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Cadman T, Strandberg-Larsen K, Calas L, Christiansen M, Culpin I, Dadvand P, de Castro M, Foraster M, Fossati S, Guxens M, Harris JR, Hillegers M, Jaddoe V, Lee Y, Lepeule J, El Marroun H, Maule M, McEachen R, Moccia C, Nader J, Nieuwenhuijsen M, Nybo Andersen AM, Pearson R, Swertz M, Vafeiadi M, Vrijheid M, Wright J, Lawlor DA, Pedersen M. Urban environment in pregnancy and postpartum depression: An individual participant data meta-analysis of 12 European birth cohorts. Environment International 2024; 185:108453. [PMID: 38368715 DOI: 10.1016/j.envint.2024.108453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Urban environmental exposures associate with adult depression, but it is unclear whether they are associated to postpartum depression (PPD). OBJECTIVES We investigated associations between urban environment exposures during pregnancy and PPD. METHODS We included women with singleton deliveries to liveborn children from 12 European birth cohorts (N with minimum one exposure = 30,772, analysis N range 17,686-30,716 depending on exposure; representing 26-46 % of the 66,825 eligible women). We estimated maternal exposure during pregnancy to ambient air pollution with nitrogen dioxide (NO2) and particulate matter (PM2.5 and PM10), road traffic noise (Lden), natural spaces (Normalised Difference Vegetation Index; NDVI, proximity to major green or blue spaces) and built environment (population density, facility richness and walkability). Maternal PPD was assessed 3-18 months after birth using self-completed questionnaires. We used adjusted logistic regression models to estimate cohort-specific associations between each exposure and PPD and combined results via meta-analysis using DataSHIELD. RESULTS Of the 30,772 women included, 3,078 (10 %) reported having PPD. Exposure to PM10 was associated with slightly increased odds of PPD (adjusted odd ratios (OR) of 1.08 [95 % Confidence Intervals (CI): 0.99, 1.17] per inter quartile range increment of PM10) whilst associations for exposure to NO2 and PM2.5 were close to null. Exposure to high levels of road traffic noise (≥65 dB vs. < 65 dB) was associated with an OR of 1.12 [CI: 0.95, 1.32]. Associations between green spaces and PPD were close to null; whilst proximity to major blue spaces was associated with increased risk of PPD (OR 1.12, 95 %CI: 1.00, 1.26). All associations between built environment and PPD were close to null. Multiple exposure models showed similar results. DISCUSSION The study findings suggest that exposure to PM10, road traffic noise and blue spaces in pregnancy may increase PPD risk, however future studies should explore this causally.
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Affiliation(s)
- Tim Cadman
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands; Department of Social Medicine, School of Medicine, University of Crete, Greece.
| | - Katrine Strandberg-Larsen
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lucinda Calas
- Inserm, UMR1153 Center for Research in Epidemiology and Statistics (CRESS), Early Life Research on Later Health Team (EARoH), Paris, France
| | - Malina Christiansen
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Iryna Culpin
- MRC Integrative Epidemiology Unit at the University of Bristol, United Kingdom; Population Health Science, Bristol Medical School, University of Bristol, United Kingdom
| | - Payam Dadvand
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain
| | - Montserrat de Castro
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain
| | - Maria Foraster
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain
| | - Serena Fossati
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain
| | - Mònica Guxens
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain; Department of Child and Adolescent Psychiatry, University Medical Center, Erasmus MC, Rotterdam, the Netherlands
| | - Jennifer R Harris
- Center for Fertility and Health, Norwegian Institute of Public Health, Olso, Norway
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry, University Medical Center, Erasmus MC, Rotterdam, the Netherlands
| | - Vincent Jaddoe
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Yunsung Lee
- Center for Fertility and Health, Norwegian Institute of Public Health, Olso, Norway
| | - Johanna Lepeule
- Université Grenoble Alpes INSERM CNRS Institute for Advanced Biosciences Team of Environmental Epidemiology Applied to Development and Respiratory Health, F-38700 La Tronche, France
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry, University Medical Center, Erasmus MC, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Milena Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | - Rosie McEachen
- Bradford Institute for Health Research, Bradford BD9 6RJ, United Kingdom
| | - Chiara Moccia
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | - Johanna Nader
- Department of Genetics and Bioinformatics, Division of Health Data and Digitalisation, Norwegian Institute of Public Health, Oslo, Norway
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain
| | - Anne-Marie Nybo Andersen
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rebecca Pearson
- MRC Integrative Epidemiology Unit at the University of Bristol, United Kingdom; Population Health Science, Bristol Medical School, University of Bristol, United Kingdom; Manchester Metropolitan University, All Saints Building, All Saints, Manchester, United Kingdom
| | - Morris Swertz
- Genomics Coordination Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Marina Vafeiadi
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Martine Vrijheid
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain
| | - John Wright
- Bradford Institute for Health Research, Bradford BD9 6RJ, United Kingdom
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit at the University of Bristol, United Kingdom; Population Health Science, Bristol Medical School, University of Bristol, United Kingdom
| | - Marie Pedersen
- Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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2
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Maritano S, Moirano G, Isaevska E, Pizzi C, Ponzo V, Moccia C, Maule M, Lastrucci V, Alderotti G, Ronfani L, Brumatti LV, Rusconi F, Gagliardi L, Brescianini S, Nisticò L, De Sario M, Culasso M, Richiardi L. Examining the relationship between the environmental impact of diet and child growth from a co-benefit perspective. Environ Res 2024; 250:118496. [PMID: 38365051 DOI: 10.1016/j.envres.2024.118496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/29/2024] [Accepted: 02/13/2024] [Indexed: 02/18/2024]
Abstract
The adoption of diets that minimize both their environmental impacts and weight excess in children would be a major co-benefit for climate change mitigation. We evaluated the relationship between child diet-related environmental impact and anthropometric characteristics in an Italian birth cohort. The study involved 2127 children of the Piccolipiù birth cohort. At 4 years, their diet in the previous two months was assessed through a questionnaire, from which we derived individual: (i) diet-related daily greenhouse gas emissions (GHGE), (ii) land use (LU), (iii) adherence to the Mediterranean Diet (MD) and (iv) red meat consumption. We related these variables with overweight and obesity, waist circumference, and height at 4 years using regression models adjusted for a priori selected confounders. Diet-related GHGE and LU had a positive weak association with overweight and obesity, with an odds ratio (OR) for the fourth vs. second quartile of 1.30 for both GHGE (95% confidence intervals -CI-: 0.96; 1.77) and LU (95% CI: 0.96-1.76). Both OR estimates increased after adjustment for energy intake. GHGE and LU were not associated with height, with the exception of shorter children in the first quartile. A high vs. low MD adherence was associated with an increase in height Z-score of 0.11 (95% CI 0.01; 0.21). No association was found for red meat consumption. These results suggest that lowering the impact of high environmental impact diets may have, if anything, beneficial effects on child obesity, overweight, and height, with pro-MD patterns playing an important role.
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Affiliation(s)
- Silvia Maritano
- Cancer Epidemiology Unit, Medical Science Department, University of Turin and CPO Piemonte, Via Santena 7, 10126, Turin, Italy; University School for Advanced Studies IUSS Pavia, Palazzo del Broletto, Piazza della Vittoria, 27100, Pavia, PV, Italy.
| | - Giovenale Moirano
- Cancer Epidemiology Unit, Medical Science Department, University of Turin and CPO Piemonte, Via Santena 7, 10126, Turin, Italy
| | - Elena Isaevska
- Cancer Epidemiology Unit, Medical Science Department, University of Turin and CPO Piemonte, Via Santena 7, 10126, Turin, Italy
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Medical Science Department, University of Turin and CPO Piemonte, Via Santena 7, 10126, Turin, Italy
| | - Valentina Ponzo
- Human Nutrition Unit, Medical Science Department, University of Turin, c.so Dogliotti 14, 10126, Turin, Italy
| | - Chiara Moccia
- Cancer Epidemiology Unit, Medical Science Department, University of Turin and CPO Piemonte, Via Santena 7, 10126, Turin, Italy
| | - Milena Maule
- Cancer Epidemiology Unit, Medical Science Department, University of Turin and CPO Piemonte, Via Santena 7, 10126, Turin, Italy
| | - Vieri Lastrucci
- Epidemiology Unit, Meyer Children's Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Giorgia Alderotti
- Epidemiology Unit, Meyer Children's Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Luca Ronfani
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", via dell'Istria 65/1, 34137, Trieste, Italy
| | - Liza Vecchi Brumatti
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", via dell'Istria 65/1, 34137, Trieste, Italy
| | - Franca Rusconi
- Department of Mother and Child Health, Azienda USL Toscana Nord Ovest, Via Cocchi 7/9, 56121, Pisa, Italy
| | - Luigi Gagliardi
- Division of Neonatology and Pediatrics, Ospedale Versilia, Viareggio, Azienda AUSL Toscana Nord Ovest, Pisa, Italy
| | - Sonia Brescianini
- Center for Behavioral Sciences and Mental Health, Italian National Health Institute, 00161, Rome, Italy
| | - Lorenza Nisticò
- Center for Behavioral Sciences and Mental Health, Italian National Health Institute, 00161, Rome, Italy
| | - Manuela De Sario
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit Roma 1, Rome, Italy
| | - Martina Culasso
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit Roma 1, Rome, Italy
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Medical Science Department, University of Turin and CPO Piemonte, Via Santena 7, 10126, Turin, Italy
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3
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D'Errico A, Maritano S, Moccia C, Isaevska E, Pizzi C, Moirano G, Popovic M. [Exposome: from definition to future challenges.]. Recenti Prog Med 2023; 114:349-354. [PMID: 37229681 DOI: 10.1701/4042.40227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The exposome concept arises from the need to integrate different disciplines of public health and environmental sciences, mainly including environmental epidemiology, exposure science, and toxicology. The role of the exposome is to understand how the totality of an individual's exposures throughout the lifetime can impact human health. The etiology of a health condition is rarely explained by a single exposure. Therefore, examining the human exposome as a whole becomes relevant to simultaneously consider multiple risk factors and more accurately estimate concurrent causes of different health outcomes. Generally, the exposome is explained through three domains: general external exposome, specific external exposome, and internal exposome. The general external exposome includes measurable population-level exposures such as air pollution or meteorological factors. The specific external exposome includes information on individual exposures, such as lifestyle factors, typically obtained from questionnaires. Meanwhile, the internal exposome encompasses multiple biological responses to external factors, detected through molecular and omics analyses. Additionally, in recent decades, the socio-exposome theory has emerged, where all exposures are studied as a phenomenon dependent on the interaction between socioeconomic factors that vary depending on the context, allowing the identification of mechanisms that lead to health inequalities. The considerable production of data in exposome studies has led researchers to face new methodological and statistical challenges, introducing various approaches to estimate the effect of the exposome on health. Among the most common are regression models (Exposome-Wide Association Study - ExWAS), dimensionality reduction and exposure grouping techniques, and machine learning methods. The significant conceptual and methodological innovation of the exposome for a more holistic evaluation of the risks associated with human health is continuously expanding and will require further investigations related to the application of information obtained from studies into prevention and public health policies.
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Affiliation(s)
| | | | - Chiara Moccia
- Dipartimento di Scienze mediche, Epidemiologia dei tumori, Università di Torino
| | - Elena Isaevska
- Dipartimento di Scienze mediche, Epidemiologia dei tumori, Università di Torino
| | - Costanza Pizzi
- Dipartimento di Scienze mediche, Epidemiologia dei tumori, Università di Torino
| | - Giovenale Moirano
- Dipartimento di Scienze mediche, Epidemiologia dei tumori, Università di Torino
| | - Maja Popovic
- Dipartimento di Scienze mediche, Epidemiologia dei tumori, Università di Torino
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4
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Florian S, Ichou M, Panico L, Pinel-Jacquemin S, Vrijkotte TGM, Harskamp-van Ginkel MW, Huang RC, Carson J, Rodriguez LSM, Subiza-Pérez M, Vrijheid M, Fernández-Barrés S, Yang TC, Wright J, Corpeleijn E, Cardol M, Isaevska E, Moccia C, Kooijman MN, Voerman E, Jaddoe V, Welten M, Spada E, Rebagliato M, Beneito A, Ronfani L, Charles MA. Differences in birth weight between immigrants' and natives' children in Europe and Australia: a LifeCycle comparative observational cohort study. BMJ Open 2023; 13:e060932. [PMID: 36958776 PMCID: PMC10040079 DOI: 10.1136/bmjopen-2022-060932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/17/2023] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVE Research on adults has identified an immigrant health advantage, known as the 'immigrant health paradox', by which migrants exhibit better health outcomes than natives. Is this health advantage transferred from parents to children in the form of higher birth weight relative to children of natives? SETTING Western Europe and Australia. PARTICIPANTS We use data from nine birth cohorts participating in the LifeCycle Project, including five studies with large samples of immigrants' children: Etude Longitudinale Française depuis l'Enfance-France (N=12 494), the Raine Study-Australia (N=2283), Born in Bradford-UK (N=4132), Amsterdam Born Children and their Development study-Netherlands (N=4030) and the Generation R study-Netherlands (N=4877). We include male and female babies born to immigrant and native parents. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome is birth weight measured in grams. Different specifications were tested: birth weight as a continuous variable including all births (DV1), the same variable but excluding babies born with over 4500 g (DV2), low birth weight as a 0-1 binary variable (1=birth weight below 2500 g) (DV3). Results using these three measures were similar, only results using DV1 are presented. Parental migration status is measured in four categories: both parents natives, both born abroad, only mother born abroad and only father born abroad. RESULTS Two patterns in children's birth weight by parental migration status emerged: higher birth weight among children of immigrants in France (+12 g, p<0.10) and Australia (+40 g, p<0.10) and lower birth weight among children of immigrants in the UK (-82 g, p<0.05) and the Netherlands (-80 g and -73 g, p<0.001) compared with natives' children. Smoking during pregnancy emerged as a mechanism explaining some of the birth weight gaps between children of immigrants and natives. CONCLUSION The immigrant health advantage is not universally transferred to children in the form of higher birth weight in all host countries. Further research should investigate whether this cross-national variation is due to differences in immigrant communities, social and healthcare contexts across host countries.
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Affiliation(s)
- Sandra Florian
- French National Institute for Demographic Studies, INED, Paris, France
| | - Mathieu Ichou
- French National Institute for Demographic Studies, INED, Paris, France
| | - Lidia Panico
- French National Institute for Demographic Studies, INED, Paris, France
- Centre for Research on Social Inequalities (CRIS), Sciences Po, Paris, France
| | | | - Tanja G M Vrijkotte
- Department of Public Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Margreet W Harskamp-van Ginkel
- Department of Public Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Rae-Chi Huang
- Nutrition and Health Innovation Research Institute, Edith Cowan University School of Medical and Health Sciences, Perth, Western Australia, Australia
| | - Jennie Carson
- Telethon Kids Institute, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Loreto Santa Marina Rodriguez
- Sub Directorate for Public Health and Addictions of Gipuzkoa, Ministry of Health of the Basque Government, San Sebastián, Spain
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Mikel Subiza-Pérez
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastián, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Martine Vrijheid
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- ISGlobal, Barcelona, Spain
| | | | - Tiffany C Yang
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Institute for Health Research, Bradford, UK
| | - John Wright
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Institute for Health Research, Bradford, UK
| | - Eva Corpeleijn
- Department of Epidemiology, GECKO Drenthe Cohort, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marloes Cardol
- Department of Epidemiology, GECKO Drenthe Cohort, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Elena Isaevska
- Dipartimento di Scienze Mediche, Universita degli Studi di Torino, Torino, Italy
| | - Chiara Moccia
- Department of Medical Sciences, University of Turin, Torino, Italy
| | - Marjolein N Kooijman
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Ellis Voerman
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Vincent Jaddoe
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Marieke Welten
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Elena Spada
- Unit of Epidemiology, Meyer Children's University Hospital, Florence, Italy
| | - Marisa Rebagliato
- Predepartamental Unit of Medicine, Universitat Jaume I, Castello de la Plana, Comunitat Valenciana, Spain
- CIBERESP, Madrid, Spain
| | - Andrea Beneito
- Joint Research Unit in Epidemiology, Environment and Health, FISABIO, Valencia, Spain
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Istituto di Ricovero e Cura a Carattere Scientifico materno infantile Burlo Garofolo, Trieste, Italy
| | - Marie-Aline Charles
- Inserm and INED Joint Research Group, Paris, France
- Université Paris Cité, Inserm, Inrae, Cress, Paris, France
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5
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Moccia C, Pizzi C, Moirano G, Popovic M, Zugna D, d'Errico A, Isaevska E, Fossati S, Nieuwenhuijsen MJ, Fariselli P, Sanavia T, Richiardi L, Maule M. Modelling socioeconomic position as a driver of the exposome in the first 18 months of life of the NINFEA birth cohort children. Environ Int 2023; 173:107864. [PMID: 36913779 DOI: 10.1016/j.envint.2023.107864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 03/02/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The exposome drivers are less studied than its consequences but may be crucial in identifying population subgroups with unfavourable exposures. OBJECTIVES We used three approaches to study the socioeconomic position (SEP) as a driver of the early-life exposome in Turin children of the NINFEA cohort (Italy). METHODS Forty-two environmental exposures, collected at 18 months of age (N = 1989), were classified in 5 groups (lifestyle, diet, meteoclimatic, traffic-related, built environment). We performed cluster analysis to identify subjects sharing similar exposures, and intra-exposome-group Principal Component Analysis (PCA) to reduce the dimensionality. SEP at childbirth was measured through the Equivalised Household Income Indicator. SEP-exposome association was evaluated using: 1) an Exposome Wide Association Study (ExWAS), a one-exposure (SEP) one-outcome (exposome) approach; 2) multinomial regression of cluster membership on SEP; 3) regressions of each intra-exposome-group PC on SEP. RESULTS In the ExWAS, medium/low SEP children were more exposed to greenness, pet ownership, passive smoking, TV screen and sugar; less exposed to NO2, NOX, PM25abs, humidity, built environment, traffic load, unhealthy food facilities, fruit, vegetables, eggs, grain products, and childcare than high SEP children. Medium/low SEP children were more likely to belong to a cluster with poor diet, less air pollution, and to live in the suburbs than high SEP children. Medium/low SEP children were more exposed to lifestyle PC1 (unhealthy lifestyle) and diet PC2 (unhealthy diet), and less exposed to PC1s of the built environment (urbanization factors), diet (mixed diet), and traffic (air pollution) than high SEP children. CONCLUSIONS The three approaches provided consistent and complementary results, suggesting that children with lower SEP are less exposed to urbanization factors and more exposed to unhealthy lifestyles and diet. The simplest method, the ExWAS, conveys most of the information and is more replicable in other populations. Clustering and PCA may facilitate results interpretation and communication.
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Affiliation(s)
- Chiara Moccia
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy.
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Giovenale Moirano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Daniela Zugna
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Antonio d'Errico
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Elena Isaevska
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Serena Fossati
- ISGlobal (Barcelona Institute for Global Health), Barcelona, Spain
| | | | - Piero Fariselli
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Tiziana Sanavia
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Milena Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
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6
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Popovic M, Fiano V, Moirano G, Chiusa L, Conway DI, Garzino Demo P, Gilardetti M, Iorio GC, Moccia C, Ostellino O, Pecorari G, Ramieri G, Ricardi U, Riva G, Virani S, Richiardi L. The Impact of the COVID-19 Pandemic on Head and Neck Cancer Diagnosis in the Piedmont Region, Italy: Interrupted Time-Series Analysis. Front Public Health 2022; 10:809283. [PMID: 35265573 PMCID: PMC8899030 DOI: 10.3389/fpubh.2022.809283] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/24/2022] [Indexed: 12/16/2022] Open
Abstract
Background The COVID-19 pandemic has likely affected the most vulnerable groups of patients and those requiring time-critical access to healthcare services, such as patients with cancer. The aim of this study was to use time trend data to assess the impact of COVID-19 on timely diagnosis and treatment of head and neck cancer (HNC) in the Italian Piedmont region. Methods This study was based on two different data sources. First, regional hospital discharge register data were used to identify incident HNC in patients ≥18 years old during the period from January 1, 2015, to December 31, 2020. Interrupted time-series analysis was used to model the long-time trends in monthly incident HNC before COVID-19 while accounting for holiday-related seasonal fluctuations in the HNC admissions. Second, in a population of incident HNC patients eligible for recruitment in an ongoing clinical cohort study (HEADSpAcE) that started before the COVID-19 pandemic, we compared the distribution of early-stage and late-stage diagnoses between the pre-COVID-19 and the COVID-19 period. Results There were 4,811 incident HNC admissions in the 5-year period before the COVID-19 outbreak and 832 admissions in 2020, of which 689 occurred after the COVID-19 outbreak in Italy. An initial reduction of 28% in admissions during the first wave of the COVID-19 pandemic (RR 0.72, 95% CI 0.62-0.84) was largely addressed by the end of 2020 (RR 0.96, 95% CI 0.89-1.03) when considering the whole population, although there were some heterogeneities. The gap between observed and expected admissions was particularly evident and had not completely recovered by the end of the year in older (≥75 years) patients (RR: 0.88, 0.76-1.01), patients with a Romano-Charlson comorbidity index below 2 (RR 0.91, 95% CI: 0.84-1.00), and primary surgically treated patients (RR 0.88, 95% CI 0.80-0.97). In the subgroup of patients eligible for the ongoing active recruitment, we observed no evidence of a shift toward a more advanced stage at diagnosis in the periods following the first pandemic wave. Conclusions The COVID-19 pandemic has affected differentially the management of certain groups of incident HNC patients, with more pronounced impact on older patients, those treated primarily surgically, and those with less comorbidities. The missed and delayed diagnoses may translate into worser oncological outcomes in these patients.
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Affiliation(s)
- Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- SC Epidemiologia dei Tumori CRPT U, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte, Turin, Italy
| | - Valentina Fiano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- SC Epidemiologia dei Tumori CRPT U, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte, Turin, Italy
| | - Giovenale Moirano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- SC Epidemiologia dei Tumori CRPT U, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte, Turin, Italy
| | - Luigi Chiusa
- Pathology Unit, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza Hospital, Turin, Italy
| | - David I. Conway
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Paolo Garzino Demo
- Maxillofacial Unit, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza Hospital, Turin, Italy
| | - Marco Gilardetti
- SC Epidemiologia dei Tumori CRPT U, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte, Turin, Italy
| | | | - Chiara Moccia
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- SC Epidemiologia dei Tumori CRPT U, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte, Turin, Italy
| | - Oliviero Ostellino
- Oncology Unit, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza Hospital, Turin, Italy
| | - Giancarlo Pecorari
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Guglielmo Ramieri
- Maxillofacial Unit, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza Hospital, Turin, Italy
| | | | - Giuseppe Riva
- Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Shama Virani
- Genomic Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
- SC Epidemiologia dei Tumori CRPT U, Azienda Ospedaliero-Universitaria (A.O.U.) Città della Salute e della Scienza di Torino, Centro di Riferimento per l'Epidemiologia e la Prevenzione Oncologica (CPO) Piemonte, Turin, Italy
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Zenone M, Zocchi L, Moccia C, Passerini SG, Sanavia T, Fariselli P, Broganelli P, Ribero S, Maule M, Quaglino P. Digital dermoscopy monitoring of melanocytic lesions: Two novel calculators combining static and dynamic features to identify melanoma. J Eur Acad Dermatol Venereol 2021; 36:391-402. [PMID: 34862986 DOI: 10.1111/jdv.17852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/27/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early diagnosis is the most effective intervention to improve the prognosis of cutaneous melanoma. Even though the introduction of dermoscopy has improved the diagnostic accuracy, it can still be difficult to distinguish some melanomas from benign melanocytic lesions. Digital dermoscopy monitoring can identify dynamic changes of melanocytic lesions: To date, some algorithms were proposed, but a universally accepted one is still lacking. OBJECTIVES To identify independent predictive variables associated with the diagnosis of cutaneous melanoma and develop a multivariable dermoscopic prediction model able to discriminate benign from malignant melanocytic lesions undergoing digital dermoscopy monitoring. METHODS We collected dermoscopic images of melanocytic lesions excised after dermoscopy monitoring and carried out static and dynamic evaluations of dermoscopic features. We built two multivariable predictive models based on logistic regression and random forest. RESULTS We evaluated 173 lesions (65 cutaneous melanomas and 108 nevi). Forty-two melanomas were in situ, and the median thickness of invasive melanomas was 0.35 mm. The median follow-up time was 9.8 months for melanomas and 9.1 for nevi. The logistic regression and random forest models performed with AUC values of 0.87 and 0.89, respectively, were substantially higher than those of the static evaluation models (ABCD TDS score, 0.57; 7-point checklist, 0.59). Finally, we built two risk calculators, which translate the proposed models into user-friendly applications, to assist clinicians in the decision-making process. CONCLUSIONS The present study demonstrates that the integration of dynamic and static evaluations of melanocytic lesions is a safe approach that can significantly boost the diagnostic accuracy for cutaneous melanoma. We propose two diagnostic tools that significantly increase the accuracy in discriminating melanoma from nevi during digital dermoscopy monitoring.
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Affiliation(s)
- M Zenone
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - L Zocchi
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - C Moccia
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - S G Passerini
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - T Sanavia
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - P Fariselli
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - P Broganelli
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - S Ribero
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - P Quaglino
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
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Popovic M, Moccia C, Isaevska E, Moirano G, Pizzi C, Zugna D, Rusconi F, Merletti F, Maule M, Richiardi L. COVID-19-like symptoms and their relation to the SARS-CoV-2 epidemic in children and adults of an Italian birth cohort. Epidemiol Prev 2021; 45:486-495. [PMID: 34545726 DOI: 10.19191/ep21.6.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES to estimate the population prevalence of COVID-19-like symptoms in children and adults during the first SARS-CoV-2 epidemic wave hitting Italy in the spring 2020; to assess their geographical correlation with the cumulative number of COVID-19 cases by province; to analyse their clustering within families; to estimate their sensitivity, positive predictive value (PPV) and negative predictive value (NPV) for COVID-19 diagnosis in individuals tested for SARS-CoV-2. DESIGN cross-sectional study nested within a birth cohort. SETTING AND PARTICIPANTS mothers participating in an Italian birth cohort (NINFEA) were invited to complete an online questionnaire on COVID-19-like symptoms in their household. MAIN OUTCOME MEASURES population prevalence of COVID-19-like symptoms in children and adults, geographical correlation of COVID-19-like symptoms with the cumulative number of COVID-19 cases by province, clustering of COVID-19-like symptoms within families, and sensitivity, PPV and NPV of COVID-19-like symptoms for COVID-19 diagnosis in individuals tested for SARS-CoV-2. RESULTS information was collected on 3,184 households, 6,133 adults, and 5,751 children. In the period March-April 2020, 55.4% of the NINFEA families had at least one member with at least one COVID-19-like symptom. There was a strong geographical correlation between the population cumulative incidence of COVID-19 and the prevalence of muscle pain, fatigue, low-grade fever, and breathing difficulties in adults (Spearman's rho >=0.70). Having at least one family member with a COVID-19 diagnosis, compared with none tested for SARS-CoV-2, was associated with an increased prevalence ratio (PR) of almost all COVID-19-like symptoms in adults, and only of low-grade fever (37-37.5°C; PR 4.54; 95%CI 2.20-9.40) and anosmia/dysgeusia in children. Among adults with COVID-19 diagnosis, fatigue, muscle pain, and fever had a sensitivity >=70%. In individuals tested for SARS-CoV-2, with a 16.6% prevalence of COVID-19, breathing difficulties and nausea/vomiting had the highest PPVs, with point estimates close to 60%, and with NPVs close to 90%. CONCLUSIONS the geographical prevalence of COVID-19-like symptoms in adults may inform on local disease clusters, while certain symptoms in family members of confirmed COVID-19 cases could help identify the intra-familial spread of the virus and its further propagation in the community. Low-grade fever is frequent in children with at least one household member with COVID-19 and possibly indicates child infection.
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Affiliation(s)
- Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and Reference Centre for Epidemiology and Cancer Prevention in Piedmont (CPO Piemonte), Turin (Italy);
| | - Chiara Moccia
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and Reference Centre for Epidemiology and Cancer Prevention in Piedmont (CPO Piemonte), Turin (Italy)
| | - Elena Isaevska
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and Reference Centre for Epidemiology and Cancer Prevention in Piedmont (CPO Piemonte), Turin (Italy)
| | - Giovenale Moirano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and Reference Centre for Epidemiology and Cancer Prevention in Piedmont (CPO Piemonte), Turin (Italy)
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and Reference Centre for Epidemiology and Cancer Prevention in Piedmont (CPO Piemonte), Turin (Italy)
| | - Daniela Zugna
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and Reference Centre for Epidemiology and Cancer Prevention in Piedmont (CPO Piemonte), Turin (Italy)
| | - Franca Rusconi
- Unit of Epidemiology, Meyer Children's University Hospital, Florence (Italy)
| | - Franco Merletti
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and Reference Centre for Epidemiology and Cancer Prevention in Piedmont (CPO Piemonte), Turin (Italy)
| | - Milena Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and Reference Centre for Epidemiology and Cancer Prevention in Piedmont (CPO Piemonte), Turin (Italy)
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and Reference Centre for Epidemiology and Cancer Prevention in Piedmont (CPO Piemonte), Turin (Italy)
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Pizzi C, Moccia C, Moirano G, d'Errico A, Maule M, Fossati S, Lioret S, Calas L, Richiardi L. 1459Socioeconomic position influence on the early-life individual exposome in the Italian NINFEA birth cohort. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Early exposure to unhealthy lifestyles and environmental risk factors is known to affect health throughout the life-course. There is also evidence that the exposure patterns are influenced by the socioeconomic position (SEP).
Methods
We use the data of the Turin participants of the Italian NINFEA birth cohort (n∼2500) to study how family SEP drives the early life exposome. SEP at birth is measured through the EHII (Equivalized Household Income Indicator), while the exposome includes urban environment, diet and lifestyle exposures measured during infancy. We use standard regression models to evaluate the effect of EHII on each exposome variable accounting for multiple comparison and potential confounders (Drivers-Exposome Wide Association Study – DExWAS) and the hierarchical clustering on the principal components approach to identify groups with similar exposure pattern.
Results
The DExWAS show that low EHII is associated with lower consumption of fruit and vegetables, lower levels of NO2, building and facilities densities, traffic, walkability and connectivity index, higher land-use diversity index, and higher exposure to pets. The hierarchical cluster analysis identifies three groups, with subjects belonging to the cluster characterized by higher level of urban environment risk factors and a healthier diet having a higher mean EHII.
Conclusions
These SEP-early life exposome analyses will be replicated in several European birth cohorts participating in the H2020 ATHLETE and LifeCycle projects.
Key messages
In the Italian city of Turin children from low SEP family are exposed to higher levels of environmental risk factors and unhealthy lifestyles during infancy.
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Affiliation(s)
- Costanza Pizzi
- Department of Medical Sciences, University Of Turin, Turin, Italy
| | - Chiara Moccia
- Department of Medical Sciences, University Of Turin, Turin, Italy
| | | | - Antonio d'Errico
- Department of Medical Sciences, University Of Turin, Turin, Italy
| | - Milena Maule
- Department of Medical Sciences, University Of Turin, Turin, Italy
| | - Serena Fossati
- ISGlobal, Universitat Pompeu Fabra (UPF), CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | | | - Lucinda Calas
- Université de Paris, CRESS, INSERM, INRAE, Paris, France
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Popovic M, Fiano V, Isaevska E, Moccia C, Trevisan M, Rusconi F, De Marco L, Polidoro S, Merletti F, Pizzi C, Richiardi L. Determination of saliva epigenetic age in infancy, and its association with parental socio-economic characteristics and pregnancy outcomes. J Dev Orig Health Dis 2021; 12:319-327. [PMID: 32452337 DOI: 10.1017/s2040174420000380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Epigenetic age acceleration (AA) has been associated with adverse environmental exposures and many chronic conditions. We estimated, in the NINFEA birth cohort, infant saliva epigenetic age, and investigated whether parental socio-economic position (SEP) and pregnancy outcomes are associated with infant epigenetic AA. A total of 139 saliva samples collected at on average 10.8 (range 7-17) months were used to estimate Horvath's DNA methylation age. Epigenetic AA was defined as the residual from a linear regression of epigenetic age on chronological age. Linear regression models were used to test the associations of parental SEP and pregnancy outcomes with saliva epigenetic AA. A moderate positive association was found between DNA methylation age and chronological age, with the median absolute difference of 6.8 months (standard deviation [SD] 3.9). The evidence of the association between the indicators of low SEP and epigenetic AA was weak; infants born to unemployed mothers or with low education had on average 1 month higher epigenetic age than infants of mothers with high education and employment (coefficient 0.78 months, 95% confidence intervals [CIs]: -0.79 to 2.34 for low/medium education; 0.96, 95% CI: -1.81 to 3.73 for unemployment). There was no evidence for association of gestational age, birthweight or caesarean section with infant epigenetic AA. Using the Horvath's method, DNA methylation age can be fairly accurately predicted from saliva samples already in the first months of life. This study did not reveal clear associations between either pregnancy outcomes or parental socio-economic characteristics and infant saliva epigenetic AA.
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Affiliation(s)
- Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Valentina Fiano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Elena Isaevska
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Chiara Moccia
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Morena Trevisan
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Franca Rusconi
- Unit of Epidemiology, 'Anna Meyer' Children's University Hospital, Florence, Italy
| | - Laura De Marco
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Silvia Polidoro
- Italian Institute for Genomic Medicine (IIGM), Candiolo, Italy
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, London, UK
| | - Franco Merletti
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Turin, Italy
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Moccia C, Popovic M, Isaevska E, Fiano V, Trevisan M, Rusconi F, Polidoro S, Richiardi L. Birthweight DNA methylation signatures in infant saliva. Clin Epigenetics 2021; 13:57. [PMID: 33741061 PMCID: PMC7980592 DOI: 10.1186/s13148-021-01053-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/09/2021] [Indexed: 11/17/2022] Open
Abstract
Background Low birthweight has been repeatedly associated with long-term adverse health outcomes and many non-communicable diseases. Our aim was to look-up cord blood birthweight-associated CpG sites identified by the PACE Consortium in infant saliva, and to explore saliva-specific DNA methylation signatures of birthweight. Methods DNA methylation was assessed using Infinium HumanMethylation450K array in 135 saliva samples collected from children of the NINFEA birth cohort at an average age of 10.8 (range 7–17) months. The association analyses between birthweight and DNA methylation variations were carried out using robust linear regression models both in the exploratory EWAS analyses and in the look-up of the PACE findings in infant saliva. Results None of the cord blood birthweight-associated CpGs identified by the PACE Consortium was associated with birthweight when analysed in infant saliva. In saliva EWAS analyses, considering a false discovery rate p-values < 0.05, birthweight as continuous variable was associated with DNA methylation in 44 CpG sites; being born small for gestational age (SGA, lower 10th percentile of birthweight for gestational age according to WHO reference charts) was associated with DNA methylation in 44 CpGs, with only one overlapping CpG between the two analyses. Despite no overlap with PACE results at the CpG level, two of the top saliva birthweight CpGs mapped at genes associated with birthweight with the same direction of the effect also in the PACE Consortium (MACROD1 and RPTOR). Conclusion Our study provides an indication of the birthweight and SGA epigenetic salivary signatures in children around 10 months of age. DNA methylation signatures in cord blood may not be comparable with saliva DNA methylation signatures at about 10 months of age, suggesting that the birthweight epigenetic marks are likely time and tissue specific. Supplementary Information The online version contains supplementary material available at 10.1186/s13148-021-01053-1.
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Affiliation(s)
- Chiara Moccia
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Via Santena 7, 10126, Turin, Italy.
| | - Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Via Santena 7, 10126, Turin, Italy
| | - Elena Isaevska
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Via Santena 7, 10126, Turin, Italy
| | - Valentina Fiano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Via Santena 7, 10126, Turin, Italy
| | - Morena Trevisan
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Via Santena 7, 10126, Turin, Italy
| | - Franca Rusconi
- Unit of Epidemiology, 'Anna Meyer' Children's University Hospital, Florence, Italy
| | - Silvia Polidoro
- Italian Institute for Genomic Medicine (IIGM), Candiolo, Italy.,MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, London, UK
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO Piemonte, Via Santena 7, 10126, Turin, Italy
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Isaevska E, Moccia C, Asta F, Cibella F, Gagliardi L, Ronfani L, Rusconi F, Stazi MA, Richiardi L. Exposure to ambient air pollution in the first 1000 days of life and alterations in the DNA methylome and telomere length in children: A systematic review. Environ Res 2021; 193:110504. [PMID: 33221306 DOI: 10.1016/j.envres.2020.110504] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Exposure to air pollution during the first 1000 days of life (from conception to the 2nd year of life) might be of particular relevance for long-term child health. Changes in molecular markers such as DNA methylation and telomere length could underlie the association between air pollution exposure and pollution-related diseases as well as serve as biomarkers for past exposure. The objective of this systematic review was to assess the association between air pollution exposure during pregnancy and the first two years of life and changes in DNA methylation or telomere length in children. METHODS PubMed was searched in October 2020 by using terms relative to ambient air pollution exposure, DNA methylation, telomere length and the population of interest: mother/child dyads and children. Screening and selection of the articles was completed independently by two reviewers. Thirty-two articles matched our criteria. The majority of the articles focused on gestational air pollution exposure and measured DNA methylation/telomere length in newborn cord blood or placental tissue, to study global, candidate-gene or epigenome-wide methylation patterns and/or telomere length. The number of studies in children was limited. RESULTS Ambient air pollution exposure during pregnancy was associated with global loss of methylation in newborn cord blood and placenta, indicating the beginning of the pregnancy as a potential period of susceptibility. Candidate gene and epigenome-wide association studies provided evidence that gestational exposure to air pollutants can lead to locus-specific changes in methylation, in newborn cord blood and placenta, particularly in genes involved in cellular responses to oxidative stress, mitochondrial function, inflammation, growth and early life development. Telomere length shortening in newborns and children was seen in relation to gestational pollutant exposure. CONCLUSIONS Ambient air pollution during pregnancy is associated with changes in both global and locus-specific DNA methylation and with telomere length shortening. Future studies need to test the robustness of the association across different populations, to explore potential windows of vulnerability and assess the role of the methylation and telomere length as mediators in the association between early exposure to ambient air pollutants and specific childhood health outcomes.
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Affiliation(s)
- Elena Isaevska
- Department of Medical Sciences, University of Turin, CPO Piemonte, Turin, Italy.
| | - Chiara Moccia
- Department of Medical Sciences, University of Turin, CPO Piemonte, Turin, Italy.
| | - Federica Asta
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy.
| | - Fabio Cibella
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Palermo, Italy.
| | - Luigi Gagliardi
- Division of Neonatology and Pediatrics, Ospedale Versilia, Viareggio, AUSL Toscana Nord Ovest, Pisa, Italy.
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.
| | - Franca Rusconi
- Unit of Epidemiology, Meyer Children's University Hospital, Florence, Italy.
| | - Maria Antonietta Stazi
- Center "Behavioral Sciences and Mental Health", Istituto Superiore di Sanità, Rome, Italy.
| | - Lorenzo Richiardi
- Department of Medical Sciences, University of Turin, CPO Piemonte, Turin, Italy.
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Moccia C, Popovic M, Isaevska E, Moirano G, Pizzi C, Rusconi F, Merletti F, Maule MM, Richiardi L. Factors associated with self-perceived knowledge of COVID-19: a study among women from the NINFEA birth cohort. Epidemiol Prev 2020; 44:364-368. [PMID: 33412830 DOI: 10.19191/ep20.5-6.s2.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND health literacy may contribute to the strategies to control the Coronavirus disease 2019 (COVID-19), as individuals need to acquire promptly new health information, understand the reasons behind recommendations, and adapt their behaviour accordingly. OBJECTIVES to investigate sociodemographic and disease-related factors that can influence self-perceived knowledge (poor/medium vs high) about COVID-19 in women of the Italian NINFEA birth cohort. DESIGN cross-sectional study. SETTING AND PARTICIPANTS a web-based anonymous survey on COVID-19 was sent in April 2020 to women participating in the NINFEA cohort. A total of 3,129 women were included in the study. MAIN OUTCOME MEASURES using multiple weighted logistic regression models, self-perceived knowledge level was analysed in relation with the following variables: age, education level, family size, cumulative incidence of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) cases until 7 April 2020 by province, presence of COVID-19-like symptoms, SARS-CoV-2 testing, and COVID-19 diagnosis. RESULTS the prevalence of self-perceived poor/medium knowledge was 57%. In multivariable logistic regression analyses, the odds ratio (OR) of self-perceived poor/medium COVID-19 knowledge level was increased for low/medium compared with high education level (OR 1.57; 95%CI 1.34-1.84), and decreased for SARS-CoV-2 testing (OR 0.25; 95%CI 0.16-0.39) and COVID-19 diagnosis (OR 0.20; 95%CI 0.07-0.60). There was no evidence of association between the other analysed variables and self-perceived knowledge level. CONCLUSIONS the findings of this study suggest that low educational level is a determinant of low self-perceived knowledge on COVID-19 in middle-aged women.
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Affiliation(s)
- Chiara Moccia
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin (Italy);
| | - Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin (Italy)
| | - Elena Isaevska
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin (Italy)
| | - Giovenale Moirano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin (Italy)
| | - Costanza Pizzi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin (Italy)
| | - Franca Rusconi
- Unit of Epidemiology, "Anna Meyer" Children's University Hospital, Florence (Italy)
| | - Franco Merletti
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin (Italy)
| | - Milena Maria Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin (Italy)
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin (Italy)
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Pascarella A, Ferrandino G, Credendino SC, Moccia C, D'Angelo F, Miranda B, D'Ambrosio C, Bielli P, Spadaro O, Ceccarelli M, Scaloni A, Sette C, De Felice M, De Vita G, Amendola E. DNAJC17 is localized in nuclear speckles and interacts with splicing machinery components. Sci Rep 2018; 8:7794. [PMID: 29773831 PMCID: PMC5958099 DOI: 10.1038/s41598-018-26093-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 05/04/2018] [Indexed: 01/23/2023] Open
Abstract
DNAJC17 is a heat shock protein (HSP40) family member, identified in mouse as susceptibility gene for congenital hypothyroidism. DNAJC17 knockout mouse embryos die prior to implantation. In humans, germline homozygous mutations in DNAJC17 have been found in syndromic retinal dystrophy patients, while heterozygous mutations represent candidate pathogenic events for myeloproliferative disorders. Despite widespread expression and involvement in human diseases, DNAJC17 function is still poorly understood. Herein, we have investigated its function through high-throughput transcriptomic and proteomic approaches. DNAJC17-depleted cells transcriptome highlighted genes involved in general functional categories, mainly related to gene expression. Conversely, DNAJC17 interactome can be classified in very specific functional networks, with the most enriched one including proteins involved in splicing. Furthermore, several splicing-related interactors, were independently validated by co-immunoprecipitation and in vivo co-localization. Accordingly, co-localization of DNAJC17 with SC35, a marker of nuclear speckles, further supported its interaction with spliceosomal components. Lastly, DNAJC17 up-regulation enhanced splicing efficiency of minigene reporter in live cells, while its knockdown induced perturbations of splicing efficiency at whole genome level, as demonstrated by specific analysis of RNAseq data. In conclusion, our study strongly suggests a role of DNAJC17 in splicing-related processes and provides support to its recognized essential function in early development.
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Affiliation(s)
- A Pascarella
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - G Ferrandino
- Istituto di Ricerche Genetiche G. Salvatore, Biogem s.c.ar.l, Ariano Irpino (AV), Italy
| | - S C Credendino
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - C Moccia
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - F D'Angelo
- Istituto di Ricerche Genetiche G. Salvatore, Biogem s.c.ar.l, Ariano Irpino (AV), Italy
| | - B Miranda
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - C D'Ambrosio
- Proteomics & Mass Spectrometry Laboratory, ISPAAM, National Research Council, Napoli, Italy
| | - P Bielli
- Laboratory of Neuroembryology, Fondazione Santa Lucia, 00143, Rome, Italy.,Department of Biomedicine and Prevention, Università di Roma Tor Vergata, 00133, Rome, Italy
| | - O Spadaro
- Istituto di Ricerche Genetiche G. Salvatore, Biogem s.c.ar.l, Ariano Irpino (AV), Italy
| | - M Ceccarelli
- Istituto di Ricerche Genetiche G. Salvatore, Biogem s.c.ar.l, Ariano Irpino (AV), Italy
| | - A Scaloni
- Proteomics & Mass Spectrometry Laboratory, ISPAAM, National Research Council, Napoli, Italy
| | - C Sette
- Laboratory of Neuroembryology, Fondazione Santa Lucia, 00143, Rome, Italy.,Institute of Human Anatomy and Cell Biology, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - M De Felice
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy.,Istituto di Ricerche Genetiche G. Salvatore, Biogem s.c.ar.l, Ariano Irpino (AV), Italy
| | - G De Vita
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy.
| | - E Amendola
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Napoli, Italy.
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