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Li S, Spitz N, Ghantous A, Abrishamcar S, Reimann B, Marques I, Silver MJ, Aguilar-Lacasaña S, Kitaba N, Rezwan FI, Röder S, Sirignano L, Tuhkanen J, Mancano G, Sharp GC, Metayer C, Morimoto L, Stein DJ, Zar HJ, Alfano R, Nawrot T, Wang C, Kajantie E, Keikkala E, Mustaniemi S, Ronkainen J, Sebert S, Silva W, Vääräsmäki M, Jaddoe VWV, Bernstein RM, Prentice AM, Cosin-Tomas M, Dwyer T, Håberg SE, Herceg Z, Magnus MC, Munthe-Kaas MC, Page CM, Völker M, Gilles M, Send T, Witt S, Zillich L, Gagliardi L, Richiardi L, Czamara D, Räikkönen K, Chatzi L, Vafeiadi M, Arshad SH, Ewart S, Plusquin M, Felix JF, Moore SE, Vrijheid M, Holloway JW, Karmaus W, Herberth G, Zenclussen A, Streit F, Lahti J, Hüls A, Hoang TT, London SJ, Wiemels JL. A Pregnancy and Childhood Epigenetics Consortium (PACE) meta-analysis highlights potential relationships between birth order and neonatal blood DNA methylation. Commun Biol 2024; 7:66. [PMID: 38195839 PMCID: PMC10776586 DOI: 10.1038/s42003-023-05698-x] [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: 05/19/2023] [Accepted: 12/12/2023] [Indexed: 01/11/2024] Open
Abstract
Higher birth order is associated with altered risk of many disease states. Changes in placentation and exposures to in utero growth factors with successive pregnancies may impact later life disease risk via persistent DNA methylation alterations. We investigated birth order with Illumina DNA methylation array data in each of 16 birth cohorts (8164 newborns) with European, African, and Latino ancestries from the Pregnancy and Childhood Epigenetics Consortium. Meta-analyzed data demonstrated systematic DNA methylation variation in 341 CpGs (FDR adjusted P < 0.05) and 1107 regions. Forty CpGs were located within known quantitative trait loci for gene expression traits in blood, and trait enrichment analysis suggested a strong association with immune-related, transcriptional control, and blood pressure regulation phenotypes. Decreasing fertility rates worldwide with the concomitant increased proportion of first-born children highlights a potential reflection of birth order-related epigenomic states on changing disease incidence trends.
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Affiliation(s)
- Shaobo Li
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA
| | - Natalia Spitz
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Akram Ghantous
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Sarina Abrishamcar
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Brigitte Reimann
- Centre for Environmental Sciences, UHasselt, Agoralaan, Building D, 3590, Diepenbeek, Belgium
| | - Irene Marques
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Matt J Silver
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, London, UK
| | - Sofía Aguilar-Lacasaña
- ISGlobal, Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Negusse Kitaba
- Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Faisal I Rezwan
- Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
- Department of Computer Science, Aberystwyth University, Aberystwyth, Ceredigion, SY23 3DB, UK
| | - Stefan Röder
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research -UFZ, Leipzig, Germany
| | - Lea Sirignano
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Johanna Tuhkanen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Giulia Mancano
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gemma C Sharp
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- School of Psychology, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Catherine Metayer
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Libby Morimoto
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, Rondebosch, South Africa
| | - Heather J Zar
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, Rondebosch, South Africa
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch, South Africa
| | - Rossella Alfano
- Centre for Environmental Sciences, UHasselt, Agoralaan, Building D, 3590, Diepenbeek, Belgium
| | - Tim Nawrot
- Centre for Environmental Sciences, UHasselt, Agoralaan, Building D, 3590, Diepenbeek, Belgium
| | - Congrong Wang
- Centre for Environmental Sciences, UHasselt, Agoralaan, Building D, 3590, Diepenbeek, Belgium
| | - Eero Kajantie
- Clinical Medicine Research Unit, Medical Research Center Oulu, Oulu University, Hospital and University of Oulu, Oulu, Finland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Pediatric Research Centre, Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Elina Keikkala
- Clinical Medicine Research Unit, Medical Research Center Oulu, Oulu University, Hospital and University of Oulu, Oulu, Finland
- Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Oulu, Finland
| | - Sanna Mustaniemi
- Clinical Medicine Research Unit, Medical Research Center Oulu, Oulu University, Hospital and University of Oulu, Oulu, Finland
- Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Oulu, Finland
| | - Justiina Ronkainen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Sylvain Sebert
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Wnurinham Silva
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Marja Vääräsmäki
- Clinical Medicine Research Unit, Medical Research Center Oulu, Oulu University, Hospital and University of Oulu, Oulu, Finland
- Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Oulu, Finland
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Robin M Bernstein
- Department of Anthropology and Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
| | - Andrew M Prentice
- MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Marta Cosin-Tomas
- ISGlobal, Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Terence Dwyer
- Nuffield Department of Women's & Reproductive Health, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Siri Eldevik Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Zdenko Herceg
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer, Lyon, France
| | - Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Monica Cheng Munthe-Kaas
- Department of Pediatric Oncology and Hematology, Oslo University Hospital, Norwegian Institute of Public Health, Oslo, Norway
| | - Christian M Page
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Physical Health and Aging, Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Maja Völker
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Maria Gilles
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tabea Send
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stephanie Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lea Zillich
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Luigi Gagliardi
- Woman and Child Health Department, Ospedale Versilia, AUSL Toscana Nord Ovest, Pisa, Italy
| | - Lorenzo Richiardi
- Department of Medical Sciences, University of Turin, CPO Piemonte, Turin, Italy
| | - Darina Czamara
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Lida Chatzi
- Department of Population and Public Health Sciences, Keck School of Medicine of USC. University of Southern California, Los Angeles, CA, USA
| | - Marina Vafeiadi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece
| | - S Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | - Susan Ewart
- College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Michelle Plusquin
- Centre for Environmental Sciences, UHasselt, Agoralaan, Building D, 3590, Diepenbeek, Belgium
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sophie E Moore
- Department of Women & Children's Health, King's College London, London, UK
| | - Martine Vrijheid
- ISGlobal, Institute for Global Health, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, University of Memphis, Memphis, TN, USA
| | - Gunda Herberth
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research -UFZ, Leipzig, Germany
| | - Ana Zenclussen
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research -UFZ, Leipzig, Germany
- Perinatal Immunology, Medical Faculty, Saxonian Incubator for Clinical Translation (SIKT), University of Leipzig, Leipzig, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jari Lahti
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Anke Hüls
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Thanh T Hoang
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Stephanie J London
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Joseph L Wiemels
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA.
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Pantke PM, Herrmann-Lingen C, Rothenberger A, Poustka L, Meyer T. Is only-child status associated with a higher blood pressure in adolescence? An observational study. Eur J Pediatr 2023; 182:1377-1384. [PMID: 36662268 PMCID: PMC10023605 DOI: 10.1007/s00431-022-04800-5] [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: 04/09/2022] [Revised: 12/24/2022] [Accepted: 12/29/2022] [Indexed: 01/21/2023]
Abstract
Growing up with siblings may affect quality of life as well as hemodynamic parameters including blood pressure. Using weighted data from the nationwide and representative German KiGGs study, we assessed the relationship between only-child status, birth order, and arterial blood pressure in a cohort of 7311 adolescents aged between 11 and 17 years. Our data showed that only-children had the highest mean arterial blood pressure (87.3 ± 8.4 mmHg) as compared to first-born (86.3 ± 8.0), middle-born (86.4 ± 8.7), and youngest-born siblings (86.6 ± 8.2; p = 0.012). The two groups of only-children and first-borns differed significantly with respect to their age- and sex-specific, z-scored data for systolic (p = 0.047), diastolic (p = 0.012), and mean arterial blood pressure (p = 0.005). Linear regression models with blood pressure recordings as dependent variable adjusted to age, migration background, and age- and sex-specific z-scores of body-mass index confirmed that only-child status was an independent predictor of a higher diastolic blood pressure (p = 0.037). A similar result was observed for mean arterial blood pressure (p = 0.033), whereas systolic blood pressure was not associated with only-children status (p = 0.258). Conclusion: In summary, we found a significant and positive relationship between only-child status and blood pressure, with the highest recordings in only-children and the lowest in first-borns. Models adjusted for relevant clinical confounders demonstrated slightly higher blood pressure in only-children compared to first-borns, who are both in an alpha birth order. Although these blood pressure differences were statistically significant, they have limited, if any, clinical meaning in this age group. What is Known: • In children and adults, blood pressure is significantly higher in only-children compared to children with siblings. However, it is unclear whether there are also similar blood pressure differences in adolescents and between only-children and first-borns. What is New: • Among adolescents in the alpha birth order, growing up as an only-child is associated with significantly higher mean blood pressure than among first-borns living with younger siblings.
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Affiliation(s)
- Pauline Marie Pantke
- Klinik für Psychosomatische Medizin und Psychotherapie, Universität Göttingen, Göttingen, Germany
| | - Christoph Herrmann-Lingen
- Klinik für Psychosomatische Medizin und Psychotherapie, Universität Göttingen, Göttingen, Germany
- Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Göttingen, Von-Siebold-Str. 5, 37073, Göttingen, Germany
| | - Aribert Rothenberger
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Göttingen, Göttingen, Germany
| | - Luise Poustka
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Göttingen, Göttingen, Germany
| | - Thomas Meyer
- Klinik für Psychosomatische Medizin und Psychotherapie, Universität Göttingen, Göttingen, Germany.
- Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Göttingen, Von-Siebold-Str. 5, 37073, Göttingen, Germany.
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Favaro RR, Phillips K, Delaunay-Danguy R, Ujčič K, Markert UR. Emerging Concepts in Innate Lymphoid Cells, Memory, and Reproduction. Front Immunol 2022; 13:824263. [PMID: 35774779 PMCID: PMC9237338 DOI: 10.3389/fimmu.2022.824263] [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: 11/29/2021] [Accepted: 04/15/2022] [Indexed: 12/28/2022] Open
Abstract
Members of the innate immune system, innate lymphoid cells (ILCs), encompass five major populations (Natural Killer (NK) cells, ILC1s, ILC2s, ILC3s, and lymphoid tissue inducer cells) whose functions include defense against pathogens, surveillance of tumorigenesis, and regulation of tissue homeostasis and remodeling. ILCs are present in the uterine environment of humans and mice and are dynamically regulated during the reproductive cycle and pregnancy. These cells have been repurposed to support pregnancy promoting maternal immune tolerance and placental development. To accomplish their tasks, immune cells employ several cellular and molecular mechanisms. They have the capacity to remember a previously encountered antigen and mount a more effective response to succeeding events. Memory responses are not an exclusive feature of the adaptive immune system, but also occur in innate immune cells. Innate immune memory has already been demonstrated in monocytes/macrophages, neutrophils, dendritic cells, and ILCs. A population of decidual NK cells characterized by elevated expression of NKG2C and LILRB1 as well as a distinctive transcriptional and epigenetic profile was found to expand during subsequent pregnancies in humans. These cells secrete high amounts of interferon-γ and vascular endothelial growth factor likely favoring placentation. Similarly, uterine ILC1s in mice upregulate CXCR6 and expand in second pregnancies. These data provide evidence on the development of immunological memory of pregnancy. In this article, the characteristics, functions, and localization of ILCs are reviewed, emphasizing available data on the uterine environment. Following, the concept of innate immune memory and its mechanisms, which include epigenetic changes and metabolic rewiring, are presented. Finally, the emerging role of innate immune memory on reproduction is discussed. Advances in the comprehension of ILC functions and innate immune memory may contribute to uncovering the immunological mechanisms underlying female fertility/infertility, placental development, and distinct outcomes in second pregnancies related to higher birth weight and lower incidence of complications.
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Exploring the Associations between Single-Child Status and Childhood High Blood Pressure and the Mediation Effect of Lifestyle Behaviors. Nutrients 2022; 14:nu14030500. [PMID: 35276857 PMCID: PMC8839388 DOI: 10.3390/nu14030500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 02/07/2023] Open
Abstract
Background: This study aimed to assess the association between single-child status and childhood high blood pressure (HBP) and to explore the role of lifestyle behaviors in this relationship. Methods: This study used data from a cross-sectional survey of 50,691 children aged 7~18 years in China. Linear and logistic regression models were used to assess the relationship between single-child status and HBP, and interactions between single-child status and lifestyle behaviors were also evaluated. Mediation analysis was conducted to detect the mediation effect of lifestyle behaviors. Results: Of the participants enrolled, 67.2% were single children and 49.4% were girls. Non-single children were associated with a greater risk of HBP, especially in girls (OR = 1.11, 95%CI: 1.03~1.19). Meat consumption and sedentary behavior mediated 58.9% of the association between single-child status and HBP (p < 0.01). When stratified by sleeping duration, non-single girls of insufficient sleep and hypersomnia showed a higher risk of HBP (p < 0.05) than single-child peers, but not in those with adequate sleep. Conclusion: Findings suggest that non-single children had an increased risk of HBP, and keeping healthy lifestyle behaviors could help to mitigate the adverse impact in non-single children.
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Ziyab AH, Almari M, Mohammad A, Al-Taiar A, Karmaus W. Sex Differences in the Association of Sibship Size and Position in Sibship with Lipid Profile during Adolescence: A Cross-Sectional Study. Int J Endocrinol 2022; 2022:8727922. [PMID: 36204482 PMCID: PMC9532113 DOI: 10.1155/2022/8727922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/17/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Epidemiologic studies have reported associations of sibship size and position of the child in the sibship with multiple health outcomes, including adiposity and diabetes. However, little is known about sibling effects on lipids. Hence, this study sought to evaluate associations of the number of total, older, and younger siblings with lipid profile among adolescents. METHODS In a cross-sectional study among high school students aged 14 to 19 years, lipid levels were measured in capillary blood. Parents reported the number of siblings (total, older, and younger). Geometric means of lipids were calculated, and linear regression was used to estimate the ratio of geometric means (RoGM) and 95% confidence intervals (CI). Analyses were sex stratified. RESULTS Of the total study sample (n = 1,584), 758 (47.9%) were boys and 826 (52.1%) were girls, with median age of 16.0 years. Total cholesterol (TC) was lower by 8% (adjusted-RoGM = 0.92, 95% CI: 0.88-0.96) among boys with ≥3 older siblings compared to those with no older siblings. Similarly, boys with ≥3 younger sibling compared to those with no younger siblings had reduced TC by 7% (adjusted-RoGM = 0.93, 0.87-0.99). Moreover, an increased number of total siblings (≥4 vs. 0/1: adjusted-RoGM = 0.80, 0.67-97) and older siblings (≥3 vs. 0: adjusted-RoGM = 0.90, 0.82-0.98) were associated with reduced low-density lipoprotein cholesterol (LDL-C) among boys. Similarly, lower levels of triglycerides (TG) were seen among boys with ≥3 older siblings compared to those with no older siblings (adjusted-RoGM = 0.87, 0.78-0.96). A higher number of younger siblings was associated with increased high-density lipoprotein cholesterol (HDL-C) among boys (≥3 vs. 0: adjusted-RoGM = 1.08, 1.01-1.17). Sibship characteristics were not associated with lipids among girls. CONCLUSIONS Increased number of total, older, and younger siblings were associated with favorable lipid profiles among adolescent boys, but not girls. Mechanisms underlying these associations need further investigations.
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Affiliation(s)
- Ali H. Ziyab
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Safat, Kuwait
| | - Mohammad Almari
- Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Safat, Kuwait
| | - Anwar Mohammad
- Biochemistry and Molecular Biology Department, Research Division, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Abdullah Al-Taiar
- School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, VA, USA
| | - Wilfried Karmaus
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA
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Bohn C, Vogel M, Poulain T, Spielau U, Hilbert C, Kiess W, Körner A. Birth weight increases with birth order despite decreasing maternal pregnancy weight gain. Acta Paediatr 2021; 110:1218-1224. [PMID: 32981144 DOI: 10.1111/apa.15598] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/22/2020] [Indexed: 12/11/2022]
Abstract
AIM We investigated whether birth order is an influencing factor for birth weight independent from maternal factors. METHODS Data were obtained from the longitudinal cohort study LIFE Child and included 1864 children, of which 526 were only children. The 1338 siblings were ranked into first-borns (n = 570), second-borns (n = 606) and third-or-later-borns (n = 162). Children born prematurely, suffering from chronic or syndromic diseases, were excluded. We performed intra-family comparisons to reduce bias and assessed the impact of perinatal parameters, such as birth order on birth weight, using mixed models. RESULTS Birth weight increased with birth order. In univariate analyses, birth order had a significant effect on birth weight-SDS with second-borns having 0.29 SDS (app. 130 g) and third-borns 0.40 SDS (app. 180 g) higher values than first-borns (P < .001). Maternal pregnancy weight gain was associated with higher birth weight-SDS (P < .01) in univariate analysis, though maternal pregnancy weight gain was lower for higher birth orders. Multivariate analyses revealed that being a second or third-or-later-born child had a stronger impact on birth weight than all maternal factors. CONCLUSION Birth order must be considered a potential risk factor for higher birth weight. Maternal pregnancy weight gain is not the driving factor for higher birth weight in siblings.
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Affiliation(s)
- Claudia Bohn
- Medical Faculty LIFE Child (Leipzig Research Centre for Civilization Diseases) University of Leipzig Leipzig Germany
| | - Mandy Vogel
- Medical Faculty LIFE Child (Leipzig Research Centre for Civilization Diseases) University of Leipzig Leipzig Germany
| | - Tanja Poulain
- Medical Faculty LIFE Child (Leipzig Research Centre for Civilization Diseases) University of Leipzig Leipzig Germany
| | - Ulrike Spielau
- Department of Women and Child Health Medical Faculty Hospital for Children and Adolescents and Centre for Paediatric Research (CPL) University of Leipzig Leipzig Germany
| | - Cornelia Hilbert
- Medical Faculty LIFE Child (Leipzig Research Centre for Civilization Diseases) University of Leipzig Leipzig Germany
| | - Wieland Kiess
- Medical Faculty LIFE Child (Leipzig Research Centre for Civilization Diseases) University of Leipzig Leipzig Germany
- Department of Women and Child Health Medical Faculty Hospital for Children and Adolescents and Centre for Paediatric Research (CPL) University of Leipzig Leipzig Germany
| | - Antje Körner
- Medical Faculty LIFE Child (Leipzig Research Centre for Civilization Diseases) University of Leipzig Leipzig Germany
- Department of Women and Child Health Medical Faculty Hospital for Children and Adolescents and Centre for Paediatric Research (CPL) University of Leipzig Leipzig Germany
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Fukuya Y, Fujiwara T, Isumi A, Doi S, Ochi M. Association of Birth Order With Mental Health Problems, Self-Esteem, Resilience, and Happiness Among Children: Results From A-CHILD Study. Front Psychiatry 2021; 12:638088. [PMID: 33935832 PMCID: PMC8079750 DOI: 10.3389/fpsyt.2021.638088] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 03/17/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: This study aimed to investigate the association of birth order with mental health problems, self-esteem, resilience, and happiness among children aged 9-10 years. Methods: This was a cross-sectional study using data from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study, which was a population-based study of children in fourth grade in public schools in Adachi City, Tokyo, Japan in 2018 (N = 3,744). Parent-rated Strengths and Difficulties Questionnaire (SDQ) and self-rated resilience, happiness, and self-esteem score were used to assess child mental health. Multiple regression analysis for continuous outcomes and logistic regression for dichotomous outcomes were used to examine the association of birth order with mental health problems, resilience, happiness, and self-esteem. The analysis was controlled for child sex, mother's age, mother's education, caregiver's depressive symptoms, household income, and living with grandparents. Results: Last-borns showed the lowest total difficulties score in the SDQ, while only children showed the highest (p < 0.001). The highest prosocial behaviors score was found among last-borns (p < 0.001). Resilience score was also highest among last-borns, followed by first-borns, middle-borns, and only children. The lowest happiness score was found among middle-borns. Self-esteem score did not differ by sibling types. These associations were similar in the adjusted model and dichotomized outcomes model. Conclusions: Differential impacts of birth order on child mental health, for both positive and negative sides, were found. Further research is warranted to elucidate the mechanism of the association between birth order and the development of behavior problems and the positive aspects such as resilience, happiness, and self-esteem among children.
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Affiliation(s)
- Yoshifumi Fukuya
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Manami Ochi
- Department of Health and Welfare Services, National Institute of Public Health, Saitama, Japan
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Aurpibul L, Butler ÉM, Wongthanee A, Rerkasem A, Pruenglampoo S, Mangklabruks A, Rerkasem K, Derraik JGB. Birth order is associated with an increased risk of obesity in young adults in Thailand. J Epidemiol Community Health 2020; 75:305-308. [PMID: 33148680 DOI: 10.1136/jech-2019-213572] [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: 11/26/2019] [Revised: 05/23/2020] [Accepted: 09/28/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND There is a growing body of evidence showing that early life events are associated with increased risk of cardiovascular and metabolic diseases later in adult life. However, there is a paucity of data in this field from Asian populations. In this study, we examined the association of birth order with obesity risk and cardiometabolic outcomes in young adults in Thailand. METHODS Participants were the offspring from a birth cohort study in Chiang Mai (northern Thailand), who were followed up at ~20.5 years of age. Clinical assessments included anthropometry, blood pressure, fasting blood samples and carotid intima-media thickness. Insulin sensitivity was estimated using homeostatic model assessment of insulin resistance (HOMA-IR). Participants were stratified into two groups: first-borns and later-borns. Health outcomes between groups were compared using multivariable models adjusting for important confounders, in particular maternal body mass index (BMI). RESULTS A total of 559 participants were studied: 316 first-borns (46% males) and 243 later-borns (47% males). Adjusted models showed anthropometric differences, with first-borns being 2.3 kg heavier (p=0.023) with a BMI 0.86 kg/m2 greater (p=0.019) than later-borns. Thus, rates of obesity were higher in first-borns than in later-borns (6.6% vs 2.9%), so that first-borns had an adjusted relative risk of obesity 3.3 times greater than later-borns [95% CI 1.42 to 7.88; p=0.006]. There were no observed differences in cardiovascular or metabolic parameters assessed, including HOMA-IR. CONCLUSION As observed in other populations, first-borns in Thailand had greater BMI and an increased risk of obesity in young adulthood. However, we observed no other cardiometabolic differences between first- and later-borns.
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Affiliation(s)
- Linda Aurpibul
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Éadaoin M Butler
- A Better Start - National Science Challenge, The University of Auckland, Auckland, New Zealand.,Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Antika Wongthanee
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Amaraporn Rerkasem
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sakda Pruenglampoo
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Ampica Mangklabruks
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kittipan Rerkasem
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand .,Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - José G B Derraik
- NCD Center of Excellence, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.,A Better Start - National Science Challenge, The University of Auckland, Auckland, New Zealand.,Liggins Institute, The University of Auckland, Auckland, New Zealand.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Endocrinology Department, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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9
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Wiemels JL, Wang R, Feng Q, Clark CJ, Amatruda JF, Rubin E, Yee AC, Morimoto LM, Metayer C, Ma X. Birth Characteristics and Risk of Early-Onset Synovial Sarcoma. Cancer Epidemiol Biomarkers Prev 2020; 29:1162-1167. [PMID: 32245786 PMCID: PMC7605594 DOI: 10.1158/1055-9965.epi-20-0093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/12/2020] [Accepted: 03/26/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Synovial sarcoma is a rare cancer with peak incidence in the young adult period. Despite poor outcomes of this aggressive cancer, there is little epidemiologic research addressing its etiology. METHODS We collected birth characteristic data on synovial sarcoma cases born during 1978-2015 and diagnosed during 1988-2015 in California (n = 244), and 12,200 controls frequency-matched on year of birth. We also constructed a dataset of cancer cases in siblings of sarcoma subjects to assess familial risk. RESULTS In multivariable logistic regression analyses, synovial sarcoma was more frequent in Hispanics compared with non-Hispanic whites [OR, 1.48; 95% confidence interval (CI), 1.06-2.08]. Higher birth weight was a risk factor in Hispanics; each 500 g increase in birth weight was associated with a 22% increase in disease risk (OR, 1.22; 95% CI, 1.00-1.48). Also, a strong role for birth order was suggested, with highest risk for the first born (second child compared with first: OR, 0.61; 95% CI, 0.44-0.84; third or later compared with first: OR, 0.53; 95% CI, 0.36-0.77). Siblings of patients with synovial sarcoma did not display elevated cancer incidence, suggesting the low likelihood that strong familial predisposition alleles play a significant role in this disease. CONCLUSIONS The associations with birth weight and birth order suggest that nutritional, developmental, and environmental factors may play a role in the etiology of synovial sarcoma. IMPACT Further epidemiologic research on synovial sarcoma should evaluate epigenetic and developmental mechanisms and the formation of the archetypical t(X;18) translocation that defines this disease.
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Affiliation(s)
- Joseph L Wiemels
- Center for Genetic Epidemiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California.
| | - Rong Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Qianxi Feng
- Center for Genetic Epidemiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Cassandra J Clark
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut
| | | | - Elyssa Rubin
- Children's Hospital of Orange County, Orange, California
| | - Amy C Yee
- Center for Genetic Epidemiology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Libby M Morimoto
- School of Public Health, University of California Berkeley, Berkeley, California
| | - Catherine Metayer
- School of Public Health, University of California Berkeley, Berkeley, California
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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10
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Rerkasem K, Wongthanee A, Rerkasem A, Pruenglampoo S, Mangklabruks A, Hofman PL, Cutfield WS, Derraik JGB. Lower insulin sensitivity in young adults born preterm in Thailand. Pediatr Diabetes 2020; 21:210-214. [PMID: 31854491 DOI: 10.1111/pedi.12969] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 12/05/2019] [Accepted: 12/16/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Previous studies reported impaired glucose homeostasis among preterm survivors, but consisted almost exclusively of Caucasians. It is unknown whether Asians born preterm display similar impairments. AIM To assess glucose homeostasis and other cardiometabolic outcomes among young adults born preterm in Thailand. METHODS Participants were 575 young adult offspring of mothers from the Chiang Mai Low Birth Weight Study, born in 1989 to 1990 and followed up in 2010: 54.1% females, median age 20.6 years, including 33 individuals (5.7%) born preterm. After an overnight fast, participants underwent clinical assessments, including blood sampling (glucose, insulin, and lipid profile). Insulin sensitivity was assessed using HOMA-IR and insulin secretion estimated using HOMA-β. RESULTS In unadjusted analyses, young Thai adults born preterm were 3.2 cm shorter (P = .037), 6 kg lighter (P = .016), and had HOMA-β 34% higher (P = .026) than those born at term. Adjusted analyses accounting for important confounders showed marked impairments in glucose homeostasis among preterm survivors: fasting insulin levels were 32% greater (P = .011), with HOMA-IR and HOMA-β that were 31% (P = .020) and 43% higher (P = .005), respectively, compared to peers born at term. There were no other contrasting observations between groups, with anthropometric differences disappearing after adjustment for confounders. DISCUSSION Young adults in Thailand born preterm were more insulin resistant than peers born at term. The observed impairments in glucose metabolism among young Thai adults born preterm corroborate findings reported mostly on Caucasians. The challenge for general practitioners and public health professionals is to encourage those born preterm to make healthier lifestyle choices early on.
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Affiliation(s)
- Kittipan Rerkasem
- Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,NCD Centre, The Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Antika Wongthanee
- NCD Centre, The Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Amaraporn Rerkasem
- NCD Centre, The Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sakda Pruenglampoo
- NCD Centre, The Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Ampica Mangklabruks
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, Auckland, New Zealand.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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11
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Cai L, Ma B, Lin L, Chen Y, Yang W, Ma J, Jing J. The differences of lipid profiles between only children and children with siblings: A national survey in China. Sci Rep 2019; 9:1441. [PMID: 30723228 PMCID: PMC6363803 DOI: 10.1038/s41598-018-37695-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 12/07/2018] [Indexed: 11/17/2022] Open
Abstract
With the increasing number of the one-child family, it is important to investigate whether the only-child status is associated with dyslipidemia. Among a national sample of 65,347 Chinese children aged 6–17 years, 16,100 lipid profiles were available. Children’s height, weight, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured. In comparison to children with siblings, only children (OC) were more likely to be boys and live in urban areas. OC had less physical activity, less fried food intake, but more meat and dairy intakes. OC had significantly higher levels of TC (3.97 ± 0.78 vs. 3.89 ± 0.77) and LDL-C (2.12 ± 0.65 vs. 2.06 ± 0.64) in the overall group, and also in the subgroups of rural boys and girls. The prevalence of hyper-TC (5.48% vs. 4.43%) and hyper-LDL-C (3.97% vs. 2.96%) were significantly higher in OC than their counterparts. Furthermore, we found higher odds of hyper-LDL-C [1.43 (1.12, 1.83)] in OC after adjustments. In the subgroup analysis, only-child status was associated with increased risk of hyper-TC [1.86 (1.06, 3.26)] and hyper-LDL-C [2.65 (1.14, 6.16)] among rural boys, and hyper-LDL-C among rural girls [2.20 (1.14, 4.22)]. In conclusion, higher levels of TC and LDL-C were found in OC especially for rural children. Being an only-child was associated with increased risk of hyper-LDL-C.
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Affiliation(s)
- Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bingjie Ma
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lizi Lin
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.,Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wenhan Yang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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12
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Swaen GMH, Boffetta P, Zeegers M. Impact of changes in human reproduction on the incidence of endocrine-related diseases. Crit Rev Toxicol 2018; 48:789-795. [PMID: 30590970 DOI: 10.1080/10408444.2018.1541073] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The incidence rates of a wide range of diseases and conditions have increased over the last decades. There is controversy over the origin of these increases, whether they are caused by exposure to compounds thought to have an effect on the endocrine system, the "endocrine disruption theory", or whether some other factor is responsible. In this analysis, the authors take a closer look at the role that changes in reproductive factors have played in this respect. They apply the relative risks of age at first pregnancy and parity or family size to a set of Dutch demographic data from 1955 and 2015 and calculate the percentage of disease increase explained. The decrease in parity over the last decades explains an increase of 26% in testicular cancer. The combination of decrease in parity and increase in maternal age at first pregnancy explains an increase of 34% in hypospadias prevalence. This combination of decreased parity and increased maternal age at pregnancy explains an increase of 24% in childhood obesity prevalence. The authors further point to a perhaps even more profound effect of the trend toward smaller families. This trend has led to an estimated doubling of the proportion of children born from subfertile couples. Since children born from subfertile couples are more likely to be preterm or of low birth weight, the incidence of these conditions must have increased as well. Low birth weight and preterm delivery are risk factors for a wide range of diseases and conditions. The changes in human reproduction over the last decades have had a profound impact on the incidence of a range of diseases and conditions in the next generation and thus provide a sound explanation for a substantial portion of the reported increases. Key messages The incidence rates of a wide range of diseases and conditions have increased in the Western societies over the last decades. Many have argued that these increases are attributable to compounds thought to have effects on the human endocrine system: the endocrine disruption theory This analysis shows, however, that human reproductive factors such as maternal age at first pregnancy and parity explain substantial proportions of the reported increases.
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Affiliation(s)
- Gerard M H Swaen
- a CAPHRI Research Institute and Department of Complex Genetics , Maastricht University , Maastricht , The Netherlands
| | - Paolo Boffetta
- b Tisch Cancer Institute , Icahn School of Medicine at Mount Sinai , New York City , NY , USA
| | - Maurice Zeegers
- a CAPHRI Research Institute and Department of Complex Genetics , Maastricht University , Maastricht , The Netherlands
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13
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McKenzie C, Tan J, Macia L, Mackay CR. The nutrition-gut microbiome-physiology axis and allergic diseases. Immunol Rev 2018; 278:277-295. [PMID: 28658542 DOI: 10.1111/imr.12556] [Citation(s) in RCA: 193] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Indexed: 02/06/2023]
Abstract
Dietary and bacterial metabolites influence immune responses. This raises the question whether the increased incidence of allergies, asthma, some autoimmune diseases, cardiovascular disease, and others might relate to intake of unhealthy foods, and the decreased intake of dietary fiber. In recent years, new knowledge on the molecular mechanisms underpinning a 'diet-gut microbiota-physiology axis' has emerged to substantiate this idea. Fiber is fermented to short chain fatty acids (SCFAs), particularly acetate, butyrate, and propionate. These metabolites bind 'metabolite-sensing' G-protein-coupled receptors such as GPR43, GPR41, and GPR109A. These receptors play fundamental roles in the promotion of gut homeostasis and the regulation of inflammatory responses. For instance, these receptors and their metabolites influence Treg biology, epithelial integrity, gut homeostasis, DC biology, and IgA antibody responses. The SCFAs also influence gene transcription in many cells and tissues, through their inhibition of histone deacetylase expression or function. Contained in this mix is the gut microbiome, as commensal bacteria in the gut have the necessary enzymes to digest dietary fiber to SCFAs, and dysbiosis in the gut may affect the production of SCFAs and their distribution to tissues throughout the body. SCFAs can epigenetically modify DNA, and so may be one mechanism to account for diseases with a 'developmental origin', whereby in utero or post-natal exposure to environmental factors (such as nutrition of the mother) may account for disease later in life. If the nutrition-gut microbiome-physiology axis does underpin at least some of the Western lifestyle influence on asthma and allergies, then there is tremendous scope to correct this with healthy foodstuffs, probiotics, and prebiotics.
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Affiliation(s)
- Craig McKenzie
- Infection and Immunity Program, Department of Biochemistry, Biomedicine Discovery Institute, Monash University, Clayton, Vic., Australia
| | - Jian Tan
- Infection and Immunity Program, Department of Biochemistry, Biomedicine Discovery Institute, Monash University, Clayton, Vic., Australia
| | - Laurence Macia
- Nutritional Immunometabolism Node Laboratory, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.,School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - Charles R Mackay
- Infection and Immunity Program, Department of Biochemistry, Biomedicine Discovery Institute, Monash University, Clayton, Vic., Australia
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14
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Seneviratne SN, Derraik JGB, Jiang Y, McCowan LME, Gusso S, Biggs JB, Parry GK, Chiavaroli V, Cutfield WS, Hofman PL. Nulliparity is associated with subtle adverse metabolic outcomes in overweight/obese mothers and their offspring. Clin Endocrinol (Oxf) 2017; 87:545-551. [PMID: 28727231 DOI: 10.1111/cen.13426] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 06/23/2017] [Accepted: 07/15/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND We aimed to evaluate metabolic outcomes in overweight/obese nulliparous and multiparous women and their offspring. STUDY DESIGN Seventy-two overweight and obese women who participated in a randomized controlled trial of exercise in pregnancy were included in the study, comparing 18 nulliparous and 54 multiparous women and their singleton offspring. Women were assessed at 19 and 36 weeks of gestation. Fetal growth was measured using standard obstetric ultrasound techniques. Cord blood was collected at birth. Maternal and offspring body composition was assessed using DXA ~2 weeks after delivery. RESULTS Nulliparous women had higher HbA1c in the third trimester of pregnancy than multiparous women (5.48% vs 5.29%; P=.002) and were more insulin-resistant based on the surrogate marker sex hormone-binding globulin (354 vs 408 nmol/L; P=.047). Nulliparous women also had higher levels of the inflammatory marker tumour necrosis factor-alpha (4.74 vs 3.62 pg/mL; P=.025). At birth, the offspring of nulliparous women were on average 340 g (P=.013) and 0.69 standard deviation scores (P=.026) lighter than those born of multiparous women. Cord blood data showed lower insulin-like growth factor-II (P=.026) and higher IGF binding protein-1 (P=.002) levels in the offspring of nulliparous women. In addition, a less favourable metabolic profile was observed in the offspring of nulliparous women, as indicated by higher triglyceride (P<.001) and interleukin-6 (P=.039) concentrations. CONCLUSIONS Infants born of nulliparous overweight and obese women appear to be exposed to a less favourable metabolic environment in utero, with evidence of subtle adverse metabolic outcomes at birth compared to infants of overweight/obese multiparous women.
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Affiliation(s)
- Sumudu N Seneviratne
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - Lesley M E McCowan
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | - Silmara Gusso
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Janene B Biggs
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Graham K Parry
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | | | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
- A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
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15
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Theodore RF, Broadbent J, Nagin D, Ambler A, Hogan S, Ramrakha S, Cutfield W, Williams MJA, Harrington H, Moffitt TE, Caspi A, Milne B, Poulton R. Childhood to Early-Midlife Systolic Blood Pressure Trajectories: Early-Life Predictors, Effect Modifiers, and Adult Cardiovascular Outcomes. Hypertension 2015; 66:1108-15. [PMID: 26558818 DOI: 10.1161/hypertensionaha.115.05831] [Citation(s) in RCA: 194] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 08/21/2015] [Indexed: 01/01/2023]
Abstract
Previous studies examining blood pressure change over time have modeled an average population trajectory. Recent research among older adults suggests there may be subgroups with different blood pressure trajectories. Identifying subgroups at risk of developing adult hypertension early in life can inform effective risk reduction efforts. We sought to identify different systolic blood pressure trajectories from childhood, their correlated risk factors, and early-midlife cardiovascular outcomes. Blood pressure data at ages 7, 11, 18, 26, 32, and 38 years from a longitudinal, representative birth cohort study (n=975) were used to identify 4 distinct trajectory groups via group-based trajectory modeling: normal (21.8%), high-normal (43.3%), prehypertensive (31.6%), and hypertensive (4.2%). The categories refer to blood pressure beginning at the age of 7 years and most recently measured at the age of 38 years. Family history of high blood pressure (odds ratio [OR], 43.23; 95% confidence interval [CI], 5.27-354.65), male sex (OR, 109.48; 95% CI, 26.82-446.96), being first born (OR, 2.5; 95% CI, 1.00-8.69) and low birth weight (OR, 2.79; 95% CI, 2.49-3.09) were associated with hypertensive group membership (compared with the normal group). Higher body mass index and cigarette smoking resulted in increasing blood pressure across trajectories, particularly for the higher blood pressure groups. Prehypertensive and hypertensive trajectory groups had worse cardiovascular outcomes by early midlife. Harmful blood pressure trajectories are identifiable in childhood, associated with both antecedent and modifiable risk factors over time, and predict adult cardiovascular disease risk. Early detection and subsequent targeted prevention and intervention may reduce the lifecourse burden associated with higher blood pressure.
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Affiliation(s)
- Reremoana F Theodore
- From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology (R.F.T., S.H., S.R., R.P.), Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry (J.B.), Department of Medicine, Dunedin School of Medicine (M.J.A.W.), University of Otago, Dunedin, New Zealand; Heinz School of Public and Policy and Management, Carnegie Mellon University, Pittsburgh, PA (D.N.); Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom (A.A., T.E.M., A.C.); Liggins Institute (W.C.) and Centre of Methods and Policy Application in the Social Sciences (B.M.), University of Auckland, Auckland, New Zealand; and Departments of Psychology and Neuroscience (H.L.H., T.E.M., A.C.) and Psychiatry and Behavioral Sciences (H.L.H., T.E.M., A.C.), Duke University, Durham, NC.
| | - Jonathan Broadbent
- From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology (R.F.T., S.H., S.R., R.P.), Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry (J.B.), Department of Medicine, Dunedin School of Medicine (M.J.A.W.), University of Otago, Dunedin, New Zealand; Heinz School of Public and Policy and Management, Carnegie Mellon University, Pittsburgh, PA (D.N.); Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom (A.A., T.E.M., A.C.); Liggins Institute (W.C.) and Centre of Methods and Policy Application in the Social Sciences (B.M.), University of Auckland, Auckland, New Zealand; and Departments of Psychology and Neuroscience (H.L.H., T.E.M., A.C.) and Psychiatry and Behavioral Sciences (H.L.H., T.E.M., A.C.), Duke University, Durham, NC
| | - Daniel Nagin
- From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology (R.F.T., S.H., S.R., R.P.), Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry (J.B.), Department of Medicine, Dunedin School of Medicine (M.J.A.W.), University of Otago, Dunedin, New Zealand; Heinz School of Public and Policy and Management, Carnegie Mellon University, Pittsburgh, PA (D.N.); Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom (A.A., T.E.M., A.C.); Liggins Institute (W.C.) and Centre of Methods and Policy Application in the Social Sciences (B.M.), University of Auckland, Auckland, New Zealand; and Departments of Psychology and Neuroscience (H.L.H., T.E.M., A.C.) and Psychiatry and Behavioral Sciences (H.L.H., T.E.M., A.C.), Duke University, Durham, NC
| | - Antony Ambler
- From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology (R.F.T., S.H., S.R., R.P.), Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry (J.B.), Department of Medicine, Dunedin School of Medicine (M.J.A.W.), University of Otago, Dunedin, New Zealand; Heinz School of Public and Policy and Management, Carnegie Mellon University, Pittsburgh, PA (D.N.); Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom (A.A., T.E.M., A.C.); Liggins Institute (W.C.) and Centre of Methods and Policy Application in the Social Sciences (B.M.), University of Auckland, Auckland, New Zealand; and Departments of Psychology and Neuroscience (H.L.H., T.E.M., A.C.) and Psychiatry and Behavioral Sciences (H.L.H., T.E.M., A.C.), Duke University, Durham, NC
| | - Sean Hogan
- From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology (R.F.T., S.H., S.R., R.P.), Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry (J.B.), Department of Medicine, Dunedin School of Medicine (M.J.A.W.), University of Otago, Dunedin, New Zealand; Heinz School of Public and Policy and Management, Carnegie Mellon University, Pittsburgh, PA (D.N.); Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom (A.A., T.E.M., A.C.); Liggins Institute (W.C.) and Centre of Methods and Policy Application in the Social Sciences (B.M.), University of Auckland, Auckland, New Zealand; and Departments of Psychology and Neuroscience (H.L.H., T.E.M., A.C.) and Psychiatry and Behavioral Sciences (H.L.H., T.E.M., A.C.), Duke University, Durham, NC
| | - Sandhya Ramrakha
- From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology (R.F.T., S.H., S.R., R.P.), Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry (J.B.), Department of Medicine, Dunedin School of Medicine (M.J.A.W.), University of Otago, Dunedin, New Zealand; Heinz School of Public and Policy and Management, Carnegie Mellon University, Pittsburgh, PA (D.N.); Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom (A.A., T.E.M., A.C.); Liggins Institute (W.C.) and Centre of Methods and Policy Application in the Social Sciences (B.M.), University of Auckland, Auckland, New Zealand; and Departments of Psychology and Neuroscience (H.L.H., T.E.M., A.C.) and Psychiatry and Behavioral Sciences (H.L.H., T.E.M., A.C.), Duke University, Durham, NC
| | - Wayne Cutfield
- From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology (R.F.T., S.H., S.R., R.P.), Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry (J.B.), Department of Medicine, Dunedin School of Medicine (M.J.A.W.), University of Otago, Dunedin, New Zealand; Heinz School of Public and Policy and Management, Carnegie Mellon University, Pittsburgh, PA (D.N.); Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom (A.A., T.E.M., A.C.); Liggins Institute (W.C.) and Centre of Methods and Policy Application in the Social Sciences (B.M.), University of Auckland, Auckland, New Zealand; and Departments of Psychology and Neuroscience (H.L.H., T.E.M., A.C.) and Psychiatry and Behavioral Sciences (H.L.H., T.E.M., A.C.), Duke University, Durham, NC
| | - Michael J A Williams
- From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology (R.F.T., S.H., S.R., R.P.), Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry (J.B.), Department of Medicine, Dunedin School of Medicine (M.J.A.W.), University of Otago, Dunedin, New Zealand; Heinz School of Public and Policy and Management, Carnegie Mellon University, Pittsburgh, PA (D.N.); Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom (A.A., T.E.M., A.C.); Liggins Institute (W.C.) and Centre of Methods and Policy Application in the Social Sciences (B.M.), University of Auckland, Auckland, New Zealand; and Departments of Psychology and Neuroscience (H.L.H., T.E.M., A.C.) and Psychiatry and Behavioral Sciences (H.L.H., T.E.M., A.C.), Duke University, Durham, NC
| | - HonaLee Harrington
- From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology (R.F.T., S.H., S.R., R.P.), Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry (J.B.), Department of Medicine, Dunedin School of Medicine (M.J.A.W.), University of Otago, Dunedin, New Zealand; Heinz School of Public and Policy and Management, Carnegie Mellon University, Pittsburgh, PA (D.N.); Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom (A.A., T.E.M., A.C.); Liggins Institute (W.C.) and Centre of Methods and Policy Application in the Social Sciences (B.M.), University of Auckland, Auckland, New Zealand; and Departments of Psychology and Neuroscience (H.L.H., T.E.M., A.C.) and Psychiatry and Behavioral Sciences (H.L.H., T.E.M., A.C.), Duke University, Durham, NC
| | - Terrie E Moffitt
- From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology (R.F.T., S.H., S.R., R.P.), Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry (J.B.), Department of Medicine, Dunedin School of Medicine (M.J.A.W.), University of Otago, Dunedin, New Zealand; Heinz School of Public and Policy and Management, Carnegie Mellon University, Pittsburgh, PA (D.N.); Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom (A.A., T.E.M., A.C.); Liggins Institute (W.C.) and Centre of Methods and Policy Application in the Social Sciences (B.M.), University of Auckland, Auckland, New Zealand; and Departments of Psychology and Neuroscience (H.L.H., T.E.M., A.C.) and Psychiatry and Behavioral Sciences (H.L.H., T.E.M., A.C.), Duke University, Durham, NC
| | - Avshalom Caspi
- From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology (R.F.T., S.H., S.R., R.P.), Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry (J.B.), Department of Medicine, Dunedin School of Medicine (M.J.A.W.), University of Otago, Dunedin, New Zealand; Heinz School of Public and Policy and Management, Carnegie Mellon University, Pittsburgh, PA (D.N.); Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom (A.A., T.E.M., A.C.); Liggins Institute (W.C.) and Centre of Methods and Policy Application in the Social Sciences (B.M.), University of Auckland, Auckland, New Zealand; and Departments of Psychology and Neuroscience (H.L.H., T.E.M., A.C.) and Psychiatry and Behavioral Sciences (H.L.H., T.E.M., A.C.), Duke University, Durham, NC
| | - Barry Milne
- From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology (R.F.T., S.H., S.R., R.P.), Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry (J.B.), Department of Medicine, Dunedin School of Medicine (M.J.A.W.), University of Otago, Dunedin, New Zealand; Heinz School of Public and Policy and Management, Carnegie Mellon University, Pittsburgh, PA (D.N.); Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom (A.A., T.E.M., A.C.); Liggins Institute (W.C.) and Centre of Methods and Policy Application in the Social Sciences (B.M.), University of Auckland, Auckland, New Zealand; and Departments of Psychology and Neuroscience (H.L.H., T.E.M., A.C.) and Psychiatry and Behavioral Sciences (H.L.H., T.E.M., A.C.), Duke University, Durham, NC
| | - Richie Poulton
- From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology (R.F.T., S.H., S.R., R.P.), Department of Oral Rehabilitation, Sir John Walsh Research Institute, Faculty of Dentistry (J.B.), Department of Medicine, Dunedin School of Medicine (M.J.A.W.), University of Otago, Dunedin, New Zealand; Heinz School of Public and Policy and Management, Carnegie Mellon University, Pittsburgh, PA (D.N.); Medical Research Council Social, Genetic, and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, London, United Kingdom (A.A., T.E.M., A.C.); Liggins Institute (W.C.) and Centre of Methods and Policy Application in the Social Sciences (B.M.), University of Auckland, Auckland, New Zealand; and Departments of Psychology and Neuroscience (H.L.H., T.E.M., A.C.) and Psychiatry and Behavioral Sciences (H.L.H., T.E.M., A.C.), Duke University, Durham, NC
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16
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Derraik JGB, Ayyavoo A, Hofman PL, Biggs JB, Cutfield WS. Increasing maternal prepregnancy body mass index is associated with reduced insulin sensitivity and increased blood pressure in their children. Clin Endocrinol (Oxf) 2015; 83:352-6. [PMID: 25388277 DOI: 10.1111/cen.12665] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 10/17/2014] [Accepted: 11/06/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We aimed to assess the effects of maternal prepregnancy body mass index (BMI) on insulin sensitivity, metabolism and blood pressure in the offspring. METHODS We studied 70 prepubertal children aged 8·9 ± 1·9 years (range 4-11 years), born 38-40 weeks of gestation and appropriate-for-gestational-age birthweight. Maternal prepregnancy body mass index (MPP BMI) was calculated from self-reported weight. Children's insulin sensitivity was measured using intravenous glucose tolerance tests and Bergman's minimal model. Other clinical assessments included auxology, fasting lipid and hormonal profiles, DXA-derived body composition and 24-h ambulatory blood pressure monitoring. Data were analysed using random effect mixed models, adjusting for important confounders and a random factor to account for sibling clusters. RESULTS Increasing MPP BMI was correlated with increasing BMI standard deviation scores (SDS) (r = 0·30; P = 0·012) and lower insulin sensitivity in their children (r = -0·34; P = 0·004). In multivariate regression models, increasing MPP BMI was associated with lower insulin sensitivity (β = -0·040; P = 0·005), with every 1 kg/m(2) increase in MPP BMI associated with a 4·0% decrease in offspring insulin sensitivity. Greater MPP BMI was associated with higher systolic blood pressure in the daytime (β = 0·794; P = 0·010) and night-time (β = 0·800; P = 0·017), as well as higher 24-h mean arterial pressure (β = 0·508; P = 0·025) in the offspring. CONCLUSION Greater maternal prepregnancy BMI is associated with lower insulin sensitivity and higher blood pressure in their children, effects that were independent of offspring adiposity. Thus, higher maternal BMI prior to pregnancy (even among women of normal BMI) may contribute to increased risk of type 2 diabetes and other metabolic diseases in the subsequent generation.
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Affiliation(s)
- José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Ahila Ayyavoo
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Gravida: National Centre for Growth and Development, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Gravida: National Centre for Growth and Development, Auckland, New Zealand
| | - Janene B Biggs
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Gravida: National Centre for Growth and Development, Auckland, New Zealand
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17
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Derraik JGB, Ahlsson F, Lundgren M, Jonsson B, Cutfield WS. First-borns have greater BMI and are more likely to be overweight or obese: a study of sibling pairs among 26,812 Swedish women. J Epidemiol Community Health 2015; 70:78-81. [PMID: 26311896 DOI: 10.1136/jech-2014-205368] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 07/27/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND A number of large studies have shown phenotypic differences between first-borns and later-borns among adult men. In this study, we aimed to assess whether birth order was associated with height and BMI in a large cohort of Swedish women. METHODS Information was obtained from antenatal clinic records from the Swedish National Birth Register over 20 years (1991-2009). Maternal anthropometric data early in pregnancy (at approximately 10-12 weeks of gestation) were analysed on 13,406 pairs of sisters who were either first-born or second-born (n=26,812). RESULTS Early in pregnancy, first-born women were of BMI that was 0.57 kg/m(2) (2.4%) greater than their second-born sisters (p<0.0001). In addition, first-borns had greater odds of being overweight (OR 1.29; p<0.0001) or obese (OR 1.40; p<0.0001) than second-borns. First-borns were also negligibly taller (+1.2 mm) than their second-born sisters. Of note, there was a considerable increase in BMI over the 18-year period covered by this study, with an increment of 0.11 kg/m(2) per year (p<0.0001). CONCLUSIONS Our study corroborates other large studies on men, and the steady reduction in family size may contribute to the observed increase in adult BMI worldwide.
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Affiliation(s)
- José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fredrik Ahlsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Maria Lundgren
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Björn Jonsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
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18
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Donovan LE, Cundy T. Does exposure to hyperglycaemia in utero increase the risk of obesity and diabetes in the offspring? A critical reappraisal. Diabet Med 2015; 32:295-304. [PMID: 25381964 DOI: 10.1111/dme.12625] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/04/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND The idea that exposure to hyperglycaemia in utero is an important factor in the development of obesity and diabetes in the offspring has become entrenched as popular belief. AIM To appraise the literature supporting this hypothesis in the light of recent studies that have clarified the main drivers of obesity in children and adolescents. METHODS A review of published evidence from animal studies, human observational studies, systematic reviews and experimental trials that address the impact of diabetes (Types 1 and 2, genetic or gestational) on the future risk of obesity and/or glucose intolerance in the offspring. RESULTS Some animal studies support a relationship between exposure to hyperglycaemia in utero and future development of obesity and diabetes, but the results are inconsistent. Most of the human studies claiming to show a relationship have not taken into account important known confounders, such as maternal and paternal BMI. Evidence supporting a dose-response relationship between maternal hyperglycaemia exposure and obesity and diabetes in the offspring is weak, and there is no convincing evidence that treating gestational diabetes reduces the later risk of offspring obesity or glucose intolerance. CONCLUSIONS Exposure to hyperglycaemia in utero has minimal direct effect on the later risk of obesity and Type 2 diabetes. The increased risk of obesity in the offspring of women with Type 2 or gestational diabetes can be explained by confounding factors, such as parental obesity.
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Affiliation(s)
- L E Donovan
- Department of Medicine, Division of Endocrinology and Metabolism and Department of Obstetrics and Gynaecology, University of Calgary, Alberta, Canada
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19
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He JR, Xia HM, Liu Y, Xia XY, Mo WJ, Wang P, Cheng KK, Leung GM, Feng Q, Schooling CM, Qiu X. A new birthweight reference in Guangzhou, southern China, and its comparison with the global reference. Arch Dis Child 2014; 99:1091-7. [PMID: 24962952 DOI: 10.1136/archdischild-2013-305923] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To formulate a new birthweight reference for different gestational ages in Guangzhou, southern China, and compare it with the currently used reference in China and the global reference. DESIGN AND SETTING All singleton live births of more than 26 weeks' gestational age recorded in the Guangzhou Perinatal Health Care and Delivery Surveillance System for the years 2009, 2010 and 2011 (n=510 837) were retrospectively included in the study. In addition, the study sample was supplemented by all singleton live births (n=3538) at gestational ages 26-33 weeks from 2007 and 2008. We used Gaussian mixture models and robust regression to exclude outliers of birth weight and then applied Generalized Additive Models for Location, Scale, and Shape (GAMLSS) to generate smoothed percentile curves separately for gender and parity. RESULTS Of infants defined as small for gestational age (SGA) in the new reference, 15.3-47.7% (depending on gestational age) were considered appropriate for gestational age (AGA) by the currently used reference of China. Of the infants defined as SGA by the new reference, 9.2% with gestational ages 34-36 weeks and 14.3% with 37-41 weeks were considered AGA by the global reference. At the 50th centile line, the new reference curve was similar to that of the global reference for gestational ages 26-33 weeks and above the global reference for 34-40 weeks. CONCLUSIONS The new birthweight reference based on birthweight data for neonates in Guangzhou, China, differs from the reference currently used in China and the global reference, and appears to be more relevant to the local population.
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Affiliation(s)
- Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou, China Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Hui-Min Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Yu Liu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou, China Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Xiao-Yan Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou, China Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Wei-Jian Mo
- Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Ping Wang
- Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Kar Keung Cheng
- Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Qiong Feng
- Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China CUNY School of Public Health at Hunter College, New York, New York, USA
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou, China Department of Health Care, Guangzhou Women and Children's Medical Center, Guangzhou, China
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20
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Hanson MA, Gluckman PD. Early developmental conditioning of later health and disease: physiology or pathophysiology? Physiol Rev 2014; 94:1027-76. [PMID: 25287859 PMCID: PMC4187033 DOI: 10.1152/physrev.00029.2013] [Citation(s) in RCA: 717] [Impact Index Per Article: 71.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Extensive experimental animal studies and epidemiological observations have shown that environmental influences during early development affect the risk of later pathophysiological processes associated with chronic, especially noncommunicable, disease (NCD). This field is recognized as the developmental origins of health and disease (DOHaD). We discuss the extent to which DOHaD represents the result of the physiological processes of developmental plasticity, which may have potential adverse consequences in terms of NCD risk later, or whether it is the manifestation of pathophysiological processes acting in early life but only becoming apparent as disease later. We argue that the evidence suggests the former, through the operation of conditioning processes induced across the normal range of developmental environments, and we summarize current knowledge of the physiological processes involved. The adaptive pathway to later risk accords with current concepts in evolutionary developmental biology, especially those concerning parental effects. Outside the normal range, effects on development can result in nonadaptive processes, and we review their underlying mechanisms and consequences. New concepts concerning the underlying epigenetic and other mechanisms involved in both disruptive and nondisruptive pathways to disease are reviewed, including the evidence for transgenerational passage of risk from both maternal and paternal lines. These concepts have wider implications for understanding the causes and possible prevention of NCDs such as type 2 diabetes and cardiovascular disease, for broader social policy and for the increasing attention paid in public health to the lifecourse approach to NCD prevention.
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Affiliation(s)
- M A Hanson
- Academic Unit of Human Development and Health, University of Southampton, and NIHR Nutrition Biomedical Research Centre, University Hospital, Southampton, United Kingdom; and Liggins Institute and Gravida (National Centre for Growth and Development), University of Auckland, Auckland, New Zealand
| | - P D Gluckman
- Academic Unit of Human Development and Health, University of Southampton, and NIHR Nutrition Biomedical Research Centre, University Hospital, Southampton, United Kingdom; and Liggins Institute and Gravida (National Centre for Growth and Development), University of Auckland, Auckland, New Zealand
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21
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Haller F, Moskalev EA, Faucz FR, Barthelmeß S, Wiemann S, Bieg M, Assie G, Bertherat J, Schaefer IM, Otto C, Rattenberry E, Maher ER, Ströbel P, Werner M, Carney JA, Hartmann A, Stratakis CA, Agaimy A. Aberrant DNA hypermethylation of SDHC: a novel mechanism of tumor development in Carney triad. Endocr Relat Cancer 2014; 21:567-77. [PMID: 24859990 PMCID: PMC4722532 DOI: 10.1530/erc-14-0254] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Carney triad (CT) is a rare condition with synchronous or metachronous occurrence of gastrointestinal stromal tumors (GISTs), paragangliomas (PGLs), and pulmonary chondromas in a patient. In contrast to Carney-Stratakis syndrome (CSS) and familial PGL syndromes, no germline or somatic mutations in the succinate dehydrogenase (SDH) complex subunits A, B, C, or D have been found in most tumors and/or patients with CT. Nonetheless, the tumors arising among patients with CT, CSS, or familial PGL share a similar morphology with loss of the SDHB subunit on the protein level. For the current study, we employed massive parallel bisulfite sequencing to evaluate DNA methylation patterns in CpG islands in proximity to the gene loci of all four SDH subunits. For the first time, we report on a recurrent aberrant dense DNA methylation at the gene locus of SDHC in tumors of patients with CT, which was not present in tumors of patients with CSS or PGL, or in sporadic GISTs with KIT mutations. This DNA methylation pattern was correlated to a reduced mRNA expression of SDHC, and concurrent loss of the SDHC subunit on the protein level. Collectively, these data suggest epigenetic inactivation of the SDHC gene locus with functional impairment of the SDH complex as a plausible alternate mechanism of tumorigenesis in CT.
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Affiliation(s)
- Florian Haller
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - Evgeny A Moskalev
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - Fabio R Faucz
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - Sarah Barthelmeß
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - Stefan Wiemann
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthias Bieg
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - Guillaume Assie
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USAInstitute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris
| | - Jerome Bertherat
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USAInstitute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris
| | - Inga-Marie Schaefer
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - Claudia Otto
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - Eleanor Rattenberry
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - Eamonn R Maher
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USAInstitute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris
| | - Philipp Ströbel
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - Martin Werner
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - J Aidan Carney
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - Arndt Hartmann
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - Constantine A Stratakis
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
| | - Abbas Agaimy
- Institute of PathologyUniversity Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstraße 8-10, D-91054 Erlangen, GermanyProgram on Developmental Endocrinology and GeneticsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USADivision Molecular Genome AnalysisDivision of Theoretical BioinformaticsGerman Cancer Research Center (DKFZ), Heidelberg, GermanyInstitut CochinINSERM U1016, CNRS UMR 8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, FranceDepartment of EndocrinologyReferal Center for Rare Adrenal Diseases, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceInstitute of PathologyUniversity Medical Center, Georg-August University, Göttingen, GermanyInstitute of PathologyUniversity Hospital, Albert-Ludwigs University Freiburg, Freiburg, GermanySchool of Clinical and Experimental MedicineCollege of Medical and Dental Sciences, Centre for Rare Diseases and Personalised Medicine, Birmingham Women's Hospital, University of Birmingham and West Midlands Regional Genetics Service, Birmingham, UKDepartment of Medical GeneticsUniversity of Cambridge, Cambridge CB2 0QQ, UKLaboratory Medicine and PathologyEmeritus Staff, Mayo Clinic, Rochester, Minnesota, USA
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Ayyavoo A, Derraik JGB, Hofman PL, Biggs J, Cutfield WS. Metabolic, cardiovascular and anthropometric differences between prepubertal girls and boys. Clin Endocrinol (Oxf) 2014; 81:238-43. [PMID: 24612121 DOI: 10.1111/cen.12436] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 02/10/2014] [Accepted: 02/14/2014] [Indexed: 01/16/2023]
Abstract
OBJECTIVE We aimed to assess possible differences in insulin sensitivity and other metabolic, anthropometric and cardiovascular parameters between boys and girls prior to puberty. METHODS We studied 85 healthy prepubertal children (33 girls and 52 boys) aged 8.7 ± 1.9 years (range 4.0-11.9 years), born 38-40 weeks gestation, and of birth weight appropriate-for-gestational-age. Insulin sensitivity was measured using frequently sampled intravenous glucose tests and Bergman's minimal model. Other clinical assessments included anthropometric measures, fasting lipid and hormonal profiles, body composition from whole-body dual-energy X-ray absorptiometry and 24-h ambulatory blood pressure monitoring. RESULTS Prepubertal girls and boys were of similar parent-adjusted height SDS (P = 0.26), but girls had considerably more body fat (P < 0.0001), less fat-free mass (P = 0.0002) and greater abdominal adiposity (P < 0.0001). These differences in body composition were independent of adrenal androgens. Insulin sensitivity was 18% lower in girls (11.0 vs 13.4 × 10(-4) /min (mU/l); P = 0.028), but this difference disappeared with adjustment for adiposity and DHEAS concentrations. There were, however, some apparent sex differences in cardiovascular parameters, with girls displaying increased heart rate and reduced blood pressure dipping. Girls also had higher triglyceride concentrations (+23%; P = 0.036). CONCLUSION There are a number of anthropometric, metabolic and cardiovascular differences between sexes prior to the appearance of external signs of puberty. Although differences in insulin sensitivity were eliminated when adiposity and DHEAS concentrations were accounted for, there were independent differences in body composition and cardiovascular parameters. Thus, gender, adrenarche and adiposity should be accounted for in studies examining metabolic and cardiovascular outcomes prior to puberty.
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Affiliation(s)
- Ahila Ayyavoo
- Liggins Institute, University of Auckland, Auckland, New Zealand; Gravida: National Centre for Growth and Development, Auckland, New Zealand
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23
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Abstract
Chemoprevention is proposed as a clinical analogue of population prevention, aimed at reducing likelihood of disease progression, not across the population, but in identified high-risk individuals and not by behavioral or lifestyle modification, but by the use of pharmaceutical agents. Cardiovascular chemoprevention is successful via control of hyperlipidemias and hypertension. However, chemoprevention of cancer is an almost universal failure: not only are some results null; even more frequently, there is an excess of disease, including disease that the agents were chosen specifically to reduce. A brief introduction is followed by the evidence for a wide variety of agents and their largely deleterious, sometimes null, and in one case, largely beneficial, consequences as possible chemopreventives. The agents include (i) those that are food derived and their synthetic analogues: β-carotene, folic acid, retinol and retinoids, vitamin E, multivitamin supplements, vitamin C, calcium and selenium and (ii) agents targeted at metabolic and hormonal pathways: statins, estrogen and antagonists, 5α-reductase inhibitors. There are two agents for which there is good evidence of benefit when the strategy is focused on those at defined high risk but where wider application is much more problematic: aspirin and tamoxifen. The major problems with cancer chemoprevention are presented. This is followed by a hypothesis to explain the failure of cancer chemoprevention as an enterprise, arguing that the central tenets that underpin it are flawed and showing why, far from doing good, cancer chemoprevention causes harm.
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Affiliation(s)
- John D Potter
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA
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24
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Among overweight middle-aged men, first-borns have lower insulin sensitivity than second-borns. Sci Rep 2014; 4:3906. [PMID: 24503677 PMCID: PMC3915551 DOI: 10.1038/srep03906] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 01/10/2014] [Indexed: 12/30/2022] Open
Abstract
We aimed to assess whether birth order affects metabolism and body composition in overweight middle-aged men. We studied 50 men aged 45.6 ± 5.5 years, who were overweight (BMI 27.5 ± 1.7 kg/m(2)) but otherwise healthy in Auckland, New Zealand. These included 26 first-borns and 24 second-borns. Insulin sensitivity was assessed by the Matsuda method from an oral glucose tolerance test. Other assessments included DXA-derived body composition, lipid profiles, 24-hour ambulatory blood pressure, and carotid intima-media thickness. First-born men were 6.9 kg heavier (p = 0.013) and had greater BMI (29.1 vs 27.5 kg/m(2); p = 0.004) than second-borns. Insulin sensitivity in first-born men was 33% lower than in second-borns (4.38 vs 6.51; p = 0.014), despite adjustment for fat mass. There were no significant differences in ambulatory blood pressure, lipid profile or carotid intima-media thickness between first- and second-borns. Thus, first-born adults may be at a greater risk of metabolic and cardiovascular diseases.
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25
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The association of birth order with later body mass index and blood pressure: a comparison between prospective cohort studies from the United Kingdom and Brazil. Int J Obes (Lond) 2013; 38:973-9. [PMID: 24097298 PMCID: PMC4024316 DOI: 10.1038/ijo.2013.189] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 08/29/2013] [Accepted: 09/24/2013] [Indexed: 01/15/2023]
Abstract
Background: Previous studies have found greater adiposity and cardiovascular risk in first born children. The causality of this association is not clear. Examining the association in diverse populations may lead to improved insight. Methods: We examine the association between birth order and body mass index (BMI), systolic and diastolic blood pressure (SBP/DBP) in the 2004 Pelotas cohort from southern Brazil and the Avon Longitudinal Study of Parents and Children (ALSPAC) from Bristol, south-west England, restricting analysis to families with two children in order to remove confounding by family size. Results: No consistent differences in BMI, SBP or DBP were observed comparing first and second born children. Within the Pelotas 2004 cohort, first born females were thinner, with lower SBP and DBP; for example, mean difference in SBP comparing first with second born was −0.979 (95% confidence interval −2.901 to 0.943). In ALSPAC, first born females had higher BMI, SBP and DBP. In both cohorts, associations tended to be in the opposite direction in males, although no statistical evidence for gender interactions was found. Conclusions: The findings do not support an association between birth order and BMI or blood pressure. Differences to previous studies may be explained by differences in populations and/or confounding by family size in previous studies.
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Savage T, Derraik JGB, Miles HL, Mouat F, Cutfield WS, Hofman PL. Birth order progressively affects childhood height. Clin Endocrinol (Oxf) 2013; 79:379-85. [PMID: 23347499 DOI: 10.1111/cen.12156] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 11/16/2012] [Accepted: 01/15/2013] [Indexed: 12/27/2022]
Abstract
BACKGROUND There is evidence suggesting that first-born children and adults are anthropometrically different to later-borns. Thus, we aimed to assess whether birth order was associated with changes in growth and metabolism in childhood. METHODS We studied 312 healthy prepubertal children: 157 first-borns and 155 later-borns. Children were aged 3-10 years, born 37-41 weeks gestation, and of birth weight appropriate-for-gestational-age. Clinical assessments included measurement of children's height, weight, fasting lipid and hormonal profiles and DEXA-derived body composition. RESULTS First-borns were taller than later-borns (P < 0·0001), even when adjusted for parents' heights (0·31 vs 0·03 SDS; P = 0·001). There was an incremental height decrease with increasing birth order, so that first-borns were taller than second-borns (P < 0·001), who were in turn taller than third-borns (P = 0·007). Further, among sibling pairs both height SDS (P = 0·009) and adjusted height SDS (P < 0·0001) were lower in second- vs first-born children. Consistent with differences in stature, first- (P = 0·043) and second-borns (P = 0·003) had higher IGF-I concentrations than third-borns. Both first- (P < 0·001) and second-borns (P = 0·004) also had reduced abdominal adiposity (lower android fat to gynoid fat ratio) when compared with third-borns. Other parameters of adiposity and blood lipids were unaffected by birth order. CONCLUSIONS First-borns were taller than later-born children, with an incremental height reduction from first to third birth order. These differences were present after correction for genetic height, and associated to some extent with alterations in plasma IGF-I. Our findings strengthen the evidence that birth order is associated with phenotypic changes in childhood.
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Affiliation(s)
- Tim Savage
- Liggins Institute, University of Auckland, New Zealand
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27
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Ayyavoo A, Derraik JGB, Hofman PL, Cutfield WS. Is being first-born another risk factor for metabolic and cardiovascular diseases? Future Cardiol 2013; 9:447-50. [DOI: 10.2217/fca.13.41] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ahila Ayyavoo
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand
- Gravida: National Centre for Growth & Development, Auckland, New Zealand
| | - José GB Derraik
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand
- Gravida: National Centre for Growth & Development, Auckland, New Zealand
| | - Wayne S Cutfield
- Gravida: National Centre for Growth & Development, Auckland, New Zealand
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand.
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28
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Association of birth order with cardiovascular disease risk factors in young adulthood: a study of one million Swedish men. PLoS One 2013; 8:e63361. [PMID: 23696817 PMCID: PMC3656047 DOI: 10.1371/journal.pone.0063361] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 04/02/2013] [Indexed: 12/18/2022] Open
Abstract
Background Birth order has been suggested to be linked to several cardiovascular disease (CVD) risk factors, but the evidence is still inconsistent. We aim to determine the associations of birth order with body mass index (BMI), muscle strength and blood pressure. Further we will analyse whether these relationships are affected by family characteristics. Methods BMI, elbow flexion, hand grip and knee extension strength and systolic and diastolic blood pressure were measured at conscription examination in 1 065 710 Swedish young men born between 1951 and 1975. The data were analysed using linear multivariate and fixed effects regression models; the latter compare siblings and account for genetic and social factors shared by brothers. Results Fixed effect regression analysis showed that birth order was inversely associated with BMI: second and third born had 0.8% and 1.1% (p<0.001) lower BMI than first-born, respectively. The association pattern differed among muscle strengths. After adjustment for BMI, first-born presented lower elbow flexion and hand grip strength than second-born (−5.9 N and −3.8 N, respectively, p<0.001). Knee extension strength was inversely related to birth order though not always significantly. The association between birth order and blood pressure was not significant. Conclusions Birth order is negatively associated with BMI and knee extension strength, positively with elbow flexion and hand grip strength, and is not associated with blood pressure among young men. Although the effects are small, the link between birth order and some CVD risk factors is already detectable in young adulthood.
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