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Lin Z, Pan I, Pan W. On network deconvolution for undirected graphs. Biometrics 2024; 80:ujae112. [PMID: 39377517 PMCID: PMC11459367 DOI: 10.1093/biomtc/ujae112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 07/31/2024] [Accepted: 09/20/2024] [Indexed: 10/09/2024]
Abstract
Network deconvolution (ND) is a method to reconstruct a direct-effect network describing direct (or conditional) effects (or associations) between any two nodes from a given network depicting total (or marginal) effects (or associations). Its key idea is that, in a directed graph, a total effect can be decomposed into the sum of a direct and an indirect effects, with the latter further decomposed as the sum of various products of direct effects. This yields a simple closed-form solution for the direct-effect network, facilitating its important applications to distinguish direct and indirect effects. Despite its application to undirected graphs, it is not well known why the method works, leaving it with skepticism. We first clarify the implicit linear model assumption underlying ND, then derive a surprisingly simple result on the equivalence between ND and use of precision matrices, offering insightful justification and interpretation for the application of ND to undirected graphs. We also establish a formal result to characterize the effect of scaling a total-effect graph. Finally, leveraging large-scale genome-wide association study data, we show a novel application of ND to contrast marginal versus conditional genetic correlations between body height and risk of coronary artery disease; the results align with an inferred causal directed graph using ND. We conclude that ND is a promising approach with its easy and wide applicability to both directed and undirected graphs.
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Affiliation(s)
- Zhaotong Lin
- Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN 55455, United States
- Department of Statistics, Florida State University, Tallahassee, FL 32306, United States
| | - Isaac Pan
- Department of Mathematics and Statistics, Pomona College, Claremont, CA 91711, United States
| | - Wei Pan
- Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN 55455, United States
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2
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Seng LL, Liu CT, Wang J, Li J. Instrumental variable model average with applications in Mendelian randomization. Stat Med 2023; 42:3547-3567. [PMID: 37476915 DOI: 10.1002/sim.9819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/20/2023] [Accepted: 05/29/2023] [Indexed: 07/22/2023]
Abstract
Mendelian randomization is a technique used to examine the causal effect of a modifiable exposure on a trait using an observational study by utilizing genetic variants. The use of many instruments can help to improve the estimation precision but may suffer bias when the instruments are weakly associated with the exposure. To overcome the difficulty of high-dimensionality, we propose a model average estimator which involves using different subsets of instruments (single nucleotide polymorphisms, SNPs) to predict the exposure in the first stage, followed by weighting the submodels' predictions using penalization by common penalty functions such as least absolute shrinkage and selection operator (LASSO), smoothly clipped absolute deviation (SCAD) and minimax concave penalty (MCP). The model averaged predictions are then used as a genetically predicted exposure to obtain the estimation of the causal effect on the response in the second stage. The novelty of our model average estimator also lies in that it allows the number of submodels and the submodels' sizes to grow with the sample size. The practical performance of the estimator is examined in a series of numerical studies. We apply the proposed method on a real genetic dataset investigating the relationship between stature and blood pressure.
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Affiliation(s)
- Loraine Liping Seng
- Department of Statistics and Data Science, National University of Singapore, Singapore
- Duke-NUS Graduate Medical School, National University of Singapore, Singapore
| | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
- Department of Statistics, National Cheng Kung University, Tainan, Taiwan
| | - Jingli Wang
- School of Statistics and Data Science, Nankai University, China
| | - Jialiang Li
- Department of Statistics and Data Science, National University of Singapore, Singapore
- Duke-NUS Graduate Medical School, National University of Singapore, Singapore
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3
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Iddrisu AK, Besing Karadaar I, Gurah Junior J, Ansu B, Ernest DA. Mixed effects logistic regression analysis of blood pressure among Ghanaians and associated risk factors. Sci Rep 2023; 13:7728. [PMID: 37173375 PMCID: PMC10182051 DOI: 10.1038/s41598-023-34478-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/02/2023] [Indexed: 05/15/2023] Open
Abstract
Blood pressure (BP) control is a global health issue with an increase in BP beyond the normal BP leading to different stages of hypertension in humans and hence the need to identify risk factors of BP for efficient and effective control. Multiple BP measurement have proven to provide BP readings close to the true BP status of the individual. In this study, we used multiple BP measurement data on 3809 Ghanaians to determine risk factors associated with BP. The data were obtained from World Health Organization study on Global AGEing and Adult Health. We defined high blood pressure (HBP) as [Formula: see text] 130/80 mmHg or normal as [Formula: see text] 130/80 mmHg. We provide summary statistics and also used the Chi-Square test to assess significance of association between HBP versus risk factors of HBP. The aim of this study is to identify risk factors of BP using the mixed effects logistic regression model. Data were analyzed using R version 4.2.2. The results showed that the risk of high blood pressure (HBP) decreases across the three measurement periods. There is reduced risk (OR = 0.274, 95% CI = 0.2008, 0.405) of HBP among male participants relative to female participants. The risk (OR = 2.771, 95% CI = 1.8658, 4.1145) of HBP increased by 2.771-folds among those who are 60 years and above relative to those below the age of 60 years. Those whose work involves/requires vigorous exercise has 1.631-fold increase in the risk (OR = 1.631, 95% CI = 1.1151, 2.3854) of HBP relative to those whose work does not involve vigorous exercise. There is approximately 5-folds increased in the risk (OR = 4.896, 95% CI = 1.9535, 12.2268) of among those who have ever been diagnosed with diabetes. The results also revealed high risk (OR = 1.649, 95%CI = 1.1108, 2.4486) of HBP among those who have formal education. The risk (OR = 1.009, 95% CI = 1.0044, 1.0137) of HBP increases with increasing weight and a reduced risk (OR = 0.996, 95% CI = 0.9921, 0.9993) of HBP with increasing height. We found that sad experience, either mild, moderate or severe, is associated with a reduced risk of HBP. Those who have vegetable servings at least 2 cups per day have increased risk of HBP and those who have fruits servings at least 2 cups per day is associated with a reduced risk of HBP, however this is not statistically significant. To achieve success in BP control, programs should be designed with the aim of reducing weight, educate those with formal eduction on issues relating to HBP. Those whose work requires vigorous exercise are recommended to have regular check-ups to ensure that pressure build-up in the lungs is cleared. SBP is lower for women at young age but continue to increase after menopause as their BP increase becomes salt-sensitive. Hence there is need to give more attention to menopausal women so as to improve BP. Both young and old individuals are recommended to practice regular exercise since this has shown to reduce risk of being overweight or becoming diabetic and reduces the risk of HBP at yong age and old age. Also, to improve blood pressure control, programs for management of blood pressure or hypertension should focus more short stature individuals since such people are more likely to experience HBP.
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Affiliation(s)
- Abdul-Karim Iddrisu
- Department of Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, Ghana.
| | | | - Joseph Gurah Junior
- Department of Mathematics and ICT, St. Ambrose College of Education, Dormaa-Akwamu, Ghana
| | - Bismark Ansu
- Department of Mathematics and ICT, St. Ambrose College of Education, Dormaa-Akwamu, Ghana
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Howe LJ, Brumpton B, Rasheed H, Åsvold BO, Davey Smith G, Davies NM. Taller height and risk of coronary heart disease and cancer, a within-sibship Mendelian randomization study. eLife 2022; 11:72984. [PMID: 35302490 PMCID: PMC8947759 DOI: 10.7554/elife.72984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 03/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Taller people have a lower risk of coronary heart disease but a higher risk of many cancers. Mendelian randomization (MR) studies in unrelated individuals (population MR) have suggested that these relationships are potentially causal. However, population MR studies are sensitive to demography (population stratification, assortative mating) and familial (indirect genetic) effects. Methods: In this study, we performed within-sibship MR analyses using 78,988 siblings, a design robust against demography and indirect genetic effects of parents. For comparison, we also applied population MR and estimated associations with measured height. Results: Within-sibship MR estimated that 1 SD taller height lowers the odds of coronary heart disease by 14% (95% CI: 3–23%) but increases the odds of cancer by 18% (95% CI: 3–34%), highly consistent with population MR and height-disease association estimates. There was some evidence that taller height reduces systolic blood pressure and low-density lipoprotein cholesterol, which may mediate some of the protective effects of taller height on coronary heart disease risk. Conclusions: For the first time, we have demonstrated that the purported effects of height on adulthood disease risk are unlikely to be explained by demographic or familial factors, and so likely reflect an individual-level causal effect. Disentangling the mechanisms via which height affects disease risk may improve the understanding of the etiologies of atherosclerosis and carcinogenesis. Funding: This project was conducted by researchers at the MRC Integrative Epidemiology Unit (MC_UU_00011/1) and also supported by a Norwegian Research Council Grant number 295989.
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Affiliation(s)
- Laurence J Howe
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Ben Brumpton
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Humaira Rasheed
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjørn Olav Åsvold
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - George Davey Smith
- Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Neil Martin Davies
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
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Abstract
The known genetic architecture of blood pressure now comprises >30 genes, with rare variants resulting in monogenic forms of hypertension or hypotension and >1,477 common single-nucleotide polymorphisms (SNPs) being associated with the blood pressure phenotype. Monogenic blood pressure syndromes predominantly involve the renin-angiotensin-aldosterone system and the adrenal glucocorticoid pathway, with a smaller fraction caused by neuroendocrine tumours of the sympathetic and parasympathetic nervous systems. The SNPs identified in genome-wide association studies (GWAS) as being associated with the blood pressure phenotype explain only approximately 27% of the 30-50% estimated heritability of blood pressure, and the effect of each SNP on the blood pressure phenotype is small. A paucity of SNPs from GWAS are mapped to known genes causing monogenic blood pressure syndromes. For example, a GWAS signal mapped to the gene encoding uromodulin has been shown to affect blood pressure by influencing sodium homeostasis, and the effects of another GWAS signal were mediated by endothelin. However, the majority of blood pressure-associated SNPs show pleiotropic associations. Unravelling these associations can potentially help us to understand the underlying biological pathways. In this Review, we appraise the current knowledge of blood pressure genomics, explore the causal pathways for hypertension identified in Mendelian randomization studies and highlight the opportunities for drug repurposing and pharmacogenomics for the treatment of hypertension.
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Affiliation(s)
- Sandosh Padmanabhan
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Anna F Dominiczak
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
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Association between height and hypertension among US adults: analyses of National Health and Nutrition Examination Survey 2007-18. Clin Hypertens 2021; 27:6. [PMID: 33637121 PMCID: PMC7908753 DOI: 10.1186/s40885-021-00164-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background Previous studies that investigated association of height with prevalence and control of hypertension found mixed results. This cross-sectional study explored these associations among US adults (≥20 years). Methods The National Health and Nutrition Examination Survey (NHANES) 2007–18 data was analyzed. Height was measured in meters and was converted into centimeters (cm) and was further divided into quartiles: Q1 (135.3–159.2 cm), Q2 (159.3–166.2 cm), Q3 (166.3–173.6 cm), Q4 (173.7–204.5 cm). Hypertension definition of the ‘2017 American College of Cardiology/American Heart Association Guideline’ was used. Logistic regression analyses were conducted to find out the association between the dependent variable and the covariates. Linear regression analyses were conducted to find out the association of height with systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and the covariates among the individuals who were not taking any antihypertensive drugs. Crude odds ratio, adjusted odds ratio (AOR), and adjusted beta-coefficient (for linear regression) with 95% confidence interval (CI) were reported. The following covariates were included: age, gender, race/ethnicity, family income, education level, cholesterol level, high-density lipoprotein level, chronic kidney disease status, diabetes status, smoker, aerobic leisure-time physical activity, and survey period. Sample weight of NHANES was adjusted. Results Among the 21,935 participants (47.1% males), the prevalence of hypertension was 46.1%. Among 6154 participants taking medication (43.0% males), 57.2% had uncontrolled hypertension. In the final logistic regression analyses, participants in Q2 height quartile had 20% lower odds of being hypertensive compared to those in Q4 height quartile (AOR: 0.8; 95% CI: 0.7,1.0). Other height categories did not reveal any significant association. Compared to Q4 height category, Q1 (AOR: 1.7; 95% CI: 1.2,2.3), Q2 (AOR: 1.4; 95% CI: 1.1,1.8), and Q3 (AOR: 1.3; 95% CI: 1.1,1.6) height categories had higher odds of uncontrolled hypertension. PP was inversely associated and DBP was positively associated with height. Conclusions Although height was not associated with prevalence of hypertension, it had inverse association with uncontrolled hypertension. It was also significantly associated with DBP and PP among the individuals with untreated hypertension. Supplementary Information The online version contains supplementary material available at 10.1186/s40885-021-00164-4.
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Herráez A, Marrodán MD, González-Montero de Espinosa M. Variation of the cormic index since the onset of summer school camps in Spain (1887) up to present days. Am J Hum Biol 2021; 34:e23570. [PMID: 33474796 DOI: 10.1002/ajhb.23570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/31/2020] [Accepted: 01/07/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To assess a secular change in proportion between lower limbs and torso, we analyzed the evolution of cormic index in schoolchildren attending summer camps organized by the Spanish National Pedagogic Museum between 1887 and 1924, also comparing to later studies up to the present. SUBJECTS AND METHODS Unpublished primary data for height and sitting height were collected from 805 individuals of both sexes. Data were pooled in cohorts according to age and year of measurement. Additionally, the analysis included comparison with published data from both national and international populations. RESULTS Among males, a noteworthy decrease of the cormic index is perceived from the first to the last camps, while in females this is only seen for the group under 11 years old. With data from published Spanish references (1900-2019) a decrease is observed for the male series but is not evident for females. Cormic index values from the camps overlap among the international references, despite the former being from much earlier years. CONCLUSION The cormic index decreased among Spanish male children along the decades.
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Affiliation(s)
- Angel Herráez
- Departamento de Biología de Sistemas, Universidad de Alcalá, Alcala de Henares, Spain.,Grupo de Investigación Epinut (920325), Universidad Complutense de Madrid, Madrid, Spain
| | - Maria Dolores Marrodán
- Grupo de Investigación Epinut (920325), Universidad Complutense de Madrid, Madrid, Spain.,Departamento de Biodiversidad, Ecología y Evolución, Universidad Complutense de Madrid, Madrid, Spain
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8
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Gallo C, Olbers J, Ridolfi L, Scarsoglio S, Witt N. Testing a Patient-Specific In-Silico Model to Noninvasively Estimate Central Blood Pressure. Cardiovasc Eng Technol 2021; 12:144-157. [PMID: 33438147 DOI: 10.1007/s13239-020-00512-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/22/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To show some preliminary results about the possibility to exploit a cardiovascular mathematical model-made patient-specific by noninvasive data routinely measured during ordinary clinical examinations-in order to obtain sufficiently accurate central blood pressure (BP) estimates. METHODS A closed-loop multiscale (0D and 1D) model of the cardiovascular system is made patient-specific by using as model inputs the individual mean heart rate and left-ventricular contraction time, weight, height, age, sex and mean/pulse brachial BPs. The resulting framework is used to determine central systolic, diastolic, mean and pulse pressures, which are compared with the beat-averaged invasive pressures of 12 patients aged 72 ± 6.61 years. RESULTS Errors in central systolic, diastolic, mean and pulse pressures by the model are 4.26 ± 2.81, 5.86 ± 4.38, 4.98 ± 3.95 and 3.51±2.38 mmHg, respectively. CONCLUSION The proposed modeling approach shows a good patient-specific response and appears to be potentially useful in clinical practice. However, this approach needs to be evaluated in a larger cohort of patients and could possibly be improved through more accurate oscillometric BP measurement methods.
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Affiliation(s)
- Caterina Gallo
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Torino, Italy.
| | - Joakim Olbers
- Division of Cardiology, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
| | - Luca Ridolfi
- Department of Environmental, Land and Infrastructure Engineering, Politecnico di Torino, Torino, Italy
| | - Stefania Scarsoglio
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Torino, Italy
| | - Nils Witt
- Division of Cardiology, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
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Balcar VJ, Zeman T, Janout V, Janoutová J, Lochman J, Šerý O. Single Nucleotide Polymorphism rs11136000 of CLU Gene (Clusterin, ApoJ) and the Risk of Late-Onset Alzheimer's Disease in a Central European Population. Neurochem Res 2020; 46:411-422. [PMID: 33206315 DOI: 10.1007/s11064-020-03176-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/03/2020] [Accepted: 11/10/2020] [Indexed: 11/28/2022]
Abstract
Clusterin (CLU; also known as apolipoprotein J, ApoJ) is a protein of inconstant structure known to be involved in diverse processes inside and outside of brain cells. CLU can act as a protein chaperon or protein solubilizer, lipid transporter as well as redox sensor and be anti- or proapoptotic, depending on context. Primary structure of CLU is encoded by CLU gene which contains single nucleotide polymorphisms (SNP's) associated with the risk of late-onset Alzheimer's disease (LOAD). Studying a sample of Czech population and using the case-control association approach we identified C allele of the SNP rs11136000 as conferring a reduced risk of LOAD, more so in females than in males. Additionally, data from two smaller subsets of the population sample suggested a possible association of rs11136000 with diabetes mellitus. In a parallel study, we found no association between rs11136000 and mild cognitive impairment (MCI). Our findings on rs11136000 and LOAD contradict those of some previous studies done elsewhere. We discuss the multiple roles of CLU in a broad range of molecular mechanisms that may contribute to the variability of genetic studies of CLU in various ethnic groups. The above discordance notwithstanding, our conclusions support the association of rs1113600 with the risk of LOAD.
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Affiliation(s)
- Vladimir J Balcar
- Bosch Institute and Discipline of Anatomy and Histology, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia. .,Laboratory of Neurobiology and Pathological Physiology, Institute of Animal Physiology and Genetics, Academy of Sciences of the Czech Republic, Veveří 97, 602 00, Brno, Czech Republic.
| | - Tomáš Zeman
- Laboratory of Neurobiology and Pathological Physiology, Institute of Animal Physiology and Genetics, Academy of Sciences of the Czech Republic, Veveří 97, 602 00, Brno, Czech Republic.,Laboratory of Neurobiology and Molecular Psychiatry, Department of Biochemistry, Faculty of Science, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
| | - Vladimír Janout
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.,Present address: Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jana Janoutová
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic.,Present address: Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jan Lochman
- Laboratory of Neurobiology and Pathological Physiology, Institute of Animal Physiology and Genetics, Academy of Sciences of the Czech Republic, Veveří 97, 602 00, Brno, Czech Republic.,Laboratory of Neurobiology and Molecular Psychiatry, Department of Biochemistry, Faculty of Science, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
| | - Omar Šerý
- Laboratory of Neurobiology and Pathological Physiology, Institute of Animal Physiology and Genetics, Academy of Sciences of the Czech Republic, Veveří 97, 602 00, Brno, Czech Republic.,Laboratory of Neurobiology and Molecular Psychiatry, Department of Biochemistry, Faculty of Science, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
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Van De Kelft AS, Lievens C, De Groote K, Demulier L, De Backer J, T’Sjoen G, Craen M, Callewaert B, De Schepper J. Disproportion and dysmorphism in an adult Belgian population with Turner syndrome: risk factors for chronic diseases? Acta Clin Belg 2020; 75:258-266. [PMID: 31025600 DOI: 10.1080/17843286.2019.1606761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Turner syndrome (TS) is characterized by dysmorphism and body disproportion. TS women are also susceptible to a range of chronic disorders including arterial hypertension (AHT), osteoporosis, sensorineural hearing loss (SNHL), type 2 diabetes mellitus (DM2) and thyroid disease. The association between dysmorphism/body disproportion and chronic disease has never been studied in TS women. The effect of growth hormone treatment on body disproportion is also unclear. Objectives: to analyze dysmorphic features and body disproportion in TS women in relation to the presence of chronic disease and to document the effect of growth hormone therapy on body disproportion. METHOD 76 adult TS women with a regular follow up at the TS clinic UZ Ghent were invited to participate. Detailed body measurements were performed in 44 volunteering TS women. Scoring systems for overall dysmorphism, craniofacial dysmorphism, thoracic and limb abnormalities and skeletal disproportion were developed. RESULTS TS women with a higher dysmorphism score were more at risk for AHT (p = 0.04) as well as those with a higher sitting height/standing height ratio (p < 0.05). Prevalence of AHT, osteoporosis and DM 2 was lower in TS women treated with GH during childhood (p < 0.05). CONCLUSIONS Adult TS women with relatively short legs or with more physical dysmorphic stigmata were more at risk for AHT. GH therapy does not seem to increase the risk of chronic disease on the long term.
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Affiliation(s)
- An-Sofie Van De Kelft
- UZ Gent Turner Clinic, Department of pediatrics, University hospital Ghent, Ghent, Belgium
| | - Charlotte Lievens
- UZ Gent Turner Clinic, Department of pediatrics, University hospital Ghent, Ghent, Belgium
| | - Katya De Groote
- UZ Gent Turner Clinic, Department of pediatrics, University hospital Ghent, Ghent, Belgium
| | - Laurent Demulier
- UZ Gent Turner Clinic, Department of cardiology, University hospital Ghent, Ghent, Belgium
| | - Julie De Backer
- UZ Gent Turner Clinic, Department of cardiology, University hospital Ghent, Ghent, Belgium
| | - Guy T’Sjoen
- UZ Gent Turner Clinic, Department of endocrinology, University hospital Ghent, Ghent, Belgium
| | - Margarita Craen
- UZ Gent Turner Clinic, Department of pediatrics, University hospital Ghent, Ghent, Belgium
| | - Bert Callewaert
- UZ Gent Turner Clinic, Department of Pediatrics and medical genetics, University hospital Ghent, Ghent, Belgium
| | - Jean De Schepper
- UZ Gent Turner Clinic, Department of endocrinology, University hospital Ghent, Ghent, Belgium
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11
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Wells JCK, Stock JT. Life History Transitions at the Origins of Agriculture: A Model for Understanding How Niche Construction Impacts Human Growth, Demography and Health. Front Endocrinol (Lausanne) 2020; 11:325. [PMID: 32508752 PMCID: PMC7253633 DOI: 10.3389/fendo.2020.00325] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/27/2020] [Indexed: 12/18/2022] Open
Abstract
Over recent millennia, human populations have regularly reconstructed their subsistence niches, changing both how they obtain food and the conditions in which they live. For example, over the last 12,000 years the vast majority of human populations shifted from foraging to practicing different forms of agriculture. The shift to farming is widely understood to have impacted several aspects of human demography and biology, including mortality risk, population growth, adult body size, and physical markers of health. However, these trends have not been integrated within an over-arching conceptual framework, and there is poor understanding of why populations tended to increase in population size during periods when markers of health deteriorated. Here, we offer a novel conceptual approach based on evolutionary life history theory. This theory assumes that energy availability is finite and must be allocated in competition between the functions of maintenance, growth, reproduction, and defence. In any given environment, and at any given stage during the life-course, natural selection favours energy allocation strategies that maximise fitness. We argue that the origins of agriculture involved profound transformations in human life history strategies, impacting both the availability of energy and the way that it was allocated between life history functions in the body. Although overall energy supply increased, the diet composition changed, while sedentary populations were challenged by new infectious burdens. We propose that this composite new ecological niche favoured increased energy allocation to defence (immune function) and reproduction, thus reducing the allocation to growth and maintenance. We review evidence in support of this hypothesis and highlight how further work could address both heterogeneity and specific aspects of the origins of agriculture in more detail. Our approach can be applied to many other transformations of the human subsistence niche, and can shed new light on the way that health, height, life expectancy, and fertility patterns are changing in association with globalization and nutrition transition.
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Affiliation(s)
- Jonathan C. K. Wells
- Childhood Nutrition Research Centre, Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- *Correspondence: Jonathan C. K. Wells
| | - Jay T. Stock
- Department of Anthropology, University of Western Ontario, London, ON, Canada
- Department of Archaeology, Max Planck Institute for the Science of Human History, Jena, Germany
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12
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Charlton PH, Mariscal Harana J, Vennin S, Li Y, Chowienczyk P, Alastruey J. Modeling arterial pulse waves in healthy aging: a database for in silico evaluation of hemodynamics and pulse wave indexes. Am J Physiol Heart Circ Physiol 2019; 317:H1062-H1085. [PMID: 31442381 PMCID: PMC6879924 DOI: 10.1152/ajpheart.00218.2019] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/09/2019] [Accepted: 07/28/2019] [Indexed: 11/22/2022]
Abstract
The arterial pulse wave (PW) is a rich source of information on cardiovascular (CV) health. It is widely measured by both consumer and clinical devices. However, the physical determinants of the PW are not yet fully understood, and the development of PW analysis algorithms is limited by a lack of PW data sets containing reference CV measurements. Our aim was to create a database of PWs simulated by a computer to span a range of CV conditions, representative of a sample of healthy adults. The typical CV properties of 25-75 yr olds were identified through a literature review. These were used as inputs to a computational model to simulate PWs for subjects of each age decade. Pressure, flow velocity, luminal area, and photoplethysmographic PWs were simulated at common measurement sites, and PW indexes were extracted. The database, containing PWs from 4,374 virtual subjects, was verified by comparing the simulated PWs and derived indexes with corresponding in vivo data. Good agreement was observed, with well-reproduced age-related changes in hemodynamic parameters and PW morphology. The utility of the database was demonstrated through case studies providing novel hemodynamic insights, in silico assessment of PW algorithms, and pilot data to inform the design of clinical PW algorithm assessments. In conclusion, the publicly available PW database is a valuable resource for understanding CV determinants of PWs and for the development and preclinical assessment of PW analysis algorithms. It is particularly useful because the exact CV properties that generated each PW are known.NEW & NOTEWORTHY First, a comprehensive literature review of changes in cardiovascular properties with age was performed. Second, an approach for simulating pulse waves (PWs) at different ages was designed and verified against in vivo data. Third, a PW database was created, and its utility was illustrated through three case studies investigating the determinants of PW indexes. Fourth, the database and tools for creating the database, analyzing PWs, and replicating the case studies are freely available.
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Affiliation(s)
- Peter H Charlton
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Jorge Mariscal Harana
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Samuel Vennin
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London, United Kingdom
| | - Ye Li
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London, United Kingdom
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London, United Kingdom
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
- Institute of Personalized Medicine, Sechenov University, Moscow, Russia
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Montero D, Diaz-Canestro C. Body height is inversely associated with left ventricular end-diastolic pressure in heart failure with preserved ejection fraction. Eur J Prev Cardiol 2019; 27:1116-1118. [PMID: 31554412 DOI: 10.1177/2047487319873453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- David Montero
- University Heart Center, University Hospital Zurich, Switzerland.,Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Canada
| | - Candela Diaz-Canestro
- Cumming School of Medicine, Libin Cardiovascular Institute, University of Calgary, Canada
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Hwaung P, Heo M, Bourgeois B, Kennedy S, Shepherd J, Heymsfield SB. Greater Height Is Associated with a Larger Carotid Lumen Diameter. MEDICINES 2019; 6:medicines6020057. [PMID: 31091706 PMCID: PMC6631842 DOI: 10.3390/medicines6020057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/09/2019] [Accepted: 05/13/2019] [Indexed: 11/16/2022]
Abstract
Background: Previous studies link tall stature with a reduced ischemic stroke risk. One theory posits that tall people have larger cerebral artery lumens and therefore have a lower plaque occlusion risk than those who are short. Previous studies have not critically evaluated the associations between height and cerebral artery structure independent of confounding factors. Methods: The hypothesis linking stature with cerebral artery lumen size was tested in 231 adults by measuring the associations between height and common carotid artery diameter (CCAD) and intima-media thickness (IMT) after controlling for recognized vascular influencing factors (e.g., adiposity, blood pressure, plasma lipids, etc.). Results: Height remained a significant CCAD predictor across all developed multiple regression models. These models predict a ~0.03 mm increase in CCAD for each 1-cm increase in height in this sample. This magnitude of CCAD increase with height represents over a 60% enlargement of the artery's lumen area across adults varying in stature from short (150 cm) to tall (200 cm). By contrast, IMT was non-significantly correlated with height across all developed regression models. Conclusions: People who are tall have a larger absolute CCAD than people who are short, while IMT is independent of stature. These observations potentially add to the growing cardiovascular literature aimed at explaining the lower risk of ischemic strokes in tall people.
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Affiliation(s)
- Phoenix Hwaung
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA 70808, USA.
| | - Moonseong Heo
- Department of Public Health Sciences, Clemson University, Clemson, SC 29631, USA.
| | - Brianna Bourgeois
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA 70808, USA.
| | - Samantha Kennedy
- Department of Public Health Sciences, Clemson University, Clemson, SC 29631, USA.
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA.
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA 70808, USA.
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Polygenic adaptation and convergent evolution on growth and cardiac genetic pathways in African and Asian rainforest hunter-gatherers. Proc Natl Acad Sci U S A 2018; 115:E11256-E11263. [PMID: 30413626 DOI: 10.1073/pnas.1812135115] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Different human populations facing similar environmental challenges have sometimes evolved convergent biological adaptations, for example, hypoxia resistance at high altitudes and depigmented skin in northern latitudes on separate continents. The "pygmy" phenotype (small adult body size), characteristic of hunter-gatherer populations inhabiting both African and Asian tropical rainforests, is often highlighted as another case of convergent adaptation in humans. However, the degree to which phenotypic convergence in this polygenic trait is due to convergent versus population-specific genetic changes is unknown. To address this question, we analyzed high-coverage sequence data from the protein-coding portion of the genomes of two pairs of populations: Batwa rainforest hunter-gatherers and neighboring Bakiga agriculturalists from Uganda and Andamanese rainforest hunter-gatherers and Brahmin agriculturalists from India. We observed signatures of convergent positive selection between the rainforest hunter-gatherers across the set of genes with "growth factor binding" functions ([Formula: see text]). Unexpectedly, for the rainforest groups, we also observed convergent and population-specific signatures of positive selection in pathways related to cardiac development (e.g., "cardiac muscle tissue development"; [Formula: see text]). We hypothesize that the growth hormone subresponsiveness likely underlying the adult small body-size phenotype may have led to compensatory changes in cardiac pathways, in which this hormone also plays an essential role. Importantly, in the agriculturalist populations, we did not observe similar patterns of positive selection on sets of genes associated with growth or cardiac development, indicating our results most likely reflect a history of convergent adaptation to the similar ecology of rainforests rather than a more general evolutionary pattern.
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Wells JCK. Life history trade-offs and the partitioning of maternal investment: Implications for health of mothers and offspring. Evol Med Public Health 2018; 2018:153-166. [PMID: 30152817 PMCID: PMC6101534 DOI: 10.1093/emph/eoy014] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 06/08/2018] [Indexed: 12/30/2022] Open
Abstract
Lay Summary: This review sets out the hypothesis that life history trade-offs in the maternal generation favour the emergence of similar trade-offs in the offspring generation, mediated by the partitioning of maternal investment between pregnancy and lactation, and that these trade-offs help explain widely reported associations between growth trajectories and NCD risk. Growth patterns in early life predict the risk of non-communicable diseases (NCDs), but adaptive explanations remain controversial. It is widely assumed that NCDs occur either because of physiological adjustments to early constraints, or because early ecological cues fail to predict adult environmental conditions (mismatch). I present an inter-generational perspective on developmental plasticity, based on the over-arching hypothesis that a key axis of variability in maternal metabolism derives from life history trade-offs, which influence how individual mothers partition nutritional investment in their offspring between pregnancy and lactation. I review evidence for three resulting predictions: (i) Allocating relatively more energy to growth during development promotes the capacity to invest in offspring during pregnancy. Relevant mechanisms include greater fat-free mass and metabolic turnover, and a larger physical space for fetal growth. (ii) Allocating less energy to growth during development constrains fetal growth of the offspring, but mothers may compensate by a tendency to attain higher adiposity around puberty, ecological conditions permitting, which promotes nutritional investment during lactation. (iii) Since the partitioning of maternal investment between pregnancy and lactation impacts the allocation of energy to 'maintenance' as well as growth, it is expected to shape offspring NCD risk as well as adult size and body composition. Overall, this framework predicts that life history trade-offs in the maternal generation favour the emergence of similar trade-offs in the offspring generation, mediated by the partitioning of maternal investment between pregnancy and lactation, and that these trade-offs help explain widely reported associations between growth trajectories and NCD risk.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC, UK
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Gialamas A, Kinnell A, Mittinty MN, Davison B, Singh G, Lynch J. Association of anthropometric measures and cardiovascular risk factors in children and adolescents: Findings from the Aboriginal Birth Cohort study. PLoS One 2018; 13:e0199280. [PMID: 29927998 PMCID: PMC6013209 DOI: 10.1371/journal.pone.0199280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 06/05/2018] [Indexed: 01/21/2023] Open
Abstract
This study examined the association of anthropometric measures including height, leg length, trunk length and body mass index (BMI) at 11 and 18 years with systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) at 11 and 18 years. We analysed data from 661 participants from the Aboriginal Birth Cohort study–a longitudinal study based in the Northern Territory, Australia. Associations between anthropometric measures and cardiovascular risk factors were investigated in linear regression analyses adjusted for confounding, with imputation for missing data. In adjusted analyses, increasing leg length [males: 0.47mmHg/cm (0.23, 0.72); females: 0.50mmHg/cm (0.18, 0.83)], trunk length [males: 0.50mmHg/cm (0.28, 0.73); females: 0.57mmHg/cm (0.33, 0.81)] and height [males: 0.32mmHg/cm (0.16, 0.48); females: 0.32mmHg/cm (0.12, 0.52)] at 11 years was associated with higher SBP at 11 years. When these exposures were measured at 18 years the effect on SBP at 18 years had attenuated, and only increased trunk length was associated with higher SBP at 18 years for both sexes [males: 0.46mmHg/cm (0.05, 0.87); females: 0.69mmHg/cm (0.30, 1.08)]. We observed little association between height, leg length and trunk length and DBP, total cholesterol, LDL-c and HDL-c. Increased BMI was associated with elevated SBP and DBP at 11 and 18 years. Our findings suggest that height, leg length, and trunk length measured at 11 and 18 years was generally not associated with cardiovascular risk factors at 11 and 18 years. However, greater childhood BMI was associated with higher blood pressure and this association persisted into adolescence. This study contributes to the limited body of evidence on the association between measures of early anthropometry and cardiovascular risk among the Australian Aboriginal population.
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Affiliation(s)
- Angela Gialamas
- School of Public Health, University of Adelaide, Adelaide, Australia
- * E-mail:
| | - Angela Kinnell
- School of Public Health, University of Adelaide, Adelaide, Australia
| | | | - Belinda Davison
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Gurmeet Singh
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - John Lynch
- School of Public Health, University of Adelaide, Adelaide, Australia
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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Abstract
AbstractObjectiveTo retrospectively investigate the association between short stature and increased sitting height ratio (SHR) – indicators of stunting – and obesity markers in adults.DesignCross-sectional evaluation of the EPIPorto cohort. Weight, height, sitting height and waist circumference were measured. Obesity was assessed for men and women through BMI and waist-to-height ratio (WHtR). Short stature (women, <152 cm; men, <164 cm) and high SHR (women, ≥54·05 %; men, ≥53·25 %) were taken as stunting measures. OR with 95 % CI were computed using logistic regression models.SettingRepresentative sample of adults from EPIPorto, an adult cohort study from Porto, Portugal.SubjectsA sample of 1682 adults, aged 18–86 years, was analysed.ResultsHigher obesity prevalence was found among women (BMI≥30·0 kg/m2: 25·5v.13·3 %,P<0·001) and a higher proportion of men presented abdominal obesity (WHtR≥0·5: 80·1v.71·1 %,P<0·001). A positive association was found between short stature and obesity measures for women (multivariate-adjusted OR; 95 % CI: 1·75; 1·17, 2·62 for BMI≥30·0 kg/m2; 1·89; 1·24, 2·87 for WHtR≥0·5). Increased SHR was associated with higher likelihood of having BMI≥30·0 kg/m2in both sexes (multivariate-adjusted OR; 95 % CI: 2·10; 1·40, 3·16 for women; 1·92; 1·07, 3·43 for men) but not with WHtR≥0·5.ConclusionsDifferent growth markers are associated with obesity in adults. However, this association depends on the population and anthropometric measures used: short stature is associated with a higher risk of presenting excessive weight in women but not in men; SHR is more sensitive to detect this effect in both sexes.
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Bourgeois B, Watts K, Thomas DM, Carmichael O, Hu FB, Heo M, Hall JE, Heymsfield SB. Associations between height and blood pressure in the United States population. Medicine (Baltimore) 2017; 96:e9233. [PMID: 29390353 PMCID: PMC5815765 DOI: 10.1097/md.0000000000009233] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 11/17/2017] [Accepted: 11/20/2017] [Indexed: 01/10/2023] Open
Abstract
The mechanisms linking short stature with an increase in cardiovascular and cerebrovascular disease risk remain elusive. This study tested the hypothesis that significant associations are present between height and blood pressure in a representative sample of the US adult population.Participants were 12,988 men and women from a multiethnic sample (age ≥ 18 years) evaluated in the 1999 to 2006 National Health and Nutrition Examination Survey who were not taking antihypertensive medications and who had complete height, weight, % body fat, and systolic and diastolic arterial blood pressure (SBP and DBP) measurements; mean arterial blood pressure and pulse pressure (MBP and PP) were calculated. Multiple regression models for men and women were developed with each blood pressure as dependent variable and height, age, race/ethnicity, body mass index, % body fat, socioeconomic status, activity level, and smoking history as potential independent variables.Greater height was associated with significantly lower SBP and PP, and higher DBP (all P < .001) in combined race/ethnic-sex group models beginning in the 4th decade. Predicted blood pressure differences between people who are short and tall increased thereafter with greater age except for MBP. Socioeconomic status, activity level, and smoking history did not consistently contribute to blood pressure prediction models.Height-associated blood pressure effects were present in US adults who appeared in the 4th decade and increased in magnitude with greater age thereafter. These observations, in the largest and most diverse population sample evaluated to date, provide support for postulated mechanisms linking adult stature with cardiovascular and cerebrovascular disease risk.
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Affiliation(s)
| | - Krista Watts
- Department of mathematical sciences, United States Military Academy, West Point, NY
| | - Diana M. Thomas
- Department of mathematical sciences, United States Military Academy, West Point, NY
| | - Owen Carmichael
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA
| | - Frank B. Hu
- Department of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | | | - John E. Hall
- Departments of Physiology and Biophysics and Mississippi Center for Obesity Research, University of Mississippi Medical Center, Jackson, MS
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Sohn K. The Association between Height and Hypertension in Indonesia. ECONOMICS AND HUMAN BIOLOGY 2017; 27:74-83. [PMID: 28550808 DOI: 10.1016/j.ehb.2017.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 03/28/2017] [Accepted: 04/19/2017] [Indexed: 06/07/2023]
Abstract
There is growing interest in the influence of early-life conditions on the development of disease. Among diseases in adulthood, hypertension is particularly important for the developing world because considerably more people there are and will be afflicted with the disease than in the developed world and hypertensives there are often unaware of their disease status. We employed height as a proxy for the influence of early-life conditions and estimated the relation between height and hypertension status in Indonesia. We analysed 9,597 men and 10,143 women, aged 25-70. We employed a linear probability model to relate height to hypertension status by sex and age. When we controlled for an array of covariates, a 10cm increase in height was related to an approximately 7% point reduction in the likelihood of being hypertensive for both men and women. This is about a quarter of the prevalence of hypertension in Indonesia. This relation was linear and stronger among older individuals. In addition, the pre- and post-pubertal environments (measured by leg and trunk lengths, respectively) contributed similarly to hypertension. Further evidence suggests that women are more likely to be hypertensive at older ages because they are on average shorter than men.
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Affiliation(s)
- Kitae Sohn
- Department of Economics, Konkuk University. 120 Neungdong-ro. Gwangjin-gu, Seoul, 05029, South Korea; School of Economics and Finance, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
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22
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Kaulgud RS, Kaul A, Arun BS, Vijayalaxmi PB. Neck Circumference and Leg Length as Surrogate Markers of Coronary Artery Disease - Simplifying Cardiac Risk Stratification. J Clin Diagn Res 2017; 11:OC17-OC19. [PMID: 28658827 DOI: 10.7860/jcdr/2017/21937.9934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 02/20/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Coronary angiography is the gold standard for quantification of coronary atherosclerosis. But, being invasive, it has inherent complications. Hence, we examined the accuracy of prediction of coronary angiography using simple anthropometric indices. AIM To identify a patient friendly method to predict coronary artery disease using simple anthropometric parameters, by testing their correlation with coronary artery disease severity scoring system. MATERIALS AND METHODS We conducted a cross-sectional study on patients undergoing elective coronary angiography. A total of 48 patients were included in the study. Neck circumference and leg length of the patients were noted. The severity of coronary atherosclerosis was quantified using Jenkin's scoring system. Mean and standard deviation for each continuous variable was calculated. The correlation between Jenkins' score, neck circumference and leg length was tested. The data analysis was done using IBM-SPSS software. RESULTS Mean leg length among the study population was 88.70 cm (±2.51 cm) among males, 79.04 cm (±4.32 cm) among females and 83.66 cm (±3.26 cm) overall. Mean neck circumference was 36.87 cm (±4.37 cm) among males, 36.04 cm (±3.65 cm) among females and 36.44 cm (±3.99 cm) when combined together. There was no correlation of Jenkin's scores with leg length. But, there was significant correlation between Jenkin's scores and neck circumference. CONCLUSION Neck circumference can be used as a simple and effective tool and is better than leg length for risk stratification of patients with coronary heart disease.
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Affiliation(s)
- Ram S Kaulgud
- Assistant Professor, Department of General Medicine, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
| | - Adhishesh Kaul
- Student, Department of Medicine, Karnataka Institute of Medical Sciences, Vidyanagar, Hubli, Karnataka, India
| | - B S Arun
- Assistant Professor, Department of General Medicine, MVJ Medical College, Hoskote, Karnataka, India
| | - P B Vijayalaxmi
- Professor, Department of Medicine, SDM Medical College, Sattur, Dharwad, Karnataka, India
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Height and prevalence of hypertension in a middle-aged and older Chinese population. Sci Rep 2016; 6:39480. [PMID: 28000763 PMCID: PMC5175189 DOI: 10.1038/srep39480] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 11/23/2016] [Indexed: 11/09/2022] Open
Abstract
Evidence from epidemiological studies reported that height was inversely associated with cardiovascular diseases, but the association between height and hypertension was unclear. The purpose of this study was to explore the association between height and blood pressure or prevalence of hypertension in a middle-aged and older Chinese population. A total of 33,197 participants aged 37 to 94 years were recruited from the Dongfeng-Tongji cohort study in Hubei province, China. All participants completed baseline questionnaires, medical examinations and provided blood samples. Hypertension was define as a systolic blood pressure (SBP) over 140 mmHg or/and a diastolic blood pressure (DBP) over 90 mmHg, or current use of antihypertensive medication, or participants with self-reported physician diagnosis of hypertension. Multivariate linear and logistic regression models were used. The prevalence of hypertension was 69.1% for men and 58.0% for women. Pulse pressure (PP) and SBP, but not DBP decreased linearly with increasing height among men and women. Comparing the highest with the shortest quartile of height, the multivariate-adjusted odds ratios were 0.80 (95% confidence interval, 0.71, 0.91) for men and 0.83 (0.74, 0.92) for women. In conclusion, height was associated with reduced SBP, PP and prevalence of hypertension in a middle-aged and older Chinese population.
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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: 16] [Impact Index Per Article: 2.0] [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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Haugaard LK, Baker JL, Perng W, Belfort MB, Rifas-Shiman SL, Switkowski K, Oken E, Gillman MW. Growth in Total Height and Its Components and Cardiometabolic Health in Childhood. PLoS One 2016; 11:e0163564. [PMID: 27658308 PMCID: PMC5033234 DOI: 10.1371/journal.pone.0163564] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 09/11/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Short stature or short legs is associated with cardiometabolic disease. Few studies have addressed this issue in children, incorporated repeated measures, or studied modern cohorts. METHODS We examined if change in total height, leg length and trunk length between two time points from early (median: 3.2 years) to mid-childhood (median: 7.7 years), with and without adjustment for concurrent change in adiposity (subscapular plus triceps skinfold thickness), was associated with mid-childhood cardiometabolic risk in 315 boys and 295 girls from Project Viva. The main outcome was a cardiometabolic risk score based on sex-specific internal z-scores for systolic blood pressure, waist circumference, homeostatic model assessment of insulin resistance, triglycerides and high-density lipoprotein-cholesterol. RESULTS Mean (SD) total height was 97.9 (4.5) cm in boys and 97.1 (4.7) cm in girls in early childhood and 129.1 (7.2) cm in boys and 128.3 (7.9) cm in girls in mid-childhood. Trunk length constituted about half of total height. In linear regression models adjusted for parental anthropometry and socio-demographics, faster growth in total height, leg length and particularly trunk length, were associated with higher cardiometabolic risk in mid-childhood. Per 1 cm annual increase in trunk length, the cardiometabolic risk score was 0.23 z-score (95% confidence interval [CI] 0.08, 0.39) higher among boys and 0.47 z-score (95% CI 0.33, 0.60) higher among girls. Estimates were attenuated after adjusting for adiposity (boys: 0.03 z-score, 95% CI -0.11, 0.18; girls: 0.32 z-score, 95% CI 0.19, 0.45). CONCLUSION Rapid linear growth, particularly in trunk length, was associated with higher cardiometabolic risk in childhood, which was explained by relationships of linear growth with adiposity in boys, but only partly in girls.
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Affiliation(s)
- Line Klingen Haugaard
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
- * E-mail:
| | - Jennifer L. Baker
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - Wei Perng
- Department of Nutritional Sciences, University of Michigan, School of Public Health, Ann Arbor, Michigan, United States of America
| | - Mandy Brown Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Sheryl L. Rifas-Shiman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
| | - Karen Switkowski
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
| | - Emily Oken
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Matthew W. Gillman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
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Rodríguez López S, Bensenor IM, Giatti L, Molina MDC, Lotufo PA. Association between maternal education and blood pressure: mediation evidence through height components in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Ann Hum Biol 2016; 44:243-251. [DOI: 10.1080/03014460.2016.1188983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Santiago Rodríguez López
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
- Research and Study Centre on Culture and Society, National Scientific and Technical Research Council (CIECS-CONICET-UNC), Córdoba, Argentina
- Department of Biology, Autonomous University of Madrid, Madrid, Spain
| | - Isabela M. Bensenor
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Luana Giatti
- School of Nutrition, Federal University of Ouro Preto, Ouro Preto, Brazil
| | | | - Paulo A. Lotufo
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
- School of Medicine, University of São Paulo, São Paulo, Brazil
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Golkari A, Sabokseir A, Sheiham A, Watt RG. Socioeconomic gradients in general and oral health of primary school children in Shiraz, Iran. F1000Res 2016; 5:767. [PMID: 27239279 PMCID: PMC4879935 DOI: 10.12688/f1000research.8641.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2016] [Indexed: 01/10/2023] Open
Abstract
Background: Health status is largely determined by socio-economic status. The general health of individuals at higher social hierarchy is better than people in lower levels. Likewise, people with higher socio-economic status have better oral health than lower socio-economic groups. There has not been much work regarding the influence of socio-economic status on the health conditions of children in developing countries, particularly in Iran. The aim of this study was to compare the oral and general health conditions of primary school children of three different socio-economic areas in the city of Shiraz, Iran. Methods: This cross-sectional study was conducted on 335, 8- to 11-year-old primary schoolchildren in Shiraz. The children were selected by a three-stage cluster sampling method from three socio-economically different areas. Tools and methods used by the United Kingdom’s Medical Research Council were used to obtain anthropometric variables as indicators of general health. The Decay, Missing, Filled Teeth (DMFT) Index for permanent teeth, dmft Index for primary teeth, the Modified Developmental Defects of Enamel (DDE) Index, the Gingival Index (GI) and the Debris Index-Simplified (DI-S) were used for oral health assessment. Results: Height (P<0.001), weight (P<0.001), and BMI (P=0.001) significantly increased as the socio-economic status of area increased. GI score (P<0.001), DI-S score (P<0.001), number of permanent teeth with DDE (P=0.008), and number of DDE lesions in permanent teeth (P=0.008) significantly decreased as the socio-economic status of area increased. Discussion: Findings of this study generally confirmed that social gradients exist in both general and oral health status of the primary schoolchildren of Shiraz. The influence of socio-economic status on health condition means children have different life chances based on their socio-economic conditions. These findings emphasize the significance of interventions for tackling socio-economic inequalities in order to improve the health status of children in lower socio-economic areas.
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Affiliation(s)
- Ali Golkari
- Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, 71345-1836, Iran; Research Department of Epidemiology and Public Health, University College London, London, WC1E 7HB, UK
| | - Aira Sabokseir
- Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, 71345-1836, Iran
| | - Aubrey Sheiham
- Research Department of Epidemiology and Public Health, University College London, London, WC1E 7HB, UK
| | - Richard G Watt
- Research Department of Epidemiology and Public Health, University College London, London, WC1E 7HB, UK
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Association between upper leg length and metabolic syndrome among US elderly participants-results from the NHANES (2009-2010). JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2016; 13:58-63. [PMID: 26918014 PMCID: PMC4753013 DOI: 10.11909/j.issn.1671-5411.2016.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine the relationship between upper leg length (ULL) and metabolic syndrome (MetS) in older adults. METHODS Data was collected from National Health and Nutritional Examination Survey (NHANES, 2009-2010). 786 individuals (385 males and 401 females) who were 60 years of age or older were included in this analysis. MetS was defined as having at least three of following conditions, i.e., central obesity, dyslipidemia, insulin resistance, and hypertension based on National Cholesterol Education Program guidelines. ULL was grouped into gender-specific tertiles. RESULTS 328 (41.7%) of participants were categorized as having MetS (38.7% in men and 49.1% in women, P = 0.002). Compared to individuals in the 1(st) tertile (T1) of ULL, those in the 3(rd) tertile (T3) had lower levels of triglycerides (120.8 vs. 153.1 mg/dL, P = 0.045), waist circumference (100.7 vs. 104.2 cm, P = 0.049), and systolic blood pressure (126.7 vs. 131.4 mmHg, P = 0.005), but higher levels of high-density-lipoprotein cholesterol (58.1 vs. 52.4 mg/dL, P = 0.024). The odds ratios (95% CI) of MetS from multivariate logistic regression were 0.57 (0.32-1.03) for individuals in the T2 of ULL and 0.39 (0.24-0.64) for individuals in the T3 of ULL, respectively (P-value for the trend 0.022). CONCLUSIONS ULL was negatively associated with MetS in older adults. Further research is needed to identify potential mechanisms.
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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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Poh BK, Wong JE, Norimah AK, Deurenberg P. Differences in Body Build in Children of Different Ethnic Groups and their Impact on the Prevalence of Stunting, Thinness, Overweight, and Obesity. Food Nutr Bull 2016; 37:3-13. [PMID: 26769039 DOI: 10.1177/0379572115626025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The prevalence of stunting, thinness, overweight, and obesity among children differs by ethnicity. It is not known whether differences in body build across the ethnic groups influence the interpretation of nutritional parameters. OBJECTIVE To explore the differences in body build across the 5 main ethnic groups in Malaysia and to determine whether differences in body build have an impact on the interpretation of nutrition indicators. METHODS A total of 3227 children aged 2.0 to 12.9 years who participated in the South East Asian Nutrition Surveys (SEANUTS) in Malaysia were included in this analysis. Body weight, height, sitting height, wrist and knee breadths, and biceps and subscapular skinfolds were measured, and relative leg length, slenderness index, and sum of skinfolds were calculated. Z scores for height-for-age (HAZ) and body mass index-for-age (BAZ) were calculated using the World Health Organization (WHO) 2007 growth standards. RESULTS Differences in relative leg length and slenderness across the ethnic groups were correlated with HAZ and BAZ. Correction for differences in body build did, in some ethnic groups, have significant impact on the prevalence of stunting, thinness, overweight, and obesity, and the pattern of prevalence across ethnic groups changed. CONCLUSION At the population level, corrections for body build had only minor and mostly nonsignificant effects on prevalence, but at an individual level, corrections for body build placed a substantial number of children in different height or weight categories. Whether these misclassifications warrant additional assessment of body build in clinical practice will need further investigation.
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Affiliation(s)
- Bee Koon Poh
- Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Jyh Eiin Wong
- Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Abstract
A life course approach in epidemiology investigates the biological, behavioral and social pathways that link physical and social exposures and experiences during gestation, childhood, adolescence and adult life, and across generations, to later-life health and disease risk. We illustrate how a life course approach has been applied to cardiovascular disease, highlighting the evidence in support of the early origins of disease risk. We summarize how trajectories of cardiometabolic risk factors change over the life course and suggest that understanding underlying 'normal' or 'healthy' trajectories and the characteristics that drive deviations from such trajectories offer the potential for early prevention and for identifying means of preventing future disease.
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Affiliation(s)
- Rebecca Hardy
- MRC Unit for Lifelong Health & Ageing at UCL, 33 Bedford Place, London, WC1B 5JU, UK
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Relationship between muscle sympathetic nerve activity and aortic wave reflection characteristics in aerobic- and resistance-trained subjects. Eur J Appl Physiol 2015; 115:2609-19. [DOI: 10.1007/s00421-015-3230-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 07/29/2015] [Indexed: 12/26/2022]
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Sohn K. Is leg length a biomarker of early life conditions? Evidence from a historically short population. Am J Hum Biol 2015; 27:538-45. [DOI: 10.1002/ajhb.22682] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 12/21/2014] [Accepted: 12/29/2014] [Indexed: 11/08/2022] Open
Affiliation(s)
- Kitae Sohn
- Department of Economics; Konkuk University; 120 Neungdong-ro Gwangjin-gu Seoul 143-701 South Korea
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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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Li Y, Wang Z, Zhang L, Yang X, Song J. Characters available in photoplethysmogram for blood pressure estimation: beyond the pulse transit time. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2014; 37:367-76. [DOI: 10.1007/s13246-014-0269-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Accepted: 03/30/2014] [Indexed: 10/25/2022]
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Regnault N, Kleinman KP, Rifas-Shiman SL, Langenberg C, Lipshultz SE, Gillman MW. Components of height and blood pressure in childhood. Int J Epidemiol 2014; 43:149-59. [PMID: 24413933 DOI: 10.1093/ije/dyt248] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In children being taller is associated with higher blood pressure (BP), but few studies have divided height into its components: trunk and leg length. We examined the associations of total height, trunk length and leg length with systolic BP (SBP), diastolic BP (DBP) and pulse pressure (PP) at early childhood and mid-childhood visits, as well as change between the two visits. METHODS We obtained five measures of SBP and DBP at the early childhood visit (N = 1153, follow-up rate = 54%) and at the mid-childhood visit (N = 1086, follow-up rate = 51%) respectively, in Project Viva, a US cohort study. We measured total height and sitting height (a measure of trunk length that includes head and neck) and calculated leg length as the difference between the two. Using mixed models, we adjusted the cross-sectional analyses for leg length when trunk length was the exposure of interest, and vice versa. We also adjusted for maternal race/ethnicity, child age, sex, overall adiposity and BP measurement conditions. RESULTS At the mid-childhood visit, total height was positively associated with SBP [0.34 (0.24; 0.45) mmHg/cm] but not with DBP [0.07 (-0.003; 0.15)]. In models examining trunk and leg length separately, each was positively associated with SBP [0.72 (0.52; 0.92) and 0.33 (0.16; 0.49) respectively]. In a fully adjusted model with both leg and trunk length, only trunk length remained associated with BP. For a given leg length, a 1-cm increment in trunk length was associated with a 0.63-mmHg (0.42; 0.83) higher SBP and a 0.17-mmHg (0.02; 0.31) higher DBP. For a given trunk length, however, the associations of leg length with SBP [0.13 (-0.03; 0.30)] and with DBP [0.002 (-0.11; 0.12)] were null. These patterns were similar at the early childhood visit. CONCLUSIONS Children with greater trunk lengths have higher BPs, perhaps because of the additional pressure needed to overcome gravity to perfuse the brain.
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Affiliation(s)
- Nolwenn Regnault
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA, MRC Epidemiology Unit, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA and Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
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Kelishadi R, Farajian S. The protective effects of breastfeeding on chronic non-communicable diseases in adulthood: A review of evidence. Adv Biomed Res 2014; 3:3. [PMID: 24600594 PMCID: PMC3929058 DOI: 10.4103/2277-9175.124629] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Accepted: 08/21/2013] [Indexed: 11/17/2022] Open
Abstract
Chronic non-communicable diseases (NCDs), including cardiovascular diseases, cancers, chronic respiratory diseases, diabetes, etc., are the major causes of mortality in the world, notably in low- and middle-income countries. A growing body of evidence suggests that NCDs have a complex etiology resulting from the interaction of genetic factors, gender, age, ethnicity, and the environmental factors. It is well-documented that chronic diseases in adulthood origins in early life. In recent years, much attention has been focused on primordial and primary prevention of NCD risk factors. There are many biological and epidemiological studies on beneficial effects of breastfeeding during infancy on chronic diseases in adulthood, particularly on hypertension, obesity, diabetes, hypercholesterolemia, and cardiovascular diseases. This review article aims to summarize the current literature on the long-term effects of breastfeeding on prevention of NCDs and their risk factors. The current literature is controversial about these effects; however, a growing body of evidence suggests that breastfeeding has protective roles against obesity, hypertension, dyslipidemia, and type II diabetes mellitus during adulthood. In addition to its short-term benefits, encouraging breastfeeding can have long-term beneficial health effects at individual and population levels.
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Affiliation(s)
- Roya Kelishadi
- Professor of Pediatrics, Child Growth and Development Research Center, Isfahan, Iran
| | - Sanam Farajian
- MSc of Nutrition, Faculty of Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
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Miedema MD, Petrone AB, Arnett DK, Dodson JA, Carr JJ, Pankow JS, Hunt SC, Province MA, Kraja A, Gaziano JM, Djousse L. Adult height and prevalence of coronary artery calcium: the National Heart, Lung, and Blood Institute Family Heart Study. Circ Cardiovasc Imaging 2013; 7:52-7. [PMID: 24336983 DOI: 10.1161/circimaging.113.000681] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Adult height has been hypothesized to be inversely associated with coronary heart disease; however, studies have produced conflicting results. We sought to examine the relationship between adult height and the prevalence of coronary artery calcium (CAC), a direct measure of subclinical atherosclerosis and surrogate marker of coronary heart disease. METHODS AND RESULTS We evaluated the relationship between adult height and CAC in 2703 participants from the National Heart, Lung, and Blood Institute Family Heart Study who underwent cardiac computed tomography. We used generalized estimating equations to calculate the prevalence odds ratios for the presence of CAC (CAC>0) across sex-specific quartiles of height. The mean age of the sample was 54.8 years, and 60.2% of participants were female. There was an inverse association between adult height and CAC. After adjusting for age, race, field center, waist circumference, smoking, alcohol, physical activity, systolic blood pressure, antihypertensive medications, diabetes mellitus, diabetic medications, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, lipid-lowering medications, and income, individuals in the tallest quartile had 30% lower odds of having prevalent CAC. The odds ratios (95% confidence intervals) for the presence of CAC across consecutive sex-specific quartiles of height were 1.0 (reference), 1.15 (0.86-1.53), 0.95 (0.73-1.22), and 0.70 (0.53-0.93), and P for trend<0.01. There was no evidence of effect modification for the relationship between adult height and CAC by age or socioeconomic status. CONCLUSIONS The results of our study suggest an inverse, independent association between adult height and CAC.
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Affiliation(s)
- Michael D Miedema
- Brigham and Women's Hospital, Division of Aging, and Boston Veteran Affairs Healthcare System, Harvard Medical School, Boston, MA
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Izadi V, Kelishadi R, Qorbani M, Esmaeilmotlagh M, Taslimi M, Heshmat R, Ardalan G, Azadbakht L. Duration of breast-feeding and cardiovascular risk factors among Iranian children and adolescents: the CASPIAN III study. Nutrition 2013; 29:744-51. [PMID: 23582077 DOI: 10.1016/j.nut.2012.10.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 10/29/2012] [Accepted: 10/31/2012] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Studies examining the relationship between breast-feeding (BF) duration and cardiovascular disease (CVD) risk factors have reached contradictory results. This study aims to investigate the relationship between BF duration and CVD risk factors in adolescents. METHODS This national population-based study was conducted among 5258 Iranian students, ages 10 to 18 y living in central cities of 27 provinces of Iran. Association was examined between duration of BF and adolescent blood pressure, overweight, obesity, and fasting blood glucose and lipid profiles. Analyses were adjusted for potential confounders. RESULTS Low birth weight was less frequent in the longer than in the shorter BF duration categories (P < 0.0001). Number of children was lower in individuals with longer BF duration (P = 0.01). Individuals with longer BF duration used more homemade food than those with shorter BF duration (P < 0.0001). Means of total cholesterol and systolic blood pressure were lower in participants with the longest BF period compared with those with the shortest BF duration; this difference was marginally significant (P = 0.06). No significant association was found between BF duration and CVD risk factors in logistic regression after adjustment for potential confounders. CONCLUSIONS Although the long-term benefits of BF on preventing CVDs are well documented, controversies exist as to the association of BF duration with such beneficial effects. In this study, there was no substantial evidence that longer BF duration was protective against CVD risk factors among adolescents. More prospective studies are recommended to clarify this association.
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Affiliation(s)
- Vajihe Izadi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Ong KK, Hardy R, Shah I, Kuh D. Childhood stunting and mortality between 36 and 64 years: the British 1946 Birth Cohort Study. J Clin Endocrinol Metab 2013; 98:2070-7. [PMID: 23533234 PMCID: PMC4207952 DOI: 10.1210/jc.2012-3595] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Our aim was to examine the associations between childhood or adult height and adult mortality. METHODS In the prospective British 1946 Birth Cohort Study, childhood height was measured at 2, 4, 6, 7, 11, and 15 years, and adult height was measured at 36 years. Deaths were reported from the national health service register. RESULTS A total of 3877 study members (1963 male) contributed 106,333 person-years of follow-up; 391 deaths (228 male) were reported between the ages of 36 and 64 years. The strongest sex-adjusted association between height and mortality between ages 36 and 64 years was seen for height at age 6 years. The association was nonlinear; only study members in the shortest quintile at 6 years had a higher relative risk of adult mortality compared with those in the tallest quintile. By contemporary growth standards, 5.7% (n = 188) had heights at 6 years less than the second percentile, and a further 15.0% (n = 490) had heights between the second to ninth percentiles; these groups had higher adult mortality than all other study members (hazard ratio, 2.18; 95% confidence interval, 1.52-3.13; P < .001; and hazard ratio, 1.42; 95% confidence interval, 1.08-1.88; P = .01, respectively). Several determinants of childhood stunting (height at 6 years less than the second percentile) were directly associated with adult mortality; these included shorter parental heights and adverse early life nutrition and housing. CONCLUSIONS British men and women born in 1946 were relatively stunted as children by contemporary standards. Those who were short at age 6 years had substantially higher mortality 30 to 60 years later. Furthermore, they accounted for the well-recognized inverse association between adult height and mortality.
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Affiliation(s)
- Ken K Ong
- Medical Research Council Unit for Lifelong Health and Ageing, London WC1B 5JU, United Kingdom.
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Investigating individual- and area-level socioeconomic gradients of pulse pressure among normotensive and hypertensive participants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:571-89. [PMID: 23380912 PMCID: PMC3635164 DOI: 10.3390/ijerph10020571] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 01/21/2013] [Accepted: 01/28/2013] [Indexed: 01/19/2023]
Abstract
Socioeconomic status is a strong predictor of cardiovascular disease. Pulse pressure, the difference between systolic and diastolic blood pressure, has been identified as an important predictor of cardiovascular risk even after accounting for absolute measures of blood pressure. However, little is known about the social determinants of pulse pressure. The aim of this study was to examine individual- and area-level socioeconomic gradients of pulse pressure in a sample of 2,789 Australian adults. Using data from the North West Adelaide Health Study we estimated the association between pulse pressure and three indices of socioeconomic status (education, income and employment status) at the area and individual level for hypertensive and normotensive participants, using Generalized Estimating Equations. In normotensive individuals, area-level education (estimate: -0.106; 95% CI: -0.172, -0.041) and individual-level income (estimate: -1.204; 95% CI: -2.357, -0.050) and employment status (estimate: -1.971; 95% CI: -2.894, -1.048) were significant predictors of pulse pressure, even after accounting for the use of medication and lifestyle behaviors. In hypertensive individuals, only individual-level measures of socioeconomic status were significant predictors of pulse pressure (education estimate: -2.618; 95% CI: -4.878, -0.357; income estimate: -1.683, 95% CI: -3.743, 0.377; employment estimate: -2.023; 95% CI: -3.721, -0.326). Further research is needed to better understand how individual- and area-level socioeconomic status influences pulse pressure in normotensive and hypertensive individuals.
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Bogin B, Baker J. Low birth weight does not predict the ontogeny of relative leg length of infants and children: an allometric analysis of the NHANES III sample. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2012; 148:487-94. [PMID: 22552747 DOI: 10.1002/ajpa.22064] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Accepted: 03/01/2012] [Indexed: 12/19/2022]
Abstract
Previous research links both low birth weight (LBW) and relative leg length (RLL) to a similar set of adult pathologies, including type II diabetes, coronary vascular disease, and some cancers. Historically, LBW has been frequently used as a broad indicator of the quality of the intrauterine environment, while RLL has been considered a sensitive measure of childhood environmental quality. While these observations have been taken to suggest that these measures reflect independent exposures at different life-stages, their mutual association with a similar set of later pathologies makes this assumption less certain than it may have previously seemed. Nationally representative data from the Third National Health and Nutrition Examination Survey (NHANES III) are used to test the hypothesis that LBW predicts reductions in the development of leg length relative to stature. After controls for important socioeconomic exposures that might confound measurement of such a relationship, we find statistical and biological evidence that variation in birth weight and variation in the development of leg length relative to stature (RLL) are independent. The results suggest that these two measures may represent independent information on prenatal and postnatal environmental quality.
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Affiliation(s)
- Barry Bogin
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK.
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Arvedsen SK, Damgaard M, Norsk P. Body height and blood pressure regulation in humans during anti-orthostatic tilting. Am J Physiol Regul Integr Comp Physiol 2012; 302:R984-9. [DOI: 10.1152/ajpregu.00036.2011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The hypothesis was tested that the cardiovascular changes during an upper body anti-orthostatic maneuver in humans are more pronounced in tall than in short individuals, because of the larger intravascular hydrostatic pressure gradients. In 34 males and 41 females [20–30 yr, body height (BH) = 147–206 cm], inter-individual multiple linear regression analyses adjusted for gender and body weight were conducted between changes in cardiovascular variables versus BH during tilting of the upper body from vertical to horizontal while keeping the legs horizontal. In all the subjects, tilting induced increases in stroke volume and arterial pulse pressure and a decrease in heart rate, which each correlated significantly with BH. In males ( n = 51, BH = 163–206 cm), 24-h ambulatory mean arterial pressure increased significantly with BH ( P = 0.004, r = 0.40, α = 0.15 mmHg/cm) so that systolic/diastolic blood pressure increased by 2/2 mmHg per 15 cm increase in BH. There was no significant correlation between mean arterial pressure and BH in females ( n = 53, BH = 147–193 cm). In conclusion, a larger BH induces larger cardiovascular changes during anti-orthostatic tilting, and in males 24-h ambulatory mean arterial pressure increases with BH. The lack of a mean arterial pressure to BH correlation in females is probably because of their lower BH and greater variability in blood pressure.
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Affiliation(s)
- Sine K. Arvedsen
- Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Copenhagen
| | - Morten Damgaard
- Department of Clinical Physiology and Nuclear Medicine, Hvidovre University Hospital, Hvidovre, Denmark
| | - Peter Norsk
- Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Copenhagen
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Akinkuolie AO, Aleardi M, Ashaye AO, Gaziano JM, Djoussé L. Height and risk of heart failure in the Physicians' Health Study. Am J Cardiol 2012; 109:994-7. [PMID: 22221952 DOI: 10.1016/j.amjcard.2011.11.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 11/23/2011] [Accepted: 11/23/2011] [Indexed: 10/14/2022]
Abstract
Although previous studies have reported an association between height and cardiovascular disease, it is unclear whether height is associated with the risk of heart failure (HF). We hypothesized that height would be inversely associated with HF risk. We used prospective data from 22,042 male physicians (mean age 53.8 years) from the Physicians' Health Study. Height was self-reported at baseline. Incident HF was ascertained using follow-up questionnaires and validated through review of the medical records in a subsample. The Cox proportional hazard model was used to compute the hazard ratio (HR) and corresponding 95% confidence interval (CI). The mean height ± SD was 1.78 ± 0.07 m. A total of 1,444 HF cases occurred during a mean follow-up of 22.3 years. Compared to subjects in the lowest height category (1.40 to 1.73 m), the HR for HF was 0.86 (95% CI 0.74 to 0.99), 0.82 (95% CI 0.70 to 0.95), and 0.76 (95% CI 0.63 to 0.91) for the height categories of 1.74 to 1.78 m, 1.79 to 1.83 m, and 1.84 to 2.08 m, respectively, after adjustment for age, weight, hypertension, and diabetes mellitus (p for trend = 0.0023). The HR per SD increment in height was 0.92 (95% CI 0.86 to 0.98) in a fully adjusted model. The exclusion of those with prevalent atrial fibrillation, left ventricular hypertrophy, valvular heart disease, and a history of coronary artery bypass grafting yielded similar results (HR per SD 0.88, 95% CI 0.83 to 0.94). In conclusion, our data demonstrated an inverse association between height and incident HF in United States male physicians. Additional studies to elucidate the underlying biologic mechanisms are warranted.
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Shah NK, Smith SM, Nichols WW, Lo MC, Ashfaq U, Satish P, Johnson JA, Epstein BJ. Carvedilol reduces aortic wave reflection and improves left ventricular/vascular coupling: a comparison with atenolol (CENTRAL Study). J Clin Hypertens (Greenwich) 2011; 13:917-24. [PMID: 22142351 DOI: 10.1111/j.1751-7176.2011.00549.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Blood pressure (BP) characteristics, such as central aortic pressure and arterial stiffness, independently predict cardiovascular events. The effects of pharmacologically dissimilar β-blockers on these properties have not been fully elucidated. Patients with essential hypertension and without significant concomitant cardiovascular disease were randomly assigned to controlled-release carvedilol, force-titrated to 80 mg (n=22), or atenolol, force-titrated to 100 mg (n=19); each was given once daily for 4 weeks. Baseline characteristics were similar. At the end of week 4, atenolol and carvedilol reduced central and brachial systolic and diastolic BP to a similar extent. Central augmentation index was increased in atenolol-treated patients but not carvedilol-treated patients (atenolol 4.47% vs carvedilol -0.68%; P=.04). Mean augmented central aortic pressure increased slightly during atenolol treatment (+1.1 mm Hg) but decreased slightly during carvedilol treatment (-1.1 mm Hg), although the difference in these changes was not statistically significant (P=.23). Pulse pressure amplification was reduced more with atenolol at week 4 (atenolol -10.7% vs carvedilol -1.8%; P=.02). Therefore, we conclude that carvedilol results in more favorable pulse pressure amplification and augmentation index by increasing arterial compliance and reducing the magnitude of wave reflection, respectively, compared with atenolol.
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Affiliation(s)
- Niren K Shah
- East Coast Institute for Research, Jacksonville, FL 32223, USA.
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Prantl L, Gründl M. Males prefer a larger bust size in women than females themselves: an experimental study on female bodily attractiveness with varying weight, bust size, waist width, hip width, and leg length independently. Aesthetic Plast Surg 2011; 35:693-702. [PMID: 21359983 DOI: 10.1007/s00266-011-9669-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2010] [Accepted: 12/24/2010] [Indexed: 10/18/2022]
Abstract
What determines a female figure as attractive and is there a consensus of both sexes in judging female bodily attractiveness? To answer these questions, an extensive experiment was conducted using high-quality photographic stimulus material, several systematically varied figure parameters (weight, hip width, waist width, bust size, and leg length), and a large sample of 34,000 participants. The results showed that women prefer slightly wider hips, a narrower waist, and longer legs than men (highly significant but small effects). A clear difference was found with regard to the ideal bust size: 40% of men but only 25% of women preferred a large bust. The findings are discussed with respect to the changed role of women in Western industrialized countries who tend to concentrate on their career rather than on reproduction, and the effect of a curvaceous body with a large-sized bust on social perception.
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Ranasinghe P, Jayawardana MANAAD, Constantine GR, Sheriff MHR, Matthews DR, Katulanda P. Patterns and correlates of adult height in Sri Lanka. ECONOMICS AND HUMAN BIOLOGY 2011; 9:23-29. [PMID: 21126931 DOI: 10.1016/j.ehb.2010.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2010] [Revised: 09/15/2010] [Accepted: 09/27/2010] [Indexed: 05/30/2023]
Abstract
The present study examines patterns and socioeconomic and demographic correlates of adult height among Sri Lankan adults. Data were available for height and socio-demographic factors from a nationally representative cross-sectional sample of 4477 subjects above 18 years. Recruitment was between 2005 and 2006. Mean age of all subjects was 46.1±15.1 years. Mean height of males and females were 163.6±6.9cm and 151.4±6.4cm respectively. Mean height showed a significant negative correlation with age (p<0.001, r=-0.207). Highest mean height in females 154.0±5.9cm and males 165.6±6.9cm were observed in those born after 1977. Rural females (151.4±6.2cm) were significantly taller than the urban (151.3±7.2cm). However, this was not observed in males. In multivariate analysis, year of birth, level of education and household income were significantly associated with height. Height demonstrated a significant negative correlation with systolic blood pressure (r=-0.032), presence of diabetes (r=-0.069), total cholesterol (r=-0.106), HDL cholesterol (r=-0.142) and LDL cholesterol (r=-0.104). Height was associated with household income and level of education in Sri Lanka and demonstrated a distinct increasing trend over successive generations.
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Affiliation(s)
- Priyanga Ranasinghe
- Diabetes Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka
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Takenaka T, Sato T, Hoshi H, Kato N, Sueyoshi K, Tsuda M, Watanabe Y, Takane H, Ohno Y, Suzuki H. Height constitutes an important predictor of mortality in end-stage renal disease. Cardiol Res Pract 2010; 2011:242353. [PMID: 21113297 PMCID: PMC2989382 DOI: 10.4061/2011/242353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 09/20/2010] [Accepted: 10/02/2010] [Indexed: 12/23/2022] Open
Abstract
Aim. Height is an important determinant of augmentation index (AI) that anticipates cardiovascular prognosis. There is a scanty of the data whether short height predicts survival in patients with end-stage renal diseases, a high risk population. Methods. Fifty two hypertensive patients with type 2 diabetic nephropathy receiving hemodialysis and 52 patients with nondiabetic nephropathy were enrolled. In addition to AI estimated with radial artery tonometry, classical cardiovascular risk factors were considered. Patients were followed for 2 years to assess cardiovascular prognosis. Results. Cox hazards regression revealed that both smoking and shortness in height independently contributed to total mortality and indicated that smoking as well as the presence of left ventricular hypertrophy predicted cardiovascular mortality. Our findings implicated that high AI, the presence of diabetes, and low high-density lipoprotein cholesterol were significant contributors to cardiovascular events. Conclusions. Our findings provide new evidence that shortness in height independently contributes to total mortality in hemodialysis patients.
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Affiliation(s)
- Tsuneo Takenaka
- Department of Medicine, Saitama Medical College, 38 Moro-hongo, Moroyama, Iruma, Saitama 395-0495, Japan
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Harding S, Whitrow M, Lenguerrand E, Maynard M, Teyhan A, Cruickshank JK, Der G. Emergence of ethnic differences in blood pressure in adolescence: the determinants of adolescent social well-being and health study. Hypertension 2010; 55:1063-9. [PMID: 20194305 DOI: 10.1161/hypertensionaha.109.142935] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The cause of ethnic differences in cardiovascular disease remains a scientific challenge. Blood pressure tracks from late childhood to adulthood. We examined ethnic differences in changes in blood pressure between early and late adolescence in the United Kingdom. Longitudinal measures of blood pressure, height, weight, leg length, smoking, and socioeconomic circumstances were obtained from London, United Kingdom, schoolchildren of White British (n=692), Black Caribbean (n=670), Black African (n=772), Indian (n=384), and Pakistani and Bangladeshi (n=402) ethnicity at 11 to 13 years and 14 to 16 years. Predicted age- and ethnic-specific means of blood pressure, adjusted for anthropometry and social exposures, were derived using mixed models. Among boys, systolic blood pressure did not differ by ethnicity at 12 years, but the greater increase among Black Africans than Whites led to higher systolic blood pressure at 16 years (+2.9 mm Hg). Among girls, ethnic differences in mean systolic blood pressure were not significant at any age, but while systolic blood pressure hardly changed with age among White girls, it increased among Black Caribbeans and Black Africans. Ethnic differences in diastolic blood pressure were more marked than those for systolic blood pressure. Body mass index, height, and leg length were independent predictors of blood pressure, with few ethnic-specific effects. Socioeconomic disadvantage had a disproportionate effect on blood pressure for girls in minority groups. The findings suggest that ethnic divergences in blood pressure begin in adolescence and are particularly striking for boys. They signal the need for early prevention of adverse cardiovascular disease risks in later life.
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Affiliation(s)
- Seeromanie Harding
- Medical Research Council Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom.
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Bogin B, Varela-Silva MI. Leg length, body proportion, and health: a review with a note on beauty. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2010; 7:1047-75. [PMID: 20617018 PMCID: PMC2872302 DOI: 10.3390/ijerph7031047] [Citation(s) in RCA: 209] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 01/28/2010] [Accepted: 03/08/2010] [Indexed: 02/06/2023]
Abstract
Decomposing stature into its major components is proving to be a useful strategy to assess the antecedents of disease, morbidity and death in adulthood. Human leg length (femur + tibia), sitting height (trunk length + head length) and their proportions, for example, (leg length/stature), or the sitting height ratio (sitting height/stature x 100), among others) are associated with epidemiological risk for overweight (fatness), coronary heart disease, diabetes, liver dysfunction and certain cancers. There is also wide support for the use of relative leg length as an indicator of the quality of the environment for growth during infancy, childhood and the juvenile years of development. Human beings follow a cephalo-caudal gradient of growth, the pattern of growth common to all mammals. A special feature of the human pattern is that between birth and puberty the legs grow relatively faster than other post-cranial body segments. For groups of children and youth, short stature due to relatively short legs (i.e., a high sitting height ratio) is generally a marker of an adverse environment. The development of human body proportions is the product of environmental x genomic interactions, although few if any specific genes are known. The HOXd and the short stature homeobox-containing gene (SHOX) are genomic regions that may be relevant to human body proportions. For example, one of the SHOX related disorders is Turner syndrome. However, research with non-pathological populations indicates that the environment is a more powerful force influencing leg length and body proportions than genes. Leg length and proportion are important in the perception of human beauty, which is often considered a sign of health and fertility.
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Affiliation(s)
- Barry Bogin
- Health & Lifespan Research Centre, School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK; E-Mail:
| | - Maria Inês Varela-Silva
- Health & Lifespan Research Centre, School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK; E-Mail:
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