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Fu L, Cheng H, Xiong J, Xiao P, Shan X, Li Y, Li Y, Zhao X, Mi J. Mediating role of inflammatory biomarkers in the causal effect of body composition on glycaemic traits and type 2 diabetes. Diabetes Obes Metab 2024; 26:5444-5454. [PMID: 39228266 DOI: 10.1111/dom.15923] [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: 07/16/2024] [Revised: 08/20/2024] [Accepted: 08/20/2024] [Indexed: 09/05/2024]
Abstract
OBJECTIVE The aim was to investigate the mediating role of inflammatory biomarkers in the causal effect of body composition on glycaemic traits and type 2 diabetes. METHODS A retrospective observational study and a Mendelian randomization (MR) study were used. Observational analyses were performed using data from 4717 Chinese children and adolescents aged 6-18 years who underwent dual-energy X-ray absorptiometry for body composition. MR analyses were based on summary statistics from UK Biobank, deCODE2021, Meta-Analysis of Glucose and Insulin-Related Traits Consortium (MAGIC) and other large consortiums. Inflammatory biomarkers included leptin, adiponectin, osteocalcin, fibroblast growth factor 23 (FGF23) and parathyroid hormone (PTH). RESULTS In a retrospective observational study, increased fat mass had a positive effect on homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of pancreatic beta cell function (HOMA-β) through FGF23, whereas fat-free mass produced the opposite effects. PTH and osteocalcin played significant roles in the association of fat mass and fat-free mass with fasting glucose, fasting insulin and HOMA-IR (all p < 0.05). Mediation MR results indicated that childhood body mass index affected glycaemic traits through leptin and adiponectin. There existed a causal effect of fat-free mass on type 2 diabetes via FGF23 (indirect effect: OR [odds ratio]: 1.14 [95% CI, confidence interval: 1.01-1.28]) and adiponectin (OR: 0.85 [95% CI: 0.77-0.93]). Leptin mediated the causal association of fat mass (indirect effect: β: -0.05 [95% CI: -0.07, -0.02]) and fat-free mass (β: 0.03 [95% CI: 0.01, 0.04]) with fasting glucose. CONCLUSIONS Our findings suggest that different body compositions have differential influences on glycaemic traits and type 2 diabetes through distinct inflammatory biomarkers. The findings may be helpful in tailoring management of body composition based on inflammatory biomarkers with different glycaemic statuses.
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Affiliation(s)
- Liwan Fu
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hong Cheng
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Jingfan Xiong
- Child and Adolescent Chronic Disease Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Pei Xiao
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xinying Shan
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Yanyan Li
- Child and Adolescent Chronic Disease Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Yan Li
- Child and Adolescent Chronic Disease Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Xiaoyuan Zhao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Jie Mi
- Center for Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
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Bell JA, Carslake D, Hughes A, Tilling K, Dodd JW, Doidge JC, Harrison DA, Rowan KM, Davey Smith G. Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK. BMC Med 2024; 22:391. [PMID: 39272119 PMCID: PMC11401253 DOI: 10.1186/s12916-024-03598-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 08/29/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Adiposity shows opposing associations with mortality within COVID-19 versus non-COVID-19 respiratory conditions. We assessed the likely causality of adiposity for mortality among intensive care patients with COVID-19 versus non-COVID-19 by examining the consistency of associations across temporal and geographical contexts where biases vary. METHODS We used data from 297 intensive care units (ICUs) in England, Wales, and Northern Ireland (Intensive Care National Audit and Research Centre Case Mix Programme). We examined associations of body mass index (BMI) with 30-day mortality, overall and by date and region of ICU admission, among patients admitted with COVID-19 (N = 34,701; February 2020-August 2021) and non-COVID-19 respiratory conditions (N = 25,205; February 2018-August 2019). RESULTS Compared with non-COVID-19 patients, COVID-19 patients were younger, less often of a white ethnic group, and more often with extreme obesity. COVID-19 patients had fewer comorbidities but higher mortality. Socio-demographic and comorbidity factors and their associations with BMI and mortality varied more by date than region of ICU admission. Among COVID-19 patients, higher BMI was associated with excess mortality (hazard ratio (HR) per standard deviation (SD) = 1.05; 95% CI = 1.03-1.07). This was evident only for extreme obesity and only during February-April 2020 (HR = 1.52, 95% CI = 1.30-1.77 vs. recommended weight); this weakened thereafter. Among non-COVID-19 patients, higher BMI was associated with lower mortality (HR per SD = 0.83; 95% CI = 0.81-0.86), seen across all overweight/obesity groups and across dates and regions, albeit with a magnitude that varied over time. CONCLUSIONS Obesity is associated with higher mortality among COVID-19 patients, but lower mortality among non-COVID-19 respiratory patients. These associations appear vulnerable to confounding/selection bias in both patient groups, questioning the existence or stability of causal effects.
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Affiliation(s)
- Joshua A Bell
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - David Carslake
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Amanda Hughes
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - James W Dodd
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Academic Respiratory Unit, Southmead Hospital, University of Bristol, Bristol, UK
| | - James C Doidge
- Intensive Care National Audit & Research Centre (ICNARC), London, UK
| | - David A Harrison
- Intensive Care National Audit & Research Centre (ICNARC), London, UK
| | - Kathryn M Rowan
- Intensive Care National Audit & Research Centre (ICNARC), London, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Kesaite V, Greve J. The impact of excess body weight on employment outcomes: A systematic review of the evidence. ECONOMICS AND HUMAN BIOLOGY 2024; 54:101398. [PMID: 38718448 DOI: 10.1016/j.ehb.2024.101398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 04/19/2024] [Accepted: 04/25/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Excess body weight has been recognised as an important factor in influencing labour market outcomes. Several hypotheses explain the causal effect of excess body weight on employment outcomes, including productivity, labour supply, and discrimination. In this review, we provide a systematic synthesis of the evidence on the causal impact of excess body weight on labour market outcomes worldwide. METHODS We searched Econ Lit, and Web of Science databases for relevant studies published from 1st Jan 2010-20 th Jan 2023. Studies were included if they were either longitudinal analysis, pooled cross-sectional or cross-sectional studies if they used instrumental variable methodology based on Mendelian Randomisation. Only studies with measures of body weight and employment outcomes were included. RESULTS The number of potentially relevant studies constituted 4321 hits. A total of 59 studies met the inclusion criteria and were qualitatively reviewed by the authors. Most of the included studies were conducted in the USA (N=18), followed by the UK (N=9), Germany (N=6), Finland (N=4), and non-EU countries (N=22). Evidence from the included studies suggests that the effect of excess weight differs by gender, ethnicity, country, and time period. White women with excess weight in the USA, the UK, Germany, Canada, and in the EU (multi-country analyses) are less likely to be employed, and when employed they face lower wages compared to normal weight counterparts. For men there is no effect of excess weight on employment outcomes or the magnitude of the effect is much smaller or even positive in some cases. CONCLUSIONS This review has shown that despite ample research on the relationship between excess weight and employment status and wages, robust causal evidence of the effects of excess weight on employment outcomes remains scarce and relies significantly on strong statistical and theoretical assumptions. Further research into these relationships outside of USA and Western Europe context is needed.
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Affiliation(s)
- Viktorija Kesaite
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom.
| | - Jane Greve
- VIVE - The Danish Center for Social Science Research, Herluf Trolles Gade 11, Copenhagen K 1052, Denmark
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Spiga F, Davies AL, Tomlinson E, Moore TH, Dawson S, Breheny K, Savović J, Gao Y, Phillips SM, Hillier-Brown F, Hodder RK, Wolfenden L, Higgins JP, Summerbell CD. Interventions to prevent obesity in children aged 5 to 11 years old. Cochrane Database Syst Rev 2024; 5:CD015328. [PMID: 38763517 PMCID: PMC11102828 DOI: 10.1002/14651858.cd015328.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
BACKGROUND Prevention of obesity in children is an international public health priority given the prevalence of the condition (and its significant impact on health, development and well-being). Interventions that aim to prevent obesity involve behavioural change strategies that promote healthy eating or 'activity' levels (physical activity, sedentary behaviour and/or sleep) or both, and work by reducing energy intake and/or increasing energy expenditure, respectively. There is uncertainty over which approaches are more effective and numerous new studies have been published over the last five years, since the previous version of this Cochrane review. OBJECTIVES To assess the effects of interventions that aim to prevent obesity in children by modifying dietary intake or 'activity' levels, or a combination of both, on changes in BMI, zBMI score and serious adverse events. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was February 2023. SELECTION CRITERIA Randomised controlled trials in children (mean age 5 years and above but less than 12 years), comparing diet or 'activity' interventions (or both) to prevent obesity with no intervention, usual care, or with another eligible intervention, in any setting. Studies had to measure outcomes at a minimum of 12 weeks post baseline. We excluded interventions designed primarily to improve sporting performance. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our outcomes were body mass index (BMI), zBMI score and serious adverse events, assessed at short- (12 weeks to < 9 months from baseline), medium- (9 months to < 15 months) and long-term (≥ 15 months) follow-up. We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS This review includes 172 studies (189,707 participants); 149 studies (160,267 participants) were included in meta-analyses. One hundred forty-six studies were based in high-income countries. The main setting for intervention delivery was schools (111 studies), followed by the community (15 studies), the home (eight studies) and a clinical setting (seven studies); one intervention was conducted by telehealth and 31 studies were conducted in more than one setting. Eighty-six interventions were implemented for less than nine months; the shortest was conducted over one visit and the longest over four years. Non-industry funding was declared by 132 studies; 24 studies were funded in part or wholly by industry. Dietary interventions versus control Dietary interventions, compared with control, may have little to no effect on BMI at short-term follow-up (mean difference (MD) 0, 95% confidence interval (CI) -0.10 to 0.10; 5 studies, 2107 participants; low-certainty evidence) and at medium-term follow-up (MD -0.01, 95% CI -0.15 to 0.12; 9 studies, 6815 participants; low-certainty evidence) or zBMI at long-term follow-up (MD -0.05, 95% CI -0.10 to 0.01; 7 studies, 5285 participants; low-certainty evidence). Dietary interventions, compared with control, probably have little to no effect on BMI at long-term follow-up (MD -0.17, 95% CI -0.48 to 0.13; 2 studies, 945 participants; moderate-certainty evidence) and zBMI at short- or medium-term follow-up (MD -0.06, 95% CI -0.13 to 0.01; 8 studies, 3695 participants; MD -0.04, 95% CI -0.10 to 0.02; 9 studies, 7048 participants; moderate-certainty evidence). Five studies (1913 participants; very low-certainty evidence) reported data on serious adverse events: one reported serious adverse events (e.g. allergy, behavioural problems and abdominal discomfort) that may have occurred as a result of the intervention; four reported no effect. Activity interventions versus control Activity interventions, compared with control, may have little to no effect on BMI and zBMI at short-term or long-term follow-up (BMI short-term: MD -0.02, 95% CI -0.17 to 0.13; 14 studies, 4069 participants; zBMI short-term: MD -0.02, 95% CI -0.07 to 0.02; 6 studies, 3580 participants; low-certainty evidence; BMI long-term: MD -0.07, 95% CI -0.24 to 0.10; 8 studies, 8302 participants; zBMI long-term: MD -0.02, 95% CI -0.09 to 0.04; 6 studies, 6940 participants; low-certainty evidence). Activity interventions likely result in a slight reduction of BMI and zBMI at medium-term follow-up (BMI: MD -0.11, 95% CI -0.18 to -0.05; 16 studies, 21,286 participants; zBMI: MD -0.05, 95% CI -0.09 to -0.02; 13 studies, 20,600 participants; moderate-certainty evidence). Eleven studies (21,278 participants; low-certainty evidence) reported data on serious adverse events; one study reported two minor ankle sprains and one study reported the incident rate of adverse events (e.g. musculoskeletal injuries) that may have occurred as a result of the intervention; nine studies reported no effect. Dietary and activity interventions versus control Dietary and activity interventions, compared with control, may result in a slight reduction in BMI and zBMI at short-term follow-up (BMI: MD -0.11, 95% CI -0.21 to -0.01; 27 studies, 16,066 participants; zBMI: MD -0.03, 95% CI -0.06 to 0.00; 26 studies, 12,784 participants; low-certainty evidence) and likely result in a reduction of BMI and zBMI at medium-term follow-up (BMI: MD -0.11, 95% CI -0.21 to 0.00; 21 studies, 17,547 participants; zBMI: MD -0.05, 95% CI -0.07 to -0.02; 24 studies, 20,998 participants; moderate-certainty evidence). Dietary and activity interventions compared with control may result in little to no difference in BMI and zBMI at long-term follow-up (BMI: MD 0.03, 95% CI -0.11 to 0.16; 16 studies, 22,098 participants; zBMI: MD -0.02, 95% CI -0.06 to 0.01; 22 studies, 23,594 participants; low-certainty evidence). Nineteen studies (27,882 participants; low-certainty evidence) reported data on serious adverse events: four studies reported occurrence of serious adverse events (e.g. injuries, low levels of extreme dieting behaviour); 15 studies reported no effect. Heterogeneity was apparent in the results for all outcomes at the three follow-up times, which could not be explained by the main setting of the interventions (school, home, school and home, other), country income status (high-income versus non-high-income), participants' socioeconomic status (low versus mixed) and duration of the intervention. Most studies excluded children with a mental or physical disability. AUTHORS' CONCLUSIONS The body of evidence in this review demonstrates that a range of school-based 'activity' interventions, alone or in combination with dietary interventions, may have a modest beneficial effect on obesity in childhood at short- and medium-term, but not at long-term follow-up. Dietary interventions alone may result in little to no difference. Limited evidence of low quality was identified on the effect of dietary and/or activity interventions on severe adverse events and health inequalities; exploratory analyses of these data suggest no meaningful impact. We identified a dearth of evidence for home and community-based settings (e.g. delivered through local youth groups), for children living with disabilities and indicators of health inequities.
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Affiliation(s)
- Francesca Spiga
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Annabel L Davies
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Eve Tomlinson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Theresa Hm Moore
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Sarah Dawson
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jelena Savović
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Yang Gao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Sophie M Phillips
- Department of Sport and Exercise Science, Durham University, Durham, UK
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Child Health and Physical Activity Laboratory, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Frances Hillier-Brown
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Human Nutrition Research Centre and Population Health Sciences Institute, University of Newcastle, Newcastle, UK
| | - Rebecca K Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Julian Pt Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Carolyn D Summerbell
- Department of Sport and Exercise Science, Durham University, Durham, UK
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
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Spiga F, Tomlinson E, Davies AL, Moore TH, Dawson S, Breheny K, Savović J, Hodder RK, Wolfenden L, Higgins JP, Summerbell CD. Interventions to prevent obesity in children aged 12 to 18 years old. Cochrane Database Syst Rev 2024; 5:CD015330. [PMID: 38763518 PMCID: PMC11102824 DOI: 10.1002/14651858.cd015330.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
BACKGROUND Prevention of obesity in adolescents is an international public health priority. The prevalence of overweight and obesity is over 25% in North and South America, Australia, most of Europe, and the Gulf region. Interventions that aim to prevent obesity involve strategies that promote healthy diets or 'activity' levels (physical activity, sedentary behaviour and/or sleep) or both, and work by reducing energy intake and/or increasing energy expenditure, respectively. There is uncertainty over which approaches are more effective, and numerous new studies have been published over the last five years since the previous version of this Cochrane Review. OBJECTIVES To assess the effects of interventions that aim to prevent obesity in adolescents by modifying dietary intake or 'activity' levels, or a combination of both, on changes in BMI, zBMI score and serious adverse events. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was February 2023. SELECTION CRITERIA Randomised controlled trials in adolescents (mean age 12 years and above but less than 19 years), comparing diet or 'activity' interventions (or both) to prevent obesity with no intervention, usual care, or with another eligible intervention, in any setting. Studies had to measure outcomes at a minimum of 12 weeks post baseline. We excluded interventions designed primarily to improve sporting performance. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our outcomes were BMI, zBMI score and serious adverse events, assessed at short- (12 weeks to < 9 months from baseline), medium- (9 months to < 15 months) and long-term (≥ 15 months) follow-up. We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS This review includes 74 studies (83,407 participants); 54 studies (46,358 participants) were included in meta-analyses. Sixty studies were based in high-income countries. The main setting for intervention delivery was schools (57 studies), followed by home (nine studies), the community (five studies) and a primary care setting (three studies). Fifty-one interventions were implemented for less than nine months; the shortest was conducted over one visit and the longest over 28 months. Sixty-two studies declared non-industry funding; five were funded in part by industry. Dietary interventions versus control The evidence is very uncertain about the effects of dietary interventions on body mass index (BMI) at short-term follow-up (mean difference (MD) -0.18, 95% confidence interval (CI) -0.41 to 0.06; 3 studies, 605 participants), medium-term follow-up (MD -0.65, 95% CI -1.18 to -0.11; 3 studies, 900 participants), and standardised BMI (zBMI) at long-term follow-up (MD -0.14, 95% CI -0.38 to 0.10; 2 studies, 1089 participants); all very low-certainty evidence. Compared with control, dietary interventions may have little to no effect on BMI at long-term follow-up (MD -0.30, 95% CI -1.67 to 1.07; 1 study, 44 participants); zBMI at short-term (MD -0.06, 95% CI -0.12 to 0.01; 5 studies, 3154 participants); and zBMI at medium-term (MD 0.02, 95% CI -0.17 to 0.21; 1 study, 112 participants) follow-up; all low-certainty evidence. Dietary interventions may have little to no effect on serious adverse events (two studies, 377 participants; low-certainty evidence). Activity interventions versus control Compared with control, activity interventions do not reduce BMI at short-term follow-up (MD -0.64, 95% CI -1.86 to 0.58; 6 studies, 1780 participants; low-certainty evidence) and probably do not reduce zBMI at medium- (MD 0, 95% CI -0.04 to 0.05; 6 studies, 5335 participants) or long-term (MD -0.05, 95% CI -0.12 to 0.02; 1 study, 985 participants) follow-up; both moderate-certainty evidence. Activity interventions do not reduce zBMI at short-term follow-up (MD 0.02, 95% CI -0.01 to 0.05; 7 studies, 4718 participants; high-certainty evidence), but may reduce BMI slightly at medium-term (MD -0.32, 95% CI -0.53 to -0.11; 3 studies, 2143 participants) and long-term (MD -0.28, 95% CI -0.51 to -0.05; 1 study, 985 participants) follow-up; both low-certainty evidence. Seven studies (5428 participants; low-certainty evidence) reported data on serious adverse events: two reported injuries relating to the exercise component of the intervention and five reported no effect of intervention on reported serious adverse events. Dietary and activity interventions versus control Dietary and activity interventions, compared with control, do not reduce BMI at short-term follow-up (MD 0.03, 95% CI -0.07 to 0.13; 11 studies, 3429 participants; high-certainty evidence), and probably do not reduce BMI at medium-term (MD 0.01, 95% CI -0.09 to 0.11; 8 studies, 5612 participants; moderate-certainty evidence) or long-term (MD 0.06, 95% CI -0.04 to 0.16; 6 studies, 8736 participants; moderate-certainty evidence) follow-up. They may have little to no effect on zBMI in the short term, but the evidence is very uncertain (MD -0.09, 95% CI -0.2 to 0.02; 3 studies, 515 participants; very low-certainty evidence), and they may not reduce zBMI at medium-term (MD -0.05, 95% CI -0.1 to 0.01; 6 studies, 3511 participants; low-certainty evidence) or long-term (MD -0.02, 95% CI -0.05 to 0.01; 7 studies, 8430 participants; low-certainty evidence) follow-up. Four studies (2394 participants) reported data on serious adverse events (very low-certainty evidence): one reported an increase in weight concern in a few adolescents and three reported no effect. AUTHORS' CONCLUSIONS The evidence demonstrates that dietary interventions may have little to no effect on obesity in adolescents. There is low-certainty evidence that activity interventions may have a small beneficial effect on BMI at medium- and long-term follow-up. Diet plus activity interventions may result in little to no difference. Importantly, this updated review also suggests that interventions to prevent obesity in this age group may result in little to no difference in serious adverse effects. Limitations of the evidence include inconsistent results across studies, lack of methodological rigour in some studies and small sample sizes. Further research is justified to investigate the effects of diet and activity interventions to prevent childhood obesity in community settings, and in young people with disabilities, since very few ongoing studies are likely to address these. Further randomised trials to address the remaining uncertainty about the effects of diet, activity interventions, or both, to prevent childhood obesity in schools (ideally with zBMI as the measured outcome) would need to have larger samples.
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Affiliation(s)
- Francesca Spiga
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Eve Tomlinson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Annabel L Davies
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Theresa Hm Moore
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jelena Savović
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rebecca K Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Julian Pt Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Carolyn D Summerbell
- Department of Sport and Exercise Science, Durham University, Durham, UK
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
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Megersa BS, Andersen GS, Abera M, Abdissa A, Zinab B, Ali R, Admassu B, Kedir E, Nitsch D, Filteau S, Girma T, Yilma D, Wells JC, Friis H, Wibaek R. Associations of early childhood body mass index trajectories with body composition and cardiometabolic markers at age 10 years: the Ethiopian infant anthropometry and body composition (iABC) birth cohort study. Am J Clin Nutr 2024; 119:1248-1258. [PMID: 38458400 DOI: 10.1016/j.ajcnut.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/17/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Variability in body mass index (BMI) (kg/m2) trajectories is associated with body composition and cardiometabolic markers in early childhood, but it is unknown how these associations track to later childhood. OBJECTIVES We aimed to assess associations of BMI trajectories from 0 to 5 y with body composition and cardiometabolic markers at 10 y. METHODS In the Ethiopian infant anthropometry and body composition (iABC) birth cohort, we previously identified 4 distinct BMI trajectories from 0 to 5 y: stable low BMI (19.2%), normal BMI (48.8%), rapid growth to high BMI (17.9%), and slow growth to high BMI (14.1%). At 10 y, we obtained data from 320 children on anthropometry, body composition, abdominal subcutaneous and visceral fat, and cardiometabolic markers. Associations of BMI trajectories and 10-y outcomes were analyzed using multiple linear regression. RESULTS Compared with children with the normal BMI trajectory, those with rapid growth to high BMI had 1.7 cm (95% CI: 0.1, 3.3) larger waist circumference and those with slow growth to high had 0.63 kg/m2 (95% CI: 0.09, 1.17) greater fat mass index and 0.19 cm (95% CI: 0.02, 0.37) greater abdominal subcutaneous fat, whereas those with stable low BMI had -0.28 kg/m2 (95% CI: -0.59, 0.03) lower fat-free mass at 10 y. Although the confidence bands were wide and included the null value, children with rapid growth to high BMI trajectory had 48.6% (95% CI: -1.4, 123.8) higher C-peptide concentration and those with slow growth to high BMI had 29.8% (95% CI: -0.8, 69.8) higher insulin and 30.3% (95% CI: -1.1, 71.6) higher homeostasis model assessment of insulin resistance, whereas those with rapid growth to high BMI had -0.23 mmol/L (95% CI: -0.47, 0.02) lower total cholesterol concentration. The trajectories were not associated with abdominal visceral fat, blood pressure, glucose, and other lipids at 10 y. CONCLUSIONS Children with rapid and slow growth to high BMI trajectories before 5 y tend to show higher measures of adiposity and higher concentrations of markers related to glucose metabolism at 10 y. CLINICAL TRIAL REGISTRY ISRCTN46718296 (https://www.isrctn.com/ISRCTN46718296).
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Affiliation(s)
- Bikila S Megersa
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.
| | | | - Mubarek Abera
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | | | - Beakal Zinab
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark; Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Rahma Ali
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark; Department of Population and Family Health, Jimma University, Jimma, Ethiopia
| | - Bitiya Admassu
- Department of Population and Family Health, Jimma University, Jimma, Ethiopia
| | - Elias Kedir
- Department of Radiology, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Dorothea Nitsch
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tsinuel Girma
- Department of Pediatrics and Child Health, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Daniel Yilma
- Department of Internal Medicine, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Jonathan Ck Wells
- Childhood Nutrition Research Center, Population Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Rasmus Wibaek
- Clinical Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
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7
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Battisti S, Pedone C, Tramontana F, Napoli N, Alhamar G, Russo E, Agnoletti V, Paolucci E, Galgani M, Giampalma E, Paviglianiti A, Strollo R. Abdominal adipose tissue distribution assessed by computed tomography and mortality in hospitalised patients with COVID-19: a retrospective longitudinal cohort study. Endocrine 2024; 83:597-603. [PMID: 37736820 DOI: 10.1007/s12020-023-03530-4] [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: 06/26/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Visceral adiposity has been associated with an increased risk of critical illness in COVID-19 patients. However, if it also associates to a poor survival is still not well established. The aim of the study was to assess the relationship between abdominal fat distribution and COVID-19 mortality. METHODS In this six-month longitudinal cohort study, abdominal visceral (VAT) and subcutaneous adipose tissues (SAT) were measured by computed tomography in a cohort of 174 patients admitted to the emergency department with a diagnosis of COVID-19, during the first wave of pandemic. The primary exposure and outcome measures were VAT and SAT at hospital admission, and death at 30 and 180 days, respectively. RESULTS Overall survival was not different according to VAT (p = 0.94), SAT (p = 0.32) and VAT/SAT ratio (p = 0.64). However, patients in the lowest SAT quartile (thickness ≤ 11.25 mm) had a significantly reduced survival compared to those with thicker SAT (77 vs. 94% at day 30; 74 vs. 91% at day 180, p = 0.01). Similarly, a thinner SAT was associated with lower survival in Intensive Care Unit (ICU) admitted patients, independently of sex or age (p = 0.02). The VAT/SAT ratio showed a non-linear increased risk of ICU admission, which plateaued out and tended for inversion at values greater than 1.9 (p = 0.001), although was not associated with increased mortality rate. CONCLUSIONS In our cohort, visceral adiposity did not increase mortality in patients with COVID-19, but low SAT may be associated with poor survival.
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Affiliation(s)
- Sofia Battisti
- Radiology Department, AUSL Romagna M. Bufalini Hospital, Cesena, Italy
- Radiology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
- Department of Experimental, Diagnostic and Specialty Medicine - DIMES, Alma Mater Studiorum-Università di Bologna, S.Orsola-Malpighi Hospital, Bologna, Italy
| | - Claudio Pedone
- Department of Medicine and Surgery, Research Unit of Geriatrics, Università Campus Bio-Medico di Roma, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Operative Research Unit of Geriatrics, Rome, Italy
| | - Flavia Tramontana
- Department of Medicine and Surgery, Research Unit of Endocrinology & Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Nicola Napoli
- Department of Medicine and Surgery, Research Unit of Endocrinology & Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Ghadeer Alhamar
- Department of Medicine and Surgery, Research Unit of Endocrinology & Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Emanuele Russo
- Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Cesena, Italy
| | - Vanni Agnoletti
- Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Cesena, Italy
| | - Elisa Paolucci
- Internal Medicine Unit, AUSL Romagna, M.Bufalini Hospital, Cesena, Italy
| | - Mario Galgani
- Department of Molecular Medicine and Medical Biotechnology, University of Naples "Federico II", Naples, Italy
- Institute for Endocrinology and Experimental Oncology "G. Salvatore", Consiglio Nazionale delle Ricerche (C.N.R.), Naples, Italy
| | | | - Annalisa Paviglianiti
- Department of Medicine and Surgery, Research Unit of Endocrinology & Diabetes, Università Campus Bio-Medico di Roma, Rome, Italy
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, 08908, Barcelona, Spain
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), 08908, Barcelona, Spain
| | - Rocky Strollo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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8
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Bull CJ, Hazelwood E, Legge DN, Corbin LJ, Richardson TG, Lee M, Yarmolinsky J, Smith-Byrne K, Hughes DA, Johansson M, Peters U, Berndt SI, Brenner H, Burnett-Hartman A, Cheng I, Kweon SS, Le Marchand L, Li L, Newcomb PA, Pearlman R, McConnachie A, Welsh P, Taylor R, Lean MEJ, Sattar N, Murphy N, Gunter MJ, Timpson NJ, Vincent EE. Impact of weight loss on cancer-related proteins in serum: results from a cluster randomised controlled trial of individuals with type 2 diabetes. EBioMedicine 2024; 100:104977. [PMID: 38290287 PMCID: PMC10844806 DOI: 10.1016/j.ebiom.2024.104977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/03/2024] [Accepted: 01/06/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Type 2 diabetes is associated with higher risk of several cancer types. However, the biological intermediates driving this relationship are not fully understood. As novel interventions for treating and managing type 2 diabetes become increasingly available, whether they also disrupt the pathways leading to increased cancer risk is currently unknown. We investigated the effect of a type 2 diabetes intervention, in the form of intentional weight loss, on circulating proteins associated with cancer risk to gain insight into potential mechanisms linking type 2 diabetes and adiposity with cancer development. METHODS Fasting serum samples from participants with diabetes enrolled in the Diabetes Remission Clinical Trial (DiRECT) receiving the Counterweight-Plus weight-loss programme (intervention, N = 117, mean weight-loss 10 kg, 46% diabetes remission) or best-practice care by guidelines (control, N = 143, mean weight-loss 1 kg, 4% diabetes remission) were subject to proteomic analysis using the Olink Oncology-II platform (48% of participants were female; 52% male). To identify proteins which may be altered by the weight-loss intervention, the difference in protein levels between groups at baseline and 1 year was examined using linear regression. Mendelian randomization (MR) was performed to extend these results to evaluate cancer risk and elucidate possible biological mechanisms linking type 2 diabetes and cancer development. MR analyses were conducted using independent datasets, including large cancer meta-analyses, UK Biobank, and FinnGen, to estimate potential causal relationships between proteins modified during intentional weight loss and the risk of colorectal, breast, endometrial, gallbladder, liver, and pancreatic cancers. FINDINGS Nine proteins were modified by the intervention: glycoprotein Nmb; furin; Wnt inhibitory factor 1; toll-like receptor 3; pancreatic prohormone; erb-b2 receptor tyrosine kinase 2; hepatocyte growth factor; endothelial cell specific molecule 1 and Ret proto-oncogene (Holm corrected P-value <0.05). Mendelian randomization analyses indicated a causal relationship between predicted circulating furin and glycoprotein Nmb on breast cancer risk (odds ratio (OR) = 0.81, 95% confidence interval (CI) = 0.67-0.99, P-value = 0.03; and OR = 0.88, 95% CI = 0.78-0.99, P-value = 0.04 respectively), though these results were not supported in sensitivity analyses examining violations of MR assumptions. INTERPRETATION Intentional weight loss among individuals with recently diagnosed diabetes may modify levels of cancer-related proteins in serum. Further evaluation of the proteins identified in this analysis could reveal molecular pathways that mediate the effect of adiposity and type 2 diabetes on cancer risk. FUNDING The main sources of funding for this work were Diabetes UK, Cancer Research UK, World Cancer Research Fund, and Wellcome.
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Affiliation(s)
- Caroline J Bull
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; School of Translational Health Sciences, Dorothy Hodgkin Building, University of Bristol, Bristol, UK
| | - Emma Hazelwood
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Danny N Legge
- School of Translational Health Sciences, Dorothy Hodgkin Building, University of Bristol, Bristol, UK
| | - Laura J Corbin
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tom G Richardson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Matthew Lee
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, WHO, Lyon, France
| | - James Yarmolinsky
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Karl Smith-Byrne
- Cancer Epidemiology Unit, Oxford Population Health, University of Oxford, UK
| | - David A Hughes
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mattias Johansson
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, WHO, Lyon, France
| | - Ulrike Peters
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sonja I Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea; Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | | | - Li Li
- Department of Family Medicine, University of Virginia, Charlottesville, VA, USA
| | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; School of Public Health, University of Washington, Seattle, WA, USA
| | - Rachel Pearlman
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Alex McConnachie
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Roy Taylor
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Mike E J Lean
- Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Neil Murphy
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, WHO, Lyon, France
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, WHO, Lyon, France; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emma E Vincent
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; School of Translational Health Sciences, Dorothy Hodgkin Building, University of Bristol, Bristol, UK.
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9
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O'Neill KN, Bell JA, Smith GD, Fraser A, Howe LD, Kearney PM, Robinson O, Tilling K, Willeit P, O'Keeffe LM. Childhood socioeconomic position and sex-specific trajectories of metabolic traits across early life: prospective cohort study. EBioMedicine 2023; 98:104884. [PMID: 37989036 PMCID: PMC10700592 DOI: 10.1016/j.ebiom.2023.104884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/27/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Socioeconomic inequalities in cardiovascular disease risk begin early in life and are more pronounced in females than males later in life. Causal atherogenic traits explaining this are not well understood. We explored sex-specific associations between childhood socioeconomic position (SEP) and molecular measures of systemic metabolism across early life. METHODS Data were from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based birth cohort in southwest England. Pregnant women with an expected delivery date between 1991 and 1992 were invited to participate. Maternal education was the primary indicator of SEP. Concentrations of 148 metabolic traits from targeted metabolomics (nuclear magnetic resonance spectroscopy) from research clinics at ages 7, 15, 18 and 25 years were analysed. The sex-specific slope index of inequality (SII) in trajectories of metabolic traits was estimated using multilevel models. FINDINGS Total number of participants included was 6537 (12,543 repeated measures). Lower maternal education was associated with more adverse levels of several atherogenic lipids and key metabolic traits among females at age 7 years, but not males. For instance, SII for very small very-low-density lipoprotein (VLDL) concentrations was 0.16SD (95% CI: 0.01, 0.30) among females and -0.02SD (95% CI: -0.16, 0.13) among males. Between 7 and 25 years, inequalities widened among females and emerged among males particularly for VLDL particle concentrations, apolipoprotein-B concentrations, and inflammatory glycoprotein acetyls. For instance, at 25 years, SII for very small VLDL concentrations was 0.36SD (95% CI: 0.20, 0.52) and 0.22SD (95% CI: 0.04, 0.40) among females and males respectively. INTERPRETATION Prevention of socioeconomic inequalities in cardiovascular disease risk requires a life course approach beginning at the earliest opportunity, especially among females. FUNDING The UK Medical Research Council and Wellcome (grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. A comprehensive list of grants funding is available on the ALSPAC website (http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf). KON is supported by a Health Research Board (HRB) of Ireland Investigator Led Award (ILP-PHR-2022-008). JB, GDS and KT work in a unit funded by the UK MRC (MC_UU_00011/1 and MC UU 00011/3) and the University of Bristol. OR is supported by a UKRI Future Leaders Fellowship (MR/S03532X/1). These funding sources had no role in the design and conduct of this study. This publication is the work of the authors and KON will serve as guarantor for the contents of this paper.
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Affiliation(s)
- Kate N O'Neill
- School of Public Health, Western Gateway Building, University College Cork, Cork, Ireland.
| | - Joshua A Bell
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS82BN, UK; Population Health Sciences, Bristol Medical School, Oakfield House, Oakfield Grove, Bristol, BS82BN, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS82BN, UK; Population Health Sciences, Bristol Medical School, Oakfield House, Oakfield Grove, Bristol, BS82BN, UK
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS82BN, UK; Population Health Sciences, Bristol Medical School, Oakfield House, Oakfield Grove, Bristol, BS82BN, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS82BN, UK; Population Health Sciences, Bristol Medical School, Oakfield House, Oakfield Grove, Bristol, BS82BN, UK
| | - Patricia M Kearney
- School of Public Health, Western Gateway Building, University College Cork, Cork, Ireland
| | - Oliver Robinson
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Kate Tilling
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS82BN, UK; Population Health Sciences, Bristol Medical School, Oakfield House, Oakfield Grove, Bristol, BS82BN, UK
| | - Peter Willeit
- Clinical Epidemiology Team, Medical University of Innsbruck, Austria; Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Linda M O'Keeffe
- School of Public Health, Western Gateway Building, University College Cork, Cork, Ireland; MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS82BN, UK; Population Health Sciences, Bristol Medical School, Oakfield House, Oakfield Grove, Bristol, BS82BN, UK
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10
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Brotman SM, Oravilahti A, Rosen JD, Alvarez M, Heinonen S, van der Kolk BW, Fernandes Silva L, Perrin HJ, Vadlamudi S, Pylant C, Deochand S, Basta PV, Valone JM, Narain MN, Stringham HM, Boehnke M, Kuusisto J, Love MI, Pietiläinen KH, Pajukanta P, Laakso M, Mohlke KL. Cell-Type Composition Affects Adipose Gene Expression Associations With Cardiometabolic Traits. Diabetes 2023; 72:1707-1718. [PMID: 37647564 PMCID: PMC10588284 DOI: 10.2337/db23-0365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Abstract
Understanding differences in adipose gene expression between individuals with different levels of clinical traits may reveal the genes and mechanisms leading to cardiometabolic diseases. However, adipose is a heterogeneous tissue. To account for cell-type heterogeneity, we estimated cell-type proportions in 859 subcutaneous adipose tissue samples with bulk RNA sequencing (RNA-seq) using a reference single-nuclear RNA-seq data set. Cell-type proportions were associated with cardiometabolic traits; for example, higher macrophage and adipocyte proportions were associated with higher and lower BMI, respectively. We evaluated cell-type proportions and BMI as covariates in tests of association between >25,000 gene expression levels and 22 cardiometabolic traits. For >95% of genes, the optimal, or best-fit, models included BMI as a covariate, and for 79% of associations, the optimal models also included cell type. After adjusting for the optimal covariates, we identified 2,664 significant associations (P ≤ 2e-6) for 1,252 genes and 14 traits. Among genes proposed to affect cardiometabolic traits based on colocalized genome-wide association study and adipose expression quantitative trait locus signals, 25 showed a corresponding association between trait and gene expression levels. Overall, these results suggest the importance of modeling cell-type proportion when identifying gene expression associations with cardiometabolic traits. ARTICLE HIGHLIGHTS
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Affiliation(s)
- Sarah M. Brotman
- Department of Genetics, The University of North Carolina, Chapel Hill, NC
| | - Anniina Oravilahti
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jonathan D. Rosen
- Department of Genetics, The University of North Carolina, Chapel Hill, NC
| | - Marcus Alvarez
- Department of Human Genetics, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA
| | - Sini Heinonen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Birgitta W. van der Kolk
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Lilian Fernandes Silva
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Hannah J. Perrin
- Department of Genetics, The University of North Carolina, Chapel Hill, NC
| | | | - Cortney Pylant
- Department of Epidemiology, The University of North Carolina, Chapel Hill, NC
| | - Sonia Deochand
- Department of Epidemiology, The University of North Carolina, Chapel Hill, NC
| | - Patricia V. Basta
- Department of Epidemiology, The University of North Carolina, Chapel Hill, NC
| | - Jordan M. Valone
- Department of Genetics, The University of North Carolina, Chapel Hill, NC
- UNC Neuroscience Center, The University of North Carolina, Chapel Hill, NC
| | - Morgan N. Narain
- Department of Genetics, The University of North Carolina, Chapel Hill, NC
- Curriculum of Toxicology and Environmental Medicine, The University of North Carolina, Chapel Hill, NC
| | - Heather M. Stringham
- Department of Biostatistics and Center for Statistical Genetics, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Michael Boehnke
- Department of Biostatistics and Center for Statistical Genetics, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Johanna Kuusisto
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Michael I. Love
- Department of Genetics, The University of North Carolina, Chapel Hill, NC
- Department of Biostatistics, The University of North Carolina, Chapel Hill, NC
| | - Kirsi H. Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- HealthyWeightHub, Endocrinology, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Päivi Pajukanta
- Department of Human Genetics, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA
- Institute for Precision Health, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA
| | - Markku Laakso
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Karen L. Mohlke
- Department of Genetics, The University of North Carolina, Chapel Hill, NC
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11
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Ma G, Li J, Xie J, Li Y, Xu K, He Y, Yang J, Du H, Liu X. Pulse pressure and its association with body composition among Chinese men and women without diagnosed hypertension: the China Kadoorie Biobank. J Hypertens 2023; 41:1802-1810. [PMID: 37682069 PMCID: PMC10552820 DOI: 10.1097/hjh.0000000000003549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Wide brachial pulse pressure (PP) has been associated with cardiovascular events, while its population distribution and association with body composition were poorly characterized in large populations. METHODS We evaluated the age and sex distributions of PP and its associations with body composition using baseline data from the China Kadoorie Biobank. A total of 434 200 participants without diagnosed hypertension were included in the analysis. Wide PP was defined as PP above 65 mmHg. Body composition variables, including BMI, waist circumference, waist-to-hip ratio (WHR), fat mass index (FMI), fat-free mass index (FFMI), and body fat percentage (BF%), were obtained from bioelectrical impedance analysis. RESULTS Overall, 14.3% of the participants had wide PP. Older age was consistently associated with wider PP in women but only after the andropause stage in men. The independent associations of BMI with wide PP were stronger than other body composition measures. The adjusted differences (men/women, mmHg) in PP per standard deviation (SD) increase in BMI (1.55/1.47) were higher than other body composition (BF%: 0.32/0.64, waist circumference: 0.33/0.39; WHR: 0.49/0.42). In addition, sex differences were observed. In men, the per SD difference in PP was higher for FFMI than for FMI (0.91 vs. 0.67, P < 0.05), whereas in women, it was higher for FMI than for FFMI (1.01 vs. 0.72, P < 0.05). CONCLUSION Our nationwide population-based study presented the sex-specific distribution of PP over age and identified differential associations of PP with fat and fat-free mass in men and women.
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Affiliation(s)
- Guoqing Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Junqi Li
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Jiawen Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Yunfeng Li
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Kun Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Yafang He
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Jiaomei Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Xin Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, China
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12
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Ishida A, Taira H, Shinzato T, Ohya Y. Association between visceral fat mass and arterial stiffness among community-based screening participants. Hypertens Res 2023; 46:2488-2496. [PMID: 37353686 DOI: 10.1038/s41440-023-01350-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/25/2023]
Abstract
Obesity and arterial stiffness are important risk factors for disease development. However, the relationship between obesity and arterial stiffness remains unclear. We examined the relationship of visceral fat area (VFA) and anthropometric obesity indices with arterial stiffness. This cross-sectional study was conducted among 2 789 participants (50% women) who underwent both VFA and brachial-ankle pulse wave velocity (baPWV) measurements during health checkups. Body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), a body shape index (ABSI), and body roundness index (BRI) were assessed. Visceral fat area was quantified using abdominal computed tomography. In women, VFA and all anthropometric indices positively correlated with age. In men, VFA, WHtR, ABSI, and BRI positively correlated with age; BMI inversely correlated with age; and WC did not correlate with age. Visceral fat area significantly correlated with anthropometric indices, but its correlation with ABSI was modest. In women, baPWV showed modest correlations with VFA and anthropometric indices and little correlations with BMI. In men, baPWV modestly correlated with VFA, WHtR, ABSI, and BRI, but inversely correlated with BMI and did not significantly correlate with WC. The multivariable-adjusted model showed that VFA and anthropometric indices, except ABSI, were inversely associated with baPWV; however, they were positively associated with metabolic syndrome components, including hypertension, dyslipidemia, and hyperglycemia. A body-shaped index weakly associated positively with baPWV, but misclassified individuals at risk for metabolic syndrome components. Visceral fat area and most anthropometric obesity indices were positively associated with hypertension, dyslipidemia, and hyperglycemia, but inversely associated with baPWV. Visceral fat area and anthropometric indices, except a body-shaped index, were inversely associated with brachial-ankle pulse wave velocity but positively associated with metabolic syndrome components, including hypertension, dyslipidemia, and hyperglycemia.
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Affiliation(s)
- Akio Ishida
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
| | - Hirona Taira
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | | | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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13
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Maidowski L, Kiess W, Baber R, Dathan-Stumpf A, Ceglarek U, Vogel M. Tracking of serum lipids in healthy children on a year-to-year basis. BMC Cardiovasc Disord 2023; 23:386. [PMID: 37532994 PMCID: PMC10398926 DOI: 10.1186/s12872-023-03391-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/11/2023] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVES To assess the stability of lipid profiles throughout childhood and evaluate their onset and dynamic. MATERIALS AND METHODS Lipid markers were longitudinally measured in more than 1300 healthy children from the LIFE Child study (Germany) and categorized into normal, at-risk, or adverse. Year-to-year intra-person persistence of the categories during follow-ups was examined and Pearson's correlation coefficient was calculated. RESULTS We found strong positive correlations for TC, LDL-C and ApoB (r > 0.75, p < 0.001) from the age of four years. Correlations were lowest during the first two years of life. Most children with normal levels also had normal levels the following year. Children with at-risk levels showed a tendency towards normal levels at the follow-up visit. Adverse levels of TC, LDL-C, ApoB (all ages), and HDL-C (from age 15) persisted in more than half of the affected children. Age-dependent patterns of stability were most pronounced and similar for TC, LDL-C, and ApoB. CONCLUSIONS Normal levels of serum lipids show high stability and adverse levels stabilized in early childhood for TC, LDL, and ApoB. At-risk and adverse levels of TC, LDL-C or ApoB may warrant further or repeated diagnostic measurements with regards to preventing CVD in the long run.
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Affiliation(s)
- Ludwig Maidowski
- University of Leipzig, LIFE Child Leipzig Research Center for Civilization Diseases, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany.
| | - Wieland Kiess
- University of Leipzig, LIFE Child Leipzig Research Center for Civilization Diseases, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany
- University of Leipzig, Hospital for Children and Adolescents, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Ronny Baber
- University of Leipzig, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Paul-List-Str. 13-15, 04013, Leipzig, Germany
- University of Leipzig, Leipzig Medical Biobank, Liebigstr. 27, 04103, Leipzig, Germany
| | - Anne Dathan-Stumpf
- University of Leipzig, Department of Women and Child Health, Liebigstr. 20a, 04103, Leipzig, Germany
| | - Uta Ceglarek
- University of Leipzig, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Paul-List-Str. 13-15, 04013, Leipzig, Germany
| | - Mandy Vogel
- University of Leipzig, LIFE Child Leipzig Research Center for Civilization Diseases, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany
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14
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Flores V, Spicer AB, Sonsalla MM, Richardson NE, Yu D, Sheridan GE, Trautman ME, Babygirija R, Cheng EP, Rojas JM, Yang SE, Wakai MH, Hubbell R, Kasza I, Tomasiewicz JL, Green CL, Dantoin C, Alexander CM, Baur JA, Malecki KC, Lamming DW. Regulation of metabolic health by dietary histidine in mice. J Physiol 2023; 601:2139-2163. [PMID: 36086823 PMCID: PMC9995620 DOI: 10.1113/jp283261] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/01/2022] [Indexed: 11/08/2022] Open
Abstract
Low-protein (LP) diets are associated with a decreased risk of diabetes in humans, and promote leanness and glycaemic control in both rodents and humans. While the effects of an LP diet on glycaemic control are mediated by reduced levels of the branched-chain amino acids, we have observed that reducing dietary levels of the other six essential amino acids leads to changes in body composition. Here, we find that dietary histidine plays a key role in the response to an LP diet in male C57BL/6J mice. Specifically reducing dietary levels of histidine by 67% reduces the weight gain of young, lean male mice, reducing both adipose and lean mass without altering glucose metabolism, and rapidly reverses diet-induced obesity and hepatic steatosis in diet-induced obese male mice, increasing insulin sensitivity. This normalization of metabolic health was associated not with caloric restriction or increased activity, but with increased energy expenditure. Surprisingly, the effects of histidine restriction do not require the energy balance hormone Fgf21. Histidine restriction that was started in midlife promoted leanness and glucose tolerance in aged males but not females, but did not affect frailty or lifespan in either sex. Finally, we demonstrate that variation in dietary histidine levels helps to explain body mass index differences in humans. Overall, our findings demonstrate that dietary histidine is a key regulator of weight and body composition in male mice and in humans, and suggest that reducing dietary histidine may be a translatable option for the treatment of obesity. KEY POINTS: Protein restriction (PR) promotes metabolic health in rodents and humans and extends rodent lifespan. Restriction of specific individual essential amino acids can recapitulate the benefits of PR. Reduced histidine promotes leanness and increased energy expenditure in male mice. Reduced histidine does not extend the lifespan of mice when begun in midlife. Dietary levels of histidine are positively associated with body mass index in humans.
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Affiliation(s)
- Victoria Flores
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Alexandra B. Spicer
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA
| | - Michelle M. Sonsalla
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Nicole E. Richardson
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
- Endocrinology and Reproductive Physiology Graduate Training Program, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Deyang Yu
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
- Molecular and Environmental Toxicology Program, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Grace E. Sheridan
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Michaela E. Trautman
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Reji Babygirija
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
- Graduate Program in Cellular and Molecular Biology, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Eunhae P. Cheng
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Jennifer M. Rojas
- Department of Physiology and Institute for Diabetes, Obesity, and Metabolism, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Shany E. Yang
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Matthew H. Wakai
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Ryan Hubbell
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Ildiko Kasza
- McArdle Laboratory for Cancer Research, University of Wisconsin-Madison, Madison, WI 53705, USA
| | | | - Cara L. Green
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Claudia Dantoin
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Caroline M. Alexander
- McArdle Laboratory for Cancer Research, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Joseph A. Baur
- Department of Physiology and Institute for Diabetes, Obesity, and Metabolism, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kristen C. Malecki
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA
| | - Dudley W. Lamming
- William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
- Interdepartmental Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
- Endocrinology and Reproductive Physiology Graduate Training Program, University of Wisconsin-Madison, Madison, WI 53706, USA
- Molecular and Environmental Toxicology Program, University of Wisconsin-Madison, Madison, WI 53706, USA
- Graduate Program in Cellular and Molecular Biology, University of Wisconsin-Madison, Madison, WI 53706, USA
- University of Wisconsin Carbone Cancer Center, Madison, WI 53705, USA
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15
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Hu Y, Gu Z, Xu M, He W, Wu L, Xu Z, Guo L. Body mass index and clinical outcomes in patients with heart failure with preserved ejection fraction mediated by diastolic blood pressure status? Heliyon 2023; 9:e16515. [PMID: 37274719 PMCID: PMC10238725 DOI: 10.1016/j.heliyon.2023.e16515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 06/06/2023] Open
Abstract
Background The "obesity paradox" has been elucidated in patients with heart failure (HF). Current guidelines introduce a target diastolic blood pressure (DBP) < 80 mmHg but >70 mmHg in HF patients. Due to reduced coronary perfusion, low DBP has a deleterious impact on cardiovascular outcomes. This present study aimed to assess the relationship between BMI and adjudicated clinical outcomes in HFpEF patients according to the status of DBP. Methods We analyzed the data in 1749 HFpEF patients from the Americas of the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) Trial. The population was stratified by DBP (<70 mmHg, and ≥70 mmHg) and BMI strata (normal weight, overweight, and obesity). Cox proportional hazards models and competing-risks regression analysis were performed. Results At baseline, the median BMI and DBP were 32.9 kg/m2 (interquartile range 28.0-38.5 kg/m2) and 70 mmHg (interquartile range 62-80 mmHg), respectively. In the multivariable analysis, obesity was associated with better survival rates in the total HFpEF population (all-cause death: HR = 0.439, 95% CI 0.256-0.750; and cardiovascular death: HR = 0.378, 95% CI 0.182-0.787). In patients with DBP<70 mmHg, obesity was not significantly associated with reduced risks for all-cause death (HR = 0.531, 95% CI: 0.263-1.704) and cardiovascular death (HR = 0.680, 95% CI: 0.254-1.819). However, multivariate analyses for cardiovascular death (HR = 0.339, 95% CI: 0.117-0.983) and all-cause death (HR = 0.389, 95% CI: 0.156-0.969) were significant in patients with DBP≥70 mmHg. Nevertheless, there were no interactions between DBP and BMI. Conclusions The obesity paradox was observed in patients with HFpEF, regardless of DBP strata (<70 mmHg, and ≥70 mmHg).
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Affiliation(s)
- YingQiu Hu
- Emergency Department of the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - ZhenBang Gu
- Medical School of Nanchang University, Nanchang, Jiangxi, China
| | - MeiLing Xu
- Urology Department of the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - WenFeng He
- Department of Medical Genetics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - LiDong Wu
- Emergency Department of the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - ZhiCheng Xu
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - LinJuan Guo
- Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
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16
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Dong H, Cheng H, Liu J, Yan Y, Zhao X, Shan X, Huang G, Mi J. Overfat cutoffs and the optimal combination of body fat indices for detecting cardiometabolic risk among school-aged children. Obesity (Silver Spring) 2023; 31:802-810. [PMID: 36746769 DOI: 10.1002/oby.23651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/10/2022] [Accepted: 10/21/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This study aimed to develop cutoffs and the optimal combination for body fat indices for screening cardiometabolic risk (CMR) among the pediatric population. METHODS This cross-sectional study consisted of 8710 (50.3% boys) Chinese children aged 6 to 18 years. Body fat indices, including fat mass index (FMI), body fat percentage, trunk to leg fat ratio (TLR), and android to gynoid fat ratio, were derived from dual-energy x-ray absorptiometry scans. The area under the receiver operating characteristic curve was used to determine the best combination and optimal cutoffs of body fat indices to identify CMR. RESULTS Compared with anthropometry-based obesity measures, i.e., BMI and waist circumference, the FMI + TLR combination presented statistically higher area under the receiver operating characteristic curve values for discriminating CMR and its clustering. The optimal overfat cutoffs of FMI and TLR were respectively determined at the 75th percentile in boys and at the 80th percentile of FMI and the 75th percentile of TLR in girls. Moreover, simplified thresholds derived from age-group-merged cutoffs showed similar performance as optimal cutoffs in detecting CMR. CONCLUSIONS Both the optimal and simplified overfat cutoffs were provided for the Chinese pediatric population. The use of FMI and TLR together allows for adequate screening of CMR and its clustering.
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Affiliation(s)
- Hongbo Dong
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Hong Cheng
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Junting Liu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Yinkun Yan
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiaoyuan Zhao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Xinying Shan
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Guimin Huang
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Jie Mi
- Center for Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
- Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
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17
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Wan B, Ma N, Lu W. Mendelian randomization investigation identified the causal relationship between body fat indexes and the risk of bladder cancer. PeerJ 2023; 11:e14739. [PMID: 36700002 PMCID: PMC9869775 DOI: 10.7717/peerj.14739] [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: 09/06/2022] [Accepted: 12/22/2022] [Indexed: 01/22/2023] Open
Abstract
Background Observational studies have suggested that obesity is associated with the risk of bladder cancer (BCa). However, their causal relationship remains unclear. This study aimed to prove the causal relationship between obesity and the risk of BCa by using Mendelian randomization. Methods Single-nucleotide polymorphisms (SNPs) correlated with body fat indexes were screened from several genome-wide association studies (GWAS) with more than 300,000 individuals. Summary-level genetic data of BCa-related GWAS were obtained from a European cohort with a sample size of 218,792. An inverse-variance-weighted (IVW) method was used as the major MR analysis. The MR-Egger regression, IVW regression, leave-one-out test, and MR-Pleiotropy Residual Sum and Outlier methods were used to test the reliability and stability of MR results. Results Genetically predicted per 1-SD increase in body fat indexes (whole body fat mass, and the right leg, left leg, right arm, left arm, and trunk fat mass) were associated with increased BCa risk with values of 51.8%, 77.9%, 75.1%, 67.2%, 59.7%, and 36.6%, respectively. Sensitivity analyses suggested that the genetically determined risk effect of obesity on BCa was stable and reliable. Conclusions Our study provided powerful evidence to support the causal hypothesis that the genetically predicted high body fat mass was associated with a risk increase for BCa. The finding is a new idea for drawing up prevention strategies for BCa.
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Affiliation(s)
- Bangbei Wan
- Reproductive Medical Center, Hainan Women and Children’s Medical Center, Haikou, Hainan, China,Department of Urology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, Hainan, China
| | - Ning Ma
- Reproductive Medical Center, Hainan Women and Children’s Medical Center, Haikou, Hainan, China
| | - Weiying Lu
- Reproductive Medical Center, Hainan Women and Children’s Medical Center, Haikou, Hainan, China
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18
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Elhakeem A, Ronkainen J, Mansell T, Lange K, Mikkola TM, Mishra BH, Wahab RJ, Cadman T, Yang T, Burgner D, Eriksson JG, Järvelin MR, Gaillard R, Jaddoe VWV, Lehtimäki T, Raitakari OT, Saffery R, Wake M, Wright J, Sebert S, Lawlor DA. Effect of common pregnancy and perinatal complications on offspring metabolic traits across the life course: a multi-cohort study. BMC Med 2023; 21:23. [PMID: 36653824 PMCID: PMC9850719 DOI: 10.1186/s12916-022-02711-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/14/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Common pregnancy and perinatal complications are associated with offspring cardiometabolic risk factors. These complications may influence multiple metabolic traits in the offspring and these associations might differ with offspring age. METHODS We used data from eight population-based cohort studies to examine and compare associations of pre-eclampsia (PE), gestational hypertension (GH), gestational diabetes (GD), preterm birth (PTB), small (SGA) and large (LGA) for gestational age (vs. appropriate size for gestational age (AGA)) with up to 167 plasma/serum-based nuclear magnetic resonance-derived metabolic traits encompassing lipids, lipoproteins, fatty acids, amino acids, ketones, glycerides/phospholipids, glycolysis, fluid balance, and inflammation. Confounder-adjusted regression models were used to examine associations (adjusted for maternal education, parity age at pregnancy, ethnicity, pre/early pregnancy body mass index and smoking, and offspring sex and age at metabolic trait assessment), and results were combined using meta-analysis by five age categories representing different periods of the offspring life course: neonates (cord blood), infancy (mean ages: 1.1-1.6 years), childhood (4.2-7.5 years); adolescence (12.0-16.0 years), and adulthood (22.0-67.8 years). RESULTS Offspring numbers for each age category/analysis varied from 8925 adults (441 PTB) to 1181 infants (135 GD); 48.4% to 60.0% were females. Pregnancy complications (PE, GH, GD) were each associated with up to three metabolic traits in neonates (P≤0.001) with some evidence of persistence to older ages. PTB and SGA were associated with 32 and 12 metabolic traits in neonates respectively, which included an adjusted standardised mean difference of -0.89 standard deviation (SD) units for albumin with PTB (95% CI: -1.10 to -0.69, P=1.3×10-17) and -0.41 SD for total lipids in medium HDL with SGA (95% CI: -0.56 to -0.25, P=2.6×10-7), with some evidence of persistence to older ages. LGA was inversely associated with 19 metabolic traits including lower levels of cholesterol, lipoproteins, fatty acids, and amino acids, with associations emerging in adolescence, (e.g. -0.11 SD total fatty acids, 95% CI: -0.18 to -0.05, P=0.0009), and attenuating with older age across adulthood. CONCLUSIONS These reassuring findings suggest little evidence of wide-spread and long-term impact of common pregnancy and perinatal complications on offspring metabolic traits, with most associations only observed for newborns rather than older ages, and for perinatal rather than pregnancy complications.
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Affiliation(s)
- Ahmed Elhakeem
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Justiina Ronkainen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Toby Mansell
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Katherine Lange
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Tuija M Mikkola
- Folkhälsan Research Center, Helsinki, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Binisha H Mishra
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | - Rama J Wahab
- Department of Paediatrics, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - Tim Cadman
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, UK
| | - David Burgner
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
| | - Johan G Eriksson
- Folkhälsan Research Center, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science and Technology (A*STAR), Singapore, Singapore
| | - Marjo-Riitta Järvelin
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Romy Gaillard
- Department of Paediatrics, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - Vincent W V Jaddoe
- Department of Paediatrics, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, Netherlands
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Finnish Cardiovascular Research Center Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Richard Saffery
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals National Health Service Foundation Trust, Bradford, UK
| | - Sylvain Sebert
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
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19
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Pati S, Irfan W, Jameel A, Ahmed S, Shahid RK. Obesity and Cancer: A Current Overview of Epidemiology, Pathogenesis, Outcomes, and Management. Cancers (Basel) 2023; 15:485. [PMID: 36672434 PMCID: PMC9857053 DOI: 10.3390/cancers15020485] [Citation(s) in RCA: 138] [Impact Index Per Article: 138.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Obesity or excess body fat is a major global health challenge that has not only been associated with diabetes mellitus and cardiovascular disease but is also a major risk factor for the development of and mortality related to a subgroup of cancer. This review focuses on epidemiology, the relationship between obesity and the risk associated with the development and recurrence of cancer and the management of obesity. METHODS A literature search using PubMed and Google Scholar was performed and the keywords 'obesity' and cancer' were used. The search was limited to research papers published in English prior to September 2022 and focused on studies that investigated epidemiology, the pathogenesis of cancer, cancer incidence and the risk of recurrence, and the management of obesity. RESULTS About 4-8% of all cancers are attributed to obesity. Obesity is a risk factor for several major cancers, including post-menopausal breast, colorectal, endometrial, kidney, esophageal, pancreatic, liver, and gallbladder cancer. Excess body fat results in an approximately 17% increased risk of cancer-specific mortality. The relationship between obesity and the risk associated with the development of cancer and its recurrence is not fully understood and involves altered fatty acid metabolism, extracellular matrix remodeling, the secretion of adipokines and anabolic and sex hormones, immune dysregulation, and chronic inflammation. Obesity may also increase treatment-related adverse effects and influence treatment decisions regarding specific types of cancer therapy. Structured exercise in combination with dietary support and behavior therapy are effective interventions. Treatment with glucagon-like peptide-1 analogues and bariatric surgery result in more rapid weight loss and can be considered in selected cancer survivors. CONCLUSIONS Obesity increases cancer risk and mortality. Weight-reducing strategies in obesity-associated cancers are important interventions as a key component of cancer care. Future studies are warranted to further elucidate the complex relationship between obesity and cancer with the identification of targets for effective interventions.
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Affiliation(s)
- Sukanya Pati
- College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | | | - Ahmad Jameel
- College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Shahid Ahmed
- College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
- Saskatoon Cancer Center, Saskatchewan Cancer Agency, Saskatoon, SK S7N 4H4, Canada
| | - Rabia K. Shahid
- College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
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20
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Moore THM, Phillips S, Heslehurst N, Hodder RK, Dawson S, Gao Y, Hesketh K, Summerbell CD. Interventions to prevent obesity in children under 2 years old. Hippokratia 2022. [DOI: 10.1002/14651858.cd015324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Theresa HM Moore
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Sophie Phillips
- Department of Sport and Exercise Sciences; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
| | - Nicola Heslehurst
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
- Population Health Sciences Institute; Newcastle University; Newcastle upon Tyne UK
| | - Rebecca K Hodder
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
- National Centre of Implementation Science; The University of Newcastle; Callaghan Australia
- Population Health Research Program; Hunter Medical Research Institute; New Lambton Heights Australia
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Yang Gao
- Department of Sport, Physical Education and Health; Hong Kong Baptist University; Kowloon Hong Kong
| | - Kathryn Hesketh
- MRC Epidemiology Unit; University of Cambridge; Cambridge UK
| | - Carolyn D Summerbell
- Department of Sport and Exercise Sciences; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
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21
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Adiposity and NMR-measured lipid and metabolic biomarkers among 30,000 Mexican adults. COMMUNICATIONS MEDICINE 2022; 2:143. [PMID: 36376486 PMCID: PMC9663185 DOI: 10.1038/s43856-022-00208-2] [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: 05/03/2022] [Accepted: 10/28/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adiposity is a major cause of morbidity and mortality in part due to effects on blood lipids. Nuclear magnetic resonance (NMR) spectroscopy provides direct information on >130 biomarkers mostly related to blood lipid particles. METHODS Among 28,934 Mexican adults without chronic disease and not taking lipid-lowering therapy, we examine the cross-sectional relevance of body-mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and hip circumference (HC) to NMR-measured metabolic biomarkers. Confounder-adjusted associations between each adiposity measure and NMR biomarkers are estimated before and after mutual adjustment for other adiposity measures. RESULTS Markers of general (ie, BMI), abdominal (ie, WC and WHR) and gluteo-femoral (ie, HC) adiposity all display similar and strong associations across the NMR-platform of biomarkers, particularly for biomarkers that increase cardiometabolic risk. Higher adiposity associates with higher levels of Apolipoprotein-B (about 0.35, 0.30, 0.35, and 0.25 SD higher Apolipoprotein-B per 2-SD higher BMI, WHR, WC, and HC, respectively), higher levels of very low-density lipoprotein particles (and the cholesterol, triglycerides, and phospholipids within these lipoproteins), higher levels of all fatty acids (particularly mono-unsaturated fatty acids) and multiple changes in other metabolic biomarkers including higher levels of branched-chain amino acids and the inflammation biomarker glycoprotein acetyls. Associations for general and abdominal adiposity are fairly independent of each other but, given general and abdominal adiposity, higher gluteo-femoral adiposity is associated with a strongly favourable cardiometabolic lipid profile. CONCLUSIONS Our results provide insight to the lipidic and metabolomic signatures of different adiposity markers in a previously understudied population where adiposity is common but lipid-lowering therapy is not.
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22
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Wang R, Li X, Huangfu S, Yao Q, Wu P, Wu Z, Li L, Wang Y, Yang M, Hacker M, Zhou H, Yan R, Li S. Combining body mass index with waist circumference to assess coronary microvascular function in patients with non-obstructive coronary artery disease. J Nucl Cardiol 2022; 29:2434-2445. [PMID: 34476781 PMCID: PMC9553765 DOI: 10.1007/s12350-021-02788-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 08/12/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Coronary microvascular dysfunction (CMD) may precede clinically overt coronary artery disease (CAD). Overall and central obesity (CO) are major risk factors for CAD. This study sought to investigate the subclinical significance of body adiposity patterns based on the CMD risk. METHODS A total of 128 patients with non-obstructive CAD were prospectively enrolled. Patients were categorized into 4 anthropometric groups: normal weight and non-CO (NWNCO, n = 41), normal weight and CO (NWCO, n = 20), excess weight and non-CO (EWNCO, n = 26), and excess weight and CO (EWCO, n = 41). Patients underwent rest/stress electrocardiography-gated 13N-ammonia positron emission tomography to measure absolute myocardial blood flow (MBF), myocardial flow reserve (MFR), hemodynamic parameters, and cardiac function. RESULTS Resting MBF did not differ between groups (P = .36). Compared with the NWNCO group, hyperemic MBF and MFR were significantly lower in the NWCO and EWCO groups. Notably, patients with NWCO presented the lowest hyperemic MBF and MFR and the highest incidence of CMD. Waist circumference was an independent risk factor for CMD (OR 1.05, 95% CI 1.01 to 1.10, P = .02). CONCLUSION In patients with non-obstructive CAD, CO may be associated with an increased risk of CMD to better fit the study findings which did not assess management or monitoring of MBF and MFR.
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Affiliation(s)
- Ruonan Wang
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
| | - Xiang Li
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Shihao Huangfu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
| | - Qi Yao
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
| | - Ping Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
| | - Zhifang Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
- Collaborative Innovation Center for Molecular Imaging of Precision Medicine, Taiyuan, Shanxi, China
| | - Li Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
| | - Yuetao Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Minfu Yang
- Department of Nuclear Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Haitao Zhou
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China
| | - Rui Yan
- Shanxi Key Laboratory of Molecular Imaging, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Sijin Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Taiyuan, 030001, Shanxi, China.
- Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan, Shanxi, China.
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23
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Bell JA, Richardson TG, Wang Q, Sanderson E, Palmer T, Walker V, O'Keeffe LM, Timpson NJ, Cichonska A, Julkunen H, Würtz P, Holmes MV, Davey Smith G. Effects of general and central adiposity on circulating lipoprotein, lipid, and metabolite levels in UK Biobank: A multivariable Mendelian randomization study. THE LANCET REGIONAL HEALTH. EUROPE 2022; 21:100457. [PMID: 35832062 PMCID: PMC9272390 DOI: 10.1016/j.lanepe.2022.100457] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Background The direct effects of general adiposity (body mass index (BMI)) and central adiposity (waist-to-hip-ratio (WHR)) on circulating lipoproteins, lipids, and metabolites are unknown. Methods We used new metabolic data from UK Biobank (N=109,532, a five-fold higher N over previous studies). EDTA-plasma was used to quantify 249 traits with nuclear-magnetic-resonance spectroscopy including subclass-specific lipoprotein concentrations and lipid content, plus pre-glycemic and inflammatory metabolites. We used univariable and multivariable two-stage least-squares regression models with genetic risk scores for BMI and WHR as instruments to estimate total (unadjusted) and direct (mutually-adjusted) effects of BMI and WHR on metabolic traits; plus effects on statin use and interaction by sex, statin use, and age (proxy for medication use). Findings Higher BMI decreased apolipoprotein B and low-density lipoprotein cholesterol (LDL-C) before and after WHR-adjustment, whilst BMI increased triglycerides only before WHR-adjustment. These effects of WHR were larger and BMI-independent. Direct effects differed markedly by sex, e.g., triglycerides increased only with BMI among men, and only with WHR among women. Adiposity measures increased statin use and showed metabolic effects which differed by statin use and age. Among the youngest (38-53y, statins-5%), BMI and WHR (per-SD) increased LDL-C (total effects: 0.04-SD, 95%CI=-0.01,0.08 and 0.10-SD, 95%CI=0.02,0.17 respectively), but only WHR directly. Among the oldest (63-73y, statins-29%), BMI and WHR directly lowered LDL-C (-0.19-SD, 95%CI=-0.27,-0.11 and -0.05-SD, 95%CI=-0.16,0.06 respectively). Interpretation Excess adiposity likely raises atherogenic lipid and metabolite levels exclusively via adiposity stored centrally, particularly among women. Apparent effects of adiposity on lowering LDL-C are likely explained by an effect of adiposity on statin use. Funding UK Medical Research Council; British Heart Foundation; Novo Nordisk; National Institute for Health Research; Wellcome Trust; Cancer Research UK.
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Affiliation(s)
- Joshua A. Bell
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tom G. Richardson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Novo Nordisk Research Centre Oxford, Old Road Campus, Oxford, UK
| | - Qin Wang
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Eleanor Sanderson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tom Palmer
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Venexia Walker
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Linda M. O'Keeffe
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- School of Public Health, Western Gateway Building, University College Cork, Ireland
| | - Nicholas J. Timpson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | | | - Michael V. Holmes
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit at the University of Oxford, Oxford, UK
- National Institute for Health Research, Oxford Biomedical Research Centre, Oxford University Hospital, Oxford, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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24
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Moore THM, Phillips S, Hodder RK, O'Brien KM, Hillier-Brown F, Dawson S, Gao Y, Summerbell CD. Interventions to prevent obesity in children aged 2 to 4 years old. Hippokratia 2022. [DOI: 10.1002/14651858.cd015326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Theresa HM Moore
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- Methods Support Unit, Editorial Methods Department; Cochrane; London UK
| | - Sophie Phillips
- Department of Sport and Exercise Sciences; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
| | - Rebecca K Hodder
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
- National Centre of Implementation Science; The University of Newcastle; Callaghan Australia
| | - Kate M O'Brien
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
- National Centre of Implementation Science; The University of Newcastle; Callaghan Australia
| | - Frances Hillier-Brown
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
- Population Health Sciences Institute; Newcastle University; Newcastle upon Tyne UK
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Yang Gao
- Department of Sport, Physical Education and Health; Hong Kong Baptist University; Kowloon Hong Kong
| | - Carolyn D Summerbell
- Department of Sport and Exercise Sciences; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle Upon Tyne UK
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25
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Silventoinen K, Li W, Jelenkovic A, Sund R, Yokoyama Y, Aaltonen S, Piirtola M, Sugawara M, Tanaka M, Matsumoto S, Baker LA, Tuvblad C, Tynelius P, Rasmussen F, Craig JM, Saffery R, Willemsen G, Bartels M, van Beijsterveldt CEM, Martin NG, Medland SE, Montgomery GW, Lichtenstein P, Krueger RF, McGue M, Pahlen S, Christensen K, Skytthe A, Kyvik KO, Saudino KJ, Dubois L, Boivin M, Brendgen M, Dionne G, Vitaro F, Ullemar V, Almqvist C, Magnusson PKE, Corley RP, Huibregtse BM, Knafo-Noam A, Mankuta D, Abramson L, Haworth CMA, Plomin R, Bjerregaard-Andersen M, Beck-Nielsen H, Sodemann M, Duncan GE, Buchwald D, Burt SA, Klump KL, Llewellyn CH, Fisher A, Boomsma DI, Sørensen TIA, Kaprio J. Changing genetic architecture of body mass index from infancy to early adulthood: an individual based pooled analysis of 25 twin cohorts. Int J Obes (Lond) 2022; 46:1901-1909. [PMID: 35945263 PMCID: PMC9492534 DOI: 10.1038/s41366-022-01202-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 11/09/2022]
Abstract
Background Body mass index (BMI) shows strong continuity over childhood and adolescence and high childhood BMI is the strongest predictor of adult obesity. Genetic factors strongly contribute to this continuity, but it is still poorly known how their contribution changes over childhood and adolescence. Thus, we used the genetic twin design to estimate the genetic correlations of BMI from infancy to adulthood and compared them to the genetic correlations of height. Methods We pooled individual level data from 25 longitudinal twin cohorts including 38,530 complete twin pairs and having 283,766 longitudinal height and weight measures. The data were analyzed using Cholesky decomposition offering genetic and environmental correlations of BMI and height between all age combinations from 1 to 19 years of age. Results The genetic correlations of BMI and height were stronger than the trait correlations. For BMI, we found that genetic correlations decreased as the age between the assessments increased, a trend that was especially visible from early to middle childhood. In contrast, for height, the genetic correlations were strong between all ages. Age-to-age correlations between environmental factors shared by co-twins were found for BMI in early childhood but disappeared altogether by middle childhood. For height, shared environmental correlations persisted from infancy to adulthood. Conclusions Our results suggest that the genes affecting BMI change over childhood and adolescence leading to decreasing age-to-age genetic correlations. This change is especially visible from early to middle childhood indicating that new genetic factors start to affect BMI in middle childhood. Identifying mediating pathways of these genetic factors can open possibilities for interventions, especially for those children with high genetic predisposition to adult obesity.
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Affiliation(s)
- Karri Silventoinen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland. .,Center for Twin Research, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Weilong Li
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Aline Jelenkovic
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Spain.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Reijo Sund
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Yoshie Yokoyama
- Department of Public Health Nursing, Osaka Metropolitan University, Osaka, Japan
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland FIMM, Helsinki, Finland
| | - Maarit Piirtola
- Institute for Molecular Medicine Finland FIMM, Helsinki, Finland.,UKK Institute - Centre for Health Promotion Research, Tampere, Finland
| | - Masumi Sugawara
- Faculty of Human Studies, Shirayuri University, Tokyo, Japan
| | - Mami Tanaka
- Center for Forensic Mental Health, Chiba University, Chiba, Japan
| | - Satoko Matsumoto
- Institute for Education and Human Development, Ochanomizu University, Tokyo, Japan
| | - Laura A Baker
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Catherine Tuvblad
- Department of Psychology, University of Southern California, Los Angeles, CA, USA.,School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Per Tynelius
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Finn Rasmussen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Jeffrey M Craig
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University School of Medicine, Geelong, Australia.,Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Richard Saffery
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Gonneke Willemsen
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, Amsterdam, Netherlands
| | - Meike Bartels
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, Amsterdam, Netherlands
| | | | - Nicholas G Martin
- Genetic Epidemiology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Sarah E Medland
- Genetic Epidemiology Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Grant W Montgomery
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Shandell Pahlen
- Department of Psychology, University of California, Riverside, Riverside, CA, 92521, USA
| | - Kaare Christensen
- The Danish Twin Registry, Department of Public Health, Epidemiology, Biostatistics & Biodemography, University of Southern Denmark Odense, Odense, Denmark.,Department of Clinical Biochemistry and Pharmacology and Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Axel Skytthe
- The Danish Twin Registry, Department of Public Health, Epidemiology, Biostatistics & Biodemography, University of Southern Denmark Odense, Odense, Denmark
| | - Kirsten O Kyvik
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Kimberly J Saudino
- Boston University, Department of Psychological and Brain Sciencies, Boston, MA, USA
| | - Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Michel Boivin
- École de psychologie, Université Laval, Québec, Canada
| | - Mara Brendgen
- Département de psychologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | | | - Frank Vitaro
- École de psychoéducation, Université de Montréal, Montréal, Québec, Canada
| | - Vilhelmina Ullemar
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.,Theme Women's Health, Karolinska University Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Robin P Corley
- Institute for Behavioral Genetics, University of Colorado, Boulder, Colorado, USA
| | - Brooke M Huibregtse
- Department of Psychology and Neuroscience, University of Colorado, Boulder, Colorado, USA
| | | | - David Mankuta
- Hadassah Hospital Obstetrics and Gynecology Department, Hebrew University Medical School, Jerusalem, Israel
| | - Lior Abramson
- The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Robert Plomin
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Morten Bjerregaard-Andersen
- Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau.,Department of Endocrinology, Hospital of Southwest Jutland, Esbjerg, Denmark.,Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | | | - Morten Sodemann
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
| | - Glen E Duncan
- Washington State Twin Registry, Washington State University - Health Sciences Spokane, Spokane, WA, USA
| | - Dedra Buchwald
- Washington State Twin Registry, Washington State University - Health Sciences Spokane, Spokane, WA, USA
| | - S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Clare H Llewellyn
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Abigail Fisher
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Dorret I Boomsma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit, Amsterdam, Amsterdam, Netherlands
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Public Health (Section of Epidemiology), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Institute for Molecular Medicine Finland FIMM, Helsinki, Finland
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26
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O'Neill KN, Bell JA, Davey Smith G, Tilling K, Kearney PM, O'Keeffe LM. Puberty Timing and Sex-Specific Trajectories of Systolic Blood Pressure: a Prospective Cohort Study. Hypertension 2022; 79:1755-1764. [PMID: 35587023 PMCID: PMC9278704 DOI: 10.1161/hypertensionaha.121.18531] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Sex differences in systolic blood pressure (SBP) emerge during adolescence but the role of puberty is not well understood. We examined sex-specific changes in SBP preceding and following puberty and examined the impact of puberty timing on SBP trajectories in females and males. METHODS Trajectories of SBP before and after puberty and by timing of puberty in females and males in a contemporary birth cohort study were analyzed. Repeated measures of height from age 5 to 20 years were used to identify puberty timing (age at peak height velocity). SBP was measured on ten occasions from 3 to 24 years (N participants, 4062; repeated SBP measures, 29 172). Analyses were performed using linear spline multilevel models based on time before and after puberty and were adjusted for parental factors and early childhood factors. RESULTS Mean age at peak height velocity was 11.7 years (SD, 0.8) for females and 13.6 years (SD, 0.9) for males. Males had faster rates of increase in SBP before puberty leading to 10.19 mm Hg (95% CI, 6.80-13.57) higher mean SBP at puberty which remained similar at 24 years (mean difference, 11.43 mm Hg [95% CI, 7.22-15.63]). Puberty timing was associated with small transient differences in SBP trajectories postpuberty in both sexes and small differences at 24 years in females only. CONCLUSIONS A large proportion of the higher SBP observed in males compared with females in early adulthood is accrued before puberty. Interventions targeting puberty timing are unlikely to influence SBP in early adulthood.
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Affiliation(s)
- Kate N O'Neill
- School of Public Health, University College Cork, Ireland (K.N.O.N., P.M.K., L.M.O.K.)
| | - Joshua A Bell
- MRC Integrative Epidemiology Unit at the University of Bristol, United Kingdom (J.A.B., G.D.S., K.T., L.M.O.K.).,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom (J.A.B., G.D.S., K.T., L.M.O.K.)
| | - George Davey Smith
- MRC Integrative Epidemiology Unit at the University of Bristol, United Kingdom (J.A.B., G.D.S., K.T., L.M.O.K.).,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom (J.A.B., G.D.S., K.T., L.M.O.K.)
| | - Kate Tilling
- MRC Integrative Epidemiology Unit at the University of Bristol, United Kingdom (J.A.B., G.D.S., K.T., L.M.O.K.).,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom (J.A.B., G.D.S., K.T., L.M.O.K.)
| | - Patricia M Kearney
- School of Public Health, University College Cork, Ireland (K.N.O.N., P.M.K., L.M.O.K.)
| | - Linda M O'Keeffe
- School of Public Health, University College Cork, Ireland (K.N.O.N., P.M.K., L.M.O.K.).,MRC Integrative Epidemiology Unit at the University of Bristol, United Kingdom (J.A.B., G.D.S., K.T., L.M.O.K.).,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom (J.A.B., G.D.S., K.T., L.M.O.K.)
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27
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Moore THM, Tomlinson E, Spiga F, Higgins JPT, Gao Y, Caldwell DM, Nobles J, Dawson S, Ijaz S, Savovic J, Hodder RK, Wolfenden L, Jago R, Phillips S, Hillier-Brown F, Summerbell CD. Interventions to prevent obesity in children aged 12 to 18 years old. Hippokratia 2022. [DOI: 10.1002/14651858.cd015330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Theresa HM Moore
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Eve Tomlinson
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - Francesca Spiga
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - Julian PT Higgins
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- NIHR Bristol Biomedical Research Centre; University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol; Bristol UK
| | - Yang Gao
- Department of Sport, Physical Education and Health; Hong Kong Baptist University; Kowloon Hong Kong
| | - Deborah M Caldwell
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - James Nobles
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Sharea Ijaz
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Jelena Savovic
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Rebecca K Hodder
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
| | - Luke Wolfenden
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
| | - Russell Jago
- NIHR Applied Research Collaboration West (ARC West); University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- NIHR Bristol Biomedical Research Centre; University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol; Bristol UK
- Centre for Exercise, Nutrition & Health Sciences; School for Policy Studies, University of Bristol; Bristol UK
| | - Sophie Phillips
- Fuse - Centre for Translational Research in Public Health; Newcastle upon Tyne UK
- Department of Sport and Exercise Science; Durham University; Durham UK
| | - Frances Hillier-Brown
- Fuse - Centre for Translational Research in Public Health; Newcastle upon Tyne UK
- Human Nutrition Research Centre and Population Health Sciences Institute; University of Newcastle; Newcastle UK
| | - Carolyn D Summerbell
- Fuse - Centre for Translational Research in Public Health; Newcastle upon Tyne UK
- Department of Sport and Exercise Science; Durham University; Durham UK
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28
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Moore THM, Tomlinson E, Spiga F, Higgins JPT, Gao Y, Caldwell DM, Nobles J, Dawson S, Ijaz S, Savovic J, Hodder RK, Wolfenden L, Jago R, Phillips S, Hillier-Brown F, Summerbell CD. Interventions to prevent obesity in children aged 5 to 11 years old. Hippokratia 2022. [DOI: 10.1002/14651858.cd015328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Theresa HM Moore
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Eve Tomlinson
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - Francesca Spiga
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - Julian PT Higgins
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol; Bristol UK
| | - Yang Gao
- Department of Sport, Physical Education and Health; Hong Kong Baptist University; Kowloon Hong Kong
| | - Deborah M Caldwell
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
| | - James Nobles
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- Population Health Sciences, Bristol Medical School, University of Bristol; Bristol UK
| | - Sarah Dawson
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- Population Health Sciences, Bristol Medical School, University of Bristol; Bristol UK
| | - Sharea Ijaz
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Jelena Savovic
- Population Health Sciences, Bristol Medical School; University of Bristol; Bristol UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
| | - Rebecca K Hodder
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
| | - Luke Wolfenden
- Hunter New England Population Health; Hunter New England Local Health District; Wallsend Australia
- School of Medicine and Public Health; The University of Newcastle; Callaghan Australia
| | - Russell Jago
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust; Bristol UK
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol; Bristol UK
- Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies; University of Bristol; Bristol UK
| | - Sophie Phillips
- Department of Sport and Exercise Science; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle upon Tyne UK
| | - Frances Hillier-Brown
- Fuse - Centre for Translational Research in Public Health; Newcastle upon Tyne UK
- Human Nutrition Research Centre and Population Health Sciences Institute; University of Newcastle; Newcastle UK
| | - Carolyn D Summerbell
- Department of Sport and Exercise Science; Durham University; Durham UK
- Fuse - Centre for Translational Research in Public Health; Newcastle upon Tyne UK
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29
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Gómez-García M, Torrado J, Pereira M, Bia D, Zócalo Y. Fat-Free Mass Index, Visceral Fat Level, and Muscle Mass Percentage Better Explain Deviations From the Expected Value of Aortic Pressure and Structural and Functional Arterial Properties Than Body Fat Indexes. Front Nutr 2022; 9:856198. [PMID: 35571946 PMCID: PMC9099434 DOI: 10.3389/fnut.2022.856198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 03/21/2022] [Indexed: 12/15/2022] Open
Abstract
Bioelectrical impedance analysis (BIA)-derived indexes [e.g., fat (FMI) and fat-free mass indexes (FFMI), visceral fat level (VFL)] are used to characterize obesity as a cardiovascular risk factor (CRF). The BIA-derived index that better predicts arterial variability is still discussed.
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Affiliation(s)
- Mariana Gómez-García
- Departamento de Educación Física y Salud, Instituto Superior de Educación Física, Universidad de la República, Montevideo, Uruguay
- CUiiDARTE-Movimiento, Actividad, Salud (CUiiDARTE-MAS), Comisión Sectorial de Investigación Científica, Universidad de la República, Montevideo, Uruguay
| | - Juan Torrado
- CUiiDARTE-Movimiento, Actividad, Salud (CUiiDARTE-MAS), Comisión Sectorial de Investigación Científica, Universidad de la República, Montevideo, Uruguay
- Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY, United States
| | - María Pereira
- Department of Obstetrics and Gynecology, BronxCare Hospital Center a Clinical Affiliate of Mt Sinai Health Systems and Academic Affiliate of Icahn School of Medicine, New York, NY, United States
| | - Daniel Bia
- CUiiDARTE-Movimiento, Actividad, Salud (CUiiDARTE-MAS), Comisión Sectorial de Investigación Científica, Universidad de la República, Montevideo, Uruguay
- Departamento de Fisiología, Facultad de Medicina, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Universidad de la República, Montevideo, Uruguay
| | - Yanina Zócalo
- CUiiDARTE-Movimiento, Actividad, Salud (CUiiDARTE-MAS), Comisión Sectorial de Investigación Científica, Universidad de la República, Montevideo, Uruguay
- Departamento de Fisiología, Facultad de Medicina, Centro Universitario de Investigación, Innovación y Diagnóstico Arterial (CUiiDARTE), Universidad de la República, Montevideo, Uruguay
- *Correspondence: Yanina Zócalo
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30
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Santorelli G, West J, Yang T, Wright J, Bryant M, Lawlor D. Differences in total and regional body fat and their association with BMI in UK-born White and South Asian children: findings from the Born in Bradford birth cohort. Wellcome Open Res 2022; 6:65. [PMID: 37900936 PMCID: PMC10611948 DOI: 10.12688/wellcomeopenres.16659.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 10/31/2023] Open
Abstract
Background: Body mass index (BMI) is commonly used as a proxy to determine excess adiposity, though this may underestimate fat mass (FM) in individuals of South Asian (SA) heritage. SA tend to have greater central adiposity than white people, which is associated with a higher risk of cardiometabolic disease. In this cross-sectional study, we aimed to determine the differences in total and regional FM using Dual-energy X-ray absorptiometry (DXA), and to see if any differences in FM varied by BMI category in UK-born white and SA children aged ~9 years. Methods: Anthropometric measurements and DXA scans were undertaken from 225 white and 269 SA children from the Born in Bradford cohort study. Linear regression was used to assess ethnic differences in total body fat percent and total and regional FM. Results: Although mean BMI was similar, compared to white children, the proportion of SA children who were overweight or obese was ~10% higher, and the proportion with > 35% total body fat (TBF) was 22% and 16% higher in boys and girls respectively. Mean TBF% was greater in SA children compared to white children in the same BMI category. Fat mass index (FMI) was higher in all body regions in SA children in all BMI categories; as was total and truncal FMI in healthy and overweight, but not obese, SA children. Conclusions: Greater TBF% and total and regional FM in SA children suggests they may be at greater risk of future cardiometabolic disease at a BMI level below the obesity threshold. However, our sample size was small, and results may be influenced by selection bias and confounding; our findings need to be replicated in a larger study.
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Affiliation(s)
| | - Jane West
- Bradford Institute for Health Research, Bradford, BD9 6RJ, UK
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford, BD9 6RJ, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford, BD9 6RJ, UK
| | - Maria Bryant
- Department of Health Sciences and the Hull York Medical School, York, YO10 5DD, UK
| | - D.A. Lawlor
- Bradford Institute for Health Research, Bradford, BD9 6RJ, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, Bahamas
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
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31
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Subjective cognitive decline and total energy intake: Talk too much? Eur J Epidemiol 2022; 37:129-131. [PMID: 35211870 DOI: 10.1007/s10654-022-00849-6] [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: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 11/03/2022]
Abstract
The increasing longevity of the population has resulted in dementia becoming a leading cause of both death and disability. Dementia is not a single disease. Studies of rare Mendelian disorders have documented that Alzheimer's disease, the most common cause of dementia, is associated with a long incubation period from amyloid deposition to neurodegeneration to mild cognitive impairment and dementia. There are three broad hypotheses related to the causes of Alzheimer's dementia: (1) an aging process; (2) brain vascular disease; and (3) metabolic abnormalities associated with either increased production of amyloid-β or decreased clearance from the brain. Therefore, research on the early stages of the dementia process are of high priority. This paper reports that higher energy intake in both the Nurses' Health Study and Health Professionals Follow-up Study is associated with very early symptoms that lead to mild cognitive impairment and dementia. The results are very interesting but hard to interpret because they also show that higher energy intake is not related to body mass index, a very unusual observation. A likely hypothesis is that there is an association between reporting of dietary intake and subjective symptoms, i.e. reporting bias, accounting for their results.
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32
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Chiesa ST, Charakida M, Georgiopoulos G, Roberts JD, Stafford SJ, Park C, Mykkänen J, Kähönen M, Lehtimäki T, Ala-Korpela M, Raitakari O, Pietiäinen M, Pussinen P, Muthurangu V, Hughes AD, Sattar N, Timpson NJ, Deanfield JE. Glycoprotein Acetyls: A Novel Inflammatory Biomarker of Early Cardiovascular Risk in the Young. J Am Heart Assoc 2022; 11:e024380. [PMID: 35156387 PMCID: PMC9245818 DOI: 10.1161/jaha.121.024380] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/03/2022] [Indexed: 02/06/2023]
Abstract
Background Low-grade inflammation in the young may contribute to the early development of cardiovascular disease. We assessed whether circulating levels of glycoprotein acetyls (GlycA) were better able to predict the development of adverse cardiovascular disease risk profiles compared with the more commonly used biomarker high-sensitivity CRP (C-reactive protein). Methods and Results A total of 3306 adolescents and young adults from the Avon Longitudinal Study of Parents and Children (mean age, 15.4±0.3; n=1750) and Cardiovascular Risk in Young Finns Study (mean age, 32.1±5.0; n=1556) were included. Baseline associations between inflammatory biomarkers, body composition, cardiovascular risk factors, and subclinical measures of vascular dysfunction were assessed cross-sectionally in both cohorts. Prospective risk of developing hypertension and metabolic syndrome during 9-to-10-year follow-up were also assessed as surrogate markers for future cardiovascular risk. GlycA showed greater within-subject correlation over 9-to-10-year follow-up in both cohorts compared with CRP, particularly in the younger adolescent group (r=0.36 versus 0.07). In multivariable analyses, GlycA was found to associate with multiple lifestyle-related cardiovascular disease risk factors, cardiometabolic risk factor burden, and vascular dysfunction (eg, mean difference in flow-mediated dilation=-1.2 [-1.8, -0.7]% per z-score increase). In contrast, CRP levels appeared predominantly driven by body mass index and showed little relationship to any measured cardiovascular risk factors or phenotypes. In both cohorts, only GlycA predicted future risk of both hypertension (risk ratio [RR], ≈1.1 per z-score increase for both cohorts) and metabolic syndrome (RR, ≈1.2-1.3 per z-score increase for both cohorts) in 9-to-10-year follow-up. Conclusions Low-grade inflammation captured by the novel biomarker GlycA is associated with adverse cardiovascular risk profiles from as early as adolescence and predicts future risk of hypertension and metabolic syndrome in up to 10-year follow-up. GlycA is a stable inflammatory biomarker which may capture distinct sources of inflammation in the young and may provide a more sensitive measure than CRP for detecting early cardiovascular risk.
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Affiliation(s)
- Scott T Chiesa
- Institute of Cardiovascular Science University College London UK
| | - Marietta Charakida
- Department of Imaging Science and Biomedical Engineering King's College London UK
| | | | - Justin D Roberts
- Cambridge Centre for Sport and Exercise Sciences Anglia Ruskin University Cambridge UK
| | - Simon J Stafford
- Molecular Diagnostics Unit Medical Technology Research Centre Faculty of Health, Education, Medicine & Social Care Anglia Ruskin University Chelmsford UK
| | - Chloe Park
- Cardiometabolic Phenotyping Group Institute of Cardiovascular Science University College London UK
| | - Juha Mykkänen
- Research Centre of Applied and Preventive Cardiovascular Medicine University of Turku Finland
- Centre for Population Health Research University of Turku and Turku University Hospital Finland
| | - Mika Kähönen
- Department of Clinical Physiology Tampere University Hospital Tampere Finland
- Finnish Cardiovascular Research Center Tampere Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Terho Lehtimäki
- Finnish Cardiovascular Research Center Tampere Faculty of Medicine and Health Technology Tampere University Tampere Finland
- Department of Clinical Chemistry Fimlab Laboratories Tampere Finland
| | - Mika Ala-Korpela
- Computational Medicine Faculty of Medicine University of Oulu and Biocenter Oulu Finland
- Center for Life Course Health Research University of Oulu Finland
- NMR Metabolomics Laboratory School of Pharmacy University of Eastern Finland Kuopio Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine University of Turku Finland
- Centre for Population Health Research University of Turku and Turku University Hospital Finland
- Department of Clinical Physiology and Nuclear Medicine Turku University Hospital Turku Finland
| | - Milla Pietiäinen
- Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Pirkko Pussinen
- Oral and Maxillofacial Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland
| | - Vivek Muthurangu
- Centre for Cardiovascular Imaging UCL Institute of Cardiovascular Science London United Kingdom
| | - Alun D Hughes
- Cardiometabolic Phenotyping Group Institute of Cardiovascular Science University College London UK
- MRC Unit for Lifelong Health and AgeingUniversity College London UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences British Heart Foundation (BHF) Glasgow Cardiovascular Research CentreUniversity of Glasgow UK
| | - Nicholas J Timpson
- Population Health Sciences Bristol Medical School Faculty of Health Sciences University of Bristol UK
- Medical Research Council Integrative Epidemiology Unit University of Bristol UK
| | - John E Deanfield
- Institute of Cardiovascular Science University College London UK
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33
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Xing Z, Long C, Hu X, Chai X. Obesity is associated with greater cognitive function in patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2022; 13:953826. [PMID: 36353230 PMCID: PMC9637978 DOI: 10.3389/fendo.2022.953826] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/10/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The impact of obesity on cognitive function in patients with type 2 diabetes mellitus (T2DM) remains controversial. This study aimed to evaluate whether obesity, assessed by body mass index (BMI) was associated with cognitive function among T2DM patients and whether the effect of obesity on cognitive function was through brain structure. METHODS This was a post-hoc analysis of the Action to Control Cardiovascular Risk in Diabetes-Memory in Diabetes (ACCORD-MIND) study. The cognitive test battery included the Digit Symbol Substitution Test (DSST), Mini-Mental State Exam (MMSE), Rey Auditory Verbal Learning Test (RAVLT), and STROOP test, which were administered at baseline, and at 20, 40, and 80 months. A subgroup (n = 614) of the ACCORD-MIND study underwent MRI scanning at baseline and at 40 and 80 months. The total brain volume (TBV), abnormal white matter volume (AWM), abnormal gray matter volume (AGM), and abnormal basal ganglia volume (ABG) were estimated. The outcomes of this study were cognitive function and brain structure. RESULTS In the adjusted analyses, BMI was positively associated with the MMSE (β:0.08, 95%CI,0.01-0.16, per standard deviation [SD] increase) and RAVLT scores (β:0.09, 95%CI,0.01-0.18). It was also associated with a greater TBV (β:7.48, 95%CI,0.29-14.67). BMI was not associated with the DSST or STROOP scores, and AWM, AGM, ABG. Mediation analysis found that the effect of BMI on MMSE/RAVLT was mediated through TBV. CONCLUSION Obesity may be associated with greater cognitive function and the effect of BMI on cognitive function may be mediated by TBV among patients with T2DM. CLINICAL TRIAL REGISTRATION http://www.clinicaltrials.gov, identifier NCT00000620.
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Affiliation(s)
- Zhenhua Xing
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China
- Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, China
| | - Chen Long
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xinqun Hu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- *Correspondence: Xinqun Hu,
| | - Xiangping Chai
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China
- Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, China
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34
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San-Cristobal R, de Toro-Martín J, Vohl MC. Appraisal of Gene-Environment Interactions in GWAS for Evidence-Based Precision Nutrition Implementation. Curr Nutr Rep 2022; 11:563-573. [PMID: 35948824 PMCID: PMC9750926 DOI: 10.1007/s13668-022-00430-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW This review aims to analyse the currently reported gene-environment (G × E) interactions in genome-wide association studies (GWAS), involving environmental factors such as lifestyle and dietary habits related to metabolic syndrome phenotypes. For this purpose, the present manuscript reviews the available GWAS registered on the GWAS Catalog reporting the interaction between environmental factors and metabolic syndrome traits. RECENT FINDINGS Advances in omics-related analytical and computational approaches in recent years have led to a better understanding of the biological processes underlying these G × E interactions. A total of 42 GWAS were analysed, reporting over 300 loci interacting with environmental factors. Alcohol consumption, sleep time, smoking habit and physical activity were the most studied environmental factors with significant G × E interactions. The implementation of more comprehensive GWAS will provide a better understanding of the metabolic processes that determine individual responses to environmental exposures and their association with the development of chronic diseases such as obesity and the metabolic syndrome. This will facilitate the development of precision approaches for better prevention, management and treatment of these diseases.
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Affiliation(s)
- Rodrigo San-Cristobal
- grid.23856.3a0000 0004 1936 8390Centre Nutrition, Santé Et Société (NUTRISS), Institut Sur La Nutrition Et Les Aliments Fonctionnels (INAF), Université Laval, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390School of Nutrition, Université Laval, Quebec, QC G1V 0A6 Canada
| | - Juan de Toro-Martín
- grid.23856.3a0000 0004 1936 8390Centre Nutrition, Santé Et Société (NUTRISS), Institut Sur La Nutrition Et Les Aliments Fonctionnels (INAF), Université Laval, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390School of Nutrition, Université Laval, Quebec, QC G1V 0A6 Canada
| | - Marie-Claude Vohl
- grid.23856.3a0000 0004 1936 8390Centre Nutrition, Santé Et Société (NUTRISS), Institut Sur La Nutrition Et Les Aliments Fonctionnels (INAF), Université Laval, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390School of Nutrition, Université Laval, Quebec, QC G1V 0A6 Canada
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35
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Pehkonen J, Viinikainen J, Kari JT, Böckerman P, Lehtimäki T, Viikari J, Raitakari O. Birth weight, adult weight, and cardiovascular biomarkers: Evidence from the Cardiovascular Young Finns Study. Prev Med 2022; 154:106894. [PMID: 34801564 DOI: 10.1016/j.ypmed.2021.106894] [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: 06/17/2021] [Revised: 10/12/2021] [Accepted: 11/14/2021] [Indexed: 10/19/2022]
Abstract
This study quantifies the causal effect of birth weight on cardiovascular biomarkers in adulthood using the Cardiovascular Risk in Young Finns Study (YFS). We apply a multivariable Mendelian randomization (MVMR) method that provides a novel approach to improve inference in causal analysis based on a mediation framework. The results show that birth weight is linked to triglyceride levels (β = -0.294; 95% CI [-0.591, 0.003]) but not to low-density lipoprotein (LDL) cholesterol levels (β = 0.007; 95% CI [-0.168, 0.183]). The total effect of birth weight on triglyceride levels is partly offset by a mediation pathway linking birth weight to adult BMI (β = 0.111; 95% CI [-0.013, 0.234]). The negative total effect is consistent with the fetal programming hypothesis. The positive indirect effect via adult BMI highlights the persistence of body weight throughout a person's life and the adverse effects of high BMI on health. The results are consistent with previous findings that both low birth weight and weight gain increase health risks in adulthood.
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Affiliation(s)
- Jaakko Pehkonen
- School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland.
| | - Jutta Viinikainen
- School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland
| | - Jaana T Kari
- School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland
| | - Petri Böckerman
- School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland; Labour Institute for Economic Research, Helsinki, Finland; IZA, Bonn, Germany
| | - Terho Lehtimäki
- Department of Clinincal Chemistry, Tampere University, Finland; Fimlab Laboratoriot Oy Ltd, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Finnish Cardiovascular Research Center Tampere, Tampere University, Tampere, Finland
| | - Jorma Viikari
- Department of Medicine, University of Turku, Turku, Finland, Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Sung KT, Kuo JY, Yun CH, Lin YH, Tsai JP, Lo CI, Hsiao CC, Lai YH, Tsai CT, Hou CJY, Su CH, Yeh HI, Chien CY, Hung TC, Hung CL. Association of Region-Specific Cardiac Adiposity With Dysglycemia and New-Onset Diabetes. J Am Heart Assoc 2021; 10:e021921. [PMID: 34889106 PMCID: PMC9075230 DOI: 10.1161/jaha.121.021921] [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] [Indexed: 11/16/2022]
Abstract
Background Visceral adipose tissue is assumed to be an important indicator for insulin resistance and diabetes beyond overweight/obesity. We hypothesized that region-specific visceral adipose tissue may regulate differential biological effects for new-onset diabetes regardless of overall obesity. Methods and Results We quantified various visceral adipose tissue measures, including epicardial adipose tissue, paracardial adipose tissue, interatrial fat, periaortic fat, and thoracic aortic adipose tissue in 1039 consecutive asymptomatic participants who underwent multidetector computed tomography. We explored the associations of visceral adipose tissue with baseline dysglycemic indices and new-onset diabetes. Epicardial adipose tissue, paracardial adipose tissue, interatrial fat, periaortic fat, and thoracic aortic adipose tissue were differentially and independently associated with dysglycemic indices (fasting glucose, postprandial glucose, HbA1c, and homeostasis model assessment of insulin resistance) beyond anthropometric measures. The superimposition of interatrial fat and thoracic aortic adipose tissue on age, sex, body mass index, and baseline homeostasis model assessment of insulin resistance expanded the likelihood of baseline diabetes (from 67.2 to 86.0 and 64.4 to 70.8, P for ∆ ꭕ2: <0.001 and 0.011, respectively). Compared with the first tertile, the highest interatrial fat tertile showed a nearly doubled risk for new-onset diabetes (hazard ratio, 2.09 [95% CI, 1.38-3.15], P<0.001) after adjusting for Chinese Visceral Adiposity Index. Conclusions Region-specific visceral adiposity may not perform equally in discriminating baseline dysglycemia or diabetes, and showed differential predictive performance in new-onset diabetes. Our data suggested that interatrial fat may serve as a potential marker for new-onset diabetes.
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Affiliation(s)
- Kuo-Tzu Sung
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,Department of Medicine MacKay Medical College New Taipei City Taiwan.,Institute of Clinical MedicineNational Yang Ming Chao Tung University Taipei Taiwan
| | - Jen-Yuan Kuo
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,Department of Medicine MacKay Medical College New Taipei City Taiwan.,MacKay Medicine Nursing, and Management College Taipei Taiwan
| | - Chun-Ho Yun
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,MacKay Medicine Nursing, and Management College Taipei Taiwan.,Division of Radiology MacKay Memorial Hospital Taipei Taiwan
| | - Yueh-Hung Lin
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,Department of Medicine MacKay Medical College New Taipei City Taiwan.,Institute of Clinical MedicineNational Yang Ming Chao Tung University Taipei Taiwan
| | - Jui-Peng Tsai
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,Department of Medicine MacKay Medical College New Taipei City Taiwan
| | - Chi-In Lo
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,Department of Medicine MacKay Medical College New Taipei City Taiwan
| | - Chih-Chung Hsiao
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,Department of Medicine MacKay Medical College New Taipei City Taiwan
| | - Yau-Huei Lai
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,MacKay Medicine Nursing, and Management College Taipei Taiwan.,Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Hsinchu Taiwan
| | - Cheng-Ting Tsai
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,Department of Medicine MacKay Medical College New Taipei City Taiwan.,MacKay Medicine Nursing, and Management College Taipei Taiwan
| | - Charles Jia-Yin Hou
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,Department of Medicine MacKay Medical College New Taipei City Taiwan.,MacKay Medicine Nursing, and Management College Taipei Taiwan
| | - Cheng-Huang Su
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,Department of Medicine MacKay Medical College New Taipei City Taiwan.,MacKay Medicine Nursing, and Management College Taipei Taiwan
| | - Hung-I Yeh
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,Department of Medicine MacKay Medical College New Taipei City Taiwan.,MacKay Medicine Nursing, and Management College Taipei Taiwan
| | - Chen-Yen Chien
- Department of Medicine MacKay Medical College New Taipei City Taiwan.,MacKay Medicine Nursing, and Management College Taipei Taiwan.,Cardiovascular Division Department of Surgery MacKay Memorial Hospital Taipei Taiwan
| | - Ta-Chuan Hung
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,Department of Medicine MacKay Medical College New Taipei City Taiwan.,MacKay Medicine Nursing, and Management College Taipei Taiwan
| | - Chung-Lieh Hung
- Division of Cardiology Department of Internal Medicine MacKay Memorial Hospital Taipei Taiwan.,Department of Medicine MacKay Medical College New Taipei City Taiwan.,Institute of Biomedical SciencesMacKay Medical College New Taipei City Taiwan
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37
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Santorelli G, West J, Yang T, Wright J, Bryant M, Lawlor D. Differences in total and regional body fat and their association with BMI in UK-born White and South Asian children: findings from the Born in Bradford birth cohort. Wellcome Open Res 2021. [DOI: 10.12688/wellcomeopenres.16659.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background: Body mass index (BMI) is commonly used as a proxy to determine excess adiposity, though this may underestimate fat mass (FM) in individuals of South Asian (SA) heritage. SA tend to have greater central adiposity than white people, which is associated with a higher risk of cardiometabolic disease. In this cross-sectional study, we aimed to determine the differences in total and regional FM using Dual-energy X-ray absorptiometry (DXA), and to see if any differences in FM varied by BMI category in UK-born white and SA children aged ~9 years. Methods: Anthropometric measurements and DXA scans were undertaken from 225 white and 269 SA children from the Born in Bradford cohort study. Linear regression was used to assess ethnic differences in total body fat percent and total and regional FM. Results: Although mean BMI was similar, compared to white children, the proportion of SA children who were overweight or obese was ~20% higher, and the proportion with > 35% total body fat (TBF) was 22% and 16% higher in boys and girls respectively. Mean TBF% was greater in SA children compared to white children in the same BMI category. Fat mass index (FMI) was higher in all body regions in SA children in all BMI categories; as was total and truncal FMI in healthy and overweight, but not obese, SA children.. Conclusions: Greater TBF% and total and regional FM in SA children suggests they may be at greater risk of future cardiometabolic disease at a BMI level below the obesity threshold. However, our sample size was small, and results may be influenced by selection bias and confounding; our findings need to be replicated in a larger study.
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38
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Suri M, Suri A, Kumar D, Patel R. A Systematic Review of the Long-Term Trajectory of Hemodynamics and Body Composition in Childhood Obesity. Cureus 2021; 13:e19504. [PMID: 34912641 PMCID: PMC8664398 DOI: 10.7759/cureus.19504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 11/05/2022] Open
Abstract
Obesity has long been cited as a significant risk factor for high blood pressure, with long-term exposure linked with an increased incidence of carotid artery atherosclerosis. However, as obesity is becoming more common in young-aged children, it is important to recognize combinational factors like lifestyle, socioeconomic, and genetic factors as a cause. Increasing weight during childhood, on the other hand, is a clinically significant challenge for many physicians. It is critical to identify these risk factors since early prevention (primordial prevention) or treatment (primary prevention) to reverse the potential risks is much more likely to be effective. The objective of this review was to explore the relationship between lifestyle, anthropometric, and genetic factors and cardiometabolic risk factors. We are hopeful that our findings may aid in the primary prevention of hypertension in children and the prevention of any related cardiovascular complications that may arise later in life as a result of obesity. The synthesis of this systematic review includes a total of 15 studies using defined criteria, published up to October 2021. In addition, a total of 2,397 articles were found through an initial electronic database search and included a total of 38,182 participants. Studies explored included one or more of the following cardiovascular risk factors: body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides (TG). The findings of this study support the notion that childhood obesity may be a risk factor for a variety of adult cardiovascular disease risk factors. Several behavioral, genetic, and anthropometric factors are linked to the development of obesity during early ages, overall creating challenges in cardiovascular health during adulthood. As a result, addressing the risk factors for childhood hypertension would be advantageous for the primary prevention of its sequelae in adulthood.
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Affiliation(s)
- Megha Suri
- Medicine-Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Anuj Suri
- Internal Medicine, St. Michael's Hospital, Toronto, CAN
| | - Deepali Kumar
- Internal Medicine, Windsor University School of Medicine, Chicago, USA
| | - Rohini Patel
- Internal Medicine, Windsor University School of Medicine, Chicago, USA
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Goudswaard LJ, Bell JA, Hughes DA, Corbin LJ, Walter K, Davey Smith G, Soranzo N, Danesh J, Di Angelantonio E, Ouwehand WH, Watkins NA, Roberts DJ, Butterworth AS, Hers I, Timpson NJ. Effects of adiposity on the human plasma proteome: observational and Mendelian randomisation estimates. Int J Obes (Lond) 2021; 45:2221-2229. [PMID: 34226637 PMCID: PMC8455324 DOI: 10.1038/s41366-021-00896-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Variation in adiposity is associated with cardiometabolic disease outcomes, but mechanisms leading from this exposure to disease are unclear. This study aimed to estimate effects of body mass index (BMI) on an extensive set of circulating proteins. METHODS We used SomaLogic proteomic data from up to 2737 healthy participants from the INTERVAL study. Associations between self-reported BMI and 3622 unique plasma proteins were explored using linear regression. These were complemented by Mendelian randomisation (MR) analyses using a genetic risk score (GRS) comprised of 654 BMI-associated polymorphisms from a recent genome-wide association study (GWAS) of adult BMI. A disease enrichment analysis was performed using DAVID Bioinformatics 6.8 for proteins which were altered by BMI. RESULTS Observationally, BMI was associated with 1576 proteins (P < 1.4 × 10-5), with particularly strong evidence for a positive association with leptin and fatty acid-binding protein-4 (FABP4), and a negative association with sex hormone-binding globulin (SHBG). Observational estimates were likely confounded, but the GRS for BMI did not associate with measured confounders. MR analyses provided evidence for a causal relationship between BMI and eight proteins including leptin (0.63 standard deviation (SD) per SD BMI, 95% CI 0.48-0.79, P = 1.6 × 10-15), FABP4 (0.64 SD per SD BMI, 95% CI 0.46-0.83, P = 6.7 × 10-12) and SHBG (-0.45 SD per SD BMI, 95% CI -0.65 to -0.25, P = 1.4 × 10-5). There was agreement in the magnitude of observational and MR estimates (R2 = 0.33) and evidence that proteins most strongly altered by BMI were enriched for genes involved in cardiovascular disease. CONCLUSIONS This study provides evidence for a broad impact of adiposity on the human proteome. Proteins strongly altered by BMI include those involved in regulating appetite, sex hormones and inflammation; such proteins are also enriched for cardiovascular disease-related genes. Altogether, results help focus attention onto new proteomic signatures of obesity-related disease.
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Affiliation(s)
- Lucy J Goudswaard
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK.
- Bristol Heart Institute, Bristol, UK.
| | - Joshua A Bell
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - David A Hughes
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Laura J Corbin
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - George Davey Smith
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicole Soranzo
- Wellcome Sanger Institute, Hinxton, UK
- Department of Haematology, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - John Danesh
- Wellcome Sanger Institute, Hinxton, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - Emanuele Di Angelantonio
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - Willem H Ouwehand
- Wellcome Sanger Institute, Hinxton, UK
- Department of Haematology, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- NHS Blood and Transplant, Cambridge Biomedical Campus, Cambridge, UK
| | | | - David J Roberts
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- NHS Blood and Transplant-Oxford Centre, Level 2, John Radcliffe Hospital, Oxford, UK
- Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Adam S Butterworth
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
| | - Ingeborg Hers
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
- Bristol Heart Institute, Bristol, UK
| | - Nicholas J Timpson
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Bell JA, Wade KH, O’Keeffe LM, Carslake D, Vincent EE, Holmes MV, Timpson NJ, Davey Smith G. Body muscle gain and markers of cardiovascular disease susceptibility in young adulthood: A cohort study. PLoS Med 2021; 18:e1003751. [PMID: 34499663 PMCID: PMC8428664 DOI: 10.1371/journal.pmed.1003751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 08/03/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The potential benefits of gaining body muscle for cardiovascular disease (CVD) susceptibility, and how these compare with the potential harms of gaining body fat, are unknown. We compared associations of early life changes in body lean mass and handgrip strength versus body fat mass with atherogenic traits measured in young adulthood. METHODS AND FINDINGS Data were from 3,227 offspring of the Avon Longitudinal Study of Parents and Children (39% male; recruited in 1991-1992). Limb lean and total fat mass indices (kg/m2) were measured using dual-energy X-ray absorptiometry scans performed at age 10, 13, 18, and 25 y (across clinics occurring from 2001-2003 to 2015-2017). Handgrip strength was measured at 12 and 25 y, expressed as maximum grip (kg or lb/in2) and relative grip (maximum grip/weight in kilograms). Linear regression models were used to examine associations of change in standardised measures of these exposures across different stages of body development with 228 cardiometabolic traits measured at age 25 y including blood pressure, fasting insulin, and metabolomics-derived apolipoprotein B lipids. SD-unit gain in limb lean mass index from 10 to 25 y was positively associated with atherogenic traits including very-low-density lipoprotein (VLDL) triglycerides. This pattern was limited to lean gain in legs, whereas lean gain in arms was inversely associated with traits including VLDL triglycerides, insulin, and glycoprotein acetyls, and was also positively associated with creatinine (a muscle product and positive control). Furthermore, this pattern for arm lean mass index was specific to SD-unit gains occurring between 13 and 18 y, e.g., -0.13 SD (95% CI -0.22, -0.04) for VLDL triglycerides. Changes in maximum and relative grip from 12 to 25 y were both positively associated with creatinine, but only change in relative grip was also inversely associated with atherogenic traits, e.g., -0.12 SD (95% CI -0.18, -0.06) for VLDL triglycerides per SD-unit gain. Change in fat mass index from 10 to 25 y was more strongly associated with atherogenic traits including VLDL triglycerides, at 0.45 SD (95% CI 0.39, 0.52); these estimates were directionally consistent across sub-periods, with larger effect sizes with more recent gains. Associations of lean, grip, and fat measures with traits were more pronounced among males. Study limitations include potential residual confounding of observational estimates, including by ectopic fat within muscle, and the absence of grip measures in adolescence for estimates of grip change over sub-periods. CONCLUSIONS In this study, we found that muscle strengthening, as indicated by grip strength gain, was weakly associated with lower atherogenic trait levels in young adulthood, at a smaller magnitude than unfavourable associations of fat mass gain. Associations of muscle mass gain with such traits appear to be smaller and limited to gains occurring in adolescence. These results suggest that body muscle is less robustly associated with markers of CVD susceptibility than body fat and may therefore be a lower-priority intervention target.
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Affiliation(s)
- Joshua A. Bell
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Kaitlin H. Wade
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Linda M. O’Keeffe
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- School of Public Health, University College Cork, Cork, Ireland
| | - David Carslake
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Emma E. Vincent
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
| | - Michael V. Holmes
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- MRC Population Health Research Unit, University of Oxford, Oxford, United Kingdom
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospital, Oxford, United Kingdom
| | - Nicholas J. Timpson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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41
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Anwar MY, Raffield LM, Lange LA, Correa A, Taylor KC. Genetic underpinnings of regional adiposity distribution in African Americans: Assessments from the Jackson Heart Study. PLoS One 2021; 16:e0255609. [PMID: 34347846 PMCID: PMC8336790 DOI: 10.1371/journal.pone.0255609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 07/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND African ancestry individuals with comparable overall anthropometric measures to Europeans have lower abdominal adiposity. To explore the genetic underpinning of different adiposity patterns, we investigated whether genetic risk scores for well-studied adiposity phenotypes like body mass index (BMI) and waist circumference (WC) also predict other, less commonly measured adiposity measures in 2420 African American individuals from the Jackson Heart Study. METHODS Polygenic risk scores (PRS) were calculated using GWAS-significant variants extracted from published studies mostly representing European ancestry populations for BMI, waist-hip ratio (WHR) adjusted for BMI (WHRBMIadj), waist circumference adjusted for BMI (WCBMIadj), and body fat percentage (BF%). Associations between each PRS and adiposity measures including BF%, subcutaneous adiposity tissue (SAT), visceral adiposity tissue (VAT) and VAT:SAT ratio (VSR) were examined using multivariable linear regression, with or without BMI adjustment. RESULTS In non-BMI adjusted models, all phenotype-PRS were found to be positive predictors of BF%, SAT and VAT. WHR-PRS was a positive predictor of VSR, but BF% and BMI-PRS were negative predictors of VSR. After adjusting for BMI, WHR-PRS remained a positive predictor of BF%, VAT and VSR but not SAT. WC-PRS was a positive predictor of SAT and VAT; BF%-PRS was a positive predictor of BF% and SAT only. CONCLUSION These analyses suggest that genetically driven increases in BF% strongly associate with subcutaneous rather than visceral adiposity and BF% is strongly associated with BMI but not central adiposity-associated genetic variants. How common genetic variants may contribute to observed differences in adiposity patterns between African and European ancestry individuals requires further study.
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Affiliation(s)
- Mohammad Y. Anwar
- School of Public Health & Information Sciences, The University of Louisville, Louisville, KY, United States of America
| | - Laura M. Raffield
- Department of Genetics, University of North Carolina, Chapel Hill, NC, United States of America
| | - Leslie A. Lange
- Division of Biomedical Informatics and Personalized Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Adolfo Correa
- Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Kira C. Taylor
- School of Public Health & Information Sciences, The University of Louisville, Louisville, KY, United States of America
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42
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Murray R, Kitaba N, Antoun E, Titcombe P, Barton S, Cooper C, Inskip HM, Burdge GC, Mahon PA, Deanfield J, Halcox JP, Ellins EA, Bryant J, Peebles C, Lillycrop K, Godfrey KM, Hanson MA. Influence of Maternal Lifestyle and Diet on Perinatal DNA Methylation Signatures Associated With Childhood Arterial Stiffness at 8 to 9 Years. Hypertension 2021; 78:787-800. [PMID: 34275334 PMCID: PMC8357051 DOI: 10.1161/hypertensionaha.121.17396] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Supplemental Digital Content is available in the text. Increases in aortic pulse wave velocity, a measure of arterial stiffness, can lead to elevated systolic blood pressure and increased cardiac afterload in adulthood. These changes are detectable in childhood and potentially originate in utero, where an adverse early life environment can alter DNA methylation patterns detectable at birth. Here, analysis of epigenome-wide methylation patterns using umbilical cord blood DNA from 470 participants in the Southampton’s Women’s Survey identified differential methylation patterns associated with systolic blood pressure, pulse pressure, arterial distensibility, and descending aorta pulse wave velocity measured by magnetic resonance imaging at 8 to 9 years. Perinatal methylation levels at 16 CpG loci were associated with descending aorta pulse wave velocity, with identified CpG sites enriched in pathways involved in DNA repair (P=9.03×10−11). The most significant association was with cg20793626 methylation (within protein phosphatase, Mg2+/Mn2+ dependent 1D; β=−0.05 m/s/1% methylation change, [95% CI, −0.09 to −0.02]). Genetic variation was also examined but had a minor influence on these observations. Eight pulse wave velocity-linked dmCpGs were associated with prenatal modifiable risk factors, with cg08509237 methylation (within palmitoyl-protein thioesterase-2) associated with maternal oily fish consumption in early and late pregnancy. Lower oily fish consumption in early pregnancy modified the relationship between methylation and pulse wave velocity, with lower consumption strengthening the association between cg08509237 methylation and increased pulse wave velocity. In conclusion, measurement of perinatal DNA methylation signatures has utility in identifying infants who might benefit from preventive interventions to reduce risk of later cardiovascular disease, and modifiable maternal factors can reduce this risk in the child.
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Affiliation(s)
- Robert Murray
- From the School of Human Development and Health, Institute of Developmental Sciences Building, Faculty of Medicine (R.M., N.K., E.A., G.C.B., K.M.G., M.A.H.), University of Southampton, United Kingdom
| | - Negusse Kitaba
- From the School of Human Development and Health, Institute of Developmental Sciences Building, Faculty of Medicine (R.M., N.K., E.A., G.C.B., K.M.G., M.A.H.), University of Southampton, United Kingdom
| | - Elie Antoun
- From the School of Human Development and Health, Institute of Developmental Sciences Building, Faculty of Medicine (R.M., N.K., E.A., G.C.B., K.M.G., M.A.H.), University of Southampton, United Kingdom.,Centre for Biological Sciences, Faculty of Natural and Environmental Sciences (E.A., K.L.), University of Southampton, United Kingdom
| | - Philip Titcombe
- MRC Lifecourse Epidemiology Unit (P.T., S.B., C.C., H.M.I., P.A.M., K.M.G.), University of Southampton, United Kingdom
| | - Sheila Barton
- MRC Lifecourse Epidemiology Unit (P.T., S.B., C.C., H.M.I., P.A.M., K.M.G.), University of Southampton, United Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit (P.T., S.B., C.C., H.M.I., P.A.M., K.M.G.), University of Southampton, United Kingdom
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Unit (P.T., S.B., C.C., H.M.I., P.A.M., K.M.G.), University of Southampton, United Kingdom.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, United Kingdom (H.M.I., K.L., K.M.G., M.A.H.)
| | - Graham C Burdge
- From the School of Human Development and Health, Institute of Developmental Sciences Building, Faculty of Medicine (R.M., N.K., E.A., G.C.B., K.M.G., M.A.H.), University of Southampton, United Kingdom
| | - Pamela A Mahon
- MRC Lifecourse Epidemiology Unit (P.T., S.B., C.C., H.M.I., P.A.M., K.M.G.), University of Southampton, United Kingdom
| | - John Deanfield
- Institute of Cardiovascular Sciences, University College London, United Kingdom (J.D.)
| | - Julian P Halcox
- Swansea University Medical School, Swansea University, United Kingdom (J.P.H., E.A.E.)
| | - Elizabeth A Ellins
- Swansea University Medical School, Swansea University, United Kingdom (J.P.H., E.A.E.)
| | - Jennifer Bryant
- Department of Cardiac Magnetic Resonance Imaging, National Heart Centre Singapore (J.B.)
| | - Charles Peebles
- Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, United Kingdom (C.P.)
| | - Karen Lillycrop
- Centre for Biological Sciences, Faculty of Natural and Environmental Sciences (E.A., K.L.), University of Southampton, United Kingdom.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, United Kingdom (H.M.I., K.L., K.M.G., M.A.H.)
| | - Keith M Godfrey
- From the School of Human Development and Health, Institute of Developmental Sciences Building, Faculty of Medicine (R.M., N.K., E.A., G.C.B., K.M.G., M.A.H.), University of Southampton, United Kingdom.,MRC Lifecourse Epidemiology Unit (P.T., S.B., C.C., H.M.I., P.A.M., K.M.G.), University of Southampton, United Kingdom.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, United Kingdom (H.M.I., K.L., K.M.G., M.A.H.)
| | - Mark A Hanson
- From the School of Human Development and Health, Institute of Developmental Sciences Building, Faculty of Medicine (R.M., N.K., E.A., G.C.B., K.M.G., M.A.H.), University of Southampton, United Kingdom.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, United Kingdom (H.M.I., K.L., K.M.G., M.A.H.)
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Seo YG, Kim Y, Lim H, Kang MJ, Park KH. Relationship Between Bone Mineral Density and Body Composition According to Obesity Status in Children. Endocr Pract 2021; 27:983-991. [PMID: 34144210 DOI: 10.1016/j.eprac.2021.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/03/2021] [Accepted: 06/09/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To analyze the relationship between body composition, metabolic parameters, and bone mineral density (BMD) according to sex and the degree of obesity in children and adolescents. METHODS A total of 236 subjects with obesity, aged 10 to 15 years (36.9% girls), were enrolled. Obesity was classified into simple (SmOb) and extreme (ExOb) forms. The BMD of the total body, less head, was measured by dual energy x-ray absorptiometry, and the BMD z-score was used to evaluate the relationship of body composition with metabolic parameters. RESULTS BMD z-scores were higher in subjects with ExOb than in those with SmOb. Lean mass index (LMI), body mass index z-score, and vitamin D intake showed positive relationships, whereas percentage of body fat and serum leptin level showed negative relationships with BMD z-scores in boys. In girls, LMI and body mass index z-score showed positive relationships with BMD z-scores. In multivariable linear regressions, serum leptin level showed negative relationships with BMD z-score, only in boys. In addition, positive relationships of LMI and negative relationships of percentage of body fat with BMD z-scores were observed in subjects with SmOb. However, positive relationships of LMI with BMD z-scores were attenuated in subjects with ExOb. CONCLUSION High BMD appears to be positively associated with lean mass in children and adolescents with obesity, which might be a natural protective mechanism to withstand the excess weight. However, excessive body fat appears to be negatively associated with BMD, which might attenuate the positive relationship between lean mass and BMD in subjects with ExOb.
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Affiliation(s)
- Young-Gyun Seo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - YoonMyung Kim
- University College, Yonsei University International Campus, Incheon, Republic of Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Kyung Hee University, Yongin, Republic of Korea
| | - Min Jae Kang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
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44
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Kerkadi A, Mohsen Ali R, A. H. Shehada A, Abdelnasser AbouHassanein E, Moawad J, Bawadi H, Shi Z. Association between central obesity indices and iron status indicators among Qatari adults. PLoS One 2021; 16:e0250759. [PMID: 33914792 PMCID: PMC8084168 DOI: 10.1371/journal.pone.0250759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 04/13/2021] [Indexed: 12/20/2022] Open
Abstract
Co-existence of iron deficiency and obesity in adults has been reported in many countries. However, little is known on the association between obesity and iron deficiency in Qatar. This study aimed to investigate the link between abdominal obesity indices and iron status among adults in Qatar. A random sample of 1000 healthy Qatari adults, aged 20-50 years, was obtained from Qatar Biobank study. Body weight, waist circumference, dual x-ray absorptiometry (DXA) parameters and iron status indicators were measured using standard techniques. Multiple regression analysis was used to examine the associations. The prevalence of iron deficiency and anaemia were 35.4 and 25%, respectively. Of the participants with a large waist circumference, 31.7% had anaemia. Ferritin significantly increased with the increase in the android fat to gynoid fat ratio and visceral fat in both genders. Serum iron and transferring saturation decreased significantly with the increase in waist circumference in women. In both genders, C-reactive protein increased with the increase in all obesity indices. Standardized values of waist circumference, android fat, gynoid fat ratio and visceral fat were significantly associated with log transformed ferritin in men and women. Waist circumference was inversely related to serum iron (β:-0.95, 95% CI:-1.50,-0.39) and transferrin saturation (β:-1.45, 95%CI:-2.46, -0.43) in women. In men, waist circumference was positively associated with haemoglobin level (β: 0.16, 95% CI:0.04, 0.29). Central obesity coexists with anaemia among the study population. Elevated central obesity indices were associated with an increase in ferritin concentration. The increased ferritin concentration may be attributed to the increase in inflammatory status as a result of an increase in c-reactive protein concentration associated with central obesity.
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Affiliation(s)
- Abdelhamid Kerkadi
- Human Nutrition Department, College of Health Sciences, Qu-Health, Qatar University, Doha, Qatar
| | - Reem Mohsen Ali
- Human Nutrition Department, College of Health Sciences, Qu-Health, Qatar University, Doha, Qatar
| | - Alaa A. H. Shehada
- Human Nutrition Department, College of Health Sciences, Qu-Health, Qatar University, Doha, Qatar
| | | | - Joyce Moawad
- Human Nutrition Department, College of Health Sciences, Qu-Health, Qatar University, Doha, Qatar
| | - Hiba Bawadi
- Human Nutrition Department, College of Health Sciences, Qu-Health, Qatar University, Doha, Qatar
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, Qu-Health, Qatar University, Doha, Qatar
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45
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Abstract
The known genetic architecture of blood pressure now comprises >30 genes, with rare variants resulting in monogenic forms of hypertension or hypotension and >1,477 common single-nucleotide polymorphisms (SNPs) being associated with the blood pressure phenotype. Monogenic blood pressure syndromes predominantly involve the renin-angiotensin-aldosterone system and the adrenal glucocorticoid pathway, with a smaller fraction caused by neuroendocrine tumours of the sympathetic and parasympathetic nervous systems. The SNPs identified in genome-wide association studies (GWAS) as being associated with the blood pressure phenotype explain only approximately 27% of the 30-50% estimated heritability of blood pressure, and the effect of each SNP on the blood pressure phenotype is small. A paucity of SNPs from GWAS are mapped to known genes causing monogenic blood pressure syndromes. For example, a GWAS signal mapped to the gene encoding uromodulin has been shown to affect blood pressure by influencing sodium homeostasis, and the effects of another GWAS signal were mediated by endothelin. However, the majority of blood pressure-associated SNPs show pleiotropic associations. Unravelling these associations can potentially help us to understand the underlying biological pathways. In this Review, we appraise the current knowledge of blood pressure genomics, explore the causal pathways for hypertension identified in Mendelian randomization studies and highlight the opportunities for drug repurposing and pharmacogenomics for the treatment of hypertension.
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Affiliation(s)
- Sandosh Padmanabhan
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Anna F Dominiczak
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
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46
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Santorelli G, West J, Yang T, Wright J, Bryant M, Lawlor D. Differences in total and regional body fat and their association with BMI in UK-born White and South Asian children: findings from the Born in Bradford birth cohort. Wellcome Open Res 2021. [DOI: 10.12688/wellcomeopenres.16659.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Body mass index (BMI) is commonly used as a proxy to determine excess adiposity, though this may underestimate fat mass (FM) in individuals of South Asian (SA) heritage. SA tend to have greater central adiposity than white people, which is associated with a higher risk of cardiometabolic disease. In this cross-sectional study, we aimed to determine the differences in total and regional FM using Dual-energy X-ray absorptiometry (DXA), and to see if any differences in FM varied by BMI category in UK-born white and SA children aged ~9 years. Methods: Anthropometric measurements and DXA scans were undertaken from 225 white and 269 SA children from the Born in Bradford cohort study. Linear regression was used to assess ethnic differences in total body fat percent and total and regional FM. Results: Although the mean BMI was similar, compared to white children, the proportion of SA children who were overweight or obese was ~20% higher, they had a median of 2kg more total FM, and the proportion with > 35% total body fat (TBF) was 22% and 16% higher in boys and girls respectively. Mean TBF% was greater in each BMI category, as was truncal, android and gynoid FM, with the greatest differences between ethnic groups observed in the healthy and overweight categories. Conclusions: Greater TBF% and total and regional FM in the healthy- and overweight BMI categories observed in SA children suggests they may be at greater risk of future cardiometabolic disease at a BMI level below obesity threshold. However, our sample size was small, and results may be influenced by selection bias and confounding; our findings need to be replicated in a larger study.
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47
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Zhang CH, Sheng JQ, Xie WH, Luo XQ, Xue YN, Xu GL, Chen C. Mechanism and Basis of Traditional Chinese Medicine Against Obesity: Prevention and Treatment Strategies. Front Pharmacol 2021; 12:615895. [PMID: 33762940 PMCID: PMC7982543 DOI: 10.3389/fphar.2021.615895] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 01/26/2021] [Indexed: 12/13/2022] Open
Abstract
In the last few decades, the incidences of obesity and related metabolic disorders worldwide have increased dramatically. Major pathophysiology of obesity is termed "lipotoxicity" in modern western medicine (MWM) or "dampness-heat" in traditional Chinese medicine (TCM). "Dampness-heat" is a very common and critically important syndrome to guild clinical treatment in TCM. However, the pathogenesis of obesity in TCM is not fully clarified, especially by MWM theories compared to TCM. In this review, the mechanism underlying the action of TCM in the treatment of obesity and related metabolic disorders was thoroughly discussed, and prevention and treatment strategies were proposed accordingly. Hypoxia and inflammation caused by lipotoxicity exist in obesity and are key pathophysiological characteristics of "dampness-heat" syndrome in TCM. "Dampness-heat" is prevalent in chronic low-grade systemic inflammation, prone to insulin resistance (IR), and causes variant metabolic disorders. In particular, the MWM theories of hypoxia and inflammation were applied to explain the "dampness-heat" syndrome of TCM, and we summarized and proposed the pathological path of obesity: lipotoxicity, hypoxia or chronic low-grade inflammation, IR, and metabolic disorders. This provides significant enrichment to the scientific connotation of TCM theories and promotes the modernization of TCM.
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Affiliation(s)
- Chang-Hua Zhang
- College of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Jun-Qing Sheng
- College of Life Science, Nanchang University, Nanchang, China
| | - Wei-Hua Xie
- College of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Xiao-Quan Luo
- Experimental Animal Science and Technology Center of TCM, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Ya-Nan Xue
- College of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Guo-Liang Xu
- Research Center for Differentiation and Development of Basic Theory of TCM, Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Chen Chen
- School of Biomedical Sciences, University of Queensland, Brisbane, QLD, Australia
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48
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Anderson AS, Renehan AG, Saxton JM, Bell J, Cade J, Cross AJ, King A, Riboli E, Sniehotta F, Treweek S, Martin RM. Cancer prevention through weight control-where are we in 2020? Br J Cancer 2021; 124:1049-1056. [PMID: 33235315 PMCID: PMC7960959 DOI: 10.1038/s41416-020-01154-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 10/07/2020] [Accepted: 10/22/2020] [Indexed: 02/07/2023] Open
Abstract
Growing data from epidemiological studies highlight the association between excess body fat and cancer incidence, but good indicative evidence demonstrates that intentional weight loss, as well as increasing physical activity, offers much promise as a cost-effective approach for reducing the cancer burden. However, clear gaps remain in our understanding of how changes in body fat or levels of physical activity are mechanistically linked to cancer, and the magnitude of their impact on cancer risk. It is important to investigate the causal link between programmes that successfully achieve short-term modest weight loss followed by weight-loss maintenance and cancer incidence. The longer-term impact of weight loss and duration of overweight and obesity on risk reduction also need to be fully considered in trial design. These gaps in knowledge need to be urgently addressed to expedite the development and implementation of future cancer-control strategies. Comprehensive approaches to trial design, Mendelian randomisation studies and data-linkage opportunities offer real possibilities to tackle current research gaps. In this paper, we set out the case for why non-pharmacological weight-management trials are urgently needed to support cancer-risk reduction and help control the growing global burden of cancer.
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Affiliation(s)
- Annie S Anderson
- Centre for Research into Cancer Prevention and Screening, Division of Population Health & Genomics. Level 7, Mailbox 7, University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK.
| | - Andrew G Renehan
- The Christie NHS Foundation Trust, Manchester Cancer Research Centre, NIHR Manchester Biomedical Research Centre, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health University of Manchester, Wilmslow Rd, Manchester, M20 4BX, UK
| | - John M Saxton
- Department of Sport, Exercise & Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Room 259, Northumberland Building, Newcastle Upon Tyne, NE1 8ST, UK
| | - Joshua Bell
- MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK
| | - Janet Cade
- Nutritional Epidemiology Group, School of Food Science and Nutrition, G11, Stead House, University of Leeds, Leeds, LS2 9JT, UK
| | - Amanda J Cross
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Angela King
- NIHR Cancer and Nutrition Collaboration, Level E and Pathology Block (mailpoint 123), Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London, W2 1PG, UK
| | - Falko Sniehotta
- Policy Research Unit Behavioural Science, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Room 306, 3rd Floor, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, UK
| | - Richard M Martin
- MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Bristol, BS8 2BN, UK
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Body mass index and potential correlates among elementary school children in Jordan. Eat Weight Disord 2021; 26:629-638. [PMID: 32328908 DOI: 10.1007/s40519-020-00899-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/01/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Childhood obesity and overweight are on the rise worldwide, and Jordanian children are no exception to this rule. Childhood Obesity has major implications on the physical and mental health of individuals, and it can often develop into adult obesity. Obesity/overweight correlates have not been researched extensively in the Middle East region, where Jordan is central. This region is undergoing tremendous changes because of wars, globalization, and the influx of refugees. The cultural and eating habits of the people are changing along with demographical changes. Thus, timely research is required to assess the current health state of this dynamic society. The main goal of this study is to understand the environmental and cultural factors that are associated with Body Mass Index (BMI) z score in elementary school children in Jordan. METHODS A total of 1260 children enrolled in this descriptive, cross-sectional study. The study used a parental self-reporting questionnaire that contains possible factors associated with BMI, zBMI, demographics, and other pertinent information. RESULTS Several factors have been associated with higher zBMI among elementary school children: if a child owns a smartphone (p = 0.0037), uses electronics to play ([Formula: see text]), uses electronics for longer hours ([Formula: see text]), eats food while using electronics or watching TV ([Formula: see text] and [Formula: see text], respectively), sleeps less hours in weekends ([Formula: see text]), was breastfed for lower number of months ([Formula: see text]), lives in rural areas ([Formula: see text]), goes to a private school ([Formula: see text]) and is a male ([Formula: see text]). CONCLUSION Investigating characteristics and environmental determinants of childhood obesity play an essential role in establishing effective intervention program and reduce future risks of morbidity. LEVEL OF EVIDENCE Level V, descriptive (cross-sectional) study.
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50
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Bell JA, Santos Ferreira DL, Fraser A, Soares ALG, Howe LD, Lawlor DA, Carslake D, Davey Smith G, O'Keeffe LM. Sex differences in systemic metabolites at four life stages: cohort study with repeated metabolomics. BMC Med 2021; 19:58. [PMID: 33622307 PMCID: PMC7903597 DOI: 10.1186/s12916-021-01929-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/27/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Males experience higher rates of coronary heart disease (CHD) than females, but the circulating traits underpinning this difference are poorly understood. We examined sex differences in systemic metabolites measured at four life stages, spanning childhood to middle adulthood. METHODS Data were from the Avon Longitudinal Study of Parents and Children (7727 offspring, 49% male; and 6500 parents, 29% male). Proton nuclear magnetic resonance (1H-NMR) spectroscopy from a targeted metabolomics platform was performed on EDTA-plasma or serum samples to quantify 229 systemic metabolites (including lipoprotein-subclass-specific lipids, pre-glycaemic factors, and inflammatory glycoprotein acetyls). Metabolites were measured in the same offspring once in childhood (mean age 8 years), twice in adolescence (16 years and 18 years) and once in early adulthood (25 years), and in their parents once in middle adulthood (50 years). Linear regression models estimated differences in metabolites for males versus females on each occasion (serial cross-sectional associations). RESULTS At 8 years, total lipids in very-low-density lipoproteins (VLDL) were lower in males; levels were higher in males at 16 years and higher still by 18 years and 50 years (among parents) for medium-or-larger subclasses. Larger sex differences at older ages were most pronounced for VLDL triglycerides-males had 0.19 standard deviations (SD) (95% CI = 0.12, 0.26) higher at 18 years, 0.50 SD (95% CI = 0.42, 0.57) higher at 25 years, and 0.62 SD (95% CI = 0.55, 0.68) higher at 50 years. Low-density lipoprotein (LDL) cholesterol, apolipoprotein-B, and glycoprotein acetyls were generally lower in males across ages. The direction and magnitude of effects were largely unchanged when adjusting for body mass index measured at the time of metabolite assessment on each occasion. CONCLUSIONS Our results suggest that males begin to have higher VLDL triglyceride levels in adolescence, with larger sex differences at older ages. Sex differences in other CHD-relevant metabolites, including LDL cholesterol, show the opposite pattern with age, with higher levels among females. Such life course trends may inform causal analyses with clinical endpoints in specifying traits which underpin higher age-adjusted CHD rates commonly seen among males.
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Affiliation(s)
- Joshua A Bell
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Bristol, BS8 2BN, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Diana L Santos Ferreira
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ana Luiza G Soares
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol NIHR Biomedical Research Centre, Bristol, UK
| | - David Carslake
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Bristol NIHR Biomedical Research Centre, Bristol, UK
| | - Linda M O'Keeffe
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Bristol, BS8 2BN, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- School of Public Health, Western Gateway Building, University College Cork, Cork, Ireland
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