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Kahn FK, Wake M, Lycett K, Clifford S, Burgner DP, Goldsmith G, Grobler AC, Lange K, Cheung M. Vascular function and stiffness: population epidemiology and concordance in Australian children aged 11-12 years and their parents. BMJ Open 2019; 9:34-43. [PMID: 31273014 PMCID: PMC6624058 DOI: 10.1136/bmjopen-2017-020896] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To describe the epidemiology and parent-child concordance of vascular function in a population-based sample of Australian parent-child dyads at child age 11-12 years. DESIGN Cross-sectional study (Child Health CheckPoint), nested within a prospective cohort study, the Longitudinal Study of Australian Children (LSAC). SETTING Assessment centres in seven major Australian cities and eight regional towns or home visits, February 2015-March 2016. PARTICIPANTS Of all participating CheckPoint families (n=1874), 1840 children (49% girls) and 1802 parents (88% mothers) provided vascular function data. Survey weights and methods were applied to account for LSAC's complex sample design and clustering within postcodes and strata. OUTCOME MEASURES The SphygmoCor XCEL assessed vascular function, generating estimates of brachial and central systolic blood pressure and diastolic blood pressure, central pulse pressure, augmentation index and carotid-femoral pulse wave velocity. Pearson's correlation coefficients and multivariable linear regression models estimated parent-child concordance. RESULTS Hypertension was present in 3.9% of children and 9.0% of parents. Mean child and parent values for augmentation index were 4.5% (SD 11.6) and 21.3% (SD 12.3), respectively, and those for carotid-femoral pulse wave velocity were 4.48 m/s (SD 0.59) and 6.85 m/s (SD 1.14), respectively. Parent-child correlation for brachial systolic blood pressure was 0.20 (95% CI 0.15 to 0.24), brachial diastolic blood pressure 0.21 (95% CI 0.16 to 0.26), central systolic blood pressure 0.21 (95% CI 0.16 to 0.25), central diastolic blood pressure 0.21 (95% CI0.17 to 0.26), central pulse pressure 0.19 (95% CI 0.14 to 0.24), augmentation index 0.28 (95% CI 0.23 to 0.32) and pulse wave velocity 0.22 (95% CI 0.18 to 0.27). CONCLUSIONS We report Australian values for traditional and more novel vascular function markers, providing a reference for future population studies. Cross-generational concordance in multiple vascular function markers is already established by age 11-12 years, with mechanisms of heritability remaining to be explored.
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Affiliation(s)
- Freya K Kahn
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Cardiology, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Kate Lycett
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Susan Clifford
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - David P Burgner
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Greta Goldsmith
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Katherine Lange
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Michael Cheung
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Cardiology, The Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
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Berentzen NE, Wijga AH, van Rossem L, Koppelman GH, van Nieuwenhuizen B, Gehring U, Spijkerman AMW, Smit HA. Family history of myocardial infarction, stroke and diabetes and cardiometabolic markers in children. Diabetologia 2016; 59:1666-74. [PMID: 27239670 DOI: 10.1007/s00125-016-3988-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/22/2016] [Indexed: 01/15/2023]
Abstract
AIMS/HYPOTHESIS Despite the overlap in occurrence of cardiovascular disease (CVD) and type 2 diabetes and their risk factors, family history of these diseases has not yet been investigated simultaneously in relation to cardiometabolic markers in offspring. We examined how a family history of CVD and/or diabetes relates to cardiometabolic markers in offspring, and to what extent these diseases independently contribute to cardiometabolic markers. METHODS We used data from 1,374 12-year-old children and their parents participating in a birth cohort study in the Netherlands. Family history of CVD (myocardial infarction [MI] and stroke) and diabetes were reported by the parents. Children were classified as 'no', 'moderate' or 'strong' family history, based on early/late onset of disease in parents and grandparents. Cardiometabolic markers were measured at 12 years of age: waist circumference, cholesterol, blood pressure and HbA1c. RESULTS Compared with those with no family history, children with a strong family history of MI and/or stroke and/or diabetes (29% of the study population) had 0.13 mmol/l higher total cholesterol (TC) (95% CI 0.03, 0.23) and 0.18 higher TC/HDL-cholesterol (HDLC) ratio (95% CI 0.04, 0.32). A strong family history of MI or diabetes was independently associated with unfavourable cardiometabolic markers specific to those diseases. These associations remained after adjusting for BMI. Children with a moderate family history had no unfavourable cardiometabolic markers. CONCLUSIONS/INTERPRETATION One-third of the children had a strong family history of CVD and/or diabetes. These children had higher TC levels and TC/HDLC ratios than children with no family history. A strong family history of MI or diabetes was independently associated with unfavourable cardiometabolic markers specific to those diseases.
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Affiliation(s)
- Nina E Berentzen
- Center for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Alet H Wijga
- Center for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, the Netherlands.
| | - Lenie van Rossem
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Gerard H Koppelman
- University of Groningen, UMCG, Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, GRIAC Research Institute, Groningen, the Netherlands
| | - Bo van Nieuwenhuizen
- Center for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, the Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Annemieke M W Spijkerman
- Center for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, the Netherlands
| | - Henriëtte A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
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Khoury M, Manlhiot C, Gibson D, Chahal N, Stearne K, Dobbin S, McCrindle BW. Universal screening for cardiovascular disease risk factors in adolescents to identify high-risk families: a population-based cross-sectional study. BMC Pediatr 2016; 16:11. [PMID: 26795037 PMCID: PMC4721118 DOI: 10.1186/s12887-016-0548-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 01/12/2016] [Indexed: 11/11/2022] Open
Abstract
Background Universal screening of children for dyslipidemia and other cardiovascular risk factors has been recommended. Given the clustering of cardiovascular risk factors within families, one benefit of screening adolescents may be to identify “at-risk” families in which adult members might also be at elevated risk and potentially benefit from medical evaluation. Methods Cross-sectional study of grade 9 students evaluating adiposity, lipids and blood pressure. Data collected by Heart Niagara Inc. through the Healthy Heart Schools’ Program. Parents completed questionnaires, evaluating family history of dyslipidemia, hypertension, diabetes and early cardiovascular disease events in parents and siblings (first-degree relatives), and grandparents (second-degree relatives). Associations between positive risk factor findings in adolescents and presence of a positive family history were assessed in logistic regression models. Results N = 4014 adolescents ages 14–15 years were screened; 3467 (86 %) provided family medical history. Amongst adolescents, 4.7 % had dyslipidemia, 9.5 % had obesity, and 3.5 % had elevated blood pressure. Central adiposity (waist-to-height ratio ≥0.5) in the adolescent was associated with increased odds of diabetes in first- (OR:2.0 (1.6–2.6), p < 0.001) and second-degree relatives (OR:1.3 (1.1–1.6), p = 0.002). Dyslipidemia was associated with increased odds of diabetes (OR:1.6 (1.1–2.3), p < 0.001), hypertension (OR:2.2 (1.5–3.2), p < 0.001) and dyslipidemia (OR:2.2 (1.5–3.2),p < 0.001) in first degree relatives. Elevated blood pressure did not identify increased odds of a positive family history. Conclusions Presence of obesity and/or dyslipidemia in adolescents identified through a universal school-based screening program is associated with risk factor clustering within families. Universal pediatric cardiometabolic screening may be an effective entry into reverse cascade screening.
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Affiliation(s)
- Michael Khoury
- Labatt Family Heart Centre, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Cedric Manlhiot
- Labatt Family Heart Centre, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Don Gibson
- Heart Niagara Inc., Niagara Falls, ON, Canada
| | - Nita Chahal
- Labatt Family Heart Centre, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | | | | | - Brian W McCrindle
- Labatt Family Heart Centre, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
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de Ferranti SD. Familial hypercholesterolemia in children and adolescents: A clinical perspective. J Clin Lipidol 2015; 9:S11-9. [DOI: 10.1016/j.jacl.2015.04.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 04/25/2015] [Indexed: 11/16/2022]
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Gidding SS, Prospero C, Hossain J, Zappalla F, Balagopal P(B, Falkner B, Kwiterovich P. A double-blind randomized trial of fish oil to lower triglycerides and improve cardiometabolic risk in adolescents. J Pediatr 2014; 165:497-503.e2. [PMID: 25008950 PMCID: PMC5646219 DOI: 10.1016/j.jpeds.2014.05.039] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 03/18/2014] [Accepted: 05/22/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the efficacy of 4 g/day fish oil to lower triglycerides and impact lipoprotein particles, inflammation, insulin resistance, coagulation, and thrombosis. STUDY DESIGN Participants (n = 42, age 14 ± 2 years) with hypertriglyceridemia and low-density lipoprotein (LDL) cholesterol <160 mg/dL were enrolled in a randomized, double-blind, crossover trial comparing 4 g of fish oil daily with placebo. Treatment interval was 8 weeks with a 4-week washout. Lipid profile, lipoprotein particle distribution and size, glucose, insulin, high-sensitivity C-reactive protein, interleukin-6, fibrinogen, plasminogen activator inhibitor-1, and thrombin generation were measured. RESULTS Baseline lipid profile was total cholesterol 194 (5.4) mg/dL (mean [SE]), triglycerides 272 (21) mg/dL, high-density lipoprotein cholesterol 39 (1) mg/dL, and LDL cholesterol 112 (3.7) mg/dl. LDL particle number was 1614 (60) nmol/L, LDL size was 19.9 (1.4) nm, and large very low-density lipoprotein/chylomicron particle number was 9.6 (1.4) nmol/L. Triglycerides decreased on fish oil treatment but the difference was not significant compared with placebo (-52 ± 16 mg/dL vs -16 ± 16 mg/dL). Large very low-density lipoprotein particle number was reduced (-5.83 ± 1.29 nmol/L vs -0.96 ± 1.31 nmol/L; P < .0001). There was no change in LDL particle number or size. There was a trend towards a lower prothrombotic state (lower fibrinogen and plasminogen activator inhibitor-1; .10 > P > .05); no other group differences were seen. CONCLUSIONS In children, fish oil (4 g/day) lowers triglycerides slightly and may have an antithrombotic effect but has no effect on LDL particles.
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Affiliation(s)
- Samuel S. Gidding
- Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE,Division of Nephrology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA
| | - Carol Prospero
- Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE
| | - Jobayer Hossain
- Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE
| | - Frances Zappalla
- Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, DE,Division of Nephrology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA
| | - Prabhakaran (Babu) Balagopal
- Department of Research, The Nemours Children’s Clinic, Wilmington, DE,Mayo Clinic College of Medicine, Rochester, MN
| | - Bonita Falkner
- Division of Nephrology, Department of Internal Medicine, Thomas Jefferson University, Philadelphia, PA
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Glueck CJ, Morrison JA, Wang P, Woo JG. Early and late menarche are associated with oligomenorrhea and predict metabolic syndrome 26 years later. Metabolism 2013; 62:1597-606. [PMID: 23953892 DOI: 10.1016/j.metabol.2013.07.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 06/13/2013] [Accepted: 07/16/2013] [Indexed: 12/27/2022]
Abstract
OBJECTIVE We determined whether simple, clinical information on late and early menarche could help identify adult women with metabolic syndrome (MetS) and oligomenorrhea. MATERIALS/METHODS We carried out a 26-year prospective follow-up of 272 suburban schoolgirls from ages 5-22 to 30-46. RESULTS Early menarche (≤10 years, 5.2% of girls) and late menarche (≥16 years, 6.7% of girls) were both associated with oligomenorrhea (≥42 days) in adulthood, 29% and 11%, vs. 5% for normal menarche (11-15 years), p=.004. Early menarche was characterized by high childhood BMI (LS mean±SE: 21.2 ±1.0 kg/m2) and by high childhood and adult MetS (15%, 36%). Girls with late menarche had the lowest childhood BMI (18.1±1.0), no childhood MetS, and the highest adult MetS (47%). Increasing age at menarche was associated with uniformly decreasing childhood BMI and MetS, but with a U-shaped pattern of BMI (p = .05), MetS (p=.008), and oligomenorrhea (p=.02) in adulthood. Change to MetS from median ages 13 to 38 was associated with early-late menarche (OR=3.11, 95% CI 1.37-7.07, p=.007). MetS in adulthood was associated with childhood MetS (OR=8.03, 95% CI 2.57-25.08, p=.0003) and with early-late menarche (OR =3.43, 95% CI 1.44-8.15, p=.005). CONCLUSIONS Menarche age had a curvilinear ('U' shaped) relationship with MetS and oligomenorrhea in adulthood. Late menarche and early menarche are risk factors for adult oligomenorrhea, MetS, and cardiometabolic abnormalities. Girls with early (≤ age 10) and with late menarche (≥ 16) represent a group at high risk for adult cardiometabolic abnormalities and oligomenorrhea that is easily identifiable by physicians.
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Affiliation(s)
- Charles J Glueck
- Cholesterol and Metabolism Center, Jewish Hospital of Cincinnati, Cincinnati Children's Hospital Medical Center.
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Washington RL. Primary care providers can help prevent cardiovascular disease in children--and their parents. J Pediatr 2012; 160:539-40. [PMID: 22284920 DOI: 10.1016/j.jpeds.2011.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 12/27/2011] [Indexed: 10/14/2022]
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