased faster than controls (P < 0.001). Mismatch female offspring showed greater increase in BMI (P < 0.001) and abdominal circumference (P = 0.008) vs controls. ACTH and cortisol slopes from 2 to 24 months of age were similar between groups in both sexes. Cortisol and ACTH increased after weaning in all groups. CONCLUSIONS Mismatch produces sexually dimorphic post-natal growth phenotypes.
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Affiliation(s)
- Cun Li
- Texas Pregnancy and Life-course Health Center, Department of Animal Sciences, University of Wyoming, Laramie, Wyoming, USA
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, Texas, USA
| | - Susan Jenkins
- Texas Pregnancy and Life-course Health Center, Department of Animal Sciences, University of Wyoming, Laramie, Wyoming, USA
| | - Hillary F. Huber
- Texas Pregnancy and Life-course Health Center, Department of Animal Sciences, University of Wyoming, Laramie, Wyoming, USA
| | - Peter W. Nathanielsz
- Texas Pregnancy and Life-course Health Center, Department of Animal Sciences, University of Wyoming, Laramie, Wyoming, USA
- Southwest National Primate Research Center, Texas Biomedical Research Institute, San Antonio, Texas, USA
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Tagi VM, Giannini C, Chiarelli F. Insulin Resistance in Children. Front Endocrinol (Lausanne) 2019; 10:342. [PMID: 31214120 PMCID: PMC6558106 DOI: 10.3389/fendo.2019.00342] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/13/2019] [Indexed: 12/28/2022] Open
Abstract
Insulin resistance (IR) is a pathological condition strongly associated with obesity. However, corticosteroids or growth hormone therapy and genetic diseases may affect insulin sensitivity lifelong. In obese children and adolescents of any age there is an evident association between IR and an increased prevalence of type 2 diabetes (T2D) and other elements contributing to the metabolic syndrome, leading to a higher cardiovascular risk. Therefore, early diagnosis and interventions in the attempt to prevent T2D when glycemia values are still normal is fundamental. The gold standard technique used to evaluate IR is the hyperinsulinemic euglycemic clamp, however it is costly and difficult to perform in clinical and research sets. Therefore, several surrogate markers have been proposed. Although the treatment of insulin resistance in children is firstly targeted to lifestyle interventions, in selected cases the integration of a pharmacological intervention might be taken into consideration. The aim of this review is to present the current knowledge on IR in children, starting with an outline of the recent evidences about the congenital forms of deficiency in insulin functioning and therefore focusing on the physiopathology of IR, its appropriate measurement, consequences, treatment options and prevention strategies.
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Darendeliler F. IUGR: Genetic influences, metabolic problems, environmental associations/triggers, current and future management. Best Pract Res Clin Endocrinol Metab 2019; 33:101260. [PMID: 30709755 DOI: 10.1016/j.beem.2019.01.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The children with intrauterine growth restriction (IUGR) especially if they make a catch-up growth in early life have a higher risk for long term problems including short stature and also developing metabolic syndrome, Type 2 diabetes, insulin resistance and cardiovascular diseases. The studies also support that these children may have abnormalities in pubertal timing, adrenarche and reproductive function. The aim of this review was to summarize the published reports mainly on puberty and reproductive functions in children born IUGR at older ages in association with metabolic problems that they encounter. Possible mechanisms explaining these outcomes are discussed. Lastly strategies that may be taken for the prevention of IUGR related morbidities at later life are shortly presented.
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Affiliation(s)
- Feyza Darendeliler
- İstanbul University, Istanbul Faculty of Medicine, Pediatric Endocrinology Unit, İstanbul, Turkey.
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37
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The relationship between IGF-I and -II concentrations and body composition at birth and over the first 2 months. Pediatr Res 2019; 85:687-692. [PMID: 30745570 PMCID: PMC6435390 DOI: 10.1038/s41390-019-0331-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 01/26/2019] [Accepted: 02/01/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Insulin-like growth factor (IGF)-I and -II play an important role in prenatal growth. During the first 2 months from birth, body fat doubles, and rapid weight gain during this time increases future risk of cardiometabolic disease. The aim of this study was to determine whether IGF measurements at birth associate with body composition and the trajectory of its changes in the first 2 months. METHODS Umbilical cord IGF-I and -II concentrations were measured in term infants. Air displacement plethysmography was performed at birth and 2 months. Fat mass (FM) and fat-free mass (FFM) were corrected for infant length (L) to FM/L3 and FFM/L2, respectively. RESULTS In 601 (317 male) infants, IGF-I concentrations at birth were associated with FM/L3 and FFM/L2 Z-scores at birth (R2 = 0.05 and 0.04, respectively, P < 0.001), and IGF-II concentrations were associated with FFM/L2 Z-scores at birth (R2 = 0.01, P = 0.02). Lower IGF-I concentrations were weakly associated with increases in FM/L3 Z-scores over the first 2 months (R2 = 0.01, P = 0.003). CONCLUSION IGF-I concentrations at birth are associated with adiposity and lean mass at birth and inversely with the trajectory of FM accumulation over the first 2 months. IGF-I measurements only account for a small amount of the variance in these measures.
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Perry BI, Upthegrove R, Thompson A, Marwaha S, Zammit S, Singh SP, Khandaker G. Dysglycaemia, Inflammation and Psychosis: Findings From the UK ALSPAC Birth Cohort. Schizophr Bull 2019; 45:330-338. [PMID: 29635418 PMCID: PMC6403055 DOI: 10.1093/schbul/sby040] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Psychosis is associated with both dysglycaemia and low-grade inflammation, but population-based studies investigating the interplay between these factors are scarce. AIMS (1) To explore the direction of association between markers of dysglycaemia, inflammation and psychotic experiences (PEs); and (2) To explore whether dysglycaemia moderates and/or mediates the association between inflammation and PEs. METHOD Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort were modeled using logistic and linear regression to examine cross-sectional and longitudinal associations between markers of dysglycaemia (ages 9 and 18), interleukin-6 (IL-6) (age 9), and PEs (ages 12 and 18). We tested for an interaction between dysglycaemia and IL-6 on risk of PEs at age 18, and tested whether dysglycaemia mediated the relationship between IL-6 and PEs. RESULTS Based on 2627 participants, at age 18, insulin resistance (IR) was associated with PEs (adjusted OR = 2.32; 95% CI, 1.37-3.97). IR was associated with IL-6 both cross-sectionally and longitudinally. Interaction analyses under a multiplicative model showed that IR moderated the association between IL-6 at age 9 and PEs at age 18 (adjusted OR for interaction term = 2.18; 95% C.I., 1.06-4.49). Mediation analysis did not support a model of IR mediating the relationship between IL-6 and PEs. IMPLICATIONS IR is associated with PEs in young people even before the onset of clinical psychosis. Metabolic alterations may interact with childhood inflammation to increase risk of PEs. The findings have implications for clinical practice and future research.
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Affiliation(s)
- Benjamin Ian Perry
- Department of Psychiatry, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
- Unit of Mental Health and Wellbeing, University of Warwick, Coventry, UK
| | - Rachel Upthegrove
- Insitute for Mental Health, University of Birmingham, Birmingham, UK
- Department of Psychiatry, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Andrew Thompson
- Department of Psychiatry, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
- Unit of Mental Health and Wellbeing, University of Warwick, Coventry, UK
| | - Steven Marwaha
- Department of Psychiatry, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
- Unit of Mental Health and Wellbeing, University of Warwick, Coventry, UK
| | - Stanley Zammit
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
- Institute of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Swaran Preet Singh
- Department of Psychiatry, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
- Unit of Mental Health and Wellbeing, University of Warwick, Coventry, UK
| | - Golam Khandaker
- Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge, UK
- Department of Psychiatry, Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, UK
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Horton DM, Saint DA, Gatford KL, Kind KL, Owens JA. Sex-specific programming of adult insulin resistance in guinea pigs by variable perinatal growth induced by spontaneous variation in litter size. Am J Physiol Regul Integr Comp Physiol 2019; 316:R352-R361. [PMID: 30735437 DOI: 10.1152/ajpregu.00341.2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Intrauterine growth restriction (IUGR) and subsequent neonatal catch-up growth are implicated in programming of insulin resistance later in life. Spontaneous IUGR in the guinea pig, due to natural variation in litter size, produces offspring with asymmetric IUGR and neonatal catch-up growth. We hypothesized that spontaneous IUGR and/or accelerated neonatal growth would impair insulin sensitivity in adult guinea pigs. Insulin sensitivity of glucose metabolism was determined by hyperinsulinemic-euglycemic clamp (HEC) in 38 (21 male, 17 female) young adult guinea pigs from litters of two-to-four pups. A subset (10 male, 8 female) were infused with d-[3-3H]glucose before and during the HEC to determine rates of basal and insulin-stimulated glucose utilization, storage, glycolysis, and endogenous glucose production. n males, the insulin sensitivity of whole body glucose uptake ( r = 0.657, P = 0.002) and glucose utilization ( r = 0.884, P = 0.004) correlated positively and independently with birth weight, but not with neonatal fractional growth rate (FGR10-28). In females, the insulin sensitivity of whole body and partitioned glucose metabolism was not related to birth weight, but that of endogenous glucose production correlated negatively and independently with FGR10-28 ( r = -0.815, P = 0.025). Thus, perinatal growth programs insulin sensitivity of glucose metabolism in the young adult guinea pig and in a sex-specific manner; impaired insulin sensitivity, including glucose utilization, occurs after IUGR in males and impaired hepatic insulin sensitivity after rapid neonatal growth in females.
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Affiliation(s)
- Dane M Horton
- Robinson Research Institute, The University of Adelaide , Adelaide, South Australia , Australia.,Adelaide Medical School, The University of Adelaide , Adelaide, South Australia , Australia
| | - David A Saint
- Adelaide Medical School, The University of Adelaide , Adelaide, South Australia , Australia
| | - Kathryn L Gatford
- Robinson Research Institute, The University of Adelaide , Adelaide, South Australia , Australia.,Adelaide Medical School, The University of Adelaide , Adelaide, South Australia , Australia
| | - Karen L Kind
- Robinson Research Institute, The University of Adelaide , Adelaide, South Australia , Australia.,School of Animal and Veterinary Sciences, The University of Adelaide , Adelaide, South Australia , Australia
| | - Julie A Owens
- Robinson Research Institute, The University of Adelaide , Adelaide, South Australia , Australia.,Adelaide Medical School, The University of Adelaide , Adelaide, South Australia , Australia.,Office of the Deputy Vice-Chancellor Research, Deakin University, Waurn Ponds, Geelong, Victoria , Australia
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40
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Tang A, Slopen N, Nelson CA, Zeanah CH, Georgieff MK, Fox NA. Catch-up growth, metabolic, and cardiovascular risk in post-institutionalized Romanian adolescents. Pediatr Res 2018; 84:842-848. [PMID: 30323348 PMCID: PMC6330119 DOI: 10.1038/s41390-018-0196-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Reduced prenatal growth followed by rapid postnatal weight gain are risk factors for developing metabolic and cardiovascular disease. Children reared in institutions experience a similar pattern of growth restriction followed by catch-up growth after removal. We explored whether patterns of catch-up growth affect metabolic and cardiovascular outcomes in previously institutionalized adolescents. METHOD A longitudinal study of institutionalized infants randomized to care as usual (n = 68) or foster care intervention (n = 68), and never institutionalized controls (n = 127). Body mass index (BMI) was measured at baseline (20 months), 30, 42 months, and ages 8, 12, 16. At age 16, metabolic and pro-inflammatory markers were derived from blood samples. RESULTS Four BMI trajectories were derived (i.e., average-stable, low-stable, elevated, and accelerated). The accelerated trajectory was comprised predominately of children randomized to foster care, who also exhibited higher levels of glycosylated hemoglobin and C-reactive protein than the other three trajectories. Also, children placed in foster care at younger ages were more likely to be on the accelerated rather than the average-stable trajectory. CONCLUSIONS Although catch-up growth is viewed as a positive improvement among post-institutionalized children, rapid/continuous increases in body size pose a health concern. Attention should be given to monitoring weight gain, diet, and physical activity.
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Affiliation(s)
- Alva Tang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Natalie Slopen
- Shool of Public Health, University of Maryland, College Park, MD, USA
| | - Charles A Nelson
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Michael K Georgieff
- Department of Pediatrics, Institute of Child Development, and Center for Neurobehavioral Development, University of Minnesota, Minneapolis, MN, USA
| | - Nathan A Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA.
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41
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Vasquez F, Corvalan C, Uauy R, Kain J. Impact of gaining or maintaining excessive weight in infancy on markers of metabolic homeostasis in young children: A longitudinal study in Chilean children. Prev Med Rep 2018; 12:298-303. [PMID: 30406008 PMCID: PMC6214876 DOI: 10.1016/j.pmedr.2018.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/04/2018] [Accepted: 10/14/2018] [Indexed: 11/16/2022] Open
Abstract
Childhood obesity in Chile is one of the highest in the world. The objective of this study was to assess the impact of excessive weight gained or maintained over a 3-year period, on markers of metabolic homeostasis in young children. This is a longitudinal study which includes 243 children followed from 4 to 7 years. We assessed BMI, body fat percentage, waist circumference (WC), waist-hip ratio (WHR), waist-height (WH) and trunk fat as well as the following metabolic parameters: glucose, insulin, triglycerides, total cholesterol, LDL, HDL and metabolic risk score. Kruskal- Wallis was used to assess differences in metabolic markers by nutritional status and logistic regression to determine the effect of maintaining or gaining excess weight over the 3-year period, compared with children who maintained a normal weight. Children who were obese at both ages compared with those who were normal weight, had a significantly higher WC, serum concentrations of total fat, total cholesterol, triglycerides, LDL cholesterol and metabolic risk score (P < 0.05). Children who were overweight or obese at 4 and 7 years, had a greater risk of having a high WC (OR: 3.37; P = 0.03), total cholesterol (OR: 4.17; P < 0.003), triglycerides (OR: 1.96; P = 0.04); thus a higher metabolic risk score (OR: 3.21; P = 0.003). Excess weight maintained over time in early childhood, significantly increases the risk of having higher serum biomarkers of cardiovascular risk, which in turn determines the magnitude of cardiovascular and metabolic risks later in life. A Chilean cohort study followed from 4 to 7 years showed that the prevalence of overweight/obese increased from 32 to 35%. 23% of children remained overweight/obese at both ages. 13% of children changed from normal to overweight. Excess weight maintained over time increases disruption of metabolic homeostasis. Cardiovascular parameters may determine the magnitude of cardiovascular risks.
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Affiliation(s)
- Fabian Vasquez
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Camila Corvalan
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Ricardo Uauy
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Juliana Kain
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
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Andrich DE, Ou Y, Melbouci L, Leduc-Gaudet JP, Auclair N, Mercier J, Secco B, Tomaz LM, Gouspillou G, Danialou G, Comtois AS, St-Pierre DH. Altered Lipid Metabolism Impairs Skeletal Muscle Force in Young Rats Submitted to a Short-Term High-Fat Diet. Front Physiol 2018; 9:1327. [PMID: 30356919 PMCID: PMC6190893 DOI: 10.3389/fphys.2018.01327] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 09/03/2018] [Indexed: 12/15/2022] Open
Abstract
Obesity and ensuing disorders are increasingly prevalent in young populations. Prolonged exposure to high-fat diets (HFD) and excessive lipid accumulation were recently suggested to impair skeletal muscle functions in rodents. We aimed to determine the effects of a short-term HFD on skeletal muscle function in young rats. Young male Wistar rats (100–125 g) were fed HFD or a regular chow diet (RCD) for 14 days. Specific force, resistance to fatigue and recovery were tested in extensor digitorum longus (EDL; glycolytic) and soleus (SOL; oxidative) muscles using an ex vivo muscle contractility system. Muscle fiber typing and insulin signaling were analyzed while intramyocellular lipid droplets (LD) were characterized. Expression of key markers of lipid metabolism was also measured. Weight gain was similar for both groups. Specific force was decreased in SOL, but not in EDL of HFD rats. Muscle resistance to fatigue and force recovery were not altered in response to the diets. Similarly, muscle fiber type distribution and insulin signaling were not influenced by HFD. On the other hand, percent area and average size of intramyocellular LDs were significantly increased in the SOL of HFD rats. These effects were consistent with the increased expression of several mediators of lipid metabolism in the SOL muscle. A short-term HFD impairs specific force and alters lipid metabolism in SOL, but not EDL muscles of young rats. This indicates the importance of clarifying the early mechanisms through which lipid metabolism affects skeletal muscle functions in response to obesogenic diets in young populations.
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Affiliation(s)
- David E Andrich
- Département des Sciences de l'Activités Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Groupe de Recherche en Activité Physique Adaptée, Université du Québec à Montréal, Montreal, QC, Canada.,Département des Sciences Biologiques, Université du Québec à Montréal, Montreal, QC, Canada
| | - Ya Ou
- Département des Sciences de l'Activités Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Groupe de Recherche en Activité Physique Adaptée, Université du Québec à Montréal, Montreal, QC, Canada.,Centre de Recherche du CHU Sainte-Justine, Montreal, QC, Canada
| | - Lilya Melbouci
- Département des Sciences de l'Activités Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Groupe de Recherche en Activité Physique Adaptée, Université du Québec à Montréal, Montreal, QC, Canada.,Centre de Recherche du CHU Sainte-Justine, Montreal, QC, Canada
| | - Jean-Philippe Leduc-Gaudet
- Département des Sciences de l'Activités Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Groupe de Recherche en Activité Physique Adaptée, Université du Québec à Montréal, Montreal, QC, Canada
| | - Nickolas Auclair
- Département des Sciences de l'Activités Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Groupe de Recherche en Activité Physique Adaptée, Université du Québec à Montréal, Montreal, QC, Canada.,Centre de Recherche du CHU Sainte-Justine, Montreal, QC, Canada
| | - Jocelyne Mercier
- Département des Sciences de l'Activités Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Groupe de Recherche en Activité Physique Adaptée, Université du Québec à Montréal, Montreal, QC, Canada.,Centre de Recherche du CHU Sainte-Justine, Montreal, QC, Canada
| | - Blandine Secco
- Centre de Recherche de l'Institut de Cardiologie et de Pneumologie de Québec, Ville de Québec, QC, Canada
| | - Luciane Magri Tomaz
- Département des Sciences de l'Activités Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Groupe de Recherche en Activité Physique Adaptée, Université du Québec à Montréal, Montreal, QC, Canada.,Centre de Recherche du CHU Sainte-Justine, Montreal, QC, Canada
| | - Gilles Gouspillou
- Département des Sciences de l'Activités Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Groupe de Recherche en Activité Physique Adaptée, Université du Québec à Montréal, Montreal, QC, Canada
| | - Gawiyou Danialou
- Département des Sciences de l'Activités Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Royal Military College Saint-Jean, Saint-Jean-sur-Richelieu, QC, Canada
| | - Alain-Steve Comtois
- Département des Sciences de l'Activités Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Groupe de Recherche en Activité Physique Adaptée, Université du Québec à Montréal, Montreal, QC, Canada
| | - David H St-Pierre
- Département des Sciences de l'Activités Physique, Université du Québec à Montréal, Montreal, QC, Canada.,Groupe de Recherche en Activité Physique Adaptée, Université du Québec à Montréal, Montreal, QC, Canada.,Centre de Recherche du CHU Sainte-Justine, Montreal, QC, Canada
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Gunderson EP, Greenspan LC, Faith MS, Hurston SR, Quesenberry CP. Breastfeeding and growth during infancy among offspring of mothers with gestational diabetes mellitus: a prospective cohort study. Pediatr Obes 2018; 13:492-504. [PMID: 29691992 PMCID: PMC6108892 DOI: 10.1111/ijpo.12277] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 01/11/2018] [Accepted: 01/15/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Breastfeeding (BF) may protect against obesity and type 2 diabetes mellitus in children exposed to maternal diabetes in utero, but its effects on infant growth among this high-risk group have rarely been evaluated. OBJECTIVES The objective of this study was to evaluate BF intensity and duration in relation to infant growth from birth through 12 months among offspring of mothers with gestational diabetes mellitus (GDM). METHODS Prospective cohort of 464 GDM mother-infant dyads (28% White, 36% Hispanic, 26% Asian, 8% Black, 2% other). Weight and length measured at birth, 6-9 weeks, 6 months and 12 months. Categorized as intensive BF or formula feeding (FF) groups at 6-9 weeks (study baseline), and intensity from birth through 12 months as Group 1: consistent exclusive/mostly FF, Group 2: transition from BF to FF within 3-9 months and Group 3: consistent exclusive/mostly BF. Multivariable mixed linear regression models estimated adjusted mean (95% confidence interval) change in z-scores; weight-for-length (WLZ), weight-for-age and length-for-age. RESULTS Compared with intensive BF at 6-9 weeks, FF showed greater increases in WLZ-scores from 6 to 9 weeks to 6 months [+0.38 (0.13 to 0.62) vs. +0.02 (-0.15 to 0.19); p = 0.02] and birth to 12 months [+1.11 (0.87 to 1.34) vs. +0.53 (0.37 to 0.69); p < 0.001]. For 12-month intensity and duration, Groups 2 and 3 had smaller WLZ-score increases than Group 1 from 6 to 9 weeks to 6 months [-0.05 (-0.27 to 0.18) and +0.07 (-0.19 to 0.23) vs. +0.40 (0.15 to 0.64); p = 0.01 and 0.07], and birth to 12 months [+0.60 (0.39 to 0.82) and +0.59 (0.33 to 0.85) vs. +0.97 (0.75 to 1.19); p < 0.05]. CONCLUSIONS Among offspring of mothers with GDM, high intensity BF from birth through 1 year is associated with slower infant ponderal growth and lower weight gain.
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Affiliation(s)
- E. P. Gunderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - L. C. Greenspan
- Department of Pediatrics, The Permanente Medical Group, San Francisco, CA, USA
| | - M. S. Faith
- Department of Counseling, School, and Educational Psychology, University of Buffalo, Buffalo, NY, USA
| | - S. R. Hurston
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - C. P. Quesenberry
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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Ramirez-Silva I, Rivera JA, Trejo-Valdivia B, Stein AD, Martorell R, Romieu I, Barraza-Villarreal A, Avila-Jiménez L, Ramakrishnan U. Relative Weight Gain Through Age 4 Years Is Associated with Increased Adiposity, and Higher Blood Pressure and Insulinemia at 4-5 Years of Age in Mexican Children. J Nutr 2018; 148:1135-1143. [PMID: 29924321 PMCID: PMC6669951 DOI: 10.1093/jn/nxy068] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 11/10/2017] [Accepted: 03/12/2018] [Indexed: 12/25/2022] Open
Abstract
Background Rapid early weight gain has been associated with increased risk of obesity and cardiometabolic alterations, but evidence in low and middle-income countries is inconclusive. Objective We evaluated the relation between relative weight gain from 1 to 48 mo with adiposity and cardiometabolic risk factors at 4-5 y of age, and determined if adiposity is a mediator for cardiometabolic alterations. Methods We studied 428 Mexican children with anthropometric and blood pressure (BP) information from birth to 5 y of age from POSGRAD (Prenatal Omega-3 fatty acid Supplementation and child GRowth And Development), of whom 334 provided measures of adiposity and cardiometabolic risk markers at 4 y. We estimated relative weight gain by means of conditional weight-for-height z scores for the age intervals 1-6, 6-12, 12-24, and 24-48 mo. Associations between relative weight gain and adiposity and cardiometabolic risk markers (lipid profile, triglycerides, insulin, glucose, and BP) were analyzed by multivariate multiple linear models and path analysis. Results A 1-unit increase in conditional weight-for-height z score within each age interval was positively associated with adiposity at 5 y, with coefficients of 0.43-0.89 for body mass index (BMI) z score, 1.08-3.65 mm for sum of skinfolds, and 1.21-3.87 cm for abdominal circumference (all P < 0.01). Positive associations were documented from ages 6 to 48 mo with systolic BP (coefficient ranges: 1.19-1.78 mm Hg; all P < 0.05) and from ages 12 to 48 mo with diastolic BP (1.28-0.94 mm Hg; P < 0.05) at 5 y. Conditional weight-for-height z scores at 12-24 and 24-48 mo of age were more strongly associated with adiposity and BP relative to younger ages. A unit increase in conditional weight-for-height z scores from 12 to 24 mo was associated with 14% higher insulin levels (P < 0.05) at 4 y. Path analyses documented that the associations of conditional weight gain with BP were mediated by BMI and sum of skinfolds. Conclusion Relative weight gain at most periods during the first 4 y of life was associated with greater adiposity and higher systolic and diastolic BP at 5 y. These associations with BP were mediated by adiposity. Relative weight gain from 12 to 24 mo was associated with increased serum insulin concentrations at 4 y, but there were no associations with lipid profiles or glucose concentration.
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Affiliation(s)
| | | | | | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Reynaldo Martorell
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Isabelle Romieu
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | | | | | - Usha Ramakrishnan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
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45
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Gat-Yablonski G, De Luca F. Effect of Nutrition on Statural Growth
. Horm Res Paediatr 2018; 88:46-62. [PMID: 28365689 DOI: 10.1159/000456547] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 01/11/2017] [Indexed: 12/14/2022] Open
Abstract
In children, proper growth and development are often regarded as a surrogate marker for good health. A complex system controls the initiation, rate, and cessation of growth, and thus gives a wonderful example of the interactions between genetics, epigenetics, and environmental factors (especially stress and nutrition). Malnutrition is considered a leading cause of growth attenuation in children. This review summarizes our current knowledge regarding the mechanisms linking nutrition and skeletal growth, including systemic factors, such as insulin, growth hormone, insulin-like growth factor-1, fibroblast growth factor-21, etc., and local mechanisms, including mTOR, miRNAs, and epigenetics. Studying the molecular mechanisms regulating skeletal growth may lead to the establishment of better nutritional and therapeutic regimens for more effective linear growth in children with malnutrition and growth abnormalities.
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Affiliation(s)
- Galia Gat-Yablonski
- The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Children's Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Felsenstein Medical Research Center, Petach Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Francesco De Luca
- Section of Endocrinology and Diabetes, St. Christopher's Hospital for Children, Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
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46
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Abstract
Early nutrition may have long-lasting metabolic impacts in adulthood. Even though breast milk is the gold standard, most infants are at least partly formula-fed. Despite obvious improvements, infant formulas remain perfectible to reduce the gap between breastfed and formula-fed infants. Improvements such as reducing the protein content, modulating the lipid matrix and adding prebiotics, probiotics and synbiotics, are discussed regarding metabolic health. Numerous questions remain to be answered on how impacting the infant formula composition may modulate the host metabolism and exert long-term benefits. Interactions between early nutrition (composition of human milk and infant formula) and the gut microbiota profile, as well as mechanisms connecting gut microbiota to metabolic health, are highlighted. Gut microbiota stands as a key actor in the nutritional programming but additional well-designed longitudinal human studies are needed.
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47
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Dietary fatty acids sex-specifically modulate guinea pig postnatal development via cortisol concentrations. Sci Rep 2018; 8:471. [PMID: 29323260 PMCID: PMC5765112 DOI: 10.1038/s41598-017-18978-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 12/18/2017] [Indexed: 12/20/2022] Open
Abstract
Early ontogenetic periods and postnatal maturation in organisms are sex-specifically sensitive to hypothalamic-pituitary-adrenal (HPA)-axis activities, related glucocorticoid secretions, and their effects on energy balance and homeostasis. Dietary polyunsaturated (PUFAs) and saturated (SFAs) fatty acids potentially play a major role in this context because PUFAs positively affect HPA-axis functions and a shift towards SFAs may impair body homeostasis. Here we show that dietary PUFAs positively affect postnatal body mass gain and diminish negative glucocorticoid-effects on structural growth rates in male guinea pigs. In contrast, SFAs increased glucocorticoid concentrations, which positively affected testes size and testosterone concentrations in males, but limited their body mass gain and first year survival rate. No distinct diet-related effects were detectable on female growth rates. These results highlight the importance of PUFAs in balancing body homeostasis during male's juvenile development, which clearly derived from a sex-specific energetic advantage of dietary PUFA intakes compared to SFAs.
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48
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Effects of growth hormone treatment on anthropometrics, metabolic risk, and body composition variables in small for gestational age patients. An Pediatr (Barc) 2017. [DOI: 10.1016/j.anpede.2016.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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49
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Mispireta ML, Caulfield LE, Zavaleta N, Merialdi M, Putnick DL, Bornstein MH, DiPietro JA. Effect of maternal zinc supplementation on the cardiometabolic profile of Peruvian children: results from a randomized clinical trial. J Dev Orig Health Dis 2017; 8:56-64. [PMID: 27748235 PMCID: PMC5822716 DOI: 10.1017/s2040174416000568] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Zinc is an essential micronutrient for the development of the fetal renal, cardiovascular and metabolic systems; however, there is limited evidence of its effects on the postnatal cardiometabolic function. In this study, we evaluated the effect of maternal zinc supplementation during pregnancy on the cardiometabolic profile of the offspring in childhood. A total of 242 pregnant women were randomly assigned to receive a daily supplement containing iron+folic acid with or without zinc. A follow-up study was conducted when children of participating mothers were 4.5 years of age to evaluate their cardiometabolic profile, including anthropometric measures of body size and composition, blood pressure, lipid profile and insulin resistance. No difference in measures of child cardiometabolic risk depending on whether mothers received supplemental zinc during pregnancy. Our results do not support the hypothesis that maternal zinc supplementation reduces the risk of offspring cardiometabolic disease.
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Affiliation(s)
- M L Mispireta
- 1Kasiska School of Health Professions,Idaho State University,Pocatello,ID,USA
| | - L E Caulfield
- 2Department of International Health,Center for Human Nutrition,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA
| | - N Zavaleta
- 4Instituto de Investigación Nutricional,Lima,Peru
| | - M Merialdi
- 5Global Health Division,Becton Dickinson, Franklin Lakes,NJ,USA
| | - D L Putnick
- 6Eunice Kennedy ShriverNational Institute of Child Health and Human Development,National Institutes of Health,Bethesda,MD,USA
| | - M H Bornstein
- 6Eunice Kennedy ShriverNational Institute of Child Health and Human Development,National Institutes of Health,Bethesda,MD,USA
| | - J A DiPietro
- 3Department of Population, Family and Reproductive Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA
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50
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Voerman E, Jaddoe VWV, Franco OH, Steegers EAP, Gaillard R. Critical periods and growth patterns from fetal life onwards associated with childhood insulin levels. Diabetologia 2017; 60:81-88. [PMID: 27757489 PMCID: PMC5495163 DOI: 10.1007/s00125-016-4135-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/21/2016] [Indexed: 01/20/2023]
Abstract
AIMS/HYPOTHESIS We aimed to identify critical periods and specific longitudinal growth patterns from fetal life onwards associated with childhood insulin and C-peptide levels. METHODS In a prospective population-based cohort study of 4328 children, we repeatedly measured (femur) length and (estimated fetal) weight from the second trimester of fetal life until 6 years of age. BMI was calculated from 6 months onwards. Insulin and C-peptide levels were measured at 6 years of age. RESULTS Preterm birth and small or large size for gestational age at birth were not associated with childhood insulin levels. Conditional growth modelling showed that, independent of growth in other time intervals, weight growth in each time interval from birth onwards, length growth from 6 months onwards and BMI growth from 12 months onwards were positively associated with childhood insulin levels. The strongest associations were present for weight and BMI growth between 48 and 72 months of age. Repeated measurement analyses showed that, compared with children in the lowest quartile of childhood insulin, those in the highest quartile had a higher length from birth onwards and a higher weight and BMI from 24 months onwards. These differences increased with age. No associations were observed for fetal growth characteristics. Similar results were observed for C-peptide levels. CONCLUSIONS/INTERPRETATION Our results suggest that rapid length, weight and BMI growth from birth onwards, but not during fetal life, is associated with higher insulin levels in childhood.
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Affiliation(s)
- Ellis Voerman
- The Generation R Study Group (Room Na-2915), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group (Room Na-2915), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Romy Gaillard
- The Generation R Study Group (Room Na-2915), Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
- Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
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