1
|
Zhang L, Yin W, Yu W, Wang P, Wang H, Zhang X, Zhu P. Environmental exposure to outdoor artificial light at night during pregnancy and fetal size: A prospective cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 883:163521. [PMID: 37062314 DOI: 10.1016/j.scitotenv.2023.163521] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 04/05/2023] [Accepted: 04/11/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Previous studies suggested outdoor artificial light at night (ALAN) exposure may contribute to children and adult obesity, but less is known about the associations of outdoor ALAN exposure during pregnancy with fetal size. METHODS From 2015 to 2021, 6210 mother-child pairs were included. Average outdoor ALAN levels during pregnancy were measured using satellite imaging data. Fetal biparietal diameter, head circumference, abdominal circumference (AC), and femur length were measured before delivery with ultrasonography. We also collected anthropometric birth outcomes, including birth length, birth weight, macrosomia, low birth weight, small for gestational age, and large for gestational age at delivery. Multivariable linear regression models and binary logistic regression models were used to examine the potential associations of outdoor ALAN with fetal size adjusting for a broad set of potential confounds. RESULTS An IQR (14.87 nW/cm2/sr) increase in outdoor ALAN during pregnancy was associated with 1.30 (β = 1.30, 95 % CI: 0.31,2.29) higher AC percentiles and 13 % (OR = 1.13, 95 % CI: 1.00,1.27) higher odds of macrosomia after adjusting confounders. In sex stratification analysis, an IQR (14.87 nW/cm2/sr) increase in outdoor ALAN during pregnancy was associated with 1.65 (β = 1.65, 95 % CI: 0.24,3.06) higher fetal AC percentiles and 27 % (OR = 1.27, 95 % CI: 1.06,1.53) higher odds of macrosomia in females. CONCLUSIONS Our findings suggest that higher outdoor ALAN exposure during pregnancy is associated with larger fetal AC and a higher risk of macrosomia, particularly in the female fetus. Future studies are needed to verify these preliminary findings and identify potential mechanisms for the association.
Collapse
Affiliation(s)
- Lei Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Wanjun Yin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Wenjie Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Peng Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Haixia Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Xiujun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
| |
Collapse
|
2
|
Complementary feeding practices and their association with adiposity indicators at 12 months of age. J Dev Orig Health Dis 2020; 12:780-787. [PMID: 33222718 DOI: 10.1017/s2040174420001038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Nutrition during the first 1000 days of life represents a window of opportunity to reduce the risk of metabolic dysfunctions later in life. Exclusive breastfeeding (EBF) and adequate introduction of solid foods are essential to promote metabolic and nutritional benefits. We evaluated the association of infant feeding practices from birth to 6 months (M) with adiposity indicators at 12 M. We performed a secondary analysis of 106 healthy term infants born from a cohort of healthy pregnant women. Type of breastfeeding (exclusive or nonexclusive), the start of complementary feeding (CF) (before (<4 M) or after (≥4 M)), and adiposity (body mass index - BMI, body mass index-for-age - BMI/A, waist circumference - WC, and waist circumference-length ratio - WLR) were evaluated at 12 M using descriptive statistics, mean differences, X2, and linear regression models. During the first 6 M, 28.3% (n = 30) of the infants received EBF. Early CF (<4 M) was present in 26.4% (n = 28) of the infants. Children who started CF < 4 M were less breastfed, received added sugars as the most frequently introduced food category, and showed higher BMI, BMI/A, WC, and WLR; those who consumed added sugars early (<4 M) had a higher WC. Starting CF < 4 M was the main factor associated with a higher WC at 12 M. Unhealthy infant feeding practices, such as lack of EBF, early CF, and early introduction of sugars, may be associated with higher adiposity at 12 M.
Collapse
|
3
|
Sousa-Sá E, Zhang Z, Pereira JR, Veldman SLC, Okely AD, Santos R. The Get-Up! study: adiposity and blood pressure in Australian toddlers. Porto Biomed J 2020; 5:e063. [PMID: 32734008 PMCID: PMC7386441 DOI: 10.1097/j.pbj.0000000000000063] [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: 01/22/2020] [Accepted: 03/29/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Because the elevated blood pressure (BP) in childhood is strongly associated with overweight and is a risk factor for later cardiovascular disease, a need to comprehend the early development of BP and its association with overweight is needed. We assessed differences of BP by weight status in Australian toddlers. METHODS From the Get-Up! Study in Australia, this sample included 265 toddlers (136 boys), aged 19.6 ± 4.2 months. BP was measured with a digital vital signs monitor. Participants were categorized as nonoverweight and overweight according to the World Health Organization definition for body mass index (BMI). Physical activity was captured with activPAL accelerometers, during childcare hours. To test differences in BP between nonoverweight and overweight children, we performed an analysis of covariance adjusting for sex, age, physical activity, and socioeconomic status. RESULTS Children with overweight showed higher z systolic BP values (P = .042 for BMI and P = .023 for waist circumference) when compared to nonoverweight children. However, no differences were found for z diastolic BP levels, between overweight and nonoverweight children. After adjustments for potential confounders (socioeconomic status, physical activity, sex, and age), there were no significant differences in BP variables between BMI and waist circumference groups. CONCLUSIONS No associations between adiposity and BP levels were found in this sample. The unadjusted results, however, showed that children with higher levels of adiposity (BMI and waist circumference) exhibited higher levels of BP. Additional research is needed to determine which environmental and genetic factors might contribute to pediatric hypertension, particularly among toddlers.
Collapse
Affiliation(s)
- Eduarda Sousa-Sá
- Early Start, Faculty of Social Sciences, University of Wollongong
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Zhiguang Zhang
- Early Start, Faculty of Social Sciences, University of Wollongong
| | - João R Pereira
- Early Start, Faculty of Social Sciences, University of Wollongong
- Research Unit for Sport and Physical Activity, University of Coimbra, Coimbra
| | | | - Anthony D Okely
- Early Start, Faculty of Social Sciences, University of Wollongong
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Rute Santos
- Early Start, Faculty of Social Sciences, University of Wollongong
- Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
| |
Collapse
|
4
|
Aris IM, Rifas-Shiman SL, Li LJ, Belfort MB, Hivert MF, Oken E. Early-Life Predictors of Systolic Blood Pressure Trajectories From Infancy to Adolescence: Findings From Project Viva. Am J Epidemiol 2019; 188:1913-1922. [PMID: 31497850 DOI: 10.1093/aje/kwz181] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 08/07/2019] [Accepted: 08/12/2019] [Indexed: 01/11/2023] Open
Abstract
Childhood blood pressure (BP) is a strong predictor of later risk of cardiovascular disease. However, few studies have assessed dynamic BP trajectories throughout the early-life period. We investigated the relationship between early-life factors and systolic BP (SBP) from infancy to adolescence using linear spline mixed-effects models among 1,370 children from Project Viva, a Boston, Massachusetts-area cohort recruited in 1999-2002. After adjusting for confounders and child height, we observed higher SBP in children exposed to gestational diabetes mellitus (vs. normoglycemia; age 3 years: β = 3.16 mm Hg (95% confidence interval (CI): 0.28, 6.04); age 6 years: β = 1.83 mm Hg (95% CI: 0.06, 3.60)), hypertensive disorders of pregnancy (vs. normal maternal BP; age 6 years: β = 1.39 mm Hg (95% CI: 0.10, 2.67); age 9 years: β = 1.84 mm Hg (95% CI: 0.34, 3.34); age 12 years: β = 1.70 mm Hg (95% CI: 0.48, 2.92)), higher neonatal SBP (per 10-mm Hg increase; age 3 years: β = 1.26 mm Hg (95% CI: 0.42, 2.09); age 6 years: β = 1.00 mm Hg (95% CI: 0.49, 1.51); age 9 years: β = 0.75 mm Hg (95% CI: 0.17, 1.33)), and formula milk in the first 6 months of life (vs. breast milk only; age 12 years: β = 2.10 mm Hg (95% CI: 0.46, 3.74); age 15 years: β = 3.52 mm Hg (95% CI: 1.40, 5.64); age 18 years: β = 4.94 mm Hg (95% CI: 1.88, 7.99)). Our findings provide evidence of programming of offspring SBP trajectories by gestational diabetes, hypertensive disorders of pregnancy, and formula milk intake and of neonatal BP being a potentially useful marker of childhood BP. These factors could be relevant in identifying children who are at risk of developing elevated BP.
Collapse
Affiliation(s)
- Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Ling-Jun Li
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Division of Obstetrics and Gynecology, KK Women’s and Children’s Hospital, Singapore
- Obstetrics and Gynecology Academic Clinical Program, Duke-National University of Singapore Graduate Medical School, Singapore
| | - Mandy B Belfort
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| |
Collapse
|
5
|
Eny KM, Maguire JL, Dai DWH, Lebovic G, Adeli K, Hamilton JK, Hanley AJ, Mamdani M, McCrindle BW, Tremblay MS, Parkin PC, Birken CS. Association of accelerated body mass index gain with repeated measures of blood pressure in early childhood. Int J Obes (Lond) 2019; 43:1354-1362. [PMID: 30940913 PMCID: PMC6760600 DOI: 10.1038/s41366-019-0345-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 02/18/2019] [Accepted: 02/24/2019] [Indexed: 01/05/2023]
Abstract
Background/objectives We examined the association for rates of age- and sex-standardized body mass index (zBMI) gain between 0–3, 3–18, and 18–36 months with BP in children at 36–72 months of age. Methods We collected repeated measures of zBMI and BP in 2502 children. zBMI was calculated using the World Health Organization standards. Each child’s zBMI at birth and rates of zBMI gain in each period from birth to 36 months were estimated using linear spline multilevel models. Generalized estimating equations were used to determine whether zBMI at birth and zBMI gain between 0–3, 3–18, and 18–36 months were each associated with repeated measures of BP at 36–72 months of age. We sequentially conditioned on zBMI at birth and zBMI gain in each period prior to each period tested, as covariates, and adjusted for important socio-demographic, familial, and study design covariates. We examined whether these associations were modified by birthweight or maternal obesity, by including interaction terms. Results After adjusting for all covariates and conditioning on prior zBMI gains, a 1 standard deviation unit faster rate of zBMI gain during 0–3 months, (β = 0.59 mmHg; 95% CI 0.31, 0.86) and 3–18 months (β = 0.74 mmHg; 95% CI 0.46, 1.03) were each associated with higher systolic BP at 36–72 months. No significant associations were observed, however, for zBMI at birth or zBMI gain in the 18–36 month growth period. zBMI gains from 0–3 and 3–18 months were also associated with diastolic BP. Birthweight significantly modified the relationship during the 3–18 month period (p = 0.02), with the low birthweight group exhibiting the strongest association for faster rate of zBMI gain with higher systolic BP (β = 1.31 mmHg; 95% CI 0.14, 2.48). Conclusions Given that long-term exposure to small elevations in BP are associated with subclinical cardiovascular disease, promoting interventions targeting healthy growth in infancy may be important.
Collapse
Affiliation(s)
- Karen M Eny
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
| | - Jonathon L Maguire
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Department of Pediatrics, St. Michael's Hospital, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | - David W H Dai
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Gerald Lebovic
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Khosrow Adeli
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jill K Hamilton
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Endocrinology, The Hospital for Sick Children, Toronto, Canada
| | - Anthony J Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | - Muhammad Mamdani
- Li Ka Shing Centre for Healthcare Analytics Research and Training, St. Michael's Hospital, Toronto, Canada
| | - Brian W McCrindle
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada.,Preventative Cardiology, The Hospital for Sick Children, Toronto, Canada
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Patricia C Parkin
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada. .,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. .,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada. .,Department of Nutritional Sciences, University of Toronto, Toronto, Canada.
| | | |
Collapse
|
6
|
Abstract
Blood pressure (BP) tracks from childhood to adulthood, and early BP trajectories predict cardiovascular disease risk later in life. Excess postnatal weight gain is associated with vascular changes early in life. However, to what extent it is associated with children's BP is largely unknown. In 853 healthy 5-year-old children of the Wheezing-Illnesses-Study-Leidsche-Rijn (WHISTLER) birth cohort, systolic (SBP) and diastolic BP (DBP) were measured, and z scores of individual weight gain rates adjusted for length gain rates were calculated using at least two weight and length measurements from birth until 3 months of age. Linear regression analyses were conducted to investigate the association between weight gain rates adjusted for length gain rates and BP adjusted for sex and ethnicity. Each standard deviation increase in weight gain rates adjusted for length gain rates was associated with 0.9 mmHg (95% CI 0.3, 1.5) higher sitting SBP after adjustment for confounders. Particularly in children in the lowest birth size decile, high excess weight gain was associated with higher sitting SBP values compared to children with low weight gain rates adjusted for length gain rates. BMI and visceral adipose tissue partly explained the association between excess weight gain and sitting SBP (β 0.5 mmHg, 95% CI -0.3, 1.3). Weight gain rates adjusted for length gain rates were not associated with supine SBP or DBP. Children with excess weight gain, properly adjusted for length gain, in the first three months of life, particularly those with a small birth size, showed higher sitting systolic BP at the age of 5 years.
Collapse
|
7
|
Al-Domi H, Al-Shorman A. Increased waist circumference is associated with subclinical atherosclerosis in schoolchildren. Diabetes Metab Syndr 2019; 13:264-269. [PMID: 30641709 DOI: 10.1016/j.dsx.2018.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 09/07/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Waist circumference (WC) is an indicator of adiposity; particularly visceral fat, cardiometabolic risk factors and related morbidity. The aim of this study was to determine the attribution of WC to increased carotid intima-media thickness (cIMT) and circulating levels of inflammation and endothelial dysfunction in schoolchildren. METHODS A total of 122 children (61 boys and 61 girls) aged 10-15 years were distributed into three groups: (i) the lower smoothed sex- and age-specific WC (LWC) group (ii) the middle smoothed sex- and age-specific WC (MWC) group, and (iii) the higher smoothed sex- and age-specific WC (HWC) group. Measurements of cIMT using high-resolution B-mode ultrasound, lipemic profile, blood pressure, serum proinflammatory cytokines and soluble adhesion molecules were performed. RESULTS Mean measured values in the HWC and/or MWC groups showed significantly higher values (p ≤ 0.05) of cIMT (mm), total cholesterol, triglycerides, low-density lipoprotein (LDL), blood pressure, interlukien-6 (IL-6), and interlukien-1 beta (IL-1β), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1(ICAM-1) and E-selectin, and significantly lower values of high-density lipoprotein (HDL) as compared to the LWC group. Using multiple linear regression analysis of WC-SDS adjusted for BMI-SDS with the studied subclinical atherosclerosis risk, WC-SDS was significantly (p ≤ 0.05) associated with the variation in HDL (R2 = -0.12), LDL (R2 = 0.36), IL-6 (R2 = 0.26), and VCAM-1 (R2 = 0.26). CONCLUSIONS Higher WC is positively associated with atherosclerosis risk factors including increased cIMT, a state of dyslipidemia, higher blood pressure and circulating levels of inflammation and adhesion molecules among schoolchildren. Waist circumference seems to be useful for the prediction of subclinical atherosclerosis in schoolchildren.
Collapse
Affiliation(s)
- Hayder Al-Domi
- Department of Nutrition and Food Science, School of Agriculture, The University of Jordan, Amman, 11942, Jordan.
| | - Alaa Al-Shorman
- Department of Nutrition and Food Science, School of Agriculture, The University of Jordan, Amman, 11942, Jordan.
| |
Collapse
|
8
|
Sletner L, Mahon P, Crozier SR, Inskip HM, Godfrey KM, Chiesa S, Bhowruth DJ, Charakida M, Deanfield J, Cooper C, Hanson M. Childhood Fat and Lean Mass: Differing Relations to Vascular Structure and Function at Age 8 to 9 Years. Arterioscler Thromb Vasc Biol 2018; 38:2528-2537. [PMID: 30354210 PMCID: PMC6248304 DOI: 10.1161/atvbaha.118.311455] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective- Childhood body mass index (BMI) has been related to vascular structure and function. However, little is known about the differing contributions of fat and lean mass to this relationship. Our objectives were to relate the fat and lean mass (bone excluded) components of BMI (fat mass index and lean mass index; mass [kg]/height [m]2) to vascular measures in prepubertal children. Approach and Results- In the UK Southampton Women's Survey mother-offspring cohort, 983 children had dual x-ray absorptiometry and vascular measurements at 8 to 9 years. Using linear regression analyses, we found that most vascular measures were related to BMI, but fat and lean mass contributed differently. Systolic blood pressure was positively associated with both fat mass index (β=0.91 [95% CI, 0.52-1.30] mm Hg) and lean mass index (β=2.16 [95% CI, 1.47-2.85] mm Hg), whereas pulse rate was positively associated with fat mass index (β=0.93 [95% CI, 0.48-1.38] b/min) but negatively associated with lean mass index (β=-1.79 [95% CI, -2.59 to -0.99] b/min). The positive relation between BMI and carotid intima-media thickness was mainly due to a positive association with lean mass index (β=0.013 [95% CI, 0.008-0.019] mm). Carotid-femoral pulse wave velocity, but not carotid-radial pulse wave velocity, was positively associated with fat mass index (β=0.06 [95% CI, 0.03-0.09] m/s). For systolic blood pressure, carotid-femoral pulse wave velocity and reactive hyperemia significant interactions indicated that the association with fat mass depended on the amount of lean mass. Conclusions- In prepubertal children, differences in vascular structure and function in relation to BMI probably represent combinations of adverse effects of fat mass, adaptive effects of body size, and relatively protective effects of lean mass.
Collapse
Affiliation(s)
- Line Sletner
- Dept. of Pediatric and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Pamela Mahon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Sarah R. Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Scott Chiesa
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - Devina J. Bhowruth
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - Marietta Charakida
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - John Deanfield
- Vascular Physiology Unit, Institute of Cardiovascular Science, University College London, London, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mark Hanson
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
| |
Collapse
|
9
|
Effect of early postnatal nutrition on chronic kidney disease and arterial hypertension in adulthood: a narrative review. J Dev Orig Health Dis 2018; 9:598-614. [PMID: 30078383 DOI: 10.1017/s2040174418000454] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Intrauterine growth restriction (IUGR) has been identified as a risk factor for adult chronic kidney disease (CKD), including hypertension (HTN). Accelerated postnatal catch-up growth superimposed to IUGR has been shown to further increase the risk of CKD and HTN. Although the impact of excessive postnatal growth without previous IUGR is less clear, excessive postnatal overfeeding in experimental animals shows a strong impact on the risk of CKD and HTN in adulthood. On the other hand, food restriction in the postnatal period seems to have a protective effect on CKD programming. All these effects are mediated at least partially by the activation of the renin-angiotensin system, leptin and neuropeptide Y (NPY) signaling and profibrotic pathways. Early nutrition, especially in the postnatal period has a significant impact on the risk of CKD and HTN at adulthood and should receive specific attention in the prevention of CKD and HTN.
Collapse
|
10
|
Postnatal height and adiposity gain, childhood blood pressure and prehypertension risk in an Asian birth cohort. Int J Obes (Lond) 2017; 41:1011-1017. [PMID: 28186098 DOI: 10.1038/ijo.2017.40] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 01/06/2017] [Accepted: 01/31/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE There have been hypotheses that early life adiposity gain may influence blood pressure (BP) later in life. We examined associations between timing of height, body mass index (BMI) and adiposity gains in early life with BP at 48 months in an Asian pregnancy-birth cohort. METHODS In 719 children, velocities for height, BMI and abdominal circumference (AC) were calculated at five intervals [0-3, 3-12, 12-24, 24-36 and 36-48 months]. Triceps (TS) and subscapular skinfold (SS) velocities were calculated between 0-18, 18-36 and 36-48 months. Systolic (SBP) and diastolic blood pressure (DBP) was measured at 48 months. Growth velocities at later periods were adjusted for growth velocities in preceding intervals, as well as measurements at birth. RESULTS After adjusting for confounders and child height at BP measurement, each unit z-score gain in BMI, AC, TS and SS velocities at 36-48 months were associated with 2.3 (95% CI:1.6, 3.1), 2.1 (1.3, 2.8), 1.4 (0.6, 2.2) and 1.8 (1, 2.6) mmHg higher SBP respectively, and 0.9 (0.4, 1.4), 0.9 (0.4, 1.3), 0.6 (0.1, 1.1) and 0.8 (0.3, 1.3) mmHg higher DBP respectively. BMI and adiposity velocities (AC, TS or SS) at various intervals in the first 36 months however, were not associated with BP. Faster BMI, AC, TS and SS velocities, but not height, at 36-48 months were associated with 0.22 (0.15, 0.29), 0.17 (0.10, 0.24), 0.11 (0.04, 0.19) and 0.15 (0.08, 0.23) units higher SBP z-score respectively, and OR=1.46 (95% CI: 1.13-1.90), 1.49 (1.17-1.92), 1.45 (1.09-1.92) and 1.43 (1.09, 1.88) times higher risk of prehypertension/hypertension respectively at 48 months. CONCLUSIONS Our results indicated that faster BMI and adiposity (AC, TS or SS) velocities only at the preceding interval before 48 months (36-48 months), but not at earlier intervals in the first 36 months, are predictive of BP and prehypertension/hypertension at 48 months.
Collapse
|
11
|
Aris IM, Soh SE, Tint MT, Saw SM, Rajadurai VS, Godfrey KM, Gluckman PD, Yap F, Chong YS, Lee YS. Associations of gestational glycemia and prepregnancy adiposity with offspring growth and adiposity in an Asian population. Am J Clin Nutr 2015; 102:1104-12. [PMID: 26423388 DOI: 10.3945/ajcn.115.117614] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 09/03/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Maternal obesity and hyperglycemia increase risk of obesity and diabetes in offspring later in life. OBJECTIVE We examined the relation between gestational glycemia and prepregnancy body mass index (ppBMI) with offspring growth in an Asian mother-offspring cohort. DESIGN Pregnant mothers undertook a 75-g 2-h oral-glucose-tolerance test at 26-28 wk of gestation. In 937 singleton offspring, ≤9 serial measurements of weight and length were obtained from birth until 36 mo of age. RESULTS Gestational fasting plasma glucose (FPG) was positively associated with birth weight (B: 0.17; 95% CI: 0.10, 0.24; P < 0.001) and birth BMI (B: 0.15; 95% CI: 0.06, 0.40; P = 0.001) but not at ≥3 mo of age. In contrast, maternal ppBMI was positively associated with birth variables and conditional growth in weight and BMI in the first 36 mo of life. However, gestational FPG and prepregnancy obesity status interacted significantly for the association with offspring growth and overweight status in the first 36 mo of life (P-interaction < 0.01). In nonobese mothers, each unit increase in gestational FPG was associated with increased offspring weight (B: 0.08; 95% CI: 0.008, 0.16; P = 0.03) and BMI (B: 0.08; 95% CI: 0.003, 0.15; P = 0.04) as well as increased risk of overweight in the first 36 mo of life (OR: 1.36; 95% CI: 1.10, 1.68). However, in obese mothers, each unit increase in gestational FPG was associated with decreased offspring weight (B: -0.01; 95% CI: -0.02, -0.003) and BMI (B: -0.008; 95% CI: -0.01, -0.002) velocity (P < 0.01 for both) and decreased risk of overweight (OR: 0.59; 95% CI: 0.41, 0.86) in the first 36 mo of life. CONCLUSIONS Prepregnancy adiposity was associated with offspring growth in early childhood. Although pooled analyses showed no demonstrable difference by 3 mo of age, there were contrasting and opposite associations of gestational glycemia with weight and BMI in the first 36 mo of life in offspring of nonobese and obese mothers separately. This study was registered at clinicaltrials.gov as NCT01174875.
Collapse
Affiliation(s)
- Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Departments of Paediatrics and
| | - Shu E Soh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Departments of
| | - Mya Thway Tint
- Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, and
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Departments of
| | | | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Departments of Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fabian Yap
- Paediatrics, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore Graduate Medical School, Lee Kong Chian School of Medicine, Singapore; and
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Departments of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, and
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Departments of Paediatrics and Division of Paediatric Endocrinology and Diabetes, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore
| |
Collapse
|
12
|
Williams TC, Drake AJ. What a general paediatrician needs to know about early life programming. Arch Dis Child 2015; 100:1058-63. [PMID: 25990501 DOI: 10.1136/archdischild-2014-307958] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 04/28/2015] [Indexed: 01/13/2023]
Abstract
The process whereby early exposure to an adverse environment has an influence on later life outcomes has been called 'early life programming'. While epidemiological evidence for this has been available for decades, only in recent years have the mechanisms, in particular epigenetic modifications, for this process begun to be elucidated. We discuss the evidence for early life programming, the possible mechanisms, how effects may be transmitted across generations, and conclude by looking at some examples relevant to general paediatrics.
Collapse
Affiliation(s)
- Thomas C Williams
- Neonatal Unit, Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Amanda J Drake
- University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, UK
| |
Collapse
|
13
|
Associations of infant milk feed type on early postnatal growth of offspring exposed and unexposed to gestational diabetes in utero. Eur J Nutr 2015; 56:55-64. [PMID: 26415764 PMCID: PMC5290064 DOI: 10.1007/s00394-015-1057-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 09/23/2015] [Indexed: 02/04/2023]
Abstract
Purpose
Infants on prolonged breastfeeding are known to grow slower during the first year of life. It is still unclear if such effects are similar in offspring exposed to gestational diabetes (GDM) in utero. We examined the associations of infant milk feeding on postnatal growth from birth till 36 months of age in offspring exposed and unexposed to GDM. Methods Pregnant
mothers undertook 75 g 2-h oral glucose tolerance tests at 26–28 weeks of gestation for GDM diagnosis. Up to 9 measurements of offspring weight and length were collected from birth till 36 months, and interviewer-administered questionnaires were used to ascertain the duration of breastfeeding. Results There was a statistically significant interaction between GDM status and breastmilk intake by any (pinteraction = 0.038) or exclusive/predominant breastfeeding (pinteraction = 0.035) for the outcome of conditional weight gain. In offspring of non-GDM mothers (n = 835), greater breastmilk intake (BF ≥ 4 milk months) was associated with lower conditional gains in weight [B (95 % CI) −0.48 (−0.58, −0.28); p < 0.001] within the first year of life, as well as decreasing weight SDS velocity [−0.01 (−0.02, −0.005); p < 0.001] and BMI SDS velocity [−0.008 (0.01, −0.002); p = 0.008] across age in the first 36 months. In offspring of GDM mothers (n = 181), however, greater breastmilk intake was associated with increased conditional gains in weight [0.72 (0.23, 1.20); p = 0.029] and BMI SDS [0.49 (0.04, 0.95); p = 0.04] in the first 6 months and did not demonstrate the decreasing weight and BMI SDS velocity observed in offspring of non-GDM mothers. Conclusions The reduced weight gain in the first year of life conferred by greater breastmilk intake in non-GDM children was not observed in GDM children. Clinical trial registration This study is registered under the Clinical Trials identifier NCT01174875; http://www.clinicaltrials.gov/ct2/show/NCT01174875?term=GUSTO&rank=2. Electronic supplementary material The online version of this article (doi:10.1007/s00394-015-1057-0) contains supplementary material, which is available to authorized users.
Collapse
|