1
|
Huang AA, Huang SY. Covariate dependent Markov chains constructed with gradient boost modeling can effectively generate long-term predictions of obesity trends. BMC Res Notes 2023; 16:346. [PMID: 38001467 PMCID: PMC10668339 DOI: 10.1186/s13104-023-06610-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
IMPORTANCE The prevalence of obesity among United States adults has increased from 30.5% in 1999 to 41.9% in 2020. However, despite the recognition of long-term weight gain as an important public health issue, there is a paucity of studies studying the long-term weight gain and building models for long-term projection. METHODS A retrospective, cross-sectional cohort study using the publicly available National Health and Nutrition Examination Survey (NHANES 2017-2020) was conducted in patients who completed the weight questionnaire and had accurate data for both weight at time of survey and weight ten years ago. Multistate gradient boost modeling classifiers were used to generate covariate dependent transition matrices and Markov chains were utilized for multistate modeling. RESULTS Of the 6146 patients that met the inclusion criteria, 3024 (49%) of patients were male and 3122 (51%) of patients were female. There were 2252 (37%) White patients, 1257 (20%) Hispanic patients, 1636 (37%) Black patients, and 739 (12%) Asian patients. The average BMI was 30.16 (SD = 7.15), the average weight was 83.67 kilos (SD = 22.04), and the average weight change was a 3.27 kg (SD = 14.97) increase in body weight (Fig. 1). A total of 2411 (39%) patients lost weight, and 3735 (61%) patients gained weight (Table 1). We observed that 87 (1%) of patients were underweight (BMI < 18.5), 2058 (33%) were normal weight (18.5 ≤ BMI < 25), 1376 (22%) were overweight (25 ≤ BMI < 30) and 2625 (43%) were obese (BMI > 30). From analysis of the transitions between normal/underweight, overweight, and obese, we observed that after 10 years, of the patients who were underweight, 65% stayed underweight, 32% became normal weight, 2% became overweight, and 2% became obese. After 10 years, of the patients who were normal weight, 3% became underweight, 78% stayed normal weight, 17% became overweight, and 2% became obese. Of the patients who were overweight, 71% stayed overweight, 0% became underweight, 14% became normal weight, and 15% became obese. Of the patients who were obese, 84% stayed obese, 0% became underweight, 1% became normal weight, and 14% became overweight. CONCLUSIONS United States adults are at risk of transitioning from normal weight to becoming overweight or obese. Covariate dependent Markov chains constructed with gradient boost modeling can effectively generate long-term predictions.
Collapse
Affiliation(s)
- Alexander A Huang
- Cornell University, Ithaca, NY, USA.
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | | |
Collapse
|
2
|
Li C, Pan Y, Zhang R, Huang Z, Li D, Han Y, Larkin C, Rao V, Sun X, Kelly TN. Genomic Innovation in Early Life Cardiovascular Disease Prevention and Treatment. Circ Res 2023; 132:1628-1647. [PMID: 37289909 PMCID: PMC10328558 DOI: 10.1161/circresaha.123.321999] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality globally. Although CVD events do not typically manifest until older adulthood, CVD develops gradually across the life-course, beginning with the elevation of risk factors observed as early as childhood or adolescence and the emergence of subclinical disease that can occur in young adulthood or midlife. Genomic background, which is determined at zygote formation, is among the earliest risk factors for CVD. With major advances in molecular technology, including the emergence of gene-editing techniques, along with deep whole-genome sequencing and high-throughput array-based genotyping, scientists now have the opportunity to not only discover genomic mechanisms underlying CVD but use this knowledge for the life-course prevention and treatment of these conditions. The current review focuses on innovations in the field of genomics and their applications to monogenic and polygenic CVD prevention and treatment. With respect to monogenic CVD, we discuss how the emergence of whole-genome sequencing technology has accelerated the discovery of disease-causing variants, allowing comprehensive screening and early, aggressive CVD mitigation strategies in patients and their families. We further describe advances in gene editing technology, which might soon make possible cures for CVD conditions once thought untreatable. In relation to polygenic CVD, we focus on recent innovations that leverage findings of genome-wide association studies to identify druggable gene targets and develop predictive genomic models of disease, which are already facilitating breakthroughs in the life-course treatment and prevention of CVD. Gaps in current research and future directions of genomics studies are also discussed. In aggregate, we hope to underline the value of leveraging genomics and broader multiomics information for characterizing CVD conditions, work which promises to expand precision approaches for the life-course prevention and treatment of CVD.
Collapse
Affiliation(s)
- Changwei Li
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C. Li, R.Z., Z.H., X.S.)
| | - Yang Pan
- Division of Nephrology, Department of Medicine, College of Medicine, University of Illinois Chicago (Y.P., D.L., Y.H., C.L., V.R., T.N.K.)
| | - Ruiyuan Zhang
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C. Li, R.Z., Z.H., X.S.)
| | - Zhijie Huang
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C. Li, R.Z., Z.H., X.S.)
| | - Davey Li
- Division of Nephrology, Department of Medicine, College of Medicine, University of Illinois Chicago (Y.P., D.L., Y.H., C.L., V.R., T.N.K.)
| | - Yunan Han
- Division of Nephrology, Department of Medicine, College of Medicine, University of Illinois Chicago (Y.P., D.L., Y.H., C.L., V.R., T.N.K.)
| | - Claire Larkin
- Division of Nephrology, Department of Medicine, College of Medicine, University of Illinois Chicago (Y.P., D.L., Y.H., C.L., V.R., T.N.K.)
| | - Varun Rao
- Division of Nephrology, Department of Medicine, College of Medicine, University of Illinois Chicago (Y.P., D.L., Y.H., C.L., V.R., T.N.K.)
| | - Xiao Sun
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (C. Li, R.Z., Z.H., X.S.)
| | - Tanika N Kelly
- Division of Nephrology, Department of Medicine, College of Medicine, University of Illinois Chicago (Y.P., D.L., Y.H., C.L., V.R., T.N.K.)
| |
Collapse
|
3
|
Genetic risk score for common obesity and anthropometry in Spanish schoolchildren. ENDOCRINOL DIAB NUTR 2023; 70:107-114. [PMID: 36868927 DOI: 10.1016/j.endien.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/22/2022] [Indexed: 03/05/2023]
Abstract
IntroductionCommon or non-syndromic obesity is a complex polygenic trait conditioned by biallelic or single-base polymorphisms called SNPs (Single-Nucleotide Polymorphisms) that present an additive effect and act synergistically. Most genotype-obese phenotype association studies include body mass index (BMI) or waist-to-height ratio (WtHR), and very few introduce a broad anthropometric profile. ObjectiveTo verify whether a genetic risk score (GRS) developed from 10 SNPs is associated with the obesity phenotype assessed from anthropometric measures indicative of excess weight, adiposity and fat distribution. Material and methodsA series of 438 Spanish schoolchildren (6-16 years old) were evaluated anthropometrically (weight, height, waist circumference, skinfold thickness, BMI, WtHR, body fat percentage [%BF]). Ten SNPs were genotyped from saliva samples, generating a GRS for obesity, establishing genotype-phenotype association. ResultsSchoolchildren categorised as obese by BMI, ICT and %BF had higher GRS than their non-obese peers. The prevalence of overweight and adiposity was higher in subjects with a GRS above the median. Similarly, between 11 and 16 years of age, all anthropometric variables presented higher averages. ConclusionsGRS estimated from the 10 SNPs can be a diagnostic tool for the potential risk of obesity in Spanish schoolchildren and could be useful from the preventive perspective.
Collapse
|
4
|
An R, Shen J, Xiao Y. Applications of Artificial Intelligence to Obesity Research: Scoping Review of Methodologies. J Med Internet Res 2022; 24:e40589. [PMID: 36476515 PMCID: PMC9856437 DOI: 10.2196/40589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/05/2022] [Accepted: 11/01/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity is a leading cause of preventable death worldwide. Artificial intelligence (AI), characterized by machine learning (ML) and deep learning (DL), has become an indispensable tool in obesity research. OBJECTIVE This scoping review aimed to provide researchers and practitioners with an overview of the AI applications to obesity research, familiarize them with popular ML and DL models, and facilitate the adoption of AI applications. METHODS We conducted a scoping review in PubMed and Web of Science on the applications of AI to measure, predict, and treat obesity. We summarized and categorized the AI methodologies used in the hope of identifying synergies, patterns, and trends to inform future investigations. We also provided a high-level, beginner-friendly introduction to the core methodologies to facilitate the dissemination and adoption of various AI techniques. RESULTS We identified 46 studies that used diverse ML and DL models to assess obesity-related outcomes. The studies found AI models helpful in detecting clinically meaningful patterns of obesity or relationships between specific covariates and weight outcomes. The majority (18/22, 82%) of the studies comparing AI models with conventional statistical approaches found that the AI models achieved higher prediction accuracy on test data. Some (5/46, 11%) of the studies comparing the performances of different AI models revealed mixed results, indicating the high contingency of model performance on the data set and task it was applied to. An accelerating trend of adopting state-of-the-art DL models over standard ML models was observed to address challenging computer vision and natural language processing tasks. We concisely introduced the popular ML and DL models and summarized their specific applications in the studies included in the review. CONCLUSIONS This study reviewed AI-related methodologies adopted in the obesity literature, particularly ML and DL models applied to tabular, image, and text data. The review also discussed emerging trends such as multimodal or multitask AI models, synthetic data generation, and human-in-the-loop that may witness increasing applications in obesity research.
Collapse
Affiliation(s)
- Ruopeng An
- Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Jing Shen
- Department of Physical Education, China University of Geosciences, Beijing, China
| | - Yunyu Xiao
- Weill Cornell Medical College, Cornell University, Ithaca, NY, United States
| |
Collapse
|
5
|
Epigenome-wide association analysis of pancreatic exocrine cells from high-fat- and normal diet-fed mice and its potential use for understanding the oncogenesis of human pancreatic cancer. Biochem Biophys Res Commun 2022; 637:50-57. [DOI: 10.1016/j.bbrc.2022.10.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 10/30/2022] [Indexed: 12/24/2022]
|
6
|
Puntuación de riesgo genético para la obesidad común y antropometría en escolares españoles. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
7
|
Zhou Y, Zha L, Pan S. The Risk of Atrial Fibrillation Increases with Earlier Onset of Obesity: A Mendelian Randomization Study. Int J Med Sci 2022; 19:1388-1398. [PMID: 36035367 PMCID: PMC9413561 DOI: 10.7150/ijms.72334] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/28/2022] [Indexed: 11/05/2022] Open
Abstract
Background: Obesity is a well-established risk factor for atrial fibrillation (AF). Previous epidemiological research on obesity and AF often focused on adult populations and now broadened to earlier in life. Therefore, this study aimed to determine the relationships between obesity at different periods of life and the risk of AF. Methods: A two-sample Mendelian randomization (MR) study design using summarised data from 6 genome-wide association studies (GWASs) was employed in this study. Single nucleotide polymorphisms (SNPs) associated with adult obesity, childhood obesity, childhood body mass index (BMI), waist-to-hip ratio adjusted for BMI (WHRadjBMI), birth weight and AF were independently retrieved from large-scale GWASs. For SNP identification, the genome-wide significance threshold was set at p <5.00×10-8. To obtain causal estimates, MR analysis was conducted using the inverse variance-weighted (IVW) method. The weighted median, MR-Egger methods and MR-robust adjusted profile score (MR-RAPS) were used to evaluate the robustness of MR analysis. Results: A total of 204 SNPs were identified as the genetic instrumental variables (5 SNPs for childhood obesity, 13 SNPs for childhood BMI, 137 SNPs for birth weight, 35 SNPs for adult WHRadjBMI, and 14 SNPs for adult obesity). The results of MR analysis demonstrated that the genetically predicted adult obesity, childhood BMI, and birth weight were associated with AF risk. Notably, a 1 unit standard deviation (1-SD) increase in adult obesity was related to a 13% increased risk of AF [p=6.51×10-7, OR, 1.13 (95% CI, 1.08-1.19)], a 1-SD increase in childhood BMI was related to a 18% increased risk of AF [p=1.77×10-4, OR, 1.18 (95% CI, 1.08-1.29)], and a 1-SD increase in birth weight was related to a 26% increased risk of AF [p=1.27×10-7, OR, 1.26 (95% CI, 1.16-1.37)]. There was no evidence of pleiotropy or heterogeneity between the MR estimates obtained from multiple SNPs. Conclusion: Our study reveals the association of genetic susceptibility to obesity with a higher risk of AF. Moreover, an earlier age at obesity was associated with an increased risk of AF. Therefore, public awareness of the dangers of obesity and active early weight control may prevent the development of AF.
Collapse
Affiliation(s)
- Yingchao Zhou
- Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Lingfeng Zha
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Silin Pan
- Heart Center, Women and Children's Hospital, Qingdao University, Qingdao, China
| |
Collapse
|
8
|
Demerdash HM. Weight regain after bariatric surgery: Promoters and potential predictors. World J Meta-Anal 2021; 9:438-454. [DOI: 10.13105/wjma.v9.i5.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/07/2021] [Accepted: 09/17/2021] [Indexed: 02/06/2023] Open
Abstract
Obesity is globally viewed as chronic relapsing disease. Bariatric surgery offers the most efficient and durable weight loss approach. However, weight regain after surgery is a distressing issue as obesity can revert. Surgical procedures were originally designed to reduce food intake and catalyze weight loss, provided that its role is marginalized in long-term weight maintenance. Consequently, it is essential to establish a scientifically standardized applicable definitions for weight regain, which necessitates enhanced comprehension of the clinical situation, as well as have realistic expectations concerning weight loss. Moreover, several factors are proposed to influence weight regain as psychological, behavioral factors, hormonal, metabolic, anatomical lapses, as well as genetic predisposition. Recently, there is a growing evidence of utilization of scoring system to anticipate excess body weight loss, along with characterizing certain biomarkers that identify subjects at risk of suboptimal weight loss after surgery. Furthermore, personalized counseling is warranted to help select bariatric procedure, reinforce self-monitoring skills, motivate patient, encourage mindful eating practices, to avoid recidivism.
Collapse
Affiliation(s)
- Hala Mourad Demerdash
- Department of Clinical Pathology, Alexandria University Hospitals, Alexandria 21311, Egypt
| |
Collapse
|
9
|
Heianza Y, Zhou T, Sun D, Hu FB, Qi L. Healthful plant-based dietary patterns, genetic risk of obesity, and cardiovascular risk in the UK biobank study. Clin Nutr 2021; 40:4694-4701. [PMID: 34237696 DOI: 10.1016/j.clnu.2021.06.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/09/2021] [Accepted: 06/17/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND & AIMS People with a higher genetic risk for obesity are more likely to develop cardiovascular disease (CVD), and healthy plant-based dietary patterns may be associated with decreased risks of obesity and cardiovascular events. We investigated whether adherence to healthy plant-foods-rich dietary patterns might attenuate risks of obesity and related cardiovascular abnormalities for people at genetically higher risk of obesity. METHODS This study included 121,799 middle-aged adults in UK Biobank who were initially free of metabolic diseases and cancer. We calculated a healthful plant-based diet index (hPDI) based on 17 major food groups as well as a genetic risk score (GRS) for obesity consisting of body mass index (BMI)-associated variants. The incidence of cardiovascular events (myocardial infarction, MI, or stroke) was prospectively followed during a mean (SD) 5.1 (0.9) years. RESULTS We found significant interactions between GRS and hPDI on adiposity (Pinteraction <0.0001); adherence to hPDI was more strongly associated with lower levels of adiposity among participants with higher GRS than those with lower GRS. Further, we found a similar pattern of GRS-hPDI interactions on untreated hypertension (Pinteraction = 0.0036). When we tested GRS-hPDI interactions on cardiovascular events, adherence to hPDI was more strongly associated with a decreased risk of MI among people with high GRS (above median) than those with low GRS (Pinteraction = 0.006). Among participants with high GRS, high adherence to hPDI (the top tertile of hPDI) was associated with an HR 0.54 (95% CI: 0.39, 0.74) for MI, as compared to low adherence. CONCLUSIONS Adherence to healthy plant-based dietary patterns significantly attenuated risks of cardiovascular abnormalities for people at genetically higher risk of obesity. Our results support the precision medicine strategies considering genetics and dietary habits to modify cardiovascular health for people at higher risk of genetically determined obesity.
Collapse
Affiliation(s)
- Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Tao Zhou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Dianjianyi Sun
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| |
Collapse
|
10
|
Development of a Genetic Risk Score to predict the risk of overweight and obesity in European adolescents from the HELENA study. Sci Rep 2021; 11:3067. [PMID: 33542408 PMCID: PMC7862459 DOI: 10.1038/s41598-021-82712-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 01/22/2021] [Indexed: 11/08/2022] Open
Abstract
Obesity is the result of interactions between genes and environmental factors. Since monogenic etiology is only known in some obesity-related genes, a genetic risk score (GRS) could be useful to determine the genetic predisposition to obesity. Therefore, the aim of our study was to build a GRS able to predict genetic predisposition to overweight and obesity in European adolescents. A total of 1069 adolescents (51.3% female), aged 11-19 years participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) cross-sectional study were genotyped. The sample was divided in non-overweight (non-OW) and overweight/obesity (OW/OB). From 611 single nucleotide polymorphisms (SNP) available, a first screening of 104 SNPs univariately associated with obesity (p < 0.20) was established selecting 21 significant SNPs (p < 0.05) in the multivariate model. Unweighted GRS (uGRS) was calculated by summing the number of risk alleles and weighted GRS (wGRS) by multiplying the risk alleles to each estimated coefficient. The area under curve (AUC) was calculated in uGRS (0.723) and wGRS (0.734) using tenfold internal cross-validation. Both uGRS and wGRS were significantly associated with body mass index (BMI) (p < .001). Both GRSs could potentially be considered as useful genetic tools to evaluate individual's predisposition to overweight/obesity in European adolescents.
Collapse
|
11
|
Yang J, Ju X, Liu F, Asan O, Church T, Smith J. Prediction for the Risk of Multiple Chronic Conditions Among Working Population in the United States With Machine Learning Models. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2021; 2:291-298. [PMID: 35402965 PMCID: PMC8940207 DOI: 10.1109/ojemb.2021.3117872] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/22/2021] [Accepted: 09/30/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: Chronic diseases have become the most prevalent and costly health conditions in the healthcare industry, deteriorating the quality of life, adversely affecting the work productivity, and costing astounding medical resources. However, few studies have been conducted on the predictive analysis of multiple chronic conditions (MCC) based on the working population. Results: Seven machine learning algorithms are used to support the decision making of healthcare practitioner on the risk of MCC. The models were developed and validated using checkup data from 451,425 working population collected by the healthcare providers. Our result shows that all proposed models achieved satisfactory performance, with the AUC values ranging from 0.826 to 0.850. Among the seven predictive models, the gradient boosting tree model outperformed other models, achieving an AUC of 0.850. Conclusions: Our risk prediction model shows great promise in automating real-time diagnosis, supporting healthcare practitioners to target high-risk individuals efficiently, and helping healthcare practitioners tailor proactive strategies to prevent the onset or delay the progression of the chronic diseases.
Collapse
Affiliation(s)
- Jingmei Yang
- Division of System EngineeringBoston University Boston MA 02246 USA
| | - Xinglong Ju
- Price College of BusinessUniversity of Oklahoma Norman OK 73019 USA
- School of Civil and Environmental EngineeringCornell University Ithaca NY 14853 USA
| | - Feng Liu
- School of Systems and EnterprisesStevens Institute of Technology Hoboken NJ 07030 USA
| | - Onur Asan
- School of Systems and EnterprisesStevens Institute of Technology Hoboken NJ 07030 USA
| | | | - Jeff Smith
- Catapult Health Inc. Dallas TX 75254 USA
| |
Collapse
|
12
|
Seral-Cortes M, Sabroso-Lasa S, De Miguel-Etayo P, Gonzalez-Gross M, Gesteiro E, Molina-Hidalgo C, De Henauw S, Erhardt É, Censi L, Manios Y, Karaglani E, Widhalm K, Kafatos A, Beghin L, Meirhaeghe A, Salazar-Tortosa D, Ruiz JR, Moreno LA, Esteban LM, Labayen I. Interaction Effect of the Mediterranean Diet and an Obesity Genetic Risk Score on Adiposity and Metabolic Syndrome in Adolescents: The HELENA Study. Nutrients 2020; 12:E3841. [PMID: 33339255 PMCID: PMC7766705 DOI: 10.3390/nu12123841] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 02/07/2023] Open
Abstract
Obesity and metabolic syndrome (MetS) are worldwide major health challenges. The Mediterranean diet (MD) is associated with a better cardiometabolic profile, but these beneficial effects may be influenced by genetic variations, modulating the predisposition to obesity or MetS. The aim was to assess whether interaction effects occur between an obesity genetic risk score (obesity-GRS) and the MD on adiposity and MetS in European adolescents. Multiple linear regression models were used to assess the interaction effects of an obesity-GRS and the MD on adiposity and MetS and its components. Interaction effects between the MD on adiposity and MetS were observed in both sex groups (p < 0.05). However, those interaction effects were only expressed in a certain number of adolescents, when a limited number of risk alleles were present. Regarding adiposity, a total of 51.1% males and 98.7% females had lower body mass index (BMI) as a result of higher MD adherence. Concerning MetS, only 9.9% of males with higher MD adherence had lower MetS scores. However, the same effect was observed in 95.2% of females. In conclusion, obesity-related genotypes could modulate the relationship between MD adherence and adiposity and MetS in European adolescents; the interaction effect was higher in females than in males.
Collapse
Affiliation(s)
- Miguel Seral-Cortes
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Faculty of Health Sciences, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, 50009 Zaragoza, Spain; (M.S.-C.); (L.A.M.)
| | | | - Pilar De Miguel-Etayo
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Faculty of Health Sciences, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, 50009 Zaragoza, Spain; (M.S.-C.); (L.A.M.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Marcela Gonzalez-Gross
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- ImFine Research Group, Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
- Institute of Nutritional and Food Sciences, Nutritional Physiology, University of Bonn, 53113 Bonn, Germany
| | - Eva Gesteiro
- ImFine Research Group, Department of Health and Human Performance, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Cristina Molina-Hidalgo
- EFFECTS 262 Department of Medical Physiology, School of Medicine, University of Granada, 18071 Granada, Spain;
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Éva Erhardt
- Department of Pediatrics, Medical School, University of Pécs, 7623 Pécs, Hungary;
| | - Laura Censi
- Council for Agricultural Research and Economics-Research Center for Food and Nutrition, 00198 Rome, Italy;
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, 176 71 Athens, Greece; (Y.M); (E.K.)
| | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, 176 71 Athens, Greece; (Y.M); (E.K.)
| | - Kurt Widhalm
- Division of Gastroenterology and Hepatology, Department of Internal Med III, Austria and Austrian Academic Institute for Clinical Nutrition, 1090 Vienna, Austria;
| | - Anthony Kafatos
- Faculty of Medicine, University of Crete, 715 00 Crete, Greece;
| | - Laurent Beghin
- CIC-1403-Inserm-CHU, Clinical Investigation Center, LIRIC UMR 995 Inserm, CHU Lille, Université de Lille, 59000 Lille, France;
| | - Aline Meirhaeghe
- UMR1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-Related Diseases, Centre Hosp, Institut Pasteur de Lille, Université de Lille, 59019 Lille, France;
| | - Diego Salazar-Tortosa
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ 85719, USA;
| | - Jonatan R. Ruiz
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Department of Physical and Sports Education, School of Sports Science, Sport and Health University Research Institute (iMUDS), University of Granada, 18016 Granada, Spain;
| | - Luis A. Moreno
- Growth, Exercise, NUtrition and Development (GENUD) Research Group, Faculty of Health Sciences, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, 50009 Zaragoza, Spain; (M.S.-C.); (L.A.M.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Luis Mariano Esteban
- Escuela Politécnica de La Almunia, Universidad de Zaragoza, 50100 Zaragoza, Spain;
| | - Idoia Labayen
- Department of Health Sciences, Public University of Navarra, 31006 Pamplona, Spain;
| |
Collapse
|
13
|
Abstract
A new cardiometabolic-based chronic disease (CMBCD) model is presented that provides a basis for early and sustainable, evidence-based therapeutic targeting to promote cardiometabolic health and mitigate the development and ravages of cardiovascular disease. In the first part of this JACC State-of-the-Art Review, a framework is presented for CMBCD, focusing on 3 primary drivers (genetics, environment, and behavior) and 2 metabolic drivers (adiposity and dysglycemia) with applications to 3 cardiovascular endpoints (coronary heart disease, heart failure, and atrial fibrillation). Specific mechanistic pathways are presented configuring early primary drivers with subsequent adiposity, insulin resistance, β-cell dysfunction, and metabolic syndrome, leading to cardiovascular disease. The context for building this CMBCD model is to expose actionable targets for prevention to achieve optimal cardiovascular outcomes. The tactical implementation of this CMBCD model is the subject of second part of this JACC State-of-the-Art Review.
Collapse
|
14
|
Cardiometabolic-Based Chronic Disease, Adiposity and Dysglycemia Drivers: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 75:525-538. [PMID: 32029136 DOI: 10.1016/j.jacc.2019.11.044] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/06/2019] [Accepted: 11/17/2019] [Indexed: 02/07/2023]
Abstract
A new cardiometabolic-based chronic disease (CMBCD) model is presented that provides a basis for early and sustainable, evidence-based therapeutic targeting to promote cardiometabolic health and mitigate the development and ravages of cardiovascular disease. In the first part of this JACC State-of-the-Art Review, a framework is presented for CMBCD, focusing on 3 primary drivers (genetics, environment, and behavior) and 2 metabolic drivers (adiposity and dysglycemia) with applications to 3 cardiovascular endpoints (coronary heart disease, heart failure, and atrial fibrillation). Specific mechanistic pathways are presented configuring early primary drivers with subsequent adiposity, insulin resistance, β-cell dysfunction, and metabolic syndrome, leading to cardiovascular disease. The context for building this CMBCD model is to expose actionable targets for prevention to achieve optimal cardiovascular outcomes. The tactical implementation of this CMBCD model is the subject of second part of this JACC State-of-the-Art Review.
Collapse
|
15
|
Longitudinal association of a body mass index (BMI) genetic risk score with growth and BMI changes across the life course: The Cardiovascular Risk in Young Finns Study. Int J Obes (Lond) 2020; 44:1733-1742. [PMID: 32494039 DOI: 10.1038/s41366-020-0611-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 03/27/2020] [Accepted: 05/20/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND The role of genetic risk scores associated with adult body mass index (BMI) on BMI levels across the life course is unclear. We examined if a 97 single nucleotide polymorphism weighted genetic risk score (wGRS97) associated with age-related progression in BMI at different life stages and distinct developmental trajectories of BMI across the early life course. METHODS 2188 Cardiovascular Risk in Young Finns Study participants born pre-1980 who had genotype data and objective measurements of height and weight collected up to 8 times from age 6 to 49 years. Associations were examined using Individual Growth Curve analysis, Latent Class Growth Mixture Modelling, and Poisson modified regression. RESULTS The wGRS97 associated with BMI from age 6 years with peak effect sizes observed at age 30 years (females: 1.14 kg/m2; males: 1.09 kg/m2 higher BMI per standard deviation increase in wGRS97). The association between wGRS97 and BMI became stronger with age in childhood but slowed in adolescence, especially in females, and weakened at age 35-40 years. A higher wGRS97 associated with an increased BMI velocity in childhood and adulthood, but not with BMI change in adulthood. Compared with belonging to a 'normal stable' life-course trajectory group (normal BMI from childhood to adulthood), a one standard deviation higher wGRS97 associated with a 13-127% increased risk of belonging to a less favourable life-course BMI trajectory group. CONCLUSIONS Individuals with genetic susceptibility to higher adult BMI have higher levels and accelerated rates of increase in BMI in childhood/adolescence, and are at increased risk of having a less favourable life-course BMI trajectory.
Collapse
|
16
|
Wu F, Buscot MJ, Niinikoski H, Rovio SP, Juonala M, Sabin MA, Jula A, Rönnemaa T, Viikari JSA, Raitakari OT, Magnussen CG, Pahkala K. Age-Specific Estimates and Comparisons of Youth Tri-Ponderal Mass Index and Body Mass Index in Predicting Adult Obesity-Related Outcomes. J Pediatr 2020; 218:198-203.e6. [PMID: 31757470 DOI: 10.1016/j.jpeds.2019.10.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/09/2019] [Accepted: 10/24/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To estimate and compare tri-ponderal mass index (TMI) and body mass index (BMI) at each age from childhood to young adulthood in the prediction of adulthood obesity-related outcomes. STUDY DESIGN Participants of this observational study (n = 432) were from a 20-year infancy-onset randomized atherosclerosis prevention trial. BMI and TMI were calculated using weight and height measured annually from participants between ages 2 and 20 years. Outcomes were aortic intima-media thickness (at the age of 15, 17, or 19 years), impaired fasting glucose and elevated insulin levels, homeostasis model assessment of insulin resistance index, serum lipids, and hypertension at the age of 20 years. Poisson regressions, Pearson correlation, logistic regression, and area under the curve (AUC) were used to estimate and/or compare associations and predictive utilities between BMI and TMI with all outcomes. RESULTS The associations and predictive utilities of BMI and TMI with all outcomes were stronger at older ages. BMI had significantly stronger correlations than TMI with insulin (at age 16 years), systolic blood pressure (age 5-20 years), and triglycerides (age 18 years). BMI had significantly greater predictive utilities than TMI for insulin resistance (at age 14-16 years; difference in AUC = 0.018-0.024), elevated insulin levels (age 14-16 years; difference in AUC = 0.018 and 0.025), and hypertension (age 16 to 20 years; difference in AUC = 0.017-0.022) but they were similar for other outcomes. CONCLUSIONS TMI is not superior to BMI at any ages from childhood to young adulthood in the prediction of obesity-related outcomes in young adulthood.
Collapse
Affiliation(s)
- Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
| | - Marie-Jeanne Buscot
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Harri Niinikoski
- Department of Paediatrics, University of Turku, Turku, Finland; Department of Physiology, University of Turku, Turku, Finland
| | - Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Matthew A Sabin
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia; Department of Paediatrics, and University of Melbourne, Melbourne, VIC, Australia
| | - Antti Jula
- National Institute for Health and Welfare, Turku, Finland
| | | | | | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| |
Collapse
|
17
|
Easy-to-use tool for evaluating the elevated acute kidney injury risk against reduced cardiovascular disease risk during intensive blood pressure control. J Hypertens 2020; 38:511-518. [DOI: 10.1097/hjh.0000000000002282] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
18
|
Graham CAM, Pedlar CR, Hearne G, Lorente-Cebrián S, González-Muniesa P, Mavrommatis Y. The Association of Parental Genetic, Lifestyle, and Social Determinants of Health with Offspring Overweight. Lifestyle Genom 2020; 13:99-106. [PMID: 32069471 DOI: 10.1159/000505749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 01/03/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION In the UK, the number of comorbidities seen in children has increased along with the worsening obesity rate. These comorbidities worsen into adulthood. Genome-wide association studies have highlighted single nucleotide polymorphisms associated with the weight status of adults and offspring individually. To date, in the UK, parental genetic, lifestyle, and social determinants of health have not been investigated alongside one another as influencers of offspring weight status. A comprehensive obesity prevention scheme would commence prior to conception and involve parental intervention including all known risk factors. This current study aims to identify the proportion of overweight that can be explained by known parental risk factors, including genetic, lifestyle, and social determinants of health with offspring weight status in the UK. METHODS A cross-sectional study was carried out on 123 parents. Parental and offspring anthropometric data and parental lifestyle and social determinants of health data were self-reported. Parental genetic data were collected by use of GeneFiX saliva collection vials and genotype were assessed for brain-derived neurotrophic factor (BDNF) gene rs6265, melanocortin 4 receptor (MC4R) gene rs17782313, transmembrane protein 18 (TMEM18) gene rs2867125, and serine/threonine-protein kinase (TNN13K) gene rs1514175. Associations were assessed between parental data and the weight status of offspring. RESULTS Maternal body mass index modestly predicted child weight status (p < 0.015; R2 = 0.15). More mothers of overweight children carried the MC4R rs17782313 risk allele (77.8%; p = 0.007) compared to mothers of normal-weight children. Additionally, fathers who were not Caucasian and parents who slept for <7 h/night had a larger percentage of overweight children when compared to their counterparts (p = 0.039; p = 0.014, respectively). CONCLUSION Associations exist between the weight status of offspring based solely on parental genetic, lifestyle, and social determinants of health data. Further research is required to appropriately address future interventions based on genetic and lifestyle risk groups on a pre-parent cohort.
Collapse
Affiliation(s)
- Catherine A M Graham
- Faculty of Health and Life Sciences, Department of Sport, Health and Social Work, Oxford Brookes University, Oxford, United Kingdom,
| | - Charles R Pedlar
- Faculty of Sport Health and Applied Science, Department of Nutrition, St. Mary's University, Twickenham, London, United Kingdom
| | - Gary Hearne
- Faculty of Science and Technology, Department of Design Engineering and Mathematics, Middlesex University, London, United Kingdom
| | - Silvia Lorente-Cebrián
- Centre for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.,IdiSNA - Navarra Health Research Institute, Pamplona, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIII, Madrid, Spain
| | - Pedro González-Muniesa
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, Pamplona, University of Navarra, Pamplona, Spain.,Centre for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.,IdiSNA - Navarra Health Research Institute, Pamplona, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIII, Madrid, Spain
| | - Yiannis Mavrommatis
- Faculty of Sport Health and Applied Science, Department of Nutrition, St. Mary's University, Twickenham, London, United Kingdom
| |
Collapse
|
19
|
Mechanick JI, Farkouh ME, Newman JD, Garvey WT. Cardiometabolic-Based Chronic Disease, Adiposity and Dysglycemia Drivers: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 75:525-538. [PMID: 32029136 PMCID: PMC7187687 DOI: 10.1016/j.jacc.2019.11.044,+10.1016/s0735-1097(20)31152-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/06/2019] [Accepted: 11/17/2019] [Indexed: 02/01/2024]
Abstract
A new cardiometabolic-based chronic disease (CMBCD) model is presented that provides a basis for early and sustainable, evidence-based therapeutic targeting to promote cardiometabolic health and mitigate the development and ravages of cardiovascular disease. In the first part of this JACC State-of-the-Art Review, a framework is presented for CMBCD, focusing on 3 primary drivers (genetics, environment, and behavior) and 2 metabolic drivers (adiposity and dysglycemia) with applications to 3 cardiovascular endpoints (coronary heart disease, heart failure, and atrial fibrillation). Specific mechanistic pathways are presented configuring early primary drivers with subsequent adiposity, insulin resistance, β-cell dysfunction, and metabolic syndrome, leading to cardiovascular disease. The context for building this CMBCD model is to expose actionable targets for prevention to achieve optimal cardiovascular outcomes. The tactical implementation of this CMBCD model is the subject of second part of this JACC State-of-the-Art Review.
Collapse
Affiliation(s)
- Jeffrey I Mechanick
- Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Michael E Farkouh
- Peter Munk Cardiac Centre and the Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan D Newman
- Division of Cardiology and Center for the Prevention of Cardiovascular Disease, Department of Medicine, New York University Medical Center, New York, New York
| | - W Timothy Garvey
- Department of Nutrition Sciences and Diabetes Research Center, University of Alabama at Birmingham, Birmingham, Alabama; Geriatric Research Education and Clinical Center, Birmingham VA Medical Center, Birmingham, Alabama
| |
Collapse
|
20
|
Mechanick JI, Farkouh ME, Newman JD, Garvey WT. Cardiometabolic-Based Chronic Disease, Adiposity and Dysglycemia Drivers: JACC State-of-the-Art Review. J Am Coll Cardiol 2020; 75. [PMID: 32029136 PMCID: PMC7187687 DOI: 10.1016/j.jacc.2019.11.044, 10.1016/s0735-1097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
A new cardiometabolic-based chronic disease (CMBCD) model is presented that provides a basis for early and sustainable, evidence-based therapeutic targeting to promote cardiometabolic health and mitigate the development and ravages of cardiovascular disease. In the first part of this JACC State-of-the-Art Review, a framework is presented for CMBCD, focusing on 3 primary drivers (genetics, environment, and behavior) and 2 metabolic drivers (adiposity and dysglycemia) with applications to 3 cardiovascular endpoints (coronary heart disease, heart failure, and atrial fibrillation). Specific mechanistic pathways are presented configuring early primary drivers with subsequent adiposity, insulin resistance, β-cell dysfunction, and metabolic syndrome, leading to cardiovascular disease. The context for building this CMBCD model is to expose actionable targets for prevention to achieve optimal cardiovascular outcomes. The tactical implementation of this CMBCD model is the subject of second part of this JACC State-of-the-Art Review.
Collapse
Affiliation(s)
- Jeffrey I. Mechanick
- Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Michael E. Farkouh
- Peter Munk Cardiac Centre and the Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan D. Newman
- Division of Cardiology and Center for the Prevention of Cardiovascular Disease, Department of Medicine, New York University Medical Center, New York, New York
| | - W. Timothy Garvey
- Department of Nutrition Sciences and Diabetes Research Center, University of Alabama at Birmingham, Birmingham, Alabama;,Geriatric Research Education and Clinical Center, Birmingham VA Medical Center, Birmingham, Alabama
| |
Collapse
|
21
|
El Tahir O, de Jonge RCJ, Ouburg S, Morré SA, van Furth AM. Study protocol: The Dutch 20|30 Postmeningitis study: a cross-sectional follow-up of two historical childhood bacterial meningitis cohorts on long-term outcomes. BMC Pediatr 2019; 19:519. [PMID: 31888554 PMCID: PMC6936081 DOI: 10.1186/s12887-019-1900-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 12/22/2019] [Indexed: 04/11/2023] Open
Abstract
Background Bacterial meningitis (BM) is a serious, life-threatening infectious disease of the central nervous system that often occurs in young children. The most common severe to moderate sequelae following BM are sensorineural hearing loss, neuromotor disabilities and mental retardation, while subtle sequelae include academic and behavioral disabilities. It is largely unknown whether these more subtle sequelae persist into adolescence and adulthood. Therefore, this study will investigate the very long-term effects of childhood BM in later life. Better understanding of long-term effects and early identification of adverse outcomes after BM are essential for more timely interventions. Additionally, certain single nucleotide polymorphisms (SNPs) are associated with disease severity and might predict adverse sequelae. These include SNPs in genes encoding for pathogen recognition and immune response upon infection. Accordingly, a secondary objective of this study is to investigate the role of genetic variation in BM and use any insights to predict short- and long-term outcomes. Methods In the Dutch 20|30 Postmeningitis study, adolescents and young adults (n = 947) from two historical cohorts with a prior episode of BM during childhood will be enrolled into a cross-sectional follow-up investigation using mainly questionnaires that examine executive and behavioral functioning, health-related quality of life, subjective hearing, mood and sleeping disorders, academic performance, and economic self-sufficiency. The results will be compared to normative data by one-sample t-tests. Multivariable regression analysis will be used to assess for any associations with causative pathogens and severity of BM. Participants that complete the questionnaires will be approached to provide a swab for buccal DNA and subsequent sequencing analyses. Logistic regression models will be used to predict sequelae. Discussion The unique follow-up duration of this cohort will enable us to gain insights into the possible very long-term adverse effects of childhood BM and how these might impact on quality of life. The investigation of host genetic factors will contribute to the development of prediction models which will serve as prognostic tools to identify children who are at high risk of adverse outcome after BM. Trial Registration Dutch Trial Register NTR-6891. Retrospectively registered 28 December 2017.
Collapse
Affiliation(s)
- O El Tahir
- Department of Pediatric Infectious Diseases and Immunology, AI&II, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - R C J de Jonge
- Department of Pediatric Surgery, Erasmus MC Rotterdam - Sophia Children's Hospital Pediatric Intensive Care Unit, Rotterdam, The Netherlands
| | - S Ouburg
- Department of Medical Microbiology and Infection Control, Laboratory of Immunogenetics VU University Medical Center, Amsterdam, The Netherlands
| | - S A Morré
- Department of Genetics and Cell Biology, Institute for Public Health Genomics (IPHG), Research School GROW (School for Oncology & Developmental Biology), Faculty of Health, Medicine & Life Sciences, University of Maastricht, Maastricht, The Netherlands
| | - A M van Furth
- Department of Pediatric Infectious Diseases and Immunology, AI&II, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
22
|
Viljakainen H, Dahlström E, Figueiredo R, Sandholm N, Rounge TB, Weiderpass E. Genetic risk score predicts risk for overweight and obesity in Finnish preadolescents. Clin Obes 2019; 9:e12342. [PMID: 31595703 PMCID: PMC6900004 DOI: 10.1111/cob.12342] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 09/04/2019] [Indexed: 12/12/2022]
Abstract
Common genetic variants predispose to obesity with varying contribution by age. We incorporated known genetic variants into genetic risk scores (GRSs) and investigated their associations with overweight/obesity and central obesity in preadolescents. Furthermore, we compared GRSs with lifestyle factors, and tested if they predict the change in body size and shape in a 4-year follow-up. We utilized 1142 subjects from the Finnish Health in Teens (Fin-HIT) cohort. Overweight and obesity were defined with age- and gender-specific body mass index (BMI) z-score (BMIz), while central obesity by the waist-to-height ratio (WHtR). Background data on parental language, eating habits, leisure-time physical activity (LTPA) and sleep duration were included. Genotyping was performed with the Metabochip platform. Weighted, standardized GRSs were derived. Of the11-year-old children, 25.5% were at least overweight and 90.8% had Finnish speaking background. BMI-GRS was associated with higher risk for overweight with odds ratio (95% confidence interval) of 1.39 (1.20; 1.60) and obesity 1.41 (1.08; 1.83), but not with central obesity. BMI-GRS was weakly and inversely associated with the changes in BMIz and WHtR in the 4-year follow-up. Waist-to-hip ratio-GRS was not related to any obesity measures at baseline nor in the follow-up. The effect of BMI-GRS is similar to that of low LTPA on overweight. An interaction between parental language and BMI-GRS was noted (P = .019): BMI-GRS associated more strongly with overweight in Swedish than in Finnish speakers. We further identified two suggestive genetic variants near LOC101926977 and LOC105369677 associated with BMIz in preadolescents which were replicated in the adult population. In preadolescents, known genetic predisposing factors induce a risk for overweight comparable to low LTPA. However, the GRS was poor in predicting short-term changes in BMI or WHtR.
Collapse
Affiliation(s)
- Heli Viljakainen
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Emma Dahlström
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Department of Nephrology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Rejane Figueiredo
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Niina Sandholm
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Department of Nephrology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Trine B Rounge
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Department of Research, Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Elisabete Weiderpass
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
- Department of Research, Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
23
|
Saijo Y, Ito Y, Yoshioka E, Sato Y, Minatoya M, Araki A, Miyashita C, Kishi R. Identifying a risk score for childhood obesity based on predictors identified in pregnant women and 1-year-old infants: An analysis of the data of the Hokkaido Study on Environment and Children's Health. Clin Pediatr Endocrinol 2019; 28:81-89. [PMID: 31384099 PMCID: PMC6646240 DOI: 10.1297/cpe.28.81] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/10/2019] [Indexed: 11/25/2022] Open
Abstract
This study aimed to construct a childhood obesity risk index based on predictors
identified in pregnant women and 1-yr-old infants. The primary outcome was an identified
obesity index of > 20% at 6–8 yr of age. Of a total sample size of 6,846 mother-child
pairs, 80% and 20% were randomly allocated to the derivation and validation cohorts,
respectively. For the derivation cohort, univariate and multivariate logistic regression
analyses of data were conducted to identify the final predictors to determine the
childhood obesity risk score algorithm. These included pre-pregnancy body mass index
(BMI), child’s gender, smoking during pregnancy, education, and obesity index at one yr of
age. The β coefficients for categories of predictor variables were each divided by the
smallest value among them. The quotient was rounded off to the integer and assigned to the
risk score, and a value of zero was assigned to reference categories. A total risk score
was calculated for each individual. A cutoff point ≥ 16 had 22.2% and 21.8% positive
predictive values in the derivation and validation cohorts, respectively. In conclusion,
the childhood obesity risk score algorithm was constructed based on generic predictors
that can be easily obtained from maternal and child health handbooks.
Collapse
Affiliation(s)
- Yasuaki Saijo
- Department of Social Medicine, Asahikawa Medical University, Sapporo, Japan
| | - Yoshiya Ito
- Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Sapporo, Japan
| | - Eiji Yoshioka
- Department of Social Medicine, Asahikawa Medical University, Sapporo, Japan
| | - Yukihiro Sato
- Department of Social Medicine, Asahikawa Medical University, Sapporo, Japan
| | - Machiko Minatoya
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan.,Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Atsuko Araki
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| |
Collapse
|
24
|
Kopanitsa G, Dudchenko A, Ganzinger M. Machine Learning Algorithms in Cardiology Domain: A Systematic Review (Preprint). JMIR Med Inform 2019. [DOI: 10.2196/14784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
25
|
Jiménez-Osorio AS, Aguilar-Lucio AO, Cárdenas-Hernández H, Musalem-Younes C, Solares-Tlapechco J, Costa-Urrutia P, Medina-Contreras O, Granados J, Rodríguez-Arellano ME. Polymorphisms in Adipokines in Mexican Children with Obesity. Int J Endocrinol 2019; 2019:4764751. [PMID: 31354816 PMCID: PMC6634012 DOI: 10.1155/2019/4764751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 04/10/2019] [Accepted: 04/16/2019] [Indexed: 12/22/2022] Open
Abstract
The high prevalence of childhood obesity in Mexico is alarming in the health-science field. We propose to investigate the contribution of adipokines and cytokines polymorphisms and common BMI/obesity-associated loci, revealed in genome-wide association studies in Caucasian adult cohorts, with childhood obesity. This study included 773 Mexican-Mestizo children (5-15 years old) in a case-control study. The polymorphisms included were ADIPOQ (rs6444174), TNF-α (rs1800750), IL-1β (rs1143643), IL-6 (rs1524107; rs2069845), NEGR1 (rs34305371), SEC16B-RASAL2 (rs10913469), TMEM18 (rs6548238; rs7561317), GNPDA2 (rs16857402), LEP (rs2167270), MTCH2 (rs10838738), LGR4-LIN7C-BDNF (rs925946), BCDIN3D-FAIM2 (rs7138803), FTO (rs62033400), MC4R (rs11872992), MC4R (rs17782313), and KCTD15 (rs29942). No significant contribution was found with adipokines and cytokines polymorphisms in this study. Only both TMEM18 (rs6548238; rs7561317) polymorphisms were found associated with obesity (OR=0.5, P=0.008) and were in linkage disequilibrium (r2=0.87). The linear regression showed that the rs7561317 polymorphism of TMEM18 is negatively associated with obesity. This report highlights the influence of TMEM18 in Mexican-Mestizo children obesity, while adipokine and cytokine polymorphisms were not associated with it.
Collapse
Affiliation(s)
- Angélica Saraí Jiménez-Osorio
- Laboratorio de Medicina Genómica del Hospital Regional Lic, Adolfo López Mateos, ISSSTE, Av. Universidad 1321, Florida, C.P. 01030, Álvaro Obregón, Mexico City, Mexico
| | - Alma Olivia Aguilar-Lucio
- Servicio de Neonatología del Hospital Regional Lic, Adolfo López Mateos, ISSSTE, Av. Universidad 1321, Florida, C.P. 01030, Álvaro Obregón, Mexico City, Mexico
| | - Helios Cárdenas-Hernández
- Laboratorio de Medicina Genómica del Hospital Regional Lic, Adolfo López Mateos, ISSSTE, Av. Universidad 1321, Florida, C.P. 01030, Álvaro Obregón, Mexico City, Mexico
| | - Claudette Musalem-Younes
- Laboratorio de Medicina Genómica del Hospital Regional Lic, Adolfo López Mateos, ISSSTE, Av. Universidad 1321, Florida, C.P. 01030, Álvaro Obregón, Mexico City, Mexico
| | - Jacqueline Solares-Tlapechco
- Laboratorio de Medicina Genómica del Hospital Regional Lic, Adolfo López Mateos, ISSSTE, Av. Universidad 1321, Florida, C.P. 01030, Álvaro Obregón, Mexico City, Mexico
| | - Paula Costa-Urrutia
- Laboratorio de Medicina Genómica del Hospital Regional Lic, Adolfo López Mateos, ISSSTE, Av. Universidad 1321, Florida, C.P. 01030, Álvaro Obregón, Mexico City, Mexico
| | - Oscar Medina-Contreras
- Laboratorio de Medicina Genómica del Hospital Regional Lic, Adolfo López Mateos, ISSSTE, Av. Universidad 1321, Florida, C.P. 01030, Álvaro Obregón, Mexico City, Mexico
- Laboratorio de Investigación en Inmunología y Proteómica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Julio Granados
- Laboratorio de Medicina Genómica del Hospital Regional Lic, Adolfo López Mateos, ISSSTE, Av. Universidad 1321, Florida, C.P. 01030, Álvaro Obregón, Mexico City, Mexico
- División de Inmunogenética, Departamento de Trasplantes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, C.P. 14080, Mexico City, Mexico
| | - Martha Eunice Rodríguez-Arellano
- Laboratorio de Medicina Genómica del Hospital Regional Lic, Adolfo López Mateos, ISSSTE, Av. Universidad 1321, Florida, C.P. 01030, Álvaro Obregón, Mexico City, Mexico
| |
Collapse
|
26
|
Wang HY, Chang SC, Lin WY, Chen CH, Chiang SH, Huang KY, Chu BY, Lu JJ, Lee TY. Machine Learning-Based Method for Obesity Risk Evaluation Using Single-Nucleotide Polymorphisms Derived from Next-Generation Sequencing. J Comput Biol 2018; 25:1347-1360. [DOI: 10.1089/cmb.2018.0002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Hsin-Yao Wang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
- Ph.D. Program in Biomedical Engineering, Chang Gung University, Taoyuan City, Taiwan
| | - Shih-Cheng Chang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Wan-Ying Lin
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Chun-Hsien Chen
- Department of Information Management, Chang Gung University, Taoyuan City, Taiwan
| | - Szu-Hsien Chiang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Kai-Yao Huang
- Department of Medical Research, Hsinchu Mackay Memorial Hospital, Hsinchu City, Taiwan
| | - Bo-Yu Chu
- Department of Computer Science and Engineering, Yuan Ze University, Taoyuan City, Taiwan
| | - Jang-Jih Lu
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Tzong-Yi Lee
- Department of Computer Science and Engineering, Yuan Ze University, Taoyuan City, Taiwan
- Warshel Institute for Computational Biology, The Chinese University of Hong Kong, Shenzhen, China
- School of Science and Engineering, The Chinese University of Hong Kong, Shenzhen, China
| |
Collapse
|
27
|
Ghalem M, Murtaza B, Belarbi M, Akhtar Khan N, Hichami A. Antiinflammatory and antioxidant activities of a polyphenol‐rich extract from
Zizyphus lotus
L fruit pulp play a protective role against obesity. J Food Biochem 2018. [DOI: 10.1111/jfbc.12689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Meriem Ghalem
- Physiologie de la Nutrition & Toxicologie (NUTox), UMR INSERM U1231 Lipides Université de Bourgogne Franche‐Comté Dijon France
- Laboratoire des Substances Naturelles et Bioactives (LASNABIO) University of Abou‐Bekr Belkaid Tlemcen Algeria
| | - Babar Murtaza
- Physiologie de la Nutrition & Toxicologie (NUTox), UMR INSERM U1231 Lipides Université de Bourgogne Franche‐Comté Dijon France
| | - Meriem Belarbi
- Laboratory of Natural Products University of Abou‐Bekr Belkaid Tlemcen Algeria
| | - Naim Akhtar Khan
- Physiologie de la Nutrition & Toxicologie (NUTox), UMR INSERM U1231 Lipides Université de Bourgogne Franche‐Comté Dijon France
| | - Aziz Hichami
- Physiologie de la Nutrition & Toxicologie (NUTox), UMR INSERM U1231 Lipides Université de Bourgogne Franche‐Comté Dijon France
| |
Collapse
|
28
|
Clinical relevance and validity of tools to predict infant, childhood and adulthood obesity: a systematic review. Public Health Nutr 2018; 21:3135-3147. [PMID: 29996950 DOI: 10.1017/s1368980018001684] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To determine the global availability of a multicomponent tool predicting overweight/obesity in infancy, childhood, adolescence or adulthood; and to compare their predictive validity and clinical relevance.Design/SettingThe PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. The databases PubMed, EMBASE, CINAHL, Web of Science and PsycINFO were searched. Additional articles were identified via reference lists of included articles. Risk of bias was assessed using the Academy of Nutrition and Dietetics' Quality Criteria Checklist. The National Health and Medical Research Council's Levels of Evidence hierarchy was used to assess quality of evidence. Predictive performance was evaluated using the ABCD framework. SUBJECTS Eligible studies: tool could be administered at any life stage; quantified the risk of overweight/obesity onset; used more than one predictor variable; and reported appropriate prediction statistical outcomes. RESULTS Of the initial 4490 articles identified, twelve articles (describing twelve tools) were included. Most tools aimed to predict overweight and/or obesity within childhood (age 2-12 years). Predictive accuracy of tools was consistently adequate; however, the predictive validity of most tools was questioned secondary to poor methodology and statistical reporting. Globally, five tools were developed for dissemination into clinical practice, but no tools were tested within a clinical setting. CONCLUSIONS To our knowledge, a clinically relevant and highly predictive overweight/obesity prediction tool is yet to be developed. Clinicians can, however, act now to identify the strongest predictors of future overweight/obesity. Further research is necessary to optimise the predictive strength and clinical applicability of such a tool.
Collapse
|
29
|
Rosso N, Giabbanelli P. Accurately Inferring Compliance to Five Major Food Guidelines Through Simplified Surveys: Applying Data Mining to the UK National Diet and Nutrition Survey. JMIR Public Health Surveill 2018; 4:e56. [PMID: 29848474 PMCID: PMC6000477 DOI: 10.2196/publichealth.9536] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/07/2018] [Accepted: 04/13/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND National surveys in public health nutrition commonly record the weight of every food consumed by an individual. However, if the goal is to identify whether individuals are in compliance with the 5 main national nutritional guidelines (sodium, saturated fats, sugars, fruit and vegetables, and fats), much less information may be needed. A previous study showed that tracking only 2.89% of all foods (113/3911) was sufficient to accurately identify compliance. Further reducing the data needs could lower participation burden, thus decreasing the costs for monitoring national compliance with key guidelines. OBJECTIVE This study aimed to assess whether national public health nutrition surveys can be further simplified by only recording whether a food was consumed, rather than having to weigh it. METHODS Our dataset came from a generalized sample of inhabitants in the United Kingdom, more specifically from the National Diet and Nutrition Survey 2008-2012. After simplifying food consumptions to a binary value (1 if an individual consumed a food and 0 otherwise), we built and optimized decision trees to find whether the foods could accurately predict compliance with the major 5 nutritional guidelines. RESULTS When using decision trees of a similar size to previous studies (ie, involving as many foods), we were able to correctly infer compliance for the 5 guidelines with an average accuracy of 80.1%. This is an average increase of 2.5 percentage points over a previous study, showing that further simplifying the surveys can actually yield more robust estimates. When we allowed the new decision trees to use slightly more foods than in previous studies, we were able to optimize the performance with an average increase of 3.1 percentage points. CONCLUSIONS Although one may expect a further simplification of surveys to decrease accuracy, our study found that public health dietary surveys can be simplified (from accurately weighing items to simply checking whether they were consumed) while improving accuracy. One possibility is that the simplification reduced noise and made it easier for patterns to emerge. Using simplified surveys will allow to monitor public health nutrition in a more cost-effective manner and possibly decrease the number of errors as participation burden is reduced.
Collapse
Affiliation(s)
- Nicholas Rosso
- Data Analytics for Complex Human Behaviors Laboratory, Computer Science Department, Northern Illinois University, DeKalb, IL, United States
| | - Philippe Giabbanelli
- Data Analytics for Complex Human Behaviors Laboratory, Department of Computer Science, Furman University, Greenville, SC, United States
| |
Collapse
|
30
|
Belsky DW. Translating Polygenic Analysis for Prevention: From Who to How. CIRCULATION. CARDIOVASCULAR GENETICS 2017; 10:CIRCGENETICS.117.001798. [PMID: 28620073 DOI: 10.1161/circgenetics.117.001798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Daniel W Belsky
- From the Department of Medicine, Duke University School of Medicine and Center for Population Health Science and Population Research Institute, Duke University.
| |
Collapse
|