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Alnuaimi S, Reljic T, Abdulla FS, Memon H, Al-Ali S, Smith T, Serdarevic F, Velija Asimi Z, Kumar A, Semiz S. PPAR agonists as add-on treatment with metformin in management of type 2 diabetes: a systematic review and meta-analysis. Sci Rep 2024; 14:8809. [PMID: 38627464 PMCID: PMC11021491 DOI: 10.1038/s41598-024-59390-z] [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] [Received: 12/12/2023] [Accepted: 04/10/2024] [Indexed: 04/19/2024] Open
Abstract
The combination of metformin and the peroxisome proliferator-activated receptors (PPAR) agonists offers a promising avenue for managing type 2 diabetes (T2D) through their potential complementary mechanisms of action. The results from randomized controlled trials (RCT) assessing the efficacy of PPAR agonists plus metformin versus metformin alone in T2D are inconsistent, which prompted the conduct of the systematic review and meta-analysis. We searched MEDLINE and EMBASE from inception (1966) to March 2023 to identify all RCTs comparing any PPAR agonists plus metformin versus metformin alone in T2D. Categorical variables were summarized as relative risk along with 95% confidence interval (CI). Twenty RCTs enrolling a total of 6058 patients met the inclusion criteria. The certainty of evidence ranged from moderate to very low. Pooled results show that using PPAR agonist plus metformin, as compared to metformin alone, results in lower concentrations of fasting glucose [MD = - 22.07 mg/dl (95% CI - 27.17, - 16.97), HbA1c [MD = - 0.53% (95% CI - 0.67, - 0.38)], HOMA-IR [MD = - 1.26 (95% CI - 2.16, - 0.37)], and fasting insulin [MD = - 19.83 pmol/L (95% CI - 29.54, - 10.13)] without significant increase in any adverse events. Thus, synthesized evidence from RCTs demonstrates the beneficial effects of PPAR agonist add-on treatment versus metformin alone in T2D patients. In particular, novel dual PPARα/γ agonist (tesaglitazar) demonstrate efficacy in improving glycaemic and lipid concentrations, so further RCTs should be performed to elucidate the long-term outcomes and safety profile of these novel combined and personalized therapeutic strategies in the management of T2D.PROSPERO registration no. CRD42023412603.
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Affiliation(s)
- Saif Alnuaimi
- College of Medicine and Health Sciences, Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates
| | - Tea Reljic
- Research Methodology and Biostatistics Core, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Fatima S Abdulla
- College of Medicine and Health Sciences, Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates
| | - Hamda Memon
- College of Medicine and Health Sciences, Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates
| | - Sarah Al-Ali
- College of Medicine and Health Sciences, Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates
| | - Teagen Smith
- Research Methodology and Biostatistics Core, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Fadila Serdarevic
- Sarajevo Medical School, University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Zelija Velija Asimi
- Sarajevo Medical School, University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Ambuj Kumar
- Research Methodology and Biostatistics Core, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Sabina Semiz
- College of Medicine and Health Sciences, Khalifa University, PO Box 127788, Abu Dhabi, United Arab Emirates.
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Tamayo Martinez N, Serdarevic F, Tahirovic E, Daenekindt S, Keizer R, Jansen PW, Tiemeier H. What maternal educational mobility tells us about the mother's parenting routines, offspring school achievement and intelligence. Soc Sci Med 2024; 345:116667. [PMID: 38364725 DOI: 10.1016/j.socscimed.2024.116667] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Educational mobility at the macro-level is a common measure of social inequality. Nonetheless, the correlates of mobility of education at the individual level are less well studied. We evaluated whether educational mobility of the second generation (compared to the first generation level) predicts differences in parenting practices of the second generation and school achievement and intelligence in the third generation. METHODS Data from a population-based cohort of children in the Netherlands (N = 3547; 49.4% boys) were analyzed. Maternal, grandparental education and family routines, a parenting practice, were reported by the mother. Child school achievement at the end of primary school (∼12 years, with the national Dutch academic test score) and child intelligence (∼6 and 13 years) were measured in a standardized manner. Also, a child genome-wide polygenic score of academic attainment was calculated. To estimate the effect of educational mobility, inverse probability-weighted linear models and Diagonal Reference Models (DRM) were used. RESULTS Upward maternal educational mobility was associated with better offspring school achievement, higher intelligence, and more family routines if compared to offspring of mothers with no upward mobility. However, mothers did not implement the same level of family routines as similarly educated mothers and grandfathers who already had achieved this educational level. Likewise, children of mothers with upward educational mobility had lower school achievement and intelligence than children of similarly educated mothers with no mobility. Child's genetic potential for education followed a similar association pattern with higher potential in children of upward mobile mothers. CONCLUSION Policymakers might overlook social inequalities when focused on parental socioeconomic status. Grandparental socioeconomic status, which independently predicts child school achievement, intelligence, and parental family routines, should also be assessed. The child's genetic endowment reflects the propensity for education across generations that partly underlies mobility and some of its effect on the offspring.
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Affiliation(s)
- Nathalie Tamayo Martinez
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Fadila Serdarevic
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Emin Tahirovic
- Association South East European Network for Medical Research-SOVE, Sarajevo, Bosnia and Herzegovina.
| | | | - Renske Keizer
- Erasmus School of Social and Behavioral Sciences, Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, the Netherlands.
| | - Pauline W Jansen
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands.
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, USA.
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Hamzic E, Spahic L, Pistoljevic N, Dzanko E, Pasic S, Kadric L, Serdarevic F, Hajdarpasic A. Exploratory genetic analysis in children with autism spectrum disorder and other developmental disorders using whole exome sequencing. Biomol Biomed 2024. [PMID: 38421723 DOI: 10.17305/bb.2024.10221] [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] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Indexed: 03/02/2024]
Abstract
Developmental disorders (DDs), such as autism spectrum disorder (ASD), incorporate various conditions; once identified, further diagnostics are necessary to specify their type and severity. The aim of this exploratory study was to identify genetic variants that can help differentiate ASD early from other DDs. We selected 36 children (mean age 60.1 months) with DDs using Developmental Behavioral Scales (DBS) through "EDUS-Education for All", an organization providing services for children with developmental disorders in Bosnia and Herzegovina. We further rated children's autistic traits with the preschool version of the Childhood Autism Rating Scale, second edition (CARS-II). We defined ASD if scores were >25.5 and other DDs if scores were <25.5. Diagnosis of ASD and DD were independently confirmed by child psychiatrists. Whole exome sequencing (WES) was performed by Veritas Genetics, USA, using Illumina NovaSeq 6000 (Illumina Inc., San Diego, CA, USA) next-generation sequencing (NGS) apparatus. We tested genetic association by applying SKAT-O, which optimally combines the standard Sequence Kernel Association Test (SKAT) and burden tests to identify rare variants associated with complex traits in samples of limited power. The analysis yielded seven genes (DSE, COL10A1, DLK2, CSMD1, FAM47E, PPIA, PYDC2) to potentially differentiate observed phenotypic characteristics between our cohort participants with ASD and other DDs. Our exploratory study in a small sample of participants with ASD and other DDs contributed to gene discovery in differentiating ASD from DDs. A replication study is needed in a larger sample to confirm our results.
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Affiliation(s)
- Edin Hamzic
- Biocomputix, Sarajevo, Bosnia and Herzegovina; BioCertica, Paarl, South Africa
| | - Lemana Spahic
- International Burch University, Sarajevo, Bosnia and Herzegovina
| | | | - Eldin Dzanko
- Education for All (EDUS), Sarajevo, Bosnia and Herzegovina
| | - Sanela Pasic
- Department of Economics and Business, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Lejla Kadric
- Department of Medical Biology and Genetics, Sarajevo Medical School, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Fadila Serdarevic
- Department of Epidemiology, Sarajevo Medical School, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina; Department of Child and Adolescent Psychiatry, Erasmus MC, Rotterdam, the Netherlands
| | - Aida Hajdarpasic
- Department of Medical Biology and Genetics, Sarajevo Medical School, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
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Defina S, Woofenden T, Baltramonaityte V, Pariante CM, Lekadir K, Jaddoe VWV, Serdarevic F, Tiemeier H, Walton E, Felix JF, Cecil CAM. Effects of Pre- and Postnatal Early-Life Stress on Internalizing, Adiposity, and Their Comorbidity. J Am Acad Child Adolesc Psychiatry 2024; 63:255-265. [PMID: 37453606 DOI: 10.1016/j.jaac.2023.05.034] [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: 02/07/2023] [Revised: 05/26/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Depression and obesity are 2 highly prevalent and often comorbid conditions. Exposure to early-life stress (ELS) has been associated with both depression and obesity in adulthood, as well as their preclinical manifestations during development. However, it remains unclear whether (1) associations differ depending on the timing of stress exposure (prenatal vs postnatal), and whether (2) ELS is a shared risk factor underlying the comorbidity between the 2 conditions. METHOD Leveraging data from 2 large population-based birth cohorts (ALSPAC: n = 8,428 [52% male participants]; Generation R: n = 4,268 [48% male participants]), we constructed comprehensive cumulative measures of prenatal (in utero) and postnatal (from birth to 10 years) ELS. At age 13.5 years, we assessed the following: internalizing symptoms (using maternal reports); fat mass percentage (using dual-energy X-ray absorptiometry); and their comorbidity, defined as the co-occurrence of high internalizing and high adiposity. RESULTS Both prenatal (total effect [95% CI] = 0.20 [0.16; 0.22]) and postnatal stress (β [95%CI] = 0.22 [0.17; 0.25]) were associated with higher internalizing symptoms, with evidence of a more prominent role of postnatal stress. A weaker association (driven primarily by prenatal stress) was observed between stress and adiposity (prenatal: 0.07 [0.05; 0.09]; postnatal: 0.04 [0.01; 0.07]). Both prenatal (odds ratio [95%CI] = 1.70 [1.47; 1.97]) and postnatal (1.87 [1.61; 2.17]) stress were associated with an increased risk of developing comorbidity. CONCLUSION We found evidence of timing and shared causal effects of ELS on psycho-cardiometabolic health in adolescence; however, future research is warranted to clarify how these associations may unfold over time. DIVERSITY & INCLUSION STATEMENT We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group.
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Affiliation(s)
- Serena Defina
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | | | | | | | - Vincent W V Jaddoe
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Fadila Serdarevic
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Janine F Felix
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Charlotte A M Cecil
- Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Leiden University Medical Center, Leiden, the Netherlands.
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Serdarevic F, Luo M, Karabegović I, Binter AC, Alemany S, Mutzel R, Guxens M, Bustamante M, Hajdarpasic A, White T, Felix JF, Cecil CAM, Tiemeier H. DNA methylation at birth and fine motor ability in childhood: an epigenome-wide association study with replication. Epigenetics 2023; 18:2207253. [PMID: 37139702 PMCID: PMC10161945 DOI: 10.1080/15592294.2023.2207253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Lower fine motor performance in childhood has been associated with poorer cognitive development and neurodevelopmental conditions such as autism spectrum disorder, yet, biological underpinnings remain unclear. DNA methylation (DNAm), an essential process for healthy neurodevelopment, is a key molecular system of interest. In this study, we conducted the first epigenome-wide association study of neonatal DNAm with childhood fine motor ability and further examined the replicability of epigenetic markers in an independent cohort. The discovery study was embedded in Generation R, a large population-based prospective cohort, including a subsample of 924 ~ 1026 European-ancestry singletons with available data on DNAm in cord blood and fine motor ability at a mean (SD) age of 9.8 (0.4) years. Fine motor ability was measured using a finger-tapping test (3 subtests including left-, right-hand and bimanual), one of the most frequently used neuropsychological instruments of fine motor function. The replication study comprised 326 children with a mean (SD) age of 6.8 (0.4) years from an independent cohort, the INfancia Medio Ambiente (INMA) study. Four CpG sites at birth were prospectively associated with childhood fine motor ability after genome-wide correction. Of these, one CpG (cg07783800 in GNG4) was replicated in INMA, showing that lower levels of methylation at this site were associated with lower fine motor performance in both cohorts. GNG4 is highly expressed in the brain and has been implicated in cognitive decline. Our findings support a prospective, reproducible association between DNAm at birth and fine motor ability in childhood, pointing to GNG4 methylation at birth as a potential biomarker of fine motor ability.
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Affiliation(s)
- Fadila Serdarevic
- Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
- Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Sarajevo Medical School, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Mannan Luo
- Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Irma Karabegović
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Anne-Claire Binter
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Silvia Alemany
- Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
- Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ryan Mutzel
- Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Monica Guxens
- Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Mariona Bustamante
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Aida Hajdarpasic
- Department of Medical Biology, and Genetics, Sarajevo Medical School, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Tonya White
- Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Charlotte A M Cecil
- Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
- Department of Social and Behavioral Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Memon H, Abdulla F, Reljic T, Alnuaimi S, Serdarevic F, Asimi ZV, Kumar A, Semiz S. Effects of combined treatment of probiotics and metformin in management of Type 2 diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract 2023:110806. [PMID: 37369280 DOI: 10.1016/j.diabres.2023.110806] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/22/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Lifestyle changes and dietary intervention, including the use of probiotics, can modulate dysbiosis of gut microbiome and contribute to the management of type 2 diabetes mellitus (T2DM). This systematic review and meta-analysis aim to assess the efficacy of metformin plus probiotics versus metformin alone on outcomes in patients with T2DM. METHODS We searched MEDLINE and EMBASE from inception to February 2023 to identify all randomized controlled trials (RCTs), which compared the use of metformin plus probiotics versus metformin alone in adult patients with T2DM. Data were summarized as mean differences (MD) with 95% confidence interval (CI) and pooled under the random effects model. Findings Fourteen RCTs (17 comparisons, 1009 patients) were included in this systematic review. Pooled results show a significant decrease in fasting glucose (FG) (MD=-0.64, 95% CI=-1.06, -0.22) and HbA1c (MD=-0.29, 95% CI=-0.47, -0.10) levels in patients with T2DM treated with metformin plus probiotics versus metformin alone. The addition of probiotics to metformin resulted in lower odds of gastrointestinal adverse events (Odds ratio=0.18, 95% CI=0.09, 0.3.8; I2=0%). CONCLUSIONS The addition of probiotics to metformin therapy is associated with improvement in T2DM outcomes. However, high-quality and adequately reported RCTs are needed in the future to confirm our findings.
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Affiliation(s)
- Hamda Memon
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Fatima Abdulla
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Tea Reljic
- Research Methodology and Biostatistics Core, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Saif Alnuaimi
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Fadila Serdarevic
- Sarajevo Medical School, University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina; Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Zelija Velija Asimi
- Sarajevo Medical School, University Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Ambuj Kumar
- Research Methodology and Biostatistics Core, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Sabina Semiz
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates.
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Sammallahti S, Serdarevic F, Tiemeier H. Excessive Crying, Behavior Problems, and Amygdala Volume: A Study From Infancy to Adolescence. J Am Acad Child Adolesc Psychiatry 2023; 62:675-683. [PMID: 36758936 DOI: 10.1016/j.jaac.2023.01.014] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/30/2022] [Accepted: 01/31/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Excessive crying in infancy has been associated with increased risk of later behavioral problems. To identify individuals at risk for behavioral problems and to understand the mechanisms underlying excessive crying and irritability in infancy, research into the neurobiology of excessive crying is needed. We examined whether excessive crying and irritability in infancy are associated with behavioral problems and amygdala volume among children and adolescents. METHOD This study included 4,751 singleton children from the prospective population-based Generation R Study cohort, born in the Netherlands in 2002 to 2006. Excessive crying (>3 hours on at least 1 day/wk) and irritability (Mother and Baby Scales questionnaire) were parent-rated at 3 months. Amygdala volume was measured at 10 years using magnetic resonance imaging, and internalizing and externalizing were parent-rated at 1.5, 3, 6, 10, and 14 years and self-rated at 14 years. Covariates included child age, sex, national origin, gestational age, and maternal age, psychopathology score, parity, education, relationship status, and family income. RESULTS Children who cried excessively in infancy had higher parent-rated internalizing (effect estimate = 0.20 SD-units, 95% CI = 0.14, 0.27) and externalizing (0.17 SD-units, 95% CI = 0.10, 0.24) throughout childhood (linear mixed models), and smaller amygdala volume at 10 years (-0.19 SD-units, 95% CI = -0.32, -0.06) (linear regression model). The pattern of associations for both behavioral problems and amygdala volume was similar for irritability. CONCLUSION Excessive crying and irritability in infancy may reflect an early vulnerability to behavioral problems and may be linked with neurobiological differences in the development of the amygdala.
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Affiliation(s)
- Sara Sammallahti
- Erasmus MC, Sophia Children's Hospital, Rotterdam, the Netherlands; University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | | | - Henning Tiemeier
- Erasmus MC, Sophia Children's Hospital, Rotterdam, the Netherlands; Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Tamayo Martinez N, Xerxa Y, Law J, Serdarevic F, Jansen PW, Tiemeier H. Double advantage of parental education for child educational achievement: the role of parenting and child intelligence. Eur J Public Health 2022; 32:690-695. [PMID: 35554528 PMCID: PMC9527951 DOI: 10.1093/eurpub/ckac044] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Parental education is one of the best predictors of child school achievement. Higher parental education is not only associated with higher child intelligence, but children from highly educated parents also perform better in school due to other family related factors. This study evaluates the relation between parental education, child non-verbal intelligence and parenting practices with child school achievement. Methods Longitudinal data from a large population-based, multi-ethnic cohort of children in the Netherlands (63% Dutch origin) followed from birth to age 13 years (3547 children; 52.3% girls) were analyzed. School achievement was measured at the end of primary school (12 years of age) with a national Dutch academic test score. Parental education was assessed at age 3 years. The non-verbal intelligence of the child was measured at age 6 years and a full intelligence was measured at age 13 years. Maternal and paternal family routines, harsh parenting and corporal punishment were assessed in early and mid-childhood. Mediation analysis was performed with the G-formula and Structural Equation Models. Results Child intelligence partially mediated [B indirect effect =0.54 95% CI (0.46, 0.62) P < 0.001] the association between parental education and child school achievement. Independent of intelligence, family routines [B indirect effect =0.04 95% CI (0.01, 0.07) P < 0.01], but not harsh parenting mediated this association. Conclusions Higher parental education was associated with better school achievement through two independent mechanisms, through higher intelligence of the child and parenting practices.
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Affiliation(s)
- Nathalie Tamayo Martinez
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Yllza Xerxa
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - James Law
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle-Upon-Tyne, UK
| | - Fadila Serdarevic
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Pauline W Jansen
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA
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Hukic M, Ponjavic M, Tahirovic E, Karabegovic A, Ferhatbegovic E, Travar M, Serdarevic F. SARS-CoV-2 virus outbreak and the emergency public health measures in Bosnia and Herzegovina: January - July, 2020. Bosn J Basic Med Sci 2021; 21:111-116. [PMID: 33091331 PMCID: PMC7861623 DOI: 10.17305/bjbms.2020.5081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/23/2020] [Accepted: 10/16/2020] [Indexed: 12/18/2022] Open
Abstract
Between March 5th and July 25th, 2020, the total number of SARS-CoV-2 confirmed cases in Bosnia and Herzegovina (BH) was 10,090, corresponding to a cumulative incidence rate of 285.7/100,000 population. Demographic and clinical information on all the cases along with exposure and contact information were collected using a standardized case report form. In suspected SARS-CoV-2 cases, respiratory specimens were collected and tested by real-time reverse-transcriptase polymerase chain reaction assay. The dynamic of the outbreak was summarized using epidemiological curves, instantaneous reproduction number Rt, and interactive choropleth maps for geographical distribution and spread. The rate of hospitalization was 14.0%(790/5646) in the Federation of Bosnia and Herzegovina (FBH) and 6.2% (267/4299) in the Republic of Srpska (RS). The death rate was 2.2% (122/5646) in FBH and 3.6% in the RS (155/4299). After the authorities lifted mandatory quarantine restrictions, the instantaneous reproduction number increased from 1.13 on May 20th to 1.72 on May 31st. The outbreak concerns both entities, FBH and RS, and it is more pronounced in those aged 20-44 years. It is important to develop the communication and emergency plan for the SARS-CoV-2 outbreak in BH, including the mechanisms to allow the ongoing notification and updates at the national level.
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Affiliation(s)
- Mirsada Hukic
- Department of Medical Sciences, Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina; Institute for Biomedical Diagnostic and Research NALAZ, Sarajevo, Bosnia and Herzegovina
| | - Mirza Ponjavic
- GAUSS Centre for Geospatial Research Sarajevo, Sarajevo, Bosnia and Herzegovina; Faculty of Engineering and Natural Sciences, International Burch University, Sarajevo, Bosnia and Herzegovina
| | - Emin Tahirovic
- Faculty of Engineering and Natural Sciences, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina; South East European Network for Medical Research (SOVE), Sarajevo, Bosnia and Herzegovina; Epidemic Location Intelligence System (ELIS) Project of Academy of Sciences and Arts of Bosnia and Herzegovina
| | - Almir Karabegovic
- GAUSS Centre for Geospatial Research Sarajevo, Sarajevo, Bosnia and Herzegovina; Faculty of Electrical Engineering, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Elvir Ferhatbegovic
- GAUSS Centre for Geospatial Research Sarajevo, Sarajevo, Bosnia and Herzegovina; Epidemic Location Intelligence System (ELIS), Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Maja Travar
- Epidemic Location Intelligence System (ELIS), Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina; Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina; University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
| | - Fadila Serdarevic
- South East European Network for Medical Research (SOVE), Sarajevo, Bosnia and Herzegovina; Epidemic Location Intelligence System (ELIS), Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina; Erasmus Medical Center, Erasmus University, Rotterdam, Netherlands; Faculty of Medicine, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
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10
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Semiz S, Serdarevic F. Prevention and Management of Type 2 Diabetes and Metabolic Syndrome in the Time of COVID-19: Should We Add a Cup of Coffee? Front Nutr 2020; 7:581680. [PMID: 33123550 PMCID: PMC7573071 DOI: 10.3389/fnut.2020.581680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/07/2020] [Indexed: 01/08/2023] Open
Abstract
Recent evidence shows that COVID-19 patients with existing metabolic disorders, such as diabetes and metabolic syndrome, are exposed to a high risk of morbidity and mortality. At the same time, in order to manage the pandemic, the health authorities around the world are advising people to stay at home. This results in decreased physical activity and an increased consumption of an unhealthy diet, which often leads to an increase in body weight, risk for diabetes, insulin resistance, and metabolic syndrome, and thus, paradoxically, to a high risk of morbidity and mortality due to COVID-19 complications. Here we summarize the evidence demonstrating that the promotion of a healthy life style, including physical activity and a dietary intake of natural polyphenols present in coffee and tea, has the potential to improve the prevention and management of insulin resistance and diabetes in the time of COVID-19 pandemic. Particularly, it would be pertinent to evaluate further the potential positive effects of coffee beverages, rich in natural polyphenols, as an adjuvant therapy for COVID-19, which appear not to be studied sufficiently.
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Affiliation(s)
- Sabina Semiz
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates.,Association South East European Network for Medical Research-SOVE, Sarajevo, Bosnia and Herzegovina
| | - Fadila Serdarevic
- Association South East European Network for Medical Research-SOVE, Sarajevo, Bosnia and Herzegovina.,Department of Child and Adolescent Psychiatry, Erasmus Medical Centre Rotterdam, Rotterdam, Netherlands
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11
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Hasanagic S, Serdarevic F. Potential role of memantine in the prevention and treatment of COVID-19: its antagonism of nicotinic acetylcholine receptors and beyond. Eur Respir J 2020; 56:13993003.01610-2020. [PMID: 32554535 PMCID: PMC7301831 DOI: 10.1183/13993003.01610-2020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/05/2020] [Indexed: 11/19/2022]
Abstract
Recently, Leunget al. [1] proposed that α7-subtype nicotinic acetylcholine receptor (α7-nAChR) antagonists might decrease angiotensin-converting enzyme (ACE)2 receptor expression in respiratory epithelium and, hence, prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) invasion of pulmonary epithelial cells. Let us further theoretically evaluate this assertion and contribute to the quest for potential medications that might reduce virulence and pathogenicity of coronavirus disease 2019 (COVID-19). Smoking may be associated with progression and negative outcome of COVID-19 [1]. The receptor-binding domain of the S protein (spike) on the surface of SARS-CoV-2 interacts with the ACE2 receptor, which is an entry point of the virus into host respiratory cells [2]. Memantine, as an antagonist of α7-nAChR and NMDA receptors, may decrease ACE2 receptor expression and reduce oxidative stress and inflammation. Hence, memantine may potentially reduce SARS-CoV-2 virulence.https://bit.ly/2AZHiVg
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Affiliation(s)
- Senad Hasanagic
- Clinical Center University of Sarajevo, Dept of Psychiatry, Sarajevo, Bosnia and Herzegovina
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12
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Serdarevic F, Tiemeier H, Jansen PR, Alemany S, Xerxa Y, Neumann A, Robinson E, Hillegers MHJ, Verhulst FC, Ghassabian A. Polygenic Risk Scores for Developmental Disorders, Neuromotor Functioning During Infancy, and Autistic Traits in Childhood. Biol Psychiatry 2020; 87:132-138. [PMID: 31629460 DOI: 10.1016/j.biopsych.2019.06.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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] [Received: 12/04/2018] [Revised: 05/03/2019] [Accepted: 06/03/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Impaired neuromotor development is often one of the earliest observations in children with autism spectrum disorder (ASD). We investigated whether a genetic predisposition to developmental disorders was associated with nonoptimal neuromotor development during infancy and examined the genetic correlation between nonoptimal neuromotor development and autistic traits in the general population. METHODS In a population-based cohort in The Netherlands (2002-2006), we calculated polygenic risk scores (PRSs) for ASD and attention-deficit/hyperactivity disorder (ADHD) using genome-wide association study summary statistics. In 1921 children with genetic data, parents rated autistic traits at 6 years of age. Among them, 1174 children (61.1%) underwent neuromotor examinations (tone, responses, senses, and other observations) during infancy (9-20 weeks of age). We used linear regressions to examine associations of PRSs with neuromotor scores and autistic traits. We performed a bivariate genome-based restricted maximum likelihood analysis to explore whether genetic susceptibility underlies the association between neuromotor development and autistic traits. RESULTS Higher PRSs for ASD were associated with less optimal overall infant neuromotor development, in particular low muscle tone. Higher PRSs for ADHD were associated with less optimal senses. PRSs for ASD and those for ADHD both were associated with autistic traits. The single nucleotide polymorphism-based heritability of overall motor development was 20% (SE = .21) and of autistic traits was 68% (SE = .26). The genetic correlation between overall motor development and autistic traits was .35 (SE = .21, p < .001). CONCLUSIONS We found that genetic liabilities for ASD and ADHD covary with neuromotor development during infancy. Shared genetic liability might partly explain the association between nonoptimal neuromotor development during infancy and autistic traits in childhood.
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Affiliation(s)
- Fadila Serdarevic
- Generation R Study Group, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands; Department of Pediatrics, New York University School of Medicine, New York, New York
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Philip R Jansen
- Generation R Study Group, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands; Department of Complex Trait Genetics, Center for Neuroscience and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Silvia Alemany
- Barcelona Institute for Global Health, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Yllza Xerxa
- Generation R Study Group, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands
| | - Alexander Neumann
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands
| | - Elise Robinson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Manon H J Hillegers
- Generation R Study Group, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, Rotterdam, The Netherlands
| | - Akhgar Ghassabian
- Department of Pediatrics, New York University School of Medicine, New York, New York; Department of Population Health, New York University School of Medicine, New York, New York; Department of Environmental Medicine, New York University School of Medicine, New York, New York
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13
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Hamidovic A, Karapetyan K, Serdarevic F, Choi SH, Eisenlohr-Moul T, Pinna G. Higher Circulating Cortisol in the Follicular vs. Luteal Phase of the Menstrual Cycle: A Meta-Analysis. Front Endocrinol (Lausanne) 2020; 11:311. [PMID: 32582024 PMCID: PMC7280552 DOI: 10.3389/fendo.2020.00311] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/24/2020] [Indexed: 01/27/2023] Open
Abstract
Although results of animal research show that interactions between stress and sex hormones are implicated in the development of affective disorders in women, translation of these findings to patients has been scarce. As a basic step toward advancing this field of research, we analyzed findings of studies which reported circulating cortisol levels in healthy women in the follicular vs. luteal phase of the menstrual cycle. We deemed this analysis critical not only to advance our understanding of basic physiology, but also as an important contrast to the findings of future studies evaluating stress and sex hormones in women with affective disorders. We hypothesized that cortisol levels would be lower in the follicular phase based on the proposition that changes in levels of potent GABAergic neurosteroids, including allopregnanolone, during the menstrual cycle dynamically change in the opposite direction relative to cortisol levels. Implementing strict inclusion criteria, we compiled results of high-quality studies involving 778 study participants to derive a standardized mean difference between circulating cortisol levels in the follicular vs. luteal phase of the menstrual cycle. In line with our hypothesis, our meta-analysis found that women in the follicular phase had higher cortisol levels than women in the luteal phase, with an overall Hedges' g of 0.13 (p < 0.01) for the random effects model. No significant between-study difference was detected, with the level of heterogeneity in the small range. Furthermore, there was no evidence of publication bias. As cortisol regulation is a delicate process, we review some of the basic mechanisms by which progesterone, its potent metabolites, and estradiol regulate cortisol output and circulation to contribute to the net effect of higher cortisol in the follicular phase.
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Affiliation(s)
- Ajna Hamidovic
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
- *Correspondence: Ajna Hamidovic
| | - Kristina Karapetyan
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
| | - Fadila Serdarevic
- Department of Epidemiology, Erasmus Medical Centre Rotterdam, Rotterdam, Netherlands
| | - So Hee Choi
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
| | - Tory Eisenlohr-Moul
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Graziano Pinna
- The Psychiatric Institute, Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
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Koopman‐Verhoeff ME, Serdarevic F, Kocevska D, Bodrij FF, Mileva‐Seitz VR, Reiss I, Hillegers MH, Tiemeier H, Cecil CA, Verhulst FC, Luijk MP. Preschool family irregularity and the development of sleep problems in childhood: a longitudinal study. J Child Psychol Psychiatry 2019; 60:857-865. [PMID: 30945287 PMCID: PMC6850317 DOI: 10.1111/jcpp.13060] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/07/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Previous studies have shown that poor family environments are related to more sleep problems; however, little is known about how family irregularity in early life affects the development of sleep problems over childhood using objective sleep measures. The current study tests the hypothesis that early family irregularity contributes to the development of sleep problems. METHODS This population-based study comprises 5,443 children from the Generation R Study. Family irregularity was measured with seven maternal-reported questions on family routines when children were 2 and 4 years old. Mothers reported on sleep problems at child age 3, 6, and 10 years, whereas children completed questionnaires on sleep problems at age 10. Additionally, we used tri-axial wrist accelerometers for five nights in 851 children (mean age 11.7 years) to assess sleep objectively. RESULTS Family irregularity was associated with more mother- and child-reported sleep problems at ages 3, 6, and 10 years as well as with a shorter sleep duration and later objective sleep onset, but not with sleep efficiency or waking time. The association between family irregularity and multi-informant subjective sleep problems at age 10 years was mediated by mother-reported child psychopathology at age 6 years. CONCLUSIONS Our findings show a long-term robust association of preschool family irregularity with more sleep problems during childhood as well as shorter sleep duration and later sleep onset as measured objectively with actigraphy. In part, these sleep problems were associated with family irregularity by way of child psychopathology. These findings suggest that interventions improving preschool family irregularity, which are targeted to reduce child psychopathology, may also impact the development of sleep problems beneficially.
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Affiliation(s)
- Maria Elisabeth Koopman‐Verhoeff
- Department of Child and Adolescent PsychiatryErasmus University Medical Center–Sophia Children's HospitalRotterdamThe Netherlands,The Generation R Study GroupErasmus Medical CenterRotterdamThe Netherlands
| | - Fadila Serdarevic
- Department of Child and Adolescent PsychiatryErasmus University Medical Center–Sophia Children's HospitalRotterdamThe Netherlands,The Generation R Study GroupErasmus Medical CenterRotterdamThe Netherlands
| | - Desana Kocevska
- Department of Child and Adolescent PsychiatryErasmus University Medical Center–Sophia Children's HospitalRotterdamThe Netherlands,The Generation R Study GroupErasmus Medical CenterRotterdamThe Netherlands,Department of EpidemiologyErasmus University Medical CenterRotterdamThe Netherlands
| | - F. Fenne Bodrij
- Institute of Education and Child StudiesLeiden UniversityLeidenThe Netherlands
| | - Viara R. Mileva‐Seitz
- Department of Child and Adolescent PsychiatryErasmus University Medical Center–Sophia Children's HospitalRotterdamThe Netherlands
| | - Irwin Reiss
- Department of PediatricsErasmus University Medical Center–Sophia Children's HospitalRotterdamThe Netherlands
| | - Manon H.J. Hillegers
- Department of Child and Adolescent PsychiatryErasmus University Medical Center–Sophia Children's HospitalRotterdamThe Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent PsychiatryErasmus University Medical Center–Sophia Children's HospitalRotterdamThe Netherlands,Department of Social and Behavioral ScienceHarvard TH Chan School of Public HealthBostonMAUSA
| | - Charlotte A.M. Cecil
- Department of Child and Adolescent PsychiatryErasmus University Medical Center–Sophia Children's HospitalRotterdamThe Netherlands,Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Frank C. Verhulst
- Department of Child and Adolescent PsychiatryErasmus University Medical Center–Sophia Children's HospitalRotterdamThe Netherlands,Child and Adolescent Mental Health CentreMental Health Services Capital Region, Research UnitCopenhagen University HospitalCopenhagenDenmark
| | - Maartje P.C.M. Luijk
- Department of Child and Adolescent PsychiatryErasmus University Medical Center–Sophia Children's HospitalRotterdamThe Netherlands,Department of Psychology, Education and Child StudiesErasmus University RotterdamRotterdamThe Netherlands
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15
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Xerxa Y, Rescorla LA, Serdarevic F, Van IJzendorn MH, Jaddoe VW, Verhulst FC, Luijk MPCM, Tiemeier H. The Complex Role of Parental Separation in the Association between Family Conflict and Child Problem Behavior. J Clin Child Adolesc Psychol 2019; 49:79-93. [PMID: 30657708 DOI: 10.1080/15374416.2018.1520118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Parental separation is a major adverse childhood experience. Parental separation is generally preceded by conflict, which is itself a risk factor for child problem behavior. Whether parental separation independent of conflict has negative effects on child problem behavior is unclear. This study was embedded in Generation R, a population-based cohort followed from fetal life until age 9 years. Information on family conflict was obtained from 5,808 mothers and fathers. The 4-way decomposition method was used to apportion the effects of prenatal family conflict and parental separation on child problem behavior into 4 nonoverlapping components. Structural equation modeling was used to test bidirectional effects of child problem behavior and family conflict over time. Family conflict from pregnancy onward and parental separation each strongly predicted child problem behavior up to preadolescence according to maternal and paternal ratings. Using the 4-way decomposition method, we found evidence for a strong direct effect of prenatal family conflict on child problem behavior, for reference interaction, and for mediated interaction. The evidence for interaction implies that prenatal family conflict increased the children's vulnerability to the harmful effect of parental separation. There was no evidence of a pure indirect effect of parental separation on child problem behavior. Overall, results indicated that if parental separation occurs in families with low levels of conflict, parental separation does not predict more child problem behavior. Moreover, the bidirectional pattern suggested that child problem behavior influences the persistence of family conflict.
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Affiliation(s)
- Yllza Xerxa
- Generation R Study Group, Department of Child and Adolescent Psychiatry, Erasmus University Medical Center
| | | | - Fadila Serdarevic
- Generation R Study Group, Department of Child and Adolescent Psychiatry, Erasmus University Medical Center
| | | | - Vincent W Jaddoe
- Generation R Study Group, Department of Epidemiology, Erasmus University Medical Center, Department of Pediatrics, Sophia Children's Hospital, Erasmus University Medical Center
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center
| | - Maartje P C M Luijk
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Department of Psychology, Education and Child Studies, Erasmus University Rotterdam
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center Department of Epidemiology, Erasmus Medical Center Department of Social and Behavioral Science, Harvard TH Chan School of Public Health
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16
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Serdarevic F, Jansen PR, Ghassabian A, White T, Jaddoe VWV, Posthuma D, Tiemeier H. Association of Genetic Risk for Schizophrenia and Bipolar Disorder With Infant Neuromotor Development. JAMA Psychiatry 2018; 75:96-98. [PMID: 29117282 PMCID: PMC5833534 DOI: 10.1001/jamapsychiatry.2017.3459] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This study uses data from the population-based Generation R Study of Rotterdam, the Netherlands, to assess an association of genetic risk for schizophrenia and bipolar disorder with infant neuromotor development.
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Affiliation(s)
- Fadila Serdarevic
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Philip R. Jansen
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands,Department of Complex Trait Genetics, Center for Neuroscience and Cognitive Research, Amsterdam Neuroscience, VU University, Amsterdam, the Netherlands,Department of Radiology, Erasmus Medical Center Rotterdam, the Netherlands
| | - Akhgar Ghassabian
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands,Departments of Pediatrics, Population Health, and Environmental Medicine, New York University School of Medicine, New York, New York
| | - Tonya White
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands,Department of Radiology, Erasmus Medical Center Rotterdam, the Netherlands
| | - Vincent W. V. Jaddoe
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands,Department of Pediatrics, Erasmus Medical Center–Sophia Children’s Hospital Rotterdam, the Netherlands
| | - Danielle Posthuma
- Department of Complex Trait Genetics, Center for Neuroscience and Cognitive Research, Amsterdam Neuroscience, VU University, Amsterdam, the Netherlands,Department of Clinical Genetics, VU Medical Center, Amsterdam, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center–Sophia Children’s Hospital, Rotterdam, the Netherlands,Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands,Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
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17
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Serdarevic F, Ghassabian A, van Batenburg-Eddes T, Tahirovic E, White T, Jaddoe VWV, Verhulst FC, Tiemeier H. Infant Neuromotor Development and Childhood Problem Behavior. Pediatrics 2017; 140:peds.2017-0884. [PMID: 29138362 DOI: 10.1542/peds.2017-0884] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Research of adults and school-aged children suggest a neurodevelopmental basis for psychiatric disorders. We examined whether infant neuromotor development predicted internalizing and externalizing problems in young children. METHODS In Generation R, a population-based cohort in the Netherlands (2002-2006), trained research assistants evaluated the neuromotor development of 4006 infants aged 2 to 5 months by using an adapted version of Touwen's Neurodevelopmental Examination (tone, responses, and senses and other observations). We defined nonoptimal neuromotor development as scores in the highest tertile. Mothers and fathers rated their children's behavior at ages 1.5, 3, 6, and 10 years with the Child Behavior Checklist (n = 3474, response: 86.7%). The associations were tested with generalized linear mixed models. RESULTS Overall, neuromotor development predicted internalizing scores, but no association was observed with externalizing scores. Nonoptimal muscle tone was associated with higher internalizing scores (mothers' report: β = .07; 95% confidence interval [CI]: 0.01 to 0.13; fathers' report: β = .09, 95% CI: 0.00 to 0.16). In particular, nonoptimal low muscle tone was associated with higher internalizing scores (mothers' report: β = .11; 95% CI: 0.05 to 0.18; fathers' report: β = .13; 95% CI: 0.04 to 0.22). We also observed an association between senses and other observations with internalizing scores. There was no relationship between high muscle tone or reflexes and internalizing scores. CONCLUSIONS Common emotional problems in childhood have a neurodevelopmental basis in infancy. Neuromotor assessment in infancy may help identify vulnerability to early internalizing symptoms and offer the opportunity for targeted interventions.
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Affiliation(s)
- Fadila Serdarevic
- The Generation R Study Group and.,Departments of Child and Adolescent Psychiatry and
| | - Akhgar Ghassabian
- Department of Pediatrics, Environmental Medicine, and Population Health, New York University School of Medicine, New York, New York; and
| | | | - Emin Tahirovic
- Department of Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Tonya White
- The Generation R Study Group and.,Departments of Child and Adolescent Psychiatry and.,Departments of Radiology
| | - Vincent W V Jaddoe
- Epidemiology, and.,Pediatrics, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands
| | | | - Henning Tiemeier
- Departments of Child and Adolescent Psychiatry and .,Epidemiology, and.,Psychiatry, Erasmus Medical Center, Rotterdam, Netherlands
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18
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Serdarevic F, Ghassabian A, van Batenburg-Eddes T, White T, Blanken LME, Jaddoe VWV, Verhulst FC, Tiemeier H. Infant muscle tone and childhood autistic traits: A longitudinal study in the general population. Autism Res 2017; 10:757-768. [PMID: 28181411 DOI: 10.1002/aur.1739] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 11/23/2016] [Accepted: 12/12/2016] [Indexed: 01/22/2023]
Abstract
In a longitudinal population-based study of 2,905 children, we investigated if infants' neuromotor development was associated with autistic traits in childhood. Overall motor development and muscle tone were examined by trained research assistants with an adapted version of Touwen's Neurodevelopmental Examination between ages 2 and 5 months. Tone was assessed in several positions and items were scored as normal, low, or high tone. Parents rated their children's autistic traits with the Social Responsiveness Scale (SRS) and the Pervasive Developmental Problems (PDP) subscale of the Child Behavior Checklist at 6 years. We defined clinical PDP if scores were >98th percentile of the norm population. Diagnosis of autism spectrum disorder (ASD) was clinically confirmed in 30 children. We observed a modest association between overall neuromotor development in infants and autistic traits. Low muscle tone in infancy predicted autistic traits measured by SRS (adjusted beta = 0.05, 95% CI for B: 0.00-0.02, P = 0.01), and PDP (adjusted beta = 0.08, 95% CI for B: 0.04-0.10, P < 0.001). Similar results emerged for the association of low muscle tone and clinical PDP (adjusted OR = 1.36, 95% CI: 1.08-1.72, P = 0.01) at age 6 years. Results remained unchanged if adjusted for child intelligence. There was no association between high muscle tone and SRS or PDP. Exclusion of children with ASD diagnosis did not change the association. This large study showed a prospective association of infant muscle tone with autistic traits in childhood. Our findings suggest that early detection of low muscle tone might be a gateway to improve early diagnosis of ASD. Autism Res 2017, 10: 757-768. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Fadila Serdarevic
- Erasmus Medical Centre Rotterdam, The Generation R Study Group, the Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital Rotterdam, the Netherlands
| | - Akhgar Ghassabian
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital Rotterdam, the Netherlands.,Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Tamara van Batenburg-Eddes
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital Rotterdam, the Netherlands
| | - Tonya White
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital Rotterdam, the Netherlands.,Department of Radiology, Erasmus Medical Centre Rotterdam, the Netherlands
| | - Laura M E Blanken
- Erasmus Medical Centre Rotterdam, The Generation R Study Group, the Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital Rotterdam, the Netherlands
| | - Vincent W V Jaddoe
- Erasmus Medical Centre Rotterdam, The Generation R Study Group, the Netherlands.,Department of Epidemiology, Erasmus Medical Centre Rotterdam, the Netherlands.,Department of Pediatrics, Erasmus Medical Centre-Sophia Children's Hospital Rotterdam, the Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus Medical Centre Rotterdam, the Netherlands.,Department of Psychiatry, Erasmus Medical Centre, Rotterdam, the Netherlands
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19
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Serdarevic F, van Batenburg-Eddes T, Mous SE, White T, Hofman A, Jaddoe VWV, Verhulst FC, Ghassabian A, Tiemeier H. Relation of infant motor development with nonverbal intelligence, language comprehension and neuropsychological functioning in childhood: a population-based study. Dev Sci 2015; 19:790-802. [PMID: 26549804 DOI: 10.1111/desc.12326] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 04/08/2015] [Indexed: 11/28/2022]
Abstract
Within a population-based study of 3356 children, we investigated whether infant neuromotor development was associated with cognition in early childhood. Neuromotor development was examined with an adapted version of Touwen's Neurodevelopmental Examination between 9 and 20 weeks. Parents rated their children's executive functioning at 4 years. At age 6 years, children performed intelligence and language comprehension tests, using Dutch test batteries. At age 6-9 years, neuropsychological functioning was assessed in 486 children using the validated NEPSY-II-NL test battery. We showed that less optimal neurodevelopment in infancy may predict poor mental rotation, immediate memory, shifting, and planning; but not nonverbal intelligence or language comprehension.
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Affiliation(s)
- Fadila Serdarevic
- The Generation R Study Group, Erasmus Medical Center Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, The Netherlands
| | - Tamara van Batenburg-Eddes
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, The Netherlands.,Department of Educational Neuroscience, VU Amsterdam, The Netherlands
| | - Sabine E Mous
- The Generation R Study Group, Erasmus Medical Center Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, The Netherlands
| | - Tonya White
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, The Netherlands.,Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus Medical Center Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, The Netherlands
| | - Akhgar Ghassabian
- The Generation R Study Group, Erasmus Medical Center Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children's Hospital Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center Rotterdam, The Netherlands.,Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
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20
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Janusz KB, Cortes JE, Serdarevic F, Jones RC, Jones JD, Ritger KA, Morita JY, Gerber SI, Gallagher L, Biggerstaff BJ, Hicks LA, Swerdlow DL, Fischer M, Staples JE. Influenza-like illness in a community surrounding a school-based outbreak of 2009 pandemic influenza A (H1N1) virus-Chicago, Illinois, 2009. Clin Infect Dis 2011; 52 Suppl 1:S94-101. [PMID: 21342907 DOI: 10.1093/cid/ciq025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In April 2009, following the first school closure due to 2009 pandemic influenza A (H1N1) (pH1N1) in Chicago, Illinois, area hospitals were inundated with patients presenting with influenza-like illness (ILI). The extent of disease spread into the surrounding community was unclear. We performed a household survey to estimate the ILI attack rate among community residents and compared reported ILI with confirmed pH1N1 cases and ILI surveillance data (ie, hospital ILI visits, influenza testing, and school absenteeism). The estimated ILI attack rate was 4.6% (95% confidence interval, 2.8%-7.4%), with cases distributed throughout the 5-week study period. In contrast, 36 (84%) of 43 confirmed pH1N1 cases were identified the week of the school closure. Trends in surveillance data peaked during the same week and rapidly decreased to near baseline. Public awareness and health care practices impact standard ILI surveillance data. Community-based surveys are a valuable tool to help assess the burden of ILI in a community.
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Affiliation(s)
- Kristen B Janusz
- Centers for Disease Control and Prevention, Fort Collins, Colorado 80521, USA
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21
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Vranic S, Frkovic-Grazio S, Lamovec J, Serdarevic F, Gurjeva O, Palazzo J, Bilalovic N, Lee LMJ, Gatalica Z. Adenoid cystic carcinomas of the breast have low Topo IIα expression but frequently overexpress EGFR protein without EGFR gene amplification. Hum Pathol 2010; 41:1617-23. [PMID: 20688355 DOI: 10.1016/j.humpath.2010.04.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Revised: 04/24/2010] [Accepted: 04/30/2010] [Indexed: 01/11/2023]
Abstract
Adenoid cystic carcinoma of the breast is a rare subtype of breast cancer with basal-like features. Published studies on breast adenoid cystic carcinoma are limited, resulting in relatively scarce information on the value of predictive tumor markers. We studied 20 primary cases of adenoid cystic carcinoma of the breast for expression of estrogen receptor, progesterone receptor, androgen receptor, epidermal growth factor receptor, HER-2/neu, and topoisomerase IIα using immunohistochemistry and fluorescent in situ hybridization methods. Estrogen and progesterone receptor expression were detected in 1 case each. All tumors were uniformly negative for Her-2/neu expression. Androgen receptor and topoisomerase IIα expression were weakly positive in three cases and 7 cases, respectively. Epidermal growth factor receptor overexpression was detected in 13 cases (65% of all cases). Amplification of TOP2A or HER-2/neu gene was not detected in any of the cases. Our study shows that the majority of adenoid cystic carcinomas of the breast do not overexpress Her-2/neu, topoisomerase IIα, or estrogen receptor, and thus, they are unlikely to respond to therapies targeting these proteins. However, these tumors frequently over-express epidermal growth factor receptor, indicating a potential benefit from anti-epidermal growth factor receptor therapy for patients with advanced adenoid cystic carcinomas of the breast.
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Affiliation(s)
- Semir Vranic
- Department of Pathology, Clinical Center of the University of Sarajevo, Bosnia and Herzegovina
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22
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Soares HP, Kumar A, Serdarevic F, Fiorica J, Wells RJ, Swann S, Buckner J, Sargent D, Hozo I, Djulbegovic B. Equipoise principle and NCI-sponsored clinical trials: Are investigators truly uncertain about their comparisons? J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- H. P. Soares
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Gynecology Oncology Group, Buffalo, NY; Children’s Oncology Group, Arcadia, CA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - A. Kumar
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Gynecology Oncology Group, Buffalo, NY; Children’s Oncology Group, Arcadia, CA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - F. Serdarevic
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Gynecology Oncology Group, Buffalo, NY; Children’s Oncology Group, Arcadia, CA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - J. Fiorica
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Gynecology Oncology Group, Buffalo, NY; Children’s Oncology Group, Arcadia, CA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - R. J. Wells
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Gynecology Oncology Group, Buffalo, NY; Children’s Oncology Group, Arcadia, CA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - S. Swann
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Gynecology Oncology Group, Buffalo, NY; Children’s Oncology Group, Arcadia, CA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - J. Buckner
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Gynecology Oncology Group, Buffalo, NY; Children’s Oncology Group, Arcadia, CA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - D. Sargent
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Gynecology Oncology Group, Buffalo, NY; Children’s Oncology Group, Arcadia, CA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - I. Hozo
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Gynecology Oncology Group, Buffalo, NY; Children’s Oncology Group, Arcadia, CA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - B. Djulbegovic
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Gynecology Oncology Group, Buffalo, NY; Children’s Oncology Group, Arcadia, CA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
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23
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Djulbegovic B, Kumar A, Soares HP, Serdarevic F, Wells RJ, Fiorica J, Swann S, Buckner JC, Sargent D, Hozo I. A relationship between ethics of clinical trials and therapeutic advances in cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- B. Djulbegovic
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Children’s Oncology Group, Arcadia, CA; Gynecology Oncology Group, Buffalo, NY; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Arcadia, CA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - A. Kumar
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Children’s Oncology Group, Arcadia, CA; Gynecology Oncology Group, Buffalo, NY; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Arcadia, CA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - H. P. Soares
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Children’s Oncology Group, Arcadia, CA; Gynecology Oncology Group, Buffalo, NY; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Arcadia, CA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - F. Serdarevic
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Children’s Oncology Group, Arcadia, CA; Gynecology Oncology Group, Buffalo, NY; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Arcadia, CA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - R. J. Wells
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Children’s Oncology Group, Arcadia, CA; Gynecology Oncology Group, Buffalo, NY; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Arcadia, CA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - J. Fiorica
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Children’s Oncology Group, Arcadia, CA; Gynecology Oncology Group, Buffalo, NY; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Arcadia, CA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - S. Swann
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Children’s Oncology Group, Arcadia, CA; Gynecology Oncology Group, Buffalo, NY; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Arcadia, CA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - J. C. Buckner
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Children’s Oncology Group, Arcadia, CA; Gynecology Oncology Group, Buffalo, NY; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Arcadia, CA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - D. Sargent
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Children’s Oncology Group, Arcadia, CA; Gynecology Oncology Group, Buffalo, NY; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Arcadia, CA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
| | - I. Hozo
- H Lee Moffitt Cancer Ctr & Rsrch Inst, Tampa, FL; Children’s Oncology Group, Arcadia, CA; Gynecology Oncology Group, Buffalo, NY; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Arcadia, CA; North Central Cancer Treatment Group, Rochester, MN; Univ of Indiana, Bloomington, IN
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24
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Kumar A, Soares HP, Serdarevic F, Hozo I, Buckner JC, Wells RJ, Fiorica J, Swan S, Sargent D, Djulbegovic B. How many new treatments are “breakthroughs”? Evaluation of innovations in cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. Kumar
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Indiana Univ, Gary, IN; North Central Cancer Treatment Group Affiliation, Arcadia, CA; Children’s Oncology Group, Arcadia, CA; Gynecologic Oncology Group, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN
| | - H. P. Soares
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Indiana Univ, Gary, IN; North Central Cancer Treatment Group Affiliation, Arcadia, CA; Children’s Oncology Group, Arcadia, CA; Gynecologic Oncology Group, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN
| | - F. Serdarevic
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Indiana Univ, Gary, IN; North Central Cancer Treatment Group Affiliation, Arcadia, CA; Children’s Oncology Group, Arcadia, CA; Gynecologic Oncology Group, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN
| | - I. Hozo
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Indiana Univ, Gary, IN; North Central Cancer Treatment Group Affiliation, Arcadia, CA; Children’s Oncology Group, Arcadia, CA; Gynecologic Oncology Group, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN
| | - J. C. Buckner
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Indiana Univ, Gary, IN; North Central Cancer Treatment Group Affiliation, Arcadia, CA; Children’s Oncology Group, Arcadia, CA; Gynecologic Oncology Group, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN
| | - R. J. Wells
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Indiana Univ, Gary, IN; North Central Cancer Treatment Group Affiliation, Arcadia, CA; Children’s Oncology Group, Arcadia, CA; Gynecologic Oncology Group, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN
| | - J. Fiorica
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Indiana Univ, Gary, IN; North Central Cancer Treatment Group Affiliation, Arcadia, CA; Children’s Oncology Group, Arcadia, CA; Gynecologic Oncology Group, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN
| | - S. Swan
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Indiana Univ, Gary, IN; North Central Cancer Treatment Group Affiliation, Arcadia, CA; Children’s Oncology Group, Arcadia, CA; Gynecologic Oncology Group, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN
| | - D. Sargent
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Indiana Univ, Gary, IN; North Central Cancer Treatment Group Affiliation, Arcadia, CA; Children’s Oncology Group, Arcadia, CA; Gynecologic Oncology Group, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN
| | - B. Djulbegovic
- H. Lee Moffitt Cancer Ctr & Research Inst, Tampa, FL; Indiana Univ, Gary, IN; North Central Cancer Treatment Group Affiliation, Arcadia, CA; Children’s Oncology Group, Arcadia, CA; Gynecologic Oncology Group, Philadelphia, PA; Radiation Therapy Oncology Group, Philadelphia, PA; North Central Cancer Treatment Group, Rochester, MN
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25
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Soares HP, Kumar A, Daniels S, Swann S, Cantor A, Hozo I, Clark M, Serdarevic F, Gwede C, Trotti A, Djulbegovic B. Evaluation of new treatments in radiation oncology: are they better than standard treatments? JAMA 2005; 293:970-8. [PMID: 15728168 PMCID: PMC1779758 DOI: 10.1001/jama.293.8.970] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CONTEXT The superiority of innovative over standard treatments is not known. To describe accurately the outcomes of innovations that are tested in randomized controlled trials (RCTs) 3 factors have to be considered: publication rate, quality of trials, and the choice of the adequate comparator intervention. OBJECTIVE To determine the success rate of innovative treatments by assessing preferences between experimental and standard treatments according to original investigators' conclusions, determining the proportion of RCTs that achieved primary outcomes' statistical significance, and performing meta-analysis to examine if the summary point estimate favored innovative vs standard treatments. DATA SOURCES Randomized controlled trials conducted by the Radiation Therapy Oncology Group (RTOG). STUDY SELECTION All completed phase 3 trials conducted by the RTOG since its creation in 1968 until 2002. For multiple publications of the same study, we used the one with the most complete primary outcomes and with the longest follow-up information. DATA EXTRACTION We used the US National Cancer Institute definition of completed studies to determine the publication rate. We extracted data related to publication status, methodological quality, and treatment comparisons. One investigator extracted the data from all studies and 2 independent investigators extracted randomly about 50% of the data. Disagreements were resolved by consensus during a meeting. DATA SYNTHESIS Data on 12,734 patients from 57 trials were evaluated. The publication rate was 95%. The quality of trials was high. We found no evidence of inappropriateness of the choice of comparator. Although the investigators judged that standard treatments were preferred in 71% of the comparisons, when data were meta-analyzed innovations were as likely as standard treatments to be successful (odds ratio for survival, 1.01; 99% confidence interval, 0.96-1.07; P = .5). In contrast, treatment-related mortality was worse with innovations (odds ratio, 1.76; 99% confidence interval, 1.01-3.07; P = .008). We found no predictable pattern of treatment successes in oncology: sometimes innovative treatments are better than the standard ones and vice versa; in most cases there were no substantive differences between experimental and conventional treatments. CONCLUSION The finding that the results in individual trials cannot be predicted in advance indicates that the system and rationale for RCTs is well preserved and that successful interventions can only be identified after an RCT is completed.
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Affiliation(s)
- Heloisa P Soares
- H. Lee Moffitt Cancer Center and Research Institute at University of South Florida, Tampa 33612, USA
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26
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Kumar A, Soares H, Serdarevic F. Totality of evidence: one of the keys to better oncology management. J Oncol Manag 2005; 14:12-4. [PMID: 15773599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Scientists around the world publish a tremendous amount of biomedical research every year, and the process of synthesizing the published research is an uphill task. Systematic review is the most promising technique to critically appraise and synthesize the findings and also argues for the totality of evidence, which is important for effective oncology management.
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Affiliation(s)
- Ambuj Kumar
- Department of Interdisciplinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, 12902 Magnolia Dr, Tampa, FL 33612, USA.
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