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Long SE, Sood S, Kanesa-Thasan A, Kahn LG, Urbina EM, Barrett ES, Nguyen RH, Bush NR, Swan SH, Sathyanarayana S, Trasande L. Longitudinal study of birthweight, blood pressure, and markers of arterial stiffness in children age six among the TIDES cohort. J Hypertens 2024; 42:1399-1408. [PMID: 38690915 DOI: 10.1097/hjh.0000000000003745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
OBJECTIVE Although some studies have observed an association between birthweight and cardiovascular disease in adulthood, fewer have investigated whether birthweight is linked to cardiovascular health in early childhood. This study assesses the association between birthweight and cardiovascular outcomes in children 6 years of age. STUDY DESIGN Birthweight, blood pressure (BP), and markers of arterial stiffness in children, including brachial artery distensibility and carotid-femoral pulse wave velocity (cfPWV), were obtained from 324 participants in The Infant Development and the Environment Study, a prospective multisite pregnancy cohort. Birthweight was converted into sex-specific birthweight-for-gestational-age (bw/ga) z -scores based on the INTERGROWTH-21st standard. Following 2017 American Academy of Pediatrics guidelines, SBP and DBP were transformed into sex, age, and height-specific z -scores. Associations between birthweight and cardiovascular outcomes were assessed using nested multivariable linear regression models among the overall and sex-stratified samples. RESULTS Among the overall sample, bw/ga z -score was positively associated with cfPWV [b = 0.11 m/s, 95% confidence interval (CI): 0.01 m/s, 0.21 m/s] in crude and adjusted models. No associations between birthweight and cardiovascular outcomes were detected among the sex-stratified analyses. CONCLUSION Overall, birthweight was not related to cardiovascular outcomes in children 6 years old. However, infants born with a higher birthweight may be at risk for higher cfPWV in childhood. Early intervention in pregnant people at risk of delivering high birthweight infants may be warranted if results are replicated.
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Affiliation(s)
- Sara E Long
- Department of Pediatrics, NYU School of Medicine, New York, New York
| | - Shefali Sood
- Department of Ophthalmology, Georgetown University, Washington, District of Columbia
| | | | - Linda G Kahn
- Department of Pediatrics, NYU School of Medicine, New York, New York
- Department of Population Health, NYU School of Medicine, New York, New York
| | - Elaine M Urbina
- Heart Institute, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Environmental and Occupational Health Sciences Institute; Piscataway, New Jersey
| | - Ruby H Nguyen
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (UCSF)
- Department of Pediatrics, UCSF, San Francisco, California
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sheela Sathyanarayana
- Department of Pediatrics, Seattle Children's Research Institute
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington
| | - Leonardo Trasande
- Department of Pediatrics, NYU School of Medicine, New York, New York
- Department of Population Health, NYU School of Medicine, New York, New York
- Department of Environmental Medicine, NYU School of Medicine
- NYU Wagner School of Public Service, New York, New York, USA
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Park PG, Park E, Kang HG. Increasing trend in hypertension prevalence among Korean adolescents from 2007 to 2020. BMC Public Health 2024; 24:617. [PMID: 38409007 PMCID: PMC10898016 DOI: 10.1186/s12889-024-18093-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 02/13/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The purpose of this study was to examine the prevalence of hypertension in Korean adolescents, its long-term trends, and factors associated with the development of hypertension. METHODS Data of the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2020 were combined into three time periods (2007-2011, 2012-2016, and 2017-2020). A total of 11,146 Korean adolescents aged 10-18 were included in the analysis. The definition of hypertension was based on the 2017 American Academy of Pediatrics guidelines for hypertension. RESULTS The age-adjusted prevalence of hypertension was 5.47%, 7.85%, and 9.92% in 2007-2011, 2012-2016, and 2017-2020, respectively. Long-term trend analysis using Joinpoint analysis over the observation period showed a significantly increasing trend in hypertension prevalence with a mean annual percentage change of 6.4%. Boys, those aged 13-15, those aged 16-18, overweight/obese, and those living in urban areas were more likely to develop hypertension (OR 1.980, 1.492, 3.180, 2.943, and 1.330, respectively). CONCLUSION The prevalence of hypertension in Korean adolescents was higher than the global prevalence of hypertension and showed an increase over a 13-year period. Targeted strategies for prevention and early detection of hypertension are needed in this population.
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Affiliation(s)
- Peong Gang Park
- Departments of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
- Departments of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Eujin Park
- Departments of Pediatrics, Korea University Guro Hospital, Gurodong-ro, Guro-gu, Seoul, 08308, Korea.
| | - Hee Gyung Kang
- Departments of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
- Departments of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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de Cuevillas B, Lubrecht J, Navas-Carretero S, Vreugdenhil A, Martinez JA. Sleep duration is associated with liver steatosis in children depending on body adiposity. Eur J Pediatr 2024; 183:779-789. [PMID: 38001309 PMCID: PMC10912132 DOI: 10.1007/s00431-023-05332-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023]
Abstract
Sleep is a factor associated with overweight/obesity risk, wherein interactions with fatty liver should be ascertained. The aim of this cross-sectional study was to analyze the possible relationships of sleep with liver health and whether this interplay is related to body adiposity distribution in children and adolescents. Anthropometric, clinical, and biochemical measurements were performed in children and adolescents (2-18 years old) with overweight/obesity (n = 854). Body fat distribution was clinically assessed, and several hepatic markers, including hepatic steatosis index, were calculated. Sleep time mediation (hours/day) in the relationship between the hepatic steatosis index and body fat distribution was investigated. Differences among diverse fatty liver disease scores were found between children with overweight or obesity (p < 0.05). Linear regression models showed associations between hepatic steatosis index and lifestyle markers (p < 0.001). Hepatic steatosis index was higher (about + 15%) in children with obesity compared to overweight (p < 0.001). Pear-shaped body fat distribution may seemingly play a more detrimental role on liver fat deposition. The association between sleep time and hepatic steatosis index was dependent on body mass index z-score. Post hoc analyses showed that 39% of the relationship of body fat distribution on hepatic steatosis index may be explained by sleep time. Conclusion: An association of sleep time in the relationship between body fat distribution and hepatic steatosis index was observed in children and adolescents with overweight/obesity, which can be relevant in the prevention and treatment of excessive adiposity between 2 and 18 years old. CLINICAL TRIAL NCT04805762. Import: As part of a healthy lifestyle, sleep duration might be a modifiable factor in the management of fatty liver disease in children. WHAT IS KNOWN • Sleep is an influential factor of overweight and obesity in children. • Excessive adiposity is associated with liver status in children and adolescents. WHAT IS NEW • Sleep time plays a role in the relationship between body fat distribution and liver disease. • Monitoring sleep pattern may be beneficial in the treatment of hepatic steatosis in children with excessive body weight.
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Affiliation(s)
- Begoña de Cuevillas
- Center for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain.
| | - Judith Lubrecht
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Santiago Navas-Carretero
- Center for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- IdiSNA, Health Research Institute of Navarra, Pamplona, Spain
| | - Anita Vreugdenhil
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - J Alfredo Martinez
- Center for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Precision Nutrition Program, Research Institute On Food and Health Sciences IMDEA Food, CSIC-UAM, Madrid, Spain
- Centro de Medicina y Endocrinología, Universidad de Valladolid, Valladolid, Spain
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DuBose KD, Beaman K, Habeeb C, Dlugonski D. Physical Activity, but Not Body Mass Index Is Associated With Blood Pressure in Young Children. Pediatr Exerc Sci 2024:1-6. [PMID: 38281486 DOI: 10.1123/pes.2023-0088] [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: 06/16/2023] [Revised: 11/21/2023] [Accepted: 12/06/2023] [Indexed: 01/30/2024]
Abstract
PURPOSE This study examined associations between physical activity (PA) and obesity with blood pressure (BP) in young children. Furthermore, a possible moderating effect of obesity status was examined. METHODS A cross-sectional study was completed with 121 children (3.96 [1.14] y). BP, weight, and height were measured, and body mass index (BMI) was calculated. Z scores were calculated for BMI, systolic, and diastolic values. Accelerometry measured time spent in PA intensities. Correlations and regressions examined relationships among PA intensities, BMI z scores, and BP z scores and to determine if obesity status moderated these relationships. RESULTS On average, the children spent 52 minutes per day in moderate-to-vigorous physical activity, 31% were considered overweight/obese, and 15% were considered hypertensive. After adjusting for confounders, participation in moderate, vigorous, and moderate-to-vigorous physical activity was related with lower systolic and diastolic BP z scores (P < .05). BMI z score was not related to BP values. Obesity status did not moderate the relationships between time spent in PA and BP. CONCLUSIONS Participation in PA, but not obesity, was related to lower BP levels in young children. The impact PA has on BP is the same regardless of obesity status. Thus, young children should be encouraged to be active in different intensities to benefit the cardiovascular system.
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Affiliation(s)
- Katrina D DuBose
- Department of Kinesiology, East Carolina University, Greenville, NC,USA
| | - Kathryn Beaman
- Department of Kinesiology, East Carolina University, Greenville, NC,USA
| | - Christine Habeeb
- Department of Kinesiology, East Carolina University, Greenville, NC,USA
| | - Deirdre Dlugonski
- Department of Athletic Training & Clinical Nutrition, Sports Medicine Research Institute, University of Kentucky, Lexington, KY,USA
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Baker-Smith CM, McDuffie MJ, Nescott EP, Akins RE. Factors Associated with Antihypertensive Therapy Prescription in Youth Delaware Medicaid Recipients with Primary Hypertension Diagnosis. Am J Hypertens 2024; 37:143-149. [PMID: 37815306 PMCID: PMC10790268 DOI: 10.1093/ajh/hpad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/03/2023] [Accepted: 08/31/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Higher neighborhood deprivation is associated with hypertension diagnosis in youth. In this study, we assess if there is an association between neighborhood deprivation and antihypertensive therapy prescription among insured youth with a primary hypertension diagnosis. METHODS Using a retrospective cross-sectional design, we assessed the proportion of youth with a diagnosis of primary hypertension prescribed antihypertensive therapy. We evaluated the proportion of youth prescribed antihypertensive therapy and compared prescribing patterns by area deprivation index (ADI), age, sex, obesity diagnosis, race, ethnicity, and duration of Medicaid coverage. RESULTS Of the 65,452 non-pregnant Delaware Medicaid recipients, 8-18 years of age, 1,145 (1.7%) had an International classification of diseases (ICD)-9/ICD-10 diagnosis of primary hypertension; 165 of the 1,145 (14%) were prescribed antihypertensive therapy. Factors associated with a greater odds of prescription by multivariable logistic regression were age, obesity diagnosis, and duration of Medicaid full benefit coverage. Odds of antihypertensive therapy prescription did not vary by race, ethnicity, or ADI. CONCLUSIONS Antihypertensive therapy prescription rates are poor despite national guideline recommendations. Among youth receiving Delaware Medicaid between 2014 and 2019, prescription proportions were highest among youth of older age, with an obesity diagnosis, and among youth with longer duration of Medicaid benefit coverage. Although high area deprivation has been shown to be associated with the diagnosis of hypertension, high vs. low area deprivation was not associated with greater antihypertensive therapy prescription among youth with primary hypertension. Our finding of a mismatch between hypertension diagnosis and antihypertensive therapy prescription highlights a potential disparity in antihypertensive therapy prescription in youth.
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Affiliation(s)
- Carissa M Baker-Smith
- Cardiovascular Research and Innovation Program, Nemours Cardiac Center, Nemours Children’s Health, Wilmington, Delaware, USA
| | - Mary J McDuffie
- Center for Community Research & Service, University of Delaware Biden School of Public Policy and Administration, University of Delaware, Newark, Delaware, USA
| | - Erin P Nescott
- Center for Community Research & Service, University of Delaware Biden School of Public Policy and Administration, University of Delaware, Newark, Delaware, USA
| | - Robert E Akins
- Center for Pediatric Clinical Research and Development, Nemours Children’s Health, Wilmington, Delaware, USA
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Baker-Smith CM, Yang W, McDuffie MJ, Nescott EP, Wolf BJ, Wu CH, Zhang Z, Akins RE. Association of Area Deprivation With Primary Hypertension Diagnosis Among Youth Medicaid Recipients in Delaware. JAMA Netw Open 2023; 6:e233012. [PMID: 36920393 PMCID: PMC10018318 DOI: 10.1001/jamanetworkopen.2023.3012] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/30/2023] [Indexed: 03/16/2023] Open
Abstract
Importance The association between degree of neighborhood deprivation and primary hypertension diagnosis in youth remains understudied. Objective To assess the association between neighborhood measures of deprivation and primary hypertension diagnosis in youth. Design, Setting, and Participants This cross-sectional study included 65 452 Delaware Medicaid-insured youths aged 8 to 18 years between January 1, 2014, and December 31, 2019. Residence was geocoded by national area deprivation index (ADI). Exposures Higher area deprivation. Main Outcomes and Measures The main outcome was primary hypertension diagnosis based on International Classification of Diseases, Ninth Revision and Tenth Revision codes. Data were analyzed between September 1, 2021, and December 31, 2022. Results A total of 65 452 youths were included in the analysis, including 64 307 (98.3%) without a hypertension diagnosis (30 491 [47%] female and 33 813 [53%] male; mean [SD] age, 12.5 (3.1) years; 12 500 [19%] Hispanic, 25 473 [40%] non-Hispanic Black, 24 565 [38%] non-Hispanic White, and 1769 [3%] other race or ethnicity; 13 029 [20%] with obesity; and 31 548 [49%] with an ADI ≥50) and 1145 (1.7%) with a diagnosis of primary hypertension (mean [SD] age, 13.3 [2.8] years; 464 [41%] female and 681 [59%] male; 271 [24%] Hispanic, 460 [40%] non-Hispanic Black, 396 [35%] non-Hispanic White, and 18 [2%] of other race or ethnicity; 705 [62%] with obesity; and 614 [54%] with an ADI ≥50). The mean (SD) duration of full Medicaid benefit coverage was 61 (16) months for those with a diagnosis of primary hypertension and 46.0 (24.3) months for those without. By multivariable logistic regression, residence within communities with ADI greater than or equal to 50 was associated with 60% greater odds of a hypertension diagnosis (odds ratio [OR], 1.61; 95% CI 1.04-2.51). Older age (OR per year, 1.16; 95%, CI, 1.14-1.18), an obesity diagnosis (OR, 5.16; 95% CI, 4.54-5.85), and longer duration of full Medicaid benefit coverage (OR, 1.03; 95% CI, 1.03-1.04) were associated with greater odds of primary hypertension diagnosis, whereas female sex was associated with lower odds (OR, 0.68; 95%, 0.61-0.77). Model fit including a Medicaid-by-ADI interaction term was significant for the interaction and revealed slightly greater odds of hypertension diagnosis for youths with ADI less than 50 (OR, 1.03; 95% CI, 1.03-1.04) vs ADI ≥50 (OR, 1.02; 95% CI, 1.02-1.03). Race and ethnicity were not associated with primary hypertension diagnosis. Conclusions and Relevance In this cross-sectional study, higher childhood neighborhood ADI, obesity, age, sex, and duration of Medicaid benefit coverage were associated with a primary hypertension diagnosis in youth. Screening algorithms and national guidelines may consider the importance of ADI when assessing for the presence and prevalence of primary hypertension in youth.
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Affiliation(s)
- Carissa M. Baker-Smith
- Cardiovascular Research and Innovation Program, Nemours Cardiac Center, Nemours Children’s Health, Wilmington, Delaware
| | - Wei Yang
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Mary J. McDuffie
- Center for Community Research and Service, University of Delaware Biden School of Public Policy and Administration, University of Delaware, Newark
| | - Erin P. Nescott
- Center for Community Research and Service, University of Delaware Biden School of Public Policy and Administration, University of Delaware, Newark
| | | | - Cathy H. Wu
- Data Science Institute, University of Delaware, Newark
| | - Zugui Zhang
- Institute for Research in Equity and Community Health, Christiana Care Health Services, Inc, Newark, Delaware
| | - Robert E. Akins
- Center for Pediatric Clinical Research and Development, Nemours Children’s Health, Wilmington, Delaware
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Hanevold CD. Racial-ethnic disparities in childhood hypertension. Pediatr Nephrol 2023; 38:619-623. [PMID: 35962260 DOI: 10.1007/s00467-022-05707-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Coral D Hanevold
- Professor Emeritus of Pediatrics, Division of Nephrology, University of Washington, Seattle, WA, USA.
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Coronado F, Melvin SC, Bell RA, Zhao G. Global Responses to Prevent, Manage, and Control Cardiovascular Diseases. Prev Chronic Dis 2022; 19:E84. [PMID: 36480801 DOI: 10.5888/pcd19.220347] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Fátima Coronado
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.,Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS S107-1, Atlanta GA 30341
| | - Sandra Carr Melvin
- Institute for the Advancement of Minority Health, Ridgeland, Mississippi
| | - Ronny A Bell
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Guixiang Zhao
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Liu S, Lan Y, He G, Chen B, Jia Y. The associations between problematic smartphone use and blood pressure among 2,573 aged 9-17 years students in Shanghai, China. Front Public Health 2022; 10:904509. [PMID: 36159281 PMCID: PMC9490019 DOI: 10.3389/fpubh.2022.904509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/16/2022] [Indexed: 01/22/2023] Open
Abstract
Objectives This study aimed to (1) examine the cross-sectional association between problematic smartphone use (PSU) and blood pressure (BP) in children and adolescents and (2) determine whether the association between PSU and BP differs by the grade of students. Methods We recruited a total of 2,573 participants from 14 schools in Shanghai by a two-stage sampling method. We derived BP data from the participant's most recent medical examination data, including systolic blood pressure (SBP) and diastolic blood pressure (DBP). We measured PSU by a modified PSU Classification Scale. We also assessed demographic characteristics, body mass index, behavioral variables, and physiological characteristics. Results High school students had higher BP and PSU scores than primary and middle school students. PSU on the dimension of information collection was associated positively with both SBP and DBP among primary and middle school students, with the β (95% CI) values of 0.282 (0.018, 0.546) and 0.229 (0.031, 0.427). Meanwhile, the dimension of the relationship of social network was associated positively with SBP among primary and middle school students, with a β (95% CI) value of 0.390 (0.062, 0.717). PSU on the dimension of information collection was positively associated with the development of high BP, with a OR (95% CI) value of 1.072 (1.011, 1.137) among primary and middle school students. Conclusions PSU might be a potential correlate of high BP among school-age children and adolescents. The associations between PSU and BP differed by the grade of students as well as according to the four dimensions of PSU.
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Affiliation(s)
- Shaojie Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China
| | - Yukun Lan
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China
| | - Gengsheng He
- Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China
| | - Bo Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China
| | - Yingnan Jia
- Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, China,*Correspondence: Yingnan Jia
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Ni Y, Simpson CL, Davis RL, Szpiro AA, Karr CJ, Kovesdy CP, Hjorten RC, Tylavsky FA, Bush NR, LeWinn KZ, Winkler CA, Kopp JB, Obi Y. Associations between APOL1 genetic variants and blood pressure in African American mothers and children from a U.S. pregnancy cohort: Modification by air pollution exposures. ENVIRONMENTAL RESEARCH 2022; 212:113186. [PMID: 35358541 PMCID: PMC9233157 DOI: 10.1016/j.envres.2022.113186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/04/2022] [Accepted: 03/23/2022] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Carriage of high-risk APOL1 genetic variants is associated with increased risks for kidney diseases in people of African descent. Less is known about the variants' associations with blood pressure or potential moderators. METHODS We investigated these associations in a pregnancy cohort of 556 women and 493 children identified as African American. Participants with two APOL1 risk alleles were defined as having the high-risk genotype. Blood pressure in both populations was measured at the child's 4-6 years visit. We fit multivariate linear and Poisson regressions and further adjusted for population stratification to estimate the APOL1-blood pressure associations. We also examined the associations modified by air pollution exposures (particulate matter ≤2.5 μ m in aerodynamic diameter [PM2.5] and nitrogen dioxide) and explored other moderators such as health conditions and behaviors. RESULTS Neither APOL1 risk alleles nor risk genotypes had a main effect on blood pressure in mothers or children. However, each 2-μg/m3 increase of four-year average PM2.5 was associated with a 16.3 (95%CI: 5.7, 26.9) mmHg higher diastolic blood pressure in mothers with the APOL1 high-risk genotype, while the estimated effect was much smaller in mothers with the low-risk genotype (i.e., 2.9 [95%CI: -3.1, 8.8] mmHg; Pinteraction = 0.01). Additionally, the associations of APOL1 risk alleles and the high-risk genotype with high blood pressure (i.e., SBP and/or DBP ≥ 90th percentile) were stronger in girls vs. boys (Pinteraction = 0.02 and 0.005, respectively). CONCLUSION This study sheds light on the distribution of high blood pressure by APOL1 genetic variants and informs regulatory policy to protect vulnerable population subgroups.
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Affiliation(s)
- Yu Ni
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
| | - Claire L Simpson
- Department of Genetics, Genomics and Informatics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Robert L Davis
- Center for Biomedical Informatics, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Adam A Szpiro
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA; Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Csaba P Kovesdy
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN, USA; Nephrology Section, Memphis VA Medical Center, Memphis, TN, USA
| | - Rebecca C Hjorten
- Pediatrics Division of Nephrology, Seattle Children's Hospital, Seattle, WA, USA
| | - Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Cheryl A Winkler
- Basic Research Laboratory, Molecular Genetic Epidemiology Section, Frederick National Laboratory for Cancer Research, National Cancer Institute, Frederick, MD, USA
| | - Jeffrey B Kopp
- Kidney Disease Section, Kidney Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Yoshitsugu Obi
- Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA; Department of Medicine-Nephrology, University of Tennessee Health Science Center, Memphis, TN, USA
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