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D’Amato G, Brescia V, Fontana A, Natale MP, Lovero R, Varraso L, Di Serio F, Simonetti S, Muggeo P, Faienza MF. Biomarkers and Biochemical Indicators to Evaluate Bone Metabolism in Preterm Neonates. Biomedicines 2024; 12:1271. [PMID: 38927478 PMCID: PMC11201126 DOI: 10.3390/biomedicines12061271] [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: 05/17/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
The purpose of the present study was to evaluate the concentrations of some bone turnover markers in preterm neonates with uncomplicated clinical course in the first month of life. Samples from 13 preterm neonates were collected at three different times: at birth (T0) from umbilical cord blood (UCB); and at 15 (T1) and 30 (T2) days of life from peripheral blood (PB). The concentrations of calcium (Ca), phosphate (P), total alkaline phosphatase (ALP), Collagen Type 1 Amino-terminal Propeptide (PINP), osteocalcin (OC), Collagen Type 1 Carboxyl-Terminal Telopeptide (CTX) and Leptin were assessed. A statistically significant difference for ALP concentration at birth versus T1 and T2 was found. An evident increase in the median concentrations of CTX, OC and PINP from T0 to T2 were observed. A significant difference was also found for Leptin concentration at T0 compared to T1. In preterm infants, in the absence of acute or chronic medical conditions and without risk factors for metabolic bone disease (MBD) of prematurity, there is a significant increase in bone turnover markers during the first month of life. The knowledge of the variations in these markers in the first weeks of life, integrated by the variations in the biochemical indicators of bone metabolism, could help in recognizing any conditions at risk of developing bone diseases.
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Affiliation(s)
- Gabriele D’Amato
- Neonatal Intensive Care Unit, Di Venere Hospital, 70012 Bari, Italy; (G.D.); (M.P.N.)
| | - Vincenzo Brescia
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, 70124 Bari, Italy; (A.F.); (R.L.); (L.V.); (F.D.S.)
| | - Antonietta Fontana
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, 70124 Bari, Italy; (A.F.); (R.L.); (L.V.); (F.D.S.)
| | - Maria Pia Natale
- Neonatal Intensive Care Unit, Di Venere Hospital, 70012 Bari, Italy; (G.D.); (M.P.N.)
| | - Roberto Lovero
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, 70124 Bari, Italy; (A.F.); (R.L.); (L.V.); (F.D.S.)
| | - Lucia Varraso
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, 70124 Bari, Italy; (A.F.); (R.L.); (L.V.); (F.D.S.)
| | - Francesca Di Serio
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, 70124 Bari, Italy; (A.F.); (R.L.); (L.V.); (F.D.S.)
| | - Simonetta Simonetti
- Clinical Pathology and Neonatal Screening, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, 70124 Bari, Italy;
| | - Paola Muggeo
- Department of Pediatric Oncology and Hematology, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, 70124 Bari, Italy;
| | - Maria Felicia Faienza
- Pediatric Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari “A. Moro”, 70124 Bari, Italy;
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2
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Miller AN, Curtiss J, Kielt MJ. Nutritional Needs of the Infant with Bronchopulmonary Dysplasia. Neoreviews 2024; 25:e12-e24. [PMID: 38161180 DOI: 10.1542/neo.25-1-e12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Growth failure is a common problem in infants with established bronchopulmonary dysplasia (BPD). Suboptimal growth for infants with BPD is associated with unfavorable respiratory and neurodevelopmental outcomes; however, high-quality evidence to support best nutritional practices are limited for this vulnerable patient population. Consequently, there exists a wide variation in the provision of nutritional care and monitoring of growth for infants with BPD. Other neonatal populations at risk for growth failure, such as infants with congenital heart disease, have demonstrated improved growth outcomes with the creation and compliance of clinical protocols to guide nutritional management. Developing clinical protocols to guide nutritional management for infants with BPD may similarly improve long-term outcomes. Given the absence of high-quality trials to guide nutritional practice in infants with BPD, the best available evidence of systematic reviews and clinical recommendations can be applied to optimize growth and decrease variation in the care of these infants.
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Affiliation(s)
- Audrey N Miller
- Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital and Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH
| | - Jennifer Curtiss
- Department of Clinical Nutrition and Lactation, Nationwide Children's Hospital, Columbus, OH
| | - Matthew J Kielt
- Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital and Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH
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3
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Snega Priya P, Pratiksha Nandhini P, Arockiaraj J. A comprehensive review on environmental pollutants and osteoporosis: Insights into molecular pathways. ENVIRONMENTAL RESEARCH 2023; 237:117103. [PMID: 37689340 DOI: 10.1016/j.envres.2023.117103] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/28/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
A significant problem that has an impact on community wellbeing is environmental pollution. Environmental pollution due to air, water, or soil pollutants might pose a severe risk to global health, necessitating intense scientific effort. Osteoporosis is a common chronic condition with substantial clinical implications on mortality, morbidity, and quality of life. It is closely linked to bone fractures. Worldwide, osteoporosis affects around 200 million people, and every year, there are almost 9 million fractures. There is evidence that certain environmental factors may increase the risk of osteoporosis in addition to traditional risk factors. It is crucial to understand the molecular mechanisms at play because there is a connection between osteoporosis and exposure to environmental pollutants such as heavy metals, air pollutants, endocrine disruptors, metal ions and trace elements. Hence, in this scoping review, we explore potential explanations for the link between pollutants and bone deterioration through deep insights into molecular pathways. Understanding and recognizing these pollutants as modifiable risk factors for osteoporosis would possibly help to enhance environmental policy thereby aiding in the improvement of bone health and improving patient quality of life.
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Affiliation(s)
- P Snega Priya
- Toxicology and Pharmacology Laboratory, Department of Biotechnology, SRM Institute of Science and Technology, Faculty of Science and Humanities, Kattankulatur, 603203, Chengalpattu District, Tamil Nadu, India
| | - P Pratiksha Nandhini
- Toxicology and Pharmacology Laboratory, Department of Biotechnology, SRM Institute of Science and Technology, Faculty of Science and Humanities, Kattankulatur, 603203, Chengalpattu District, Tamil Nadu, India
| | - Jesu Arockiaraj
- Toxicology and Pharmacology Laboratory, Department of Biotechnology, SRM Institute of Science and Technology, Faculty of Science and Humanities, Kattankulatur, 603203, Chengalpattu District, Tamil Nadu, India.
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4
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Miller AN, Curtiss J, Taylor SN, Backes CH, Kielt MJ. A review and guide to nutritional care of the infant with established bronchopulmonary dysplasia. J Perinatol 2023; 43:402-410. [PMID: 36494567 DOI: 10.1038/s41372-022-01578-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/20/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022]
Abstract
Bronchopulmonary dysplasia (BPD) remains the most common long-term morbidity of premature birth, and the incidence of BPD is not declining despite medical advancements. Infants with BPD are at high risk for postnatal growth failure and are often treated with therapies that suppress growth. Additionally, these infants may display excess weight gain relative to linear growth. Optimal growth and nutrition are needed to promote lung growth and repair, improve long-term pulmonary function, and improve neurodevelopmental outcomes. Linear growth in particular has been associated with favorable outcomes yet can be difficult to achieve in these patients. While there has been a significant clinical and research focus regarding BPD prevention and early preterm nutrition, there is a lack of literature regarding nutritional care of the infant with established BPD. There is even less information regarding how nutritional needs change as BPD evolves from an acute to chronic disease. This article reviews the current literature regarding nutritional challenges, enteral nutrition management, and monitoring for patients with established BPD. Additionally, this article provides a practical framework for interdisciplinary nutritional care based on our clinical experience at the Comprehensive Center for Bronchopulmonary Dysplasia.
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Affiliation(s)
- Audrey N Miller
- Division of Neonatology, Department of Pediatrics, Ohio State University, Nationwide Children's Hospital, Columbus, OH, USA. .,Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital, Columbus, OH, USA.
| | - Jennifer Curtiss
- Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Clinical Nutrition and Lactation, Nationwide Children's Hospital, Columbus, OH, USA
| | - Sarah N Taylor
- Division of Neonatology, Yale School of Medicine, New Haven, CT, USA
| | - Carl H Backes
- Division of Neonatology, Department of Pediatrics, Ohio State University, Nationwide Children's Hospital, Columbus, OH, USA.,Division of Cardiology, Nationwide Children's Hospital, Columbus, OH, USA.,Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Matthew J Kielt
- Division of Neonatology, Department of Pediatrics, Ohio State University, Nationwide Children's Hospital, Columbus, OH, USA.,Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children's Hospital, Columbus, OH, USA
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5
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Noritz G, Davidson L, Steingass K. Providing a Primary Care Medical Home for Children and Youth With Cerebral Palsy. Pediatrics 2022; 150:e2022060055. [PMID: 36404756 DOI: 10.1542/peds.2022-060055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cerebral palsy (CP) is the most common motor disorder of childhood, with prevalence estimates ranging from 1.5 to 4 in 1000 live births. This clinical report seeks to provide primary care physicians with guidance to detect children with CP; collaborate with specialists in treating the patient; manage associated medical, developmental, and behavioral problems; and provide general medical care to their patients with CP.
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Affiliation(s)
- Garey Noritz
- Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio; and
| | - Lynn Davidson
- The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Katherine Steingass
- Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio; and
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Lin L, Gamble GD, Crowther CA, Bloomfield FH, Agosti M, Atkinson SA, Biasini A, Embleton ND, Lamy Filho F, Fusch C, Gianni ML, Kutman HGK, Koo W, Litmanovitz I, Morgan C, Mukhopadhyay K, Neri E, Picaud JC, Rochow N, Roggero P, Stroemmen K, Tan MJ, Tandoi FM, Wood CL, Zachariassen G, Harding JE. Sex-Specific Effects of Nutritional Supplements for Infants Born Early or Small: An Individual Participant Data Meta-Analysis (ESSENCE IPD-MA) II: Growth. Nutrients 2022; 14:nu14020392. [PMID: 35057573 PMCID: PMC8781781 DOI: 10.3390/nu14020392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 12/10/2022] Open
Abstract
Neonatal nutritional supplements may improve early growth for infants born small, but effects on long-term growth are unclear and may differ by sex. We assessed the effects of early macronutrient supplements on later growth. We searched databases and clinical trials registers from inception to April 2019. Participant-level data from randomised trials were included if the intention was to increase macronutrient intake to improve growth or development of infants born preterm or small-for-gestational-age. Co-primary outcomes were cognitive impairment and metabolic risk. Supplementation did not alter BMI in childhood (kg/m2: adjusted mean difference (aMD) -0.11[95% CI -0.47, 0.25], p = 0.54; 3 trials, n = 333). Supplementation increased length (cm: aMD 0.37[0.01, 0.72], p = 0.04; 18 trials, n = 2008) and bone mineral content (g: aMD 10.22[0.52, 19.92], p = 0.04; 6 trials, n = 313) in infancy, but not at older ages. There were no differences between supplemented and unsupplemented groups for other outcomes. In subgroup analysis, supplementation increased the height z-score in male toddlers (aMD 0.20[0.02, 0.37], p = 0.03; 10 trials, n = 595) but not in females, and no significant sex interaction was observed (p = 0.21). Macronutrient supplementation for infants born small may not alter BMI in childhood. Supplementation increased growth in infancy, but these effects did not persist in later life. The effects did not differ between boys and girls.
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Affiliation(s)
- Luling Lin
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand; (L.L.); (G.D.G.); (C.A.C.); (F.H.B.)
| | - Greg D. Gamble
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand; (L.L.); (G.D.G.); (C.A.C.); (F.H.B.)
| | - Caroline A. Crowther
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand; (L.L.); (G.D.G.); (C.A.C.); (F.H.B.)
| | - Frank H. Bloomfield
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand; (L.L.); (G.D.G.); (C.A.C.); (F.H.B.)
| | - Massimo Agosti
- NICU, Woman and Child Department, Ospedale Del Ponte, Insubria University, 21100 Varese, Italy; (M.A.); (F.M.T.)
| | - Stephanie A. Atkinson
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.A.A.); (C.F.); (N.R.)
| | - Augusto Biasini
- Donor Human Milk Bank Italian Association (AIBLUD), 20126 Milan, Italy;
| | - Nicholas D. Embleton
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK;
| | - Fernando Lamy Filho
- Departamento de Medicina, Universidade Federal do Maranhão (UFMA), São Luís 65080-805, Brazil;
| | - Christoph Fusch
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.A.A.); (C.F.); (N.R.)
- Department of Pediatrics, Nuremberg General Hospital, Paracelsus Medical University, 90471 Nuremberg, Germany
| | - Maria L. Gianni
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milan, Italy; (M.L.G.); (P.R.)
- Department of Clinical Sciences and Community Health, University of Milan, Via Commenda 19, 20122 Milan, Italy
| | | | - Winston Koo
- Department of Nutrition and Food Science, Wayne State University, Detroit, MI 48202, USA;
| | - Ita Litmanovitz
- Department of Neonatology, Meir Medical Center, Kfar Saba 4428164, Israel;
| | - Colin Morgan
- Department of Neonatology, Liverpool Women’s Hospital, Liverpool L8 7SS, UK;
| | - Kanya Mukhopadhyay
- Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India;
| | - Erica Neri
- Department of Psychology, University of Bologna, 40126 Bologna, Italy;
| | - Jean-Charles Picaud
- Division of Neonatology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France;
- CarMen Laboratory, INSERM, INRA, Claude Bernard University Lyon 1, 69310 Pierre Benite, France
| | - Niels Rochow
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada; (S.A.A.); (C.F.); (N.R.)
- Department of Pediatrics, Nuremberg General Hospital, Paracelsus Medical University, 90471 Nuremberg, Germany
| | - Paola Roggero
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Commenda 12, 20122 Milan, Italy; (M.L.G.); (P.R.)
| | - Kenneth Stroemmen
- Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Rikshospitalet, Oslo University Hospital, 0188 Oslo, Norway;
| | - Maw J. Tan
- Department of Developmental Paediatrics, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK;
| | - Francesco M. Tandoi
- NICU, Woman and Child Department, Ospedale Del Ponte, Insubria University, 21100 Varese, Italy; (M.A.); (F.M.T.)
| | - Claire L. Wood
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4AX, UK;
| | - Gitte Zachariassen
- H.C. Andersen Children’s Hospital, Odense University Hospital and University of Southern Denmark, 5000 Odense, Denmark;
| | - Jane E. Harding
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand; (L.L.); (G.D.G.); (C.A.C.); (F.H.B.)
- Correspondence: ; Tel.: +64-99236439
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Chen W, Zhang Z, Dai S, Xu L. Risk factors for metabolic bone disease among preterm infants less than 32 weeks gestation with Bronchopulmonary dysplasia. BMC Pediatr 2021; 21:235. [PMID: 34001070 PMCID: PMC8127285 DOI: 10.1186/s12887-021-02705-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 05/06/2021] [Indexed: 11/25/2022] Open
Abstract
Background Bronchopulmonary dysplasia (BPD) infants present an increased incidence of metabolic bone disease (MBD), but it is unknown which factors contribute to this. The aim of this study was to determine the risk factors for developing MBD in BPD infants. Methods A retrospective review of the medical records of BPD infants admitted to the Neonatal intensive care unit at Zhangzhou Hospital between Jun 2016 and May 2020 was performed. BPD infants with MBD were identified, two contemporaneous without MBD matched by gestational age and gender were randomly selected as controls for each case of MBD. The association between putative risk factors and MBD was estimated with ORs and 95% CIs. A P-value threshold ≤0.2 was used in univariate analysis for inclusion into a multivariate (adjusted) model with a P-value of < 0.05 as statistically significant. Results A total of 156 BPD infants were enrolled with 52 cases of MBD and 104 controls. Fetal growth restriction (OR 6.00, 95% CI, 1.81–19.84), extremely low birth weight (OR 3.10, 95% CI, 1.07–8.94), feeding volume < 80 mL/kg/d at the end of the 4th week after birth (OR 14.98, 95% CI, 4.04–55.58), cholestasis (OR 4.44, 95% CI, 1.59–12.40), late onset sepsis (OR 3.95, 95% CI, 1.12–13.98) and prolonged (> 2 weeks) diuretics application (OR 5.45, 95% CI, 1.25–23.84) were found to be statistically significant risk factors for MBD in BPD infants. Conclusion In BPD infants of homogeneous gestational age, fetal growth restriction, extremely low birth weight, feeding volume < 80 mL/kg/d at the end of the 4th week after birth, cholestasis and late onset sepsis are significant risk factors for MBD. These findings provide potential predictive factors for MBD in BPD infants and warrant prospective validation.
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Affiliation(s)
- Wenwen Chen
- Zhangzhou Hospital Affiliated to Fujian Medical University, Shengli W Rd, Xiangcheng District, Zhangzhou, Fujian, China.
| | - Zhenhai Zhang
- Zhangzhou Hospital Affiliated to Fujian Medical University, Shengli W Rd, Xiangcheng District, Zhangzhou, Fujian, China
| | - Shuzhen Dai
- Zhangzhou Hospital Affiliated to Fujian Medical University, Shengli W Rd, Xiangcheng District, Zhangzhou, Fujian, China
| | - Liping Xu
- Zhangzhou Hospital Affiliated to Fujian Medical University, Shengli W Rd, Xiangcheng District, Zhangzhou, Fujian, China.
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Yang Y, Wu F, Dwyer T, Antony B, Winzenberg T, Jones G. Associations of Breastfeeding, Maternal Smoking, and Birth Weight With Bone Density and Microarchitecture in Young Adulthood: a 25-Year Birth-Cohort Study. J Bone Miner Res 2020; 35:1652-1659. [PMID: 32638468 DOI: 10.1002/jbmr.4044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/17/2020] [Accepted: 04/27/2020] [Indexed: 11/07/2022]
Abstract
We have found that early-life exposures are associated with areal bone mineral density (aBMD) at ages 8 and 16 years. This study aimed to assess whether these associations persist into young adulthood when peak bone mass (PBM) is achieved and extend this analysis to microarchitecture. Participants were followed from perinatal period to 25 years old (n = 201). Outcomes were total body, spine, and hip aBMD (by dual-energy X-ray absorptiometry [DXA]), and cortical and trabecular bone measures at the distal radius and tibia (by high-resolution peripheral quantitative computed tomography [HRpQCT]). Early-life exposures including breastfeeding, maternal smoking during pregnancy, and birth weight. Sex, weight, height, vegetables, fruit and calcium intake at age 25 years were regarded as potential confounders in the analysis. There were significant interactions between period of gestation and early-life exposures for bone measures, so all analyses were stratified by period of gestation. Breastfeeding was beneficially associated with hip and total body aBMD, total, cortical and trabecular volumetric BMD (vBMD), cortical thickness, porosity, trabecular number (Tb.N), separation (Tb.Sp), and bone volume fraction (Tb.BV/TV) at radius and/or tibia at age 25 years in participants born prematurely (β ranged from -0.92 to 0.94), but there were no associations in those born at term. Maternal smoking had no association with any DXA/HRpQCT measures in those born prematurely but was detrimentally associated with inner transitional zone porosity and Tb.N (β = 0.40 and β = -0.37, respectively) in those full-term participants. Associations of birth weight with bone measures did not persist after adjustment for weight gain since birth. Breastfeeding was associated with a lower risk of lower limb fractures and maternal smoking had a deleterious association with upper limb fractures. In conclusion, breastfeeding and maternal smoking may have effects on peak bone microarchitecture whereas the association with birth weight is countered by subsequent growth. © 2020 American Society for Bone and Mineral Research.
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Affiliation(s)
- Yi Yang
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Terry Dwyer
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia.,The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
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9
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Hemida M, Vuori KA, Salin S, Moore R, Anturaniemi J, Hielm-Björkman A. Identification of modifiable pre- and postnatal dietary and environmental exposures associated with owner-reported canine atopic dermatitis in Finland using a web-based questionnaire. PLoS One 2020; 15:e0225675. [PMID: 32469869 PMCID: PMC7259748 DOI: 10.1371/journal.pone.0225675] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 05/11/2020] [Indexed: 02/06/2023] Open
Abstract
A cross-sectional hypothesis generating study was performed to investigate modifiable exposures such as whether feeding pattern (a non-processed meat based diet, NPMD, or an ultra-processed carbohydrate based diet, UPCD), certain environmental factors and their timing of exposure might be associated with the development of canine atopic dermatitis (CAD). Also, genetic and demographic factors were tested for associations with CAD. The data was collected from the validated internet-based DogRisk food frequency questionnaire in Finland. A total of 2236 dogs were eligible for the study (the owners reported 406 cases and 1830 controls). Our main interest was to analyze modifiable early risk factors of CAD, focusing on nutritional and environmental factors. We tested four early life periods; prenatal, neonatal, early postnatal and late postnatal periods. Twenty-two variables were tested for associations with CAD using logistic regression analysis. From the final models we identified novel dietary associations with CAD: the NPMD during the prenatal and early postnatal periods had a significant negative association with the incidence of CAD in adult dogs (age above 1 year). Oppositely, UPCD was associated with a significantly higher risk for CAD incidence. Other variables that were associated with a significantly lower risk for CAD were maternal deworming during pregnancy, sunlight exposure during early postnatal period, normal body condition score during the early postnatal period, the puppy being born within the same family that it would stay in, and spending time on a dirt or grass surface from 2 to 6 months. Also, the genetic factors regarding maternal history of CAD, allergy-prone breeds and more than 50% white-colored coat all showed a significant positive association with CAD incidence in agreement with previous findings. Although no causality can be established, feeding NPMD early in life seemed to be protective against CAD, while UPCD could be considered a risk factor. Prospective intervention studies are needed to establish the causal effects of the protective role of NPMD on prevalence of CAD during the fetal and early postnatal life.
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Affiliation(s)
- Manal Hemida
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
- Department of Nutrition and Clinical Nutrition, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Kristiina A. Vuori
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Siru Salin
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Robin Moore
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Johanna Anturaniemi
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Anna Hielm-Björkman
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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10
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Lin L, Amissah E, Gamble GD, Crowther CA, Harding JE. Impact of macronutrient supplements on later growth of children born preterm or small for gestational age: A systematic review and meta-analysis of randomised and quasirandomised controlled trials. PLoS Med 2020; 17:e1003122. [PMID: 32453739 PMCID: PMC7250404 DOI: 10.1371/journal.pmed.1003122] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 04/23/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Nutritional supplements may improve short-term growth of infants born small (preterm or small for gestational age), but there are few data on long-term effects and concerns that body composition may be adversely affected. Effects also may differ between girls and boys. Our systematic review and meta-analysis assessed the effects of macronutrient supplements for infants born small on later growth. METHODS AND FINDINGS We searched OvidMedline, Embase, Cochrane CENTRAL, and Cochrane Database of Systematic Reviews from inception to January 30, 2020, and controlled-trials.com, clinicaltrials.gov, and anzctr.org.au on January 30, 2020. Randomised or quasirandomised trials were included if the intention was to increase macronutrient intake to improve growth or development of infants born small and growth was assessed after discharge. Primary outcome was body mass index (BMI) in childhood. Data were pooled using random-effect models. Outcomes were evaluated in toddlers (< 3 years), childhood (3 to 8 years), adolescence (9 to 18 years), and adulthood (>18 years). Forty randomised and 2 quasirandomised trials of variable methodological quality with 4,352 infants were included. Supplementation did not alter BMI in childhood (7 trials, 1,136 children; mean difference [MD] -0.10 kg/m2, [95% confidence interval (CI) -0.37 to 0.16], p = 0.45). In toddlers, supplementation increased weight (31 trials, 2,924 toddlers; MD 0.16 kg, [0.01 to 0.30], p = 0.03) and length/height (30 trials, 2,889 toddlers; MD 0.44 cm, [0.10 to 0.77], p = 0.01), but not head circumference (29 trials, 2,797 toddlers; MD 0.15 cm, [-0.03 to 0.33], p = 0.10). In childhood, there were no significant differences between groups in height (7 trials, 1,136 children; MD 0.22 cm, [-0.48 to 0.92], p = 0.54) or lean mass (3 trials, 354 children; MD -0.07 kg, [-0.98 to 0.85], p = 0.88), although supplemented children appeared to have higher fat mass (2 trials, 201 children; MD 0.79 kg, [0.19 to 1.38], p = 0.01). In adolescence, there were no significant differences between groups in BMI (2 trials, 216 adolescents; MD -0.48 kg/m2, [-2.05 to 1.08], p = 0.60), height (2 trials, 216 adolescents; MD -0.55 cm, [-2.95 to 1.86], p = 0.65), or fat mass (2 trials, 216 adolescents; MD -1.3 5 kg, [-5.76 to 3.06], p = 0.55). In adulthood, there also were no significant differences between groups in weight z-score (2 trials, 199 adults; MD -0.11, [-0.72 to 0.50], p = 0.73) and height z-score (2 trials, 199 adults; MD -0.07, [-0.36 to 0.22], p = 0.62). In subgroup analysis, supplementation was associated with increased length/height in toddler boys (2 trials, 173 boys; MD 1.66 cm, [0.75 to 2.58], p = 0.0003), but not girls (2 trials, 159 girls; MD 0.15 cm, [-0.71 to 1.01], p = 0.74). Limitations include considerable unexplained heterogeneity, low to very low quality of evidence, and possible bias due to low or unbalanced followup. CONCLUSIONS In this systematic review and meta-analysis, we found no evidence that early macronutrient supplementation for infants born small altered BMI in childhood. Although supplements appeared to increase weight and length in toddlers, effects were inconsistent and unlikely to be clinically significant. Limited data suggested that supplementation increased fat mass in childhood, but these effects did not persist in later life. PROSPERO registration: CRD42019126918.
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Affiliation(s)
- Luling Lin
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Emma Amissah
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | | | - Jane E. Harding
- Liggins Institute, University of Auckland, Auckland, New Zealand
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11
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Baş EK, Bülbül A, Şirzai H, Arslan S, Uslu S, Baş V, Zubarioglu U, Celik M, Dursun M, Güran Ö, Kuran B. The long-term impacts of preterm birth and associated morbidities on bone health in preschool children: a prospective cross-sectional study from Turkey. J Matern Fetal Neonatal Med 2020; 35:677-684. [PMID: 32102581 DOI: 10.1080/14767058.2020.1730801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To evaluate the impact of preterm birth on bone health in preschool children.Methods: A total of 166 preschool children (aged 7-8 years) born preterm (n = 86, <37-week gestation) and at term (n = 80, ≥37 weeks of gestation) in our hospital were included in this prospective cross-sectional study. Data on antenatal, perinatal, and early postnatal characteristics and maternal obstetric history were obtained from medical records. Bone densitometry data including total bone mineral content (BMC), bone mineral density (BMD; total, lumbar, and femoral), z-scores, and bone loss were collected for each participant.Results: Current height, weight, and BMI values were significantly lower in the preterm group (p < .001). Serum calcium, phosphorus and alkaline phosphatase (ALP) levels did not differ among groups, whereas VitD3 levels were significantly higher in the preterm group (p = .039). The mean total BMC, total BMD, lumbar (L2-L4) BMD, femur BMD, total z-score, and L2-L4 z-score values were significantly lower for the preterm group, whereas the total, lumbar, and femoral bone loss were significantly higher (p < .001), regardless of the severity of prematurity. Intraventricular hemorrhage (IVH) and retinopathy were significantly associated with lower total BMC (p = .004, p = .012, respectively). Fortified breastfeeding was associated with lumbar bone loss (p = .043), and formula feeding was associated with both femur and lumbar bone loss (p = .006, p = .012, respectively).Conclusions: Our findings revealed long-term adverse effects of preterm birth on bone health, with significantly lower anthropometric values (weight, height, and BMI), lower scores for total BMC, BMD (total, lumbar, femoral), and z-scores (total, femur), along with higher bone loss (total, lumbar, femoral) and higher rates of osteopenia and osteoporosis in preschool children born preterm (whether moderate or very preterm) compared with those born at term. Exclusive breastfeeding appears to reduce the likelihood of long-term bone loss in preterm infants.
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Affiliation(s)
- Evrim Kıray Baş
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ali Bülbül
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Hülya Şirzai
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Selda Arslan
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Sinan Uslu
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Vedat Baş
- Department of pediatrics, Istanbul Arel University, Istanbul, Turkey
| | - Umut Zubarioglu
- Department of neonatology, Istanbul Yeni Yüzyıl University, Istanbul, Turkey
| | - Muhittin Celik
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Mesut Dursun
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ömer Güran
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Banu Kuran
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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12
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Mohamed M, Kamleh M, Muzzy J, Groh-Wargo S, Abu-Shaweesh J. Association of Protein and Vitamin D Intake With Biochemical Markers in Premature Osteopenic Infants: A Case-Control Study. Front Pediatr 2020; 8:546544. [PMID: 33330265 PMCID: PMC7732600 DOI: 10.3389/fped.2020.546544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 10/28/2020] [Indexed: 11/13/2022] Open
Abstract
Osteopenia in preterm infants (OP) remains an important challenge and is largely dependent on nutritional post-natal intake of factors influencing bone mineralization. We conducted a prospective case-control study to evaluate the importance of protein and vitamin D intake in OP among neonates with birth weight <1,250 g. Simultaneous serum parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium (Ca), phosphorus (P), vitamin D and protein levels were measured during the first six post-natal weeks. At 6 weeks of age, OP was evaluated using wrist radiographs. Comparisons were analyzed using multivariate linear regression, receiver operating characteristic curves, χ2 and Wilcoxon Rank Sum. Of the 26 premature infants enrolled, 13 developed radiographic OP. Daily protein intake (coef = -0.40, p = 0.001) and vitamin D concentrations (21 ± 5.7 ng/ml) were significantly lower in the OP group compared to non-OP subjects. ALP concentration exceeding 619 IU/L, sensitivity of 76.9% and specificity of 75%, was predictive of OP at 6 weeks post-natally. PTH levels were higher at 6 weeks in OP subjects (193 ± 102.5 pg/ml, p < 0.001) compared to non-OP subjects. The findings in this study support the role of vitamin D and protein intake in the development of OP in VLBW infants and inform future practice and research on best practices for OP management.
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Affiliation(s)
- Mohamed Mohamed
- Department of Pediatrics, Sanford Children's Hospital, Fargo, ND, United States.,Department of Pediatrics, University of North Dakota Grand Forks, Grand Forks, ND, United States
| | - May Kamleh
- Department of Epidemiology, Harris County Public Health, Houston, TX, United States
| | - Julia Muzzy
- Department of Pediatrics, Sanford Children's Hospital, Fargo, ND, United States.,School of Medicine, North Dakota State University, Fargo, ND, United States
| | - Sharon Groh-Wargo
- School of Medicine, Case Western Reserve University, Cleveland, OH, United States.,Department of Pediatrics, MetroHealth Medical Center, Cleveland, OH, United States
| | - Jalal Abu-Shaweesh
- Department of Pediatrics, Cleveland Clinic, Cleveland, OH, United States
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13
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Behie AM, Miszkiewicz JJ. Enamel neonatal line thickness in deciduous teeth of Australian children from known maternal health and pregnancy conditions. Early Hum Dev 2019; 137:104821. [PMID: 31330463 DOI: 10.1016/j.earlhumdev.2019.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physiological disruptions to early human development have implications for health and disease in later life. Limited research has explored how prenatal factors influence dental development in children of mothers with known pregnancy conditions. Enamel in human deciduous teeth begins forming in utero and is highly susceptible to physiological upsets experienced perinatally. The moment of birth itself is marked in deciduous enamel by the Neonatal Line (NNL) as a baby transitions from the uterine to external environment. This study evaluates the effect of maternal health factors that include stress and alcohol consumption on NNL in teeth from Australian children. STUDY DESIGN AND SUBJECTS Mothers (n = 53) were interviewed about their health during pregnancy and experience of birth. Sixty-five deciduous teeth (incisors, molars, one canine) from their children were donated for histological examination. Neonatal line thickness was measured from thin sections and evaluated against maternal and neonatal factors using statistical analyses, controlling for tooth type and birth number. RESULTS AND CONCLUSIONS The only maternal factor of a statistically significant effect on NNL thickness was alcohol consumption. Children of mothers who drank occasionally during pregnancy had a thicker NNL when compared to children of mothers who abstained. These results suggest that maternal lifestyle factors influence NNL formation possibly due to physiological changes that disrupt calcium homeostasis during enamel deposition. We highlight large intra-specific variation in human NNL expression. The potential of dental sampling in identifying children with prenatal exposure to alcohol is suggested.
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Affiliation(s)
- Alison M Behie
- School of Archaeology and Anthropology, 44 Linnaeus Way, Banks Building, Australian National University, Canberra 2601, Australian Capital Territory, Australia.
| | - Justyna J Miszkiewicz
- School of Archaeology and Anthropology, 44 Linnaeus Way, Banks Building, Australian National University, Canberra 2601, Australian Capital Territory, Australia.
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14
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15
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Xie LF, Alos N, Cloutier A, Béland C, Dubois J, Nuyt AM, Luu TM. The long-term impact of very preterm birth on adult bone mineral density. Bone Rep 2018; 10:100189. [PMID: 30627597 PMCID: PMC6319299 DOI: 10.1016/j.bonr.2018.100189] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/05/2018] [Accepted: 12/11/2018] [Indexed: 12/31/2022] Open
Abstract
Introduction Preterm infants are at increased risk of osteopenia of prematurity due to insufficient bone mineral accretion. Data on long term effects of prematurity on bone health are conflicting. This study aimed to compare bone mineral density (BMD) in young adults born very preterm and full-term controls and to examine factors associated with long-term bone health. Methods This observational cross-sectional study enrolled 101 young adults (18–29 years) born <29 weeks of gestation and 95 sex- and age-matched full-term controls. Participants underwent dual-energy X-ray absorptiometry to measure areal BMD and body composition. Generalized estimated equations were used to compare groups adjusting for height Z-score, lean body mass and fat mass. Results Adults born preterm were shorter and lighter than full-term controls. Areal BMD was reduced at the lumbar spine, the femoral neck and whole body in the preterm versus full-term group, but after adjustment, areal BMD Z-score was only significantly lower at the femoral neck by −0.3 unit (95% confidence interval −0.6 to −0.0). Low BMD (Z-score ≤ −1 standard deviation) at any site was observed in 53% of adults born preterm versus 28% of full-term controls, but this was not statistically significantly different. We did not identify any neonatal factors associated with lower BMD within the preterm group. Conclusions Very preterm birth is associated with lower areal BMD at the femoral neck in young adulthood, even after accounting for body size. Whether this will translate into higher risk of osteoporotic fractures later in life remains unknown.
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Affiliation(s)
- Li Feng Xie
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de la Côte-Ste-Catherine, Montreal, Quebec H3T 1C5, Canada
| | - Nathalie Alos
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de la Côte-Ste-Catherine, Montreal, Quebec H3T 1C5, Canada.,Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de la Côte-Ste-Catherine, Montreal, Quebec H3T 1C5, Canada
| | - Anik Cloutier
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de la Côte-Ste-Catherine, Montreal, Quebec H3T 1C5, Canada
| | - Chanel Béland
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de la Côte-Ste-Catherine, Montreal, Quebec H3T 1C5, Canada
| | - Josée Dubois
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de la Côte-Ste-Catherine, Montreal, Quebec H3T 1C5, Canada.,Department of Radiology, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de la Côte-Ste-Catherine, Montreal, Quebec H3T 1C5, Canada
| | - Anne Monique Nuyt
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de la Côte-Ste-Catherine, Montreal, Quebec H3T 1C5, Canada.,Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de la Côte-Ste-Catherine, Montreal, Quebec H3T 1C5, Canada
| | - Thuy Mai Luu
- Research Center, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de la Côte-Ste-Catherine, Montreal, Quebec H3T 1C5, Canada.,Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de la Côte-Ste-Catherine, Montreal, Quebec H3T 1C5, Canada
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16
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Kotecha SJ, Lowe J, Kotecha S. Effect of foetal and infant growth and body composition on respiratory outcomes in preterm-born children. Paediatr Respir Rev 2018; 28:55-62. [PMID: 29343422 DOI: 10.1016/j.prrv.2017.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 12/13/2017] [Indexed: 01/21/2023]
Abstract
Body composition and growth outcomes of preterm-born subjects have been studied by many researchers. In general, preterm-born children have lower height and weight especially in infancy. Despite showing potential for catch-up growth, they continue to lag behind their term counterparts in adolescence and adulthood. The various methods of studying body composition and the differing gestations and ages at which it is assessed may go some way to explaining the inconsistent results observed in different studies. In addition, there is a paucity of data on the effects of foetal and infant growth and of body composition on later respiratory outcomes. In largely term-born subjects, foetal growth and growth trajectories appear to have differential effects on later respiratory outcomes. Early weight gain in infancy appears to be associated with increased respiratory symptoms in childhood but catch-up growth in infancy appears to be associated with possible improved lung function status.
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Affiliation(s)
- Sarah J Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
| | - John Lowe
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
| | - Sailesh Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK.
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17
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Ruys CA, van de Lagemaat M, Lafeber HN, Rotteveel J, Finken MJJ. Leptin and IGF-1 in relation to body composition and bone mineralization of preterm-born children from infancy to 8 years. Clin Endocrinol (Oxf) 2018; 89:76-84. [PMID: 29727484 DOI: 10.1111/cen.13733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/03/2018] [Accepted: 04/24/2018] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Preterm birth has been associated with altered body composition, especially increased fat mass (FM) and decreased bone mineralization, and leptin and IGF-1 have been suggested to be involved in the regulation of both. We aimed to study the interplay between leptin, IGF-1, FM and bone mineralization measured in infancy and childhood of children born preterm. DESIGN Observational study. PATIENTS/SUBJECTS Seventy-nine (40 boys) preterm-born children (gestational age ≤32 weeks and/or birth weight ≤1500 g) aged 8 years. MEASUREMENTS Serum leptin and IGF-1 were measured at term age, at 3- and 6-month corrected age (CA), and 8 years. Body composition (fat and lean mass) and bone parameters (bone area, mineral content and density) were measured by Dual-energy X-ray Absorptiometry (DXA) at term age, 6-month CA and 8 years. RESULTS Leptin was positively associated with FM at all time points and with bone parameters at term age and 6-month CA. IGF-1 was associated with body composition and bone density at most of the time points. Explained variation in bone mineralization increased significantly by adding bone area (BA) and height to the models. CONCLUSIONS During infancy and childhood, leptin and IGF-1 were associated with body composition in preterm-born children. In addition, leptin was associated with bone parameters in early infancy, but not in childhood. It is hypothesized that a complicated interplay between multiple pathways, which most likely changes over time, is involved in regulation of body composition and bone mineralization of preterm-born infants.
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Affiliation(s)
- Charlotte A Ruys
- Department of Pediatrics/Neonatology, VU University Medical Center, Amsterdam, The Netherlands
| | - Monique van de Lagemaat
- Department of Pediatrics/Neonatology, VU University Medical Center, Amsterdam, The Netherlands
| | - Harrie N Lafeber
- Department of Pediatrics/Neonatology, VU University Medical Center, Amsterdam, The Netherlands
| | - Joost Rotteveel
- Department of Pediatric Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn J J Finken
- Department of Pediatric Endocrinology, VU University Medical Center, Amsterdam, The Netherlands
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18
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Hussain SM, Ackerman IN, Wang Y, Zomer E, Cicuttini FM. Could low birth weight and preterm birth be associated with significant burden of hip osteoarthritis? A systematic review. Arthritis Res Ther 2018; 20:121. [PMID: 29884206 PMCID: PMC5994049 DOI: 10.1186/s13075-018-1627-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Approaches for the prevention and treatment of hip osteoarthritis (OA) remain limited. There are recent data suggesting that low birth weight (LBW) and preterm birth may be risk factors for hip osteoarthritis. This has the potential to change the current paradigm of hip osteoarthritis prevention by targeting early life factors. The aim of this review was to examine the available evidence for an association of LBW and preterm birth with hip OA. The potential cost implications associated with total hip arthroplasty were also evaluated. METHODS Ovid Medline, EMBASE, and Cinahl were searched up until August 2017 using MeSH terms and key words. Methodological quality was evaluated using the National Heart Lung and Blood Institute (NHLBI) quality assessment tool. Qualitative evidence synthesis was performed to summarise the results. Bradford Hill's criteria for causation including the temporal relationship, consistency, strength of the association, specificity, dose-response relationship, and analogy were used to assess the evidence for causation. Economic modelling was used to calculate the potential economic burden associated with LBW or preterm birth related total hip arthroplasty using Australian data from 2012 to 2015. RESULTS Five studies, ranging from high to low quality, were included. Hip bone shape abnormalities examined included developmental hip dysplasia and immature hip, and hip osteoarthritis included osteophytes and total hip arthroplasty. A causal link between low birth weight or preterm birth and hip osteoarthritis was found. Of the 30,477 total hip arthroplasties performed for hip osteoarthritis in Australia in 2015, 5791 were estimated to be born preterm and 5273 with low birth weight. This equated to a potential total hip arthroplasty cost of AU$145,136,082 and AU$132,150,222 for these subgroups, respectively. CONCLUSION Available data suggest that low birth weight and preterm birth are associated with hip bone shape abnormalities and hip osteoarthritis requiring total hip arthroplasty, with a substantial associated financial burden. Given the current lack of effective treatment and prevention strategies for hip osteoarthritis, this offers a new avenue for reducing the future burden of hip osteoarthritis.
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Affiliation(s)
- Sultana Monira Hussain
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
| | - Ilana N Ackerman
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Yuanyuan Wang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Ella Zomer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Flavia M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
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19
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Chin LK, Doan J, Teoh YS, Stewart A, Forrest P, Simm PJ. Outcomes of standardised approach to metabolic bone disease of prematurity. J Paediatr Child Health 2018; 54:665-670. [PMID: 29292538 DOI: 10.1111/jpc.13813] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 09/30/2017] [Accepted: 10/25/2017] [Indexed: 11/28/2022]
Abstract
AIM To assess the current protocol of metabolic bone disease (MBD) at three Monash Health neonatal units (Melbourne, Australia). METHODS Retrospective audit of 171 infants born at <32 weeks' gestation over 18 months. Mean gestational age was 28.6 ± 2.1 weeks, and birthweight was 1190 ± 374 g. Risk factors of MBD include intra-uterine growth retardation (n = 33, 19.3%), maternal pre-eclampsia (n = 17, 9.9%), necrotising enterocolitis (n = 9, 5.4%) and medications like methylxanthines (94.2%; mean 54.8 days), diuretics (38.6%; mean 49.2 days) and glucocorticoids (5.3%; mean 35 days). RESULTS In total, 84.8% infants had an initial MBD screen (mean age 36.3 days), with 45% having repeated monitoring (mean age 71.9 days), and 14.2% had initial alkaline phosphatase levels >500 U/L, decreasing to 10.1% on follow-up. All infants received additional vitamin D supplementation of 400 IU/day, phosphate of 25.1% (n = 43) and calcium of 19.9% (n = 34). Fractures were identified from clinical documentation in 2.9% (n = 5) of infants. Stratifying into phosphate-treated and untreated groups revealed significant differences (P < 0.001) for gestational age and birthweight: 26.7 ± 1.7 weeks/918 ± 272 g for treated versus 29.2 ± 1.9 weeks/1283 ± 359 g for untreated. In the phosphate-treated group, improvement was seen in mean alkaline phosphatase (pre-treatment 467 ± 204 U/L and post-treatment 342 ± 221 U/L, P < 0.01) and mean phosphate levels (1.8 ± 0.4 vs. 2.2 ± 1.0 mmol/L, P < 0.01). Linear growth difference between phosphate-treated (n = 10) and untreated groups (n = 24) was insignificant at >6 months of age (P = 0.13), although this may reflect limited data. CONCLUSION Adequate first-line supplementation with vitamin D and phosphate appeared to improve biochemical markers of MBD, but given the observational nature of this study, further longitudinal/prospective studies are required to confirm these findings.
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Affiliation(s)
- Lit Kim Chin
- Department of Paediatrics, Dandenong Hospital, Monash Health, Melbourne, Victoria, Australia
| | - John Doan
- Department of Neonatology, Monash Health, Melbourne, Victoria, Australia
| | - Yvonne Sl Teoh
- Department of Neonatology, Monash Health, Melbourne, Victoria, Australia
| | - Alice Stewart
- Department of Endocrinology and Diabetes, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Peter Forrest
- Department of Neonatology, Monash Health, Melbourne, Victoria, Australia
| | - Peter J Simm
- Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Victoria, Australia.,Centre for Hormone Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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20
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Krikke M, Yumani D, Rustenburg C, Cranendonk A, Twisk J, Lafeber H, van Weissenbruch M. Assessing bone development in preterm infants using quantitative ultrasonography showed a decline in the early postnatal period. Acta Paediatr 2018; 107:227-233. [PMID: 28940635 DOI: 10.1111/apa.14088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 06/21/2017] [Accepted: 09/19/2017] [Indexed: 11/30/2022]
Abstract
AIM Preterm infants have an insufficient bone mineral store at birth and this study explored their bone development during the early postnatal period. METHODS The metacarpal speed of sound (mcSOS) and metacarpal bone transmission time (mcBTT) were used to assess bone development in 277 preterm infants, admitted to the neonatal intensive care unit of the VU University Medical Center, Amsterdam, the Netherlands from 2007-2012. RESULTS During the first nine postnatal weeks, the mcSOS declined from 10 to 38 m per second per week and the mcBTT declined from 20 to 71 nanoseconds per week. The pattern of change in both of these measurements showed a significant difference between infants born before 32 weeks of gestation (p = 0.048) and those born between 28 and 32 weeks of gestation (p = 0.008). There was a borderline significant difference in the pattern of change of the mcBTT in infants with a protein intake below 2 g/kg per day versus a higher intake (p = 0.050). CONCLUSION The mcSOS and mcBTT of preterm infants showed a small to moderate decline during the early postnatal period. Future studies should explore the clinical relevance of this decline and develop interventions to halt it.
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Affiliation(s)
- Marieke Krikke
- Department of Neonatology; VU University Medical Center; Amsterdam The Netherlands
| | - Dana Yumani
- Department of Neonatology; VU University Medical Center; Amsterdam The Netherlands
| | - Christine Rustenburg
- Department of Neonatology; VU University Medical Center; Amsterdam The Netherlands
| | - Anneke Cranendonk
- Department of Neonatology; VU University Medical Center; Amsterdam The Netherlands
| | - Jos Twisk
- Department of Epidemiology and Biostatistics; VU University Medical Center; Amsterdam The Netherlands
| | - Harrie Lafeber
- Department of Neonatology; VU University Medical Center; Amsterdam The Netherlands
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Liu P, Ye Z, Lu J, Lu H, Guan L, Teng Z, Gao S, Li M. A comparison of bone mineral densities and body composition between Southeast Asia college students and Chinese college students. Medicine (Baltimore) 2016; 95:e4724. [PMID: 27631220 PMCID: PMC5402563 DOI: 10.1097/md.0000000000004724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The aim of this study was to compare bone mineral densities (BMDs) and body composition between Southeast Asia college students and Chinese college students, in order to provide a certain reference enhancing college students' physical fitness.A total of 1694 Chinese college students (294 men and 1400 women, aged 18-22 years) and 250 Southeast Asia college students (148 men and 102 women, aged 19-22 years) were included in the study. Weight, height, and body mass index were measured anthropometrically. BMD values were determined by ultrasound bone densitometer and body composition was determined by body composition analyzer.Southeast Asia college students were overweight than Chinese college students (250 vs 1694) (P < 0.05). Chinese college students had a significantly lower body weight, fat mass, lean tissue mass, lean body weight, estimation of bone mass, protein, and metabolic rate but higher BMD at the calcaneus compared with Southeast Asia college students (P < 0.05 for all parameters). However, body water, intracellular fluid, and extracellular fluid were not significantly different between Chinese college students and Southeast Asia college students (P > 0.01 for all parameters).The results of this cross-sectional study suggest that Chinese college students had a higher BMD but lower body composition than Southeast Asia college students, which may be associated with genes, diet, exercise, and other factors.
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Affiliation(s)
- Peng Liu
- Department of Anatomy
- Correspondence: Peng Liu, Department of Anatomy, Guangxi Medical University, No.22 Shuangyong Road, Nanning, Guangxi 530021, China (e-mail: )
| | - Ziliang Ye
- Guangxi Medical University, Nanning, Guangxi, China
| | - Jingjing Lu
- Guangxi Medical University, Nanning, Guangxi, China
| | - Haili Lu
- Guangxi Medical University, Nanning, Guangxi, China
| | - Liping Guan
- Guangxi Medical University, Nanning, Guangxi, China
| | - Zhihai Teng
- Guangxi Medical University, Nanning, Guangxi, China
| | - Shangzhi Gao
- Guangxi Medical University, Nanning, Guangxi, China
| | - Mingyi Li
- Guangxi Medical University, Nanning, Guangxi, China
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22
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Zhu Y, Hu C, Zheng P, Miao L, Yan X, Li H, Wang Z, Gao B, Li Y. Ginsenoside Rb1 alleviates aluminum chloride-induced rat osteoblasts dysfunction. Toxicology 2016; 368-369:183-188. [PMID: 27470910 DOI: 10.1016/j.tox.2016.07.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 07/18/2016] [Accepted: 07/23/2016] [Indexed: 12/18/2022]
Abstract
Osteoblasts dysfunction, induced by aluminum (Al), plays a critical role in the osteoporosis etiology. Ginsenoside Rb1 (Rb1) has the therapeutic properties for osteoporosis. This study aimed to assess the efficiency of Rb1 in ameliorating Al-induced osteoblasts dysfunction. The osteoblasts were divided into four groups: Rb1-treated group (RG, 0.0145mg/mL Rb1), control group (CG, 0), AlCl3-treated group (AG, 0.126mg/mL AlCl3·6H2O), AlCl3+Rb1-treated group (ARG, 0.0145mg/mL Rb1 and 0.126mg/mL AlCl3·6H2O). After 24h of culture, the osteoblasts viability, the transforming growth factor-β1 (TGF-β1), bone morphogenetic protein-2 (BMP-2), the insulin-like growth factor I (IGF-I), core-binding factor α1 (Cbfα1) mRNA expressions, glutathione perioxidase (GSH-Px) and superoxide dismutase (SOD) activities, and reactive oxygen species (ROS) concentration were determined. The osteoblasts ultrastructural features were also observed. In the ARG, the osteoblasts viability, TGF-β1, BMP-2, IGF-I and Cbfα1 mRNA expressions and the GSH-Px and SOD activities were significantly increased, the ROS concentration was significantly decreased, and osteoblasts histology lesion was attenuated compared with the AG. These results demonstrated that Rb1 could significantly reverse osteoblasts viability and osteoblasts growth regulation factor, inhibit oxidative stress, and attenuate histology lesion in the osteoblasts with AlCl3. These results indicate that Rb1 can effectively alleviate the AlCl3-induced osteoblasts dysfunction.
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Affiliation(s)
- Yanzhu Zhu
- Institute of Special Animal and Plant Sciences of Chinese Academy of Agricultural Sciences, Changchun 130112, China.
| | - Chongwei Hu
- College of Animals Science, Fujian Agricultural and Forestry University, Fuzhou 350002, China
| | - Peihe Zheng
- Institute of Special Animal and Plant Sciences of Chinese Academy of Agricultural Sciences, Changchun 130112, China
| | - Liguang Miao
- Institute of Special Animal and Plant Sciences of Chinese Academy of Agricultural Sciences, Changchun 130112, China
| | - Xijun Yan
- Institute of Special Animal and Plant Sciences of Chinese Academy of Agricultural Sciences, Changchun 130112, China
| | - Haitao Li
- Institute of Special Animal and Plant Sciences of Chinese Academy of Agricultural Sciences, Changchun 130112, China
| | - Zhongying Wang
- Vascular Surgery Department, the First Hospital of Jilin University, Changchun 130021, China
| | - Bing Gao
- Institute of Special Animal and Plant Sciences of Chinese Academy of Agricultural Sciences, Changchun 130112, China
| | - Yanfei Li
- College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, China.
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23
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Postnatal Changes in Humerus Cortical Bone Thickness Reflect the Development of Metabolic Bone Disease in Preterm Infants. DISEASE MARKERS 2016; 2016:2176594. [PMID: 27194819 PMCID: PMC4852355 DOI: 10.1155/2016/2176594] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/10/2016] [Accepted: 03/31/2016] [Indexed: 11/17/2022]
Abstract
Objective. To use cortical bone thickness (CBT) of the humerus to identify risk factors for the development of metabolic bone disease in preterm infants. Methods. Twenty-seven infants born at <32 weeks of gestational age, with a birth weight of <1,500 g, were enrolled. Humeral CBT was measured from chest radiographs at birth and at 27-28, 31-32, and 36-44 weeks of postmenstrual age (PMA). The risk factors for the development of osteomalacia were statistically analyzed. Results. The humeral CBT at 36-44 weeks of PMA was positively correlated with gestational age and birth weight and negatively correlated with the duration of mechanical ventilation. CBT increased with PMA, except in six very early preterm infants in whom it decreased. Based on logistic regression analysis, gestational age and duration of mechanical ventilation were identified as risk factors for cortical bone thinning. Conclusions. Humeral CBT may serve as a radiologic marker of metabolic bone disease at 36-44 weeks of PMA in preterm infants. Cortical bones of extremely preterm infants are fragile, even when age is corrected for term, and require extreme care to lower the risk of fractures.
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Brennan-Olsen SL, Page RS, Berk M, Riancho JA, Leslie WD, Wilson SG, Saban KL, Janusek L, Pasco JA, Hodge JM, Quirk SE, Hyde NK, Hosking SM, Williams LJ. DNA methylation and the social gradient of osteoporotic fracture: A conceptual model. Bone 2016; 84:204-212. [PMID: 26723576 DOI: 10.1016/j.bone.2015.12.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 11/19/2015] [Accepted: 12/21/2015] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Although there is a documented social gradient for osteoporosis, the underlying mechanism(s) for that gradient remain unknown. We propose a conceptual model based upon the allostatic load theory, to suggest how DNA methylation (DNAm) might underpin the social gradient in osteoporosis and fracture. We hypothesise that social disadvantage is associated with priming of inflammatory pathways mediated by epigenetic modification that leads to an enhanced state of inflammatory reactivity and oxidative stress, and thus places socially disadvantaged individuals at greater risk of osteoporotic fracture. METHODS/RESULTS Based on a review of the literature, we present a conceptual model in which social disadvantage increases stress throughout the lifespan, and engenders a proinflammatory epigenetic signature, leading to a heightened inflammatory state that increases risk for osteoporotic fracture in disadvantaged groups that are chronically stressed. CONCLUSIONS Our model proposes that, in addition to the direct biological effects exerted on bone by factors such as physical activity and nutrition, the recognised socially patterned risk factors for osteoporosis also act via epigenetic-mediated dysregulation of inflammation. DNAm is a dynamic modulator of gene expression with considerable relevance to the field of osteoporosis. Elucidating the extent to which this epigenetic mechanism transduces the psycho-social environment to increase the risk of osteoporotic fracture may yield novel entry points for intervention that can be used to reduce individual and population-wide risks for osteoporotic fracture. Specifically, an epigenetic evidence-base may strengthen the importance of lifestyle modification and stress reduction programs, and help to reduce health inequities across social groups. MINI ABSTRACT Our conceptual model proposes how DNA methylation might underpin the social gradient in osteoporotic fracture. We suggest that social disadvantage is associated with priming of inflammatory signalling pathways, which is mediated by epigenetic modifications, leading to a chronically heightened inflammatory state that places disadvantaged individuals at greater risk of osteoporosis.
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Affiliation(s)
- Sharon L Brennan-Olsen
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, C/- Barwon Health, Ryrie Street, Geelong, 3220, VIC, Australia; Australian Institute for Musculoskeletal Sciences, The University of Melbourne, C/- Sunshine Hospital, Furlong Road, Melbourne, 3021, VIC, Australia; Institute for Health and Ageing, Australian Catholic University, Melbourne, 3000, VIC, Australia.
| | - Richard S Page
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, C/- Barwon Health, Ryrie Street, Geelong, 3220, VIC, Australia; Barwon Orthopaedic Research Unit, Barwon Health, Geelong, 3220, VIC, Australia
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, C/- Barwon Health, Ryrie Street, Geelong, 3220, VIC, Australia
| | - José A Riancho
- Department of Internal Medicine, Valdecilla Research Institute (IDIVAL), University of Cantabria, Santander, Spain
| | - William D Leslie
- Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Scott G Wilson
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, 6009, Australia; School of Medicine and Pharmacology, The University of Western Australia, Nedlands, 6009, WA, Australia; Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Karen L Saban
- Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, USA; Centre of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA
| | - Linda Janusek
- Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, USA
| | - Julie A Pasco
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, C/- Barwon Health, Ryrie Street, Geelong, 3220, VIC, Australia
| | - Jason M Hodge
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, C/- Barwon Health, Ryrie Street, Geelong, 3220, VIC, Australia
| | - Shae E Quirk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, C/- Barwon Health, Ryrie Street, Geelong, 3220, VIC, Australia
| | - Natalie K Hyde
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, C/- Barwon Health, Ryrie Street, Geelong, 3220, VIC, Australia
| | - Sarah M Hosking
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, C/- Barwon Health, Ryrie Street, Geelong, 3220, VIC, Australia
| | - Lana J Williams
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, C/- Barwon Health, Ryrie Street, Geelong, 3220, VIC, Australia
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Pessanha CR, da Camara Boueri BF, da Costa LR, Ferreira MR, de Abreu MDC, Pessoa LR, Pereira AD, Ribeiro DC, da Silva EM, da Costa CAS, Boaventura GT. Flaxseed flour, compared to flaxseed oil, contributes to femoral structure in male rats subjected to early weaning. Food Funct 2016; 7:1296-300. [PMID: 26866429 DOI: 10.1039/c6fo00021e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The aim of this study was to analyze whether flaxseed flour or flaxseed oil treatment contributes to femoral structure in male rats subjected to early weaning. Pups were weaned for separation from mothers at 14 days (early weaning, EW) or 21 days (control, C). After 21 days, the control (C60) was fed with the control diet. The EW group was divided based on control (EWC60), flaxseed flour (EWFF60) and flaxseed oil (EWFO60) diets until 60 days. Femoral dimension, bone mineral density (BMD), bone mineral content (BMC), area and biomechanical properties were determined. EWFO60 showed lower (P < 0.05) femur mass. EWC60 and EWFO60 showed lower (P < 0.05) distance between epiphyses, diaphysis width and BMD. BMC was lower (P < 0.05) in EWC60 (vs. C60 and EWFF60). EWC60 and EWFO60 showed lower (P < 0.05) maximum force (vs. C60). Breaking strength was lower (P < 0.05) in EWFO60 (vs. C60). EWFF60 showed higher (P < 0.05) rigidity. Flaxseed flour abbreviated the femoral fragility secondary to early weaning.
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Affiliation(s)
- Carolina Ribeiro Pessanha
- Laboratory of Experimental Nutrition, Department of Nutrition and Dietetics, Fluminense Federal University, Niterói, RJ, Brazil.
| | - Bianca Ferolla da Camara Boueri
- Laboratory of Experimental Nutrition, Department of Nutrition and Dietetics, Fluminense Federal University, Niterói, RJ, Brazil.
| | - Luanna Rodrigues da Costa
- Laboratory of Experimental Nutrition, Department of Nutrition and Dietetics, Fluminense Federal University, Niterói, RJ, Brazil.
| | - Maitê Rocha Ferreira
- Laboratory of Experimental Nutrition, Department of Nutrition and Dietetics, Fluminense Federal University, Niterói, RJ, Brazil.
| | - Maíra Duque Coutinho de Abreu
- Laboratory of Experimental Nutrition, Department of Nutrition and Dietetics, Fluminense Federal University, Niterói, RJ, Brazil.
| | - Letícia Rozeno Pessoa
- Laboratory of Experimental Nutrition, Department of Nutrition and Dietetics, Fluminense Federal University, Niterói, RJ, Brazil.
| | - Aline D'Avila Pereira
- Laboratory of Experimental Nutrition, Department of Nutrition and Dietetics, Fluminense Federal University, Niterói, RJ, Brazil.
| | - Danielle Cavalcante Ribeiro
- Laboratory of Experimental Nutrition, Department of Nutrition and Dietetics, Fluminense Federal University, Niterói, RJ, Brazil.
| | - Eduardo Moreira da Silva
- Analytical Laboratory of Restorative Biomaterials, Dental School, Fluminense Federal University, Niterói, RJ, Brazil
| | - Carlos Alberto Soares da Costa
- Laboratory of Experimental Nutrition, Department of Nutrition and Dietetics, Fluminense Federal University, Niterói, RJ, Brazil.
| | - Gilson Teles Boaventura
- Laboratory of Experimental Nutrition, Department of Nutrition and Dietetics, Fluminense Federal University, Niterói, RJ, Brazil.
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Li J, Funato M, Tamai H, Wada H, Nishihara M, Morita T, Miller SL, Egashira K. Impact of intra- and extrauterine growth on bone mineral density and content in the neonatal period of very-low-birth-weight infants. Early Hum Dev 2016; 92:1-6. [PMID: 26619067 DOI: 10.1016/j.earlhumdev.2015.10.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 10/20/2015] [Accepted: 10/21/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Very-low-birthweight infants (VLBWIs) are at high risk for suboptimal bone mineral density (BMD) and bone mineral content (BMC). Small-for-gestational-age (SGA) status also causes reduced bone mineralization in full-term infants. However, the impact of intrauterine and postnatal extrauterine growth on BMD and BMC in VLBWIs is inconclusive. METHODS We retrospectively investigated n=68 VLBWIs, comprising 45 appropriate-for-gestational-age (AGA) and 23 SGA infants who underwent lumbar spine dual-energy X-ray absorptiometry at term-equivalent age. RESULTS BMD and BMC did not differ between AGA and SGA VLBWIs. Subgroup analyses of infants with birthweight<1000 g vs 1000-1500 g, and GA<27 weeks vs ≥ 27 weeks also showed no differences in BMD and BMC between AGA and SGA infants. In contrast, infants with extrauterine growth restriction (EUGR) showed significantly lower values than those without (BMD: 0.124 ± 0.023 vs 0.141 ± 0.032 g/cm(2), P=0.02; BMC: 0.80 ± 0.26 vs 0.94 ± 0.23 g, P=0.04). There were no differences between AGA and SGA infants with EUGR. However, in the AGA cohort, infants with EUGR showed significantly lower values than those without (BMD: 0.121 ± 0.022; 0.141 ± 0.03 g/cm(2), P=0.02; BMC: 0.73 ± 0.23 vs 0.94 ± 0.23 g, P=0.005). Multiple regression analyses showed GA, weight and head circumference at birth, and weight percentile at term correlated with term BMD. Conversely, only weight percentile at term significantly correlated with term BMC. CONCLUSION EUGR, rather than IUGR, is a risk factor for reduced BMD and BMC in the neonatal period in VLBWIs.
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Affiliation(s)
- Jingang Li
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan; The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, VIC Australia.
| | - Masahisa Funato
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Hiroshi Tamai
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Hiroshi Wada
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Masato Nishihara
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Takashi Morita
- Department of Pediatrics, Yodogawa Christian Hospital, Osaka, Japan
| | - Suzanne L Miller
- The Ritchie Centre, Hudson Institute of Medical Research, Monash University, Clayton, VIC Australia; The Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC Australia
| | - Kayo Egashira
- Department of Neonatal Intensive Care Unit, Yodogawa Christian Hospital, Osaka, Japan
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Bridges KM, Pereira-da-Silva L, Tou JC, Ziegler J, Brunetti L. Bone metabolism in very preterm infants receiving total parenteral nutrition: do intravenous fat emulsions have an impact? Nutr Rev 2015; 73:823-36. [DOI: 10.1093/nutrit/nuv035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Suntornsaratoon P, Krishnamra N, Charoenphandhu N. Positive long-term outcomes from presuckling calcium supplementation in lactating rats and the offspring. Am J Physiol Endocrinol Metab 2015; 308:E1010-22. [PMID: 25852004 DOI: 10.1152/ajpendo.00049.2015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/06/2015] [Indexed: 12/12/2022]
Abstract
Adequate dietary calcium intake and the enhanced intestinal calcium absorption in lactating mothers have long been postulated to prevent maternal bone loss and benefit neonatal bone growth. We recently showed that calcium supplementation just before breastfeeding efficiently alleviated lactation-induced bone loss in dams as well as increased milk calcium concentration, which led to higher bone mineral density (BMD) in the newborns. Herein, we further elaborated in detail how presuckling calcium supplements worked in lactating rats and how they benefited bone growth in the offspring. As revealed by bone histomorphometry, presuckling supplement with calcium alone reduced the osteoclast surface and active erosion surface, leading to an increase in trabecular thickness without changes in trabecular separation or number in dams. The beneficial effects of presuckling calcium supplements, particularly the regimen containing glucose and galactose that enhanced intestinal calcium absorption, were found to last for 3 mo postweaning, although it could not restore estrogen-deficient osteopenia induced by ovariectomy. Regarding the neonatal benefits, pups nursed by calcium-supplemented dams exhibited increases in trabecular BMD, which could be observed even at the age of 27 wk. Bone elongation was also greater in pups of calcium-supplemented dams, which was due possibly to accelerated growth plate chondrocyte turnover. It could be concluded that calcium supplements markedly diminished the lactation-induced osteopenia in dams and positively affected BMD and bone elongation in growing rats. Therefore, presuckling calcium supplementation in lactating mothers is an effective strategy for promoting a long-lasting high bone density for both mother and the offspring.
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Affiliation(s)
- Panan Suntornsaratoon
- Center of Calcium and Bone Research, Faculty of Science, Mahidol University, Bangkok, Thailand; and Department of Physiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Nateetip Krishnamra
- Center of Calcium and Bone Research, Faculty of Science, Mahidol University, Bangkok, Thailand; and Department of Physiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Narattaphol Charoenphandhu
- Center of Calcium and Bone Research, Faculty of Science, Mahidol University, Bangkok, Thailand; and Department of Physiology, Faculty of Science, Mahidol University, Bangkok, Thailand
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29
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Paulsson-Björnsson L, Adams J, Bondemark L, Devlin H, Horner K, Lindh C. The impact of premature birth on the mandibular cortical bone of children. Osteoporos Int 2015; 26:637-44. [PMID: 25266484 DOI: 10.1007/s00198-014-2898-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 09/08/2014] [Indexed: 11/27/2022]
Abstract
SUMMARY Children born prematurely often have reduced skeletal mineralization. The aim in this study was to compare the cortical thickness of the lower jaw on radiographs of 8- to 10-year-old children with histories of preterm or full term births. There were no significant differences in cortical thickness between full term and preterm children at this age. INTRODUCTION The purpose of this study was to compare the cortical thickness of the mandible on panoramic radiographs of 8- to 10-year-old children with histories of preterm or full term births. METHODS Panoramic radiography was performed on 36 extremely preterm, 38 very preterm and 42 full term children at the age of 8 to 10 years. Five observers independently measured the mandibular cortical width on the panoramic radiographs at four defined sites bilaterally. Altogether, 928 sites were available. Measurements were performed twice on a random 24% of the sites by four observers. One-way analysis of variance with Tukey's post hoc test was used to test differences between groups. Intraclass correlation coefficient (ICC) was calculated for interobserver agreement while intra-observer agreement was expressed as measurement precision. RESULTS Significant differences of mandibular cortical width were found between extremely preterm and very preterm children for five of the eight measurement sites with the very preterm showing the highest value. No significant differences were found between full term and either very preterm or extremely preterm except for one measurement site, with the extremely preterm showing the lowest value. ICC varied between 0.30 and 0.83 for the different sites (mean 0.62). The precision of a single measurement varied between 0.11 and 0.45 mm (mean 0.25 mm). CONCLUSIONS From the evidence that very preterm children had significantly thicker mandibular cortices than extremely preterm children, we suggest that these findings may reflect the effect of mineral supplementation provided to premature infants, causing a 'shifting up' of bone mineral status relative to the full term peer group while maintaining the difference between very preterm and extremely preterm born children.
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30
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Abstract
PURPOSE OF REVIEW In 1986, the US Food and Drug Administration issued an aluminum mandate in hopes of minimizing patient exposure to aluminum contaminates contained in parenteral nutrition additives. The purpose of this article is to revisit the status of aluminum contamination as it relates to parenteral nutrition and to survey the recent literature to determine if any new findings have emerged. A special emphasis will be placed on the complications associated with aluminum toxicity. RECENT FINDINGS In addition to metabolic bone disease, patients with aluminum toxicity are also prone to other complications such as neurodevelopmental delays and cholestasis. Other potentially serious consequences, including osteoporosis, growth failure, and dementia, can arise years after the initial exposure to aluminum, showing that preventing toxicity is imperative. SUMMARY Unlike the rapid response to eliminating aluminum toxicity in the dialysis patient population, similar successes have not been realized in patients receiving parenteral nutrition solutions. Product formulation changes have been slow to emerge from manufacturers. It remains the responsibility of healthcare practitioners to recognize the patient populations at risk for toxicity and act accordingly. Monitoring aluminum status and purchasing products known to possess the least amount of aluminum are two such approaches.
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Affiliation(s)
- Kathleen M Gura
- aDepartment of Pharmacy, Boston Children's Hospital bMCPHS University, Boston, Massachusetts, USA
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31
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Embleton N, Wood CL. Growth, bone health, and later outcomes in infants born preterm. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2014. [DOI: 10.1016/j.jpedp.2014.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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32
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Embleton N, Wood CL. Growth, bone health, and later outcomes in infants born preterm. J Pediatr (Rio J) 2014; 90:529-32. [PMID: 25128223 DOI: 10.1016/j.jped.2014.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 08/04/2014] [Indexed: 11/25/2022] Open
Affiliation(s)
- Nicholas Embleton
- Newcastle Hospitals, NHS Foundation Trust, Newcastle, United Kingdom; Institute of Health and Society, Newcastle University, Newcastle, United Kingdom.
| | - Claire L Wood
- Newcastle Hospitals, NHS Foundation Trust, Newcastle, United Kingdom
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Moreira A, Swischuk L, Malloy M, Mudd D, Blanco C, Geary C. Parathyroid hormone as a marker for metabolic bone disease of prematurity. J Perinatol 2014; 34:787-91. [PMID: 24875407 DOI: 10.1038/jp.2014.97] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 04/09/2014] [Accepted: 04/14/2014] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To compare parathyroid hormone to alkaline phosphatase as a serologic marker for metabolic bone disease (MBD) in preterm infants. STUDY DESIGN An 18-month prospective observational study in neonates with birth weight < 1250 g. Simultaneous serum parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium (Ca) and phosphorus (P) were measured at scheduled intervals during hospitalization. At 6 weeks of age, MBD was evaluated using knee radiographs. Comparisons were analyzed using multivariate logistic regression, receiver operating characteristic (ROC) curves, χ² and Student t-test. RESULT Fourty-nine infants were included in the study: 7 with severe and 42 with mild MBD. Using ROC curves, at 660 U l⁻¹ ALP had a sensitivity of 29% and specificity of 93% for severe MBD, while a cutoff point of 180 pg ml⁻¹ gave PTH a sensitivity of 71% and specificity of 88%. Infants with severe bone disease had a lower birth weight, 21-day serum P, an increased use of glucocorticoids and caffeine, and more likely to have major neonatal morbidities. CONCLUSION PTH is an early marker with better sensitivity than ALP in screening for MBD. At 3 weeks chronologic age, a PTH level > 180 mg dl⁻¹ or a P level <4.6 pg ml⁻¹ yielded a sensitivity of 100% and specificity of 94% for severe MBD [corrected].
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Affiliation(s)
- A Moreira
- Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX, USA
| | - L Swischuk
- Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA
| | - M Malloy
- Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA
| | - D Mudd
- Marian University, Fond du Lac, WI, USA
| | - C Blanco
- Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX, USA
| | - C Geary
- Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA
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Alexander BT, Henry Dasinger J, Intapad S. Effect of low birth weight on women's health. Clin Ther 2014; 36:1913-1923. [PMID: 25064626 DOI: 10.1016/j.clinthera.2014.06.026] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 06/19/2014] [Indexed: 01/13/2023]
Abstract
PURPOSE The theory of the developmental origins of health and disease hypothesizes that low birth weight (≤5.5 lb) indicative of poor fetal growth is associated with an increased risk of chronic, noncommunicable disease in later life, including hypertension, type 2 diabetes mellitus, and osteoporosis. Whether women are at greater risk than men is not clear. Experimental studies that mimic the cause of slow fetal growth are being used to examine the underlying mechanisms that link a poor fetal environment with later chronic disease and investigate how sex and age affect programmed risk. Thus, the aims of this review are to summarize the current literature related to the effect of low birth weight on women's health and provide insight into potential mechanisms that program increased risk of chronic disease across the lifespan. METHODS A search of PubMed was performed with the keywords low birth weight, women's health, female, and sex differences; additional terms included blood pressure, hypertension, renal, cardiovascular, obesity, glucose intolerance, type 2 diabetes, osteoporosis, bone health, reproductive senescence, menopause, and aging. FINDINGS The major chronic diseases associated with low birth weight include high blood pressure and cardiovascular disease, impaired glucose homeostasis and type 2 diabetes, impaired bone mass and osteoporosis, and early reproductive aging. IMPLICATIONS Low birth weight increases the risk of chronic disease in men and women. Low birth weight is also associated with increased risk of early menopause. Further studies are needed to fully address the effect of sex and age on the developmental programming of adult health and disease in women across their lifespan.
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Affiliation(s)
- Barbara T Alexander
- Department of Physiology and Biophysics and the Women's Health Research Center, University of Mississippi Medical Center, Jackson, Mississippi.
| | - John Henry Dasinger
- Department of Physiology and Biophysics and the Women's Health Research Center, University of Mississippi Medical Center, Jackson, Mississippi
| | - Suttira Intapad
- Department of Physiology and Biophysics and the Women's Health Research Center, University of Mississippi Medical Center, Jackson, Mississippi
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