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Hauser JA, Burden SJ, Karunakaran A, Muthurangu V, Taylor AM, Jones A. Whole-Body Magnetic Resonance Imaging Assessment of the Contributions of Adipose and Nonadipose Tissues to Cardiovascular Remodeling in Adolescents. J Am Heart Assoc 2023; 12:e030221. [PMID: 37489750 PMCID: PMC10492986 DOI: 10.1161/jaha.123.030221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/27/2023] [Indexed: 07/26/2023]
Abstract
Background Greater body mass index is associated with cardiovascular remodeling in adolescents. However, body mass index cannot differentiate between adipose and nonadipose tissues. We examined how visceral and subcutaneous adipose tissue are linked with markers of early cardiovascular remodeling, independently from nonadipose tissue. Methods and Results Whole-body magnetic resonance imaging was done in 82 adolescents (39 overweight/obese; 36 female; median age, 16.3 [interquartile range, 14.4-18.1] years) to measure body composition and cardiovascular remodeling markers. Left ventricular diastolic function was assessed by echocardiography. Waist, waist:height ratio, and body mass index z scores were calculated. Residualized nonadipose tissue, subcutaneous adipose tissue, and visceral adipose tissue variables, uncorrelated with each other, were constructed using partial regression modeling to allow comparison of their individual contributions in a 3-compartment body composition model. Cardiovascular variables mostly related to nonadipose rather than adipose tissue. Nonadipose tissue was correlated positively with left ventricular mass (r=0.81), end-diastolic volume (r=0.70), stroke volume (r=0.64), left ventricular mass:end-diastolic volume (r=0.37), and systolic blood pressure (r=0.35), and negatively with heart rate (r=-0.33) (all P<0.01). Subcutaneous adipose tissue was associated with worse left ventricular diastolic function (r=-0.42 to -0.48, P=0.0007-0.02) and higher heart rates (r=0.34, P=0.007) but linked with better systemic vascular resistance (r=-0.35, P=0.006). There were no significant relationships with visceral adipose tissue and no associations of any compartment with pulse wave velocity. Conclusions Simple anthropometry does not reflect independent effects of nonadipose tissue and subcutaneous adipose tissue on the adolescent cardiovascular system. This could result in normal cardiovascular adaptations to growth being misinterpreted as pathological sequelae of excess adiposity in studies reliant on such measures.
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Affiliation(s)
- Jakob A. Hauser
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
| | - Samuel J. Burden
- Department of PaediatricsUniversity of Oxford, John Radcliffe HospitalOxfordUnited Kingdom
- Department of Women and Children’s HealthKing’s College London, St Thomas’ HospitalLondonUnited Kingdom
| | - Ajanthiha Karunakaran
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
| | - Vivek Muthurangu
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
| | - Andrew M. Taylor
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
- Great Ormond Street Hospital for Children NHS Foundation TrustLondonUnited Kingdom
| | - Alexander Jones
- Centre for Translational Cardiovascular ImagingUniversity College LondonLondonUnited Kingdom
- Department of PaediatricsUniversity of Oxford, John Radcliffe HospitalOxfordUnited Kingdom
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2
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Qu Y, Liu J, Li J, Shen S, Chen X, Tang H, Yuan Y, Xia C, Deng L, Chen G, Zheng T, Chen J, Nie L, Yuan F, Tong N, Peng L, Song B. Association of abdominal adiposity, hepatic shear stiffness with subclinical left-ventricular remodeling evaluated by magnetic resonance in adults free of overt cardiovascular diseases: a prospective study. Cardiovasc Diabetol 2023; 22:99. [PMID: 37120545 PMCID: PMC10149007 DOI: 10.1186/s12933-023-01828-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 04/06/2023] [Indexed: 05/01/2023] Open
Abstract
BACKGROUND Abdominal ectopic fat deposition and excess visceral fat depots in obesity may be related to cardiovascular disease (CVD) as both are involved in the metabolic syndrome (MetS). The awareness of the link between abdominal adiposity and subclinical cardiac remodeling would help improve treatment and outcome. Besides, liver fibrosis has also shown a potential relationship with cardiac dysfunction. Thus, we aimed to investigate the associations of magnetic resonance (MR)-based abdominal adiposity and hepatic shear stiffness with subclinical left ventricular (LV) remodeling while taking account of MetS-related confounders in adults free of overt CVD. METHODS This was an exploratory, prospective study of 88 adults (46 subjects with obesity, 42 healthy controls) who underwent 3 T cardiac and body MR exams. Measures of abdominal MR included hepatic and pancreatic proton density fat fraction (H-PDFF and P-PDFF), hepatic shear stiffness by MR elastography, and subcutaneous and visceral adipose tissue (SAT and VAT). Cardiac measures included epicardial adipose tissue (EAT) and parameters of LV geometry and function. Associations were assessed using Pearson correlation and multivariable linear regression analyses, in which age, sex, and MetS-related confounders were adjusted for. RESULTS The LV ejection fractions of all participants were within the normal range. Higher H-PDFF, P-PDFF, SAT and VAT were independently associated with lower LV global myocardial strain parameters (radial, circumferential and longitudinal peak strain [PS], longitudinal peak systolic strain rate and diastolic strain rate) (β = - 0.001 to - 0.41, p < 0.05), and P-PDFF, SAT and VAT were independently and positively associated with LV end-diastolic volume and stroke volume (β = 0.09 to 3.08, p ≤ 0.02) in the over-all cohort. In the obesity subgroup, higher P-PDFF and VAT were independently associated with lower circumferential and longitudinal PS, respectively (β = - 0.29 to - 0.05, p ≤ 0.01). No independent correlation between hepatic shear stiffness and EAT or LV remodeling was found (all p ≥ 0.05). CONCLUSIONS Ectopic fat depositions in the liver and pancreas, and excess abdominal adipose tissue pose a risk of subclinical LV remodeling beyond MetS-related CVD risk factors in adults without overt CVD. VAT may play a more considerable role as a risk factor for subclinical LV dysfunction than does SAT in individuals with obesity. The underlying mechanisms of these associations and their longitudinal clinical implications need further investigation.
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Affiliation(s)
- Yali Qu
- Department of Radiology, West China Hospital of Sichuan University, Sichuan, Chengdu, China
| | - Jing Liu
- Department of Radiology, West China Hospital of Sichuan University, Sichuan, Chengdu, China
| | - Jing Li
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Sumin Shen
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaoyi Chen
- Department of Radiology, West China Hospital of Sichuan University, Sichuan, Chengdu, China
| | - Hehan Tang
- Department of Radiology, West China Hospital of Sichuan University, Sichuan, Chengdu, China
| | - Yuan Yuan
- Department of Radiology, West China Hospital of Sichuan University, Sichuan, Chengdu, China
| | - Chunchao Xia
- Department of Radiology, West China Hospital of Sichuan University, Sichuan, Chengdu, China
| | - Liping Deng
- Department of Radiology, West China Hospital of Sichuan University, Sichuan, Chengdu, China
| | - Guoyong Chen
- Department of Radiology, West China Hospital of Sichuan University, Sichuan, Chengdu, China
| | - Tianying Zheng
- Department of Radiology, West China Hospital of Sichuan University, Sichuan, Chengdu, China
| | - Jie Chen
- Department of Radiology, West China Hospital of Sichuan University, Sichuan, Chengdu, China
| | - Lisha Nie
- GE Healthcare, MR Research China, Beijing, China
| | - Fang Yuan
- Department of Radiology, West China Hospital of Sichuan University, Sichuan, Chengdu, China
| | - Nanwei Tong
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Liqing Peng
- Department of Radiology, West China Hospital of Sichuan University, Sichuan, Chengdu, China.
| | - Bin Song
- Department of Radiology, West China Hospital of Sichuan University, Sichuan, Chengdu, China.
- Department of Radiology, Sanya People's Hospital, Hainan, Sanya, China.
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3
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Marciniak M, van Deutekom AW, Toemen L, Lewandowski AJ, Gaillard R, Young AA, Jaddoe VWV, Lamata P. A three-dimensional atlas of child's cardiac anatomy and the unique morphological alterations associated with obesity. Eur Heart J Cardiovasc Imaging 2022; 23:1645-1653. [PMID: 34931224 PMCID: PMC9671403 DOI: 10.1093/ehjci/jeab271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
AIMS Statistical shape models (SSMs) of cardiac anatomy provide a new approach for analysis of cardiac anatomy. In adults, specific cardiac morphologies associate with cardiovascular risk factors and early disease stages. However, the relationships between morphology and risk factors in children remain unknown. We propose an SSM of the paediatric left ventricle to describe its morphological variability, examine its relationship with biometric parameters and identify adverse anatomical remodelling associated with obesity. METHODS AND RESULTS This cohort includes 2631 children (age 10.2 ± 0.6 years), mostly Western European (68.3%) with a balanced sex distribution (51.3% girls) from Generation R study. Cardiac magnetic resonance short-axis cine scans were segmented. Three-dimensional left ventricular (LV) meshes are automatically fitted to the segmentations to reconstruct the anatomies. We analyse the relationships between the LV anatomical features and participants' body surface area (BSA), age, and sex, and search for features uniquely related to obesity based on body mass index (BMI). In the SSM, 19 modes described over 90% of the population's LV shape variability. Main modes of variation were related to cardiac size, sphericity, and apical tilting. BSA, age, and sex were mostly correlated with modes describing LV size and sphericity. The modes correlated uniquely with BMI suggested that obese children present with septo-lateral tilting (R2 = 4.0%), compression in the antero-posterior direction (R2 = 3.3%), and decreased eccentricity (R2 = 2.0%). CONCLUSIONS We describe the variability of the paediatric heart morphology and identify anatomical features related to childhood obesity that could aid in risk stratification. Web service is released to provide access to the new shape parameters.
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Affiliation(s)
- Maciej Marciniak
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, Kings’ College London, 5th Floor Becket House, Lambeth Palace Road, London SE1 7EU, UK
| | - Arend W van Deutekom
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Paediatrics, Generation R Study Group, Erasmus MC, University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Cardiovascular Clinical Research Facility, University of Oxford, Level 1 Oxford Heart Centre, John Radliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK
| | - Liza Toemen
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Paediatrics, Generation R Study Group, Erasmus MC, University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Adam J Lewandowski
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford Cardiovascular Clinical Research Facility, University of Oxford, Level 1 Oxford Heart Centre, John Radliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK
| | - Romy Gaillard
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Paediatrics, Generation R Study Group, Erasmus MC, University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
| | - Alistair A Young
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, Kings’ College London, 5th Floor Becket House, Lambeth Palace Road, London SE1 7EU, UK
| | - Vincent W V Jaddoe
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
- Department of Paediatrics, Generation R Study Group, Erasmus MC, University Medical Center, Wytemaweg 80, 3015 CN Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
| | - Pablo Lamata
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, Kings’ College London, 5th Floor Becket House, Lambeth Palace Road, London SE1 7EU, UK
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4
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Wu Y, Li Z, Du B, Ye Y, Wang H, Niu Y, Chen S, Wu Y, Jin H, Zhang X, Wang J, Sun K. Different Associations of Systolic Blood Pressure and Body Mass Index With Cardiac Structure and Function in Young Children. Hypertension 2022; 79:2583-2592. [DOI: 10.1161/hypertensionaha.122.19396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Both elevated systolic blood pressure (SBP) and excess weight can lead to early cardiovascular organ damage in children. In this study, we investigated whether there is a difference in the associations of SBP and body mass index (BMI) with cardiovascular structure and function in 4-year-old children.
Methods:
In 1474 children (52.3% males) from the Shanghai Birth Cohort, physical examination and echocardiography were performed. Standardized linear regression models were used to evaluate the associations of BMI
Z
score and SBP
Z
score with cardiovascular parameters and to compare the strengths of these associations.
Results:
The incidence of SBP elevation significantly increased in overweight children. SBP was positively related to heart rate, left ventricular (LV) ejection fraction and fraction shortening (β=1.824 [95% CI, 1.014–2.634], 0.579 [0.294–0.864], and 0.480 [0.257–0.704], respectively). BMI
Z
score was positively associated with LV mass index (β=1.225 [0.863–1.587]) and the risk of LV hypertrophy (odds ratio=1.428 [1.157–1.761]) but negatively related to measures of systolic function, including LV ejection fraction, LV fraction short, and global longitudinal strain (β=−0.417 [−0.735 to −0.099], −0.302 [−0.551 to −0.053], and −0.392 [−0.621 to −0.163], respectively). No noteworthy additive or multiplicative interactions between BMI and SBP were detected.
Conclusions:
Elevations in both BMI and SBP were related to cardiac structure and function in children as young as 4 years old. Elevated SBP was associated with increased heart rate and LV ejection at the early stage of BP elevation. BMI showed a closer relationship with left heart diameters and geometry than SBP.
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Affiliation(s)
- Yujian Wu
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Zhuoyan Li
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Bowen Du
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Yujiao Ye
- Children's Heart Center, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, China (Y.Y.)
| | - Hualin Wang
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Yiwei Niu
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Sun Chen
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Yurong Wu
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Hong Jin
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health (H.J.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Xi Zhang
- Clinical Research Unit (X.Z.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Jian Wang
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Kun Sun
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
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5
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Campos JO, Barros MAV, Oliveira TLPSA, Nobre IG, de Morais AS, Santos MAM, Leandro CG, Costa-Silva JH. Cardiac autonomic dysfunction in school age children with overweight and obesity. Nutr Metab Cardiovasc Dis 2022; 32:2410-2417. [PMID: 35872100 DOI: 10.1016/j.numecd.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 06/10/2022] [Accepted: 06/10/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS We investigated cardiac autonomic function in overweight and obese school-age children. METHODS AND RESULTS Quantitative cross-sectional study conducted with children (n = 110) of both genders. Children were divided by normal weight (NW; n = 54), overweight (OW; n = 24) and obese (OB; n = 32). Systolic (SBP) and diastolic (DBP) blood pressure and electrocardiograms were recorded and analyzed for heart rate and the heart rate variability (HRV) in time (SDRR, RMSSD, PRR50, SD1 and SD2) and frequency domains (HF, LF and LF/HF). The OB group presented higher SBP (p ≤ 0.01) and DBP (p ≤ 0.01). For HRV, the OB group had a lower PRR50 (p ≤ 0.01) and HF (p ≤ 0.01), associated with higher LF (p ≤ 0.01). Moderate negative correlations were found between the HF, BMI (r = -0.37; p ≤ 0.01) and WC (r = -0.38; p ≤ 0.01). Positive moderate correlation were found between LF, LF/HF and BMI (LF: r = 0.32; p ≤ 0.01; LF/HF: r = 0.31; p ≤ 0.01) and WC (LF: r = 0.34; p ≤ 0.01; LF/HF: = 0.34; p ≤ 0.01). Multiple linear regression showed a positive association between body fat and the SDRR (β: 0.48; CI: 0.2-4.2; p = 0.02). No differences were observed in cardiac electrical activity. CONCLUSION Children with obesity but not overweight presented higher blood pressure and cardiac autonomic dysfunction, with sympathetic predominance on the heart rate. This fact was positively correlated with BMI and may be considered an important marker for cardiovascular risk in children.
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Affiliation(s)
- Jéssica O Campos
- Laboratory of Nutrition, Physical Activity and Phenotypic Plasticity, Academic Center of Vitória, Universidade Federal de Pernambuco, UFPE, Vitória de Santo Antão, PE, Brazil; Laboratory of Physical Evaluation and Signal Processing, Academic Center of Vitória, Universidade Federal de Pernambuco, UFPE, Vitória de Santo Antão, PE, Brazil
| | - Monique A V Barros
- Laboratory of Nutrition, Physical Activity and Phenotypic Plasticity, Academic Center of Vitória, Universidade Federal de Pernambuco, UFPE, Vitória de Santo Antão, PE, Brazil; Laboratory of Physical Evaluation and Signal Processing, Academic Center of Vitória, Universidade Federal de Pernambuco, UFPE, Vitória de Santo Antão, PE, Brazil
| | - Tafnes L P S A Oliveira
- Laboratory of Physical Evaluation and Signal Processing, Academic Center of Vitória, Universidade Federal de Pernambuco, UFPE, Vitória de Santo Antão, PE, Brazil
| | - Isabele G Nobre
- Laboratory of Physical Evaluation and Signal Processing, Academic Center of Vitória, Universidade Federal de Pernambuco, UFPE, Vitória de Santo Antão, PE, Brazil
| | - André S de Morais
- Academic Center of Agreste, Universidade Federal de Pernambuco, UFPE, Caruaru PE, Brazil
| | - Marcos A M Santos
- Superior School of Physical Education, Universidade de Pernambuco, Recife, PE, Brazil
| | - Carol G Leandro
- Laboratory of Nutrition, Physical Activity and Phenotypic Plasticity, Academic Center of Vitória, Universidade Federal de Pernambuco, UFPE, Vitória de Santo Antão, PE, Brazil; Laboratory of Physical Evaluation and Signal Processing, Academic Center of Vitória, Universidade Federal de Pernambuco, UFPE, Vitória de Santo Antão, PE, Brazil
| | - João H Costa-Silva
- Laboratory of Nutrition, Physical Activity and Phenotypic Plasticity, Academic Center of Vitória, Universidade Federal de Pernambuco, UFPE, Vitória de Santo Antão, PE, Brazil; Laboratory of Physical Evaluation and Signal Processing, Academic Center of Vitória, Universidade Federal de Pernambuco, UFPE, Vitória de Santo Antão, PE, Brazil. /
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6
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Monasso GS, Santos S, Silva CCV, Geurtsen ML, Oei E, Gaillard R, Felix JF, Jaddoe VWV. Body fat, pericardial fat, liver fat and arterial health at age 10 years. Pediatr Obes 2022; 17:e12926. [PMID: 35509243 PMCID: PMC9541379 DOI: 10.1111/ijpo.12926] [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: 12/06/2021] [Revised: 04/14/2022] [Accepted: 04/21/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Body mass index is associated with carotid intima-media thickness and distensibility in adults and children. OBJECTIVE To examine whether general and specific fat depots are associated with these markers of arterial health at school age. METHODS This cross-sectional analysis was embedded in a population-based prospective cohort study among 4708 children aged 10 years. Body, lean and fat mass index were estimated by dual-energy X-ray absorptiometry. Pericardial, visceral and liver fat were estimated by magnetic resonance imaging. Carotid intima-media thickness and distensibility were measured by ultrasound. RESULTS A 1-standard-deviation-score (SDS) higher body mass index was associated with higher carotid intima-media thickness (0.06 SDS, 95% confidence interval [CI]: 0.03-0.08) and lower distensibility (-0.17 SDS, 95% CI: -0.20 to -0.14). These associations tended to be similar for lean mass index. A 1-SDS higher fat mass index was associated with lower carotid intima-media thickness (-0.08 SDS, 95% CI: -0.11 to -0.05) and lower distensibility (-0.10 SDS, 95% CI: -0.14 to -0.07). A 1-SDS higher liver fat fraction was associated with lower carotid intima-media thickness (-0.04 SDS, 95% CI: -0.08 to -0.00) and lower distensibility (-0.06 SDS, 95% CI: -0.10 to -0.03). We observed similar associations for visceral fat. CONCLUSIONS At school age, lean and fat mass seem to be differentially related to carotid intima-media thickness but not distensibility. Arterial development might be affected by lean mass, general and specific fat mass.
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Affiliation(s)
- Giulietta S. Monasso
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands,Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands,Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands
| | - Carolina C. V. Silva
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands,Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands
| | - Madelon L. Geurtsen
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands,Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands
| | - Edwin Oei
- Department of Radiology and Nuclear Medicine, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands
| | - Romy Gaillard
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands,Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands
| | - Janine F. Felix
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands,Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands,Department of Pediatrics, Erasmus MCUniversity Medical Center RotterdamRotterdamthe Netherlands
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7
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O’Nunain K, Park C, Urquijo H, Leyden GM, Hughes AD, Davey Smith G, Richardson TG. A lifecourse mendelian randomization study highlights the long-term influence of childhood body size on later life heart structure. PLoS Biol 2022; 20:e3001656. [PMID: 35679339 PMCID: PMC9182693 DOI: 10.1371/journal.pbio.3001656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/03/2022] [Indexed: 12/12/2022] Open
Abstract
Children with obesity typically have larger left ventricular heart dimensions during adulthood. However, whether this is due to a persistent effect of adiposity extending into adulthood is challenging to disentangle due to confounding factors throughout the lifecourse. We conducted a multivariable mendelian randomization (MR) study to separate the independent effects of childhood and adult body size on 4 magnetic resonance imaging (MRI) measures of heart structure and function in the UK Biobank (UKB) study. Strong evidence of a genetically predicted effect of childhood body size on all measures of adulthood heart structure was identified, which remained robust upon accounting for adult body size using a multivariable MR framework (e.g., left ventricular end-diastolic volume (LVEDV), Beta = 0.33, 95% confidence interval (CI) = 0.23 to 0.43, P = 4.6 × 10−10). Sensitivity analyses did not suggest that other lifecourse measures of body composition were responsible for these effects. Conversely, evidence of a genetically predicted effect of childhood body size on various other MRI-based measures, such as fat percentage in the liver (Beta = 0.14, 95% CI = 0.05 to 0.23, P = 0.002) and pancreas (Beta = 0.21, 95% CI = 0.10 to 0.33, P = 3.9 × 10−4), attenuated upon accounting for adult body size. Our findings suggest that childhood body size has a long-term (and potentially immutable) influence on heart structure in later life. In contrast, effects of childhood body size on other measures of adulthood organ size and fat percentage evaluated in this study are likely explained by the long-term consequence of remaining overweight throughout the lifecourse. Children with obesity typically have larger left ventricular heart dimensions during adulthood, but this is challenging to disentangle due to confounding factors throughout life. This study uses Mendelian randomization to provide evidence that being overweight in early life may indeed have a long-term influence on cardiac structure.
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Affiliation(s)
- Katie O’Nunain
- Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, United Kingdom
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Helena Urquijo
- Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, United Kingdom
| | - Genevieve M. Leyden
- Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, United Kingdom
- Bristol Medical School: Translational Health Sciences, Dorothy Hodgkin Building, University of Bristol, Bristol, United Kingdom
| | - Alun D. Hughes
- MRC Unit for Lifelong Health and Ageing at UCL, Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - George Davey Smith
- Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, United Kingdom
| | - Tom G. Richardson
- Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, United Kingdom
- Novo Nordisk Research Centre, Headington, Oxford, United Kingdom
- * E-mail:
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8
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Monasso GS, Silva CCV, Santos S, Goncalvez R, Gaillard R, Felix JF, Jaddoe VWV. Infant weight growth patterns, childhood BMI, and arterial health at age 10 years. Obesity (Silver Spring) 2022; 30:770-778. [PMID: 35142077 PMCID: PMC9302666 DOI: 10.1002/oby.23376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/26/2021] [Accepted: 12/14/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Associations of obesity with cardiovascular disease may originate in childhood. This study examined critical periods for BMI in relation to arterial health at school age. METHODS Among 4,731 children from a prospective cohort study, associations of infant peak weight velocity, both age and BMI at adiposity peak, and BMI trajectories with carotid artery intima-media thickness and carotid artery distensibility at 10 years were examined. RESULTS A 1-standard deviation score (SDS) higher peak weight velocity and BMI at adiposity peak were associated with higher intima-media thickness (0.10 SDS; 95% CI: 0.06 to 0.13 and 0.08 SDS; 95% CI: 0.05 to 0.12) and lower distensibility (-0.07 SDS; 95% CI: -0.10 to -0.03 and -0.07 SDS; 95% CI: -0.11 to -0.03) at 10 years. For distensibility, current BMI explained these associations. Children within the highest BMI tertile at ages 2 and 10 years had the lowest distensibility (p < 0.05), but similar intima-media thickness, compared with children constantly within the middle tertile. CONCLUSIONS Infant weight growth patterns and childhood BMI are associated with subtle differences in carotid intima-media thickness and carotid distensibility at school age. For distensibility, current BMI seems critical. Follow-up is needed to determine whether these associations lead to adult cardiovascular disease.
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Affiliation(s)
- Giulietta S. Monasso
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Carolina C. V. Silva
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Susana Santos
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Romy Goncalvez
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of Obstetrics and GynaecologyErasmus University Medical CenterRotterdamthe Netherlands
| | - Romy Gaillard
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Janine F. Felix
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study GroupErasmus University Medical CenterRotterdamthe Netherlands
- Department of PediatricsErasmus University Medical CenterRotterdamthe Netherlands
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9
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Causative Mechanisms of Childhood and Adolescent Obesity Leading to Adult Cardiometabolic Disease: A Literature Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app112311565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The past few decades have shown a worrisome increase in the prevalence of obesity and its related illnesses. This increasing burden has a noteworthy impact on overall worldwide mortality and morbidity, with significant economic implications as well. The same trend is apparent regarding pediatric obesity. This is a particularly concerning aspect when considering the well-established link between cardiovascular disease and obesity, and the fact that childhood obesity frequently leads to adult obesity. Moreover, most obese adults have a history of excess weight starting in childhood. In addition, given the cumulative character of both time and severity of exposure to obesity as a risk factor for associated diseases, the repercussions of obesity prevalence and related morbidity could be exponential in time. The purpose of this review is to outline key aspects regarding the current knowledge on childhood and adolescent obesity as a cardiometabolic risk factor, as well as the most common etiological pathways involved in the development of weight excess and associated cardiovascular and metabolic diseases.
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10
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Wang J, Wu Y, Du B, Li Z, Ye Y, Wang H, Niu Y, Chen Q, Zhang J, Chen S, Wu Y, Zhang X, Lu Y, Sun K. Growth patterns in early childhood and cardiovascular structure and function at 4 years old: A prospective cohort study. Nutr Metab Cardiovasc Dis 2021; 31:3492-3501. [PMID: 34625356 DOI: 10.1016/j.numecd.2021.08.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/31/2021] [Accepted: 08/06/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND AIMS Childhood overweight and obesity are lifetime risk factors for cardiovascular disease but the relationship between dynamic body mass index (BMI) change and cardiovascular structure and function in early childhood remains unclear. METHODS AND RESULTS This cohort study consisted 525 participants with 6 distinct representative growth patterns to examine the associations between BMI growth patterns and subsequent cardiovascular structure and function at age 4. BMIs were obtained at birth, 2 and 4 years old. Cardiovascular assessments were performed, including blood pressure (BP), cardiac geometric parameters, left ventricular (LV) function, speckle-tracking, integrated backscatter analysis and carotid intima-media thickness. Compared to the stable normal BMI pattern, children with the stable overweight (OW) pattern had significantly greater LV anatomic parameters in fully adjusted models. Children with the catch-up (CU) pattern revealed a uniform trend and had poorer strain. LV diameters and integrated backscatter signals were larger for those with BMI gain and lose pattern. Children with BMI lose pattern showed improved tendency involving LV mass index and BP. Both OW and CU patterns were associated with high systolic BP [odds ratio (95% CI): OW: 3.67 (1.08, 12.47); CU: 4.24 (1.75, 10.28)]. Compared to static BMI measurements at birth, 2 and 4 years old, dynamic BMI growth patterns were more predictive of cardiovascular structure and function at 4. CONCLUSIONS Children with overweight-related BMI growth patterns in early childhood experienced undesirable cardiovascular functional or structural changes as early as 4 years old, indicating that early intervention is needed and potentially beneficial.
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Affiliation(s)
- Jian Wang
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Yujian Wu
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Bowen Du
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Zhuoyan Li
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Yujiao Ye
- Children Heart Center, Sichuan Provincial Maternity and Child Health Care Hospital, 290 Shayan West Second Street, 610000 Chengdu, Sichuan Province, China
| | - Hualin Wang
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Yiwei Niu
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Qian Chen
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Sun Chen
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Yurong Wu
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China
| | - Xi Zhang
- Clinical Research Unit, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China.
| | - Yanan Lu
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China.
| | - Kun Sun
- Department of Pediatric Cardiology, Shanghai Jiao Tong University School of Medicine, Xinhua Hospital, 1655 Kongjiang Rd, 200092 Shanghai, China.
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11
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Kao TSA, Ling J, Hawn R, Vu C. The effects of motivational interviewing on children's body mass index and fat distributions: A systematic review and meta-analysis. Obes Rev 2021; 22:e13308. [PMID: 34170612 DOI: 10.1111/obr.13308] [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: 02/15/2021] [Revised: 04/29/2021] [Accepted: 05/25/2021] [Indexed: 12/01/2022]
Abstract
Currently, the effects of motivational interviewing (MI) on children's anthropometric changes remain unclear. This systematic review and meta-analysis examined the effects of MI on children's anthropometric changes (body mass index [BMI], waist circumference [WC], and body fat percentage [BF%]). We also assessed potential moderators of MI on children's BMI changes. This systematic review searched five databases (CINAHL, Cochrane, PsycINFO, PubMed, and Web of Sciences) from 2005 to 2020 to evaluate the effects of MI interventions that had a comparison group on children's anthropometric change as outcomes (BMI, WC, or BF%). Thirty-three articles met the inclusion criteria. We performed random-effects models and exploratory moderation analyses with mixed-effects models. The pooled effect size of MI was -0.18 (p = 0.002) on BMI, -0.65 (p < 0.001) on WC, and -0.44 (p = 0.005) on children's BF%. The relationship between MI and BMI changes was significantly moderated by the types of intervener (Q = 9.71, p = 0.021) and the existence of supplemental intervention activities (Q = 9.21, p = 0.002). Other potential moderators included children's age, weight status, intervention setting, and targeted behaviors (eating and/or physical activity). Our findings support the effectiveness of MI interventions on improving children's anthropometric outcomes (i.e., BMI, WC, and BF%).
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Affiliation(s)
- Tsui-Sui Annie Kao
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Jiying Ling
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Rachel Hawn
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Christina Vu
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
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13
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Toemen L, Santos S, Roest AA, Jelic G, van der Lugt A, Felix JF, Helbing WA, Gaillard R, Jaddoe VWV. Body Fat Distribution, Overweight, and Cardiac Structures in School-Age Children: A Population-Based Cardiac Magnetic Resonance Imaging Study. J Am Heart Assoc 2020; 9:e014933. [PMID: 32567454 PMCID: PMC7670529 DOI: 10.1161/jaha.119.014933] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background Adiposity is associated with larger left ventricular mass in children and adults. The role of body fat distribution in these associations is not clear. We examined the associations of body fat distribution and overweight with cardiac measures obtained by cardiac magnetic resonance imaging in school‐age children. Methods and Results In a population‐based cohort study including 2836 children, 10 years of age, we used anthropometric measures, dual‐energy X‐ray absorptiometry, and magnetic resonance imaging to collect information on body mass index, lean mass index, fat mass index, and abdominal visceral adipose tissue index. Indexes were standardized by height. Cardiac measures included right and left ventricular end‐diastolic volume, left ventricular mass, and mass‐to‐volume ratio as a marker for concentricity. All body fat measures were positively associated with right and left ventricular end‐diastolic volumes and left ventricular mass, with the strongest associations for lean mass index (all P<0.05). Obese children had a 1.12 standard deviation score (95% CI, 0.94–1.30) larger left ventricular mass and a 0.35 standard deviation score (95% CI, 0.14–0.57) higher left ventricular mass‐to‐volume ratio than normal weight children. Conditional on body mass index, higher lean mass index was associated with higher right and left ventricular end‐diastolic volume and left ventricular mass, whereas higher fat mass measures were inversely associated with these cardiac measures (all P<0.05). Conclusions Higher childhood body mass index is associated with a larger right and left ventricular size. This association is influenced by higher lean mass. In childhood, lean mass may be a stronger determinant of heart growth than fat mass. Fat mass may influence cardiac structures at older ages.
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Affiliation(s)
- Liza Toemen
- Generation R Study Group Erasmus MC, University Medical Center Rotterdam The Netherlands.,Pediatrics Erasmus MC, University Medical Center Rotterdam The Netherlands
| | - Susana Santos
- Generation R Study Group Erasmus MC, University Medical Center Rotterdam The Netherlands.,Pediatrics Erasmus MC, University Medical Center Rotterdam The Netherlands
| | - Arno A Roest
- Department of Pediatrics Leiden University Medical Center Leiden The Netherlands
| | - Gavro Jelic
- Generation R Study Group Erasmus MC, University Medical Center Rotterdam The Netherlands
| | - Aad van der Lugt
- Radiology Erasmus MC, University Medical Center Rotterdam The Netherlands
| | - Janine F Felix
- Generation R Study Group Erasmus MC, University Medical Center Rotterdam The Netherlands
| | - Willem A Helbing
- Pediatrics Erasmus MC, University Medical Center Rotterdam The Netherlands.,Radiology Erasmus MC, University Medical Center Rotterdam The Netherlands
| | - Romy Gaillard
- Generation R Study Group Erasmus MC, University Medical Center Rotterdam The Netherlands.,Pediatrics Erasmus MC, University Medical Center Rotterdam The Netherlands
| | - Vincent W V Jaddoe
- Generation R Study Group Erasmus MC, University Medical Center Rotterdam The Netherlands.,Pediatrics Erasmus MC, University Medical Center Rotterdam The Netherlands
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