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Antoun E, Titcombe P, Dalrymple K, Kitaba NT, Barton SJ, Flynn A, Murray R, Garratt ES, Seed PT, White SL, Cooper C, Inskip HM, Hanson M, Poston L, Godfrey KM, Lillycrop KA. DNA methylation signatures in cord blood associated with birthweight are enriched for dmCpGs previously associated with maternal hypertension or pre-eclampsia, smoking and folic acid intake. Epigenetics 2022; 17:405-421. [PMID: 33784941 PMCID: PMC8993070 DOI: 10.1080/15592294.2021.1908706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/26/2020] [Revised: 02/23/2021] [Accepted: 03/17/2021] [Indexed: 01/22/2023] Open
Abstract
Many epidemiological studies have linked low birthweight to an increased risk of non-communicable diseases (NCDs) in later life, with epigenetic proceseses suggested as an underlying mechanism. Here, we sought to identify neonatal methylation changes associated with birthweight, at the individual CpG and genomic regional level, and whether the birthweight-associated methylation signatures were associated with specific maternal factors. Using the Illumina Human Methylation EPIC array, we assessed DNA methylation in the cord blood of 557 and 483 infants from the UK Pregnancies Better Eating and Activity Trial and Southampton Women's Survey, respectively. Adjusting for gestational age and other covariates, an epigenome-wide association study identified 2911 (FDR≤0.05) and 236 (Bonferroni corrected p ≤ 6.45×10-8) differentially methylated CpGs (dmCpGs), and 1230 differentially methylated regions (DMRs) (Stouffer ≤0.05) associated with birthweight. The top birthweight-associated dmCpG was located within the Homeobox Telomere-Binding Protein 1 (HMBOX1) gene with a 195 g (95%CI: -241, -149 g) decrease in birthweight per 10% increase in methylation, while the top DMR was located within the promoter of corticotropin-releasing hormone-binding protein (CRHBP). Furthermore, the birthweight-related dmCpGs were enriched for dmCpGs previously associated with gestational hypertension/pre-eclampsia (14.51%, p = 1.37×10-255), maternal smoking (7.71%, p = 1.50 x 10-57) and maternal plasma folate levels during pregnancy (0.33%, p = 0.029). The identification of birthweight-associated methylation markers, particularly those connected to specific pregnancy complications and exposures, may provide insights into the developmental pathways that affect birthweight and suggest surrogate markers to identify adverse prenatal exposures for stratifying for individuals at risk of later NCDs.
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Affiliation(s)
- E Antoun
- Human Development and health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - P Titcombe
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - K Dalrymple
- Department of Women and Children’s Health, King’s College London, London, UK
| | - NT Kitaba
- Human Development and health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - SJ Barton
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Ac Flynn
- Department of Women and Children’s Health, King’s College London, London, UK
| | - R Murray
- Human Development and health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - ES Garratt
- Human Development and health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - PT Seed
- Department of Women and Children’s Health, King’s College London, London, UK
| | - SL White
- Department of Women and Children’s Health, King’s College London, London, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR, NIHR Southampton BiomedGical Research Centre, Southampton
| | - H M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - M Hanson
- Human Development and health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - L Poston
- Department of Women and Children’s Health, King’s College London, London, UK
| | - KM Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR, NIHR Southampton BiomedGical Research Centre, Southampton
| | - KA Lillycrop
- NIHR, NIHR Southampton BiomedGical Research Centre, Southampton
- Biological Sciences, University of Southampton, Southampton, UK
| | - UPBEAT Consortium/EpiGen Consortium
- Human Development and health, Faculty of Medicine, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Department of Women and Children’s Health, King’s College London, London, UK
- NIHR, NIHR Southampton BiomedGical Research Centre, Southampton
- Biological Sciences, University of Southampton, Southampton, UK
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Garratt E, Mistry D, Boyle C, Fellerdale M, Southcott V, King S. Arming our patients: Empowering patients to increase self-directed upper-limb activity at the Oxfordshire Stroke Rehabilitation Unit. Physiotherapy 2021. [DOI: 10.1016/j.physio.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Garratt E, King S. Therapy timetabling, an evaluation of outcomes following implementation at the Oxfordshire stroke rehabilitation unit. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Reid IR, Horne AM, Mihov B, Stewart A, Garratt E, Wiessing KR, Bolland MJ, Bastin S, Gamble GD. Anti-fracture efficacy of zoledronate in subgroups of osteopenic postmenopausal women: secondary analysis of a randomized controlled trial. J Intern Med 2019; 286:221-229. [PMID: 30887607 DOI: 10.1111/joim.12901] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND We recently reported that the administration of zoledronate every 18 months to osteopenic older women reduces the incidence of fractures. OBJECTIVE Here, we present a more detailed analysis of that trial to determine whether baseline clinical characteristics impact on the anti-fracture efficacy of this intervention. METHODS This is a prospective, randomized, placebo-controlled, double-blind trial in osteopenic postmenopausal women aged ≥ 65 years, to determine the anti-fracture efficacy of zoledronate. 2000 women were recruited using electoral rolls and randomized to receive 4 infusions of either zoledronate 5 mg or normal saline, at 18-month intervals. Each participant was followed for 6 years. Calcium supplements were not supplied. RESULTS Fragility fractures (either vertebral or nonvertebral) occurred in 190 women in the placebo group (227 fractures) and in 122 women in the zoledronate group (131 fractures), odds ratio (OR) 0.59 (95%CI 0.46, 0.76; P < 0.0001). There were no significant interactions between baseline variables (age, anthropometry, BMI, dietary calcium intake, baseline fracture status, recent falls history, bone mineral density, calculated fracture risk) and the treatment effect. In particular, the reduction in fractures appeared to be independent of baseline fracture risk, and numbers needed to treat (NNT) to prevent one woman fracturing were not significantly different across baseline fracture risk tertiles. CONCLUSIONS The present analyses indicate that the decrease in fracture numbers is broadly consistent across this cohort. The lack of relationship between NNTs and baseline fracture risk calls into question the need for BMD measurement and precise fracture risk assessment before initiating treatment in older postmenopausal women.
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Affiliation(s)
- I R Reid
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Auckland District Health Board, Auckland, New Zealand
| | - A M Horne
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - B Mihov
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - A Stewart
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - E Garratt
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - K R Wiessing
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - M J Bolland
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - S Bastin
- Auckland District Health Board, Auckland, New Zealand
| | - G D Gamble
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Garratt E, Bolton S. Stroke rehabilitation service quality improvement plan - a tale of two towns. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Barton SJ, Ngo S, Costello P, Garratt E, El-Heis S, Antoun E, Clarke-Harris R, Murray R, Bhatt T, Burdge G, Cooper C, Inskip H, van der Beek EM, Sheppard A, Godfrey KM, Lillycrop KA. DNA methylation of Th2 lineage determination genes at birth is associated with allergic outcomes in childhood. Clin Exp Allergy 2017; 47:1599-1608. [PMID: 28756630 DOI: 10.1111/cea.12988] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 07/08/2017] [Accepted: 07/12/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND There is now increasing evidence that asthma and atopy originate in part in utero, with disease risk being associated with the altered epigenetic regulation of genes. OBJECTIVE AND METHODS To determine the relationship between variations in DNA methylation at birth and the development of allergic disease, we examined the methylation status of CpG loci within the promoter regions of Th1/2 lineage commitment genes (GATA3, IL-4, IL-4R, STAT4 and TBET) in umbilical cord DNA at birth in a cohort of infants from the Southampton Women's Survey (n = 696) who were later assessed for asthma, atopic eczema and atopy. RESULTS We found that higher methylation of GATA3 CpGs -2211/-2209 at birth was associated with a reduced risk of asthma at ages 3 (median ratio [median methylation in asthma group/median methylation in non-asthma group] = 0.74, P = .006) and 6-7 (median ratio 0.90, P = .048) years. Furthermore, we demonstrated that the GATA3 CpG loci associated with later risk of asthma lie within a NF-κB binding site and that methylation here blocks transcription factor binding to the GATA3 promoter in the human Jurkat T-cell line. Associations between umbilical cord methylation of CpG loci within IL-4R with atopic eczema at 12 months (median ratio 1.02, P = .028), and TBET with atopy (median ratio 0.98, P = .017) at 6-7 years of age were also observed. CONCLUSIONS AND CLINICAL RELEVANCE Our findings provide further evidence of a developmental contribution to the risk of later allergic disorders and suggest that involvement of epigenetic mechanisms in childhood asthma is already demonstrable at birth.
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Affiliation(s)
- S J Barton
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - S Ngo
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - P Costello
- Human Development and Health Academic Unit, University of Southampton, Southampton, UK
| | - E Garratt
- Human Development and Health Academic Unit, University of Southampton, Southampton, UK
| | - S El-Heis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - E Antoun
- Human Development and Health Academic Unit, University of Southampton, Southampton, UK
| | - R Clarke-Harris
- Human Development and Health Academic Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - R Murray
- Human Development and Health Academic Unit, University of Southampton, Southampton, UK
| | - T Bhatt
- Human Development and Health Academic Unit, University of Southampton, Southampton, UK
| | - G Burdge
- Human Development and Health Academic Unit, University of Southampton, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - H Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - E M van der Beek
- Nutricia Research, Danone Nutricia Early Life Nutrition, Utrecht, The Netherlands.,Department of Pediatrics, University medical Centre Groningen, Groningen, The Netherlands
| | - A Sheppard
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - K M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,Human Development and Health Academic Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - K A Lillycrop
- NIHR Southampton Biomedical Research Centre, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK.,Centre for Biological Sciences, University of Southampton, Southampton, UK
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Huang RC, Garratt ES, Pan H, Wu Y, Davis EA, Barton SJ, Burdge GC, Godfrey KM, Holbrook JD, Lillycrop KA. Genome-wide methylation analysis identifies differentially methylated CpG loci associated with severe obesity in childhood. Epigenetics 2016; 10:995-1005. [PMID: 26646899 PMCID: PMC4844195 DOI: 10.1080/15592294.2015.1080411] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [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] [Indexed: 12/24/2022] Open
Abstract
Childhood obesity is a major public health issue. Here we investigated whether differential DNA methylation was associated with childhood obesity. We studied DNA methylation profiles in whole blood from 78 obese children (mean BMI Z-score: 2.6) and 71 age- and sex-matched controls (mean BMI Z-score: 0.1). DNA samples from obese and control groups were pooled and analyzed using the Infinium HumanMethylation450 BeadChip array. Comparison of the methylation profiles between obese and control subjects revealed 129 differentially methylated CpG (DMCpG) loci associated with 80 unique genes that had a greater than 10% difference in methylation (P-value < 0.05). The top pathways enriched among the DMCpGs included developmental processes, immune system regulation, regulation of cell signaling, and small GTPase-mediated signal transduction. The associations between the methylation of selected DMCpGs with childhood obesity were validated using sodium bisulfite pyrosequencing across loci within the FYN, PIWIL4, and TAOK3 genes in individual subjects. Three CpG loci within FYN were hypermethylated in obese individuals (all P < 0.01), while obesity was associated with lower methylation of CpG loci within PIWIL4 (P = 0.003) and TAOK3 (P = 0.001). After building logistic regression models, we determined that a 1% increase in methylation in TAOK3, multiplicatively decreased the odds of being obese by 0.91 (95% CI: 0.86 – 0.97), and an increase of 1% methylation in FYN CpG3, multiplicatively increased the odds of being obese by 1.03 (95% CI: 0.99 – 1.07). In conclusion, these findings provide evidence that childhood obesity is associated with specific DNA methylation changes in whole blood, which may have utility as biomarkers of obesity risk.
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Affiliation(s)
- R C Huang
- a Telethon Institute for Child Health Research; University of Western Australia ; Perth, Australia
| | - E S Garratt
- b Academic Unit of Human Development and Health; Faculty of Medicine; University of Southampton ; Southampton , UK
| | - H Pan
- c Singapore Institute for Clinical Sciences (SICS); A*STAR; Brenner Center for Molecular Medicine ; Singapore.,d School of Computer Engineering; Nanyang Technological University (NTU) ; Singapore
| | - Y Wu
- c Singapore Institute for Clinical Sciences (SICS); A*STAR; Brenner Center for Molecular Medicine ; Singapore
| | - E A Davis
- a Telethon Institute for Child Health Research; University of Western Australia ; Perth, Australia
| | - S J Barton
- e MRC Lifecourse Epidemiology Unit; University of Southampton ; Southampton , UK
| | - G C Burdge
- b Academic Unit of Human Development and Health; Faculty of Medicine; University of Southampton ; Southampton , UK
| | - K M Godfrey
- e MRC Lifecourse Epidemiology Unit; University of Southampton ; Southampton , UK.,f NIHR Southampton Biomedical Research Center; University of Southampton and University Hospital Southampton NHS Foundation Trust; Southampton, UK
| | - J D Holbrook
- c Singapore Institute for Clinical Sciences (SICS); A*STAR; Brenner Center for Molecular Medicine ; Singapore.,g Yong Loo Lin School of Medicine; National University of Singapore (NUS) ; Singapore
| | - K A Lillycrop
- b Academic Unit of Human Development and Health; Faculty of Medicine; University of Southampton ; Southampton , UK.,h Faculty of Natural and Environmental Sciences; University of Southampton ; Southampton , UK
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Garratt E. OP55 Effort-reward imbalance and health: a longitudinal multilevel analysis of parents and their children. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Garratt E, Clarke JAG. Responsibility for Locums. West J Med 1965. [DOI: 10.1136/bmj.1.5426.63-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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