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Vatsyayan R, Dayeh SA. A universal model of electrochemical safety limits in vivo for electrophysiological stimulation. Front Neurosci 2022; 16:972252. [PMID: 36277998 PMCID: PMC9582612 DOI: 10.3389/fnins.2022.972252] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/12/2022] [Indexed: 11/26/2022] Open
Abstract
Electrophysiological stimulation has been widely adopted for clinical diagnostic and therapeutic treatments for modulation of neuronal activity. Safety is a primary concern in an interventional design leveraging the effects of electrical charge injection into tissue in the proximity of target neurons. While modalities of tissue damage during stimulation have been extensively investigated for specific electrode geometries and stimulation paradigms, a comprehensive model that can predict the electrochemical safety limits in vivo doesn’t yet exist. Here we develop a model that accounts for the electrode geometry, inter-electrode separation, material, and stimulation paradigm in predicting safe current injection limits. We performed a parametric investigation of the stimulation limits in both benchtop and in vivo setups for flexible microelectrode arrays with low impedance, high geometric surface area platinum nanorods and PEDOT:PSS, and higher impedance, planar platinum contacts. We benchmark our findings against standard clinical electrocorticography and depth electrodes. Using four, three and two contact electrochemical impedance measurements and comprehensive circuit models derived from these measurements, we developed a more accurate, clinically relevant and predictive model for the electrochemical interface potential. For each electrode configuration, we experimentally determined the geometric correction factors that dictate geometry-enforced current spreading effects. We also determined the electrolysis window from cyclic-voltammetry measurements which allowed us to calculate stimulation current safety limits from voltage transient measurements. From parametric benchtop electrochemical measurements and analyses for different electrode types, we created a predictive equation for the cathodal excitation measured at the electrode interface as a function of the electrode dimensions, geometric factor, material and stimulation paradigm. We validated the accuracy of our equation in vivo and compared the experimentally determined safety limits to clinically used stimulation protocols. Our new model overcomes the design limitations of Shannon’s equation and applies to macro- and micro-electrodes at different density or separation of contacts, captures the breakdown of charge-density based approaches at long stimulation pulse widths, and invokes appropriate power exponents to current, pulse width, and material/electrode-dependent impedance.
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Shirley MK, Arthurs OJ, Seunarine KK, Cole TJ, Eaton S, Williams JE, Clark CA, Wells JCK. Implications of leg length for metabolic health and fitness. Evol Med Public Health 2022; 10:316-324. [PMID: 35903461 PMCID: PMC9326181 DOI: 10.1093/emph/eoac023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background and objectives Several studies have linked longer legs with favorable adult metabolic health outcomes and greater offspring birth weight. A recent Mendelian randomization study suggested a causal link between height and cardiometabolic risk; however, the underlying reasons remain poorly understood. Methodology Using a cross-sectional design, we tested in a convenience sample of 70 healthy young women whether birth weight and tibia length as markers of early-life conditions associated more strongly with metabolically beneficial traits like organ size and skeletal muscle mass (SMM) than a statistically derived height-residual variable indexing later, more canalized growth. Results Consistent with the 'developmental origins of health and disease' hypothesis, we found relatively strong associations of tibia length-but not birth weight-with adult organ size, brain size, SMM and resting energy expenditure measured by magnetic resonance imaging (MRI), dual-energy X-ray absorptiometry and indirect calorimetry, respectively. Conclusions and implications Building on prior work, these results suggest that leg length is a sensitive marker of traits directly impacting metabolic and reproductive health. Alongside findings in the same sample relating tibia length and height-residual to MRI-measured pelvic dimensions, we suggest there may exist a degree of coordination in the development of long bone, lean mass and pelvic traits, possibly centered on early, pre-pubertal growth periods. Such phenotypic coordination has important implications for fitness, serving to benefit both adult health and the health of offspring in subsequent generations.
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Affiliation(s)
- Meghan K Shirley
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Owen J Arthurs
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
- Department of Radiology, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Kiran K Seunarine
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Tim J Cole
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Simon Eaton
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Jane E Williams
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Chris A Clark
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Jonathan C K Wells
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
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Chu AHY, Yuan WL, Loy SL, Soh SE, Bernard JY, Tint MT, Ho-Lim SST, Goh H, Ramasamy A, Kumar M, Goh C, Ang LT, Shek LPC, Chong YS, Tan KH, Su LL, Biswas A, Yap F, Lee YS, Chi C, Godfrey KM, Eriksson JG, Chan SY. Maternal height, gestational diabetes mellitus and pregnancy complications. Diabetes Res Clin Pract 2021; 178:108978. [PMID: 34303772 PMCID: PMC7611603 DOI: 10.1016/j.diabres.2021.108978] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/30/2021] [Accepted: 07/19/2021] [Indexed: 11/17/2022]
Abstract
AIMS To explore the glucose-overload hypothesis of artefactual gestational diabetes (GDM) diagnosis in shorter women during oral glucose tolerance testing (OGTT), by investigating associations between height and maternal glycemia; and GDM and pregnancy complications in height-groups. METHODS Women from GUSTO (n = 1100, 2009-2010) and NUH (n = 4068, 2017-2018) cohorts underwent a mid-gestation two and three time-point 75 g 2-hour OGTT, respectively. GDM-related complications (hypertensive disorders of pregnancy, preterm delivery, emergency cesarean section, neonatal intensive care unit admission, macrosomia, birthweight) were compared within shorter and taller groups, dichotomized by ethnic-specific median height. RESULTS Using WHO-1999 criteria, 18.8% (GUSTO) to 22.9% (NUH) of women were diagnosed with GDM-1999; and by WHO-2013 criteria, 21.9% (NUH) had GDM-2013. Each 5-cm height increment was inversely associated with GDM-1999 (adjusted odds ratio [aOR, 95% CI] = 0.81 [0.76-0.87], 2-h glycemia (adjusted β [aβ, 95% CI] = -0.171 mmol/L [-0.208, -0.135]) and 1-h glycemia (aβ = -0.160 mmol/L [-0.207, -0.112]). The inverse association between height and 2-h glycemia was most marked in "Other" ethnicities (Eurasians/Caucasians/mixed/other Asians) and Indians, followed by Chinese, then Malays. Compared with non-GDM, GDM-1999 was associated with preterm delivery (aOR = 1.76 [1.19-2.61]) and higher birthweight (aβ = 57.16 g [20.95, 93.38]) only among taller but not shorter women. CONCLUSIONS Only taller women had an increased odds of GDM-related pregnancy complications. An artefactual GDM diagnosis due to glucose-overload among shorter women is plausible.
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Affiliation(s)
- Anne H Y Chu
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Wen Lun Yuan
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - See Ling Loy
- Department of Reproductive Medicine, KK Women's and Children Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Shu E Soh
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jonathan Y Bernard
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Inserm, INRAE, Paris, France
| | - Mya-Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Huecin Goh
- Department of Nursing, National University Hospital, Singapore
| | - Adaikalavan Ramasamy
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Mukkesh Kumar
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Claire Goh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Li Ting Ang
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Lin Lin Su
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Arijit Biswas
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Fabian Yap
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Claudia Chi
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, UK
| | - Johan Gunnar Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of General Practice and Primary Health Care, University of Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Wells JCK. Could consanguineous marriage provide a cultural alleviation for the obstetric dilemma? Med Hypotheses 2019; 134:109424. [PMID: 31654884 DOI: 10.1016/j.mehy.2019.109424] [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: 07/30/2019] [Revised: 09/27/2019] [Accepted: 10/09/2019] [Indexed: 11/18/2022]
Abstract
In placental mammals, a poor fit between the physical dimensions of the fetus and maternal pelvis increases the likelihood of obstructed labour. This problem is especially relevant to humans, as our species demonstrates both unique adaptations in pelvic shape and structure associated with bipedalism, and fetal encephalization. Natural selection is expected to have favoured adaptations that reduce the chances of such mismatch within individual mother-offspring dyads. Here, I hypothesise that the cultural practice of consanguineous marriage may have been favoured, on account of increasing the genetic similarity between mothers and offspring and hence the correlation between maternal and fetal physical dimensions. These benefits could be amplified if consanguineous marriage was accompanied by assortative mating for height. An additional benefit of consanguineous marriage for childbirth is the slight reduction in birth size of such offspring compared to non-consanguineous unions. Although the offspring of consanguineous unions have elevated risks of morbidity and mortality, these risks are moderate and the practice could still have been favoured by selection if the reduction in maternal mortality was greater than the increased mortality among individual offspring. This hypothesis could be tested directly by investigating whether rates of obstructed labour are lower in individuals and populations practising consanguineous marriage. At a broader level, phylogenetic analysis could be conducted to test whether consanguineous marriage appears to have originated in the areas where intensive agriculture was first practiced, as adult height typically fell in such populations, potentially exacerbating the risk of obstructed labour.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, Population, Policy and Practice Research and Teaching Programme, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, WC, UK.
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Kimura T, Hino K, Kono T, Takano A, Nitta N, Ushio N, Hino S, Takase R, Kudo M, Daigo Y, Morita W, Nakao M, Nakatsukasa M, Tamagawa T, Rafiq AM, Matsumoto A, Otani H, Udagawa J. Maternal undernutrition during early pregnancy inhibits postnatal growth of the tibia in the female offspring of rats by alteration of chondrogenesis. Gen Comp Endocrinol 2018; 260:58-66. [PMID: 29277418 DOI: 10.1016/j.ygcen.2017.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 11/30/2017] [Accepted: 12/19/2017] [Indexed: 12/31/2022]
Abstract
Epidemiological research has suggested that birth weights are correlated with adult leg lengths. However, the relationship between prenatal undernutrition (UN) and postnatal leg growth remains controversial. We investigated the effects of UN during early pregnancy on postnatal hindlimb growth and determined whether early embryonic malnutrition affects the functions of postnatal chondrocytes in rats. Undernourished Wistar dams were fed 40% of the daily intake of rats in the control groups from gestational days 5.5-11.5, and femurs, tibias, and trunks or spinal columns were morphologically measured at birth and at 16 weeks of age in control and undernourished offspring of both sexes. We evaluated cell proliferation and differentiation of cultured chondrocytes derived from neonatal tibias of female offspring and determined chondrocyte-related gene expression levels in neonatal epiphysis and embryonic limb buds. Tibial lengths of undernourished female, but not male, offspring were longer at birth and shorter at 16 weeks of age (p < .05) compared with those of control rats. In chondrocyte culture studies, stimulating effects of IGF-1 on cell proliferation (p < .01) were significantly decreased and levels of type II collagen were lower in female undernourished offspring (p < .05). These phenomena were accompanied by decreased expression levels of Col2a1 and Igf1r and increased expression levels of Fgfr3 (p < .05), which might be attributable to the decreased expression of specificity protein 1 (p < .05), a key transactivator of Col2a1 and Igf1r. In conclusion, UN stress during early pregnancy reduces postnatal tibial growth in female offspring by altering the function of chondrocytes, likely reflecting altered expression of gene transactivators.
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Affiliation(s)
- Tomoko Kimura
- Department of Anatomy, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Kodai Hino
- Department of Anatomy, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Tadaaki Kono
- Department of Anatomy, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Atsushi Takano
- Department of Medical Oncology, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Norihisa Nitta
- Department of Radiology, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Noritoshi Ushio
- Department of Radiology, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Shinjiro Hino
- Department of Medical Cell Biology, Institute of Molecular Embryology and Genetics, Kumamoto University, Kumamoto 860-8555, Japan
| | - Ryuta Takase
- Department of Medical Cell Biology, Institute of Molecular Embryology and Genetics, Kumamoto University, Kumamoto 860-8555, Japan
| | - Motoi Kudo
- Department of Anatomy, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Yataro Daigo
- Department of Medical Oncology, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Wataru Morita
- Department of Oral Functional Anatomy, Faculty of Dental Medicine, Hokkaido University, Hokkaido 060-8586, Japan
| | - Mitsuyoshi Nakao
- Department of Medical Cell Biology, Institute of Molecular Embryology and Genetics, Kumamoto University, Kumamoto 860-8555, Japan
| | - Masato Nakatsukasa
- Laboratory of Physical Anthropology, Kyoto University Graduate School of Science, Kyoto 606-8502, Japan
| | - Toshihiro Tamagawa
- Department of Anatomy, Shiga University of Medical Science, Shiga 520-2192, Japan
| | - Ashiq Mahmood Rafiq
- Department of Anatomy, Faculty of Medicine, Shimane University, Shimane 693-8501, Japan
| | - Akihiro Matsumoto
- Department of Anatomy, Faculty of Medicine, Shimane University, Shimane 693-8501, Japan
| | - Hiroki Otani
- Department of Anatomy, Faculty of Medicine, Shimane University, Shimane 693-8501, Japan
| | - Jun Udagawa
- Department of Anatomy, Shiga University of Medical Science, Shiga 520-2192, Japan.
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Wells JC. Worldwide variability in growth and its association with health: Incorporating body composition, developmental plasticity, and intergenerational effects. Am J Hum Biol 2017; 29. [DOI: 10.1002/ajhb.22954] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 10/24/2016] [Accepted: 12/10/2016] [Indexed: 12/11/2022] Open
Affiliation(s)
- Jonathan C.K. Wells
- UCL Great Ormond Street Institute of Child Health; 30 Guilford Street London WC1N 1EH United Kingdom
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Bernabé-Ortiz A, Carrillo-Larco RM, Gilman RH, Miele CH, Checkley W, Wells JC, Smeeth L, Miranda JJ. Geographical variation in the progression of type 2 diabetes in Peru: The CRONICAS Cohort Study. Diabetes Res Clin Pract 2016; 121:135-145. [PMID: 27710820 PMCID: PMC5154928 DOI: 10.1016/j.diabres.2016.09.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 08/31/2016] [Accepted: 09/05/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND The study aims were to estimate the incidence and risk factors for T2D in four settings with different degree of urbanization and altitude in Peru. METHODS Prospective cohort study conducted in urban, semi-urban, and rural areas in Peru. An age- and sex-stratified random sample of participants was taken from the most updated census. T2D was defined as fasting blood glucose ⩾7.0mmol/L or taking anti-diabetes medication. Exposures were divided into two groups: geographical variables (urbanization and altitude), and modifiable risk factors. Incidence, relative risks (RR), 95% confidence intervals (95%CI), and population attributable fractions (PAF) were estimated. RESULTS Data from 3135 participants, 48.8% males, mean age 55.6years, was analyzed. Overall baseline prevalence of T2D was 7.1% (95%CI 6.2-8.0%). At follow-up, including 6207 person-years of follow-up, a total of 121 new T2D cases were accrued, equating to an incidence of 1.95 (95%CI 1.63-2.33) per 100 person-years. There was no urban to rural gradient in the T2D incidence; however, compared to sea level sites, participants living in high altitude had a higher incidence of diabetes (RR=1.58; 95%CI 1.01-2.48). Obesity had the highest attributable risk for developing T2D, although results varied by setting, ranging from 14% to 80% depending on urbanization and altitude. CONCLUSIONS Our results suggest that the incidence of T2D was greater in high altitude sites. New cases of diabetes were largely attributed to obesity, but with substantial variation in the contribution of obesity depending on the environment. These findings can inform appropriate context-specific strategies to reduce the incidence of diabetes.
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Affiliation(s)
- Antonio Bernabé-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rodrigo M Carrillo-Larco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert H Gilman
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA; Biomedical Research Unit, Asociación Benéfica PRISMA, Lima, Peru
| | - Catherine H Miele
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
| | - William Checkley
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA; Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, USA
| | - Jonathan C Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, University College London, London, United Kingdom
| | - Liam Smeeth
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Body composition and the monitoring of non-communicable chronic disease risk. GLOBAL HEALTH EPIDEMIOLOGY AND GENOMICS 2016; 1:e18. [PMID: 29868210 PMCID: PMC5870426 DOI: 10.1017/gheg.2016.9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 06/10/2016] [Accepted: 06/14/2016] [Indexed: 12/17/2022]
Abstract
There is a need for simple proxies of health status, in order to improve monitoring of chronic disease risk within and between populations, and to assess the efficacy of public health interventions as well as clinical management. This review discusses how, building on recent research findings, body composition outcomes may contribute to this effort. Traditionally, body mass index has been widely used as the primary index of nutritional status in children and adults, but it has several limitations. We propose that combining information on two generic traits, indexing both the ‘metabolic load’ that increases chronic non-communicable disease risk, and the homeostatic ‘metabolic capacity’ that protects against these diseases, offers a new opportunity to improve assessment of disease risk. Importantly, this approach may improve the ability to take into account ethnic variability in chronic disease risk. This approach could be applied using simple measurements readily carried out in the home or community, making it ideal for M-health and E-health monitoring strategies.
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Deng Q, Lu C, Ou C, Chen L, Yuan H. Preconceptional, prenatal and postnatal exposure to outdoor and indoor environmental factors on allergic diseases/symptoms in preschool children. CHEMOSPHERE 2016; 152:459-67. [PMID: 27003368 DOI: 10.1016/j.chemosphere.2016.03.032] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 02/28/2016] [Accepted: 03/08/2016] [Indexed: 05/19/2023]
Abstract
BACKGROUND Environmental factors have been found to be associated with allergic diseases, but it is unclear which environmental factor during which exposure window causes what kind of allergic diseases. OBJECTIVES We investigated association between exposure to some predominant outdoor and indoor environmental factors during preconceptional, prenatal, and postnatal periods and allergic diseases/symptoms in 2598 children in China. METHODS Children's lifetime incidence of allergic diseases and current prevalence of allergic symptoms and exposure to indoor new furniture/redecoration and mold/dampness was surveyed by a questionnaire. Exposure to outdoor air pollutants was estimated by the concentrations measured at air quality monitoring stations. Multiple logistic regression model was used to evaluate the associations between outdoor air pollutants and indoor environmental factors and allergic diseases (asthma, allergic rhinitis, and eczema) and symptoms (wheezing, night cough, and rhinitis-like). RESULTS We found that preconceptional, prenatal, and postnatal exposure to outdoor industrial and traffic air pollutants were significantly associated with increase in the risk of childhood asthma, and also positively associated with allergic rhinitis and eczema. However, we cannot distinguish the effect of outdoor air pollutants and exposure windows because of their high correlations. New furniture was associated with eczema and allergic rhinitis during postnatal exposure, but redecoration associated with asthma and eczema during prenatal exposure. Indoor visible mold/damp stains was significant for eczema during prenatal exposure and asthma during postnatal exposure respectively, but window condensation was significant for all childhood allergic diseases during both prenatal and postnatal exposures. Allergic symptoms in children were found to be associated with exposure to indoor factors only. CONCLUSIONS Associations between outdoor air pollutants and indoor environmental factors and childhood allergic diseases/symptoms were divergent and related to the timing of exposure.
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Affiliation(s)
- Qihong Deng
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China; School of Public Health, Central South University, Changsha, Hunan, China; Institute of Environmental Health, Central South University, Changsha, Hunan, China.
| | - Chan Lu
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China
| | - Cuiyun Ou
- School of Energy Science and Engineering, Central South University, Changsha, Hunan, China
| | - Lv Chen
- School of Public Health, Central South University, Changsha, Hunan, China
| | - Hong Yuan
- Institute of Environmental Health, Central South University, Changsha, Hunan, China; The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
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Wells JCK. Commentary: The thrifty phenotype and the hierarchical preservation of tissues under stress. Int J Epidemiol 2016; 42:1223-7. [PMID: 24159066 DOI: 10.1093/ije/dyt130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Wells JCK, Devakumar D, Grijalva-Eternod CS, Manandhar DS, Costello A, Osrin D. Blood pressure and the capacity-load model in 8-year-old children from Nepal: Testing the contributions of kidney size and intergenerational effects. Am J Hum Biol 2016; 28:555-65. [PMID: 26848931 PMCID: PMC7611548 DOI: 10.1002/ajhb.22829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 10/08/2015] [Accepted: 12/21/2015] [Indexed: 12/13/2022] Open
Abstract
Objectives Growth patterns in early life are increasingly linked with subsequent cardio-metabolic risk, but the underlying mechanisms require elucidation. We have developed a theoretical model of blood pressure, treating it as a function of homeostatic metabolic capacity, and antagonistic metabolic load. We sought to differentiate prenatal and postnatal components of metabolic capacity, and to identify intergenerational contributions to offspring capacity and load. Methods We followed up at 8 years a cohort of children originally recruited into a randomized trial of maternal micronutrient supplementation in pregnancy. Maternal anthropometry was measured at recruitment. Offspring anthropometry was measured at birth, 2 years and 8 years. Offspring blood pressure, kidney size, and body composition were measured at 8 years. Regression analysis was used to investigate potential associations of maternal phenotype, birth phenotype, and current body composition with kidney size and blood pressure. Results Blood pressure was positively associated with body fat, but negatively associated with birth weight and relative leg length. Kidney size was positively associated with birth weight but not with relative leg length. Adjusting for adiposity, blood pressure was independently negatively associated with birth weight, relative leg length, and kidney length. Maternal height and BMI predicted offspring size at birth and at 8 years, but not blood pressure. Conclusions Our data provide support for the capacity-load model of blood pressure in Nepalese children. Fetal and postnatal growth and kidney dimensions all contribute to metabolic capacity. Maternal phenotype contributed to offspring capacity and load, but these associations did not propagate to blood pressure.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom
| | | | | | | | | | - David Osrin
- UCL Institute for Global Health, London, United Kingdom
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12
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Association between leg length-to-height ratio and metabolic syndrome in Chinese children aged 3 to 6 years. Prev Med Rep 2014; 1:62-7. [PMID: 26844042 PMCID: PMC4721392 DOI: 10.1016/j.pmedr.2014.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective The aim of this study is to investigate the association between leg-length-to-height ratio (LLHR) and metabolic syndrome (MetS) among Chinese children. Methods 1236 children (619 obese and 617 nonobese children) aged 3–6 years participated in a cross-sectional survey in 2005 in Tianjin, China. Information on body adiposity, metabolic traits, and related covariates was obtained using a standardized protocol. LLHR was calculated as the ratio of leg length to stature. Results In the multivariable logistic regression analyses, compared with those in the lowest quartile, odds ratios (OR) and 95% confidence intervals (CI) of MetS among children in the second through the highest quartiles of LLHR Z-score were 0.89 (95% CI, 0.64–1.25), 0.45 (95% CI, 0.32–0.63), and 0.37 (95% CI, 0.26–0.53), respectively, (Pfor trend < 0.0001 across LLHR Z-score quartiles). Compared with children with both higher levels of LLHR and lower levels of adipose indices, the corresponding ORs of MetS for those with both lower levels of LLHR and higher levels of anthropometric indices were 4.51 (95% CI, 3.08–6.62) for BMI Z-score, 3.86 (95% CI, 2.60–5.73) for waist circumference, and 2.75 (95% CI, 1.85–4.10) for waist-to-hip ratio, respectively. Conclusions Greater LLHR is inversely associated with MetS in Chinese children. Leg-length-to-height ratio (LLHR) is negatively associated with childhood obesity. Greater LLHR is inversely associated with childhood metabolic syndrome (MetS). LLHR and adiposity have a synergistic effect in relation to pediatric MetS.
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Key Words
- BMI, body mass index
- CI, confidence interval
- CVD, cardiovascular disease
- HDL, high-density lipoprotein
- LDL, low-density lipoprotein
- LLHR, leg-length-to-height ratio
- Leg length-to-height ratio
- MetS, metabolic syndrome
- Metabolic syndrome
- OR, odds ratios
- Obesity
- PI, Ponderal index
- Pediatrics
- T2D, type 2 diabetes
- WHR, waist-to-hip ratio
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Montagnese C, Nutile T, Marphatia AA, Grijalva-Eternod CS, Siervo M, Ciullo M, Wells JC. Body composition, leg length and blood pressure in a rural Italian population: a test of the capacity-load model. Nutr Metab Cardiovasc Dis 2014; 24:1204-1212. [PMID: 24984827 DOI: 10.1016/j.numecd.2014.05.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 04/30/2014] [Accepted: 05/13/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Whereas adult weight or body mass index (BMI) are directly associated with blood pressure (BP), birth weight is inversely associated with BP. The scenario for height is more complex, as both tall and short stature have been associated with higher BP. We used a theoretical model treating sitting height (SH) and tissue masses (fat mass, lean mass) as components of metabolic load, and leg length (LL) as a marker of homeostatic metabolic capacity. We predicted that decreased capacity and increased load would be independently associated with increased BP.. METHODS AND RESULTS Anthropometry, body composition (bio-electrical impedance analysis) and BP were measured in 601 adults (228 male) aged 20-91 years from three hill villages in southern Italy. Multiple regression analysis was used to investigate associations of body composition and anthropometry with BP. Adjusting for age, systolic BP (SBP) was associated with lean mass in males, and with adiposity in females, whereas diastolic BP (DBP) was associated with fat mass in both sexes. Associations of LL and SH with BP were in opposite directions. LL was inversely associated with SBP and DBP in males, with a similar trend evident in females. SH was directly associated with SBP and DBP in females, and with DBP in males. CONCLUSIONS Consistent with our theoretical model, metabolic load is associated with increased BP, though differently between the sexes, whereas metabolic capacity is independently associated with lower BP. Our findings suggest that early growth improves hemodynamic tolerance of high metabolic load in adulthood..
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Affiliation(s)
- C Montagnese
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK; Institute of Genetics and Biophysics, "A. Buzzati-Traverso" CNR, Napoli, Italy
| | - T Nutile
- Institute of Genetics and Biophysics, "A. Buzzati-Traverso" CNR, Napoli, Italy
| | - A A Marphatia
- Department of Geography, University of Cambridge, UK
| | | | - M Siervo
- Human Nutrition Research Centre, Institute for Ageing and Health, Newcastle University, UK
| | - M Ciullo
- Institute of Genetics and Biophysics, "A. Buzzati-Traverso" CNR, Napoli, Italy.
| | - J C Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK
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14
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Pomeroy E, Stock JT, Cole TJ, O'Callaghan M, Wells JCK. Relationships between neonatal weight, limb lengths, skinfold thicknesses, body breadths and circumferences in an Australian cohort. PLoS One 2014; 9:e105108. [PMID: 25162658 PMCID: PMC4146506 DOI: 10.1371/journal.pone.0105108] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 07/17/2014] [Indexed: 12/11/2022] Open
Abstract
Background Low birth weight has been consistently associated with adult chronic disease risk. The thrifty phenotype hypothesis assumes that reduced fetal growth impacts some organs more than others. However, it remains unclear how birth weight relates to different body components, such as circumferences, adiposity, body segment lengths and limb proportions. We hypothesized that these components vary in their relationship to birth weight. Methods We analysed the relationship between birth weight and detailed anthropometry in 1270 singleton live-born neonates (668 male) from the Mater-University of Queensland Study of Pregnancy (Brisbane, Australia). We tested adjusted anthropometry for correlations with birth weight. We then performed stepwise multiple regression on birth weight of: body lengths, breadths and circumferences; relative limb to neck-rump proportions; or skinfold thicknesses. All analyses were adjusted for sex and gestational age, and used logged data. Results Circumferences, especially chest, were most strongly related to birth weight, while segment lengths (neck-rump, thigh, upper arm, and especially lower arm and lower leg) were relatively weakly related to birth weight, and limb lengths relative to neck-rump length showed no relationship. Skinfolds accounted for 36% of birth weight variance, but adjusting for size (neck-rump, thigh and upper arm lengths, and head circumference), this decreased to 10%. There was no evidence that heavier babies had proportionally thicker skinfolds. Conclusions Neonatal body measurements vary in their association with birth weight: head and chest circumferences showed the strongest associations while limb segment lengths did not relate strongly to birth weight. After adjusting for body size, subcutaneous fatness accounted for a smaller proportion of birth weight variance than previously reported. While heavier babies had absolutely thicker skinfolds, this was proportional to their size. Relative limb to trunk length was unrelated to birth weight, suggesting that limb proportions at birth do not index factors relevant to prenatal life.
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Affiliation(s)
- Emma Pomeroy
- Newnham College, University of Cambridge, Cambridge, United Kingdom
- Division of Biological Anthropology, Department of Archaeology and Anthropology, University of Cambridge, Cambridge, United Kingdom
- * E-mail:
| | - Jay T. Stock
- Division of Biological Anthropology, Department of Archaeology and Anthropology, University of Cambridge, Cambridge, United Kingdom
| | - Tim J. Cole
- Population Policy and Practice, UCL Institute of Child Health, London, United Kingdom
| | - Michael O'Callaghan
- School of Medicine, Mater Clinical School, University of Queensland, Brisbane, Queensland, Australia
| | - Jonathan C. K. Wells
- Division of Biological Anthropology, Department of Archaeology and Anthropology, University of Cambridge, Cambridge, United Kingdom
- Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom
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15
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Brite J, Shiroma EJ, Bowers K, Yeung E, Laughon SK, Grewal JG, Zhang C. Height and the risk of gestational diabetes: variations by race/ethnicity. Diabet Med 2014; 31:332-40. [PMID: 24308574 PMCID: PMC4205756 DOI: 10.1111/dme.12355] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 08/01/2013] [Accepted: 10/26/2013] [Indexed: 12/25/2022]
Abstract
AIMS Gestational diabetes is a common pregnancy complication affecting races/ethnicities disproportionally. Adult height, an indicator of both genetic and early-life factors, is inconsistently associated with gestational diabetes risk. We examined the association and whether it varies by races in a nationally representative US cohort. METHODS Analyses were conducted among 135 861 pregnancies in the Consortium on Safe Labor, 5567 of which were diagnosed with gestational diabetes based on medical records review. Generalized estimating equations were used to estimate odds ratios (95% confidence intervals) of gestational diabetes, controlling for other risk factors including body weight. Additionally, a meta-analysis of 15 761 pregnancies with gestational diabetes and 205 828 without gestational diabetes was conducted to estimate the pooled mean difference in height between those with gestational diabetes and control subjects. RESULTS Height was inversely associated with gestational diabetes risk across races/ethnicities, with the strongest association among Asians (P for interaction < 0.01). Comparing extreme quartiles (> 168 vs. < 157 cm), adjusted odds ratios (95% confidence intervals) were 0.18 (0.09-0.36) for Asians/Pacific Islanders, 0.33 (0.29-0.38) for non-Hispanic white women, 0.39 (0.31-0.51) for Hispanics and 0.59 (0.47-0.75) for non-Hispanic black women. Meta-analysis found women with gestational diabetes to be significantly shorter than others. CONCLUSIONS Taller women are at lower risk of developing gestational diabetes, with the magnitude of association varying significantly across races/ethnicities.
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Affiliation(s)
- J Brite
- Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; School of Public Health, City University of New York, New York, NY
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16
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Pomeroy E, Wells JC, Stanojevic S, Miranda JJ, Cole TJ, Stock JT. Birth month associations with height, head circumference, and limb lengths among peruvian children. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2014; 154:115-24. [DOI: 10.1002/ajpa.22484] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 01/18/2014] [Indexed: 12/20/2022]
Affiliation(s)
- Emma Pomeroy
- Newnham CollegeUniversity of CambridgeCambridge UK
- Division of Biological AnthropologyDepartment of Archaeology and AnthropologyUniversity of CambridgeCambridge UK
| | | | - Sanja Stanojevic
- Division of Respiratory MedicineThe Hospital for Sick ChildrenToronto ON Canada
| | - J. Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases and Department of MedicineSchool of Medicine, Universidad Peruana Cayetano HerediaLima Peru
| | - Tim J. Cole
- Centre of Paediatric Epidemiology and BiostatisticsUCL Institute of Child HealthLondon UK
| | - Jay T. Stock
- Division of Biological AnthropologyDepartment of Archaeology and AnthropologyUniversity of CambridgeCambridge UK
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Cook MB, Gamborg M, Aarestrup J, Sørensen TI, Baker JL. Childhood height and birth weight in relation to future prostate cancer risk: a cohort study based on the copenhagen school health records register. Cancer Epidemiol Biomarkers Prev 2013; 22:2232-40. [PMID: 24089459 PMCID: PMC3863763 DOI: 10.1158/1055-9965.epi-13-0712] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Adult height has been positively associated with prostate cancer risk. However, the exposure window of importance is currently unknown and assessments of height during earlier growth periods are scarce. In addition, the association between birth weight and prostate cancer remains undetermined. We assessed these relationships in a cohort of the Copenhagen School Health Records Register (CSHRR). METHODS The CSHRR comprises 372,636 school children. For boys born between the 1930s and 1969, birth weight and annual childhood heights-measured between ages 7 and 13 years-were analyzed in relation to prostate cancer risk. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI). RESULTS There were 125,211 males for analysis, 2,987 of who were subsequently diagnosed with prostate cancer during 2.57 million person-years of follow-up. Height z-score was significantly associated with prostate cancer risk at all ages (HRs, 1.13 to 1.14). Height at age 13 years was more important than height change (P = 0.024) and height at age 7 years (P = 0.024), when estimates from mutually adjusted models were compared. Adjustment of birth weight did not alter the estimates. Birth weight was not associated with prostate cancer risk. CONCLUSIONS The association between childhood height and prostate cancer risk was driven by height at age 13 years. IMPACT Our findings implicate late childhood, adolescence, and adulthood growth periods as containing the exposure window(s) of interest that underlies the association between height and prostate cancer. The causal factor may not be singular given the complexity of both human growth and carcinogenesis.
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Affiliation(s)
- Michael B. Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD
| | - Michael Gamborg
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals – Part of the Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark
| | - Julie Aarestrup
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals – Part of the Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark
| | - Thorkild I.A. Sørensen
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals – Part of the Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jennifer L. Baker
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospitals – Part of the Copenhagen University Hospital, The Capital Region, Copenhagen, Denmark
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Johnston LW, Harris SB, Retnakaran R, Gerstein HC, Zinman B, Hamilton J, Hanley AJ. Short leg length, a marker of early childhood deprivation, is associated with metabolic disorders underlying type 2 diabetes: the PROMISE cohort study. Diabetes Care 2013; 36:3599-606. [PMID: 24089539 PMCID: PMC3816896 DOI: 10.2337/dc13-0254] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Short leg length, a marker of early childhood deprivation, has been used in studies of the association of early life conditions with adult chronic disease risk. The objective of this study was to determine the cross-sectional associations of leg length with measures of insulin sensitivity and β-cell function. RESEARCH DESIGN AND METHODS Subjects (n = 462) at risk for type 2 diabetes were recruited into the PROspective Metabolism and ISlet cell Evaluation (PROMISE) longitudinal cohort. Leg length was calculated from sitting and standing height at the 3-year clinical examination. Glucose tolerance status was determined using an oral glucose tolerance test. Insulin sensitivity was assessed using homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda insulin sensitivity index (ISI), while the insulinogenic index over HOMA-IR (IGI/IR) and the insulin secretion sensitivity index 2 (ISSI-2) determined β-cell function. Multiple linear regression analysis was conducted, adjusting for covariates including age, sex, ethnicity, family history of diabetes, waist, and weight. RESULTS Leg length and leg-to-height ratio were significantly associated with HOMA-IR (β = -0.037, β = -10.49, respectively; P < 0.0001), ISI (β = 0.035, β = 8.83, respectively; P < 0.0001), IGI/IR (β = 0.021, P < 0.05; β = 7.60, P < 0.01, respectively), and ISSI-2 (β = 0.01, P < 0.03; β = 3.34, P < 0.01, respectively) after adjustment for covariates. The association of shorter leg length with lower insulin sensitivity was most evident for those with high waist circumferences. CONCLUSIONS Shorter legs were independently associated with lower insulin sensitivity and β-cell function, suggesting that early childhood deprivation may increase the risk of developing diabetes.
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Batty GD, Shipley MJ, Gunnell D, Huxley R, Kivimaki M, Woodward M, Lee CMY, Smith GD. Height, wealth, and health: an overview with new data from three longitudinal studies. ECONOMICS AND HUMAN BIOLOGY 2009; 7:137-152. [PMID: 19628438 DOI: 10.1016/j.ehb.2009.06.004] [Citation(s) in RCA: 170] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Revised: 06/23/2009] [Accepted: 06/23/2009] [Indexed: 05/28/2023]
Abstract
This overview, based on a literature review and new data from the three cohorts (Whitehall Studies I and II, and the Vietnam Experience Study), has four objectives: (a) to outline the major determinants of height, so providing an indication as to what exposures this characteristic may capture; (b) to summarise, by reviewing reports from large scale studies, the relation between adult height and a range of disease outcomes--both somatic and psychiatric--with particular emphasis on coronary heart disease (CHD) and stroke; (c) to discuss why these relationships may exist, in particular, the role, if any, of socioeconomic position in explaining the apparent associations; and, finally (d) to outline future research directions in this field. The large majority of evidence for predictors of height, and its health consequences, comes from observational studies. While genetic predisposition is a major determinant of height, secular rises in childhood and adult stature across successive birth cohorts suggest that early life environment also has an important impact. Plausible non-genetic determinants of height include nutrition, illness, socioeconomic status, and psychosocial stress. Evidence for an association between height and a series of health endpoints is accumulating. Thus, shorter people appear to experience increased risk of CHD, and these associations appear to be independent of socioeconomic position and other potentially confounding variables. For stroke, and its sub-types, findings are less clear. In contrast to CHD, some cancers, such as carcinoma of the colorectum, prostate, breast (in women), central nervous system, skin, endometrium, thyroid and blood (haematopoietic) are more common in taller people. While height may be negatively related to the risk of completed suicide, conclusions about the links between stature and other health endpoints is problematic given the paucity of evidence, which should be addressed. Ultimately, for want of better data, investigators in this area have used height as a proxy for a range of pre-adult exposures. In future, research should aim to explore the predictive capacity of direct measures of diet, psychosocial stress, childhood chronic illness and so on, rather than focus on height or its components. The problem is that extended follow-up of child cohorts with such data are required, and studies which hold these data are not currently available, although several are either maturing to the point where they offer sufficient clinical outcomes to facilitate analyses or are in the advanced planning stage.
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Affiliation(s)
- G David Batty
- Medical Research Council Social & Public Health Sciences Unit, Glasgow, UK.
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20
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Li L, Dangour AD, Power C. Early life influences on adult leg and trunk length in the 1958 British birth cohort. Am J Hum Biol 2007; 19:836-43. [PMID: 17696141 DOI: 10.1002/ajhb.20649] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES Short leg length has been associated with increased disease risk. We investigated (1) whether taller childhood stature predicts longer adult leg than trunk length; (2) the effects of early life factors on adult leg/trunk length. METHODS We used data from the 1958 British birth cohort on height in childhood and at 45 years, leg and trunk length at 45 years and early life factors (n approximately 5,900). RESULTS For a SD increase in height at 7 years, adult leg length increased more than trunk length (2.5-2.8 cm vs. 1.9 cm). Parental height had a stronger association with adult than childhood height, and leg than trunk length. Prenatal factors were associated with leg (maternal smoking) and trunk length (birth order); birth weight had a similar effect on leg and trunk lengths. Large family size, overcrowding, and social housing were more strongly associated with leg than trunk length: deficits in adult height (0.4-0.8 cm) were mostly due to shorter legs. CONCLUSIONS Socio-economic adversity in childhood is associated with delayed early growth, shorter adult leg length, and stature. Leg length is the height component most sensitive to early environment. Studies of early life and adult disease could usefully assess adult leg length in addition to height.
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Affiliation(s)
- Leah Li
- Centre for Pediatric Epidemiology and Biostatistics, Institute of Child Health, University College London, London, United Kingdom.
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21
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Ferrie JE, Langenberg C, Shipley MJ, Marmot MG. Birth weight, components of height and coronary heart disease: evidence from the Whitehall II study. Int J Epidemiol 2006; 35:1532-42. [PMID: 16931524 DOI: 10.1093/ije/dyl184] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Previous studies have suggested that shorter leg length, not trunk length, may explain the inverse association between height and coronary heart disease (CHD) risk. However, investigation of the importance of birth weight for these associations has been limited. This study examines associations of measures of stature and birth weight with CHD risk factors (measures of blood pressure and lipids, 2 h glucose, waist-hip ratio and fibrinogen) and incident non-fatal coronary events in middle age. METHODS Data were derived mostly from the Phase 5 (1997-99) clinical screening of the Whitehall II study of British civil servants. The main cross-sectional analyses included 1084 women and 2290 men with complete data. RESULTS In women total height and leg length were the measures that tended to be most strongly associated with CHD risk factors, while in men leg length demonstrated the closest associations. Although associations between trunk length and CHD risk factors were weaker, trunk length was the component of height that appeared to be most closely associated with coronary events. Associations between birth weight and CHD risk factors and coronary events were generally weaker than for any measure of stature. Adjustment for birth weight had little effect on associations between components of stature and CHD risk factors or events. CONCLUSION Findings from this relatively privileged cohort confirmed that shorter leg length underlies the inverse association between height and CHD risk factors in middle-aged women and men. Furthermore, in this study population shorter trunk length was more closely associated with incident, non-fatal coronary events.
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Affiliation(s)
- Jane E Ferrie
- International Centre for Health and Society, Department of Epidemiology and Public Health, UCL, London, UK.
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22
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Asao K, Kao WHL, Baptiste-Roberts K, Bandeen-Roche K, Erlinger TP, Brancati FL. Short stature and the risk of adiposity, insulin resistance, and type 2 diabetes in middle age: the Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994. Diabetes Care 2006; 29:1632-7. [PMID: 16801590 DOI: 10.2337/dc05-1997] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the association between stature-related measurements (height, leg length, and leg length-to-height ratio) and adiposity, insulin resistance, and glucose intolerance. RESEARCH DESIGN AND METHODS We conducted a cross-sectional analysis of a nationally representative sample of 7,424 adults aged 40-74 years, from the Third National Health and Nutrition Examination Survey (1988-1994). The main outcome measures were percent body fat, homeostasis model assessment of insulin resistance (HOMA-IR), and glucose intolerance based on the World Health Organization's 1985 criteria for an oral glucose tolerance test. RESULTS Shorter height and leg length, and lower leg length-to-height ratio, were associated with higher percent body fat, especially in women. Lower leg length-to-height ratio was associated with greater insulin resistance estimated by HOMA-IR. In multinomial regression models adjusting for potential confounders, including percent body fat, the relative prevalence of type 2 diabetes per 1-SD lower values in height, leg length, and leg length-to-height ratio were 1.10 (95% CI 0.94-0.29), 1.17 (0.98-1.39), and 1.19 (1.02-1.39), respectively. CONCLUSIONS Our study supports the hypothesis that adult markers of prepubertal growth, especially leg length-to-height ratio, are associated with adiposity, insulin resistance, and type 2 diabetes in the general U.S. population.
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Affiliation(s)
- Keiko Asao
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA
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23
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Leary S, Davey Smith G, Ness A. Smoking during pregnancy and components of stature in offspring. Am J Hum Biol 2006; 18:502-12. [PMID: 16788904 DOI: 10.1002/ajhb.20518] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The objective of this study was to examine the association between maternal smoking during pregnancy and offspring height and its components. The analysis was based on 6,340 white singletons born in 1991-1992 and enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC), who had maternal smoking data recorded for at least one trimester in pregnancy, and who had their height recorded at age 7.5. Smoking at any time in pregnancy was associated with a reduction in offspring height, trunk, and leg length, and the leg-to-trunk ratio, after adjustment for age and sex. After additional adjustment for maternal factors, social factors, and breastfeeding, associations with leg length and leg-to-trunk ratio remained, with reductions of 0.25 cm (95% confidence interval, 0.05-0.46 cm) in leg length and 0.30% (95% confidence interval, 0.03-0.57%) in leg-to-trunk ratio if the mother smoked. Findings were similar when the smoking data were analyzed separately for each trimester. Furthermore, in each trimester, the more a mother smoked, the greater the reduction in offspring height, leg length, and leg-to-trunk ratio. These dose-response relationships remained after adjustment for all potential confounders for leg length and leg-to-trunk ratio. Smoking at any time in pregnancy reduces offspring height and its components, and in particular leg length and leg-to-trunk ratio at age 7.5.
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Affiliation(s)
- Sam Leary
- Unit of Paediatric and Perinatal Epidemiology, Department of Community-Based Medicine, University of Bristol, Bristol BS8 1TQ, UK
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Martin RM, Gunnell D, Pemberton J, Frankel S, Davey Smith G. Cohort profile: The Boyd Orr cohort--an historical cohort study based on the 65 year follow-up of the Carnegie Survey of Diet and Health (1937-39). Int J Epidemiol 2005; 34:742-9. [PMID: 15964910 DOI: 10.1093/ije/dyi124] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Richard M Martin
- Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK
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25
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Langenberg C, Shipley MJ, Batty GD, Marmot MG. Adult socioeconomic position and the association between height and coronary heart disease mortality: findings from 33 years of follow-up in the Whitehall Study. Am J Public Health 2005; 95:628-32. [PMID: 15798120 PMCID: PMC1449231 DOI: 10.2105/2004.046219] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2004] [Indexed: 11/04/2022]
Abstract
In the Whitehall Study, which followed 17,139 male civil servants over 33 years, the association between tall stature and coronary heart disease (CHD) mortality differed between employment grades. In men without CHD at study entry, the hazard ratio per 15-cm increase in height was 0.77 (95% confidence interval [CI]=0.69, 0.85; P<0.001) for the highest grades, but 0.84 (95% CI=0.69, 1.03; P=.10) for middle and 0.95 (95% CI=0.75, 1.20; P=.65) for low grades, suggesting that childhood and adult social conditions may interact in their influence on coronary risk.
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Affiliation(s)
- Claudia Langenberg
- Department of Epidemiology and Public Health, University College London Medical School, 1-19 Torrington Pl, London, England, United Kingdom.
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Hart CL, MacKinnon PL, Watt GCM, Upton MN, McConnachie A, Hole DJ, Davey Smith G, Gillis CR, Hawthorne VM. The Midspan studies. Int J Epidemiol 2005; 34:28-34. [PMID: 15705739 DOI: 10.1093/ije/dyh348] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Carole L Hart
- Public Health and Health Policy, Division of Community Based Sciences, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, Scotland, UK.
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Hardy R, Langenberg C. Commentary: The association between height growth and cholesterol levels during puberty: implications for adult health. Int J Epidemiol 2003; 32:1110-1. [PMID: 14681285 DOI: 10.1093/ije/dyg315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rebecca Hardy
- MRC National Survey of Health and Development, Department of Epidemiology and Public Health, Royal Free & University College London Medical School, 1-19 Torrington Place, London WC1E 6BT, UK.
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Langenberg C, Hardy R, Kuh D, Wadsworth ME. Influence of height, leg and trunk length on pulse pressure, systolic and diastolic blood pressure. J Hypertens 2003; 21:537-43. [PMID: 12640247 DOI: 10.1097/00004872-200303000-00019] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the effects of height, leg and trunk length on pulse pressure (PP), systolic (SBP) and diastolic blood pressure (DBP) in men and women. DESIGN Prospective, population-based, birth cohort study. SETTING England, Scotland and Wales. PARTICIPANTS A total of 1472 men and 1563 women aged 53 years and followed since their birth in 1946. MAIN OUTCOME MEASURES PP, SBP and DBP at age 53 years. RESULTS PP increased linearly with decreasing height and leg length in men and women [shortest compared with the tallest height (leg length) group, men 54.6 versus 51.0 mmHg (55.8 versus 50.7 mmHg), women 52.9 versus 48.4 mmHg (53.3 versus 48.6 mmHg); P for trend < or = 0.001 in each case]. Adjustment for adult confounding factors and childhood social class or birth weight only slightly weakened these results (P for trend < or = 0.01 in each case). SBP, but not DBP, showed similar but weaker trends in men and women, except for the association with height in men, which lost statistical significance after adjustment. Trunk length was not associated with any outcome measure in men or women. CONCLUSIONS Short height and leg length are associated with increased PP and SBP, but not DBP, in middle-aged men and women. PP is a potential mediator between short height and leg length and increased risk of coronary heart disease. Future studies of the association between shortness and coronary heart disease should consider the role of arterial hemodynamics.
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Affiliation(s)
- Claudia Langenberg
- MRC National Survey of Health and Development, Department of Epidemiology and Public Health, Royal Free and University College London Medical School, 1-19 Torrington Place, London WC1 6BT, UK.
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Gunnell D, Whitley E, Upton MN, McConnachie A, Smith GD, Watt GCM. Associations of height, leg length, and lung function with cardiovascular risk factors in the Midspan Family Study. J Epidemiol Community Health 2003; 57:141-6. [PMID: 12540691 PMCID: PMC1732388 DOI: 10.1136/jech.57.2.141] [Citation(s) in RCA: 139] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Taller people and those with better lung function are at reduced risk of coronary heart disease (CHD). Biological mechanisms for these associations are not well understood, but both measures may be markers for early life exposures. Some studies have shown that leg length, an indicator of pre-pubertal nutritional status, is the component of height most strongly associated with CHD risk. Other studies show that height-CHD associations are greatly attenuated when lung function is controlled for. This study examines (1) the association of height and the components of height (leg length and trunk length) with CHD risk factors and (2) the relative strength of the association of height and forced expiratory volume in one second (FEV(1)) with risk factors for CHD. SUBJECTS AND METHODS Cross sectional analysis of data collected at detailed cardiovascular screening examinations of 1040 men and 1298 women aged 30-59 whose parents were screened in 1972-76. Subjects come from 1477 families and are members of the Midspan Family Study. SETTING The towns of Renfrew and Paisley in the West of Scotland. RESULTS Taller subjects and those with better lung function had more favourable cardiovascular risk factor profiles, associations were strongest in relation to FEV(1). Higher FEV(1) was associated with lower blood pressure, cholesterol, glucose, fibrinogen, white blood cell count, and body mass index. Similar, but generally weaker, associations were seen with height. These associations were not attenuated in models controlling for parental height. Longer leg length, but not trunk length, was associated with lower systolic and diastolic blood pressure. Longer leg length was also associated with more favourable levels of cholesterol and body mass index than trunk length. CONCLUSIONS These findings provide indirect evidence that measures of lung development and pre-pubertal growth act as biomarkers for childhood exposures that may modify an individual's risk of developing CHD. Genetic influences do not seem to underlie height-CHD associations.
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Affiliation(s)
- D Gunnell
- Department of Social Medicine, University of Bristol, Bristol, UK.
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Abstract
Associations between different patterns of childhood growth and later adult health have recently received much attention. Most studies have found higher mortality in shorter people, explained by their higher incidence of cardiorespiratory disease. In this chapter, associations of cancer with markers of growth at different developmental phases - infancy, childhood and puberty - and with final adult height are reviewed. The relationship between birthweight and cancer is generally positive, with the greatest risk among high-birthweight babies. Childhood and adult tallness are related to higher cancer risk. This is particularly evident for cancers of the breast, prostate, colo-rectum, haematopoietic system and endometrium. Leg length may be more strongly associated than trunk length with cancer risk. Possible explanations for these findings are discussed in relation to nutritional intake and hormonal levels.
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Affiliation(s)
- Mona Okasha
- Department of Social Medicine, Canynge Hall, Whiteladies Road, Bristol, BS8 2PR, UK
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31
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Gunnell D. Commentary: Can adult anthropometry be used as a ‘biomarker’ for prenatal and childhood exposures? Int J Epidemiol 2002. [DOI: 10.1093/ije/31.2.390] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Smith GD, Greenwood R, Gunnell D, Sweetnam P, Yarnell J, Elwood P. Leg length, insulin resistance, and coronary heart disease risk: the Caerphilly Study. J Epidemiol Community Health 2001; 55:867-72. [PMID: 11707479 PMCID: PMC1731819 DOI: 10.1136/jech.55.12.867] [Citation(s) in RCA: 173] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Adult height has been inversely associated with coronary heart disease risk in several studies. The mechanism for this association is not well understood, however, and this was investigated by examining components of stature, cardiovascular disease risk factors and subsequent coronary heart disease in a prospective study. METHODS All men aged 45-59 years living in the town of Caerphilly, South Wales were approached, and 2512 (89%) responded and underwent a detailed examination, which included measurement of height and sitting height (from which an estimate of leg length was derived). Participants were followed up through repeat examinations and the cumulative incidence of coronary heart disease-both fatal and non-fatal-over a 15 year follow up period is the end point in this report. RESULTS Cross sectional associations between cardiovascular risk factors and components of stature (total height, leg length and trunk length) demonstrated that factors related to the insulin resistance syndrome-the homeostasis model assessment of insulin resistance, fasting triglyceride levels and total to HDL cholesterol ratio-were less favourable in men with shorter legs, while showing reverse or no associations with trunk length. Fibrinogen levels were inversely associated with leg length and showed a weaker association with trunk length. Forced expiratory volume in one second was unrelated to leg length but strongly positively associated to trunk length. Other risk factors showed little association with components of stature. The risk of coronary heart disease was inversely related to leg length but showed little association with trunk length. CONCLUSION Leg length is the component of stature related to insulin resistance and coronary heart disease risk. As leg length is unrelated to lung function measures it is unlikely that these can explain the association in this cohort. Factors that influence leg length in adulthood-including nutrition, other influences on growth in early life, genetic and epigenetic influences-merit further investigation in this regard. The reported associations suggest that pre-adult influences are important in the aetiology of coronary heart disease and insulin resistance.
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Affiliation(s)
- G D Smith
- Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK.
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Gunnell D. Commentary: Early insights into height, leg length, proportionate growth and health. Int J Epidemiol 2001; 30:221-2. [PMID: 11369718 DOI: 10.1093/ije/30.2.221] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Gunnell
- Department of Social Medicine, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK
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