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Ghaderian M, Barekatain B, Sabri MR, Hovsepian S, Ahmadi A, Dehghan B, Mahdavi C, Ramezani Nezhad D, Arezoo M. Assessment of Vascular Indices by Abdominal Aortic Ultrasonography in Preterm Neonates with Bronchopulmonary Dysplasia. Pediatr Cardiol 2024; 45:1816-1822. [PMID: 37690064 DOI: 10.1007/s00246-023-03295-7] [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: 06/08/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023]
Abstract
Preterm infants with bronchopulmonary dysplasia (BPD) frequently encounter systemic hypertension, yet the underlying cause remains elusive. Given the absence of prior investigations concerning the correlation between systemic hypertension and aortic thickness, we undertook this study to assess and juxtapose diverse vascular indices amidst preterm neonates with BPD, preterm neonates lacking BPD, and healthy neonates, utilizing abdominal aorta ultrasonography. This cross-sectional study encompassed 20 preterm neonates, 20 preterm neonates with BPD, and 20 healthy neonates, meticulously matched for sex and postnatal age. Comprehensive demographic, anthropometric, and clinical evaluation data were documented. The neonates underwent abdominal aortic ultrasonography for comparative evaluation of aortic wall thickness and vasomotor function across the three groups. The study revealed that neonates with BPD exhibited a notably higher average systolic blood pressure than preterm and term neonates (P < 0.05). Conversely, echocardiographic parameters such as input impedance, and arterial wall stiffness index displayed no substantial variance among the three groups (P > 0.05). The mean (SD) aortic intima-media thickness (aIMT) for preterm neonates with BPD, preterm neonates, and term neonates were 814 (193.59) μm, 497.50 (172.19) μm, and 574.00 (113.20) μm, correspondingly (P < 0.05). Furthermore, the mean (SD) pulsatile diameter for preterm neonates with BPD, preterm neonates, and term neonates were 1.52 (0.81) mm, 0.91 (0.55) mm, and 1.34 (0.51) mm, respectively (P < 0.05). Following adjustment for birth weight, sex, and gestational age at birth, the study identified a noteworthy correlation between aIMT and BPD. The investigation concluded that the mean aortic intima-media thickness (aIMT) was significantly elevated in preterm neonates with BPD, signifying a potential early indicator of atherosclerosis and predisposition to future heightened blood pressure and cardiovascular ailments. Consequently, the study postulates that aIMT could be a consistent and well-tolerated marker for identifying BPD patients at risk of developing these health complications.
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Affiliation(s)
- Mehdi Ghaderian
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behzad Barekatain
- Department of Pediatrics, Division of Neonatology, Development Research Center, Child Growth, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Sabri
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Silva Hovsepian
- Metabolic Liver Disease Research Center, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Ahmadi
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bahar Dehghan
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Chehreh Mahdavi
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Davood Ramezani Nezhad
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Arezoo
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
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Muchira JM. Maternal-Child Cardiovascular Health: The Pathway to Reducing the Early Onset and Intergenerational Burden of Cardiovascular Disease. J Cardiovasc Nurs 2024; 39:297-301. [PMID: 38848242 DOI: 10.1097/jcn.0000000000001104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Affiliation(s)
- James M Muchira
- James M. Muchira, PhD, MSN Assistant Professor, Center for Research Development and Scholarship, Vanderbilt University School of Nursing, Nashville, TN
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3
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Muchira JM, Mogos MF, Park C, Logan J, Piano MR. A Mother-Child Dyadic Approach to Evaluating Subclinical Cardiovascular Disease in Young Children: A Feasibility Study. J Cardiovasc Nurs 2024; 39:307-317. [PMID: 36066587 DOI: 10.1097/jcn.0000000000000944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cardiovascular (CV) risk factors can be transmitted from mothers to their children. However, it is challenging to measure and identify subclinical CV risk in young children using traditional CV risk methods and metrics. OBJECTIVE The purpose of this study was to determine the feasibility of recruiting mother-child dyads and measuring arterial stiffness (pulse wave velocity, augmentation index/pressure), blood pressure (BP), BP circadian pattern, specifically nocturnal BP dipping, and CV health metrics in mothers and in children aged 1 to 5 years. METHODS All BP and arterial stiffness measures were obtained using the noninvasive automated oscillometric Mobil-O-Graph device. Also measured were blood cholesterol level; glucose level; body mass index (BMI); and smoking, diet, and physical activity history. Descriptive statistics were used for assessing recruitment feasibility and Pearson correlations for mother-child associations. RESULTS Thirty-five mother-child dyads completed the protocol. Recruitment reach was 89% and retention rate was 80%. Mothers were 34.3 ± 5.4 years old with a mean systolic BP (SBP) of 114.6 ± 9.5 mm Hg and BMI of 26.0 ± 6.5. Children were 3 ± 1.4 years old with a mean SBP of 103.3 ± 9.4 mm Hg and BMI z -scores of -0.3 ± 1.5. Arterial stiffness parameters were within normal ranges for mothers and children. Twenty-three percent of mothers did not exhibit nocturnal dipping (<10% decrease between day and nighttime SBP). Maternal SBP was positively correlated with child BMI z -scores ( r = 0.42, P = .022) as well as mother-child augmentation pressure ( r = 0.51, P = .010). CONCLUSIONS Our findings support using a mother-child approach and novel noninvasive approaches to assess and target CV risk in mothers and their young children.
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Ardiana M, Santoso A, Hermawan HO, Nugraha RA, Pikir BS, Suryawan IGR. Acute effects of cigarette smoke on Endothelial Nitric Oxide synthase, vascular cell adhesion molecule 1 and aortic intima media thickness. F1000Res 2023; 10:396. [PMID: 38046985 PMCID: PMC10690037 DOI: 10.12688/f1000research.28375.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 12/05/2023] Open
Abstract
Background. Cigarette smoking could induce endothelial dysfunction and the increase of circulating markers of inflammation by activation of monocytes. This can lead to increased intima media thickness (IMT) of entire blood vessels and result in acceleration of the atherosclerosis process. However, to our knowledge, little is known about the role of cigarette smoking in this atherosclerotic inflammatory process. The aim of this study is to explore the link between cigarette smoking and its effect on endothelial nitric oxide synthase (e-NOS) and vascular cell adhesion molecule 1 (VCAM-1). Methods. An experimental study with a post-test only controlled group design was used. We used 18 Wistar rats ( Rattus norvegicus) randomly subdivided into two groups: group K (-) were not exposed to tobacco smoke, whereas group K (+) were exposed to smoke equivalent of more than 40 cigarettes for 28 days daily. After 28 days, samples were analyzed for e-NOS, VCAM-1 and aortic IMT. Results . Our results indicate that tobacco smoke can enhance the expression of VCAM-1 on rat cardiac vascular endothelial cells, resulting in a decreased expression of e-NOS level and increase of aortic IMT. Linear regression model found that eNOS level negatively correlated wiith aortic IMT ( r 2 = 0.584, β = -0.764, p < 0.001), whereas VCAM-1 expression did not correlate with aortic IMT ( r 2 = 0.197, p = 0.065). Conclusion. Low e-NOS level and high VCAM-1 level observed after cigarette smoke exposure which may increase aortic IMT.
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Affiliation(s)
- Meity Ardiana
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, 60272, Indonesia
| | - Anwar Santoso
- Department of Cardiology and Vascular Medicine, Faculty of Medicine University of Indonesia - National Cardiovascular Centre Harapan Kita Hospital, Jakarta, DKI Jakarta, 11420, Indonesia
| | - Hanestya Oky Hermawan
- Department of Biomedicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Ricardo Adrian Nugraha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, 60272, Indonesia
| | - Budi Susetyo Pikir
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, 60272, Indonesia
| | - I. Gde Rurus Suryawan
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, 60272, Indonesia
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5
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Hartel TC, Oelofse A, De Smidt JJA. Vascular Effects, Potential Pathways and Mediators of Fetal Exposure to Alcohol and Cigarette Smoking during Pregnancy: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6398. [PMID: 37510630 PMCID: PMC10378932 DOI: 10.3390/ijerph20146398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
(1) Background: Programming of atherosclerosis results in vascular structure and function alterations, which may be attributed to fetal exposure to maternal tobacco smoking, alcohol consumption and several lifestyle factors in the first few years of life. This review aims to study the effects of teratogen exposure in utero on vascular dysfunction in offspring and consider mediators and pathways originating from the fetal environment. (2) Methods: Eligible studies were identified in the PubMed, Scopus and Web of Science databases. After the full-text screening, 20 articles were included in the narrative synthesis. (3) Results: The literature presents evidence supporting the detrimental effects of fetal exposure to tobacco smoking on vascular alterations in both human and animal studies. Alcohol exposure impaired endothelial dilation in animal studies, but human studies on both tobacco and alcohol exposure are still sparse. Reduction in nitric oxide (NO) bioavailability and alterations in the epigenome in infants through the upregulation of pro-oxidative and proinflammatory genes may be the common denominators. (4) Conclusion: While maternal smoking and alcohol consumption have more negative outcomes on the infant in the short term, several factors during the first few years of life may mediate the development of vascular dysfunction. Therefore, more prospective studies are needed to ascertain the long-term effects of teratogen exposure, specifically in South Africa.
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Affiliation(s)
- Tammy C Hartel
- Department of Medical Biosciences, Faculty of Natural Sciences, University of the Western Cape, Private Bag X17, Bellville, Cape Town 7530, South Africa
| | - André Oelofse
- Department of Medical Biosciences, Faculty of Natural Sciences, University of the Western Cape, Private Bag X17, Bellville, Cape Town 7530, South Africa
| | - Juléy J A De Smidt
- Department of Medical Biosciences, Faculty of Natural Sciences, University of the Western Cape, Private Bag X17, Bellville, Cape Town 7530, South Africa
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6
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Varley BJ, Nasir RF, Skilton MR, Craig ME, Gow ML. Early Life Determinants of Vascular Structure in Fetuses, Infants, Children, and Adolescents: A Systematic Review and Meta-Analysis. J Pediatr 2023; 252:101-110.e9. [PMID: 36029824 DOI: 10.1016/j.jpeds.2022.08.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the association between early life exposures during the first 1000 days (conception to age 24 months) and aortic intima-media thickness (aIMT), an early indicator of cardiovascular disease (CVD) risk, in youths. STUDY DESIGN The MEDLINE, Embase, Scopus, CINAHL, and Allied and Complementary Medicine databases were searched from inception to July 2021. Eligibility criteria included observational controlled studies in youths aged <20 years with risk factors/exposures during the first 1000 days and aIMT measurements (unadjusted mean ± SD). Outcome data were pooled using a random-effects meta-analysis. Meta-regression was used to investigate confounders. RESULTS A total of 8657 articles were identified, of which 34 were included in our meta-analysis. The age of participants ranged from 22.9 weeks gestation in utero to 10.9 years. In the meta-analysis (n = 1220 cases, n = 1997 controls), the following factors were associated with greater aIMT: small for gestational age (SGA) status (14 studies, mean difference, 0.082 mm; 95% CI, 0.051-0.112; P < .001; I2 = 97%), intrauterine growth restriction (6 studies; mean difference, 0.198 mm, 95% CI, 0.088-0.309; P < .001; I2 = 97%), preeclampsia (2 studies; mean difference, 0.038 mm; 95% CI, 0.024-0.051; P < .001; I2 = 38%), and large for gestational age (LGA) status (3 studies; mean difference, 0.089 mm; 95% CI, 0.043-0.0136; P < .001; I2 = 93%). In meta-regression, older age (P < .001), higher prevalence of maternal smoking (P = .04), and SGA (P < .001) were associated with greater difference in aIMT in preterm participants compared with controls. Limitations included the high heterogeneity present in most meta-analyses and the scope of our meta-regression. CONCLUSIONS Adverse early life exposures are associated with greater aIMT in youths, consistent with an increased risk for CVD later in life. Further research is needed to determine whether intervention and preventive strategies deliver clinical benefits to improve future cardiovascular health.
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Affiliation(s)
- Benjamin J Varley
- University of Sydney Children's Hospital Westmead Clinical School, Sydney, Australia
| | - Reeja F Nasir
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia
| | - Michael R Skilton
- University of Sydney Children's Hospital Westmead Clinical School, Sydney, Australia; Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia; The University of Sydney School of Medicine, Sydney, Australia; Sydney Institute for Women, Children and Their Families, Sydney Local Health District, Sydney, Australia
| | - Maria E Craig
- University of Sydney Children's Hospital Westmead Clinical School, Sydney, Australia; School of Women's and Children's Health, The University of New South Wales, Sydney, Australia; Institute of Endocrinology and Diabetes, Children's Hospital at Westmead, Sydney, Australia
| | - Megan L Gow
- University of Sydney Children's Hospital Westmead Clinical School, Sydney, Australia; School of Women's and Children's Health, The University of New South Wales, Sydney, Australia; Institute of Endocrinology and Diabetes, Children's Hospital at Westmead, Sydney, Australia.
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7
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Varley BJ, Henry A, Roberts L, Davis G, Skilton MR, Craig ME, Gow ML. Intrauterine exposure to preeclampsia does not impair vascular health in children. Front Public Health 2022; 10:1071304. [PMID: 36620255 PMCID: PMC9814159 DOI: 10.3389/fpubh.2022.1071304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background and objectives Preeclampsia is a serious multisystem blood pressure disorder during pregnancy that is associated with increased long-term risk of cardiovascular disease to the mother and offspring. We investigated the vascular health of children exposed to intrauterine preeclampsia. Materials and methods This was a cross-sectional study of offspring in a prospective cohort of women with complications during pregnancy. Children aged between 2 and 5 years [median age 4.7 (2.8, 5.1) years] exposed to intrauterine preeclampsia (n = 26) or normotensive controls (n = 34), were recruited between July 2020 and April 2021. Vascular health was assessed by measuring aortic intima-media thickness and pulse wave velocity. Univariate generalized linear regression models were used to explore associations between vascular measurements and explanatory variables. Results Children exposed to preeclampsia had a lower body mass index at assessment (15.5 vs. 16.2 kg/m2, p = 0.04), birth weight (2.90 vs. 3.34 kg, p = 0.004), gestational age at birth (37.5 vs. 39.4 weeks, p < 0.001) and higher frequency of preterm birth (27% vs. 6%, p = 0.02). There were no differences in vascular health between children exposed to preeclampsia vs. controls (mean aortic intima-media thickness 0.575 mm vs. 0.563 mm, p = 0.51, pulse wave velocity 4.09 vs. 4.18 m/s, p = 0.54) and there were no significant associations in univariate analyses. Conclusions There were no major adverse differences in vascular health which contrasts with existing studies. This suggests exposure to intrauterine preeclampsia may result in a less severe cardiovascular phenotype in young children. While reassuring, longitudinal studies are required to determine if and when exposure to intrauterine preeclampsia affects vascular health in children.
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Affiliation(s)
- Benjamin J. Varley
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, NSW, Australia,Department of Paediatrics and Child Health, St George Hospital, Kogarah, NSW, Australia
| | - Amanda Henry
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia,Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia,Department of Women's Health, St George Hospital, Kogarah, NSW, Australia,The George Institute for Global Health, Sydney, NSW, Australia
| | - Lynne Roberts
- Department of Women's Health, St George Hospital, Kogarah, NSW, Australia,School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Gregory Davis
- Department of Women's Health, St George Hospital, Kogarah, NSW, Australia,School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Michael R. Skilton
- Boden Initiative, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia,Sydney Medical School, University of Sydney, Sydney, NSW, Australia,Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW, Australia
| | - Maria E. Craig
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, NSW, Australia,Department of Paediatrics and Child Health, St George Hospital, Kogarah, NSW, Australia,Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia,Department of Women's Health, St George Hospital, Kogarah, NSW, Australia
| | - Megan L. Gow
- The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, NSW, Australia,Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, NSW, Australia,Department of Women's Health, St George Hospital, Kogarah, NSW, Australia,*Correspondence: Megan L. Gow ✉
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Moustafa A, Popat H, Ayer J, Haghighi M, Skilton M, Carmo KB. Infants With Congenital Heart Disease at Risk of Early Atherosclerotic Disease. J Am Heart Assoc 2022; 11:e025772. [DOI: 10.1161/jaha.122.025772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background
Aortic intima‐media thickness (aIMT) measurement is an established indicator of preclinical atherosclerosis. We aimed to describe the aIMT in infants with congenital heart disease undergoing cardiac surgery over the first year of life and explore its association with cardiopulmonary bypass, growth velocity, and a diagnosis of left heart obstruction.
Methods and Results
A prospective cohort study measuring mean and maximum aIMT preoperatively, at 3 months, and 1 year of age in neonates with congenital heart disease undergoing cardiac surgery. Twenty‐four infants with a median gestation of 39 weeks and a median birth weight of 3184 g were included. Sixteen (67%) infants had left outflow tract obstruction. Gestation correlated inversely with baseline mean aIMT (β=−0.027,
P
=0.018) and positively with the percentage of increase in mean and maximum aIMT between baseline and 3 months (β=17%,
P
=0.027 and β=15%,
P
=0.023). The presence of left outflow obstruction was significantly associated with increasing mean and maximum aIMT between baseline and 1 year (mean aIMT change: β=34%,
P
=0.017 and maximum aIMT change β=43%,
P
=0.001). Both subgroups of left heart obstruction and non‐left heart obstruction significantly changed over time (
P
=0.001 and
P
<0.001) but trends were not statistically different between both subgroups (
P
=0.21). Growth velocity and cardiopulmonary bypass were not associated with baseline or change in aIMT over the first year of life.
Conclusions
AIMT significantly increased over the first 3 months in our cohort of infants with repaired congenital heart disease. Increasing gestation was associated with decreasing aIMT at 3 months. Growth velocity and cardiopulmonary bypass were not associated with aIMT changes over the first year. Left heart obstruction was associated with a trend toward increased aIMT.
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Affiliation(s)
- Ahmed Moustafa
- Grace Centre for Newborn Intensive Care The Children’s Hospital at Westmead Sydney New South Wales Australia
- Faculty of Medicine and Health The University of Sydney New South Wales Sydney Australia
| | - Himanshu Popat
- Grace Centre for Newborn Intensive Care The Children’s Hospital at Westmead Sydney New South Wales Australia
- Faculty of Medicine and Health The University of Sydney New South Wales Sydney Australia
| | - Julian Ayer
- Faculty of Medicine and Health The University of Sydney New South Wales Sydney Australia
- The Heart Centre for Children The Children’s Hospital at Westmead Sydney New South Wales Australia
| | - Marjan Haghighi
- Faculty of Medicine and Health The University of Sydney New South Wales Sydney Australia
- The Heart Centre for Children The Children’s Hospital at Westmead Sydney New South Wales Australia
| | - Michael Skilton
- Faculty of Medicine and Health The University of Sydney New South Wales Sydney Australia
| | - Kathryn Browning Carmo
- Grace Centre for Newborn Intensive Care The Children’s Hospital at Westmead Sydney New South Wales Australia
- Faculty of Medicine and Health The University of Sydney New South Wales Sydney Australia
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Early life determinants of arterial stiffness in neonates, infants, children and adolescents: A systematic review and meta-analysis. Atherosclerosis 2022; 355:1-7. [PMID: 35841718 DOI: 10.1016/j.atherosclerosis.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/22/2022] [Accepted: 07/07/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Certain exposures and risk factors during the first 1,000 days of life are known to influence future cardiovascular disease (CVD) risk. Pulse wave velocity (PWV) is a measure of arterial stiffness and a recognised surrogate marker of CVD. We performed a systematic review and meta-analyses to investigate whether early life exposures were associated with increased PWV compared with controls in youth. METHODS Databases AMED, MEDLINE, EMBASE, CINAHL and Scopus were searched from inception until February 2022. ELIGIBILITY CRITERIA observational controlled studies in youth aged <20 years with risk factors/exposure during the first 1,000 days and PWV measurement. This review is registered with PROSPERO (CRD42019137559). Outcome data were pooled using random-effects meta-analysis. Meta-regression was used to investigate potential confounders. RESULTS We identified 24 eligible studies. Age of participants ranged from 1-day to 19-years at time of PWV assessment. Exposures included pre-term birth, small for gestational age (SGA), maternal diabetes and assisted reproductive technologies, none of which were significantly associated with PWV in meta-analysis. Sub-group analysis by age demonstrated increased PWV in childhood and adolescence in those exposed to maternal diabetes or born SGA. In meta-regression of pre-term studies, higher prevalence of SGA was associated with increased PWV compared with controls (p = 0.034, R2 = 1). CONCLUSIONS We found limited evidence that youth exposed to maternal diabetes or born SGA have increased PWV, consistent with increased future CVD risk. These changes in PWV appear to manifest in later childhood and adolescence. Further research is required to better understand the observed relationships.
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10
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Gow ML, Varley BJ, Nasir RF, Skilton MR, Craig ME. Aortic intima media thickness in children and adolescents with type 1 diabetes: A systematic review. Pediatr Diabetes 2022; 23:489-498. [PMID: 35191150 PMCID: PMC9303881 DOI: 10.1111/pedi.13322] [Citation(s) in RCA: 3] [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: 11/07/2021] [Accepted: 02/03/2022] [Indexed: 11/30/2022] Open
Abstract
AIMS Greater aortic intima media thickness (aIMT), a marker of subclinical atherosclerosis, can identify individuals at risk of CVD. This systematic review with meta-analysis compared aIMT in youth with type 1 diabetes and healthy controls. METHODS A systematic search of published literature (to July 2021) was undertaken using electronic databases MEDLINE, EMBASE, Scopus, CINAHL and AMED. Eligible studies reported aIMT in participants aged <20 years with type 1 diabetes and healthy controls. Meta-analysis was used to combine outcome data, presented as forest plots. Moderator analysis and metaregression were conducted to identify study and participant characteristics associated with aIMT. Publication bias was assessed by funnel plot inspection. RESULTS Meta-analysis of nine studies (n = 1030 with type 1 diabetes and n = 498 healthy control participants) indicated, with high heterogeneity (I2 98%), that youth with type 1 diabetes have higher aIMT compared with healthy controls (mean difference [95% CIs]: 0.11 [0.04, 0.18] mm, P = 0.003). Factors associated with greater aIMT in type 1 diabetes compared to controls included: use of a phased array probe versus linear array probe; longer diabetes duration; higher insulin dose; higher BMI z score and waist circumference; higher LDL cholesterol; higher triglycerides; and higher diastolic blood pressure. CONCLUSIONS Type 1 diabetes in youth is associated with higher aIMT compared with healthy control individuals. Longer duration of diabetes and major CVD risk factors were also associated with higher aIMT. Together, these findings provide a strong rationale for targeting modifiable risk factors in CVD prevention. Registered in PROSPERO on 8 August 2019 (CRD42019137559).
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Affiliation(s)
- Megan L. Gow
- Children's Hospital Westmead Clinical SchoolThe University of SydneySydneyAustralia,School of Women's and Children's HealthThe University of New South WalesSydneyAustralia
| | - Benjamin J. Varley
- Children's Hospital Westmead Clinical SchoolThe University of SydneySydneyAustralia
| | - Reeja F. Nasir
- Faculty of Medicine and HealthThe University of SydneySydneyAustralia
| | | | - Maria E. Craig
- Children's Hospital Westmead Clinical SchoolThe University of SydneySydneyAustralia,School of Women's and Children's HealthThe University of New South WalesSydneyAustralia,Faculty of Medicine and HealthThe University of SydneySydneyAustralia
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The Assessment of Maternal and Fetal Intima-Media Thickness in Perinatology. J Clin Med 2022; 11:jcm11051168. [PMID: 35268257 PMCID: PMC8911195 DOI: 10.3390/jcm11051168] [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: 12/05/2021] [Revised: 01/30/2022] [Accepted: 02/17/2022] [Indexed: 12/10/2022] Open
Abstract
Intima-media thickness (IMT) measurement is a non-invasive method of arterial wall assessment. An increased IMT is a common manifestation of atherosclerosis associated with endothelial dysfunction. In the course of pregnancy, various maternal organs, including the endothelium, are prepared for their new role. However, several pre-gestational conditions involving endothelial dysfunction, such as diabetes, chronic hypertension, and obesity, may impair the adaptation to pregnancy, whereas vascular changes may also affect fetal development, thus, influencing the fetal IMT. In the conducted studies, a correlation was found between an increased fetal abdominal aorta IMT (aIMT) and placental dysfunctions, which may subsequently impact both the mother and the fetus, and contribute to gestational hypertension, preeclampsia (PE), and fetal growth restriction (FGR). In fact, data indicate that following the delivery, the endothelial dysfunction persists and influences the future health of the mother and the newborn. Hypertensive disorders in pregnancy increase the maternal risk of chronic hypertension, obesity, and vascular events. Moreover, individuals born from pregnancies complicated by preeclampsia or fetal growth restriction are at high risk of obesity, diabetes, hypertension, and cardiovascular disease. Therefore, understanding the pathomechanism underlying an increased aIMT in preeclampsia and FGR, as well as subsequent placental dysfunctions, is essential for developing targeted therapies. This review summarizes recent publications regarding IMT and demonstrates how IMT measurements affect predicting perinatal complications.
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12
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SGLT2 inhibitor dapagliflozin prevents atherosclerotic and cardiac complications in experimental type 1 diabetes. PLoS One 2022; 17:e0263285. [PMID: 35176041 PMCID: PMC8853531 DOI: 10.1371/journal.pone.0263285] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 01/17/2022] [Indexed: 02/07/2023] Open
Abstract
Introduction Cardiovascular disease (CVD) is two to five times more prevalent in diabetic patients and is the leading cause of death. Therefore, identification of novel therapeutic strategies that reduce the risk of CVD is a research priority. Clinical trials showed that reduction in the relative risk of heart failure by sodium-glucose cotransporter 2 inhibitors (SGLT2i) are partly beyond their glucose lowering effects, however, the molecular mechanisms are still elusive. Here we investigated the role of SGLT2i dapagliflozin (DAPA) in the prevention of diabetes-induced cardiovascular complications. Methods Type 1 diabetes was induced with streptozotocin (65 mg/bwkg, ip.) in adult, male Wistar rats. Following the onset of diabetes rats were treated for six weeks with DAPA (1 mg/bwkg/day, po.). Results DAPA decreased blood glucose levels (D: 37±2.7 vs. D+DAPA: 18±5.6 mmol/L; p<0.05) and prevented metabolic decline. Aortic intima-media thickening was mitigated by DAPA. DAPA abolished cardiac hypertrophy, and myocardial damage. Cardiac inflammation and fibrosis were also moderated after DAPA treatment. Conclusions These data support the preventive and protective role of SGLT2i in diabetes-associated cardiovascular disease. SGLT2i may provide novel therapeutic strategy to hinder the development of cardiovascular diseases in type 1 diabetes, thereby improve the outcomes.
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13
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Wiertsema CJ, Jaddoe VWV, Mulders AGMGJ, Gaillard R. Childhood Blood Pressure, Carotid Intima Media Thickness, and Distensibility After In Utero Exposure to Gestational Hypertensive Disorders. J Am Heart Assoc 2022; 11:e023163. [PMID: 35043656 PMCID: PMC9238488 DOI: 10.1161/jaha.121.023163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Offspring exposed to gestational hypertensive disorders have higher blood pressure and increased risk of stroke in later life. Gestational hypertensive disorders might influence vascular development in the offspring, predisposing them to a higher blood pressure and stroke in later life. Methods and Results In a population‐based cohort among 4777 mother–offspring pairs, we examined whether gestational hypertension, preeclampsia, and higher gestational blood pressure across the full blood pressure spectrum were associated with offspring blood pressure, carotid intima media thickness, and distensibility at the age of 10 years. Offspring exposed to gestational hypertension, but not preeclampsia, had higher systolic and diastolic blood pressure (0.17 [95% CI, 0.02–0.31] and 0.23 [95% CI, 0.08–0.38] increases in standard deviation scores, respectively), whereas no associations with intima media thickness and distensibility were present. Higher maternal systolic and diastolic blood pressure in early, mid, and late pregnancy were associated with higher offspring systolic and diastolic blood pressure and lower distensibility (P values <0.05), but not with intima media thickness. The associations were not explained by maternal, birth, or child factors. Paternal systolic and diastolic blood pressure were also associated with these offspring outcomes (P values <0.05), with a comparable strength as maternal–offspring associations. Conclusions Gestational hypertension and higher gestational blood pressure, even below the diagnostic threshold for gestational hypertensive disorders, are associated with higher offspring blood pressure and lower carotid distensibility. No associations were found for preeclampsia with offspring vascular outcomes. As maternal–offspring and paternal–offspring associations were comparable, these associations are more likely driven by genetic predisposition and shared lifestyle rather than by a direct intrauterine effect.
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Affiliation(s)
- Clarissa J Wiertsema
- The Generation R Study Group Erasmus University Medical Center Rotterdam The Netherlands.,Department of Pediatrics Sophia's Children's HospitalErasmus University Medical Center Rotterdam The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group Erasmus University Medical Center Rotterdam The Netherlands.,Department of Pediatrics Sophia's Children's HospitalErasmus University Medical Center Rotterdam The Netherlands
| | - Annemarie G M G J Mulders
- Departments of Obstetrics and Gynecology Erasmus University Medical Center Rotterdam The Netherlands
| | - Romy Gaillard
- The Generation R Study Group Erasmus University Medical Center Rotterdam The Netherlands.,Department of Pediatrics Sophia's Children's HospitalErasmus University Medical Center Rotterdam The Netherlands
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14
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Olander RFW, Sundholm JKM, Suonsyrjä S, Sarkola T. Arterial health during early childhood following abnormal fetal growth. BMC Pediatr 2022; 22:40. [PMID: 35031019 PMCID: PMC8759262 DOI: 10.1186/s12887-021-02951-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/13/2021] [Indexed: 12/11/2022] Open
Abstract
Background Abnormal fetal growth is associated with increased cardiovascular risk in adulthood. We investigated the effect of fetal programming on arterial health and morphology during early childhood. Methods We examined 90 children (median age 5.81 years, interquartile range: 5.67; 5.95), born small for gestational age with fetal growth restriction, large or appropriate for gestational age (SGA, N = 23, LGA, N = 19, AGA N = 48). We measured body composition, anthropometrics, blood pressure, pulse wave velocity (PWV), lipids, glucose and inflammatory markers, and assessed carotid, brachial, radial and femoral arterial morphology and stiffness using very-high resolution ultrasound (46–71 MHz). Results LGA showed increased anthropometry, lean body mass and body mass index. SGA displayed decreased anthropometry and lean body mass. Blood pressure, PWV, carotid artery stiffness and blood work did not differ groupwise. Differences in lumen diameters, intima-media thicknesses (IMT) and adventitia thicknesses disappeared when adjusted for lean body mass and sex. In multiple regression models arterial dimensions were mainly predicted by lean body mass, with birth weight remaining associated only with carotid and brachial lumen dimensions, and not with IMTs. Carotid-femoral PWV was predicted by height and blood pressure only. No independent effect of adiposity was observed. Conclusions Arterial dimensions in childhood associate with current anthropometrics, especially lean body mass, and sex, explaining differences in arterial layer thickness. We found no signs of fetal programming of cardiovascular risk or arterial health in early childhood. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02951-2.
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Affiliation(s)
- Rasmus F W Olander
- Children's Hospital, Pediatric Research Center, University of Helsinki, and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, FIN-00029, Helsinki, Finland. .,Minerva Foundation Institute for Medical Research, Helsinki, Finland.
| | - Johnny K M Sundholm
- Children's Hospital, Pediatric Research Center, University of Helsinki, and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, FIN-00029, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Sanna Suonsyrjä
- Children's Hospital, Pediatric Research Center, University of Helsinki, and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, FIN-00029, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Taisto Sarkola
- Children's Hospital, Pediatric Research Center, University of Helsinki, and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, FIN-00029, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
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15
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Koemel NA, Senior AM, Dissanayake HU, Ross J, McMullan RL, Kong Y, Phang M, Hyett J, Raubenheimer D, Gordon A, Simpson SJ, Skilton MR. Maternal dietary fatty acid composition and newborn epigenetic aging-a geometric framework approach. Am J Clin Nutr 2022; 115:118-127. [PMID: 34591100 DOI: 10.1093/ajcn/nqab318] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 09/17/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Maternal nutrition is associated with epigenetic and cardiometabolic risk factors in offspring. Research in humans has primarily focused on assessing the impact of individual nutrients. OBJECTIVES We sought to assess the collective impact of maternal dietary MUFAs, PUFAs, and SFAs on epigenetic aging and cardiometabolic risk markers in healthy newborn infants using a geometric framework approach. METHODS Body fatness (n = 162), aortic intima-media thickness (aIMT; n = 131), heart rate variability (n = 118), and epigenetic age acceleration (n = 124) were assessed in newborn infants. Maternal dietary intake was cross-sectionally assessed in the immediate postpartum period via a validated 80-item self-administered FFQ. Generalized additive models were used to explore interactive associations of nutrient intake, with results visualized as response surfaces. RESULTS After adjustment for total energy intake, maternal age, gestational age, and sex there was a 3-way interactive association of MUFAs, PUFAs, and SFAs (P = 0.001) with newborn epigenetic aging. This suggests that the nature of each fat class association depends upon one another. Response surfaces revealed MUFAs were positively associated with newborn epigenetic age acceleration only at proportionately lower intakes of SFAs or PUFAs. We also demonstrate a potential beneficial association of omega-3 (n-3) PUFAs with newborn epigenetic age acceleration (P = 0.008). There was no significant association of fat class with newborn aIMT, heart rate variability, or body fatness. CONCLUSIONS In this study, we demonstrated an association between maternal dietary fat class composition and epigenetic aging in newborns. Future research should consider other characteristics such as the source of maternal dietary fatty acids.
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Affiliation(s)
- Nicholas A Koemel
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Alistair M Senior
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia.,School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - Hasthi U Dissanayake
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia.,Sleep Research Group, The University of Sydney, Sydney, Australia
| | - Jason Ross
- CSIRO Health and Biosecurity, Sydney, Australia
| | - Rowena L McMullan
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Yang Kong
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Melinda Phang
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Jon Hyett
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia
| | - David Raubenheimer
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - Adrienne Gordon
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia
| | - Stephen J Simpson
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - Michael R Skilton
- Charles Perkins Centre, The University of Sydney, Sydney, Australia.,Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, The University of Sydney, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia.,Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia
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16
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Abstract
Cardiovascular diseases caused by atherosclerosis do not typically manifest before middle age; however, the disease process begins early in life. Preclinical atherosclerosis can be quantified with imaging methods in healthy populations long before clinical manifestations present. Cohort studies have shown that childhood exposure to risk factors, such as dyslipidaemia, elevated blood pressure and tobacco smoking, are associated with adult preclinical atherosclerotic phenotypes. Importantly, these long-term effects are substantially reduced if the individual becomes free from the risk factor by adulthood. As participants in the cohorts continue to age and clinical end points accrue, the strongest evidence linking exposure to risk factors in early life with cardiovascular outcomes has begun to emerge. Although science has deciphered the natural course of atherosclerosis, discovered its causal risk factors and developed effective means to intervene, we are still faced with an ongoing global pandemic of atherosclerotic diseases. In general, atherosclerosis goes undetected for too long, and preventive measures, if initiated at all, are inadequate and/or come too late. In this Review, we give an overview of the available literature suggesting the importance of initiating the prevention of atherosclerosis in early life and provide a summary of the major paediatric programmes for the prevention of atherosclerotic disease. We also highlight the limitations of current knowledge and indicate areas for future research.
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17
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Filippatos TD, Alexakis K, Mavrikaki V, Mikhailidis DP. Nonalcoholic Fatty Pancreas Disease: Role in Metabolic Syndrome, "Prediabetes," Diabetes and Atherosclerosis. Dig Dis Sci 2022; 67:26-41. [PMID: 33469809 DOI: 10.1007/s10620-021-06824-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 01/05/2021] [Indexed: 02/06/2023]
Abstract
Fat accumulation in the pancreas associated with obesity and the metabolic syndrome (MetS) has been defined as "non-alcoholic fatty pancreas disease" (NAFPD). The aim of this review is to describe the association of NAFPD with obesity, MetS, type 2 diabetes mellitus (T2DM) and atherosclerosis and also increase awareness regarding NAFPD. Various methods are used for the detection and quantification of pancreatic fat accumulation that may play a significant role in the differences that have been observed in the prevalence of NAFPD. Endoscopic ultrasound provides detailed images of the pancreas and its use is expected to increase in the future. Obesity and MetS have been recognized as NAFPD risk factors. NAFPD is strongly associated with non-alcoholic fatty liver disease (NAFLD) and it seems that the presence of both may be related with aggravation of NAFLD. A role of NAFPD in the development of "prediabetes" and T2DM has also been suggested by most human studies. Accumulation of fat in pancreatic tissue possibly initiates a vicious cycle of beta-cell deterioration and further pancreatic fat accumulation. Additionally, some evidence indicates a correlation between NAFPD and atherosclerotic markers (e.g., carotid intima-media thickness). Weight loss and bariatric surgery decreases pancreatic triglyceride content but pharmacologic treatments for NAFPD have not been evaluated in specifically designed studies. Hence, NAFPD is a marker of local fat accumulation possibly associated with beta-cell function impairment, carbohydrate metabolism disorders and atherosclerosis.
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Affiliation(s)
- T D Filippatos
- Metabolic Diseases Research Unit, Internal Medicine Laboratory, School of Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, Heraklion, Crete, Greece.
| | - K Alexakis
- Metabolic Diseases Research Unit, Internal Medicine Laboratory, School of Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, Heraklion, Crete, Greece
| | - V Mavrikaki
- Metabolic Diseases Research Unit, Internal Medicine Laboratory, School of Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, Heraklion, Crete, Greece
| | - D P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, NW3 2QG, UK.,Mohammed Bin Rashid University (MBRU) of Medicine and Health Sciences, Dubai, United Arab Emirates
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18
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Kumar S, Mankowski RT, Anton SD, Babu Balagopal P. Novel insights on the role of spexin as a biomarker of obesity and related cardiometabolic disease. Int J Obes (Lond) 2021; 45:2169-2178. [PMID: 34253845 DOI: 10.1038/s41366-021-00906-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/15/2021] [Accepted: 07/01/2021] [Indexed: 02/06/2023]
Abstract
Spexin (SPX) is a 14-amino acid neuropeptide, discovered recently using bioinformatic techniques. It is encoded by the Ch12:orf39 gene that is widely expressed in different body tissues/organs across species, and secreted into systemic circulation. Recent reports have highlighted a potentially important regulatory role of SPX in obesity and related comorbidities. SPX is also ubiquitously expressed in human tissues, including white adipose tissue. The circulating concentration of SPX is significantly lower in individuals with obesity compared to normal weight counterparts. SPX's role in obesity appears to be related to various factors, such as the regulation of energy expenditure, appetite, and eating behaviors, increasing locomotion, and inhibiting long-chain fatty acid uptake into adipocytes. Recent reports have also suggested SPX's relationship with novel biomarkers of cardiovascular disease (CVD) and glucose metabolism and evoked the potential role of SPX as a key biomarker/player in the early loss of cardiometabolic health and development of CVD and diabetes later in life. Data on age-related changes in SPX and SPX's response to various interventions are also emerging. The current review focuses on the role of SPX in obesity and related comorbidities across the life span, and its response to interventions in these conditions. It is expected that this article will provide new ideas for future research on SPX and its metabolic regulation, particularly related to cardiometabolic diseases.
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Affiliation(s)
- Seema Kumar
- Division of Pediatric Endocrinology, Mayo Clinic, Rochester, MN, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Robert T Mankowski
- Department of Aging and Geriatric Research, Institute on Aging, University of Florida, Gainesville, FL, USA
| | - Stephen D Anton
- Department of Aging and Geriatric Research, Institute on Aging, University of Florida, Gainesville, FL, USA
| | - P Babu Balagopal
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA. .,Department of Biomedical Research, Nemours Children's Health System, Jacksonville, FL, USA.
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19
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Ardiana M, Utami E, Pikir B, Santoso A. Preventive effect of Nigella sativa on M1/M2 ratio, reducing risk of endothelial dysfunction in cigarette smoked Wistars. F1000Res 2021; 10:917. [PMID: 36071890 PMCID: PMC9403357 DOI: 10.12688/f1000research.53713.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Smoking is one of the top three causes of cardiovascular disease (CVD). Natural antioxidants including black cumin ( Nigella sativa) may inhibit the pathogenesis of initial process of atherosclerosis. The aim of this study was to determine the effect of black cumin (Nigella sativa) in preventing endothelial dysfunction mainly through macrophage M1/M2 inflammatory response in cigarette smoked male Wistars. Methods: In total, 50 Wistar rats were randomly allocated to five experimental groups: two control groups, namely no intervention (K-) and exposure to smoke of 40 cigarettes each day (K+); and three treatment groups: rats given a dose of 0.3 g (P1), 0.6 g (P2) or 1.2 g (P3) black cumin per kilograms bodyweight/ day, respectively, and exposed to smoke of 40 cigarettes each day. After 28 days of cigarette smoke exposure, macrophage M1/M2 ratio was evaluated by counting total M1 and M2 in ten microscope field of view. Data were analysed by Mann-Whitney test. Results: The M1 / M2 ratio on K (-) was 0.9 7 ± 0.9 8 (<1) which means M2 was dominant, while the M1 / M2 ratio on K (+) was of 4.97 ± 3.42 (> 1) which means M1 dominant. There was no significant difference in the number of M1 count in treatment groups P1, P2, P3 (p value = 0.996; 0.170; 0.884, respectively) when compared with K+. Additionally, P2 group has the lower M1 number with the highest significance value when compared to K+. The number of M1 counts on P1 did not differ significantly when compared to P2 with p = 0.121 and P3 with p = 0.936. Conclusions: In sum, ethanol extract of black cumin prevents endothelial dysfunction by inhibiting increase in macrophages M1 / M2 ratio in rats Wistar exposed to sub-chronic cigarette smoke.
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Affiliation(s)
- Meity Ardiana
- Faculty of Medicine, Airlangga University, Surabaya, East Java, Indonesia
- Cardiology and Vascular Medicine, Soetomo General Hospital, Surabaya, East Java, Indonesia
| | - Eka Utami
- Faculty of Medicine, Airlangga University, Surabaya, East Java, Indonesia
- Cardiology and Vascular Medicine, Soetomo General Hospital, Surabaya, East Java, Indonesia
| | - Budi Pikir
- Faculty of Medicine, Airlangga University, Surabaya, East Java, Indonesia
- Cardiology and Vascular Medicine, Soetomo General Hospital, Surabaya, East Java, Indonesia
| | - Anwar Santoso
- Cardiology and Vascular Medicine, Harapan Kita National Hospital, Jakarta, West Java, Indonesia
- Faculty of Medicine, University of Indonesia, Jakarta, West Java, Indonesia
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20
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Flores-Ramírez AG, Tovar-Villegas VI, Maharaj A, Garay-Sevilla ME, Figueroa A. Effects of L-Citrulline Supplementation and Aerobic Training on Vascular Function in Individuals with Obesity across the Lifespan. Nutrients 2021; 13:nu13092991. [PMID: 34578869 PMCID: PMC8466140 DOI: 10.3390/nu13092991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 12/20/2022] Open
Abstract
Children with obesity are at higher risk for developing cardiometabolic diseases that once were considered health conditions of adults. Obesity is commonly associated with cardiometabolic risk factors such as dyslipidemia, hyperglycemia, hyperinsulinemia and hypertension that contribute to the development of endothelial dysfunction. Endothelial dysfunction, characterized by reduced nitric oxide (NO) production, precedes vascular abnormalities including atherosclerosis and arterial stiffness. Thus, early detection and treatment of cardiometabolic risk factors are necessary to prevent deleterious vascular consequences of obesity at an early age. Non-pharmacological interventions including L-Citrulline (L-Cit) supplementation and aerobic training stimulate endothelial NO mediated vasodilation, leading to improvements in organ perfusion, blood pressure, arterial stiffness, atherosclerosis and metabolic health (glucose control and lipid profile). Few studies suggest that the combination of L-Cit supplementation and exercise training can be an effective strategy to counteract the adverse effects of obesity on vascular function in older adults. Therefore, this review examined the efficacy of L-Cit supplementation and aerobic training interventions on vascular and metabolic parameters in obese individuals.
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Affiliation(s)
- Anaisa Genoveva Flores-Ramírez
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, León 37320, Mexico; (A.G.F.-R.); (V.I.T.-V.)
| | - Verónica Ivette Tovar-Villegas
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, León 37320, Mexico; (A.G.F.-R.); (V.I.T.-V.)
| | - Arun Maharaj
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409, USA;
| | - Ma Eugenia Garay-Sevilla
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, León 37320, Mexico; (A.G.F.-R.); (V.I.T.-V.)
- Correspondence: (M.E.G.-S.); (A.F.)
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409, USA;
- Correspondence: (M.E.G.-S.); (A.F.)
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21
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Salnikova D, Orekhova V, Grechko A, Starodubova A, Bezsonov E, Popkova T, Orekhov A. Mitochondrial Dysfunction in Vascular Wall Cells and Its Role in Atherosclerosis. Int J Mol Sci 2021; 22:8990. [PMID: 34445694 PMCID: PMC8396504 DOI: 10.3390/ijms22168990] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 12/27/2022] Open
Abstract
Altered mitochondrial function is currently recognized as an important factor in atherosclerosis initiation and progression. Mitochondrial dysfunction can be caused by mitochondrial DNA (mtDNA) mutations, which can be inherited or spontaneously acquired in various organs and tissues, having more or less profound effects depending on the tissue energy status. Arterial wall cells are among the most vulnerable to mitochondrial dysfunction due to their barrier and metabolic functions. In atherosclerosis, mitochondria cause alteration of cellular metabolism and respiration and are known to produce excessive amounts of reactive oxygen species (ROS) resulting in oxidative stress. These processes are involved in vascular disease and chronic inflammation associated with atherosclerosis. Currently, the list of known mtDNA mutations associated with human pathologies is growing, and many of the identified mtDNA variants are being tested as disease markers. Alleviation of oxidative stress and inflammation appears to be promising for atherosclerosis treatment. In this review, we discuss the role of mitochondrial dysfunction in atherosclerosis development, focusing on the key cell types of the arterial wall involved in the pathological processes. Accumulation of mtDNA mutations in isolated arterial wall cells, such as endothelial cells, may contribute to the development of local inflammatory process that helps explaining the focal distribution of atherosclerotic plaques on the arterial wall surface. We also discuss antioxidant and anti-inflammatory approaches that can potentially reduce the impact of mitochondrial dysfunction.
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Affiliation(s)
- Diana Salnikova
- Faculty of Medicine, Lomonosov Moscow State University, 119192 Moscow, Russia;
- Laboratory of Oncoproteomics, Institute of Carconigenesis, N. N. Blokhin Cancer Research Centre, 115478 Moscow, Russia
| | - Varvara Orekhova
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, 125315 Moscow, Russia; (E.B.); (A.O.)
| | - Andrey Grechko
- Federal Scientific Clinical Center for Resuscitation and Rehabilitation, 109240 Moscow, Russia;
| | - Antonina Starodubova
- Federal Research Centre for Nutrition, Biotechnology and Food Safety, 109240 Moscow, Russia;
- Therapy Faculty, Pirogov Russian National Research Medical University, 117997 Moscow, Russia
| | - Evgeny Bezsonov
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, 125315 Moscow, Russia; (E.B.); (A.O.)
- Institute of Human Morphology, 117418 Moscow, Russia
| | - Tatyana Popkova
- V. A. Nasonova Institute of Rheumatology, 115522 Moscow, Russia;
| | - Alexander Orekhov
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, 125315 Moscow, Russia; (E.B.); (A.O.)
- Institute of Human Morphology, 117418 Moscow, Russia
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22
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Al-Biltagi M, El razaky O, El Amrousy D. Cardiac changes in infants of diabetic mothers. World J Diabetes 2021; 12:1233-1247. [PMID: 34512889 PMCID: PMC8394229 DOI: 10.4239/wjd.v12.i8.1233] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/11/2021] [Accepted: 07/07/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetes mellitus (DM) is a systemic chronic metabolic disorder characterized by increased insulin resistance and/or β- cell defects. It affects all ages from the foetal life, neonates, childhood to late adulthood. Gestational diabetes is a critical risk factor for congenital heart diseases (CHDs). Moreover, the risk increases with low maternal education, high body mass index at conception, undiagnosed pre-gestational diabetes, inadequate antenatal care, improper diabetes control, and maternal smoking during pregnancy. Maternal DM significantly affects the foetal heart and foetal–placental circulation in both structure and function. Cardiac defects, myocardial hypertrophy are three times more prevalent in infants of diabetic mothers (IDMs). Antenatal evaluation of the cardiac function and structures can be performed with foetal electrocardiography and echocardiography. Postnatal cardiac evaluation can be performed with natal and postnatal electrocardiography and echocardiography, detection of early atherosclerotic changes by measuring aortic intima-media thickness, and retinal vascular changes by retinal photography. Ameliorating the effects of diabetes during pregnancy on the offspring depends mainly on pregestational and gestational diabetes prevention. However, other measures to reduce the risk, such as using medications, nutritional supplements, or probiotics, still need more research. This review discusses the mechanism of foetal sequels and the risk factors that increase the prevalence of CHDs in gestational DM, the various cardiac outcomes of gestational DM on the foetus and offspring, cardiac evaluation of foetuses and IDMs, and how to alleviate the consequences of gestational DM on the offspring.
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Affiliation(s)
- Mohammed Al-Biltagi
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 35127, Egypt
- Department of Pediatrics, University Medical Center, Arabian Gulf University, Manama 26671, Bahrain
| | - Osama El razaky
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 35127, Egypt
| | - Doaa El Amrousy
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 35127, Egypt
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Lawson JS, Glenn WK. Infection and food combine to cause atherosclerotic coronary heart disease - Review and hypothesis. IJC HEART & VASCULATURE 2021; 35:100807. [PMID: 34286061 PMCID: PMC8273202 DOI: 10.1016/j.ijcha.2021.100807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 02/07/2023]
Abstract
HYPOTHESIS It is hypothesised that a combination of childhood and later life infections and excess food consumption, particularly of Western style food, initiates and contributes to atherosclerotic coronary heart disease. To consider this hypothesis we have conducted a brief review of the role of childhood infections, food, and their combined influence on atherosclerosis. EVIDENCE (i) Studies of populations with high prevalence of infections and low "hunter gather" like food consumption, have extremely low prevalence of atherosclerosis, (ii) there are consistent associations between infections in childhood and adult atherosclerotic coronary heart disease, (iii) there is an association between increased body weight, (an indication of excess eating), and atherosclerotic heart disease, and (iv) there is evidence that a combination of increased body weight and infections influences the development of atherosclerotic coronary heart disease.Infections do not appear to act independently to cause atherosclerosis. A combination of both food and infection appears to be required to cause atheroma. CONCLUSION The hypothesis that infections when combined with excess eating initiates atherosclerosis, is plausible. ACTION Action aimed at prevention of atherosclerotic heart disease is possible. There are three safe approaches to prevention (i) encouragement of Mediterranean like diets, (ii) avoidance of overeating and (iii) vigorous control of infections among all age groups. There is a need to monitor patients with a history of serious childhood infections and poor nutrition. In addition, for high risk subjects, cholesterol lowering statins are of proven and safe value.
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Affiliation(s)
- James S. Lawson
- School of Biotechnology and Biomolecular Science, University of New South Wales, Sydney, NSW 2052, Australia
| | - Wendy K. Glenn
- School of Biotechnology and Biomolecular Science, University of New South Wales, Sydney, NSW 2052, Australia
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Ardiana M, Susetyo Pikir B, Santoso A, Oky Hermawan H, Jibril Al-Farabi M. The effect of subchronic cigarette smoke exposure on oxidative stress parameters and endothelial nitric oxide synthase in a rat aorta. ARYA ATHEROSCLEROSIS 2021; 17:1-7. [PMID: 35685232 PMCID: PMC9137237 DOI: 10.22122/arya.v17i0.2150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/13/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND The compounds in cigarette smoke are believed to cause oxidative stress, leading to endothelial dysfunction. Understanding the mechanism of endothelial dysfunction due to cigarette smoke is useful for the development of early and preventive therapy for cardiovascular diseases (CVDs) with smoking risk factors. METHODS In this experimental study, a posttest-only control group design was used. 20 Wistar rats were divided into two groups: a smoking group (exposed to 40 cigarettes per day for 4 weeks) and a control group. After the exposure, the animals were sacrificed and aortas were removed for measurement of malondialdehyde (MDA), superoxide dismutase (SOD), endothelial nitric oxide synthase (eNOS), intima-media thickness (IMT), and for histological analysis. RESULTS Exposure to cigarette smoke caused a significant decrease in SOD activity (24.28 ± 4.90; P = 0.027) and eNOS levels (50.81 ± 4.18; P = 0.014), but no significant effect on the level of MDA (17.08 ± 5.78; P = 0.551). Histological analysis showed an increase in IMT (13.27 ± 2.40; P = 0.000) and disorganization and vacuolation of smooth muscle cells in tunica media after exposure to cigarette smoke. The regression analysis showed a significant negative relationship between the eNOS level and IMT (β = -1.012, P = 0.009). CONCLUSION Subchronic exposure to cigarette smoke caused a decrease in SOD activity and eNOS levels, but no significant change in MDA levels. This study also indicated that smoking causes IMT thickening and pathological structural changes in the aorta. Another finding indicated that a decrease in eNOS levels could cause an increase in the IMT of the aorta.
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Affiliation(s)
- Meity Ardiana
- Lecturer, Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Airlangga, Surabaya, Indonesia
| | - Budi Susetyo Pikir
- Professor, Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Airlangga, Surabaya, Indonesia
| | - Anwar Santoso
- Lecturer, Department of Cardiology, Faculty of Medicine, University of Indonesia; National Cardiovascular Center, Harapan Kita Hospital, Jakarta, Indonesia
| | - Hanestya Oky Hermawan
- Resident, Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Airlangga, Surabaya, Indonesia
| | - Makhyan Jibril Al-Farabi
- Resident, Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Airlangga, Surabaya, Indonesia
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Influence of intrauterine growth status on aortic intima-media thickness and aortic diameter in near-term fetuses: a comparative cross-sectional study. J Dev Orig Health Dis 2021; 13:212-219. [PMID: 34127175 DOI: 10.1017/s2040174421000295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Intrauterine undernutrition may lead to fetal vascular programming. We compared abdominal aortic intima-media thickness (aIMT) and aortic diameter (aD) between appropriate for gestational age (AGA) and growth-restricted fetuses (GRF). We recruited 136 singleton fetuses at 34-37 weeks of gestation from Fetal Medicine Unit of Aga Khan University Hospital, Karachi (January-November 2017). Subjects were classified as AGA (n = 102) and GRF (n = 34) using INTER-GROWTH 21st growth reference and standard ultrasound protocol. Their far- and near-wall aIMT and aD were compared after adjustment of maternal age, first-trimester body mass index, fetal gender, hypertension and hyperglycemia in pregnancy. As the severity of growth restriction increased in GRF, aIMT and aD showed an increasing and a decreasing trend, respectively. Both far- and near-wall aIMT in GRF [(adj. β = 0.082, 95% confidence interval [CI] 0.042-0.123) and (adj. β = 0.049, 95% CI 0.010-0.089)] were significantly greater with reference to AGA fetuses. GRF subgroup analysis into small for gestational age (SGA) fetuses and intrauterine growth restricted (IUGR) revealed highly significant difference between AGA and IUGR for far (0.142 mm, P-value < 0.001) and near-wall aIMT (0.115 mm, P-value < 0.001) and marginally significant aD difference (0.51 mm, P-value 0.05). These findings suggest that the extent of fetal aortic remodelling is influenced by the severity of growth restriction. Hence, the targeted interventions for the cardiovascular health promotion of IUGR and SGA born neonates are desirable during early childhood, particularly in set ups with high prevalence of low birth weight babies.
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Affiliation(s)
- Jes Sanddal Lindholt
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Elitary Research Centre for Individualized Medicine in Arterial Disease (CIMA), University of Southern Denmark, Odense, Denmark
| | - Rikke Søgaard
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Elitary Research Centre for Individualized Medicine in Arterial Disease (CIMA), University of Southern Denmark, Odense, Denmark
- Advisory Board Regarding the National Screening Programmes, Danish National Board of Health, Copenhagen, Denmark
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Yuste S, Ludwig IA, Romero M, Piñol‐Felis C, Catalán Ú, Pedret A, Valls RM, Fernández‐Castillejo S, Motilva M, Macià A, Rubió L. Metabolic Fate and Cardiometabolic Effects of Phenolic Compounds from Red‐Fleshed Apple in Hypercholesterolemic Rats: A Comparative Study with Common White‐Fleshed Apple. The AppleCOR Study. Mol Nutr Food Res 2021; 65:e2001225. [DOI: 10.1002/mnfr.202001225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/02/2021] [Indexed: 12/15/2022]
Affiliation(s)
- Silvia Yuste
- Food Technology Department XaRTA‐TPV Agrotecnio Center Escola Tècnica Superior d'Enginyeria Agrària University of Lleida, Avda/Alcalde Rovira Roure 191 Catalonia 25198 Lleida Spain
| | - Iziar A. Ludwig
- Food Technology Department XaRTA‐TPV Agrotecnio Center Escola Tècnica Superior d'Enginyeria Agrària University of Lleida, Avda/Alcalde Rovira Roure 191 Catalonia 25198 Lleida Spain
- Department de Medicina i Cirurgia Facultat de Medicina i Ciències de la Salut Functional Nutrition, Oxidation and Cardiovascular Diseases Group (NFOC‐Salut) Universitat Rovira i Virgili C/Sant Llorenç 21 Reus 43201 Spain
| | - María‐Paz Romero
- Food Technology Department XaRTA‐TPV Agrotecnio Center Escola Tècnica Superior d'Enginyeria Agrària University of Lleida, Avda/Alcalde Rovira Roure 191 Catalonia 25198 Lleida Spain
| | - Carme Piñol‐Felis
- Department of Medicine University of Lleida, Lleida Catalonia Spain
- Institut de Recerca Biomèdica de Lleida, Fundació Dr. Pifarré IRBLleida, Lleida Catalonia Spain
| | - Úrsula Catalán
- Department de Medicina i Cirurgia Facultat de Medicina i Ciències de la Salut Functional Nutrition, Oxidation and Cardiovascular Diseases Group (NFOC‐Salut) Universitat Rovira i Virgili C/Sant Llorenç 21 Reus 43201 Spain
- Eurecat Centre Tecnologic de Catalunya Unitat de Nutrició i Salut Reus Catalonia Spain
| | - Anna Pedret
- Department de Medicina i Cirurgia Facultat de Medicina i Ciències de la Salut Functional Nutrition, Oxidation and Cardiovascular Diseases Group (NFOC‐Salut) Universitat Rovira i Virgili C/Sant Llorenç 21 Reus 43201 Spain
- Eurecat Centre Tecnologic de Catalunya Unitat de Nutrició i Salut Reus Catalonia Spain
| | - Rosa M. Valls
- Department de Medicina i Cirurgia Facultat de Medicina i Ciències de la Salut Functional Nutrition, Oxidation and Cardiovascular Diseases Group (NFOC‐Salut) Universitat Rovira i Virgili C/Sant Llorenç 21 Reus 43201 Spain
- Eurecat Centre Tecnologic de Catalunya Unitat de Nutrició i Salut Reus Catalonia Spain
| | - Sara Fernández‐Castillejo
- Department de Medicina i Cirurgia Facultat de Medicina i Ciències de la Salut Functional Nutrition, Oxidation and Cardiovascular Diseases Group (NFOC‐Salut) Universitat Rovira i Virgili C/Sant Llorenç 21 Reus 43201 Spain
| | - María‐José Motilva
- Food Technology Department XaRTA‐TPV Agrotecnio Center Escola Tècnica Superior d'Enginyeria Agrària University of Lleida, Avda/Alcalde Rovira Roure 191 Catalonia 25198 Lleida Spain
- Instituto de Ciencias de la Vid y del Vino (ICVV) Consejo Superior de Investigaciones Científicas‐CSIC, Gobierno de La Rioja, Universidad de La Rioja, Finca “La Grajera” Carretera de Burgos km 6 La Rioja 26007, Logroño Spain
| | - Alba Macià
- Food Technology Department XaRTA‐TPV Agrotecnio Center Escola Tècnica Superior d'Enginyeria Agrària University of Lleida, Avda/Alcalde Rovira Roure 191 Catalonia 25198 Lleida Spain
| | - Laura Rubió
- Food Technology Department XaRTA‐TPV Agrotecnio Center Escola Tècnica Superior d'Enginyeria Agrària University of Lleida, Avda/Alcalde Rovira Roure 191 Catalonia 25198 Lleida Spain
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Mckenzie KM, Nasir R, Kong Y, Dissanayake HU, McMullan R, Gordon A, Meroni A, Phang M, Skilton MR. Maternal Dietary Carbohydrate Intake and Newborn Aortic Wall Thickness. Nutrients 2021; 13:1382. [PMID: 33924014 PMCID: PMC8073292 DOI: 10.3390/nu13041382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/02/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
Evidence from animal models indicates that maternal diet during pregnancy affects offspring cardiometabolic health. Improving carbohydrate quality during high-risk pregnancies reduces aortic intima-medial thickness; a marker for early atherosclerosis; in the infant offspring. We sought to determine whether maternal carbohydrate quantity and quality are associated with newborn aortic intima-medial thickness in healthy pregnancies. Maternal diet throughout pregnancy was evaluated in 139 mother-child dyads using a validated food frequency questionnaire. Carbohydrate intake was expressed as quantity (% total energy), quality (fibre, glycaemic index), and glycaemic burden (glycaemic load). Aortic intima-medial thickness was measured by high-frequency ultrasound of the neonatal abdominal aorta. Neither quantity nor quality of maternal carbohydrate intake during pregnancy was associated with meaningful differences in offspring maximum aortic intima-medial thickness with the exception of fibre intake in women with overweight or obesity which was inversely associated (-8 μm [95% CI -14, -1] per g fibre, p = 0.04). In healthy pregnancy, the quantity and quality of maternal carbohydrate intake is likely not a meaningful modifiable lifestyle factor for influencing offspring vascular health. The effect of carbohydrate quality may only be evident in high-risk pregnancies, consistent with previous findings. These findings may be confirmed in prospective dietary trials in pregnancy.
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Affiliation(s)
- Kirsty M. Mckenzie
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Reeja Nasir
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Yang Kong
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Hasthi U. Dissanayake
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Rowena McMullan
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
- Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia
| | - Adrienne Gordon
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
- Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW 2000, Australia
| | - Alice Meroni
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
| | - Melinda Phang
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
| | - Michael R. Skilton
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia; (K.M.M.); (R.N.); (Y.K.); (H.U.D.); (R.M.); (A.M.); (M.P.)
- Sydney Medical School, Charles Perkins Centre, University of Sydney, Camperdown, NSW 2006, Australia;
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW 2000, Australia
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Abstract
Adults who were born preterm are at increased risk of hypertension and cardiovascular disease in later life. Infants born late preterm are the majority of preterm births; however, the effect of late preterm on risk of cardiovascular disease is unclear. The objective of this study was to assess whether vascular health and cardiac autonomic control differ in a group of late preterm newborn infants compared to a group of term-born infants.A total of 35 healthy late preterm newborn infants, with normal growth (34-36 completed weeks' gestation) and 139 term-born infants (37-42 weeks' gestation) were compared in this study. Aortic wall thickening, assessed as aortic intima-media thickness (IMT) by high-resolution ultrasound, and cardiac autonomic control, assessed by heart rate variability, were measured during the first week of life. Postnatal age of full-term and late preterm infants at the time of the study was 5 days (standard deviation [SD] 5) and 4 days (SD 3), respectively.Infants born late preterm show reduced aortic IMT (574 μm [SD 51] vs. 612 μm [SD 73]) and reduced heart rate variability [log total power 622.3 (606.5) ms2 vs. 1180. 6 (1114.3) ms2], compared to term infants. These associations remained even after adjustment for sex and birth weight.Infants born late preterm show selective differences in markers of cardiovascular risk, with potentially beneficial differences in aortic wall thickness in contrast to potentially detrimental differences in autonomic control, when compared with term-born control infants. These findings provide pathophysiologic evidence to support an increased risk of hypertension and sudden cardiac death in individuals born late preterm.
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30
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Cirakoglu OF, Karadeniz AG, Akyüz AR, Aydın C, Şahin S, Erkan H. Abdominal Aortic Intima-Media Thickness Predicts Coronary Artery Disease Severity in Patients With Stable Angina Pectoris: A Prospective Study. Angiology 2021; 72:754-761. [PMID: 33663258 DOI: 10.1177/0003319721998853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Accurately identifying coronary artery disease (CAD) is the key element in guiding the work-up of patients with suspected angina. Thickening of the arterial wall is a hallmark of atherosclerosis. Therefore, the main purpose of this study was to determine whether abdominal aortic intima-media thickness (AAIMT), which is the earliest zone of atherosclerotic manifestations, has a predictive value in CAD severity. A total of 255 consecutive patients who were referred for invasive coronary angiography due to suspected stable angina pectoris were prospectively included in the study. B-mode ultrasonography was used to determine AAIMT before coronary angiography. Coronary artery disease severity was assessed with the SYNTAX score (SS). A history of hypertension, age, dyslipidemia, and higher AAIMT (odds ratio: 2.570; 95%CI 1.831-3.608; P < .001) were independent predictors of intermediate or high SS. An AAIMT <1.3 mm had a negative predictive value of 98% for the presence of intermediate or high SS and 83% for obstructive CAD. In conclusion, AAIMT showed a significant and independent predictive value for intermediate or high SS. Therefore, AAIMT may be a noninvasive and useful tool for decision-making by cardiologists (eg, to use a more invasive approach).
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Affiliation(s)
- Omer Faruk Cirakoglu
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Ayşe Gül Karadeniz
- Department of Radiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Ali Riza Akyüz
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Cihan Aydın
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Sinan Şahin
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Hakan Erkan
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
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Santi D, Spaggiari G, Greco C, Lazzaretti C, Paradiso E, Casarini L, Potì F, Brigante G, Simoni M. The "Hitchhiker's Guide to the Galaxy" of Endothelial Dysfunction Markers in Human Fertility. Int J Mol Sci 2021; 22:2584. [PMID: 33806677 PMCID: PMC7961823 DOI: 10.3390/ijms22052584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 02/24/2021] [Accepted: 02/28/2021] [Indexed: 02/06/2023] Open
Abstract
Endothelial dysfunction is an early event in the pathogenesis of atherosclerosis and represents the first step in the pathogenesis of cardiovascular diseases. The evaluation of endothelial health is fundamental in clinical practice and several direct and indirect markers have been suggested so far to identify any alterations in endothelial homeostasis. Alongside the known endothelial role on vascular health, several pieces of evidence have demonstrated that proper endothelial functioning plays a key role in human fertility and reproduction. Therefore, this state-of-the-art review updates the endothelial health markers discriminating between those available for clinical practice or for research purposes and their application in human fertility. Moreover, new molecules potentially helpful to clarify the link between endothelial and reproductive health are evaluated herein.
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Affiliation(s)
- Daniele Santi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 42121 Modena, Italy; (C.G.); (C.L.); (E.P.); (L.C.); (G.B.); (M.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy;
| | - Giorgia Spaggiari
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy;
| | - Carla Greco
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 42121 Modena, Italy; (C.G.); (C.L.); (E.P.); (L.C.); (G.B.); (M.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy;
| | - Clara Lazzaretti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 42121 Modena, Italy; (C.G.); (C.L.); (E.P.); (L.C.); (G.B.); (M.S.)
- International PhD School in Clinical and Experimental Medicine (CEM), University of Modena and Reggio Emilia, 42121 Modena, Italy
| | - Elia Paradiso
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 42121 Modena, Italy; (C.G.); (C.L.); (E.P.); (L.C.); (G.B.); (M.S.)
- International PhD School in Clinical and Experimental Medicine (CEM), University of Modena and Reggio Emilia, 42121 Modena, Italy
| | - Livio Casarini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 42121 Modena, Italy; (C.G.); (C.L.); (E.P.); (L.C.); (G.B.); (M.S.)
- Center for Genomic Research, University of Modena and Reggio Emilia, 42121 Modena, Italy
| | - Francesco Potì
- Department of Medicine and Surgery-Unit of Neurosciences, University of Parma, 43121 Parma, Italy;
| | - Giulia Brigante
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 42121 Modena, Italy; (C.G.); (C.L.); (E.P.); (L.C.); (G.B.); (M.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy;
| | - Manuela Simoni
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 42121 Modena, Italy; (C.G.); (C.L.); (E.P.); (L.C.); (G.B.); (M.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy;
- Center for Genomic Research, University of Modena and Reggio Emilia, 42121 Modena, Italy
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Andraos S, Jones B, Lange K, Clifford SA, Thorstensen EB, Kerr JA, Wake M, Saffery R, Burgner DP, O'Sullivan JM. Trimethylamine N-oxide (TMAO) Is not Associated with Cardiometabolic Phenotypes and Inflammatory Markers in Children and Adults. Curr Dev Nutr 2021; 5:nzaa179. [PMID: 33501405 PMCID: PMC7813154 DOI: 10.1093/cdn/nzaa179] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Trimethylamine N-oxide (TMAO) is a diet- and microbiome-derived metabolite and a proposed biomarker of adverse cardiometabolic outcomes. TMAO studies have mainly been conducted in individuals with cardiometabolic disease, and studies in population-derived samples are limited. OBJECTIVE We aimed to investigate the associations between plasma TMAO concentrations and its precursors [carnitine, choline, betaine, and dimethylglycine (DMG)] with metabolic syndrome (MetS) scores, preclinical cardiovascular phenotypes, and inflammatory biomarkers (i.e. high-sensitivity C-reactive protein and serum glycoprotein acetyls) in a population-derived cohort of children and their parents. METHODS The concentrations of TMAO and its precursors were quantified using UHPLC coupled with tandem MS (UHPLC/MS-MS) in 1166 children (mean age 11 y ± 0.5 y, 51% female) and 1324 adults (44 y ± 5.1 y, 87% female) participating in The Growing Up in Australia's Child Health CheckPoint Study. We developed multivariable fractional polynomial models to analyze associations between TMAO, its precursors, MetS (adjusted for sex and age), and cardiovascular phenotypes (adjusted for sex, age, BMI, household income, and the urinary albumin to creatinine ratio). Pearson's correlations were computed to identify associations between TMAO, its precursors, and inflammatory biomarkers. RESULTS The concentrations of TMAO precursors, but not TMAO itself, were associated with MetS, cardiovascular phenotypes, and inflammatory biomarkers in children and adults. CONCLUSIONS TMAO precursors, but not TMAO itself, were associated with adverse cardiometabolic and inflammatory phenotypes in children and adults. TMAO precursor concentrations may better reflect cardiovascular health and inflammatory status within the wider population. Replication in other population settings and mechanistic studies are warranted.
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Affiliation(s)
- Stephanie Andraos
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Beatrix Jones
- Department of Statistics, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - Katherine Lange
- The Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Susan A Clifford
- The Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | | | - Jessica A Kerr
- The Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Melissa Wake
- The Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Richard Saffery
- The Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - David P Burgner
- The Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Justin M O'Sullivan
- Liggins Institute, The University of Auckland, Auckland, New Zealand
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
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Vodovotz Y, Barnard N, Hu FB, Jakicic J, Lianov L, Loveland D, Buysse D, Szigethy E, Finkel T, Sowa G, Verschure P, Williams K, Sanchez E, Dysinger W, Maizes V, Junker C, Phillips E, Katz D, Drant S, Jackson RJ, Trasande L, Woolf S, Salive M, South-Paul J, States SL, Roth L, Fraser G, Stout R, Parkinson MD. Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit. Front Med (Lausanne) 2020; 7:585744. [PMID: 33415115 PMCID: PMC7783318 DOI: 10.3389/fmed.2020.585744] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/20/2020] [Indexed: 12/13/2022] Open
Abstract
Declining life expectancy and increasing all-cause mortality in the United States have been associated with unhealthy behaviors, socioecological factors, and preventable disease. A growing body of basic science, clinical research, and population health evidence points to the benefits of healthy behaviors, environments and policies to maintain health and prevent, treat, and reverse the root causes of common chronic diseases. Similarly, innovations in research methodologies, standards of evidence, emergence of unique study cohorts, and breakthroughs in data analytics and modeling create new possibilities for producing biomedical knowledge and clinical translation. To understand these advances and inform future directions research, The Lifestyle Medicine Research Summit was convened at the University of Pittsburgh on December 4-5, 2019. The Summit's goal was to review current status and define research priorities in the six core areas of lifestyle medicine: plant-predominant nutrition, physical activity, sleep, stress, addictive behaviors, and positive psychology/social connection. Forty invited subject matter experts (1) reviewed existing knowledge and gaps relating lifestyle behaviors to common chronic diseases, such as cardiovascular disease, diabetes, many cancers, inflammatory- and immune-related disorders and other conditions; and (2) discussed the potential for applying cutting-edge molecular, cellular, epigenetic and emerging science knowledge and computational methodologies, research designs, and study cohorts to accelerate clinical applications across all six domains of lifestyle medicine. Notably, federal health agencies, such as the Department of Defense and Veterans Administration have begun to adopt "whole-person health and performance" models that address these lifestyle and environmental root causes of chronic disease and associated morbidity, mortality, and cost. Recommendations strongly support leveraging emerging research methodologies, systems biology, and computational modeling in order to accelerate effective clinical and population solutions to improve health and reduce societal costs. New and alternative hierarchies of evidence are also be needed in order to assess the quality of evidence and develop evidence-based guidelines on lifestyle medicine. Children and underserved populations were identified as prioritized groups to study. The COVID-19 pandemic, which disproportionately impacts people with chronic diseases that are amenable to effective lifestyle medicine interventions, makes the Summit's findings and recommendations for future research particularly timely and relevant.
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Affiliation(s)
- Yoram Vodovotz
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - Neal Barnard
- Department of Medicine, George Washington University School of Medicine, Washington, DC, United States
| | - Frank B. Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - John Jakicic
- School of Education, University of Pittsburgh, Pittsburgh, PA, United States
| | - Liana Lianov
- American College of Lifestyle Medicine, Chesterfield, MO, United States
| | | | - Daniel Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Eva Szigethy
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Toren Finkel
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Gwendolyn Sowa
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States
| | - Paul Verschure
- Institute for Bioengineering of Catalunya, Barcelona Institute of Science and Technology, Catalan Institute of Advanced Studies, Barcelona, Spain
| | - Kim Williams
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States
| | | | | | - Victoria Maizes
- Department of Internal Medicine, University of Arizona, Tucson, AZ, United States
| | - Caesar Junker
- United States Air Force, Washington, DC, United States
| | - Edward Phillips
- Department of Physical Medicine and Rehabilitation, Veterans Administration Boston Healthcare System, Boston, MA, United States
| | - David Katz
- True Health Initiative, Derby, CT, United States
| | - Stacey Drant
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, United States
| | - Richard J. Jackson
- Department of Environmental Health Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Leonardo Trasande
- Department of Pediatrics and Environmental Medicine, New York University, New York, NY, United States
| | - Steven Woolf
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Marcel Salive
- Division of Geriatrics and Clinical Gerontology, National Institute on Aging, Bethesda, MD, United States
| | - Jeannette South-Paul
- Department of Family Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Sarah L. States
- Phipps Conservatory and Botanical Gardens, Pittsburgh, PA, United States
| | - Loren Roth
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Gary Fraser
- Department of Medicine, Preventive Medicine and Public Health, Loma Linda University, Loma Linda, CA, United States
| | - Ron Stout
- Ardmore Institute of Health, Ardmore, OK, United States
| | - Michael D. Parkinson
- University of Pittsburgh Medical Center Health Plan/WorkPartners, Pittsburgh, PA, United States
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Oikonomou N, Fouzas S, Gkentzi D, Dimitriou G, Karatza AA. Aortic intima-media thickness in neonates exposed to early-onset preeclampsia. Early Hum Dev 2020; 151:105166. [PMID: 32889166 DOI: 10.1016/j.earlhumdev.2020.105166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/02/2020] [Accepted: 08/24/2020] [Indexed: 02/08/2023]
Abstract
Aortic intima-media thickness (aIMT) and its ratio to aortic diameter (aIMT/AoD) were measured on the second and fifth postnatal day in 39 neonates exposed to early-onset preeclampsia and 39 controls. Both aIMT and aIMT/AoD were higher in neonates exposed to preeclampsia (P < 0.001 for all comparisons).
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Affiliation(s)
- Nikoleta Oikonomou
- Neonatal Intensive Care Unit, Department of Pediatrics, University of Patras Medical School, Greece
| | - Sotirios Fouzas
- Neonatal Intensive Care Unit, Department of Pediatrics, University of Patras Medical School, Greece.
| | - Despoina Gkentzi
- Neonatal Intensive Care Unit, Department of Pediatrics, University of Patras Medical School, Greece
| | - Gabriel Dimitriou
- Neonatal Intensive Care Unit, Department of Pediatrics, University of Patras Medical School, Greece
| | - Ageliki A Karatza
- Neonatal Intensive Care Unit, Department of Pediatrics, University of Patras Medical School, Greece
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Noninvasive Testing for Diagnosis of Stable Coronary Artery Disease in the Elderly. Int J Mol Sci 2020; 21:ijms21176263. [PMID: 32872444 PMCID: PMC7503866 DOI: 10.3390/ijms21176263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/20/2020] [Accepted: 08/25/2020] [Indexed: 11/17/2022] Open
Abstract
Efficient diagnostic approaches to detect coronary artery disease (CAD) in elderly patients are necessary to ensure optimal and timely treatment. The population of suspected CAD patients older than 70 years is especially vulnerable and constantly growing. Finding the optimal diagnostic approach is challenging due to certain features of this population, such as high prevalence of comorbidities, existing contraindications to exercise tests or cognitive decline, which hinders correct assessment of the patient's situation. Moreover, some symptoms of CAD can have variable significance in the elderly compared to younger adult groups. In this review, we present current recommendations of the United States (US) and European cardiologists' associations and discuss their applicability for diagnostics in the elderly population. Exercise electrocardiogram (ECG) and exercise stress echocardiography (SE) tests are not feasible for a substantial proportion of elderly patients. Coronary computed tomography angiography (CTA) appears to be an attractive alternative for such patients, but is not universally applicable; for instance, it is problematic in patients with significant calcification of the vessels. Moreover, more studies are needed to compare the results delivered by CTA to those of other diagnostic methods. Future efforts should be focused on comparative studies to better understand the limits and advantages of different diagnostic methods and their combinations. It is possible that some of the currently used diagnostic criteria could be improved to better accommodate the needs of the elderly population.
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Orekhov AN, Ivanova EA, Markin AM, Nikiforov NG, Sobenin IA. Genetics of Arterial-Wall-Specific Mechanisms in Atherosclerosis: Focus on Mitochondrial Mutations. Curr Atheroscler Rep 2020; 22:54. [PMID: 32772280 DOI: 10.1007/s11883-020-00873-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Mutations in both nuclear and mitochondrial genes are associated with the development of atherosclerotic lesions in arteries and may provide a partial explanation to the focal nature of lesion distribution in the arterial wall. This review is aimed to discuss the genetic aspects of atherogenesis with a special focus on possible pro-atherogenic variants (mutations) of the nuclear and mitochondrial genomes that may be implicated in atherosclerosis development and progression. RECENT FINDINGS Mutations in the nuclear genes generally do not cause a phenotype restricted to a specific vascular wall cell and manifest themselves mostly at the organism level. Such mutations can act as important contributors to changes in lipid metabolism and modulate other risk factors of atherosclerosis. By contrast, mitochondrial DNA (mtDNA) mutations occurring locally in the arterial wall cells or in circulating immune cells may play a site-specific role in atherogenesis. The mosaic distribution of heteroplasmic mtDNA mutations in the arterial wall tissue may explain, at least to some extent, the locality and focality of atherosclerotic lesions distribution. The genetic mechanisms of atherogenesis include alterations of both nuclear and mitochondrial genomes. Altered lipid metabolism and inflammatory response of resident arterial wall and circulating immune cells may be related to mtDNA damage and defective mitophagy, which hinders clearance of dysfunctional mitochondria. Mutations of mtDNA can have mosaic distribution and locally affect functionality of endothelial and subendothelial intimal cells in the arterial wall contributing to atherosclerotic lesion development.
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Affiliation(s)
- Alexander N Orekhov
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, 8 Baltiiskaya Street, Moscow, Russia, 125315. .,Laboratory of Infection Pathology and Molecular Microecology, Institute of Human Morphology, 3 Tsyurupa Street, Moscow, Russia, 117418.
| | - Ekaterina A Ivanova
- Institute for Atherosclerosis Research, 2-1-207 Osennyaya Street, Moscow, Russia, 121609.
| | - Alexander M Markin
- Laboratory of Infection Pathology and Molecular Microecology, Institute of Human Morphology, 3 Tsyurupa Street, Moscow, Russia, 117418
| | - Nikita G Nikiforov
- Centre of Collective Usage, Institute of Gene Biology, Russian Academy of Sciences, 34/5 Vavilova Street, Moscow, Russia, 119334.,Laboratory of Medical Genetics, Institute of Experimental Cardiology, National Medical Research Center of Cardiology, 15A 3-rd Cherepkovskaya Street, Moscow, Russia, 121552
| | - Igor A Sobenin
- Laboratory of Angiopathology, Institute of General Pathology and Pathophysiology, 8 Baltiiskaya Street, Moscow, Russia, 125315.,Laboratory of Medical Genetics, Institute of Experimental Cardiology, National Medical Research Center of Cardiology, 15A 3-rd Cherepkovskaya Street, Moscow, Russia, 121552
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Andraos S, Lange K, Clifford SA, Jones B, Thorstensen EB, Kerr JA, Wake M, Saffery R, Burgner DP, O'Sullivan JM. Plasma Trimethylamine N-Oxide and Its Precursors: Population Epidemiology, Parent-Child Concordance, and Associations with Reported Dietary Intake in 11- to 12-Year-Old Children and Their Parents. Curr Dev Nutr 2020; 4:nzaa103. [PMID: 32666035 PMCID: PMC7335361 DOI: 10.1093/cdn/nzaa103] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/18/2020] [Accepted: 06/02/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Trimethylamine N-oxide (TMAO) is a microbiome- and diet-derived metabolite implicated in adverse cardiovascular outcomes. To date, studies of plasma TMAO concentrations have largely focused on individuals with metabolic disease. As such, data on TMAO concentrations in population settings and parent-child dyads are lacking. OBJECTIVES This study aimed to investigate parent-child concordance, age, and sex effects on plasma concentrations of TMAO and its precursors [l-carnitine, choline, betaine, and dimethylglycine (DMG)]. Associations between concentrations of TMAO and its precursors and self-reported dietary intakes of animal protein (i.e., red meat, meat products, chicken, fish, milk products, and cheese) and fast-food meals were also investigated. METHODS A total of 1166 children (mean ± SD age: 11 ± 0.5 y, 51% female) and 1324 parents (mean ± SD age: 44 ± 5.1 y, 87% female) had a biomedical assessment as part of Growing Up in Australia's Child Health Checkpoint. Plasma TMAO and precursor concentrations were quantified using ultra-high-pressure LC coupled with tandem MS. RESULTS Familial dyads significantly contributed to plasma TMAO and precursor concentrations (P < 0.0001), explaining 37% of variance for TMAO concentrations. Least-square mean ± SE plasma TMAO was lower in children (0.79 ± 0.02 µM on the log-scale) than in adults (1.22 ± 0.02 µM). By contrast, children's betaine (40.30 ± 0.34 µM) and DMG concentrations (1.02 ± 0.01 µM on the log-scale) were higher than adults' betaine (37.50 ± 0.32 µM) and DMG concentrations (0.80 ± 0.01 µM) (P < 0.0001). Mean values of all metabolites, except adult TMAO, were higher in males than in females (P < 0.001). Greater reported intake of red meat and fish was associated with higher TMAO concentrations in both children [estimates (95% CIs) for red meat: 0.06 (0.01, 0.10); fish: 0.11 (0.06, 0.17)] and adults [red meat: 0.13 (0.08, 0.17); meat products: 0.07 (0.03, 0.12); and fish: 0.09 (0.04, 0.14)]. CONCLUSIONS Age, sex, and shared family factors, including diet, contribute to variation in plasma concentrations of TMAO and its precursors.
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Affiliation(s)
- Stephanie Andraos
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Katherine Lange
- The Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Susan A Clifford
- The Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Beatrix Jones
- Department of Statistics, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | | | - Jessica A Kerr
- The Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Melissa Wake
- The Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Richard Saffery
- The Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - David P Burgner
- The Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
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Abstract
Previous studies reported an inverse association between healthy dietary patterns (such as Mediterranean diet) and the incidence of cardiovascular events. As the mechanism accounting for cardiovascular disease is prevalently due to the atherothrombosis, where a pivotal role is played by platelet activation, it would be arguable that diets with protective effects against cardiovascular disease exert an anti-atherothrombotic effect via inhibition of platelet activation. There are several and sparse typologies of studies, which investigated if single nutrients by diets recognized as having cardiovascular protection may exert an antithrombotic effect. The most investigated nutrients are key components of the Mediterranean diets such as fruits and vegetables, fish, olive oil, and wine; other diets with protective effects include nuts and cocoa. Here we summarize experimental and human interventional studies which investigated the antithrombotic effects of such nutrients in experimental models of thrombosis or analyzed biomarkers of clotting, platelet, and fibrinolysis activation in human; furthermore in vitro studies explored the underlying mechanism at level of several cell lines such as platelets or endothelial cells. In this context, we analyzed if nutrients affect simultaneously or separately clotting, platelet, and fibrinolysis pathways giving special attention to the relationship between oxidative stress and thrombosis as most nutrients are believed to possess antioxidant properties.
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Affiliation(s)
- Francesco Violi
- From the Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy (F.V., D.P., P.P.).,Mediterranea Cardiocentro, Napoli, Italy (F.V., P.P., R.C.)
| | - Daniele Pastori
- From the Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy (F.V., D.P., P.P.)
| | - Pasquale Pignatelli
- From the Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy (F.V., D.P., P.P.).,Mediterranea Cardiocentro, Napoli, Italy (F.V., P.P., R.C.)
| | - Roberto Carnevale
- Mediterranea Cardiocentro, Napoli, Italy (F.V., P.P., R.C.).,Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Italy (R.C.)
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da Rosa Santos L, de Araujo SS, Vieira EFDS, Estevam CDS, dos Santos JL, Wichi RB, Lima FB, Carvalho CRO, Aidar FJ, Marçal AC. Effects of 12 Weeks of Resistance Training on Cardiovascular Risk Factors in School Adolescents. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E220. [PMID: 32384612 PMCID: PMC7279337 DOI: 10.3390/medicina56050220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 12/11/2022]
Abstract
Background and objectives: The practice of physical exercise, especially resistance exercise, is important for the treatment and/or prevention of cardiovascular risk factors in adult individuals. However, there are few studies on its effects on adolescent individuals. Therefore, the aim of the present study was to evaluate the effects of applying a 12-week resistance training program on cardiovascular risk factors in adolescents. Materials and Methods: Thus, 122 adolescents aged 13-16 years of both genders participated in the study from school in the city of Lagarto, Sergipe (SE), Brazil, divided into two groups: Control Group (CG) and Group undergoing resistance training (RTG). Blood collection and anthropometric measurements were performed before and after the 12-week resistance training program (RTP). Results: After 12 weeks of the RTP in the adolescents, there was a reduction in the triglyceride variables (9.55%, p = 0.0286), Low-Density Lipoproteins (LDL) (5.42%, p = 0.0244), non-High-Density Lipoproteins (HDL) (5.40%, p = 0.0019), blood glucose (6.71%, p = 0.0040), systolic blood pressure (10.13%, p < 0.0001), as well as an increase in the body weight variable (1.73%, p = 0.0003). Conclusions: It was concluded that a 12-week RTP can prevent and/or alleviate the development of several chronic degenerative diseases in adulthood and that resistance training is important for maintaining the health of adolescents.
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Affiliation(s)
- Lorrany da Rosa Santos
- Departamento de Educação Física, Universidade Federal de Sergipe, São Cristóvão 49040-780, Brazil; (L.d.R.S.); (S.S.d.A.); (E.F.d.S.V.); (J.L.d.S.); (R.B.W.)
| | - Silvan Silva de Araujo
- Departamento de Educação Física, Universidade Federal de Sergipe, São Cristóvão 49040-780, Brazil; (L.d.R.S.); (S.S.d.A.); (E.F.d.S.V.); (J.L.d.S.); (R.B.W.)
- Secretaria de Estado da Educação, do Esporte e da Cultura (SEED/SE), Aracaju 49075-470, Brazil
| | - Erlânyo Francisco dos Santos Vieira
- Departamento de Educação Física, Universidade Federal de Sergipe, São Cristóvão 49040-780, Brazil; (L.d.R.S.); (S.S.d.A.); (E.F.d.S.V.); (J.L.d.S.); (R.B.W.)
| | | | - Jymmys Lopes dos Santos
- Departamento de Educação Física, Universidade Federal de Sergipe, São Cristóvão 49040-780, Brazil; (L.d.R.S.); (S.S.d.A.); (E.F.d.S.V.); (J.L.d.S.); (R.B.W.)
| | - Rogério Brandão Wichi
- Departamento de Educação Física, Universidade Federal de Sergipe, São Cristóvão 49040-780, Brazil; (L.d.R.S.); (S.S.d.A.); (E.F.d.S.V.); (J.L.d.S.); (R.B.W.)
| | - Fábio Bessa Lima
- Departamento de Fisiologia e Biofísica, Instituto de Ciências Biomédicas I (ICB I), Universidade de São Paulo, São Paulo 05508-000, Brazil; (F.B.L.); (C.R.O.C.)
| | - Carla Roberta Oliveira Carvalho
- Departamento de Fisiologia e Biofísica, Instituto de Ciências Biomédicas I (ICB I), Universidade de São Paulo, São Paulo 05508-000, Brazil; (F.B.L.); (C.R.O.C.)
| | - Felipe José Aidar
- Physical Education Department and Group of Studies and Research of Performance, Sport, Health and Paralympic Sports―GEPEPS, Universidade Federal de Sergipe, São Cristóvão 49100-000, Brazil;
| | - Anderson Carlos Marçal
- Departamento de Morfologia, Universidade Federal de Sergipe, São Cristóvão 49100-000, Brazil
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Baumgartner L, Weberruß H, Oberhoffer-Fritz R, Schulz T. Vascular Structure and Function in Children and Adolescents: What Impact Do Physical Activity, Health-Related Physical Fitness, and Exercise Have? Front Pediatr 2020; 8:103. [PMID: 32266183 PMCID: PMC7096378 DOI: 10.3389/fped.2020.00103] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/27/2020] [Indexed: 12/15/2022] Open
Abstract
A physically active lifestyle can prevent cardiovascular disease. Exercise intervention studies in children and adolescents that aim to increase physical activity have resulted in reduced vascular wall thickening and improve cardiovascular function. Here we review the literature that explores the correlations between physical activity, health-related physical fitness, and exercise interventions with various measures of vascular structure and function in children and adolescents. While several of these studies identified improvements in vascular structure in response to physical activity, these associations were limited to studies that relied on questionnaires. Of concern, these findings were not replicated in studies featuring quantitative assessment of physical activity with accelerometers. Half of the studies reviewed reported improved vascular function with increased physical activity, with the type of vascular measurement and the way physical activity was assessed having an influence on the reported relationships. Similary, most of the studies identified in the literature report a beneficial association of health-related physical fitness with vascular structure and function. Overall, it was difficult to compare the results of these studies to one another as different methodologies were used to measure both, health-related physical fitness and vascular function. Likewise, exercise interventions may reduce both arterial wall thickness and increased vascular stiffness in pediatric populations at risk, but the impact clearly depends on the duration of the intervention and varies depending on the target groups. We identified only one study that examined vascular structure and function in young athletes, a group of particular interest with respect to understanding of cardiovascular adaptation to exercise. In conclusion, future studies will be needed that address the use of wall:diameter or wall:lumen-ratio as part of the evaluation of arterial wall thickness. Furthermore, it will be critical to introduce specific and quantitative measurements of physical activity, as intensity and duration of participation likely influence the effectiveness of exercise interventions.
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Affiliation(s)
- Lisa Baumgartner
- Institute of Preventive Pediatrics, TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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Phang M, Ross J, Raythatha JH, Dissanayake HU, McMullan RL, Kong Y, Hyett J, Gordon A, Molloy P, Skilton MR. Epigenetic aging in newborns: role of maternal diet. Am J Clin Nutr 2020; 111:555-561. [PMID: 31942922 DOI: 10.1093/ajcn/nqz326] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 12/09/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Epigenetic aging is associated with higher risk of cardiovascular disease, cancer, and all-cause mortality and may be a mechanistic link between early-life exposures, such as maternal dietary characteristics during pregnancy, and risk of adult disease. OBJECTIVES We sought to determine the early-life risk factors for newborn epigenetic aging, specifically maternal dietary macronutrient intake, and whether epigenetic aging is associated with cardiovascular health markers in the newborn. METHODS Epigenetic age acceleration of 169 newborns was measured from saliva using the Horvath age calculator. Maternal diet during pregnancy was assessed using food-frequency questionnaires. RESULTS Newborns with positive age acceleration were more likely to be female and have greater body fatness. Maternal intakes of saturated fat [6.2 wk epigenetic age acceleration (95% CI: 1.0, 11.3) per 5% of energy; P = 0.02] and monounsaturated fat [12.4 wk (95% CI: 4.2, 20.5) per 5% of energy; P = 0.003] were associated with higher epigenetic age acceleration in the newborn. The strongest association of individual fatty acids were for palmitoleic acid (25.3 wk; 95% CI: 11.4, 39.2; P = 0.0004), oleic acid (2.2 wk; 95% CI: 0.8, 3.6; P = 0.002), and palmitic acid (2.9 wk; 95% CI: 1.0, 4.9; P = 0.004) per 1% of energy intake. Vitamin D supplementation was associated with lower epigenetic age acceleration (-8.1 wk; 95% CI: -14.5, -1.7; P = 0.01). Epigenetic age acceleration was associated with aortic intima-media thickness in preterm infants [1.0 µm (95% CI: 0.2, 1.8) per week of epigenetic age acceleration; P = 0.01], but not among those born at term (P = 0.78). Epigenetic age acceleration was not associated with heart rate variability in either preterm or term born infants (both P > 0.2). CONCLUSIONS This study provides evidence of maternal dietary characteristics that are associated with epigenetic aging in the offspring. Prospective intervention studies are required to determine whether such associations are causal.
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Affiliation(s)
- Melinda Phang
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Jason Ross
- CSIRO Health and Biosecurity, Sydney, Australia
| | - Jineel H Raythatha
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Hasthi U Dissanayake
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Sleep Research Group, University of Sydney, Sydney, Australia
| | - Rowena L McMullan
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Sydney, Australia
| | - Yang Kong
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
| | - Jon Hyett
- Royal Prince Alfred Hospital, Sydney, Australia
| | - Adrienne Gordon
- Sydney Medical School, University of Sydney, Sydney, Australia.,Royal Prince Alfred Hospital, Sydney, Australia
| | | | - Michael R Skilton
- Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, University of Sydney, Sydney, Australia.,Sydney Medical School, University of Sydney, Sydney, Australia
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