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Hoang MT, Jung SJ, Lee H, Kim HC. Parent-Offspring Associations of Ideal Cardiovascular Health Metrics: Findings From the 2014 to 2021 Korea National Health and Nutrition Examination Survey. J Am Heart Assoc 2024; 13:e030995. [PMID: 38214252 PMCID: PMC10926814 DOI: 10.1161/jaha.123.030995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Studies have reported the strength of cardiovascular health (CVH) metrics in parent-offspring relationships. This study aimed to describe the sex-specific associations between CVH in parents and adult offspring. METHODS AND RESULTS This study was conducted on the Korea National Health and Nutrition Examination Survey data set, which analyzed trios of mother-father-child, with the child's age from 20 to 39 years. To use the nature of sampling design, survey weighting was applied to all our analyses. Ideal CVH was defined as a cluster of at least 5 ideal individual CVH metrics. We examined the association between parents and their adult offspring regarding clustering CVH and individual CVH metrics through odds ratios and 95% CIs using multiple logistic regression with standard errors adjusted for within-family clustering. The study included 1267 married couples comprising 748 sons and 819 daughters. After adjusting for household income and offspring's sex, age, education, and alcohol consumption, an offspring with either parent attaining a nonideal CVH was 3.52 times more likely to have nonideal CVH. Fathers' nonideal CVH was significantly positively associated with the daughters' nonideal CVH. Maternal nonideal CVH was significantly positively associated with the son's nonideal CVH. When analyzing individual CVH metrics, ideal status in fathers or mothers reduced the likelihood of their offspring having a nonideal status. CONCLUSIONS This cross-sectional study showed positive and differential associations of CVH and its components between parents' and offsprings' nonideal status. Our hypothesis-generating results suggest the relevance of using CVH as a composite indicator in family-centered approaches and heart-health interventions.
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Affiliation(s)
- Manh Thang Hoang
- Department of Public HealthGraduate School, Yonsei UniversitySeoulKorea
- Department of Preventive MedicineHanyang University College of MedicineSeoulKorea
| | - Sun Jae Jung
- Department of Preventive MedicineYonsei University College of MedicineSeoulKorea
| | - Hokyou Lee
- Department of Preventive MedicineYonsei University College of MedicineSeoulKorea
| | - Hyeon Chang Kim
- Department of Preventive MedicineYonsei University College of MedicineSeoulKorea
- Institute for Innovation in Digital Healthcare, Yonsei UniversitySeoulKorea
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Kobayashi MA, Lee TK, St George SM, Lebron C, Dorcius D, Prado G, Messiah SE. Intergenerational cardiovascular disease risks among Hispanics living in the United States. Pediatr Obes 2022; 17:e12870. [PMID: 34751514 DOI: 10.1111/ijpo.12870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/02/2021] [Accepted: 09/20/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Few studies have assessed intergenerational associations of obesity and cardiovascular disease risks from parents to their children among Hispanic Americans. OBJECTIVES To assess intergenerational cardiovascular associations among Hispanic families. METHODS Using baseline data from an obesity-focused efficacy trial targeting Hispanic adolescents (n = 280) and their parents, we conducted a series of logistic regression analyses to investigate the effects of parental BMI and blood pressure on adolescents' BMI and blood pressure, respectively. RESULTS After adjusting for significant socio-demographic variables and adolescents' lifestyle behaviours, adolescents were more than twice as likely to be in the severely obese versus overweight range when their parents had obesity (vs. non-obese; OR = 2.55, 95% CI = 1.20, 5.39) and more than twice as likely to be in the severely obese versus obese weight range (OR = 2.44, 95% CI = 1.22, 4.87) when their parents had obesity. When compared to those with normal blood pressure, adolescents who had parents with elevated blood pressure/hypertension were more than twice as likely to have elevated blood pressure (OR = 2.05, 95% CI = 1.04, 4.00) or be classified as hypertensive stage 1/2 (OR = 2.81, 95% CI = 1.31, 6.01). CONCLUSIONS Both severe obesity and elevated blood pressure are highly associated among Hispanic parent-child dyads. Findings underscore the potential benefits of intervening with the family system.
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Affiliation(s)
- Marissa A Kobayashi
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA.,Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Tae K Lee
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Sara M St George
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Cynthia Lebron
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA.,School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - David Dorcius
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA.,Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Guillermo Prado
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA.,School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Sarah E Messiah
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA.,Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center, School of Public Health, Dallas, Texas, USA.,Center for Pediatric Population Health, UTHealth School of Public Health and Children's Health System of Texas, Dallas, Texas, USA
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Abstract
Low birthweight has been related to an increased risk of adult cardiovascular disease (CVD). Transgenerational studies have been used to investigate likely mechanisms underlying this inverse association. However, previous studies mostly examined the association of offspring birthweight with CVD risk factors among parents. In this study, we investigated the association between offspring birthweight and individual CVD risk factors, an index of CVD risk factors, and education in their parents, aunts/uncles, and aunts'/uncles' partners. Birth data (Medical Birth Registry, Norway (MBRN) (1967-2012)) was linked to CVD risk factor data (the County Study, Age 40 Program, and Cohort Norway (CONOR)) for the parents, aunts/uncles, and their partners. For body mass index (BMI), resting heart rate (RHR), systolic blood pressure (SBP), total cholesterol (TC), triglycerides (TG), and a risk factor index, the associations were examined by linear regression. For smoking and education, they were examined by logistic regression. Low birthweight was associated with an unfavorable risk factor profile in all familial relationships. For each kg increase in birthweight, the mean risk factor index decreased by -0.14 units (-0.15, -0.13) in mothers, -0.11 (-0.12, -0.10) in fathers, and -0.02 (-0.05, -0.00) to -0.07 (-0.09, -0.06) in aunts/uncles and their partners. The association in mothers was stronger than fathers, but it was also stronger in aunts/uncles than their partners. Profound associations between birthweight and CVD risk factors in extended family members were observed that go beyond the expected genetic similarities in pedigrees, suggesting that mechanisms like environmental factors, assortative mating, and genetic nurturing may explain these associations.
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The Role of Family Health History in Predicting Midlife Chronic Disease Outcomes. Am J Prev Med 2021; 61:509-517. [PMID: 34229928 PMCID: PMC8818302 DOI: 10.1016/j.amepre.2021.02.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 01/13/2021] [Accepted: 02/04/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The generational relevance for determining disease risk for the leading causes of morbidity and mortality for U.S. adults is a source of debate. METHODS Data on 12,300 adults (Add Health Study Members) participating in Wave V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health (also known as Add Health) were merged with data from respondents' parents (n=2,013) participating in the Add Health Parent Study (2015-2017). Analyses beginning in January 2020 examined the concordance in lifetime occurrence of chronic conditions across 4 generations, including cardiovascular disease, diabetes, hypertension, hyperlipidemia, obesity, cancer, and depression and examined the associations between individual disease history and ones' family health history for the same condition. RESULTS Mean ages were 37.4 years for Add Health Study Members and 62.9 years for Add Health Parent Study mothers. The histories of mothers from the Add Health Parent Study on hyperlipidemia (AOR=1.61, 95% CI=1.04, 2.48), obesity (AOR=1.77, 95% CI=1.27, 2.48), and depression (AOR=1.87, 95% CI=1.19, 2.95) were significantly associated with increased odds of Add Health Study Member report of these conditions. Maternal great grandparent hyperlipidemia history was significantly associated with the Add Health Study Member hyperlipidemia (AOR=2.81, 95% CI=1.51, 5.21). Histories of diabetes in maternal grandfather (AOR=2.41, 95% CI=1.24, 4.69) and maternal great grandparent (AOR=3.05, 95% CI=1.45, 6.43) were significantly associated with Add Health Study Member diabetes. Each additional point in the Add Health Parent Study mothers' cardiometabolic risk factor index was associated with an 11% increase (incidence rate ratio=1.11, 95% CI=1.04, 1.19) in the expected count of cardiometabolic risk conditions for the Add Health Study Members. CONCLUSIONS Multigenerational health histories have value for quantifying the probability of diabetes, obesity, depression, and hyperlipidemia in early mid-adulthood. Family health history knowledge is relevant for health promotion and disease prevention strategies.
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Jensen TM, Duke NN, Harris KM, Hotz VJ, Perreira KM. Like Parent, Like Child: Intergenerational Patterns of Cardiovascular Risk Factors at Midlife. J Adolesc Health 2021; 68:596-603. [PMID: 32753345 PMCID: PMC7854782 DOI: 10.1016/j.jadohealth.2020.06.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 06/04/2020] [Accepted: 06/25/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE We aimed to assess the prevalence of four cardiovascular risk factors (obesity, diabetes, excessive alcohol intake, and cigarette smoking) for parents and their adult children at the same approximate midlife age. We also evaluated associations of parents' cardiovascular risk factors, childhood health exposures, and social contexts (i.e., family, school, and neighborhood) during adolescence with adult children's cardiovascular health at midlife. METHODS We used data from respondents at Wave V of the National Longitudinal Study of Adolescent to Adult Health who had corresponding parent (mostly mothers) data from Wave I. The final sample included 10,466 adult children with a mean age of 37.8 years. Descriptive statistics and logistic regression models were estimated, accounting for the National Longitudinal Study of Adolescent to Adult Health sampling design. RESULTS At similar ages (i.e., 35-45 years) to their parents, adult children had higher rates of excessive drinking and obesity than their parents, lower rates of diabetes, and similar rates of smoking. Adult children's health largely converged and correlated with their parents' health at similar ages. Cardiovascular risks for adult children were also significantly associated with their childhood health exposures and social contexts during adolescence. Some associations varied with respect to the health status of parents at Wave I. CONCLUSIONS The cardiovascular risk of parents at midlife is strongly associated with the cardiovascular risk of their adult children at midlife. The status of parents' health during adolescence can also modify the significance and magnitude of associations between childhood health exposures or adolescent social contexts and adult children's cardiovascular risk factors.
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Affiliation(s)
- Todd M Jensen
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Naomi N Duke
- Department of Pediatrics, Duke University, Durham, North Carolina
| | - Kathleen Mullan Harris
- Department of Sociology & Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - V Joseph Hotz
- Department of Economics, Duke University, Durham, North Carolina
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Benschop L, Schalekamp-Timmermans S, Roeters van Lennep JE, Jaddoe VWV, Steegers EAP, Ikram MK. Cardiovascular Risk Factors Track From Mother to Child. J Am Heart Assoc 2019; 7:e009536. [PMID: 30371323 PMCID: PMC6404879 DOI: 10.1161/jaha.118.009536] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Cardiovascular risk factors can track from mother to child by several pathways: pregnancy complications, genetic inheritance, and shared environmental risk factors after pregnancy. The degree of tracking, and to which extent this is influenced by these pathways, is unknown. We hypothesized that cardiovascular risk factors track from mother to child regardless of pregnancy complications and environmental risk factors. We determined the degree of tracking between maternal and offspring micro‐ and macrovascular cardiovascular risk factors after pregnancy and the extent to which this is influenced by pregnancy complications and shared environmental risk factors. Methods and Results We included 5624 mother‐offspring pairs from The Generation R Study, an ongoing prospective, population‐based birth cohort. Information on pregnancy complications (preeclampsia, small for gestational age, and preterm birth) was obtained through hospital charts. Mother‐offspring associations were assessed 6 years after pregnancy (central retinal arteriolar and venular calibers, body mass index, blood pressure, left atrial diameter, aortic root diameter, left ventricular mass, fractional shortening, and pulse wave velocity) and 9 years after pregnancy (body mass index and blood pressure). We observed that worse cardiovascular parameters in mothers were associated with worse cardiovascular parameters in their offspring 6 and 9 years after pregnancy (P<0.001). Results were similar when mother‐offspring pairs with a previous pregnancy complication were excluded. Conclusions Six and 9 years after pregnancy, an adverse cardiovascular profile in mothers is strongly associated with an adverse cardiovascular profile in their offspring. Results were not attenuated by environmental exposures or a previous pregnancy complication. This supports the hypothesis that cardiovascular risk factors (micro‐ and macrovascular) track from mother to child, regardless of the course of pregnancy.
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Affiliation(s)
- Laura Benschop
- 1 Department of Obstetrics and Gynecology Erasmus Medical Center Rotterdam The Netherlands
| | | | | | - Vincent W V Jaddoe
- 3 Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands.,4 Department of Pediatrics Erasmus Medical Center Rotterdam The Netherlands
| | - Eric A P Steegers
- 1 Department of Obstetrics and Gynecology Erasmus Medical Center Rotterdam The Netherlands
| | - M Kamran Ikram
- 3 Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands.,5 Department of Neurology Erasmus Medical Center Rotterdam The Netherlands
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Zhang X, Yang J, Wang Y, Liu W, Yang W, Gao L, Schwertz R, Welker A, Zhang F, Zhou Y. Epidemiological characteristics of elevated blood pressure among middle and high school students aged 12-17 years: a cross-sectional study in Jiangsu Province, China, 2017-2018. BMJ Open 2019; 9:e027215. [PMID: 31446405 PMCID: PMC6720134 DOI: 10.1136/bmjopen-2018-027215] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 06/13/2019] [Accepted: 07/11/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE In this study, we aimed to present the epidemiological characteristics of elevated blood pressure among middle and high school students aged 12-17 years in Jiangsu Province. SETTING Hypertension, which is considered a rare disease in children, is an important early precursor to long-term cardiovascular damage, and elevated blood pressure in childhood is a strong predictor of hypertension in adulthood. PARTICIPANTS Physical examination and questionnaire investigation among children aged 12-17 years in Jiangsu Province were conducted from 2017 to 2018. MAIN OUTCOME MEASURES Physical measurements included height, weight, blood pressure and history of menarche/first spermatorrhoea. Questionnaire investigation included family type, delivery mode, lifestyle habits and psychological test. RESULTS In our study we investigated 17 791 middle and high school students, consisting of 8701 female students and 9090 male students. The prevalence of screening elevated blood pressure among students aged 12-17 years was 20.0% (95% CI 19.2% to 20.9%) for female students and 22.3% (95% CI 21.5% to 23.2%) for male students. The prevalence of screening elevated blood pressure for urban male middle and high school students was higher than that of elevated blood pressure for rural male middle and high school students. However, similar phenomenon cannot be observed among female students. For both male and female students, body mass index (BMI), obesity/overweight and menarche/first spermatorrhoea can be a risk factor contributing to elevated blood pressure, and sleep time and regional distribution might be important factors that need to be investigated in depth. CONCLUSION We found a relatively high prevalence of screening elevated blood pressure among students aged 12-17 years for both female and male students in Jiangsu Province. The risk factors can be BMI, obesity/overweight and menarche/first spermatorrhoea.
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Affiliation(s)
- Xiyan Zhang
- Jiangsu Province Center for Disease Control and Prevention, Nanjing, China
| | - Jie Yang
- Jiangsu Province Center for Disease Control and Prevention, Nanjing, China
| | - Yan Wang
- Jiangsu Province Center for Disease Control and Prevention, Nanjing, China
| | - Weina Liu
- Jiangsu Province Center for Disease Control and Prevention, Nanjing, China
| | - Wenyi Yang
- Jiangsu Province Center for Disease Control and Prevention, Nanjing, China
| | - Liuwei Gao
- Jiangsu Province Center for Disease Control and Prevention, Nanjing, China
- School of Public Health, Southeast University, Nanjing, China
| | - Rainer Schwertz
- Local Health Authority Rhein-Neckar-Kreis, Heidelberg, Germany
| | - Andreas Welker
- Local Health Authority Rhein-Neckar-Kreis, Heidelberg, Germany
| | - Fengyun Zhang
- Jiangsu Province Center for Disease Control and Prevention, Nanjing, China
| | - Yonglin Zhou
- Jiangsu Province Center for Disease Control and Prevention, Nanjing, China
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8
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Offspring birth weight and cardiovascular mortality among parents: the role of cardiovascular risk factors. J Dev Orig Health Dis 2018; 9:351-357. [DOI: 10.1017/s2040174418000065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAn inverse association between offspring birth weight (BW) and higher risk of parental cardiovascular disease (CVD) mortality and morbidity has been reported. Shared environmental, genetic and intrauterine factors may be responsible for explaining these associations. We studied the role of parental CVD risk factors in the association between offspring BW and CVD mortality among mothers and fathers. All births registered in Medical Birth Registry Norway (1967–2012) were linked to three health surveys, National Educational Registry and Cause of Death Registry. Number of births with information of parental CVD risk factors available for the analyses was 1,006,557 (520,670 for mothers and 485,887 for fathers). Cox proportional hazards regression models were used, following CVD deaths in parents from 1974 to 2012. An inverse association between offspring BW and CVD mortality was observed among both parents: hazard ratio 1.60 (1.44–1.75) for mothers and 1.16 (1.10–1.23) for fathers. Among mothers, adjustment for smoking, triglycerides and diabetes reduced the risk to 1.36 (1.25–1.52), 1.57 (1.43–1.73) and 1.58 (1.43–1.79), respectively. Adjustment for diastolic blood pressure (DBP) and systolic blood pressure (SBP) both reduced the risk to 1.53 (1.37–1.66). Among fathers, adjustments for smoking, DBP, SBP reduced the risk to 1.08 (1.02–1.15), 1.13 (1.06–1.19) and 1.14 (1.08–1.22), respectively. Triglycerides and diabetes both reduced the risk to 1.15 (1.09–1.12). Our results indicate that shared environmental factors might be important in the association. A stronger association in mothers suggest that intrauterine factors also are at play.
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The antihypertensive MTHFR gene polymorphism rs17367504-G is a possible novel protective locus for preeclampsia. J Hypertens 2017; 35:132-139. [PMID: 27755385 PMCID: PMC5131692 DOI: 10.1097/hjh.0000000000001131] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Preeclampsia is a complex heterogeneous disease commonly defined by new-onset hypertension and proteinuria in pregnancy. Women experiencing preeclampsia have increased risk for cardiovascular diseases (CVD) later in life. Preeclampsia and CVD share risk factors and pathophysiologic mechanisms, including dysregulated inflammation and raised blood pressure. Despite commonalities, little is known about the contribution of shared genes (pleiotropy) to these diseases. This study aimed to investigate whether genetic risk factors for hypertension or inflammation are pleiotropic by also being associated with preeclampsia. METHODS We genotyped 122 single nucleotide polymorphisms (SNPs) in women with preeclampsia (n = 1006) and nonpreeclamptic controls (n = 816) from the Norwegian HUNT Study. SNPs were chosen on the basis of previously reported associations with either nongestational hypertension or inflammation in genome-wide association studies. The SNPs were tested for association with preeclampsia in a multiple logistic regression model. RESULTS The minor (G) allele of the intronic SNP rs17367504 in the gene methylenetetrahydrofolate reductase (MTHFR) was associated with a protective effect on preeclampsia (odds ratio 0.65, 95% confidence interval 0.53-0.80) in the Norwegian cohort. This association did not replicate in an Australian preeclampsia case-control cohort (P = 0.68, odds ratio 1.05, 95% confidence interval 0.83-1.32, minor allele frequency = 0.15). CONCLUSION MTHFR is important for regulating transmethylation processes and is involved in regulation of folate metabolism. The G allele of rs17367504 has previously been shown to protect against nongestational hypertension. Our study suggests a novel association between this allele and reduced risk for preeclampsia. This is the first study associating the minor (G) allele of a SNP within the MTHFR gene with a protective effect on preeclampsia, and in doing so identifying a possible pleiotropic protective effect on preeclampsia and hypertension.
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Dong Y, Ma J, Song Y, Dong B, Wang Z, Yang Z, Wang X, Prochaska JJ. National Blood Pressure Reference for Chinese Han Children and Adolescents Aged 7 to 17 Years. Hypertension 2017; 70:897-906. [PMID: 28923902 DOI: 10.1161/hypertensionaha.117.09983] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 07/17/2017] [Accepted: 08/23/2017] [Indexed: 11/16/2022]
Abstract
We sought to develop and validate a national blood pressure (BP) reference based on age, sex, and height for Chinese children. Data were obtained on 197 430 children aged 7 to 17 who participated in the Chinese National Survey on Students' Constitution and Health in 2010. BP percentiles were estimated and fitted using the lambda, mu, and sigma method and then compared with a US reference and China existing reference. In an external independent validation sample of 59 653 children aged 7 to 18 from 7 Chinese provinces in 2013, the prevalence of elevated BP was compared applying the 3 references. BP values were similar for boys and girls at the younger ages (7-13 years) and lower height percentiles, whereas higher at the older ages (14-17 years) for boys than girls. At medial height in boys and girls aged 7 to 13, the 50th, 90th, 95th, and 99th percentiles of BP for the new national reference were consistent with US reference and lower than current Chinese reference. In the independent sample, elevated BP prevalence, based on the new national reference, ranged from 7.8% to 18.5% among children aged 7 to 17, which was higher than the US reference values (4.3%-14.5%) and lower than the current Chinese reference (12.9%-25.5%) in each age group. The new national BP reference for Chinese children based on age, sex, and height from large-scale and nationally representative data seems to improve the ability for identifying Chinese hypertensive children and for stratifying them with regard to cardiovascular risk.
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Affiliation(s)
- Yanhui Dong
- From the Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China (Y.D., J.M., Y.S., B.D., Z.W., Z.Y., X.W.); and Stanford Prevention Research Center, Department of Medicine, Stanford University, CA (Y.S., J.J.P.)
| | - Jun Ma
- From the Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China (Y.D., J.M., Y.S., B.D., Z.W., Z.Y., X.W.); and Stanford Prevention Research Center, Department of Medicine, Stanford University, CA (Y.S., J.J.P.).
| | - Yi Song
- From the Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China (Y.D., J.M., Y.S., B.D., Z.W., Z.Y., X.W.); and Stanford Prevention Research Center, Department of Medicine, Stanford University, CA (Y.S., J.J.P.).
| | - Bin Dong
- From the Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China (Y.D., J.M., Y.S., B.D., Z.W., Z.Y., X.W.); and Stanford Prevention Research Center, Department of Medicine, Stanford University, CA (Y.S., J.J.P.)
| | - Zhenghe Wang
- From the Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China (Y.D., J.M., Y.S., B.D., Z.W., Z.Y., X.W.); and Stanford Prevention Research Center, Department of Medicine, Stanford University, CA (Y.S., J.J.P.)
| | - Zhaogeng Yang
- From the Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China (Y.D., J.M., Y.S., B.D., Z.W., Z.Y., X.W.); and Stanford Prevention Research Center, Department of Medicine, Stanford University, CA (Y.S., J.J.P.)
| | - Xijie Wang
- From the Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China (Y.D., J.M., Y.S., B.D., Z.W., Z.Y., X.W.); and Stanford Prevention Research Center, Department of Medicine, Stanford University, CA (Y.S., J.J.P.)
| | - Judith J Prochaska
- From the Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China (Y.D., J.M., Y.S., B.D., Z.W., Z.Y., X.W.); and Stanford Prevention Research Center, Department of Medicine, Stanford University, CA (Y.S., J.J.P.)
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11
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2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents. J Hypertens 2017; 34:1887-920. [PMID: 27467768 DOI: 10.1097/hjh.0000000000001039] [Citation(s) in RCA: 694] [Impact Index Per Article: 99.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Increasing prevalence of hypertension (HTN) in children and adolescents has become a significant public health issue driving a considerable amount of research. Aspects discussed in this document include advances in the definition of HTN in 16 year or older, clinical significance of isolated systolic HTN in youth, the importance of out of office and central blood pressure measurement, new risk factors for HTN, methods to assess vascular phenotypes, clustering of cardiovascular risk factors and treatment strategies among others. The recommendations of the present document synthesize a considerable amount of scientific data and clinical experience and represent the best clinical wisdom upon which physicians, nurses and families should base their decisions. In addition, as they call attention to the burden of HTN in children and adolescents, and its contribution to the current epidemic of cardiovascular disease, these guidelines should encourage public policy makers to develop a global effort to improve identification and treatment of high blood pressure among children and adolescents.
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Vella S, Bezzina Sultana M, Fava S. Association of cholesterol and lifestyle markers with type 1 diabetes incidence rates at a population level. J Public Health (Oxf) 2017; 39:542-548. [PMID: 27591302 DOI: 10.1093/pubmed/fdw081] [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: 07/21/2016] [Accepted: 07/16/2016] [Indexed: 11/12/2022] Open
Abstract
Background We investigated the hypotheses that mean population body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and the prevalence of type 2 diabetes (T2DM) are correlated with type 1 diabetes (T1DM) incidence rates. Methods Population-based mean incidence rates for T1DM in children aged ≤14 years participating in the World Health Organization Diabetes Mondial (DiaMond) project were compared with population mean values for BMI, SBP, TC and FPG, as well as prevalence rates for T2DM as reported by The Global Burden of Metabolic Risk Factors Chronic Diseases Collaborating Group, using Spearman's rank correlation and multiple regression analysis. Results The mean incidence rate for T1DM in boys was significantly correlated with country mean BMI, SBP and TC in men and mean TC in women, and negatively correlated with the country incidence of T2DM in either gender. We also found significant correlations between mean incidence rates of T1DM in girls and mean BMI, SBP and TC in men and mean TC in women. In multiple regression analyses, mean TC emerged as the sole significant predictor for T1DM in both boys (P < 0.001, adjusted R2 = 0.393) and girls (P < 0.001, adjusted R2 = 0.372). Conclusion Population mean total cholesterol is a significant predictor for country incidence of type 1 diabetes in both boys and girls. This association may fuel the rising incidence rates of type 1 diabetes reported in many countries.
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Affiliation(s)
- Sandro Vella
- Diabetes and Endocrine Centre, Mater Dei Hospital, Msida, MSD 2090, Malta.,Department of Medicine, University of Malta Medical School, Msida, MSD 2090, Malta
| | | | - Stephen Fava
- Diabetes and Endocrine Centre, Mater Dei Hospital, Msida, MSD 2090, Malta.,Department of Medicine, University of Malta Medical School, Msida, MSD 2090, Malta
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Association of Parental Overweight and Cardiometabolic Diseases and Pediatric Adiposity and Lifestyle Factors with Cardiovascular Risk Factor Clustering in Adolescents. Nutrients 2016; 8:nu8090567. [PMID: 27649237 PMCID: PMC5037552 DOI: 10.3390/nu8090567] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 07/30/2016] [Accepted: 09/05/2016] [Indexed: 12/17/2022] Open
Abstract
Cardiometabolic risk factors or their precursors are observed in childhood and may continue into adulthood. We investigated the effects of parental overweight and cardiometabolic diseases and pediatric lifestyle factors on the clustering of cardiovascular risk factors among adolescents, and examined the mediating and modifying effects of pediatric adiposity on these associations. Representative adolescents (n = 2727; age, 12–16 years) were randomly recruited through multistage stratified sampling from 36 schools in Southern Taiwan. Adolescent and parent surveys were conducted in schools and participant homes, respectively. Their demographic factors, diet patterns, and physical, anthropometric, and clinical parameters were collected and analyzed. Adolescents with 1–2 and ≥3 risk components for pediatric metabolic syndrome (MetS) were defined as potential MetS (pot-MetS) and MetS, respectively. Adolescents whose parents were overweight/obese, or with diabetes and hypertension had a higher prevalence ratio of pot-MetS and MetS (1.5–1.6 and 1.9–4.2-fold, respectively). Low physical activity (<952.4 MET·min/week), long screen time (≥3 h/day) and high sugar-sweetened beverage intake (>500 mL/day) were associated with a 3.3- (95% confidence intervals (CI) = 1.5–7.3), 2.2- (95% CI = 1.1–4.4), and 26.9-fold (95% CI = 3.2–229.0) odds ratio (OR) of MetS, respectively. Pediatric body mass index (BMI) accounted for 18.8%–95.6% and 16.9%–60.3% increased prevalence ratios of these parental and pediatric risk factors for MetS. The OR of pot-MetS + MetS for sugar-sweetened beverage consumption was multiplicatively enhanced among adolescents with overweight/obesity (combined OR, 8.6-fold (95% CI = 4.3–17.3); p for multiplicative interaction, 0.009). The results suggest that parental overweight and cardiometabolic diseases and pediatric sedentary and high sugar-intake lifestyles correlate with the development of adolescent MetS, and an elevated child BMI explains a part of these associations. Pediatric adiposity might be multiplicatively associated with sugar-sweetened beverage consumption for enhancing the MetS prevalence ratio among adolescents.
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Refined phenotyping identifies links between preeclampsia and related diseases in a Norwegian preeclampsia family cohort. J Hypertens 2016; 33:2294-302. [PMID: 26259119 PMCID: PMC4596487 DOI: 10.1097/hjh.0000000000000696] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Preeclampsia is a complex genetic disease of pregnancy with a heterogenous presentation, unknown cause and potential severe outcomes for both mother and child. Preeclamptic women have increased risk for atherothrombotic cardiovascular disease. We aimed to identify heritabilities and phenotypic correlations of preeclampsia and related conditions in the Norwegian Preeclampsia Family Biobank. METHODS By applying a variance components model, a total of 493 individuals (from 138 families with increased occurrence of preeclampsia) were classified according to 30 disease-related phenotypes. RESULTS Of parous women, 75.7% (263/338) had experienced preeclampsia and 35.7% of women with and 22.4% without preeclampsia delivered children small for gestational age (SGA). We identified 11 phenotypes as heritable. The increased occurrence of preeclampsia was reflected by the presence [heritability (H2r) = 0.60)] and severity (H2r = 0.15) of preeclampsia and being born in a preeclamptic pregnancy (H2r = 0.25). Other heritable phenotypes identified included SGA (H2r = 0.40), chronic hypertension (H2r = 0.57), severity of atherothrombotic cardiovascular disease (H2r = 0.31), BMI (H2r = 0.60) and pulmonary disease (H2r = 0.91). The heritable phenotype preeclampsia overlapped with SGA (P = 0.03), whereas pulmonary disease was phenotypically correlated with atherothrombotic cardiovascular disease (P < 0.01), SGA (P = 0.02) and BMI (P = 0.02). CONCLUSION This is the first study identifying the H2r of a range of health-related conditions in preeclamptic families. Our study demonstrates how refinement of phenotypes leads to better H2r estimation and the identification of a biological relationship between preeclampsia and related traits.
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Familial Risk of Chronic Musculoskeletal Pain and the Importance of Physical Activity and Body Mass Index: Prospective Data from the HUNT Study, Norway. PLoS One 2016; 11:e0153828. [PMID: 27082110 PMCID: PMC4833298 DOI: 10.1371/journal.pone.0153828] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 04/03/2016] [Indexed: 02/02/2023] Open
Abstract
The main objectives of the current study was i) to prospectively examine if chronic musculoskeletal pain in parents is associated with risk of chronic musculoskeletal pain in their adult offspring, and ii) to assess if these parent-offspring associations are modified by offspring body mass index and leisure time physical activity. We used data on 4,742 adult offspring linked with their parents who participated in the population-based HUNT Study in Norway in 1995–97 and in 2006–08. Family relations were established through the national Family Registry. A Poisson regression model was used to estimate relative risk (RR) with 95% confidence interval (CI). In total, 1,674 offspring (35.3%) developed chronic musculoskeletal pain during the follow-up period of approximately 11 years. Both maternal (RR: 1.26, 95% CI: 1.03, 1.55) and paternal chronic musculoskeletal pain (RR: 1.29, 95% CI: 1.06, 1.57) was associated with increased risk of offspring chronic musculoskeletal pain. Compared to offspring of parents without chronic musculoskeletal pain, the adverse effect of parental pain was somewhat stronger among offspring who reported a low (RR: 1.82, 95% CI: 1.32, 2.52) versus high (RR: 1.32, 95% CI: 0.95, 1.84) level of leisure time physical activity. Offspring of parents with chronic musculoskeletal pain and who were classified as obese had more than twofold increased risk (RR: 2.33, 95% CI: 1.68, 3.24) of chronic musculoskeletal pain compared to normal weight offspring of parents without pain. In conclusion, parental chronic musculoskeletal pain is positively associated with risk of chronic musculoskeletal pain in their adult offspring. Maintenance of normal body weight may reduce the risk of chronic musculoskeletal pain in offspring of pain-afflicted parents.
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Halvorsen T, Moran A, Jacobs DR, Steffen LM, Sinaiko AR, Zhou X, Steinberger J. Relation of Cardiometabolic Risk Factors between Parents and Children. J Pediatr 2015; 167:1049-56.e2. [PMID: 26307644 PMCID: PMC4661075 DOI: 10.1016/j.jpeds.2015.07.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 06/10/2015] [Accepted: 07/27/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To explore the relations of parent-child cardiometabolic risk factors and assess the influence of adiposity on these associations. STUDY DESIGN Associations of adiposity, blood pressure (BP), lipids, fasting insulin and glucose, and a risk factor cluster score (CS) were evaluated in a cross-sectional study of 179 parents and their children (6-18 years, N = 255). Insulin resistance was assessed by euglycemic clamp in parents and children aged 10 years or older. Metabolic syndrome in parents was defined by National Cholesterol Education Program's Adult Treatment Panel III criteria. CSs of the risk factors were created based on age-specific z-scores. Analyses included Pearson correlation and linear regression, adjusted for parent and child age, sex, race, and body mass index (BMI), accounting for within-family correlation. RESULTS We found positive parent-child correlations for measures of adiposity (BMI, BMI percentile, waist, subcutaneous fat, and visceral fat; r = 0.22-0.34, all P ≤ .003), systolic BP (r = 0.20, P = .002), total cholesterol (r = 0.39, P < .001), low-density lipoprotein cholesterol (r = 0.34, P < .001), high density lipoprotein cholesterol (r = 0.26, P < .001), triglycerides (r = 0.19, P = .01), and insulin sensitivity (r = 0.22, P = .02) as well as CSs (r = 0.15, P = .02). After adjustment for BMI all parent-child correlations, except systolic BP, remained significant. CONCLUSIONS Although adiposity is strongly correlated between parents and children, many cardiometabolic risk factors correlate independent of parent and child BMI. Adverse parental cardiometabolic profiles may identify at-risk children independent of the child's adiposity status.
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Affiliation(s)
- Tanya Halvorsen
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota 55454
| | - Antoinette Moran
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota 55454
| | - David R. Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55455 USA
| | - Lyn M. Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55455 USA
| | - Alan R. Sinaiko
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota 55454
| | - Xia Zhou
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55455 USA
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN.
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Hart C, McCartney G, Gruer L, Watt G. Comparing the impact of personal and parental risk factors, and parental lifespan on all-cause mortality and cardiovascular disease: findings from the Midspan Family cohort study. J Epidemiol Community Health 2015; 69:950-7. [PMID: 26022058 DOI: 10.1136/jech-2014-205242] [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: 11/13/2014] [Accepted: 05/10/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND We aimed to identify which personal and parental factors best explained all-cause mortality and cardiovascular disease (CVD). METHODS In 1996, data were collected on 2338 adult offspring of the participants in the 1972-1976 Renfrew and Paisley prospective cohort study. Recorded risk factors were assigned to 5 groups: mid-life biological and behavioural (BB), mid-life socioeconomic, parental BB, early-life socioeconomic and parental lifespan. Participants were followed up for mortality and hospital admissions to the end of 2011. Cox proportional hazards models were used to analyse how well each group explained all-cause mortality or CVD. Akaike's Information Criterion (AIC), a measure of goodness-of-fit, identified the most important groups. RESULTS For all-cause mortality (1997 participants with complete data, 111 deaths), decreases in AIC from the null model (adjusting for age and sex) to models including mid-life BB, mid-life socioeconomic, parental BB, early-life socioeconomic and parental lifespan were 55.8, 21.6, 10.3, 7.3 and 5.9, respectively. For the CVD models (1736 participants, 276 with CVD), decreases were 37.8, 3.7, 6.7, 17.3 and 0.4. Mid-life BB factors were the most important for both all-cause mortality and CVD; mid-life socioeconomic factors were important for all-cause mortality, and early-life socioeconomic factors were important for CVD. Parental lifespan was the weakest factor. CONCLUSIONS As mid-life BB risk factors best explained all-cause mortality and CVD, continued action to reduce these is warranted. Targeting adverse socioeconomic factors in mid-life and early life may contribute to reducing all-cause mortality and CVD risk, respectively.
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Affiliation(s)
- Carole Hart
- Institute of Health and Wellbeing, Public Health, University of Glasgow, Glasgow, UK
| | | | - Laurence Gruer
- Institute of Health and Wellbeing, Public Health, University of Glasgow, Glasgow, UK
| | - Graham Watt
- Institute of Health and Wellbeing, General Practice and Primary Care, University of Glasgow, Glasgow, UK
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Vik KL, Romundstad P, Carslake D, Davey Smith G, Nilsen TIL. Transgenerational effects of parental cardiovascular disease and risk factors on offspring mortality: family-linkage data from the HUNT Study, Norway. Eur J Prev Cardiol 2014; 23:145-53. [PMID: 25425350 DOI: 10.1177/2047487314562118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 11/11/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Cardiovascular risk factors are known to be associated between parents and offspring. However, whether these associations are reflected in increased offspring mortality has not been extensively studied. DESIGN This was a family study of 32,536 father-offspring and 39,614 mother-offspring pairs who participated in the HUNT Study, Norway. METHODS Adjusted hazard ratios (HRs) for offspring total and cardiovascular mortality associated with parental levels of cardiovascular disease risk factors were estimated using Cox regression. RESULTS AND CONCLUSIONS Fathers' and mothers' reporting of cardiovascular disease (HRs: 1.18; 95% CI 1.04-1.32 and 1.20; 1.07-1.35, respectively), diabetes (HRs: 1.22; 95% CI 1.00-1.49 and 1.21; 1.05-1.40, respectively), and current smoking (HRs: 1.21; 95% CI 1.08-1.36 and 1.30; 1.15-1.47, respectively) was associated with total mortality in offspring. An inverse association was found with maternal height (HR: 0.95; 95% CI 0.91-0.99), and a suggestive inverse association with paternal height (HR: 0.98; 95% CI 0.93-1.03). Relations with offspring cardiovascular mortality were less clear and consistent. Offspring whose parents both had a risk factor did not seem to have higher mortality than would be expected from the independent effects of each parent.
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Affiliation(s)
- Kirsti L Vik
- Department of Public Health, Norwegian University of Science and Technology, Norway Liaison Committee between the Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology (NTNU), Norway
| | - Pål Romundstad
- Department of Public Health, Norwegian University of Science and Technology, Norway
| | - David Carslake
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | | | - Tom I L Nilsen
- Department of Public Health, Norwegian University of Science and Technology, Norway
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Lier R, Nilsen TIL, Vasseljen O, Mork PJ. Neck/upper back and low back pain in parents and their adult offspring: Family linkage data from the Norwegian HUNT Study. Eur J Pain 2014; 19:762-71. [PMID: 25263611 DOI: 10.1002/ejp.599] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chronic pain in the neck and low back is highly prevalent. Although heritable components have been identified, knowledge about generational transmission of spinal pain between parents and their adult offspring is sparse. METHODS This study examined the intergenerational association of spinal pain using data from 11,081 parent-offspring trios participating in the population-based HUNT Study in Norway. Logistic regression was used to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for offspring spinal pain associated with parental spinal pain. RESULTS In total, 3654 (33%) offspring reported spinal pain at participation. Maternal and paternal spinal pain was consistently associated with higher ORs for offspring spinal pain. The results suggest a slightly stronger association for parental multilevel spinal pain (i.e., both neck/upper back pain and low back pain) than for pain localized to the neck/upper back or low back. Multilevel spinal pain in both parents was associated with ORs of 2.6 (95% CI, 2.1-3.3), 2.4 (95% CI, 1.9-3.1) and 3.1 (95% CI, 2.2-4.4) for offspring neck/upper back, low back and multilevel spinal pain, respectively. CONCLUSION Parental chronic spinal pain was consistently associated with increased occurrence of chronic spinal pain in their adult offspring, and this association was particularly strong for multilevel spinal pain.
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Affiliation(s)
- R Lier
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Liaison Committee between the Central Norway Regional Health Authority, Stjørdal, Norway; the Norwegian University of Science and Technology, Trondheim, Norway
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Lier R, Nilsen TIL, Mork PJ. Parental chronic pain in relation to chronic pain in their adult offspring: family-linkage within the HUNT Study, Norway. BMC Public Health 2014; 14:797. [PMID: 25096408 PMCID: PMC4133600 DOI: 10.1186/1471-2458-14-797] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 07/24/2014] [Indexed: 11/13/2022] Open
Abstract
Background Little is known about the association between parental chronic musculoskeletal pain (CMP) and occurrence of CMP in the adult offspring. The main objective of this study was to assess the parent-offspring association of CMP, and also to examine possible modifying effects of age and sex. Methods The study includes 11 248 parent-offspring trios from the Norwegian HUNT Study with information on parental CMP obtained in 1995–97 and offspring CMP obtained in 2006–08. Logistic regression was used to calculate adjusted odds ratios (ORs) for offspring CMP associated with parental CMP. Results Maternal and paternal CMP was associated with 20-40% increased odds of CMP in sons and daughters. Both sons and daughters had an OR of 1.6 (95% CI 1.4 to 1.9) when both parents reported CMP, compared to when none of the parents had CMP. Restricting the analyses to parental CMP that was associated with limited work ability and leisure time activity did not change the strength of the association. Further, analyses stratified by parental age ±65 years showed no clear difference in the estimated associations, and there was no evidence of interaction for parental sex (P ≥ 0.39) or offspring age ±40 years (P ≥ 0.26). Conclusions This large family-linkage study show that maternal and paternal CMP are positively associated with CMP in the adult offspring, irrespective of parental and offspring age, and that the associations are strongest when both parents have CMP. Although the high prevalence of CMP in both parents and offspring suggests that not all cases are clinically relevant, the results suggest that chronic pain has a heritable component.
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Affiliation(s)
- Ragnhild Lier
- Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), N-7491 Trondheim, Norway.
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Laker RC, Lillard TS, Okutsu M, Zhang M, Hoehn KL, Connelly JJ, Yan Z. Exercise prevents maternal high-fat diet-induced hypermethylation of the Pgc-1α gene and age-dependent metabolic dysfunction in the offspring. Diabetes 2014; 63:1605-11. [PMID: 24430439 PMCID: PMC5860829 DOI: 10.2337/db13-1614] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Abnormal conditions during early development adversely affect later health. We investigated whether maternal exercise could protect offspring from adverse effects of a maternal high-fat diet (HFD) with a focus on the metabolic outcomes and epigenetic regulation of the metabolic master regulator, peroxisome proliferator-activated receptor γ coactivator-1α (Pgc-1α). Female C57BL/6 mice were exposed to normal chow, an HFD, or an HFD with voluntary wheel exercise for 6 weeks before and throughout pregnancy. Methylation of the Pgc-1α promoter at CpG site -260 and expression of Pgc-1α mRNA were assessed in skeletal muscle from neonatal and 12-month-old offspring, and glucose and insulin tolerance tests were performed in the female offspring at 6, 9, and 12 months. Hypermethylation of the Pgc-1α promoter caused by a maternal HFD was detected at birth and was maintained until 12 months of age with a trend of reduced expression of Pgc-1α mRNA (P = 0.065) and its target genes. Maternal exercise prevented maternal HFD-induced Pgc-1α hypermethylation and enhanced Pgc-1α and its target gene expression, concurrent with amelioration of age-associated metabolic dysfunction at 9 months of age in the offspring. Therefore, maternal exercise is a powerful lifestyle intervention for preventing maternal HFD-induced epigenetic and metabolic dysregulation in the offspring.
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Affiliation(s)
- Rhianna C. Laker
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA
- Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA
| | - Travis S. Lillard
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA
| | - Mitsuharu Okutsu
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA
- Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA
- Cardiovascular & Metabolic Disorders Program, Duke-NUS Graduate Medical School, Singapore
| | - Mei Zhang
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA
- Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA
- Cardiovascular & Metabolic Disorders Program, Duke-NUS Graduate Medical School, Singapore
| | - Kyle L. Hoehn
- Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA
- Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, VA
| | - Jessica J. Connelly
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA
- Department of Molecular Physiology & Biological Physics, University of Virginia School of Medicine, Charlottesville, VA
- Corresponding authors: Jessica J. Connelly, , and Zhen Yan,
| | - Zhen Yan
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA
- Center for Skeletal Muscle Research at the Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, VA
- Cardiovascular & Metabolic Disorders Program, Duke-NUS Graduate Medical School, Singapore
- Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, VA
- Department of Molecular Physiology & Biological Physics, University of Virginia School of Medicine, Charlottesville, VA
- Corresponding authors: Jessica J. Connelly, , and Zhen Yan,
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