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Koulouraki S, Paschos V, Pervanidou P, Christopoulos P, Gerede A, Eleftheriades M. Short- and Long-Term Outcomes of Preeclampsia in Offspring: Review of the Literature. CHILDREN (BASEL, SWITZERLAND) 2023; 10:826. [PMID: 37238374 PMCID: PMC10216976 DOI: 10.3390/children10050826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/18/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023]
Abstract
Preeclampsia is a multisystemic clinical syndrome characterized by the appearance of new-onset hypertension and proteinuria or hypertension and end organ dysfunction even without proteinuria after 20 weeks of pregnancy or postpartum. Residing at the severe end of the spectrum of the hypertensive disorders of pregnancy, preeclampsia occurs in 3 to 8% of pregnancies worldwide and is a major cause of maternal and perinatal morbidity and mortality, accounting for 8-10% of all preterm births. The mechanism whereby preeclampsia increases the risk of the neurodevelopmental, cardiovascular, and metabolic morbidity of the mother's offspring is not well known, but it is possible that the preeclamptic environment induces epigenetic changes that adversely affect developmental plasticity. These developmental changes are crucial for optimal fetal growth and survival but may lead to an increased risk of chronic morbidity in childhood and even later in life. The aim of this review is to summarize both the short- and long-term effects of preeclampsia on offspring based on the current literature.
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Affiliation(s)
- Sevasti Koulouraki
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Vasileios Paschos
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Panagiota Pervanidou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Panagiotis Christopoulos
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Angeliki Gerede
- Department of Obstetrics and Gynecology, Democritus University of Thrace, 691 00 Campus, Greece
| | - Makarios Eleftheriades
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, National and Kapodistrian University of Athens, 115 28 Athens, Greece
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Relationships between intrauterine fetal growth trajectories and markers of adiposity and inflammation in young adults. Int J Obes (Lond) 2022; 46:1925-1935. [PMID: 35978103 PMCID: PMC9492546 DOI: 10.1038/s41366-022-01203-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND There is now good evidence that events during gestation significantly influence the developmental well-being of an individual in later life. This study aimed to investigate the relationships between intrauterine growth trajectories determined by serial ultrasound and subsequent markers of adiposity and inflammation in the 27-year-old adult offspring from the Raine Study, an Australian longitudinal pregnancy cohort. METHODS Ultrasound fetal biometric measurements including abdominal circumference (AC), femur length (FL), and head circumference (HC) from 1333 mother-fetal pairs (Gen1-Gen2) in the Raine Study were used to develop fetal growth trajectories using group-based trajectory modeling. Linear mixed modeling investigated the relationship between adult body mass index (BMI), waist circumference (WC), and high-sensitivity C-reactive protein (hs-CRP) of Gen2 at 20 (n = 485), 22 (n = 421) and 27 (n = 437) years and the fetal growth trajectory groups, adjusting for age, sex, adult lifestyle factors, and maternal factors during pregnancy. RESULTS Seven AC, five FL and five HC growth trajectory groups were identified. Compared to the average-stable (reference) group, a lower adult BMI was observed in two falling AC trajectories: (β = -1.45 kg/m2, 95% CI: -2.43 to -0.46, P = 0.004) and (β = -1.01 kg/m2, 95% CI: -1.96 to -0.05, P = 0.038). Conversely, higher adult BMI (2.58 kg/m2, 95% CI: 0.98 to 4.18, P = 0.002) and hs-CRP (37%, 95% CI: 9-73%, P = 0.008) were observed in a rising FL trajectory compared to the reference group. A high-stable HC trajectory associated with 20% lower adult hs-CRP (95% CI: 5-33%, P = 0.011). CONCLUSION This study highlights the importance of understanding causes of the unique patterns of intrauterine growth. Different fetal growth trajectories from early pregnancy associate with subsequent adult adiposity and inflammation, which predispose to the risk of diabetes and cardiometabolic disease.
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Nordman H, Jääskeläinen J, Voutilainen R. Birth Size as a Determinant of Cardiometabolic Risk Factors in Children. Horm Res Paediatr 2021; 93:144-153. [PMID: 32846418 DOI: 10.1159/000509932] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 07/06/2020] [Indexed: 11/19/2022] Open
Abstract
The association between birth size and cardiometabolic disease risk may be U-shaped. Being born small for gestational age (SGA) has a definitive association with later cardiovascular risk, but the impact of being born large for gestational age (LGA) on cardiometabolic health is more controversial. In addition to birth size, early postnatal growth pattern and later weight gain affect cardiometabolic risk in adulthood. Most SGA-born children have catch-up and LGA-born children have catch-down growth during the first years of life. The extent of this early compensatory growth may contribute to the adverse health outcomes. Both SGA- and LGA-born children are at an increased risk for overweight and obesity. This may have a long-term impact on cardiometabolic health as overweight tends to track to adulthood. Other cardiometabolic risk factors, including alterations in glucose metabolism, dyslipidemia, hypertension, and low-grade inflammation are associated with birth weight. Many of these risk factors are related to overweight or adverse fat distribution. Since later cardiometabolic risk is often mediated by early growth pattern and later overweight in SGA and LGA children, it is important to focus on staying normal weight throughout life. Hence, effective interventions to reduce cardiometabolic risk in LGA and SGA children should be developed.
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Affiliation(s)
- Henrikki Nordman
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland,
| | - Jarmo Jääskeläinen
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Raimo Voutilainen
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
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Davidesko S, Nahum Sacks K, Friger M, Haim A, Sheiner E. Prenatal exposure to preeclampsia as a risk factor for long-term endocrine morbidity of the offspring. Hypertens Pregnancy 2020; 40:21-28. [PMID: 33264044 DOI: 10.1080/10641955.2020.1854300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: To analyze preeclampsia as a risk factor for pediatric endocrine disease. Study Design: A population-based cohort analysis comparing the risk of endocrine morbidity of children born between 1991-2014 to mothers with and without preeclampsia. Results: The study included 253,808 deliveries. Exposed offspring had significantly more endocrine hospitalizations (0.7% vs 0.4%; p < 0.001), specifically obesity (0.4% vs 0.2%, p < 0.001). While controlling for confounders, the exposed offspring had significantly more endocrine morbidity (OR 1.433 95% CI 1.115-1.841 p = 0.005). Conclusion: Preeclampsia is an independent risk factor for long-term endocrine disease of the offspring, specifically obesity.
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Affiliation(s)
- Sharon Davidesko
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev , Beer-Sheva, Israel
| | - Kira Nahum Sacks
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva, Israel
| | - Michael Friger
- Department of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev , Beer Sheva, Israel
| | - Alon Haim
- Pediatric Endocrinology and Diabetes Unit, Soroka University Medical Center, Ben-Gurion University of the Negev , Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev , Beer-Sheva, Israel
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Abstract
Background Traditional risk factors for heart failure––coronary heart disease, hypertension, diabetes mellitus, obesity, and smoking––only account for about 50% of cases. Thus, the identification of novel risk factors is of significant public health importance. As high birth weight infants are at increased risk for obesity and diabetes mellitus later in life, which are both risk factors for the development of heart failure, we sought to assess the association of high birth weight with incident heart failure in the ARIC (Atherosclerosis Risk in Communities) study. Methods and Results The ARIC study is a biracial prospective community‐based investigation of 15 792 individuals aged 45 to 64 years at baseline. Study participants who were born premature or born a twin were excluded from this analysis, resulting in 9820 participants who provided either their birth weight category (low, medium, high) or exact birth weight. After adjusting for differences in demographics, risk factors, and comorbidities, compared with medium birth weight, those with high birth weight had a significantly increased risk of incident heart failure (hazard ratio, 1.27; 95% CI, 1.05–1.54 [P=0.014]). The hazard for all‐cause mortality for high birth weight compared with medium birth weight was 1.16 (95% CI, 0.99–1.34; P=0.06). There was no association of high birth weight with myocardial infarction (hazard ratio, 1.06; 95% CI, 0.84–1.34 [P=0.6]). Conclusions High birth weight was associated with a significantly increased hazard of incident heart failure independent of traditional risk factors and a trend toward an increased hazard of death. A history of high birth weight should be ascertained in young adults for primordial prevention of heart failure and in older adults for primary prevention.
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Affiliation(s)
- Abdirahim Rashid
- Department of Internal MedicineWashington University School of Medicine in St. LouisMO
| | - Anandita Agarwala
- Cardiovascular DivisionWashington University School of Medicine in St. LouisMO
| | - Eric Novak
- Cardiovascular DivisionWashington University School of Medicine in St. LouisMO
| | - David L. Brown
- Cardiovascular DivisionWashington University School of Medicine in St. LouisMO
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Said-Mohamed R, Stein AD, Pettifor JM, Norris SA. Sanitation and diarrhoea in infancy and CRP level at 18 years: the birth-to-twenty plus cohort. Ann Hum Biol 2019; 46:415-424. [DOI: 10.1080/03014460.2019.1657496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Rihlat Said-Mohamed
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Aryeh D. Stein
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - John M. Pettifor
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Shane A. Norris
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Starnberg J, Norman M, Westrup B, Domellöf M, Berglund SK. Cardiometabolic risk factors in children born with marginally low birth weight: A longitudinal cohort study up to 7 years-of-age. PLoS One 2019; 14:e0215866. [PMID: 31002705 PMCID: PMC6474616 DOI: 10.1371/journal.pone.0215866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 04/09/2019] [Indexed: 11/28/2022] Open
Abstract
Introduction Low birth weight (LBW, <2500 g) may predict an increased risk of an adverse cardiometabolic profile later in life, but long-term effects in different populations and birth weight strata are still unclear. We explored laboratory markers of cardiometabolic risk in children born with marginally LBW (2000–2500 g). Methods This was a prospective longitudinal cohort study including 285 Swedish marginally LBW children and 95 normal birth weight (NBW, 2501–4500 g) controls. At 3.5 and 7 years of age, blood samples for glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), cholesterol, triglycerides, high- and low density lipoprotein (HDL and LDL), apolipoprotein B (ApoB) and apolipoprotein A1 (ApoA1) were assessed and compared between the groups. Results No significant differences in levels of insulin, HOMA-IR, hs-CRP or blood lipids were observed between marginally LBW and NBW children. At 7 years there was a higher proportion of marginally LBW children with elevated levels of insulin, defined as above the 90th percentile of the control group (21% vs 8.6%, p = 0.038). This association was, however, confounded by maternal ethnicity. In marginally LBW children born small for gestational age (SGA), mean fasting glucose was significantly higher compared to controls (4.7 vs 4.5 mmol/L, p = 0.020). Conclusions There were no significant differences in insulin, insulin resistance, hs-CRP or blood lipids between the marginally LBW children and controls. The subgroup of marginally LBW children born SGA may present early signs of glucose imbalance already at school age.
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Affiliation(s)
- Josefine Starnberg
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
- * E-mail:
| | - Mikael Norman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Björn Westrup
- Division of Neonatology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Domellöf
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Staffan K. Berglund
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine (WCMM), Umeå University, Umeå, Sweden
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Bhuiyan AR, Mitra AK, Ogungbe O, Kabir N. Association of HCV Infection with C-Reactive Protein: National Health and Nutrition Examination Survey (NHANES), 2009⁻2010. Diseases 2019; 7:diseases7010025. [PMID: 30813467 PMCID: PMC6473745 DOI: 10.3390/diseases7010025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/18/2019] [Accepted: 02/21/2019] [Indexed: 01/08/2023] Open
Abstract
The relationship between hepatitis C virus (HCV) infection and C-reactive protein (CRP), which is an inflammatory biomarker, is limited in studies with the general population. It was hypothesized that changes in CRP levels are genotype-dependent in the general population with HCV infection. Thus, this study aimed to assess the prevalence of HCV infection and compare CRP levels with an anti-HCV antibody, HCV-RNA status, and HCV genotypes. A total of 5611 adult participants from the National and Health Nutrition Examination (NHANES), 2009⁻2010 survey were analyzed. Proc survey frequency, means, and multivariate regression were used due to the complex survey design of NHANES. The prevalence of HCV infection among the study population was 1.6%. There were lower mean CRP levels among people with anti-HCV antibody positive status compared to those with antibody negative status (0.12 ± 0.08 vs. 0.24 ± 0.02, p = 0.08, 95% Confidence Intervals, CI: -1.12 to 0.07). Mean CRP levels were also lower in people with HCV-RNA positive status compared to those with HCV-RNA negative status (0.56 ± 0.03 vs. 0.48 ± 0.05, p = 0.62 and 95% CI: -1.37 to 0.86). However, these differences were non-significant. With respect to HCV genotypes, significantly higher CRP levels were noted among people infected with HCV genotype 2 vs. genotype 1 (0.53 ± 0.06 vs. 0.23 ± 0.05, p < 0.01, 95% CI: -0.58 to -0.02) and those with HCV genotype 2 vs. HCV genotype 3 (0.53 ± 0.06, 0.28 ± 0.04, p < 0.01, 95% CI: 0.02 to 0.48). Further studies are needed to confirm this finding.
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Affiliation(s)
- Azad R Bhuiyan
- Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS 39213, USA.
| | - Amal K Mitra
- Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS 39213, USA.
| | - Oluwabunmi Ogungbe
- Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS 39213, USA.
| | - Nusrat Kabir
- Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS 39213, USA.
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Josefina Venero‐Fernández S, Fundora‐Hernández H, Batista‐Gutierrez L, Suárez‐Medina R, de la C. Mora‐Faife E, García‐García G, del Valle‐Infante I, Gómez‐Marrero L, Britton J, Fogarty AW. The association of low birth weight with serum C reactive protein in 3-year-old children living in Cuba: A population-based prospective study. Am J Hum Biol 2017; 29:e22936. [PMID: 27859847 PMCID: PMC5484324 DOI: 10.1002/ajhb.22936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/18/2016] [Accepted: 10/08/2016] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Low birthweight is associated with a decreased risk of childhood leukemia and an increased risk of both cardiovascular disease and all-cause mortality in adult life. Possible biological mediators include systemic innate immunity and inflammation. We tested the hypothesis that birthweight was inversely associated with serum high sensitivity C reactive protein assay (hsCRP), a measure of both innate immunity and systemic inflammation. METHODS Data on birthweight and current anthropometric measures along with a range of exposures were collected at 1 and 3 years of age in a population-based cohort study of young children living in Havana, Cuba. A total of 986 children aged 3-years-old provided blood samples that were analyzed for serum hsCRP levels. RESULTS Nearly 49% of children had detectable hsCRP levels in their serum. Lower birthweight was linearly associated with the natural log of hsCRP levels (beta coefficient -0.70 mg L-1 per kg increase in birthweight, 95% CI: -1.34 to -0.06). This was attenuated but still present after adjustment for the child's sex and municipality (-0.65 mg L-1 per kg birthweight; 95% CI: -1.38 to +0.08). There were no associations between growth from birth or anthropometric measures at 3 years and systemic inflammation. CONCLUSIONS Birthweight was inversely associated with serum hsCRP levels in children aged 3 years living in Cuba. These observations provide a potential mechanism that is present at the age of 3 years to explain the association between low birthweight and both decreased childhood leukemia and increased cardiovascular disease in adults.
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Affiliation(s)
| | - Hermes Fundora‐Hernández
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - Lourdes Batista‐Gutierrez
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - Ramón Suárez‐Medina
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - Esperanza de la C. Mora‐Faife
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - Gladys García‐García
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - Ileana del Valle‐Infante
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - Liem Gómez‐Marrero
- Instituto Nacional de Higiene, Epidemiología y MicrobiologíaInfanta No 1158 e/ Llinás y ClavelCódigo Postal 10300La HabanaCuba
| | - John Britton
- Nottingham Biomedical Research Unit, Division of Epidemiology and Public HealthUniversity of Nottingham, Clinical Sciences Building, City HospitalNottinghamNG5 1PBUnited Kingdom
| | - Andrew W. Fogarty
- Nottingham Biomedical Research Unit, Division of Epidemiology and Public HealthUniversity of Nottingham, Clinical Sciences Building, City HospitalNottinghamNG5 1PBUnited Kingdom
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Czajkowska A, Mazurek K, Wiśniewski A, Kęska A, Tkaczyk J, Krawczyk K, Pałka M, Mazurek T. Insufficient physical activity increases cardiovascular risk in women with low birth mass. BIOMEDICAL HUMAN KINETICS 2017. [DOI: 10.1515/bhk-2017-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Summary
Study aim: The aim of the study was to evaluate the relationship between low birth mass and concentration of high-sensitivity C-reactive protein (hsCRP) as a cardiovascular risk factor in young women with various levels of physical activity.
Materials and methods: 102 female students aged 19.7 ± 0.8 (18.6-23.0) were included. The study group was divided according to the declared physical activity: high physical activity (HPA, n = 69) and low physical activity (LPA, n = 33). Anthropometric indices were measured: body mass, height, hip and waist circumference. hsCRP levels were obtained from venous blood samples. Birth body mass (BBM) and birth height were collected from medical documentation.
Results: Women with low BBM and LPA had a significantly higher concentration of hsCRP than women with low BBM and HPA, as well as women with normal BBM.
Conclusions: Low birth mass together with low physical activity is a strong predictor of raised concentration of hsCRP, which correlates with an increased risk of cardiovascular and metabolic diseases. Regular physical activity in women with low birth mass may prevent an increased hsCRP concentration, and as a result decrease the risk of cardiovascular and metabolic diseases.
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Affiliation(s)
- Anna Czajkowska
- Faculty of Tourism and Recreation, Józef Piłsudski University of Physical Education in Warsaw , Poland
| | - Krzysztof Mazurek
- Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw , Poland
| | - Andrzej Wiśniewski
- Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw , Poland
| | - Anna Kęska
- Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw , Poland
| | - Joanna Tkaczyk
- Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw , Poland
| | | | - Magdalena Pałka
- Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw , Poland
| | - Tomasz Mazurek
- I Chair and Department of Cardiology, Medical University of Warsaw, Warsaw , Poland
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Singer K, Lumeng CN. The initiation of metabolic inflammation in childhood obesity. J Clin Invest 2017; 127:65-73. [PMID: 28045405 DOI: 10.1172/jci88882] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
An understanding of the events that initiate metabolic inflammation (metainflammation) can support the identification of targets for preventing metabolic disease and its negative effects on health. There is ample evidence demonstrating that the initiating events in obesity-induced inflammation start early in childhood. This has significant implications on our understanding of how early life events in childhood influence adult disease. In this Review we frame the initiating events of metainflammation in the context of child development and discuss what this reveals about the mechanisms by which this unique form of chronic inflammation is initiated and sustained into adulthood.
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12
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Nordman H, Voutilainen R, Laitinen T, Antikainen L, Huopio H, Heinonen S, Jääskeläinen J. Growth and Cardiovascular Risk Factors in Prepubertal Children Born Large or Small for Gestational Age. Horm Res Paediatr 2016; 85:11-7. [PMID: 26575838 DOI: 10.1159/000441652] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/12/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Both large and small birth sizes are associated with an increased risk of developing cardiovascular and metabolic problems later in life. We studied whether such associations can be observed at prepubertal age. METHODS A cohort of 49 large (LGA), 56 appropriate (AGA), and 23 small for gestational age (SGA)-born children (age range 5-8 years) were studied. Being born SGA, AGA, or LGA was the exposure, and being overweight at prepubertal age was the main outcome. Blood pressure measurements, laboratory parameters, and whole-body dual-energy X-ray absorptiometry were secondary outcomes. RESULTS The LGA-born children were significantly taller than the AGA controls (p = 0.03), and the SGA children were lighter and shorter compared to the AGA (p = 0.002 and 0.001) and LGA children (p < 0.001). The mean plasma glucose was higher in the LGA than in the SGA group (p = 0.006). Being born LGA (OR 3.82) and the ponderal index Z-score at birth (OR 4.24) were strong predictors for being overweight or obese in childhood. CONCLUSION The children born LGA remained taller and heavier than those born AGA or SGA in mid-childhood, and they had a higher body mass index and body fat percentage than the SGA-born children. The differences in other cardiometabolic risk factors were minimal between the birth size groups.
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Affiliation(s)
- Henrikki Nordman
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
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13
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Body composition and the monitoring of non-communicable chronic disease risk. GLOBAL HEALTH EPIDEMIOLOGY AND GENOMICS 2016; 1:e18. [PMID: 29868210 PMCID: PMC5870426 DOI: 10.1017/gheg.2016.9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 06/10/2016] [Accepted: 06/14/2016] [Indexed: 12/17/2022]
Abstract
There is a need for simple proxies of health status, in order to improve monitoring of chronic disease risk within and between populations, and to assess the efficacy of public health interventions as well as clinical management. This review discusses how, building on recent research findings, body composition outcomes may contribute to this effort. Traditionally, body mass index has been widely used as the primary index of nutritional status in children and adults, but it has several limitations. We propose that combining information on two generic traits, indexing both the ‘metabolic load’ that increases chronic non-communicable disease risk, and the homeostatic ‘metabolic capacity’ that protects against these diseases, offers a new opportunity to improve assessment of disease risk. Importantly, this approach may improve the ability to take into account ethnic variability in chronic disease risk. This approach could be applied using simple measurements readily carried out in the home or community, making it ideal for M-health and E-health monitoring strategies.
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deRosset L, Strutz KL. Developmental origins of chronic inflammation: a review of the relationship between birth weight and C-reactive protein. Ann Epidemiol 2015; 25:539-43. [PMID: 25726300 DOI: 10.1016/j.annepidem.2015.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 01/01/2015] [Accepted: 01/09/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE The developmental origins of adult disease hypothesis suggests that the intrauterine environment may program postnatal health outcomes through mechanisms such as chronic inflammation. The purpose of this article was to review the literature on the association between infant birth weight and C-reactive protein (CRP), markers of the fetal environment and inflammation, respectively. METHODS We used PubMed, Google Scholar, Web of Science, ScienceDirect, the citation lists of the reviewed literature, and recommendations from experts in the field to identify potential articles. Inclusion criteria for the studies, regardless of study design, included human subjects, documented or self-reported infant birth weight, and a minimum of one measurement of CRP (during childhood, adolescence, or adulthood). RESULTS Several studies demonstrated a statistically significant inverse association between birth weight and CRP in adulthood, although in many cases only after controlling for markers of current adiposity. No studies significantly linked birth weight to CRP in childhood or adolescence. CONCLUSIONS Longitudinal studies, including multigenerational studies, are needed to further understand whether adult CRP has origins in the fetal environment.
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Affiliation(s)
- Leslie deRosset
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill.
| | - Kelly L Strutz
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing
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15
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Zhang Z, Kris-Etherton PM, Hartman TJ. Birth weight and risk factors for cardiovascular disease and type 2 diabetes in US children and adolescents: 10 year results from NHANES. Matern Child Health J 2015; 18:1423-32. [PMID: 24241968 DOI: 10.1007/s10995-013-1382-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Previous studies have shown that birth weight and other birth characteristics may be associated with risk for type 2 diabetes and cardiovascular disease (CVD) later in life; however, results using large US national survey data are limited. Our goal was to determine the aforementioned associations using nationally representative data. We studied children and adolescents 6-15 years using data from the National Health and Nutrition Examination Survey cycles 2001-2010. Survey and examination data included demographic and early childhood characteristics, current health status, physical activity information, anthropometric measurements, dietary data (total energy, saturated fat, sodium, and sugar intakes), biomarkers related to selected risk factors of CVD [systolic blood pressure (SBP), plasma C-reactive protein (CRP) and lipid profiles], and type 2 diabetes [fasting glucose, insulin, and homeostasis model assessment (HOMA)]. Birth weight (proxy-reported) was inversely associated with SBP among girls; SBP levels increased 1.4 mmHg for each 1,000 g decrease in birth weight (p = 0.003) after controlling for potential confounders. Birth weight was not associated with levels of CRP or lipid profiles across the three racial groups. In addition, birth weight was inversely related to levels of fasting insulin and HOMA among non-Hispanic Whites; for each 1,000 g decrease in birth weight, fasting insulin levels increased 9.1% (p = 0.007) and HOMA scores increased 9.8% (p = 0.007). Birth weight was inversely associated with the levels of SBP, fasting insulin, and HOMA. These results support a role for birth weight, independent of the strong effects of current body weight status, in increasing risk for CVD and type 2 diabetes.
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Affiliation(s)
- Zhiying Zhang
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, 16802, USA
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16
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McDade TW, Metzger MW, Chyu L, Duncan GJ, Garfield C, Adam EK. Long-term effects of birth weight and breastfeeding duration on inflammation in early adulthood. Proc Biol Sci 2014; 281:20133116. [PMID: 24759854 DOI: 10.1098/rspb.2013.3116] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Chronic inflammation is a potentially important physiological mechanism linking early life environments and health in adulthood. Elevated concentrations of C-reactive protein (CRP)--a key biomarker of inflammation--predict increased cardiovascular and metabolic disease risk in adulthood, but the developmental factors that shape the regulation of inflammation are not known. We investigated birth weight and breastfeeding duration in infancy as predictors of CRP in young adulthood in a large representative cohort study (n = 6951). Birth weight was significantly associated with CRP in young adulthood, with a negative association for birth weights 2.8 kg and higher. Compared with individuals not breastfed, CRP concentrations were 20.1%, 26.7%, 29.6% and 29.8% lower among individuals breastfed for less than three months, three to six months, 6-12 months and greater than 12 months, respectively. In sibling comparison models, higher birth weight was associated with lower CRP for birth weights above 2.5 kg, and breastfeeding greater than or equal to three months was significantly associated with lower CRP. Efforts to promote breastfeeding and improve birth outcomes may have clinically relevant effects on reducing chronic inflammation and lowering risk for cardiovascular and metabolic diseases in adulthood.
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Affiliation(s)
- Thomas W McDade
- Cells to Society (C2S): The Center on Social Disparities and Health, Institute for Policy Research, Northwestern University, , 2040 Sheridan Road, Evanston, IL 60208, USA, Department of Anthropology, Northwestern University, , 1810 Hinman Avenue, Evanston, IL 60208, USA, George Warren Brown School of Social Work, Washington University in St Louis, , One Brookings Drive, St Louis, MO 63130, USA, School of Education, University of California, , Irvine, 3200 Education, Irvine, CA 92697, USA, Department of Pediatrics, Northwestern University, , 225 East Chicago Avenue, Chicago, IL 60611, USA, Program on Human Development and Social Policy, Northwestern University, , 2120 Campus Drive, Evanston, IL 60208, USA
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17
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High sensitivity C-reactive protein concentrations, birthweight and cardiovascular risk markers in Brazilian children. Eur J Clin Nutr 2013; 67:664-9. [PMID: 23571847 DOI: 10.1038/ejcn.2013.75] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND/OBJECTIVES High sensitivity C-reactive protein (hs-CRP) and low birthweight have emerged as predictors of cardiovascular diseases (CVDs). In studies involving adults, higher concentrations of hs-CRP have been associated with low birthweight. This study assessed the relationship between hs-CRP and birthweight, and other risk markers for CVDs in childhood. SUBJECTS/METHODS A total of 459 Brazilian children aged 5-8 years were included in the study. hs-CRP was measured by particle-enhanced immunonephelometry. The nutritional status of the children was assessed by BMI and waist circumference. Total cholesterol and fractions, triglycerides and glucose were measured by enzymatic methods. Insulin sensitivity was determined by the homeostasis model assessment (HOMA) method. Blood pressure was measured by the HDI/Pulse Wave CR-2000 equipment (Hypertension Diagnostics, Eagan, MN, USA). A multivariate linear regression analysis investigated the association between hs-CRP and birthweight, and risk markers for CVDs. RESULTS There were positive associations between hs-CRP and gender (P=0.001), waist circumference (P<0.001) and systolic blood pressure (SBP) (P=0.03), and negative associations between hs-CRP and age (P<0.001), and high-density lipoprotein cholesterol (HDL-c) (P=0.005) (R²=0.14). Abnormal values of hs-CRP, waist circumference, HDL-c and SBP, respectively, were observed in 27.7, 26.4, 14.4 and 34.7% of the children. CONCLUSIONS Opposite to studies involving adults, there was no association between hs-CRP and birthweight, implying that time may strengthen the relationship, considering that hs-CRP-concentration-associated metabolic changes increase from childhood to adulthood. The associations between hs-CRP and waist circumference, HDL-c and SBP in very young ages is a matter of concern, especially in females, in view of the large number of children with abnormal values of these measurements.
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Wells JCK. Ethnic variability in adiposity, thrifty phenotypes and cardiometabolic risk: addressing the full range of ethnicity, including those of mixed ethnicity. Obes Rev 2012; 13 Suppl 2:14-29. [PMID: 23107256 DOI: 10.1111/j.1467-789x.2012.01034.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Ethnic groups vary in cardiometabolic risk, but the underlying mechanisms remain unclear. Several components of body composition variability (fat/lean ratio, fat distribution, lean mass composition and metabolism, and adipose tissue biology) are increasingly linked with cardiometabolic risk and vary substantially across ethnic groups. Constituents of lean mass are proposed to contribute to 'metabolic capacity', a generic trait favouring the maintenance of homeostasis. Adiposity is proposed to contribute to 'metabolic load', which at higher levels challenges metabolic homeostasis, elevating cardiometabolic risk. Ethnic differences in body composition, representing different load-capacity ratios, may therefore contribute to ethnic variability in cardiometabolic risk. Ecological and evolutionary factors potentially contributing to ethnic variability in body composition are explored. In contemporary populations, clinicians encounter an increasing range of ethnicity, along with many individuals of mixed-ethnic ancestry. Increasing understanding of the contribution of body composition to cardiometabolic risk may reduce the need to treat ethnic groups as qualitatively different. A conceptual model is proposed, treating insulin sensitivity and stroke risk as composite functions of body composition variables. Operationalizing this model may potentially improve the ability to assess cardiovascular risk across the full ethnicity spectrum, and to predict cardiometabolic consequences of excess weight gain.
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Affiliation(s)
- J C K Wells
- Childhood Nutrition Research Centre, UCL Institute of Child Health, University College London, 30 Guilford St., London, UK.
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