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Tabor E, Bach M, Werner A, Drozdzowska B, Pluskiewicz W. The Impact of Environmental and Genetic Factors on Bone Quality in Monozygotic and Dizygotic Twins. Biomedicines 2022; 10:biomedicines10102360. [PMID: 36289621 PMCID: PMC9598072 DOI: 10.3390/biomedicines10102360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/04/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022] Open
Abstract
The purpose of the research was to assess the genetic and environmental influences on bone properties. One hundred thirty-two pairs of twins (99/33 monozygotic/dizygotic) underwent anthropometric measurements and phalangeal quantitative ultrasound (DBM Sonic 1200, Igea, Italy) measuring the amplitude speed of sound (AD-SoS, m/s). The mean age was 16.78 ± 12.35 years for monozygotic twins and 14.30 ± 8 years for dizygotic. Interpair and intrapair correlations between twins were calculated. In the groups of monozygotic and dizygotic twins, Ad-SoS correlated significantly with age (r = 0.56−0.73, p < 0.05), weight (r = 0.73−0.78, p < 0.05), and height (r = 0.80−0.81, p < 0.05). The strongest intrapair correlation (r = 0.99−0.998) was noted in monozygotic females for Ad-SoS, weight, and height. There was a statistically significant correlation between the intrapair difference of Ad-SoS and age but only in the groups of monozygotic and dizygotic females (r = 0.281, r2 = 0.079, and p = 0.028; r = 0.544, r2 = 0.296, and p = 0.01, respectively). After age adjustment, it was estimated that 28.62% of Ad-SoS in women and 13.2% of Ad-SoS in men was explained by genetic influence, leading to the conclusion that Ad-SoS changed with age, weight, and height. The strongest correlation between pairs of twins was observed in monozygotic twins. The differences in bone values between female twins arose with age, which indicated the role of environmental factors.
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Affiliation(s)
- Elżbieta Tabor
- Department and Clinic of Internal Diseases, Diabetology, and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
- Correspondence:
| | - Małgorzata Bach
- Department of Applied Informatics, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Aleksandra Werner
- Department of Applied Informatics, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Bogna Drozdzowska
- Department of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Wojciech Pluskiewicz
- Metabolic Bone Diseases Unit, Department and Clinic of Internal Diseases, Diabetology, and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
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Fetal Physiologically Based Pharmacokinetic Models: Systems Information on the Growth and Composition of Fetal Organs. Clin Pharmacokinet 2020; 58:235-262. [PMID: 29987449 DOI: 10.1007/s40262-018-0685-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The growth of fetal organs is a dynamic process involving considerable changes in the anatomical and physiological parameters that can alter fetal exposure to xenobiotics in utero. Physiologically based pharmacokinetic models can be used to predict the fetal exposure as time-varying parameters can easily be incorporated. OBJECTIVE The objective of this study was to collate, analyse and integrate the available time-varying parameters needed for the physiologically based pharmacokinetic modelling of xenobiotic kinetics in a fetal population. METHODS We performed a comprehensive literature search on the physiological development of fetal organs. Data were carefully assessed, integrated and a meta-analysis was performed to establish growth trends with fetal age and weight. Algorithms and models were generated to describe the growth of these parameter values as functions of age and/or weight. RESULTS Fetal physiologically based pharmacokinetic parameters, including the size of the heart, liver, brain, kidneys, lungs, spleen, muscles, pancreas, skin, bones, adrenal and thyroid glands, thymus, gut and gonads were quantified as a function of fetal age and weight. Variability around the means of these parameters at different fetal ages was also reported. The growth of the investigated parameters was not consistent (with respect to direction and monotonicity). CONCLUSION Despite the limitations identified in the availability of some values, the data presented in this article provide a unique resource for age-dependent organ size and composition parameters needed for fetal physiologically based pharmacokinetic modelling. This will facilitate the application of physiologically based pharmacokinetic models during drug development and in the risk assessment of environmental chemicals and following maternally administered drugs or unintended exposure to environmental toxicants in this population.
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Abstract
PURPOSE OF REVIEW A growing body of epidemiological and experimental data indicate that nutritional or environmental stressors during early development can induce long-term adaptations that increase risk of obesity, diabetes, cardiovascular disease, and other chronic conditions-a phenomenon termed "developmental programming." A common phenotype in humans and animal models is altered body composition, with reduced muscle and bone mass, and increased fat mass. In this review, we summarize the recent literature linking prenatal factors to future body composition and explore contributing mechanisms. RECENT FINDINGS Many prenatal exposures, including intrauterine growth restriction, extremes of birth weight, maternal obesity, and maternal diabetes, are associated with increased fat mass, reduced muscle mass, and decreased bone density, with effects reported throughout infancy and childhood, and persisting into middle age. Mechanisms and mediators include maternal diet, breastmilk composition, metabolites, appetite regulation, genetic and epigenetic influences, stem cell commitment and function, and mitochondrial metabolism. Differences in body composition are a common phenotype following disruptions to the prenatal environment, and may contribute to developmental programming of obesity and diabetes risk.
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Affiliation(s)
- Elvira Isganaitis
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
- Research Division, Joslin Diabetes Center, 1 Joslin Place, Room 655A, Boston, 02215, MA, USA.
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Hesketh KR, Brage S, Cooper C, Godfrey KM, Harvey NC, Inskip HM, Robinson SM, Van Sluijs EMF. The association between maternal-child physical activity levels at the transition to formal schooling: cross-sectional and prospective data from the Southampton Women's Survey. Int J Behav Nutr Phys Act 2019; 16:23. [PMID: 30786904 PMCID: PMC6381630 DOI: 10.1186/s12966-019-0782-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 02/01/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity decreases through childhood, adolescence and into adulthood: parents of young children are particularly inactive, potentially negatively impacting their children's activity levels. This study aimed to determine the association between objectively measured maternal and 6-year-old children's physical activity; explore how this association differed by demographic and temporal factors; and identify change during the transition to school (from age 4-6). METHODS Data were from the UK Southampton Women's Survey. Physical activity of 530 6-year-olds and their mothers was measured concurrently using accelerometry for ≤7 days. Cross-sectionally, two-level mixed-effects linear regression was used to model the association between maternal-child daily activity behaviour at age 6 [minutes sedentary (SED); in moderate-to-vigorous physical activity (MVPA)]. Interactions with demographic factors and time of the week were tested; how the association differed across the day was also explored. Change in the association between maternal-child physical activity (from age 4-6) was assessed in a subset (n = 170) [outcomes: SED, MVPA and light physical activity (LPA)]. RESULTS Mother-child daily activity levels were positively associated (SED: β = 0.23 [0.20, 0.26] minutes/day; MVPA: 0.53 [0.43, 0.64] minutes/day). The association was stronger at weekends (vs. weekdays) (interaction term: SED: βi = 0.07 [0.02, 0.12]; MVPA: 0.44 [0.24, 0.64]). For SED, the association was stronger for those children with older siblings (vs. none); for MVPA, a stronger association was observed for those who had both younger and older siblings (vs. none) and a weaker relationship existed in spring compared to winter. Longitudinally, the association between mother-child activity levels did not change for SED and LPA. At age 6 (vs. age 4) the association between mother-child MVPA was weaker across the whole day (βi: - 0.16 [- 0.31, - 0.01]), but remained similar at both ages between 3 and 11 pm. CONCLUSIONS More active mothers have more active 6-year-olds; this association was similar for boys and girls but differed by time of week, season and by age of siblings at home. Longitudinally, the association weakened for MVPA between 4 and 6 years, likely reflecting the differing activities children engage in during school hours and increased independence. Family-based physical activity remains an important element of children's activity behaviour regardless of age. This could be exploited in interventions to increase physical activity within families.
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Affiliation(s)
| | - Soren Brage
- CEDAR and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sian M. Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Skåren L, Wang X, Bjørnerem Å. Bone trait ranking in the population is not established during antenatal growth but is robustly established in the first postnatal year. PLoS One 2018; 13:e0203945. [PMID: 30222785 PMCID: PMC6141090 DOI: 10.1371/journal.pone.0203945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/10/2018] [Indexed: 01/23/2023] Open
Abstract
Efforts to understand the pathophysiology of bone fragility must focus on bone traits during growth. We hypothesized that variance in individual trait ranking in the population distribution is established by genetic factors and is reflected in foetal trait ranking in early pregnancy, but intrauterine factors modify trait ranking in late pregnancy, followed by the reinstating of this ranking during the first postnatal year. Thus, relations with paternal factors are present in early pregnancy but are then lost and subsequently reinstated postnatal. We recruited 399 healthy pregnant women aged 20–42 years from The Mercy Hospital for Woman in Melbourne, Australia. Foetal femur length (FL) and knee-heel length (KHL) were measured by ultrasound during gestation, and FL, KHL, body length and weight were measured in neonates, infants, and parents. The z-scores were calculated using Royston models. Pearson correlation was used to assess tracking and linear mixed models to test the associations. Correlations between FL and KHL z-scores of the same trait at 20 and 30 weeks gestation, at birth, and at 12 and 24 months of age (r = 0.1–0.3) and of body length and weight at birth, and 6, 12 and 24 months (r = 0.3–0.5) became more robust after 6–12 months (r = 0.4–0.8). FL and KHL z-scores at 20 weeks gestation accounted for 4–5% of total variance, while FL, KHL, body length and weight z-scores at birth accounted for 13–26% of total variance in the same traits at 24 months. Maternal FL and KHL were associated with foetal FL and KHL at 20 and 30 weeks, but there were no such associations for paternal FL and KHL with foetal traits during gestation. Both maternal and paternal traits were associated with infant traits. Tracking in traits is not established antenatal but is robustly established at 6–12 months of age.
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Affiliation(s)
- Lise Skåren
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Xiaofang Wang
- Endocrine Centre, Austin Health, University of Melbourne, Melbourne, Australia
| | - Åshild Bjørnerem
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Endocrine Centre, Austin Health, University of Melbourne, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University Hospital of North Norway, Tromsø, Norway
- * E-mail:
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Gilsanz V, Wren TAL, Ponrartana S, Mora S, Rosen CJ. Sexual Dimorphism and the Origins of Human Spinal Health. Endocr Rev 2018; 39:221-239. [PMID: 29385433 PMCID: PMC5888211 DOI: 10.1210/er.2017-00147] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 01/24/2018] [Indexed: 12/26/2022]
Abstract
Recent observations indicate that the cross-sectional area (CSA) of vertebral bodies is on average 10% smaller in healthy newborn girls than in newborn boys, a striking difference that increases during infancy and puberty and is greatest by the time of sexual and skeletal maturity. The smaller CSA of female vertebrae is associated with greater spinal flexibility and could represent the human adaptation to fetal load in bipedal posture. Unfortunately, it also imparts a mechanical disadvantage that increases stress within the vertebrae for all physical activities. This review summarizes the potential endocrine, genetic, and environmental determinants of vertebral cross-sectional growth and current knowledge of the association between the small female vertebrae and greater risk for a broad array of spinal conditions across the lifespan.
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Affiliation(s)
- Vicente Gilsanz
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027.,Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027.,Department of Orthopaedic Surgery, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027
| | - Tishya A L Wren
- Department of Orthopaedic Surgery, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027
| | - Skorn Ponrartana
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027
| | - Stefano Mora
- Laboratory of Pediatric Endocrinology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Clifford J Rosen
- Center for Clinical and Translational Research, Maine Medical Center Research Institute, Scarborough, Maine 04074
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Holroyd CR, Osmond C, Barker DJ, Ring SM, Lawlor DA, Tobias JH, Smith GD, Cooper C, Harvey NC. Placental Size Is Associated Differentially With Postnatal Bone Size and Density. J Bone Miner Res 2016; 31:1855-1864. [PMID: 26999363 PMCID: PMC5010780 DOI: 10.1002/jbmr.2840] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 02/16/2016] [Accepted: 03/11/2016] [Indexed: 11/06/2022]
Abstract
We investigated relationships between placental size and offspring adolescent bone indices using a population-based, mother-offspring cohort. The Avon Longitudinal Study of Parents and Children (ALSPAC) recruited pregnant women from the southwest of England between 1991 and 1993. There were 12,942 singleton babies born at term who survived at least the first 12 months. From these, 8933 placentas were preserved in formaldehyde, with maternal permission for their use in research studies. At the approximate age of 15.5 years, the children underwent a dual-energy X-ray absorptiometry (DXA) scan (measurements taken of the whole body minus head bone area [BA], bone mineral content [BMC], and areal bone mineral density [aBMD]). A peripheral quantitative computed tomography (pQCT) scan (Stratec XCT2000L; Stratec, Pforzheim, Germany) at the 50% tibial site was performed at this visit and at approximately age 17.7 years. In 2010 a sample of 1680 placentas were measured and photographed. To enable comparison of effect size across different variables, predictor and outcome variables were standardized to Z-scores and therefore results may be interpreted as partial correlation coefficients. Complete placental, DXA, and pQCT data were available for 518 children at age 15.5 years. After adjustment for gender, gestational age at birth, and age at time of pQCT, the placental area was positively associated with endosteal circumference (β [95% CI]: 0.21 [0.13, 0.30], p < 0.001), periosteal circumference (β [95% CI]: 0.19 [0.10, 0.27], p < 0.001), and cortical area (β [95% CI]: 0.10 [0.01, 0.18], p = 0.03), and was negatively associated with cortical density (β [95% CI]: -0.11 [-0.20, -0.03], p = 0.01) at age 15.5 years. Similar relationships were observed for placental volume, and after adjustment for additional maternal and offspring covariates. These results suggest that previously observed associations between placental size and offspring bone development persist into older childhood, even during puberty, and that placental size is differentially related to bone size and volumetric density. © 2016 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - David Jp Barker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Sue M Ring
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Debbie A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jon H Tobias
- Academic Rheumatology, Musculoskeletal Research Unit, Avon Orthopaedic Centre, Bristol, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. .,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. .,NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Headington, Oxford, UK.
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Wood CL, Stenson C, Embleton N. The Developmental Origins of Osteoporosis. Curr Genomics 2016; 16:411-8. [PMID: 27018386 PMCID: PMC4765528 DOI: 10.2174/1389202916666150817202217] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 05/14/2015] [Accepted: 06/20/2015] [Indexed: 12/26/2022] Open
Abstract
Osteoporosis is one of the most prevalent skeletal disorders and has enormous public health consequences due to the morbidity and mortality of the resulting fractures. This article discusses the developmental origins of osteoporosis and outlines some of the modifiable and non-modifiable risk factors in both intrauterine and postnatal life that contribute to the later onset of osteoporosis. Evidence for the effects of birth size and early growth in both preterm and term born infants are discussed and the role of epigenetics within the programming hypothesis is highlighted. This review provides compelling evidence for the developmental origins of osteoporosis and highlights the importance of osteoporosis prevention at all stages of the life course.
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Affiliation(s)
- Claire L Wood
- Newcastle University, Newcastle upon Tyne, UK;; Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Nicholas Embleton
- Newcastle University, Newcastle upon Tyne, UK;; Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Jao J, Abrams EJ, Phillips T, Petro G, Zerbe A, Myer L. In Utero Tenofovir Exposure Is not Associated With Fetal Long Bone Growth. Clin Infect Dis 2016; 62:1604-1609. [PMID: 27009251 DOI: 10.1093/cid/ciw159] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/11/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Despite widespread use of tenofovir disoproxil fumarate (TDF) in pregnant and breastfeeding women, few data exist on fetal bone development after in utero TDF exposure. We evaluated fetal long bone growth in human immunodeficiency virus (HIV)-infected pregnant woman/fetus dyads in Cape Town, South Africa. METHODS Women were recruited from primary care antenatal services and underwent ultrasonography to determine femur (FLZ) and humerus (HLZ) length z scores. The duration of in utero TDF exposure was calculated in weeks. Linear regression models were applied to assess the associations between the duration of in utero TDF exposure and change in FLZ and HLZ. RESULTS A total of 646 woman/fetus dyads contributed 1376 ultrasonographic scans to this analysis: 132 dyads with ≥25 weeks, 326 with 10-24 weeks, and 188 with <10 weeks of TDF exposure. Women receiving TDF for ≥25 weeks were older than those receiving TDF for 10-24 or <10 weeks (median age, 31 vs 28 and 28 years, respectively; P < .01), and had lower HIV RNA levels (median log10 HIV RNA level, 1.59 vs 4.08 and 3.83, respectively; P < .01). Throughout gestation, overall median FLZ and HLZ were 0.30 (interquartile range, -0.03 to 0.63) and 0.22 (-0.26 to 0.59) respectively. In multivariate analysis, there was no association between duration of in utero TDF exposure per 1-week increment and change in FLZ (ß = .00; P = .51) or change in HLZ (ß = .00; P = .40). Results were similar using mixed-effects models. CONCLUSIONS Although longer follow-up is needed, these in utero data are reassuring and support the continued use of TDF in pregnancy.
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Affiliation(s)
- Jennifer Jao
- Department of Medicine and Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai
| | - Elaine J Abrams
- ICAP, Mailman School of Public Health.,College of Physicians and Surgeons, Columbia University, New York, New York
| | | | - Greg Petro
- Division of Epidemiology and Biostatistics.,Division of Obstetrics & Gynaecology
| | | | - Landon Myer
- Division of Epidemiology and Biostatistics.,Division of Desmond Tutu HIV Centre, University of Cape Town, South Africa
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Riancho JA. Epigenetics of Osteoporosis: Critical Analysis of Epigenetic Epidemiology Studies. Curr Genomics 2015; 16:405-10. [PMID: 27019615 PMCID: PMC4765527 DOI: 10.2174/1389202916666150817213250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 06/15/2015] [Accepted: 06/15/2015] [Indexed: 11/22/2022] Open
Abstract
Osteoarthritis (OA) is an age-related disease with poorly understood pathogenesis. Recent studies have demonstrated that miRNA might play a key role in OA initiation and development. We reviewed recent publications and elucidated the connection between miRNA and OA cartilage anabolic and catabolic signals, including four signaling pathways: TGF-β/Smads and BMPs signaling, associated with cartilage anabolism; and MAPK and NF-KB signaling, associated with cartilage catabolism. We also explored the relationships with MMP, ADAMTS and NOS (NitricOxide Synthases) families, as well as with the catabolic cytokines IL-1 and TNF-α. The potential role of miRNAs in biological processes such as cartilage degeneration, chondrocyte proliferation, and differentiation is discussed. Collective evidence indicates that miRNAs play a critical role in cartilage degeneration. These findings will aid in understanding the molecular network that governs articular cartilage homeostasis and in to elucidate the role of miRNA in the pathogenesis of OA.
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Affiliation(s)
- José A. Riancho
- Service of Internal Medicine, Hospital U.M. Valdecilla, and Department of Medicine, University of Cantabria. IDIVAL, RETICEF. Santander, Spain
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11
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Meconium Tenofovir Concentrations and Growth and Bone Outcomes in Prenatally Tenofovir Exposed HIV-Uninfected Children. Pediatr Infect Dis J 2015; 34:851-7. [PMID: 25961889 PMCID: PMC4573821 DOI: 10.1097/inf.0000000000000747] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Maternal tenofovir disoproxil fumarate (TDF) treatment among HIV-infected pregnant women results in fetal tenofovir (TFV) exposure. Fetal TFV toxicity was demonstrated in animals, but most clinical investigations have not observed toxicity in humans. METHODS We evaluated HIV-exposed, uninfected infants in the Surveillance Monitoring for Antiretroviral Therapy Toxicities cohort of the Pediatric HIV/AIDS Cohort Study whose mothers were prescribed TDF for ≥ 8 third trimester weeks. Infant dual-energy X-ray absorptiometry scans were obtained at 0-4 weeks to measure whole body bone mineral content. Meconium TFV concentrations were quantified by liquid chromatography-tandem mass spectrometry. RESULTS Fifty-eight TFV-exposed infants had meconium TFV quantified. Detectable concentrations were 11-48,100 ng/g; 3 infants had undetectable concentrations. Maternal TDF prescription duration ranged from 8 to 41 gestational weeks; infant gestational ages were 36-41 weeks. Meconium TFV concentrations were not correlated with TFV exposure duration or timing and did not vary by concomitant prescription of protease inhibitors. Increased meconium TFV concentrations were associated with greater gestational ages (ρ = 0.29, P = 0.03) and lower maternal plasma HIV RNA before delivery (ρ = -0.29, P = 0.04). Meconium TFV concentrations were not associated with infant weight, length (n = 58) or bone mineral content (n = 49). CONCLUSIONS For the first time, we explored associations between meconium TFV concentrations and infant growth and bone measurements; we did not observe a meconium concentration-dependent relationship for these infant outcomes. These findings support other clinical research failing to show dose-response relationships for growth and bone outcomes among intrauterine TFV-exposed infants. High meconium TFV concentrations correlated with low maternal viral load, suggesting maternal TDF adherence significantly contributes to meconium TFV concentrations.
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Moon RJ, Cole ZA, Crozier SR, Curtis EM, Davies JH, Gregson CL, Robinson SM, Dennison EM, Godfrey KM, Inskip HM, Cooper C, Harvey NC. Longitudinal changes in lean mass predict pQCT measures of tibial geometry and mineralisation at 6-7 years. Bone 2015; 75:105-10. [PMID: 25703480 PMCID: PMC4556067 DOI: 10.1016/j.bone.2015.02.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 12/19/2014] [Accepted: 02/12/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Studies in childhood suggest that both body composition and early postnatal growth are associated with bone mineral density (BMD). However, little is known of the relationships between longitudinal changes in fat (FM) and lean mass (LM) and bone development in pre-pubertal children. We therefore investigated these associations in a population-based mother-offspring cohort, the Southampton Women's Survey. METHODS Total FM and LM were assessed at birth and 6-7 years of age by dual-energy x-ray absorptiometry (DXA). At 6-7 years, total cross-sectional area (CSA) and trabecular volumetric BMD (vBMD) at the 4% site (metaphysis) of the tibia was assessed using peripheral quantitative computed tomography [pQCT (Stratec XCT-2000)]. Total CSA, cortical CSA, cortical vBMD and strength-strain index (SSI) were measured at the 38% site (diaphysis). FM, LM and bone parameters were adjusted for age and sex and standardised to create within-cohort z-scores. Change in LM (ΔLM) or FM (ΔFM) was represented by change in z-score from birth to 7 years old and conditioned on the birth measurement. Linear regression was used to explore the associations between ΔLM or ΔFM and standardised pQCT outcomes, before and after mutual adjustment and for linear growth. The β-coefficient represents SD change in outcome per unit SD change in predictor. RESULTS DXA at birth, in addition to both DXA and pQCT scans at 6-7 years, were available for 200 children (48.5% male). ΔLM adjusted for ΔFM was positively associated with tibial total CSA at both the 4% (β=0.57SD/SD, p<0.001) and 38% sites (β=0.53SD/SD, p<0.001), cortical CSA (β=0.48SD/SD, p<0.001) and trabecular vBMD (β=0.30SD/SD, p<0.001), but not with cortical vBMD. These relationships persisted after adjustment for linear growth. In contrast, ΔFM adjusted for ΔLM was only associated with 38% total and cortical CSA, which became non-significant after adjustment for linear growth. CONCLUSION In this study, gain in childhood LM was positively associated with bone size and trabecular vBMD at 6-7 years of age. In contrast, no relationships between change in FM and bone were observed, suggesting that muscle growth, rather than accrual of fat mass, may be a more important determinant of childhood bone development.
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Affiliation(s)
- Rebecca J Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Zoe A Cole
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; Rheumatology, Salisbury Hospital NHS Foundation Trust, Salisbury, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - Elizabeth M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - Justin H Davies
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Celia L Gregson
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Learning & Research Building, Southmead Hospital, Bristol BS10 5NB, UK
| | - Sian M Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - Elaine M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK; NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopedic Centre, Headington, Oxford OX3 7HE, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6YD, UK.
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Hesketh KR, McMinn AM, Ekelund U, Sharp SJ, Collings PJ, Harvey NC, Godfrey KM, Inskip HM, Cooper C, van Sluijs EMF. Objectively measured physical activity in four-year-old British children: a cross-sectional analysis of activity patterns segmented across the day. Int J Behav Nutr Phys Act 2014; 11:1. [PMID: 24405936 PMCID: PMC3896827 DOI: 10.1186/1479-5868-11-1] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 12/20/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about preschool-aged children's levels of physical activity (PA) over the course of the day. Using time-stamped data, we describe the levels and patterns of PA in a population-based sample of four-year-old British children. METHODS Within the Southampton Women's Survey the PA levels of 593 4-year-old children (51% female) were measured using (Actiheart) accelerometry for up to 7 days. Three outcome measures: minutes spent sedentary (<20 cpm); in light (LPA: ≥20-399 cpm) and in moderate-to-vigorous activity (MVPA: ≥400 cpm) were derived. Average daily activity levels were calculated and then segmented across the day (morning, afternoon and evening). MVPA was log-transformed. Two-level random intercept models were used to analyse associations between activity level and temporal and demographic factors. RESULTS Children were active for 67% (mean 568.5 SD 79.5 minutes) of their daily registered time on average, with 88% of active time spent in LPA. All children met current UK guidelines of 180 minutes of daily activity. There were no differences in children's average daily levels of sedentary activity and LPA by temporal and demographic factors: differences did emerge when activity was segmented across the day. Sex differences were largest in the morning, with girls being more sedentary, spending fewer minutes in LPA and 18% less time in MVPA than boys. Children were more sedentary and less active (LPA and MVPA) in the morning if they attended childcare full-time compared to part-time, and on weekend mornings compared to weekdays. The reverse was true for weekend afternoons and evenings. Children with more educated mothers were less active in the evenings. Children were less sedentary and did more MVPA on summer evenings compared to winter evenings. CONCLUSIONS Preschool-aged children meet current physical activity guidelines, but with the majority of their active time spent in LPA, investigation of the importance of activity intensity in younger children is needed. Activity levels over the day differed by demographic and temporal factors, highlighting the need to consider temporality in future interventions. Increasing girls' morning activity and providing opportunities for daytime activity in winter months may be worthwhile.
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Affiliation(s)
- Kathryn R Hesketh
- UKCRC Centre of Excellence for Diet and Activity Research (CEDAR), Box 296, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Alison M McMinn
- UKCRC Centre of Excellence for Diet and Activity Research (CEDAR), Box 296, Institute of Public Health, University of Cambridge, Cambridge, UK
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Cambridge, UK
| | - Ulf Ekelund
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Cambridge, UK
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Stephen J Sharp
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Cambridge, UK
| | - Paul J Collings
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Cambridge, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Esther MF van Sluijs
- UKCRC Centre of Excellence for Diet and Activity Research (CEDAR), Box 296, Institute of Public Health, University of Cambridge, Cambridge, UK
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Cambridge, UK
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14
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Hesketh KR, McMinn AM, Griffin SJ, Harvey NC, Godfrey KM, Inskip HM, Cooper C, van Sluijs EMF. Maternal awareness of young children's physical activity: levels and cross-sectional correlates of overestimation. BMC Public Health 2013; 13:924. [PMID: 24090173 PMCID: PMC3852941 DOI: 10.1186/1471-2458-13-924] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 09/11/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Factors associated with parental awareness of children's physical activity (PA) levels have not been explored in preschool-aged children. This paper investigates maternal awareness of preschool-aged children's PA levels and determined correlates associated with maternal overestimation of PA. METHODS Data from the Southampton Women's Survey, a UK population-based study, were collected March 2006 through June 2009. Daily minutes of moderate-to-vigorous PA (MVPA) were derived using accelerometry in 478 4-year-old children. Mothers who were realistic or overestimated their child's PA were identified. Log-binomial regression was used to analyse correlates of maternal overestimation of PA levels in children whose mothers perceived them to be active (n = 438). RESULTS 40.8% of children were classified as inactive: 89.7% of these were perceived to be active by their mothers (over-estimators). These mothers were more likely to think their child sometimes lacked skills required to be physically active (RR (95% CI) = 1.29(1.03-1.63)) and their child was more likely to attend nursery full-time (RR = 1.53(1.14-2.04)). They were less likely to have older children at home (RR = 0.71(0.56-0.90)). CONCLUSIONS Almost 90% of mothers of inactive preschool-aged children perceive their child to be active. Nursery-school attendance and having older siblings at home may be important to consider when designing behavioural interventions to increase PA in preschool children.
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Affiliation(s)
- Kathryn R Hesketh
- UKCRC Centre for Diet and Activity Research, Institute of Public Health, University of Cambridge, Cambridge, UK.
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15
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Delgado-Calle J, Garmilla P, Riancho JA. Do epigenetic marks govern bone mass and homeostasis? Curr Genomics 2012; 13:252-63. [PMID: 23115526 PMCID: PMC3382279 DOI: 10.2174/138920212800543129] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2011] [Revised: 12/03/2011] [Accepted: 12/09/2011] [Indexed: 12/26/2022] Open
Abstract
Bone is a specialized connective tissue with a calcified extracellular matrix in which cells are embedded. Besides providing the internal support of the body and protection for vital organs, bone also has several important metabolic functions, especially in mineral homeostasis. Far from being a passive tissue, it is continuously being resorbed and formed again throughout life, by a process known as bone remodeling. Bone development and remodeling are influenced by many factors, some of which may be modifiable in the early steps of life. Several studies have shown that environmental factors in uterus and in infancy may modify the skeletal growth pattern, influencing the risk of bone disease in later life. On the other hand, bone remodeling is a highly orchestrated multicellular process that requires the sequential and balanced events of osteoclast-mediated bone resorption and osteoblast-mediated bone formation. These processes are accompanied by specific gene expression patterns which are responsible for the differentiation of the mesenchymal and hematopoietic precursors of osteoblasts and osteoclasts, respectively, and the activity of differentiated bone cells. This review summarizes the current understanding of how epigenetic mechanisms influence these processes and their possible role in common skeletal diseases.
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Affiliation(s)
- Jesús Delgado-Calle
- Department of Internal Medicine, Hospital U.M. Valdecilla-IFIMAV-University of Cantabria, Santander, Spain
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16
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Harvey NC, Javaid K, Bishop N, Kennedy S, Papageorghiou AT, Fraser R, Gandhi SV, Schoenmakers I, Prentice A, Cooper C. MAVIDOS Maternal Vitamin D Osteoporosis Study: study protocol for a randomized controlled trial. The MAVIDOS Study Group. Trials 2012; 13:13. [PMID: 22314083 PMCID: PMC3395865 DOI: 10.1186/1745-6215-13-13] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Accepted: 02/07/2012] [Indexed: 11/24/2022] Open
Abstract
MAVIDOS is a randomised, double-blind, placebo-controlled trial (ISRCTN82927713, registered 2008 Apr 11), funded by Arthritis Research UK, MRC, Bupa Foundation and NIHR.
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Affiliation(s)
- Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
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17
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Devlin MJ, Bouxsein ML. Influence of pre- and peri-natal nutrition on skeletal acquisition and maintenance. Bone 2012; 50:444-51. [PMID: 21723972 PMCID: PMC3210869 DOI: 10.1016/j.bone.2011.06.019] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 05/30/2011] [Accepted: 06/15/2011] [Indexed: 11/29/2022]
Abstract
Early life nutrition has substantial influences on postnatal health, with both under- and overnutrition linked with permanent metabolic changes that alter reproductive and immune function and significantly increase metabolic disease risk in offspring. Since perinatal nutrition depends in part on maternal metabolic condition, maternal diet during gestation and lactation is a risk factor for adult metabolic disease. Such developmental responses may be adaptive, but might also result from constraints on, or pathological changes to, normal physiology. The rising prevalence of both obesity and osteoporosis, and the identification of links among bone, fat, brain, and gut, suggest that obesity and osteoporosis may be related, and moreover that their roots may lie in early life. Here we focus on evidence for how maternal diet during gestation and lactation affects metabolism and skeletal acquisition in humans and in animal models. We consider the effects of overall caloric restriction, and macronutrient imbalances including high fat, high sucrose, and low protein, compared to normal diet. We then discuss potential mechanisms underlying the skeletal responses, including perinatal developmental programming via disruption of the perinatal leptin surge and/or epigenetic changes, to highlight unanswered questions and identify the most critical areas for future research.
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Affiliation(s)
- M J Devlin
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA.
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18
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Lewis R, Cleal J, Ntani G, Crozier S, Mahon P, Robinson S, Harvey N, Cooper C, Inskip H, Godfrey K, Hanson M, John R. Relationship between placental expression of the imprinted PHLDA2 gene, intrauterine skeletal growth and childhood bone mass. Bone 2012; 50:337-42. [PMID: 22100507 PMCID: PMC3657144 DOI: 10.1016/j.bone.2011.11.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 11/01/2011] [Accepted: 11/02/2011] [Indexed: 01/04/2023]
Abstract
Alterations in expression of the imprinted gene PHLDA2 are linked to low birth weight in both humans and the mouse. However birth weight is a summary measure of fetal growth and provides little information on the growth rate of the fetus in early and late pregnancy. To examine the relation of PHLDA2 expression with rates of fetal growth and explore associations with the infant's body composition in early childhood, we measured PHLDA2 mRNA levels in the term placenta of 102 infants whose mothers were participating in the Southampton Women's Survey (SWS). Higher PHLDA2 expression was associated with a lower fetal femur growth velocity between 19 and 34 weeks gestation. In addition, higher placental PHLDA2 gene expression was associated with a lower child's bone mineral content at four years of age, measured using dual-energy X-ray absorptiometry. The results suggest that placental PHLDA2 may provide a biomarker for suboptimal skeletal growth in pregnancies uncomplicated by overt fetal growth restriction.
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Affiliation(s)
- R.M. Lewis
- Institute of Developmental Sciences, University of Southampton and Southampton University Hospitals NHS Trust, UK
| | - J.K. Cleal
- Institute of Developmental Sciences, University of Southampton and Southampton University Hospitals NHS Trust, UK
| | - G. Ntani
- MRC Lifecourse Epidemiology Unit, University of Southampton and Southampton University Hospitals NHS Trust, UK
| | - S.R. Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton and Southampton University Hospitals NHS Trust, UK
| | - P.A. Mahon
- MRC Lifecourse Epidemiology Unit, University of Southampton and Southampton University Hospitals NHS Trust, UK
| | - S.M. Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton and Southampton University Hospitals NHS Trust, UK
| | - N.C. Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton and Southampton University Hospitals NHS Trust, UK
| | - C. Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton and Southampton University Hospitals NHS Trust, UK
- Southampton NIHR Biomedical Research Unit in Nutrition, Diet & Lifestyle, University of Southampton and Southampton University Hospitals NHS Trust, UK
| | - H.M. Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton and Southampton University Hospitals NHS Trust, UK
| | - K.M. Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton and Southampton University Hospitals NHS Trust, UK
- Southampton NIHR Biomedical Research Unit in Nutrition, Diet & Lifestyle, University of Southampton and Southampton University Hospitals NHS Trust, UK
| | - M.A. Hanson
- Institute of Developmental Sciences, University of Southampton and Southampton University Hospitals NHS Trust, UK
- Southampton NIHR Biomedical Research Unit in Nutrition, Diet & Lifestyle, University of Southampton and Southampton University Hospitals NHS Trust, UK
| | | | - R.M. John
- Cardiff School of Biosciences, University of Cardiff, UK
- Corresponding author at: Cardiff School of Biosciences, University of Cardiff, CF10 3AX, UK. Fax: + 44 2920876328.
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Harvey NC, Mahon P, Kim M, Cole Z, Robinson S, Javaid MK, Inskip HM, Godfrey KM, Dennison EM, Cooper C. Intrauterine growth and postnatal skeletal development: findings from the Southampton Women's Survey. Paediatr Perinat Epidemiol 2012; 26:34-44. [PMID: 22150706 PMCID: PMC3641484 DOI: 10.1111/j.1365-3016.2011.01237.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We have previously demonstrated associations between fetal growth in late pregnancy and postnatal bone mass. However, the relationships between the intrauterine and early postnatal skeletal growth trajectory remain unknown. We addressed this in a large population-based mother-offspring cohort study. A total of 628 mother-offspring pairs were recruited from the Southampton Women's Survey. Fetal abdominal circumference was measured at 11, 19 and 34 weeks gestation using high-resolution ultrasound with femur length assessed at 19 and 34 weeks. Bone mineral content was measured postnatally in the offspring using dual-energy X-ray absorptiometry at birth and 4 years; postnatal linear growth was assessed at birth, 6, 12, 24, 36 and 48 months. Late pregnancy abdominal circumference growth (19-34 weeks) was strongly (P < 0.01) related to bone mass at birth, but less robustly associated with bone mass at 4 years. Early pregnancy growth (11-19 weeks) was more strongly related to bone mass at 4 years than at birth. Postnatal relationships between growth and skeletal indices at 4 years were stronger for the first and second postnatal years, than the period aged 2-4 years. The proportion of children changing their place in the distribution of growth velocities progressively reduced with each year of postnatal life. The late intrauterine growth trajectory is a better predictor of skeletal growth and mineralisation at birth, while the early intrauterine growth trajectory is a more powerful determinant of skeletal status at age 4 years. The perturbations in this trajectory which influence childhood bone mass warrant further research.
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Affiliation(s)
- N. C. Harvey
- MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
| | - P.A. Mahon
- MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
| | - M. Kim
- MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
| | - Z.A Cole
- MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
| | - S.M. Robinson
- MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
| | - M. K. Javaid
- NIHR Musculoskeletal Biomedical Research Unit, Institute of Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK
| | - H. M. Inskip
- MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
| | - K. M. Godfrey
- MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
| | - E. M. Dennison
- MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
| | - C. Cooper
- MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
,NIHR Musculoskeletal Biomedical Research Unit, Institute of Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK
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20
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Viljakainen HT, Korhonen T, Hytinantti T, Laitinen EKA, Andersson S, Mäkitie O, Lamberg-Allardt C. Maternal vitamin D status affects bone growth in early childhood--a prospective cohort study. Osteoporos Int 2011; 22:883-91. [PMID: 21153404 PMCID: PMC3034879 DOI: 10.1007/s00198-010-1499-4] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Accepted: 10/25/2010] [Indexed: 11/01/2022]
Abstract
UNLABELLED In this prospective study, 87 children were followed up from birth to 14 months with data on maternal vitamin D status during the pregnancy. Postnatal vitamin D supplementation improved vitamin D status but only partly eliminated the differences in bone variables induced by maternal vitamin D status during the fetal period. INTRODUCTION Intrauterine nutritional deficits may have permanent consequences despite improved nutritional status postnatally. We evaluated the role of prenatal and postnatal vitamin D status on bone parameters in early infancy. METHODS Eighty-seven children were followed from birth to 14 months. Background data were collected with a questionnaire and a 3-day food record. At 14 months bone variables were measured with peripheral computed tomography (pQCT) from the left tibia. Serum 25-OHD and bone turnover markers were determined. Findings were compared with maternal vitamin D status during pregnancy. RESULTS The children were divided into two groups based on vitamin D status during pregnancy. Despite discrepant S-25-OHD at baseline (median 36.3 vs. 52.5 nmol/l, p < 0.001), the values at 14 months were similar (63 vs. 66 nmol/l, p = 0.58) in Low D and High D. Serum 25-OHD increased more in Low D (p < 0.001) despite similar total intake of vitamin D (mean 12.3 μg/day). In Low D, tibial bone mineral content (BMC) was lower at birth but BMC gain was greater (multivariate analysis of variance [MANOVA]; p = 0.032) resulting in similar BMC at 14 months in the two groups. In High D, tibial total bone cross-sectional area was higher at baseline; the difference persisted at 14 months (MANOVA; p = 0.068). Bone mineral density (BMD) and ΔBMD were similar in the two groups. CONCLUSIONS Postnatal vitamin D supplementation improved vitamin D status but only partly eliminated the differences in bone variables induced by maternal vitamin D status during the fetal period. Further attention should be paid to improving vitamin D status during pregnancy.
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Affiliation(s)
- H. T. Viljakainen
- Hospital for Children and Adolescents, Helsinki University Central Hospital, Tukholmankatu 2C, PO Box 705, 00029 Helsinki, Finland
| | - T. Korhonen
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - T. Hytinantti
- Hospital for Children and Adolescents, Helsinki University Central Hospital, Tukholmankatu 2C, PO Box 705, 00029 Helsinki, Finland
| | - E. K. A. Laitinen
- Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland
| | - S. Andersson
- Hospital for Children and Adolescents, Helsinki University Central Hospital, Tukholmankatu 2C, PO Box 705, 00029 Helsinki, Finland
| | - O. Mäkitie
- Hospital for Children and Adolescents, Helsinki University Central Hospital, Tukholmankatu 2C, PO Box 705, 00029 Helsinki, Finland
| | - C. Lamberg-Allardt
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
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Goodfellow LR, Cooper C, Harvey NC. Regulation of placental calcium transport and offspring bone health. Front Endocrinol (Lausanne) 2011; 2:3. [PMID: 22649358 PMCID: PMC3355895 DOI: 10.3389/fendo.2011.00003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Accepted: 01/31/2011] [Indexed: 11/24/2022] Open
Abstract
Osteoporosis causes considerable morbidity and mortality in later life, and the risk of the disease is strongly determined by peak bone mass, which is achieved in early adulthood. Poor intrauterine and early childhood growth are associated with reduced peak bone mass, and increased risk of osteoporotic fracture in older age. In this review we describe the regulatory aspects of intrauterine bone development, and then summarize the evidence relating early growth to later fracture risk. Physiological systems include vitamin D, parathyroid hormone, leptin, GH/IGF-1; finally the potential role of epigenetic processes in the underlying mechanisms will be explored. Thus factors such as maternal lifestyle, diet, body build, physical activity, and vitamin D status in pregnancy all appear to influence offspring bone mineral accrual. These data demonstrate a likely interaction between environmental factors and gene expression, a phenomenon ubiquitous in the natural world (developmental plasticity), as the potential key process. Intervention studies are now required to test the hypotheses generated by these epidemiological and physiological findings, to inform potential novel public health interventions aimed at improving childhood bone health and reducing the burden of osteoporotic fracture in future generations.
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Affiliation(s)
- Laura R. Goodfellow
- The MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of SouthamptonSouthampton, UK
| | - Cyrus Cooper
- The MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of SouthamptonSouthampton, UK
| | - Nicholas C. Harvey
- The MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of SouthamptonSouthampton, UK
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22
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Verhaeghe J. Judicious use of antenatal glucocorticoids: putting the risks into the balance. Facts Views Vis Obgyn 2011; 3:215-20. [PMID: 24753867 PMCID: PMC3991452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The administration of a course of antenatal glucocorticoids (AG) to improve neonatal outcome after preterm birth is a prime example of evidence-based medicine, but the current clinical application of AG is too broad. AG override the glucocorticoid enzymatic placental barrier in order to elicit fetal lung maturation at a pre-physiological gestational age. Yet the maturation benefit is accompanied by a number of undesirable phenomena, most of which are transient (lasting for at least 24-48 h after the last injection). These include metabolic effects in both mother and fetus and signs of reduced fetal wellbeing. In addition, the fetal growth rate slows down depending on the number of AG courses. Multiple courses may increase the risk of cerebral palsy, as neonatal dexamethasone treatment does. There are no randomised trials on the benefit-risk balance of AG in pregnancies complicated by diabetes or intra-uterine growth restriction (IUGR). Animal studies indicate that AG are associated with an inadequate response to acute hypoxaemia and different brain development. Judicious use of AG includes avoidance of multiple courses, and a case-based -approach in pregnancies with (pre)gestational diabetes, IUGR or equivocal fetal condition, until more data become available. In addition, better prediction models of preterm birth are needed.
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Affiliation(s)
- J Verhaeghe
- Department of Obstetrics and Gynaecology, U.Z. Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
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