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He B, Li Z, Xu L, Liu L, Wang S, Zhan S, Song Y. Upper arm length and knee height are associated with diabetes in the middle-aged and elderly: evidence from the China Health and Retirement Longitudinal Study. Public Health Nutr 2023; 26:190-198. [PMID: 35581171 PMCID: PMC11077445 DOI: 10.1017/s1368980022001215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/23/2022] [Accepted: 04/01/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To determine if limb lengths, as markers of early life environment, are associated with the risk of diabetes in China. DESIGN We performed a cohort analysis using data from the China Health and Retirement Longitudinal Study (CHARLS), and multivariable-adjusted Cox proportional hazard regression models were used to examine the associations between baseline limb lengths and subsequent risk of diabetes. SETTING The CHARLS, 2011-2018. PARTICIPANTS The study confined the eligible subject to 10 711 adults aged over 45 years from the CHARLS. RESULTS During a mean follow-up period of 6·13 years, 1358 cases of incident diabetes were detected. When controlling for potential covariates, upper arm length was inversely related to diabetes (hazard ratio (HR) 0·95, 95 % CI (0·91, 0·99), P = 0·028), and for every 1-cm difference in knee height, the risk of diabetes decreased by about 4 % (HR 0·96, 95 % CI (0·93, 0·99), P = 0·023). The association between upper arm length and diabetes was only significant among females while the association between knee height and diabetes was only significant among males. In analyses stratified by BMI, significant associations between upper arm length/knee height and diabetes only existed among those who were underweight (HR 0·91, 95 % CI (0·83, 1·00), P = 0·049, HR 0·92, 95 % CI (0·86, 0·99), P = 0·031). CONCLUSIONS Inverse associations were observed between upper arm length, knee height and the risk for diabetes development in a large Asian population, suggesting early life environment, especially infant nutritional status, may play an important role in the determination of future diabetes risk.
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Affiliation(s)
- Bingjie He
- Department of Epidemiology and Biostatistics, School of Public
Health, Peking University, 38 Xueyuan Road, Haidian District,
Beijing100191, People’s Republic of China
| | - Zhengyang Li
- Department of Endocrinology, Shandong Provincial Hospital
Affiliated to Shandong First Medical University, Huaiyin
District, Jinan, People’s Republic of China
| | - Lu Xu
- Department of Epidemiology and Biostatistics, School of Public
Health, Peking University, 38 Xueyuan Road, Haidian District,
Beijing100191, People’s Republic of China
| | - Lili Liu
- Department of Epidemiology and Biostatistics, School of Public
Health, Peking University, 38 Xueyuan Road, Haidian District,
Beijing100191, People’s Republic of China
| | - Shengfeng Wang
- Department of Epidemiology and Biostatistics, School of Public
Health, Peking University, 38 Xueyuan Road, Haidian District,
Beijing100191, People’s Republic of China
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public
Health, Peking University, 38 Xueyuan Road, Haidian District,
Beijing100191, People’s Republic of China
- Research Center of Clinical Epidemiology, Peking
University Third Hospital, Haidian District, Beijing,
People’s Republic of China
- Center for Intelligent Public Health, Institute for Artificial
Intelligence, Peking University, Beijing,
People’s Republic of China
| | - Yongfeng Song
- Department of Endocrinology, Shandong Provincial Hospital
Affiliated to Shandong First Medical University, Huaiyin
District, Jinan, People’s Republic of China
- Shandong Institute of Endocrine & Metabolic Diseases,
Shandong First Medical University, Jinan,
People’s Republic of China
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Shirley MK, Arthurs OJ, Seunarine KK, Cole TJ, Eaton S, Williams JE, Clark CA, Wells JCK. Implications of leg length for metabolic health and fitness. Evol Med Public Health 2022; 10:316-324. [PMID: 35903461 PMCID: PMC9326181 DOI: 10.1093/emph/eoac023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background and objectives Several studies have linked longer legs with favorable adult metabolic health outcomes and greater offspring birth weight. A recent Mendelian randomization study suggested a causal link between height and cardiometabolic risk; however, the underlying reasons remain poorly understood. Methodology Using a cross-sectional design, we tested in a convenience sample of 70 healthy young women whether birth weight and tibia length as markers of early-life conditions associated more strongly with metabolically beneficial traits like organ size and skeletal muscle mass (SMM) than a statistically derived height-residual variable indexing later, more canalized growth. Results Consistent with the 'developmental origins of health and disease' hypothesis, we found relatively strong associations of tibia length-but not birth weight-with adult organ size, brain size, SMM and resting energy expenditure measured by magnetic resonance imaging (MRI), dual-energy X-ray absorptiometry and indirect calorimetry, respectively. Conclusions and implications Building on prior work, these results suggest that leg length is a sensitive marker of traits directly impacting metabolic and reproductive health. Alongside findings in the same sample relating tibia length and height-residual to MRI-measured pelvic dimensions, we suggest there may exist a degree of coordination in the development of long bone, lean mass and pelvic traits, possibly centered on early, pre-pubertal growth periods. Such phenotypic coordination has important implications for fitness, serving to benefit both adult health and the health of offspring in subsequent generations.
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Affiliation(s)
- Meghan K Shirley
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Owen J Arthurs
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
- Department of Radiology, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
| | - Kiran K Seunarine
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Tim J Cole
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Simon Eaton
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Jane E Williams
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Chris A Clark
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
| | - Jonathan C K Wells
- UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
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3
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van der Heijden TGW, Chilunga FP, Meeks KAC, Addo J, Danquah I, Beune EJ, Bahendeka SK, Klipstein-Grobusch K, Mockenhaupt FP, Waltz MM, Agyemang C. The Magnitude and Directions of the Associations between Early Life Factors and Metabolic Syndrome Differ across Geographical Locations among Migrant and Non-Migrant Ghanaians-The RODAM Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211996. [PMID: 34831754 PMCID: PMC8622143 DOI: 10.3390/ijerph182211996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/05/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Early-life factors (ELFs) such as childhood nutrition and childhood socio-economic status could be the drivers of the increase in metabolic syndrome (MetSyn) among African populations, but data are lacking. This study evaluated whether markers of childhood nutritional status and childhood socio-economic status were associated with MetSyn in adulthood among migrant Ghanaians living in Europe and non-migrant Ghanaians living in Ghana. METHODS Data from the Research on Obesity and Diabetes among African Migrants (RODAM) study, involving 2008 migrants and 2320 non-migrants aged ≥25 years, were analysed for this study. We used leg-length to height ratio (LHR), which is an anthropometric marker of childhood nutritional status, and parental education, which is a marker of childhood socio-economic status, as proxies. Adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) were calculated by logistic regression with adjustments for demographic and lifestyle factors. RESULTS Parental education was higher among Ghanaians in Europe than among residents in rural and urban Ghana. The prevalence of MetSyn was 18.5%, 27.7% and 33.5% for rural, urban, and migrant residents, respectively. LHR was inversely associated with MetSyn among migrants. Compared with high paternal education, individuals with low paternal education had lower odds of MetSyn in migrants (AOR 0.71 95% CI 0.54-0.94). In contrast, compared with high maternal education, individuals with intermediate maternal education had higher odds of MetSyn in urban Ghanaians (AOR 4.53 95% CI 1.50-3.74). No associations were found among rural Ghanaians. CONCLUSION The magnitude and direction of the associations between ELFs and MetSyn differ across geographical locations. Intermediate maternal education was positively associated with MetSyn among urban Ghanaians, while LHR and low paternal education were inversely associated with MetSyn among migrant Ghanaians. Further research into the interplay of genetics, environment and behaviour is needed to elucidate the underlying pathological mechanisms of MetSyn amongst migrants.
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Affiliation(s)
- Thijs G. W. van der Heijden
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.J.B.); (C.A.)
- Correspondence:
| | - Felix P. Chilunga
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.J.B.); (C.A.)
| | - Karlijn A. C. Meeks
- Center for Research on Genomics & Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20894, USA;
| | - Juliet Addo
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
| | - Ina Danquah
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, 69120 Heidelberg, Germany;
| | - Erik J. Beune
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.J.B.); (C.A.)
| | - Silver K. Bahendeka
- Mother Kevin Postgraduate Medical School (MKPGMS), Uganda Martyrs University, Kampala 32297, Uganda;
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre, Utrecht University, 3584 CG Utrecht, The Netherlands;
- Division of Epidemiology and Biostatistics, Department of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Frank P. Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, 13353 Berlin, Germany;
| | - Mitzi M. Waltz
- Athena Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (F.P.C.); (E.J.B.); (C.A.)
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Basak S, Vilasagaram S, Duttaroy AK. Maternal dietary deficiency of n-3 fatty acids affects metabolic and epigenetic phenotypes of the developing fetus. Prostaglandins Leukot Essent Fatty Acids 2020; 158:102109. [PMID: 32474355 DOI: 10.1016/j.plefa.2020.102109] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 04/13/2020] [Indexed: 02/07/2023]
Abstract
Polyunsaturated fatty acids (PUFAs) play multiple physiological roles. They regulate the structure and function of cell membranes and cell growth and proliferation, and apoptosis. In addition, PUFAs are involved in cellular signaling, gene expression and serve as precursors to second messengers such as eicosanoids, docosanoids etc. and regulate several physiological processes including placentation, inflammation, immunity, angiogenesis, platelet function, synaptic plasticity, neurogenesis, bone formation, energy homeostasis, pain sensitivity, stress, and cognitive functions. Linoleic acid, 18:2n-6 (LA) and alpha-linolenic acid, 18:3n-3 (ALA) are the two essential fatty acids obtained from the diets and subsequently their long-chain polyunsaturated fatty acids (LCPUFAs) are accumulated in the body. The maternal plasma LCPUFAs especially accumulated in larger amounts in the brain during the third trimester of pregnancy via the placenta and postnatally from mother's breast milk. Various studies, including ours, suggest PUFA's important role in placentation, as well as in growth and development of the offspring. However, intakes of maternal n-3 PUFAs during pregnancy and lactation are much lower in India compared with the Western population. In India, n-3 fatty acid status is further reduced by higher intake of n-6 PUFA rich oils and trans fats. More data on the impacts of long term maternal n-3 PUFA deficiency on placental structure and function, gene expression, epigenetic changes and resultant cognitive function of fetus & infants are emerging. This review summarizes the impacts of n-3 PUFA deficiency in utero on fetal growth and development, adiposity, energy metabolism, musculoskeletal development, and epigenetic changes in feto-placental axis from the recently available pre-clinical and clinical data.
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Affiliation(s)
- Sanjay Basak
- Molecular Biology Division, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad 500007, India.
| | - Srinivas Vilasagaram
- Molecular Biology Division, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad 500007, India
| | - Asim K Duttaroy
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
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5
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Yang T, Zhang L, Yi L, Feng H, Li S, Chen H, Zhu J, Zhao J, Zeng Y, Liu H. Ensemble Learning Models Based on Noninvasive Features for Type 2 Diabetes Screening: Model Development and Validation. JMIR Med Inform 2020; 8:e15431. [PMID: 32554386 PMCID: PMC7333074 DOI: 10.2196/15431] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 12/22/2019] [Accepted: 02/07/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Early diabetes screening can effectively reduce the burden of disease. However, natural population-based screening projects require a large number of resources. With the emergence and development of machine learning, researchers have started to pursue more flexible and efficient methods to screen or predict type 2 diabetes. OBJECTIVE The aim of this study was to build prediction models based on the ensemble learning method for diabetes screening to further improve the health status of the population in a noninvasive and inexpensive manner. METHODS The dataset for building and evaluating the diabetes prediction model was extracted from the National Health and Nutrition Examination Survey from 2011-2016. After data cleaning and feature selection, the dataset was split into a training set (80%, 2011-2014), test set (20%, 2011-2014) and validation set (2015-2016). Three simple machine learning methods (linear discriminant analysis, support vector machine, and random forest) and easy ensemble methods were used to build diabetes prediction models. The performance of the models was evaluated through 5-fold cross-validation and external validation. The Delong test (2-sided) was used to test the performance differences between the models. RESULTS We selected 8057 observations and 12 attributes from the database. In the 5-fold cross-validation, the three simple methods yielded highly predictive performance models with areas under the curve (AUCs) over 0.800, wherein the ensemble methods significantly outperformed the simple methods. When we evaluated the models in the test set and validation set, the same trends were observed. The ensemble model of linear discriminant analysis yielded the best performance, with an AUC of 0.849, an accuracy of 0.730, a sensitivity of 0.819, and a specificity of 0.709 in the validation set. CONCLUSIONS This study indicates that efficient screening using machine learning methods with noninvasive tests can be applied to a large population and achieve the objective of secondary prevention.
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Affiliation(s)
- Tianzhou Yang
- School of Life Science, Liaoning University, Shenyang, China
| | - Li Zhang
- School of Life Science, Liaoning University, Shenyang, China
| | - Liwei Yi
- School of Information, Liaoning University, Shenyang, China
| | - Huawei Feng
- School of Life Science, Liaoning University, Shenyang, China
| | - Shimeng Li
- School of Life Science, Liaoning University, Shenyang, China
| | - Haoyu Chen
- School of Information, Liaoning University, Shenyang, China
| | - Junfeng Zhu
- School of Life Science, Liaoning University, Shenyang, China
| | - Jian Zhao
- School of Life Science, Liaoning University, Shenyang, China
| | - Yingyue Zeng
- School of Life Science, Liaoning University, Shenyang, China
| | - Hongsheng Liu
- School of Life Science, Liaoning University, Shenyang, China.,Research Center for Computer Simulating and Information Processing of Bio-macromolecules of Shenyang, Liaoning University, Shenyang, China.,Engineering Laboratory for Molecular Simulation and Designing of Drug Molecules of Liaoning, Shenyang, China
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6
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Danquah I, Addo J, Boateng D, Klipstein-Grobusch K, Meeks K, Galbete C, Beune E, Bahendeka S, Spranger J, Mockenhaupt FP, Stronks K, Agyemang C, Schulze MB, Smeeth L. Early-life factors are associated with waist circumference and type 2 diabetes among Ghanaian adults: The RODAM Study. Sci Rep 2019; 9:10848. [PMID: 31350427 PMCID: PMC6659619 DOI: 10.1038/s41598-019-47169-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 07/11/2019] [Indexed: 02/06/2023] Open
Abstract
Early-life experiences may fuel the emergence of obesity and type 2 diabetes among African populations. We evaluated childhood socio-economic status (SES) and childhood nutritional status as risk factors for increased waist circumference and type 2 diabetes among Ghanaian adults. In the multi-center, cross-sectional Research on Obesity and Diabetes among African Migrants (RODAM) Study, we calculated associations (adjusted for demographics and lifestyle) of parental education and anthropometric markers of childhood nutrition [leg length, leg length-to-height ratio (LHR)] with waist circumference and type 2 diabetes, respectively. Among 5,575 participants (mean age: 46.2 years; 62% female), lower education of either parent (vs. higher) was consistently associated with higher waist circumference (∆: 1.6-3.4 cm). Lower father's education tended to increase the odds of type 2 diabetes by 50% in women (95% confidence interval (CI): 1.0, 2.4). Reduced leg length and LHR were associated with higher waist circumference. But only in men, leg length was inversely related to type 2 diabetes (OR per 1 standard deviation decrease: 1.1; 95% CI: 1.0, 1.3). In this study, markers of poor childhood SES and early-life nutritional status relate to abdominal obesity in men and women and to type 2 diabetes in men. Thus, prevention efforts should start in early childhood.
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Affiliation(s)
- Ina Danquah
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany. .,Charité - Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany.
| | - Juliet Addo
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Daniel Boateng
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Karlijn Meeks
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Cecilia Galbete
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Erik Beune
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Silver Bahendeka
- Mother Kevin Postgraduate Medical School (MKPGMS), Uganda Martyrs University, Kampala, Uganda
| | - Joachim Spranger
- Charité - Universitaetsmedizin Berlin, corporate member of Freie Universitaet Berlin & Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Department of Endocrinology and Metabolism; DZHK (German Centre for Cardiovascular Research), partner site Berlin; Center for Cardiovascular Research (CCR), Berlin, Germany
| | - Frank P Mockenhaupt
- Charité - Universitaetsmedizin Berlin, corporate member of Freie Universitaet Berlin & Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Institute of Tropical Medicine and International Health, Berlin, Germany
| | - Karien Stronks
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Charles Agyemang
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Liam Smeeth
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Cheng TS, Leung GM, Hui LL, Leung JYY, Kwok MK, Au Yeung SL, Schooling CM. Associations of growth from birth to puberty with glycemic indicators at ~17.5 years: Evidence from Hong Kong's "Children of 1997" birth cohort. Pediatr Diabetes 2019; 20:380-388. [PMID: 30805996 DOI: 10.1111/pedi.12838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 01/26/2019] [Accepted: 02/19/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND From an evolutionary biology perspective, where growth and reproduction trade-off against longevity, we assessed the associations of growth from birth to puberty by phase with later glycemic indicators and any differences by sex. METHODS In the population-representative Hong Kong Chinese "Children of 1997" birth cohort (n = 8327), the relation of initial size (weight-for-age z score (WAZ) at birth, length/height-for-age z score (LAZ) at 3 months or body-mass-index-for-age z score (BAZ) at 3 months based on the World Health Organization growth standards/references) and growth at different phases (WAZ gains from 0 to 2 and 2 to 8 years, LAZ or BAZ gains from 3 months to 3 years, 3 to 8 years and 8 to 14 years) with fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) at ~17.5 years, was assessed using adjusted partial least squares regression. Additional analyses further considered growth in late and early infancy. RESULTS This study included 3276 of the cohort participants. Higher WAZ gain from 2 to 8 years, LAZ and BAZ gains from 3 to 8 years were consistently associated with higher FPG, adjusted for maternal and infant characteristics, family history of diabetes and household income. Also, higher BAZ gain from 3 to 8 years was associated with higher HbA1c. These associations did not differ by sex. CONCLUSIONS Our findings suggest different mechanisms could underlie the pathogenesis of glucose intolerance. Factors that drive specific growth at different phases need to be evaluated to better inform child growth management for long-term health outcomes.
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Affiliation(s)
- Tuck Seng Cheng
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Lai Ling Hui
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - June Yue Yan Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Man Ki Kwok
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Shiu Lun Au Yeung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China.,Environmental, Occupational, and Geospatial Health Sciences, City University of New York, School of Public Health, New York, New York
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8
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Merker A, Neumeyer L, Hertel NT, Grigelioniene G, Mohnike K, Hagenäs L. Development of body proportions in achondroplasia: Sitting height, leg length, arm span, and foot length. Am J Med Genet A 2018; 176:1819-1829. [DOI: 10.1002/ajmg.a.40356] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/07/2018] [Accepted: 05/17/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Andrea Merker
- Department of Women's and Children's HealthKarolinska Institutet Stockholm, Sweden
| | - Luitgard Neumeyer
- Pediatric Endocrinology Unit, Karolinska University Hospital Stockholm Sweden
| | - Niels Thomas Hertel
- Department of Quality, Research, Innovation & Education, Odense University Hospital Odense Denmark
| | - Giedre Grigelioniene
- Department of Molecular Medicine and SurgeryKarolinska Institutet Stockholm Sweden
- Center for Molecular Medicine, Karolinska Institutet Stockholm Sweden
- Department of Clinical GeneticsKarolinska University Hospital Stockholm Sweden
| | - Klaus Mohnike
- Otto‐von‐Guericke Universität, Universitätskinderklinik Magdeburg Germany
| | - Lars Hagenäs
- Department of Women's and Children's HealthKarolinska Institutet Stockholm, Sweden
- Pediatric Endocrinology Unit, Karolinska University Hospital Stockholm Sweden
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9
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Tottman AC, Alsweiler JM, Bloomfield FH, Gamble G, Jiang Y, Leung M, Poppe T, Thompson B, Wouldes TA, Harding JE. Long-Term Outcomes of Hyperglycemic Preterm Infants Randomized to Tight Glycemic Control. J Pediatr 2018; 193:68-75.e1. [PMID: 29198539 DOI: 10.1016/j.jpeds.2017.09.081] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/11/2017] [Accepted: 09/28/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine whether tight glycemic control of neonatal hyperglycemia changes neurodevelopment, growth, and metabolism at school age. STUDY DESIGN Children born very low birth weight and randomized as hyperglycemic neonates to a trial of tight vs standard glycemic control were assessed at 7 years corrected age, including Wechsler Intelligence Scale for Children Fourth Edition, Movement Assessment Battery for Children 2, visual and neurologic examinations, growth measures, dual X-ray absorptiometry, and frequently sampled intravenous glucose tolerance test. The primary outcome was survival without neurodevelopmental impairment at age 7 years. Outcomes were compared using linear regression, adjusted for sex, small for gestational age, birth plurality, and the clustering of twins. Data are reported as number (%) or mean (SD). RESULTS Of the 88 infants randomized, 11 (13%) had died and 57 (74% of eligible children) were assessed at corrected age 7 years. Survival without neurodevelopmental impairment occurred in 25 of 68 children (37%), with no significant difference between tight (14 of 35; 40%) and standard (11 of 33; 33%) glycemic control groups (P = .60). Children in the tight group were shorter than those in the standard group (121.3 [6.3] cm vs 125.1 [5.4] cm; P < .05), but had similar weight and head circumference. Children in the tight group had greater height-adjusted lean mass (18.7 [0.3] vs 17.6 [0.2] kg; P < .01) and lower fasting glucose concentrations (84.6 [6.30] vs 90.0 [5.6] mg⋅dL-1; P < .05), but no other differences in measures of body composition or insulin-glucose metabolism. CONCLUSION Tight glycemic control for neonatal hyperglycemia does not change survival without neurodevelopmental impairment, but reduces height, increases height-adjusted lean mass, and reduces fasting blood glucose concentrations at school age. TRIAL REGISTRATION ACTRN: 12606000270516.
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Affiliation(s)
| | - Jane Marie Alsweiler
- Liggins Institute, University of Auckland, Auckland, New Zealand; Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | | | - Greg Gamble
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Myra Leung
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Tanya Poppe
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Benjamin Thompson
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Trecia Ann Wouldes
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
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