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Lee HA, Park B, Min J, Choi EJ, Kim UJ, Park HJ, Park EA, Cho SJ, Kim HS, Lee H, Kim YJ, Hong YS, Kim EJ, Ha EH, Park H. Cohort profile: the Ewha Birth and Growth Study. Epidemiol Health 2021; 43:e2021016. [PMID: 33677859 PMCID: PMC8060523 DOI: 10.4178/epih.e2021016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/20/2021] [Indexed: 12/11/2022] Open
Abstract
With the introduction of life-course epidemiology, researchers realized the importance of identifying risk factors in early life to prevent chronic diseases. This led to the establishment of the Ewha Birth and Growth Study in 2001; the study is a prospective birth cohort designed to provide evidence of early life risk factors for a child's growth and health. Participants were recruited from those who visited Ewha Womans University Mokdong Hospital (a tertiary hospital in southwest Seoul, Korea) for prenatal care at 24-28 weeks of gestation. In total, 891 mothers enrolled in this study between 2001 and 2006 and their offspring (n=940) were followed-up. Regular check-up examinations of offspring were conducted at 3 years, 5 years, and 7 years of age and every year thereafter. To consider age-related health issues, extensive data were collected using questionnaires and measurements. In 2021, the study subjects will reach 19 years of age, and we are planning a check-up examination for early adulthood. About 20 years have passed since the cohort data were collected, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. Recently, we started reporting on topics related to adolescent health. The findings will facilitate identification of early life risk factors for chronic diseases and the development of interventions for diseases later in life.
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Affiliation(s)
- Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Bohyun Park
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jungwon Min
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Eun Jeong Choi
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ui Jeong Kim
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea.,Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Hyun Jin Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea.,Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hwayoung Lee
- Department of Anatomy, Ewha Womans University College of Medicine, Seoul, Korea
| | - Young Ju Kim
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea.,Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Young Sun Hong
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Eui-Jung Kim
- Department of Psychiatry, Ewha Womans University College of Medicine, Seoul, Korea
| | - Eun Hee Ha
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea.,Department of Occupational and Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea.,Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
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Kim B, Shah S, Park HS, Hong YC, Ha M, Kim Y, Kim BN, Kim Y, Ha EH. Adverse effects of prenatal mercury exposure on neurodevelopment during the first 3 years of life modified by early growth velocity and prenatal maternal folate level. ENVIRONMENTAL RESEARCH 2020; 191:109909. [PMID: 32871452 DOI: 10.1016/j.envres.2020.109909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 05/30/2020] [Accepted: 07/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND AIMS Previous studies have suggested that mercury exposure and folate levels during pregnancy may influence early childhood neurodevelopment. Rapid catch-up growth in children is associated with an increased risk of pathological nervous system development. We evaluated whether the association between prenatal folate and mercury-related neuropsychological dysfunction was modified by growth velocity during childhood. METHODS The Mothers and Children's Environmental Health (MOCEH) birth cohort study began in 2006 and by 2010, 1751 women had been enrolled before the second trimester of their pregnancy along with their partners. Participants visited the research center at birth and 6, 12, 24, and 36 months. We measured mercury levels in maternal and cord blood and folate in maternal serum. Questionnaires to evaluate the environment and health of their child were administered and anthropometric factors including body weight and height were measured. Certified investigators used the Bayley test to measure neurobehavioral outcomes. We calculated postnatal growth change as the change in infant weight for-age z-score between birth and 3 years. Multiple linear regression and mixed models were used to examine the association between mercury exposure and children's neurodevelopment as well as the modifying effects of folate and growth velocity. RESULTS A total of 30.6% of children experienced rapid growth during the first 3 years of life. Median values of mercury in the low folate group were significantly higher in rapid growers (3.41 μg/L in maternal blood and 5.63 μg/L in cord blood) than in average/slow growers (3.05 μg/L in maternal blood and 5.19 μg/L in cord blood). Rapid growers were also significantly associated with decreased psychomotor development scores during the first 3 years of life and with having mothers who had low prenatal folate levels, even after adjusting for potential confounders. CONCLUSION Prenatal mercury exposure adversely affects infant neurodevelopment and is associated with rapid growth during the first 3 years of life. This effect was limited to children whose mothers had low prenatal folate levels, suggesting a protective effect of folate against developmental neurotoxicity due to mercury exposure and rapid catch-up growth.
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Affiliation(s)
- Byungmi Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Surabhi Shah
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Medical Research Center, Ewha Womans University, Seoul, Republic of Korea
| | - Hye-Sook Park
- Department of Preventive Medicine, College of Medicine, Ewha Medical Research Center, Ewha Womans University, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Mina Ha
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Boong-Nnyun Kim
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yeni Kim
- Department of Child and Adolescent Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Eun-Hee Ha
- Department of Occupational and Environmental Medicine, College of Medicine, Ewha Medical Research Center, Ewha Womans University, Seoul, Republic of Korea.
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Lee SH, Lee HA, Park EA, Cho SJ, Oh SY, Park B, Park H. Combined effects of dietary zinc at 3 years of age and obesity at 7 years of age on the serum uric acid levels of Korean children. Nutr Res Pract 2020; 14:365-373. [PMID: 32765816 PMCID: PMC7390735 DOI: 10.4162/nrp.2020.14.4.365] [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] [Received: 01/22/2019] [Revised: 02/18/2019] [Accepted: 01/16/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND/OBJECTIVES To assess the longitudinal associations of the antioxidant capacity of zinc and body mass index (BMI) with serum uric acid (SUA) in South Korean children. SUBJECTS/METHODS Using follow-up data from the Ewha Birth and Growth Cohort, we included subjects who were seen at 3 and 7 years of age (n = 183; 90 boys, 93 girls). Daily zinc intake and BMI were assessed at 3 and 7 years of age. SUA measured at 7 years was used as the outcome variable. Using a general linear model, the effects of dietary zinc intake and BMI on SUA were assessed. We also assessed the combined effect of early dietary zinc intake and BMI on SUA in children. RESULTS The dietary zinc intake at 3 years of age was negatively correlated (ρ = −0.18, P = 0.04), whereas the BMI at 7 years of age was positively correlated (r = 0.18, P = 0.01), with the SUA level at 7 years of age. The dietary zinc intake level at 3 years of age and the BMI level at 7 years of age were, together, significantly related to SUA in children at 7 years of age. SUA was lower in group 1 (normal-weight, high-zinc group) than in the other two groups (group 2: normal-weight, low-zinc and overweight, high-zinc group; and group 3: overweight, low-zinc group). Our results demonstrate the combined effect of zinc intake and BMI on SUA. The combined association remained significant in both the crude and adjusted models (P < 0.01). CONCLUSIONS SUA was related to combined BMI and dietary zinc intake, and increased zinc intake and normal body weight had a beneficial effect on reducing SUA in children.
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Affiliation(s)
- Sung Hee Lee
- Department of Preventive Medicine, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Korea
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul 07985, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul 07985, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul 07985, Korea
| | - Se Young Oh
- Department of Food & Nutrition, College of Human Ecology, Kyung Hee University, Seoul 02447, Korea
| | - Bohyun Park
- Department of Preventive Medicine, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, Seoul 07804, Korea
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ACE Gene I/D Polymorphism and Obesity in 1,574 Patients with Type 2 Diabetes Mellitus. DISEASE MARKERS 2016; 2016:7420540. [PMID: 28115791 PMCID: PMC5220452 DOI: 10.1155/2016/7420540] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/14/2016] [Accepted: 12/04/2016] [Indexed: 12/28/2022]
Abstract
Association between ACE gene I/D polymorphism and the risk of overweight/obesity remains controversial. We investigated the possible relationship between ACE gene I/D polymorphism and obesity in Chinese type 2 diabetes mellitus (T2DM) patients. In this study, obesity was defined as a body mass index (BMI) value ≥ 25 kg/m2 and subjects were classified into 4 groups (lean, normal, overweight, and obese). PCR (polymerase chain reaction) was used to detect the ACE gene I/D polymorphism in T2DM patients. Metabolic measurements including blood glucose, lipid profile, and blood pressure were obtained. Frequencies of the ACE genotypes (DD, ID, and II) were not significant among the 4 groups of BMI-defined patients (P = 0.679) while ACE II carriers showed higher systolic blood pressure (SBP) and pulse pressure (PP) (all P < 0.050). Hyperglycemia, hypertension, and dyslipidemia in these T2DM patients were found to be significantly associated with BMI. In conclusion, the relationship of ACE gene I/D polymorphism with obesity is insignificant in Chinese patients with T2DM. SBP and PP might be higher in the ACE II carriers than in the DD and ID carriers.
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Wirix AJG, Kaspers PJ, Nauta J, Chinapaw MJM, Kist-van Holthe JE. Pathophysiology of hypertension in obese children: a systematic review. Obes Rev 2015; 16:831-42. [PMID: 26098701 DOI: 10.1111/obr.12305] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 05/18/2015] [Accepted: 05/18/2015] [Indexed: 12/27/2022]
Abstract
Hypertension is increasingly common in overweight and obese children. The mechanisms behind the development of hypertension in obesity are complex, and evidence is limited. In order to effectively treat obese children for hypertension, it is important to have a deeper understanding of the pathophysiology of hypertension in obese children. The present review summarizes the main factors associated with hypertension in obese children and discusses their potential role in its pathophysiology. Systematic searches were conducted in PubMed and EMBASE for articles published up to October 2014. In total, 60 relevant studies were included. The methodological quality of the included studies ranged from weak to strong. Several factors important in the development of hypertension in obese children have been suggested, including endocrine determinants, such as corticosteroids and adipokines, sympathetic nervous system activity, disturbed sodium homeostasis, as well as oxidative stress, inflammation and endothelial dysfunction. Understanding the pathophysiology of hypertension in overweight and obese children is important and could have implications for its screening and treatment. Based on solely cross-sectional observational studies, it is impossible to infer causality. Longitudinal studies of high methodological quality are needed to gain more insight into the complex mechanisms behind the development of hypertension in obese children.
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Affiliation(s)
- A J G Wirix
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - P J Kaspers
- Medical Library, VU University Medical Center, Amsterdam, The Netherlands
| | - J Nauta
- Department of Pediatric Nephrology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M J M Chinapaw
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - J E Kist-van Holthe
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Angiotensin-converting enzyme gene insertion/deletion polymorphism in nutritional disorders in children. Eur J Nutr 2014; 54:1245-54. [PMID: 25416682 DOI: 10.1007/s00394-014-0802-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 11/07/2014] [Indexed: 02/08/2023]
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Mao S, Huang S. A meta-analysis of the association between angiotensin-converting enzyme insertion/ deletion gene polymorphism and the risk of overweight/obesity. J Renin Angiotensin Aldosterone Syst 2013; 16:687-94. [PMID: 24150609 DOI: 10.1177/1470320313501218] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 07/02/2013] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The association between angiotensin-converting enzyme insertion/deletion (ACE I/D) gene polymorphism and the risk of overweight/obesity remains controversial. A meta-analysis was conducted to evaluate the association between ACE I/D gene polymorphism and overweight/obesity susceptibility. METHOD All eligible studies were included in this meta-analysis by searching PubMed, Embase and Cochrane databases through April 2013 according to a predefined criteria. RESULTS Fourteen case-control studies including 3371 cases and 4490 controls were recruited for the analysis of the association between ACE I/D gene polymorphism and overweight/obesity susceptibility. A significant association was observed between DD genotype and overweight/obesity risk in overall populations and Africans (p=0.014 and 0.010, respectively). D allele was associated with the risk of overweight/ obesity in Africans (p=0.026). However, II genotype might not be a protective factor against overweight/obesity risk in overall populations, Africans, Caucasians and Asians. CONCLUSIONS DD genotype is a risk factor for the overweight/obesity susceptibility in overall populations, particularly in Africans. D allele is a risk factor for the overweight/obesity susceptibility in Africans. Further larger studies are needed to confirm our findings.
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Affiliation(s)
- Song Mao
- Department of Nephrology, Nanjing Children's Hospital, Affiliated to Nanjing Medical University, Nanjing, China
| | - Songming Huang
- Department of Nephrology, Nanjing Children's Hospital, Affiliated to Nanjing Medical University, Nanjing, China
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Lee HA, Park H. Overview of noncommunicable diseases in Korean children and adolescents: focus on obesity and its effect on metabolic syndrome. J Prev Med Public Health 2013; 46:173-82. [PMID: 23946875 PMCID: PMC3740222 DOI: 10.3961/jpmph.2013.46.4.173] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 07/15/2013] [Indexed: 02/06/2023] Open
Abstract
Obesity during childhood is a dominant risk factor for noncommunicable diseases (NCDs), and is itself considered a disease that needs to be treated. Recently, the growth in childhood obesity in Korea has become stagnant; however, two in every ten children are still overweight. In addition, 60% or more of overweight children have at least one metabolic syndrome risk factor. Thus, childhood obesity should be controlled through lifestyle modification. This paper reviews studies of the modifiable risk factors of obesity in Korean children. According to the life-course approach, preschool-aged children (<5 years) are influenced by their parents rather than individual habits because they are under mostly parental care. Elementary school-aged children (6 to 11 years) are affected by overlapping individual and parental effects. This may mean that the establishment of individual behavior patterns begins during this period. The conditions of poor eating habits such as skipping meals, eating out, and high fat intake, along with low physical activity, facilitate increased obesity among adolescents (12 to 18 years). Notably, adolescent girls show high rates of both underweight and obesity, which may lead to the development of NCDs in their offspring. Therefore, the problem of NCDs is no longer limited to adults, but is also prevalent among children. In addition, early intervention offers cost-effective opportunities for preventing NCDs. Thus, children need primary consideration, adequate monitoring, diagnosis, and treatment to reduce the burden of NCDs later in adulthood.
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Affiliation(s)
- Hye Ah Lee
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
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