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Zhang S, Larsen B, Sydnor VJ, Zeng T, An L, Yan X, Kong R, Kong X, Gur RC, Gur RE, Moore TM, Wolf DH, Holmes AJ, Xie Y, Zhou JH, Fortier MV, Tan AP, Gluckman P, Chong YS, Meaney MJ, Deco G, Satterthwaite TD, Yeo BT. In-vivo whole-cortex marker of excitation-inhibition ratio indexes cortical maturation and cognitive ability in youth. bioRxiv 2024:2023.06.22.546023. [PMID: 38586012 PMCID: PMC10996460 DOI: 10.1101/2023.06.22.546023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
A balanced excitation-inhibition ratio (E/I ratio) is critical for healthy brain function. Normative development of cortex-wide E/I ratio remains unknown. Here we non-invasively estimate a putative marker of whole-cortex E/I ratio by fitting a large-scale biophysically-plausible circuit model to resting-state functional MRI (fMRI) data. We first confirm that our model generates realistic brain dynamics in the Human Connectome Project. Next, we show that the estimated E/I ratio marker is sensitive to the GABA-agonist benzodiazepine alprazolam during fMRI. Alprazolam-induced E/I changes are spatially consistent with positron emission tomography measurement of benzodiazepine receptor density. We then investigate the relationship between the E/I ratio marker and neurodevelopment. We find that the E/I ratio marker declines heterogeneously across the cerebral cortex during youth, with the greatest reduction occurring in sensorimotor systems relative to association systems. Importantly, among children with the same chronological age, a lower E/I ratio marker (especially in association cortex) is linked to better cognitive performance. This result is replicated across North American (8.2 to 23.0 years old) and Asian (7.2 to 7.9 years old) cohorts, suggesting that a more mature E/I ratio indexes improved cognition during normative development. Overall, our findings open the door to studying how disrupted E/I trajectories may lead to cognitive dysfunction in psychopathology that emerges during youth.
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Affiliation(s)
- Shaoshi Zhang
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore
- Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore
- Department of Medicine, Human Potential Translational Research Programme & Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National Univeristy of Singapore, Signapore
| | - Bart Larsen
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Lifespan Brain Institute (LiBI) of Penn Medicine and CHOP, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Valerie J. Sydnor
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Lifespan Brain Institute (LiBI) of Penn Medicine and CHOP, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tianchu Zeng
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore
- Department of Medicine, Human Potential Translational Research Programme & Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National Univeristy of Singapore, Signapore
| | - Lijun An
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore
- Department of Medicine, Human Potential Translational Research Programme & Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National Univeristy of Singapore, Signapore
| | - Xiaoxuan Yan
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore
- Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore
- Department of Medicine, Human Potential Translational Research Programme & Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National Univeristy of Singapore, Signapore
| | - Ru Kong
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore
- Department of Medicine, Human Potential Translational Research Programme & Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National Univeristy of Singapore, Signapore
| | - Xiaolu Kong
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore
- Department of Medicine, Human Potential Translational Research Programme & Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National Univeristy of Singapore, Signapore
- ByteDance, Singapore
| | - Ruben C. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Lifespan Brain Institute (LiBI) of Penn Medicine and CHOP, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Lifespan Brain Institute (LiBI) of Penn Medicine and CHOP, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tyler M. Moore
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Lifespan Brain Institute (LiBI) of Penn Medicine and CHOP, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Daniel H. Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Avram J Holmes
- Department of Psychiatry, Brain Health Institute, Rutgers University, Piscataway, NJ, United States
- Wu Tsai Institute, Yale University, New Haven, CT, United States
| | - Yapei Xie
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore
- Department of Medicine, Human Potential Translational Research Programme & Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National Univeristy of Singapore, Signapore
| | - Juan Helen Zhou
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore
- Department of Medicine, Human Potential Translational Research Programme & Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National Univeristy of Singapore, Signapore
| | - Marielle V Fortier
- Department of Diagnostic and Interventional Imaging, KK Women’s and Children’s Hospital, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Ai Peng Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Peter Gluckman
- UK Centre for Human Evolution, Adaptation and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Gustavo Deco
- Center for Brain and Cognition, Department of Technology and Information, Universitat Pompeu Fabra, Barcelona, Spain
- Institució Catalana de la Recerca i Estudis Avançats, Universitat Barcelona, Barcelona, Spain
| | - Theodore D. Satterthwaite
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
- Lifespan Brain Institute (LiBI) of Penn Medicine and CHOP, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - B.T. Thomas Yeo
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore
- Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore
- Department of Medicine, Human Potential Translational Research Programme & Institute for Digital Medicine (WisDM), Yong Loo Lin School of Medicine, National Univeristy of Singapore, Signapore
- Martinos Center for Biomedical Imaging, Massachusetts General Hopstial, Charlestown, MA, USA
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Shama T, O’Sullivan JM, Rahman N, Kakon SH, Tofail F, Hossain MI, Zeilani M, Haque R, Gluckman P, Forrester T, Nelson CA. Multidimensional evaluation of the early emergence of executive function and development in Bangladeshi children using nutritional and psychosocial intervention: A randomized controlled trial protocol. PLoS One 2024; 19:e0296529. [PMID: 38489293 PMCID: PMC10942035 DOI: 10.1371/journal.pone.0296529] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/23/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION Reversing malnutrition-induced impairment of cognition and emotional regulation is a critical global gap. We hypothesize that brain-targeted micronutrient supplemented nutritional rehabilitation in children with moderate acute malnutrition, followed by 2 years micronutrient supplementation will impact on the cognition and emotion regulation of these children. METHODS The primary outcome of this prospective, randomized controlled trial is to study the development of executive functions (EFs) and emotion regulation (ER) in this cohort. Moderate acute malnourished (MAM; WLZ/WHZ <-2 and ≥-3 z-score, and/or 11.5 cm ≤ MUAC < 12.5cm; n = 140)children aged around one year (11m-13m) in Mirpur, Dhaka, Bangladesh will be randomized (1:1) to receive either locally produced Ready to Use Supplementary Food (RUSF) or Enhanced Ready to Use Supplementary Food (E-RUSF) until anthropometric recovery (WLZ/WHZ > -1SD), or for 3 months after enrollment (whichever is earlier). The randomized MAMs groups will be given either Small Quantity Lipid Based Nutrient Supplement (SQLNS) or Enhanced Small Quantity Lipid Based Nutrient Supplement (E-SQLNS), respectively until the end of the 2-year follow up period. Standard psychosocial stimulation will be provided to the MAMs intervention groups. Biological samples will be collected, anthropometric and neurocognitive assessments will be performed at 2 (22m-26m) and 3 (34m-38m) years of age. Two control groups will be recruited: 1), non-malnourished one-year (11m-13m) old children (WLZ/WHZ score>-1SD; n = 70); and 2) three-year (34m-38m) old children (n = 70) with untreated MAM (WHZ <-2 and ≥-3 z-score, and/or 11.5≤MUAC<12.5 cm). The 3-year-old MAM reference group will be assessed once and provided with 2 months of nutritional rehabilitation support (RUSF Nutriset's Plumpy'Sup™).
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Affiliation(s)
- Talat Shama
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Justin M. O’Sullivan
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
- The Maurice Wilkins Centre, The University of Auckland, Auckland, New Zealand
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore, Singapore
| | - Navin Rahman
- Laboratories of Cognitive Neuroscience, Department of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts, United States of America
| | - Shahria H. Kakon
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Fahmida Tofail
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Md Iqbal Hossain
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Mamane Zeilani
- Department of External Research and Nutrition Strategy, Nutriset SAS, Malaunay, France
| | - Rashidul Haque
- International Centre for Diarrheal Disease Research, Dhaka, Bangladesh
| | - Peter Gluckman
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore, Singapore
| | - Terrence Forrester
- Faculty of Medical Sciences, UWI Solutions for Developing Countries, The University of the West Indies (UWI), Kingston, Jamaica
| | - Charles A. Nelson
- Laboratories of Cognitive Neuroscience, Department of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Harvard Graduate School of Education, Cambridge, Massachusetts, United States of America
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Arnett AB, Guiney H, Bakir-Demir T, Trudgen A, Schierding W, Reid V, O'Sullivan J, Gluckman P, Reese E, Poulton R. Resting EEG correlates of neurodevelopment in a socioeconomically and linguistically diverse sample of toddlers: Wave 1 of the Kia Tīmata Pai best start New Zealand study. Dev Cogn Neurosci 2024; 65:101336. [PMID: 38157733 PMCID: PMC10790011 DOI: 10.1016/j.dcn.2023.101336] [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: 07/19/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024] Open
Abstract
Development of communication and self-regulation skills is fundamental to psychosocial maturation in childhood. The Kia Tīmata Pai Best Start (KTP) longitudinal study aims to promote these skills through interventions delivered at early childcare centers across New Zealand. In addition to evaluating effects of the interventions on behavioral and cognitive outcomes, the study utilizes electroencephalography (EEG) to characterize cortical development in a subsample of participating children. Here, we present results of the baseline resting EEG assessment with 193 children aged 15 to 33 months. We identified EEG correlates of individual differences in demographics, communication abilities, and temperament. We obtained communication and behavior ratings from multiple informants, and we applied contemporary analytic methods to the EEG data. Periodic spectral power adjusted for aperiodic activity was most closely associated with demographic, language, and behavioral measures. As in previous studies, gamma power was positively associated with verbal language. Alpha power was positively associated with effortful control. Nonverbal and verbal language measures showed distinct associations with EEG indices, as did the three temperament domains. Our results identified a number of candidate EEG measurements for use as longitudinal markers of optimal cortical development and response to interventions in the KTP cohort.
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Affiliation(s)
- Anne B Arnett
- Developmental Medicine, Boston Children's Hospital, Boston, MA, USA; Pediatrics, Harvard Medical School, Cambridge, MA, USA.
| | - Hayley Guiney
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | | | - Anita Trudgen
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - William Schierding
- Liggins Institute, University of Auckland, Auckland, New Zealand; Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | - Vincent Reid
- School of Psychology, University of Waikato, Hamilton, New Zealand
| | | | - Peter Gluckman
- Liggins Institute, University of Auckland, Auckland, New Zealand.
| | - Elaine Reese
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Richie Poulton
- Department of Psychology, University of Otago, Dunedin, New Zealand
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4
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Kway YM, Thirumurugan K, Michael N, Tan KH, Godfrey KM, Gluckman P, Chong YS, Venkataraman K, Khoo EYH, Khoo CM, Leow MKS, Tai ES, Chan JK, Chan SY, Eriksson JG, Fortier MV, Lee YS, Velan SS, Feng M, Sadananthan SA. A fully convolutional neural network for comprehensive compartmentalization of abdominal adipose tissue compartments in MRI. Comput Biol Med 2023; 167:107608. [PMID: 37897959 DOI: 10.1016/j.compbiomed.2023.107608] [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: 04/10/2023] [Revised: 09/18/2023] [Accepted: 10/17/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Existing literature has highlighted structural, physiological, and pathological disparities among abdominal adipose tissue (AAT) sub-depots. Accurate separation and quantification of these sub-depots are crucial for advancing our understanding of obesity and its comorbidities. However, the absence of clear boundaries between the sub-depots in medical imaging data has challenged their separation, particularly for internal adipose tissue (IAT) sub-depots. To date, the quantification of AAT sub-depots remains challenging, marked by a time-consuming, costly, and complex process. PURPOSE To implement and evaluate a convolutional neural network to enable granular assessment of AAT by compartmentalization of subcutaneous adipose tissue (SAT) into superficial subcutaneous (SSAT) and deep subcutaneous (DSAT) adipose tissue, and IAT into intraperitoneal (IPAT), retroperitoneal (RPAT), and paraspinal (PSAT) adipose tissue. MATERIAL AND METHODS MRI datasets were retrospectively collected from Singapore Preconception Study for Long-Term Maternal and Child Outcomes (S-PRESTO: 389 women aged 31.4 ± 3.9 years) and Singapore Adult Metabolism Study (SAMS: 50 men aged 28.7 ± 5.7 years). For all datasets, ground truth segmentation masks were created through manual segmentation. A Res-Net based 3D-UNet was trained and evaluated via 5-fold cross-validation on S-PRESTO data (N = 300). The model's final performance was assessed on a hold-out (N = 89) and an external test set (N = 50, SAMS). RESULTS The proposed method enabled reliable segmentation of individual AAT sub-depots in 3D MRI volumes with high mean Dice similarity scores of 98.3%, 97.2%, 96.5%, 96.3%, and 95.9% for SSAT, DSAT, IPAT, RPAT, and PSAT respectively. CONCLUSION Convolutional neural networks can accurately sub-divide abdominal SAT into SSAT and DSAT, and abdominal IAT into IPAT, RPAT, and PSAT with high accuracy. The presented method has the potential to significantly contribute to advancements in the field of obesity imaging and precision medicine.
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Affiliation(s)
- Yeshe M Kway
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kashthuri Thirumurugan
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore
| | - Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore
| | - Kok Hian Tan
- Duke-National University of Singapore Graduate Medical School, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kavita Venkataraman
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore
| | - Eric Yin Hao Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chin Meng Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Medicine, National University Health System, Singapore
| | - Melvin Khee-Shing Leow
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University (NTU), Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital (TTSH), Singapore
| | - E Shyong Tai
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Endocrinology, University Medicine Cluster, National University Health System, Singapore
| | - Jerry Ky Chan
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore; Experimental Fetal Medicine Group, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University Health System, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Marielle V Fortier
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Paediatric Endocrinology, Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore
| | - Mengling Feng
- Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore; Institute of Data Science, National University of Singapore, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science Technology, and Research, Singapore.
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Reese E, Kokaua J, Guiney H, Bakir-Demir T, McLauchlan J, Edgeler C, Schaughency E, Taumoepeau M, Salmon K, Clifford A, Maruariki N, McNaughton S, Gluckman P, Nelson C, O'Sullivan J, Wei R, Pergher V, Amjad S, Trudgen A, Poulton R. Kia Tīmata Pai (Best Start): a study protocol for a cluster randomised trial with early childhood teachers to support children's oral language and self-regulation development. BMJ Open 2023; 13:e073361. [PMID: 37770258 PMCID: PMC10546103 DOI: 10.1136/bmjopen-2023-073361] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION Oral language skills are associated with children's later self-regulation and academic skills; in turn, self-regulation in early childhood predicts successful functioning later in life. The primary objective of this study is to evaluate the separate and combined effectiveness of an oral language intervention (Enhancing Rich Conversations, ENRICH) and a self-regulation intervention (Enhancing Neurocognitive Growth with the Aid of Games and Exercise, ENGAGE) with early childhood teachers and parents for children's oral language, self-regulation and academic functioning. METHODS AND ANALYSIS The Kia Tīmata Pai (Best Start) study is a cluster randomised controlled trial with teachers and children in approximately 140 early childhood centres in New Zealand. Centres are randomly assigned to receive either oral language intervention only (ENRICH), self-regulation intervention only (ENGAGE), both interventions (ENRICH+ENGAGE) or an active control condition. Teachers' and parents' practices and children's oral language and self-regulation development are assessed at baseline at age 1.5 years and approximately every 9 months to age 5, and academic performance at age 6. Teacher-child interactions will also be videotaped each year in a subset of the centres. Children's brain and behaviour development and parent-child interactions will be assessed every 6 months to age 6 years in a subgroup of volunteers. ETHICS AND DISSEMINATION The Kia Tīmata Pai trial and the two substudies (Video Project; Brain and Behaviour Development) have been approved by the University of Otago Human Ethics Committee (Health; H20/116), and reviewed for cultural responsiveness by: the Ngāi Tahu Research Committee (University of Otago), the Māori Advisory Group (University of Auckland, Liggins Institute) and an internal cultural advisory group. Results will be disseminated in international and national peer-reviewed academic journals and communicated to local, national and international organisations serving early childhood teachers, parents and young children. Data will be available via communication with the corresponding author. TRIAL REGISTRATION NUMBER ACTRN12621000845831.
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Affiliation(s)
- Elaine Reese
- Psychology, University of Otago - Dunedin Campus, Dunedin, New Zealand
| | - Jesse Kokaua
- Division of Health Sciences, Pacific Islands Research and Student Support Unit, University of Otago - Dunedin Campus, Dunedin, New Zealand
| | - Hayley Guiney
- Psychology, University of Otago - Dunedin Campus, Dunedin, New Zealand
| | - Tugce Bakir-Demir
- Psychology, University of Otago - Dunedin Campus, Dunedin, New Zealand
| | | | | | | | - Mele Taumoepeau
- Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Karen Salmon
- Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Amanda Clifford
- Psychology, University of Otago - Dunedin Campus, Dunedin, New Zealand
| | | | - Stuart McNaughton
- Faculty of Education and Social Work, University of Auckland, Auckland, New Zealand
| | - Peter Gluckman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Charles Nelson
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Brookline, Massachusetts, USA
| | | | - Ran Wei
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Brookline, Massachusetts, USA
| | - Valentina Pergher
- Division of Developmental Medicine, Boston Children's Hospital, Harvard Medical School, Brookline, Massachusetts, USA
| | - Sophia Amjad
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Anita Trudgen
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, University of Otago, Dunedin, New Zealand
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6
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Huang P, Tint MT, Lee M, Ngoh ZM, Gluckman P, Chong YS, Han W, Fu Y, Wee CL, Fortier MV, Ang KK, Lee YS, Yap F, Eriksson JG, Meaney MJ, Tan AP. Functional activity of the caudate mediates the relation between early childhood microstructural variations and elevated metabolic syndrome scores. Neuroimage 2023; 278:120273. [PMID: 37473977 DOI: 10.1016/j.neuroimage.2023.120273] [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: 04/14/2023] [Revised: 06/10/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Metabolic syndrome score in children assesses the risk of developing cardiovascular disease in future. We aim to probe the role of the caudate in relation to the metabolic syndrome score. Furthermore, using both functional and structural neuroimaging, we aim to examine the interplay between functional and structural measures. METHODS A longitudinal birth cohort study with functional and structural neuroimaging data obtained at 4.5, 6.0 and 7.5 years and metabolic syndrome scores at 8.0 years was used. Pearson correlation and linear regression was used to test for correlation fractional anisotropy (FA) and fractional amplitude of low frequency fluctuations (fALFF) of the caudate with metabolic syndrome scores. Mediation analysis was used to test if later brain measures mediated the relation between earlier brain measures and metabolic syndrome scores. Inhibitory control was also tested as a mediator of the relation between caudate brain measures and metabolic syndrome scores. RESULTS FA at 4.5 years and fALFF at 7.5 years of the left caudate was significantly correlated with metabolic syndrome scores. Post-hoc mediation analysis showed that fALFF at 7.5 years fully mediated the relation between FA at 4.5 years and metabolic syndrome scores. Inhibitory control was significantly correlated with fALFF at 7.5 years, but did not mediate the relation between fALFF at 7.5 years and metabolic syndrome scores. CONCLUSIONS We found that variations in caudate microstructure at 4.5 years predict later variation in functional activity at 7.5 years. This later variation in functional activity fully mediates the relation between microstructural changes in early childhood and metabolic syndrome scores at 8.0 years.
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Affiliation(s)
- Pei Huang
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Marissa Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Zhen Ming Ngoh
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Centre for Human Evolution, Adaptation and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics & Gynaecology, National University Hospital Singapore, Singapore
| | - Weiping Han
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore; Center for Neuro-Metabolism and Regeneration Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China; School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yu Fu
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Caroline Lei Wee
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Marielle V Fortier
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Diagnostic and Interventional Radiology, KK Women's and Children's Hospital, Singapore
| | - Kai Keng Ang
- Institute for Infocomm Research, Agency for Science, Technology and Research (A*STAR), Singapore; School of Computer Science and Engineering, Nanyang Technological University, Singapore
| | - Yung Seng Lee
- Department of Paedatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Fabian Yap
- Department of Paediatrics, Endocrinology Service, KK Women's and Children's Hospital, Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Brain - Body Initiative, Agency for Science and Technology (A*STAR), Singapore
| | - Ai Peng Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Diagnostic Imaging, National University Hospital Singapore, Singapore.
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7
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Yan X, Kong R, Xue A, Yang Q, Orban C, An L, Holmes AJ, Qian X, Chen J, Zuo XN, Zhou JH, Fortier MV, Tan AP, Gluckman P, Chong YS, Meaney MJ, Bzdok D, Eickhoff SB, Yeo BTT. Homotopic local-global parcellation of the human cerebral cortex from resting-state functional connectivity. Neuroimage 2023; 273:120010. [PMID: 36918136 PMCID: PMC10212507 DOI: 10.1016/j.neuroimage.2023.120010] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/25/2023] [Accepted: 03/08/2023] [Indexed: 03/13/2023] Open
Abstract
Resting-state fMRI is commonly used to derive brain parcellations, which are widely used for dimensionality reduction and interpreting human neuroscience studies. We previously developed a model that integrates local and global approaches for estimating areal-level cortical parcellations. The resulting local-global parcellations are often referred to as the Schaefer parcellations. However, the lack of homotopic correspondence between left and right Schaefer parcels has limited their use for brain lateralization studies. Here, we extend our previous model to derive homotopic areal-level parcellations. Using resting-fMRI and task-fMRI across diverse scanners, acquisition protocols, preprocessing and demographics, we show that the resulting homotopic parcellations are as homogeneous as the Schaefer parcellations, while being more homogeneous than five publicly available parcellations. Furthermore, weaker correlations between homotopic parcels are associated with greater lateralization in resting network organization, as well as lateralization in language and motor task activation. Finally, the homotopic parcellations agree with the boundaries of a number of cortical areas estimated from histology and visuotopic fMRI, while capturing sub-areal (e.g., somatotopic and visuotopic) features. Overall, these results suggest that the homotopic local-global parcellations represent neurobiologically meaningful subdivisions of the human cerebral cortex and will be a useful resource for future studies. Multi-resolution parcellations estimated from 1479 participants are publicly available (https://github.com/ThomasYeoLab/CBIG/tree/master/stable_projects/brain_parcellation/Yan2023_homotopic).
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Affiliation(s)
- Xiaoxuan Yan
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore; N.1 Institute for Health and Institute for Digital Medicine (WisDM), National University of Singapore, Singapore; Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore
| | - Ru Kong
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore; N.1 Institute for Health and Institute for Digital Medicine (WisDM), National University of Singapore, Singapore
| | - Aihuiping Xue
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore; N.1 Institute for Health and Institute for Digital Medicine (WisDM), National University of Singapore, Singapore
| | - Qing Yang
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore; N.1 Institute for Health and Institute for Digital Medicine (WisDM), National University of Singapore, Singapore
| | - Csaba Orban
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore; N.1 Institute for Health and Institute for Digital Medicine (WisDM), National University of Singapore, Singapore
| | - Lijun An
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore; N.1 Institute for Health and Institute for Digital Medicine (WisDM), National University of Singapore, Singapore
| | - Avram J Holmes
- Yale University, Departments of Psychology and Psychiatry, New Haven, CT, Unites States of America
| | - Xing Qian
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jianzhong Chen
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore; N.1 Institute for Health and Institute for Digital Medicine (WisDM), National University of Singapore, Singapore
| | - Xi-Nian Zuo
- State Key Laboratory of Cognitive Neuroscience and Learning/IDG McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; National Basic Public Science Data Center, China
| | - Juan Helen Zhou
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore; Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore
| | - Marielle V Fortier
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Ai Peng Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Peter Gluckman
- UK Centre for Human Evolution, Adaptation and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore; Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Danilo Bzdok
- Department of Biomedical Engineering, Montreal Neurological Institute, McGill University, Montreal, QC, Canada; Mila - Quebec AI Institute, Montreal, QC, Canada
| | - Simon B Eickhoff
- Institute for Systems Neuroscience, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany; Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Center Jülich, Jülich, Germany
| | - B T Thomas Yeo
- Centre for Sleep and Cognition (CSC) & Centre for Translational Magnetic Resonance Research (TMR), Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore; N.1 Institute for Health and Institute for Digital Medicine (WisDM), National University of Singapore, Singapore; Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore; Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, Unites States of America.
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8
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Michael N, Gupta V, Fogel A, Huang J, Chen L, Sadananthan SA, Ong YY, Aris IM, Pang WW, Yuan WL, Loy SL, Thway Tint M, Tan KH, Chan JK, Chan SY, Shek LPC, Yap F, Godfrey K, Chong YS, Gluckman P, Velan SS, Forde CG, Lee YS, Eriksson JG, Karnani N. Longitudinal characterization of determinants associated with obesogenic growth patterns in early childhood. Int J Epidemiol 2022; 52:426-439. [PMID: 36087338 PMCID: PMC10114026 DOI: 10.1093/ije/dyac177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 02/15/2022] [Accepted: 08/29/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Longitudinal assessment of the determinants of obesogenic growth trajectories in childhood can suggest appropriate developmental windows for intervention. METHODS Latent class growth mixture modelling was used to identify body mass index (BMI) z-score trajectories from birth to age 6 years in 994 children from a prospective mother-offspring cohort (Chinese, Indian and Malay ethnicities) based in Singapore. We evaluated the early-life determinants of the trajectories as well as their associations with cardiometabolic risk markers at age 6 years. RESULTS Five BMI z-score trajectory patterns were identified, three within the healthy weight range, alongside early-acceleration and late-acceleration obesogenic trajectories. The early-acceleration pattern was characterized by elevated fetal abdominal circumference growth velocity, BMI acceleration immediately after birth and crossing of the obesity threshold by age 2 years. The late-acceleration pattern had normal fetal growth and BMI acceleration after infancy, and approached the obesity threshold by age 6 years. Abdominal fat, liver fat, insulin resistance and odds of pre-hypertension/hypertension were elevated in both groups. Indian ethnicity, high pre-pregnancy BMI, high polygenic risk scores for obesity and shorter breastfeeding duration were common risk factors for both groups. Malay ethnicity and low maternal educational attainment were uniquely associated with early BMI acceleration, whereas nulliparity and obesogenic eating behaviours in early childhood were uniquely associated with late BMI acceleration. CONCLUSION BMI acceleration starting immediately after birth or after infancy were both linked to early cardiometabolic alterations. The determinants of these trajectories may be useful for developing early risk stratification and intervention approaches to counteract metabolic adversities linked to childhood obesity.
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Affiliation(s)
- Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Varsha Gupta
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Anna Fogel
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Jonathan Huang
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Li Chen
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Yi Ying Ong
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA
| | - Wei Wei Pang
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wen Lun Yuan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Université de Paris, CRESS, Inserm, INRAE, Paris, France
| | - See Ling Loy
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore.,Academic Medicine, Duke-National University of Singapore Graduate Medical School, Singapore
| | - Jerry Ky Chan
- Duke-NUS Medical School, Singapore.,Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Fabian Yap
- Duke-NUS Medical School, Singapore.,Department of Pediatrics, KK Women's and Children's Hospital, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Keith Godfrey
- MRC Lifecourse Epidemiology Centre and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Institute of Bioengineering & Bioimaging, Agency for Science Technology and Research, Singapore
| | - Ciarán G Forde
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Bioinformatics Institute, Agency for Science Technology and Research, Singapore
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9
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Gluckman P. Congratulatory address by the International Science Council (ISC). Health Technol 2022. [DOI: 10.1007/s12553-022-00673-8] [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: 11/24/2022]
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10
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Gluckman P, Bardsley A. Policy and political perceptions of risk: the challenges to building resilient energy systems. Philos Trans A Math Phys Eng Sci 2022; 380:20210146. [PMID: 35220771 DOI: 10.1098/rsta.2021.0146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/09/2021] [Indexed: 06/14/2023]
Abstract
Decisions relating to energy systems resilience must take into account a range of environmental and societal transitions together with an array of future threats. These must be assessed broadly and systematically but also must consider how risks and vulnerabilities are linked, and that small events can cascade across a system and between systems to escalate into large-scale collapse. Developing resilience involves not only identifying such threats and potential points of failure but acting upon them with an appropriate level of future planning. Decision-making in complex systems is often affected by cognitive biases and runs into contestation and obstacles of politics, policy complexities and differing views of potential futures. This paper discusses the challenges to building resilient systems for the future, given the inevitable biases and differing risk perspectives of decision-makers at all levels that often confound expert analysis. This article is part of the theme issue 'Developing resilient energy systems'.
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Affiliation(s)
- Peter Gluckman
- Koi Tū: The Centre for Informed Futures, University of Auckland, 18 Waterloo Quadrant, Auckland 1010, New Zealand
| | - Anne Bardsley
- Koi Tū: The Centre for Informed Futures, University of Auckland, 18 Waterloo Quadrant, Auckland 1010, New Zealand
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11
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12
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Gluckman P. Together, we must help refugee researchers to thrive. Nature 2022; 603:793. [DOI: 10.1038/d41586-022-00863-4] [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: 11/09/2022]
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13
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Loo EXL, Ooi DSQ, Ong M, Ta LDH, Lau HX, Tay MJY, Yap QV, Chan YH, Tham EH, Goh AEN, Van Bever H, Teoh OH, Eriksson JG, Chong YS, Gluckman P, Yap FKP, Karnani N, Xu J, Tan KML, Tan KH, Lee BW, Kramer M, Shek LPC, Meaney MJ, Broekman BFP. Associations Between Eczema and Attention Deficit Hyperactivity Disorder Symptoms in Children. Front Pediatr 2022; 10:837741. [PMID: 35433544 PMCID: PMC9007142 DOI: 10.3389/fped.2022.837741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/15/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Epidemiological studies suggest a link between eczema and attention deficit hyperactivity disorder (ADHD), but underlying mechanisms have not been examined. OBJECTIVE We aim to investigate the association between eczema and subsequent ADHD symptoms in the Growing Up in Singapore Towards healthy Outcomes cohort and explore the role of pro-inflammatory cytokines and gut microbiome. METHODS The modified International Study of Asthma and Allergies in Childhood questionnaire and Computerized Diagnostic Interview Schedule for Children Version IV were administered to assess reported eczema within the first 18 months and presence of ADHD symptoms at 54 months, respectively. Skin prick testing at 18 months, cytokines in maternal blood during pregnancy and cord blood and the mediating role of the gut microbiome at 24 months were assessed. RESULTS After adjusting for confounders, eczema with or without a positive skin prick test was associated with doubling the risk of ADHD symptoms. No differences in maternal and cord blood cytokines were observed in children with and without eczema, or children with and without ADHD. Gut microbiome dysbiosis was observed in children with eczema and children with ADHD. Children with eczema also had lower gut bacterial Shannon diversity. However, the relationship between eczema and ADHD was not mediated by gut microbiome. CONCLUSION Early life eczema diagnosis is associated with a higher risk of subsequent ADHD symptoms in children. We found no evidence for underlying inflammatory mechanism or mediation by gut microbiome dysbiosis. Further research should evaluate other mechanisms underlying the link between eczema and ADHD. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/ct2/show/NCT01174875], identifier [NCT01174875].
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Affiliation(s)
- Evelyn Xiu Ling Loo
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Delicia Shu Qin Ooi
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Minyee Ong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Le Duc Huy Ta
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hui Xing Lau
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Michelle Jia Yu Tay
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qai Ven Yap
- Department of Biostatistics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yiong Huak Chan
- Department of Biostatistics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Elizabeth Huiwen Tham
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Anne Eng Neo Goh
- Allergy Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Hugo Van Bever
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Oon Hoe Teoh
- Respiratory Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Johan Gunnar Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore.,Folkhälsan Research Center, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Fabian Kok Peng Yap
- Duke-NUS Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Endocrinology Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Bioinformatics Institute, Agency for Science, Technology and Research, Singapore, Singapore
| | - Jia Xu
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Karen Mei Ling Tan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Bee Wah Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Michael Kramer
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore.,Department of Pediatrics and of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, QC, Canada
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Sackler Program for Epigenetics & Psychobiology at McGill University, Montreal, QC, Canada.,Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Department of Psychiatry, OLVG and Amsterdam UMC, VU University, Amsterdam, Netherlands
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14
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Tan AP, Ngoh ZM, Yeo SSP, Koh DXP, Gluckman P, Chong YS, Daniel LM, Rifkin-Graboi A, Fortier MV, Qiu A, Meaney M. Left lateralization of neonatal caudate microstructure affects emerging language development at 24 months. Eur J Neurosci 2021; 54:4621-4637. [PMID: 34125467 PMCID: PMC9541223 DOI: 10.1111/ejn.15347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/08/2021] [Indexed: 11/27/2022]
Abstract
The complex interaction between brain and behaviour in language disorder is well established. Yet to date, the imaging literature in the language disorder field has continued to pursue heterogeneous and relatively small clinical cross‐sectional samples, with emphasis on cortical structures and volumetric analyses of subcortical brain structures. In our current work, we aimed to go beyond this state of knowledge to focus on the microstructural features of subcortical brain structures (specifically the caudate nucleus) in a large cohort of neonates and study its association with emerging language skills at 24 months. Variations in neonatal brain microstructure could be interpreted as a proxy for in utero brain development. As language development is highly dependent on cognitive function and home literacy environment, we also examined their effect on the caudate–language function relationship utilizing a conditional process model. Our findings suggest that emerging language development at 24 months is influenced by the degree of left lateralization of neonatal caudate microstructure, indexed by diffusion tensor imaging (DTI)‐derived fractional anisotropy (FA). FA is an indirect measure of neuronal and dendritic density within grey matter structures. We also found that the caudate–language function relationship is partially mediated by cognitive function. The conditional indirect effect of left caudate FA on language composite score through cognitive function was only statistically significant at low levels of home literacy score (−1 standard deviation [SD]). The authors proposed that this may be related to ‘compensatory’ development of cognitive skills in less favourable home literacy environments.
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Affiliation(s)
- Ai Peng Tan
- Department of Diagnostic Imaging, National University Health System, Singapore
| | - Zhen Ming Ngoh
- Singapore Institute for Clinical Sciences (SICS), A*STAR Research Entities (ARES), Singapore
| | - Shayne Siok Peng Yeo
- Singapore Institute for Clinical Sciences (SICS), A*STAR Research Entities (ARES), Singapore
| | - Dawn Xin Ping Koh
- Singapore Institute for Clinical Sciences (SICS), A*STAR Research Entities (ARES), Singapore.,Duke-National University of Singapore Graduate Medical School, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences (SICS), A*STAR Research Entities (ARES), Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences (SICS), A*STAR Research Entities (ARES), Singapore
| | - Lourdes Mary Daniel
- Department of Child Development, KK Women's and Children's Hospital, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore
| | - Anne Rifkin-Graboi
- Centre for Research in Child Development, National Institute of Education, Singapore
| | - Marielle V Fortier
- Department of Diagnostic and Interventional Radiology, KK Women's and Children's Hospital, Singapore
| | - Anqi Qiu
- Department of Biomedical Engineering, National University of Singapore (NUS), Singapore
| | - Michael Meaney
- Singapore Institute for Clinical Sciences (SICS), A*STAR Research Entities (ARES), Singapore.,Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore.,Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
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15
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Kaiser M, Chen ATY, Gluckman P. Should policy makers trust composite indices? A commentary on the pitfalls of inappropriate indices for policy formation. Health Res Policy Syst 2021; 19:40. [PMID: 33752689 PMCID: PMC7983348 DOI: 10.1186/s12961-021-00702-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/03/2021] [Indexed: 04/12/2023] Open
Abstract
Background This paper critically discusses the use and merits of global indices, in particular, the Global Health Security Index (GHSI; Cameron et al. https://www.ghsindex.org/#l-section--map) in times of an imminent crisis, such as the current pandemic. This index ranked 195 countries according to their expected preparedness in the case of a pandemic or other biological threat. The coronavirus disease 2019 (Covid-19) pandemic provides the background to compare each country's predicted performance from the GHSI with the actual performance. In general, there is an inverted relation between predicted versus actual performance, i.e. the predicted top performers are among those that are the worst hit. Obviously, this reflects poorly on the potential policy uses of this index in imminent crisis management. Methods The paper analyses the GHSI and identifies why it may have struggled to predict actual pandemic preparedness as evidenced by the Covid-19 pandemic. The paper also uses two different data sets, one from the Worldmeter on the spread of the Covid-19 pandemics, and the other from the International Network for Government Science Advice (INGSA) Evidence-to-Policy Tracker, to draw comparisons between the actual introduction of pandemic response policies and the corresponding death rate in 29 selected countries. Results This paper analyses the reasons for the poor match between prediction and reality in the index, and mentions six general observations applying to global indices in this respect. These observations are based on methodological and conceptual analyses. The level of abstraction in these global indices builds uncertainties upon uncertainties and hides implicit value assumptions, which potentially removes them from the policy needs on the ground. Conclusions From the analysis, the question is raised if the policy community might have better tools for decision-making in a pandemic. On the basis of data from the INGSA Evidence-to-Policy Tracker, and with backing in studies from social psychology and philosophy of science, some simple heuristics are suggested, which may be more useful than a global index.
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Affiliation(s)
- Matthias Kaiser
- The Centre for the Study of the Sciences and the Humanities (SVT), University of Bergen, Bergen, Norway.
| | - Andrew Tzer-Yeu Chen
- Koi Tū: The Centre for Informed Futures, The University of Auckland, Auckland, New Zealand.
| | - Peter Gluckman
- Koi Tū: The Centre for Informed Futures, The University of Auckland, Auckland, New Zealand.
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16
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Affiliation(s)
- David Skegg
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Peter Gluckman
- International Science Council, Paris, France; Koi Tū: The Centre for Informed Futures, University of Auckland, Auckland 1142, New Zealand.
| | - Geoffrey Boulton
- International Science Council, Paris, France; Grant Institute, University of Edinburgh, Edinburgh, UK
| | | | - Salim S Abdool Karim
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Peter Piot
- London School of Hygiene & Tropical Medicine, London, UK
| | - Christiane Woopen
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany
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17
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Eng D, Tham E, Jafar N, Tan J, Cai S, Goh D, Lee Y, Shek L, Teoh O, Yap F, Gluckman P, Chong Y, Gooley J, Meaney M, Broekman B. Sleep problems mediate the relationship between chronotype and socioemotional problems during early development. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.285] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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Li LJ, Tan KH, Aris IM, Man REK, Gan ATL, Chong YS, Saw SM, Gluckman P, Wong TY, Lamoureux E. Retinal vasculature and 5-year metabolic syndrome among women with gestational diabetes mellitus. Metabolism 2018; 83:216-224. [PMID: 29051041 DOI: 10.1016/j.metabol.2017.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 09/03/2017] [Accepted: 10/09/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND Women with gestational diabetes mellitus (GDM) are at greater risk of metabolic syndrome (MetS). We studied the association between second-trimester retinal microvasculature and 5-year MetS incidence in women with GDM. METHODS A total of 142 mothers with GDM were recruited and followed up 5years after delivery. Retinal photography was performed at 26-28weeks gestation and metabolic outcomes were assessed at the 5-year postpartum follow-up visit. GDM and MetS were defined based on World Health Organization (WHO) guidelines and Adults Treatment Panel (ATP) III guidelines, respectively. Modified-Poisson regression was applied to study the association between second-trimester retinal microvasculature and incident 5-year maternal MetS, after adjusting for major confounders. Area under the curve (AUC) was calculated based on the final model. RESULTS Our prospective cohort reported a 9.2% incidence rate of 5-year MetS among women with GDM. After adjusting for maternal age, ethnicity, college degree, pre-pregnancy BMI and fasting glucose at 26-28week gestation, each 10μm widening in retinal venular caliber was associated with an increased relative risk of 1.6 (95% confidence interval [CI]: 1.0, 2.8) in incident MetS. In addition to traditional risks of pre-pregnancy BMI and fasting glucose level at 26-28week gestation, retinal venular caliber mildly increased the prediction of 5-year maternal MetS by 1.8%. CONCLUSIONS Second-trimester retinal venular widening was associated with incident 5-year maternal MetS in women with GDM. Our study suggests that mother with GDM at risk of future MetS development may have already presented retinal microvascular abnormalities during pregnancy.
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Affiliation(s)
- Ling-Jun Li
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, Singapore; KK Women's and Children's Hospital, Singapore.
| | - Kok Hian Tan
- Duke-NUS Medical School, Singapore; KK Women's and Children's Hospital, Singapore
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore
| | - Ryan Eyn Kidd Man
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | | | - Yap Seng Chong
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Growth, Development & Metabolism, Singapore
| | - Seang Mei Saw
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, Singapore
| | - Ecosse Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Duke-NUS Medical School, Singapore
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19
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Hanson M, Gluckman P. Commentary: Developing the future: life course epidemiology, DOHaD and evolutionary medicine. Int J Epidemiol 2018; 45:993-996. [PMID: 27880687 DOI: 10.1093/ije/dyw105] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mark Hanson
- Institute of Developmental Sciences, .,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK and
| | - Peter Gluckman
- Liggins Institute, University of Auckland, Auckland, New Zealand
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20
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Li LJ, Tan KH, Aris IM, Chong YS, Saw SM, Gluckman P, Wang JJ, Wong TY. Gestational retinal microvasculature and the risk of 5 year postpartum abnormal glucose metabolism. Diabetologia 2017; 60:2368-2376. [PMID: 28939944 DOI: 10.1007/s00125-017-4441-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 08/01/2017] [Indexed: 12/20/2022]
Abstract
AIMS/HYPOTHESIS Changes in retinal microvasculature may reflect insulin resistance. We examined the association of changes in retinal microvasculature during pregnancy and risk of subsequent abnormal glucose metabolism in a cohort of mothers at baseline and 5 years postpartum. METHODS Of the participants from the Singapore birth cohort (Growing Up in Singapore Towards Healthy Outcomes [GUSTO]), 276 mothers attended both baseline (at 26-28 weeks of gestation) and follow-up (5 year postpartum) visits. At baseline we performed retinal photography and assessed retinal microvascular variables using a validated grading system. At follow-up, we assessed glucose tolerance using a 75 g OGTT. We defined abnormal glucose metabolism if participants: (1) had onset of gestational diabetes mellitus (GDM) in subsequent pregnancies within a 5 year follow-up period (n = 103) or (2) had prediabetes (impaired fasting glucose, impaired glucose tolerance or HbA1c 5.7-6.4% [39-46 mmol/mol]) and diabetes diagnosed at the 5 year follow-up visit (n = 84), according to WHO guidelines. RESULTS The incidence of GDM in subsequent pregnancy and abnormal glucose metabolism 5 years postpartum was 25.2% and 30.4%, respectively. Each 10 μm widening in retinal venular calibre was associated with a significant risk of postpartum abnormal glucose metabolism (RR 1.2 [95% CI 1.0, 1.5]), independent of maternal age, college education, ethnicity, pre-pregnancy BMI and GDM at baseline. Narrower retinal arteriolar calibre and venular branching angle at baseline was associated with a higher insulin resistance index (1.4 [95% CI 1.1, 1.7] and 1.3 [95% CI 1.1, 1.6], respectively) at follow-up. CONCLUSIONS/INTERPRETATION Retinal microvasculature in pregnant women was associated with abnormal glucose metabolism 5 years postpartum. Alteration of microvascular structure during pregnancy may signal subclinical changes that underlie the development of prediabetes and diabetes.
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Affiliation(s)
- Ling-Jun Li
- Singapore Eye Research Institute, Singapore National Eye Centre, The Academia, 20 College Road, Discovery Tower Level 6, Singapore, 169856, Singapore.
- Academic Medicine Research Institute, Duke-NUS Medical School, Singapore, Singapore.
| | - Kok Hian Tan
- Academic Medicine Research Institute, Duke-NUS Medical School, Singapore, Singapore
- Division of Obstetrics and Gynecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Izzuddin M Aris
- Growth, Development and Metabolism, Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
| | - Yap Seng Chong
- Growth, Development and Metabolism, Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Seang Mei Saw
- Singapore Eye Research Institute, Singapore National Eye Centre, The Academia, 20 College Road, Discovery Tower Level 6, Singapore, 169856, Singapore
- Academic Medicine Research Institute, Duke-NUS Medical School, Singapore, Singapore
| | - Peter Gluckman
- Growth, Development and Metabolism, Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
| | - Jie Jin Wang
- Academic Medicine Research Institute, Duke-NUS Medical School, Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, The Academia, 20 College Road, Discovery Tower Level 6, Singapore, 169856, Singapore
- Academic Medicine Research Institute, Duke-NUS Medical School, Singapore, Singapore
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21
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Loo EXL, Goh A, Aris IBM, Teoh OH, Shek LPC, Lee BW, Chan YH, Tint MT, Soh SE, Saw SM, Gluckman P, Godfrey KM, Chong YS, Yap F, Kramer MS, Van Bever H, Lee YS. Effects of infant weight gain on subsequent allergic outcomes in the first 3 years of life. BMC Pediatr 2017; 17:134. [PMID: 28576134 PMCID: PMC5457600 DOI: 10.1186/s12887-017-0890-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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] [Received: 11/02/2016] [Accepted: 05/23/2017] [Indexed: 11/20/2022] Open
Abstract
Background The association between early weight gain and later allergic outcomes has not been well studied. We examined the relation between weight gain and the subsequent development of allergic outcomes in the first 36 months of life in a Singapore birth cohort. Methods In repeated visits in the first 15 months, we measured infant weight and administered questionnaires ascertaining allergic outcomes. At ages 18 and 36 months, we administered skin prick tests (SPTs) to inhalant and food allergens. Results At 18 months, 13.5% had a positive SPT, 3.5% had wheeze and a positive SPT, 3.9% had rhinitis and a positive SPT, and 6.1% had eczema and a positive SPT. Higher weight gain from 6 to 9 months, 9 to 12 months and 12 to 15 months were independently associated with a reduced risk of developing a positive SPT at 18 months (p-trend ≤0.03). At 36 months, 23.5% had a positive SPT, 11.9% had wheeze and a positive SPT, 12.2% rhinitis and a positive SPT, and 11.5% eczema and a positive SPT. Higher weight gain from 12 to 15 months was associated with a reduced risk of developing a positive SPT at 36 months (p-trend <0.01). No significant associations were observed between weight gain in any period and wheeze, rhinitis or eczema combined with a positive SPT at 18 or 36 months. Conclusion Higher weight gain in the first 15 months of life was associated with a reduced risk of allergen sensitization, but not with combinations of allergic symptoms. Trial registration NCT01174875 Registered 1 July 2010, retrospectively registered. Electronic supplementary material The online version of this article (doi:10.1186/s12887-017-0890-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Evelyn Xiu-Ling Loo
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, 117609, Singapore
| | - Anne Goh
- Department of Paediatrics, Allergy service, KK Women's and Children's Hospital, Singapore, 229899, Singapore
| | - Izzuddin Bin Mohd Aris
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, 117609, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Oon Hoe Teoh
- Department of Paediatrics, Respiratory Service Medicine, KK Women's and Children's Hospital, Singapore, 229899, Singapore
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, 119228, Singapore
| | - Bee Wah Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Mya Thway Tint
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Shu-E Soh
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, 117609, Singapore
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, 117609, Singapore.,Liggins Institute, University of Auckland, Auckland, 1023, New Zealand
| | - Keith M Godfrey
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK.,Medical Research Council Lifecourse Epidemiology Unit, Southampton, SO16 6YD, UK
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, 117609, Singapore.,Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| | - Fabian Yap
- Department of Paediatric Endocrinology, KK Women's and Children's Hospital, Singapore, 229899, Singapore
| | - Michael S Kramer
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore.,Department of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montréal, QC, H3A 1A2, Canada
| | - Hugo Van Bever
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, 119228, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, 117609, Singapore. .,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore. .,Division of Endocrinology and Diabetes, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, 119074, Singapore.
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22
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Sheppard A, Ngo S, Li X, Boyne M, Thompson D, Pleasants A, Gluckman P, Forrester T. Molecular Evidence for Differential Long-term Outcomes of Early Life Severe Acute Malnutrition. EBioMedicine 2017; 18:274-280. [PMID: 28330812 PMCID: PMC5405153 DOI: 10.1016/j.ebiom.2017.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/14/2017] [Accepted: 03/01/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Severe acute malnutrition (SAM) in infants may present as one of two distinct syndromic forms: non-edematous (marasmus), with severe wasting and no nutritional edema; or edematous (kwashiorkor) with moderately severe wasting. These differences may be related to developmental changes prior to the exposure to SAM and phenotypic changes appear to persist into adulthood with differences between the two groups. We examined whether the different response to SAM and subsequent trajectories may be explained by developmentally-induced epigenetic differences. METHODS We extracted genomic DNA from muscle biopsies obtained from adult survivors of kwashiorkor (n=21) or marasmus (n=23) and compared epigenetic profiles (CpG methylation) between the two groups using the Infinium® 450K BeadChip array. FINDINGS We found significant differences in methylation of CpG sites from 63 genes in skeletal muscle DNA. Gene ontology studies showed significant differential methylation of genes in immune, body composition, metabolic, musculoskeletal growth, neuronal function and cardiovascular pathways, pathways compatible with the differences in the pathophysiology of adult survivors of SAM. INTERPRETATION These findings suggest persistent developmental influences on adult physiology in survivors of SAM. Since children who develop marasmus have lower birth weights and after rehabilitation have different intermediary metabolism, these studies provide further support for persistent developmentally-induced phenomena mediated by epigenetic processes affecting both the infant response to acute malnutrition and later life consequences. FUNDING Supported by a Grant from the Bill and Melinda Gates Foundation (Global Health OPP1066846), Grand Challenge "Discover New Ways to Achieve Healthy Growth." EVIDENCE BEFORE THIS STUDY Previous research has shown that infants who develop either kwashiorkor or marasmus in response to SAM differ in birth weight and subsequently have different metabolic patterns in both infancy and adulthood. ADDED VALUE OF THIS STUDY This study demonstrates epigenetic differences in the skeletal muscle of adult survivors of marasmus versus kwashiorkor and these differences are in genes that may underlie the longer-term consequences. IMPLICATIONS OF ALL THE AVAILABLE EVIDENCE These data are compatible with the different clinical responses to SAM arising from developmentally-induced epigenetic changes laid down largely before birth and provide evidence for the predictive adaptive response model operating in human development.
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Affiliation(s)
- Allan Sheppard
- The Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand
| | - Sherry Ngo
- The Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand
| | - Xiaoling Li
- The Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand
| | - Michael Boyne
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston 7, Jamaica
| | - Debbie Thompson
- Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston 7, Jamaica
| | - Anthony Pleasants
- The Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand
| | - Peter Gluckman
- The Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand
| | - Terrence Forrester
- The Liggins Institute, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand; UWI Solutions for Developing Countries, The University of the West Indies, Mona, Kingston 7, Jamaica.
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23
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Li LJ, Kramer M, Tapp RJ, Man REK, Lek N, Cai S, Yap F, Gluckman P, Tan KH, Chong YS, Koh JY, Saw SM, Cheung YB, Wong TY. Gestational diabetes mellitus and retinal microvasculature. BMC Ophthalmol 2017; 17:4. [PMID: 28100181 PMCID: PMC5241913 DOI: 10.1186/s12886-016-0398-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 12/16/2016] [Indexed: 12/17/2022] Open
Abstract
Background Small-vessel dysfunction may be an important consequence of chronic hyperglycemia. We examined the association between gestational diabetes mellitus (GDM), a state of transient hyperglycemia during pregnancy, and retinal microvascular changes in pregnant women at 26–28 weeks of pregnancy. Methods A total of 1136 pregnant women with singleton pregnancies were recruited during their first trimester at two major Singapore maternity hospitals in an on-going birth cohort study. Participants underwent an oral glucose tolerance test and retinal imaging at 26–28 weeks gestation (n = 542). We used the 1999 World Health Organization (WHO) criteria to define GDM: ≥7.0 mmol/L for fasting glucose and/or ≥7.8 mmol/L for 2-h post-glucose. Retinal microvasculature was measured using computer software (Singapore I Vessel Analyzer, SIVA version 3.0, Singapore Eye Research Institute, Singapore) from the retinal photographs. Results In a multiple linear regression model adjusting for age, ethnicity and maternal education, mothers with GDM had narrower arteriolar caliber (−1.6 μm; 95% Confidence Interval [CI]: −3.1 μm, −0.2 μm), reduced arteriolar fractal dimension (−0.01 Df; 95% CI: −0.02 Df, −0.001 Df;), and larger arteriolar branching angle (1.8°; 95% CI: 0.3°, 3.3°) than mothers without GDM. After further adjusting for traditional risks of GDM, arteriolar branching angle remained significantly larger in mothers with GDM than those without GDM (2.0°; 95% CI: 0.5°, 3.6°). Conclusions GDM was associated with a series of retinal arteriolar abnormalities, including narrower caliber, reduced fractal dimension and larger branching angle, suggesting that transient hyperglycemia during pregnancy may cause small-vessel dysfunction.
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Affiliation(s)
- Ling-Jun Li
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore.,Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Michael Kramer
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Canada
| | - Robyn J Tapp
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Ryan E K Man
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Ngee Lek
- Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore.,KK Women's and Children's Hospital, Singapore, Singapore
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Fabian Yap
- KK Women's and Children's Hospital, Singapore, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Kok Hian Tan
- KK Women's and Children's Hospital, Singapore, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore.,Singapore Institute for Clinical Sciences, Growth, Development & Metabolism, Singapore, Singapore
| | - Jia Yu Koh
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Seang Mei Saw
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Yin Bun Cheung
- Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore. .,Department for International Health, University of Tampere, Tampere, Finland.
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore. .,Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore.
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24
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Affiliation(s)
- Mark Hanson
- Institute of Developmental Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Peter Gluckman
- Liggins Institute and Office of the Chief Science Advisor to the Prime Minister, University of Auckland, Auckland, New Zealand
| | - Flavia Bustreo
- Family, Women's and Children's Health, WHO, Geneva, Switzerland
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25
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Un Lam C, Hsu CYS, Yee R, Koh D, Lee YS, Chong MFF, Cai M, Kwek K, Saw SM, Gluckman P, Chong YS. Early-life factors affect risk of pain and fever in infants during teething periods. Clin Oral Investig 2016; 20:1861-1870. [PMID: 26592811 DOI: 10.1007/s00784-015-1658-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 03/05/2015] [Accepted: 11/10/2015] [Indexed: 12/25/2022]
Abstract
AIM This longitudinal study aimed to investigate the prevalence of teething-related pain and fever and the early-life factors that may affect the risk of experiencing these disturbances within the first 1.5 years of life. MATERIALS AND METHODS Participants were recruited (n = 1033) through the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort (n = 1237). Interviews were performed tri-monthly regarding the prevalence of teething pain and fever in children from 6 to 18 months of age. Crude and multivariable analyses were conducted using Poisson-log regression models. RESULTS Prevalence rates for teething pain and fever were 35.5 and 49.9 % respectively. Multivariable Poisson regression analysis showed maternal second-hand tobacco smoke (SHS) exposure to increase the risk of both pain (mean ratio = 1.35; p = 0.006) and fever (mean ratio = 1.22; p = 0.025), whereas SHS exposure plus active smoking further increased risk of teething pain in the children (mean ratio = 1.89; p = 0.029). Delivery via Caesarean section increased risk of teething pain (mean ratio = 1.27; p = 0.033), while prenatal plasma vitamin D insufficiency lowered such a risk (mean ratio = 0.62; p = 0.012). Compared to Chinese infants, Indian babies exhibited lower risk of teething pain and fever (both p ≤ 0.001). CONCLUSIONS Early-life factors such as tobacco smoke exposure and vitamin insufficiency during pregnancy, ethnicity and childbirth via Caesarean section may significantly affect the child's susceptibility to teething-related pain and fever. CLINICAL RELEVANCE Knowledge of prevalence and risk factors of teething disturbances may better equip primary caregivers and healthcare professionals to accurately detect teething-related local and/or systemic signs/symptoms and effectively facilitate tobacco cessation among pregnant women.
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Affiliation(s)
- Carolina Un Lam
- Discipline of Oral Sciences, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Chin-Ying Stephen Hsu
- Discipline of Oral Sciences, Faculty of Dentistry, National University of Singapore, Singapore, Singapore.
| | - Robert Yee
- Discipline of Oral Sciences, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - David Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Yung Seng Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mary Foong-Fong Chong
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (A*STAR), Brenner Centre for Molecular Medicine, Singapore, Singapore
| | - Meijin Cai
- Discipline of Oral Sciences, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Kenneth Kwek
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital (KKH), Singapore, Singapore
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (A*STAR), Brenner Centre for Molecular Medicine, Singapore, Singapore
| | - Yap Seng Chong
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Li LJ, Ong PG, Colega MT, Han CY, Chen LW, Man Eyn Kidd R, Lamoureux E, Gluckman P, Kwek K, Chong YS, Saw SM, Godfrey KM, Wong TY, Foong-Fong MC. Correction: The Impact of Macronutrients on Retinal Microvasculature among Singapore Pregnant Women during the Mid-Late Gestation. PLoS One 2016; 11:e0165218. [PMID: 27755592 PMCID: PMC5068787 DOI: 10.1371/journal.pone.0165218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pone.0160704.].
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Fraser M, Bennet L, Helliwell R, Wells S, Williams C, Gluckman P, Gunn AJ, Inder T. Regional Specificity of Magnetic Resonance Imaging and Histopathology Following Cerebral Ischemia in Preterm Fetal Sheep. Reprod Sci 2016; 14:182-91. [PMID: 17636230 DOI: 10.1177/1933719107299612] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Early and accurate evaluation of the nature and extent of cerebral injury in the preterm infant brain is important for prognostication and decision making in the neonatal intensive care unit. The capability of magnetic resonance imaging (MRI) to define acute ischemic changes in white and gray matter in comparison to contemporaneous histopathology has not been adequately ascertained. The aim of this study is to assess whether postmortem MRI predicts the nature and extent of brain injury in a preterm fetal sheep model of cerebral hypoperfusion. MRI examinations were performed on fetal sheep brains (d99-100 gestation), perfusion fixed 72 hours after an ischemic insult (n = 7) with left-hemispheric placement of a microdialysis probe and compared with sham-occlusion (n = 3) and unoperated-control fetuses (n = 4). Cerebral ischemia was associated with MRI changes including global cerebral injury and diffuse white matter signal abnormality, which corresponded closely with histological damage. However, histological changes in deep structures, including the corona radiata, thalamus, and globus pallidus were not reliably detected on MRI. These findings confirm that in preterm fetal sheep, MRI can accurately assess cortical gray matter and subcortical and periventricular white matter abnormalities 3 days after hypoxic-ischemic injury but appears to have limited sensitivity to detect injury to deep structures.
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Affiliation(s)
- Mhoyra Fraser
- Liggins Institute, University of Auckland, New Zealand. m.fraser@ auckland.ac.nz
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Gluckman P. Comment and Response from a Health Authority Manager. J Health Serv Res Policy 2016. [DOI: 10.1177/135581969900400107] [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: 11/17/2022]
Affiliation(s)
- Peter Gluckman
- Director of Strategic Planning & Consumer Affairs Lambeth, Southwark & Lewisham Health Authority 1 Lower Marsh, London SE1 7NT, UK
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Ross AB, Colega MT, Lim AL, Silva-Zolezzi I, Macé K, Saw SM, Kwek K, Gluckman P, Godfrey KM, Chong YS, Chong MFF. Whole grain intake, determined by dietary records and plasma alkylresorcinol concentrations, is low among pregnant women in Singapore. Asia Pac J Clin Nutr 2016; 24:674-82. [PMID: 26693753 DOI: 10.6133/apjcn.2015.24.4.19] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES To quantify whole grain intake in pregnant women in Singapore in order to provide the first detailed analysis of whole grain intake in an Asian country and in pregnant women. METHODS AND STUDY DESIGN Analysis of 24-h diet recalls in a cross-sectional cohort study and analysis of a biomarker of whole grain intake (plasma alkylresorcinols) in a subset of subjects. The Growing Up in Singapore Towards healthy Outcomes-mother offspring cohort study based in Singapore. 998 pregnant mothers with complete 24-h recalls taken during their 26-28th week of gestation. Plasma samples from a randomly select subset of 100 subjects were analysed for plasma alkylresorcinols. RESULTS Median (IQR) whole grain intake for the cohort and the 30% who reported eating whole grains were 0 (IQR 0, 9) and 23.6 (IQR 14.6, 44.2) g/day respectively. Plasma alkylresorcinol concentrations were very low [median (IQR)=9 (3, 15) nmol/L], suggesting low intake of whole grain wheat in this population. Plasma alkylresorcinols were correlated with whole grain wheat intake (Spearman's r=0.35; p<0.01). CONCLUSIONS Whole grain intake among pregnant mothers in Singapore was well below the 2-3 (60-95 g) servings of whole grains per day recommended by the Singapore Health Promotion Board. Efforts to increase whole grain intake should be supported to encourage people to choose whole grains over refined grains in their diet.
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Affiliation(s)
- Alastair B Ross
- Food and Nutritional Science, Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden. .,Nestlé Research Centre, Vers chez les Blanc, Lausanne, Switzerland
| | - Marjorelee T Colega
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Ai Lin Lim
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore
| | | | - Katherine Macé
- Nestlé Research Centre, Vers chez les Blanc, Lausanne, Switzerland
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | | | - Peter Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore.,Liggins Institute, Auckland, New Zealand
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, UK
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore.,Clinical Nutrition Research Centre, SICS, A*STAR, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
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Affiliation(s)
| | - Peter Gluckman
- Office of the Prime Minister's Chief Science Advisor, Auckland, New Zealand
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Foo VHX, Verkicharla PK, Ikram MK, Chua SYL, Cai S, Tan CS, Chong YS, Kwek K, Gluckman P, Wong TY, Ngo C, Saw SM, On Behalf Of The Gusto Study Group. Axial Length/Corneal Radius of Curvature Ratio and Myopia in 3-Year-Old Children. Transl Vis Sci Technol 2016; 5:5. [PMID: 26929885 PMCID: PMC4757459 DOI: 10.1167/tvst.5.1.5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 12/13/2015] [Indexed: 12/15/2022] Open
Abstract
PURPOSE This study investigated the association of axial length (AL) to corneal radius of curvature (CRC) ratio with spherical equivalent (SE) in a 3-year old Asian cohort. METHODS Three-hundred forty-nine 3-year old Asian children from The Growing Up in Singapore towards Healthy Outcomes (GUSTO) birth cohort study underwent AL and CRC measurements with a noncontact ocular biometer and cycloplegic refraction using an autorefractor. The ratio of AL to CRC (AL/CRC) was calculated for all the participants, and subsequently AL, CRC, and AL/CRC were analyzed in relationship to SE. RESULTS The SE showed better correlation with AL/CRC (Spearman's correlation coefficient, ρ = -0.53; 95% confidence interval [CI]: -0.66; -0.49; P < 0.001) compared to either AL or CRC alone ([ρ = -0.36; 95% CI: -0.51 to 0.51; P = 0.01] and [ρ = 0.05; 95% CI: -0.04 to 0.17; P = 0.34], respectively). Mean AL/CRC was 2.91 ± 0.06 among myopes and decreased to 2.79 ± 0.06 among hyperopes. Axial length to corneal radius of curvature was strongly correlated with SE in myopes (ρ = -0.78; 95% CI: -3.76; -0.79; P = < 0.001), but not in emmetropes and hyperopes ([ρ = -0.39; 95% CI: -10.73; -0.57; P = 0.01] and [ρ = -0.18; 95% CI: -17.28; 12.42; P = 0.38], respectively). Linear regression adjusted for gender and ethnicity showed a 0.74-diopter shift in SE towards myopia with every 0.1 increase in AL/CRC ratio (P < 0.001, r2 = 0.33). CONCLUSION The correlation between SE and AL/CRC is stronger than that between AL or CRC alone. This suggests that in a research setting, when cycloplegic refraction is difficult to perform on 3-year-old children, AL/CRC may be the next best reference for refractive error. TRANSLATIONAL RELEVANCE In the research setting, AL/CRC may be the next best reference for refractive error over AL alone when cycloplegic refraction is unavailable in 3-year old children.
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Affiliation(s)
| | | | - Mohammad Kamran Ikram
- Department of Ophthalmology, National University Hospital, National University Health System, Singapore, Singapore ; Memory Aging & Cognition Center, National University Health System, Singapore, Singapore
| | - Sharon Yu Lin Chua
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Shirong Cai
- Department of Obstetrics and Gynecology, National University Hospital, National University Health System, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics and Gynecology, National University Hospital, National University Health System, Singapore, Singapore ; Singapore Institute for Clinical Sciences - ASTAR, Singapore, Singapore
| | - Kenneth Kwek
- KK Women's and Children's Hospital, Singapore, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences - ASTAR, Singapore, Singapore ; Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Tien-Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore ; Department of Ophthalmology, National University Hospital, National University Health System, Singapore, Singapore
| | - Cheryl Ngo
- Department of Ophthalmology, National University Hospital, National University Health System, Singapore, Singapore
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Tham E, Broekman B, Goh D, Teoh O, Chong Y, Gluckman P, Godfrey K, Meaney M, Rifkin-Graboi A, Gooley J. Nocturnal wakefulness at 3 months predicts toddler cognitive, language and motor abilities. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Song LLT, Venkataraman K, Gluckman P, Chong YS, Chee MWL, Khoo CM, Leow MK, Lee YS, Tai ES, Khoo EYH. Smaller size of high metabolic rate organs explains lower resting energy expenditure in Asian-Indian Than Chinese men. Int J Obes (Lond) 2015; 40:633-8. [PMID: 26568151 DOI: 10.1038/ijo.2015.233] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 02/11/2015] [Revised: 07/28/2015] [Accepted: 08/10/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND In Singapore, the obesity prevalence is disproportionately higher in the Asian-Indians and Malays than the Chinese. Lower resting energy expenditure (REE) may be a contributory factor. OBJECTIVE We explored the association between ethnicity and REE in Chinese, Asian-Indian and Malay men living in Singapore and determined the influence of body composition, mass/volume of high metabolic rate organs, represented by brain volume and trunk fat-free mass (FFM), and physical activity on ethnic differences. DESIGN Two hundred and forty-four men from Singapore (n=100 Chinese, 70 Asian-Indians and 74 Malays), aged 21-40 years and body mass index of 18.5-30.0 kg m(-2), were recruited in this cross-sectional study. REE was assessed by indirect calorimetry and body composition by dual-energy X-ray absorptiometry. Brain volume was measured by magnetic resonance imaging. Physical activity was assessed by the Singapore Prospective Study Program Physical Activity Questionnaire. RESULTS REE was significantly lower in Asian-Indians compared with that in Chinese after adjusting for body weight. FFM (total, trunk and limb) and total fat mass were important predictors of REE across all ethnic groups. Brain volume was positively associated with REE only in Malays. Moderate and vigorous physical activity was positively associated with REE only in Asian-Indians and Malays. The difference in REE between Asian-Indians and Chinese was attenuated but remained statistically significant after adjustment for total FFM (59±20 kcal per day), fat mass (67±20 kcal per day) and brain volume (54±22 kcal per day). The association between REE and ethnicity was no longer statistically significant after total FFM was replaced by trunk FFM (which includes heart, liver, kidney and spleen) but not when it was replaced by limb FFM (skeletal muscle). CONCLUSIONS We have demonstrated a lower REE in Asian-Indians compared with Chinese who may contribute to the higher rates of obesity in the former. This difference could be accounted for by differences in metabolically active organs.
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Affiliation(s)
- L L T Song
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - K Venkataraman
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - P Gluckman
- Singapore Institute for Clinical Sciences, Singapore
| | - Y S Chong
- Department of Obstetrics and Gynaecology, National University of Singapore, Singapore
| | - M-W L Chee
- Center for Cognitive Neuroscience, Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore
| | - C M Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Duke-National University of Singapore Graduate Medical School, Singapore.,Division of Endocrinology, National University Health System, Singapore
| | - M-Ks Leow
- Office of Clinical Sciences, Duke-National University of Singapore Graduate Medical School, Singapore
| | - Y S Lee
- Singapore Institute for Clinical Sciences, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Paediatric Endocrinology and Diabetes, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - E S Tai
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Duke-National University of Singapore Graduate Medical School, Singapore.,Division of Endocrinology, National University Health System, Singapore
| | - E Y H Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Endocrinology, National University Health System, Singapore
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Chow V, Gluckman P, Shariff S, Kanegaonkar R. Harvesting cortical temporal bone to close attic defects using a Traumadrive™. Ann R Coll Surg Engl 2015; 97:614-5. [PMID: 26492910 DOI: 10.1308/rcsann.2015.0054.2] [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: 11/22/2022] Open
Affiliation(s)
- V Chow
- Medway NHS Foundation Trust , UK
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Abstract
Evolutionary medicine, sometimes referred to as Darwinian medicine, is an emerging academic field that employs evolutionary principles to aid in the understanding of human health and disease at the levels of both the individual and the population. While its main value lies in giving an ultimate (evolutionary) perspective to patterns of health and disease, there are areas of clinical medicine and public health where it has direct application. Whereas the bulk of clinical medicine is focused on issues of proximate causation and, in particular, pathophysiological mechanisms and their treatment, evolutionary perspectives focus on understanding how and why traits evolved and how they confer greater or lesser disease risk. Evolutionary perspectives also give weight to ecological dimensions, particularly the positioning of individuals within their social and environmental context, and also their relationship to other organisms, including gut microbiota, parasites, and infectious agents. A core principle of evolutionary medicine is that selection has operated to optimize reproductive fitness, and that this is not the same as selection for health or longevity. Indeed, selection pressures wane with age, and humans have had increasing median lifespans in recent centuries, leading to greater incidence of diseases that occur in the post-reproductive period. Another distinctive feature is an appreciation of the role of cultural evolution and technology in changing the environments within which humans now live—changes that can exaggerate the mismatch between evolved biology and the environment, with health consequences. Selection can occur not only at the level of the whole organism but also at the level of a cellular clone, and evolutionary concepts have become important in understanding the progression of cancer. More controversially, evolutionary concepts are contributing to understanding the origin of human behavior at both an individual and a group level, and also to understanding some psychiatric symptomatology. Evolutionary history also contributes to disease risk through anatomical and biochemical vestiges such as the appendix or the lack of the gene to synthesize ascorbic acid (and prevent scurvy); through genetic mechanisms such as founder effects and balancing selection; and through the evolution of defense mechanisms that may operate excessively (e.g., autoimmune disorders), which can explain much common symptomatology (e.g., fever). Being well versed in evolutionary concepts enables medical students and clinicians to integrate factual knowledge of cellular biology, physiology, and anatomy into a meaningful framework, thus promoting a better understanding of human health and disease. This sentiment is being embraced by a growing number of medical schools worldwide as evidenced by the inclusion of evolutionary medicine into the core curricula.
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Tan VMH, Lee YS, Venkataraman K, Khoo EYH, Tai ES, Chong YS, Gluckman P, Leow MKS, Khoo CM. Ethnic differences in insulin sensitivity and beta-cell function among Asian men. Nutr Diabetes 2015; 5:e173. [PMID: 26192451 PMCID: PMC4521178 DOI: 10.1038/nutd.2015.24] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 06/17/2015] [Accepted: 06/21/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Lean Asian Indians are less insulin sensitive compared with Chinese and Malays, but the pancreatic beta-cell function among these ethnic groups has yet to be studied in depth. We aimed to study beta-cell function in relation to insulin sensitivity among individuals of Chinese, Malay and Asian-Indian ethnicity living in Singapore. SUBJECTS AND METHODS This is a sub-group analysis of 59 normoglycemic lean (body mass index (BMI) <23 kg m(-)(2)) adult males (14 Chinese, 21 Malays and 24 Asian Indians) from the Singapore Adults Metabolism Study. Insulin sensitivity was determined using fasting state indices (homeostatic model assessment-insulin resistance), the euglycemic-hyperinsulinemic clamp (ISI-clamp) and a liquid mixed-meal tolerance test (LMMTT) (Matsuda insulin sensitivity index (ISI-Mat)). Beta-cell function was assessed using fasting state indices (homeostatic model assessment-beta-cell function) and from the LMMTT (insulinogenic index and insulin secretion index). The oral disposition index (DI), a measure of beta-cell function relative to insulin sensitivity during the LMMTT, was calculated as a product of ISI-Mat and insulin secretion index. RESULTS Asian Indians had higher waist circumference and percent body fat than Chinese and Malays despite similar BMI. Overall, Asian Indians were the least insulin sensitive whereas the Chinese were most insulin sensitive. Asian Indians had higher beta-cell function compared with Chinese or Malays but these were not statistically different. Malays had the highest incremental area under the curve for glucose during LMMTT compared with Asian Indians and Chinese. However, there were no significant ethnic differences in the incremental insulin area under the curve. The oral DI was the lowest in Malays, followed by Asian Indians and Chinese. CONCLUSION Among lean Asians, Chinese are the most insulin sensitive whereas Asian Indians are the least insulin sensitive. However, Malays demonstrate higher postprandial glucose excursion with lower beta-cell response compare with Chinese or Asian Indians. The paths leading to type 2 diabetes mellitus might differ between these Asian ethnic groups.
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Affiliation(s)
- V M H Tan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Paediatric, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Y S Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Paediatric, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Paediatric Endocrinology and Diabetes, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore
| | - K Venkataraman
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - E Y H Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Endocrinology, Department of Medicine, National University Health System, Singapore
| | - E S Tai
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Endocrinology, Department of Medicine, National University Health System, Singapore
- Duke-NUS Graduate Medical School, Singapore
| | - Y S Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
- Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - P Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
- Liggins Institute, Auckland, New Zealand
| | - M K S Leow
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore
| | - C M Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Endocrinology, Department of Medicine, National University Health System, Singapore
- Duke-NUS Graduate Medical School, Singapore
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Chong MFF, Ong YL, Calder PC, Colega M, Wong JXY, Tan CS, Lim AL, Fisk HL, Cai S, Pang WW, Broekman BFP, Saw SM, Kwek K, Godfrey KM, Chong YS, Gluckman P, Meaney MJ, Chen H. Long-chain polyunsaturated fatty acid status during pregnancy and maternal mental health in pregnancy and the postpartum period: results from the GUSTO study. J Clin Psychiatry 2015; 76:e848-56. [PMID: 26231011 DOI: 10.4088/jcp.14m09191] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [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: 04/11/2014] [Accepted: 11/03/2014] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Studies have demonstrated a relationship between lower omega-3 long-chain polyunsaturated fatty acid (LC-PUFA) status and anxiety and depression. It is uncertain whether similar associations occur in pregnant women, when anxiety and depression could have long-term effects on the offspring. We examined the associations between plasma LC-PUFA status during pregnancy and perinatal mental health. METHOD At 26-28 weeks' gestation, plasma LC-PUFAs were measured in mothers of the Growing Up in Singapore Toward healthy Outcomes (GUSTO) mother-offspring cohort study, who were recruited between June 2009 and September 2010. Maternal symptoms of anxiety and depression were assessed with the State-Trait Anxiety Inventory (STAI) and Edinburgh Postnatal Depression Scale (EPDS) during the same period and at 3 months' postpartum. The STAI-state subscale was used as a continuous measure of current anxiety, while EPDS scores ≥ 15 during pregnancy or ≥ 13 postpartum were indicative of symptoms of probable depression. RESULTS In adjusted regression analyses (n = 698), lower plasma total omega-3 PUFA concentrations (β = -6.49 STAI-state subscale scores/unit increase of omega-3 fatty acid; 95% CI, -11.90 to -1.08) and higher plasma omega-6:omega-3 PUFA ratios (β = 6.58 scores/unit increase of fatty acid ratio; 95% CI, 1.19 to 12.66), specifically higher arachidonic acid (AA):docosahexaenoic acid, AA:eicosapentaenoic acid, and AA:docosapentaenoic acid ratios, were associated with increased antenatal anxiety (P < .05 for all), but not postpartum anxiety. There was no association between plasma PUFAs and perinatal probable depression. CONCLUSIONS No association was found with probable depression in pregnancy or postpartum. Lower plasma omega-3 fatty acids and higher omega-6:omega-3 fatty acid ratios were associated with higher antenatal anxiety, but not postpartum anxiety. Replication in other studies is needed to confirm the findings and determine the direction of causality. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01174875.
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Affiliation(s)
- Mary F F Chong
- Singapore Institute for Clinical Sciences, Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore 117609
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Chong MFF, Chia AR, Colega M, Tint MT, Aris IM, Chong YS, Gluckman P, Godfrey KM, Kwek K, Saw SM, Yap F, van Dam RM, Lee YS. Maternal Protein Intake during Pregnancy Is Not Associated with Offspring Birth Weight in a Multiethnic Asian Population. J Nutr 2015; 145:1303-10. [PMID: 25948786 DOI: 10.3945/jn.114.205948] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [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: 10/30/2014] [Accepted: 04/07/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Maternal diet during pregnancy can influence fetal growth. However, the relation between maternal macronutrient intake and birth size outcomes is less clear. OBJECTIVE We examined the associations between maternal macronutrient intake during pregnancy and infant birth size. METHODS Pregnant women (n = 835) from the Singapore GUSTO (Growing Up in Singapore Towards healthy Outcomes) mother-offspring cohort were studied. At 26-28 wk of gestation, the macronutrient intake of women was ascertained with the use of 24 h dietary recalls and 3 d food diaries. Weight, length, and ponderal index of their offspring were measured at birth. Associations were assessed by substitution models with the use of multiple linear regressions. RESULTS Mean ± SD maternal energy intake and percentage energy from protein, fat, and carbohydrates per day were 1903 ± 576 kcal, 15.6% ± 3.9%, 32.7% ± 7.5%, and 51.6% ± 8.7% respectively. With the use of adjusted models, no associations were observed for maternal macronutrient intake and birth weight. In male offspring, higher carbohydrate or fat intake with lower protein intake was associated with longer birth length (β = 0.08 cm per percentage increment in carbohydrate; 95% CI: 0.04, 0.13; β = 0.08 cm per percentage increment in fat; 95% CI: 0.02, 0.13) and lower ponderal index (β = -0.12 kg/m(3) per percentage increment in carbohydrate; 95% CI: -0.19, -0.05; β = -0.08 kg/m(3) per percentage increment in fat; 95% CI: -0.16, -0.003), but this was not observed in female offspring (P-interaction < 0.01). CONCLUSIONS Maternal macronutrient intake during pregnancy was not associated with infant birth weight. Lower maternal protein intake was significantly associated with longer birth length and lower ponderal index in male but not female offspring. However, this finding warrants further confirmation in independent studies. This trial was registered at clinicaltrials.gov as NCT01174875.
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Affiliation(s)
- Mary Foong-Fong Chong
- Clinical Nutrition Research Centre, and Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Department of Paediatrics, and
| | - Ai-Ru Chia
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore
| | - Marjorelee Colega
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore
| | | | | | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Department of Obstetrics and Gynaecology
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | | | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Fabian Yap
- Department of Paediatric Endocrinology, Kandang Kerbau Women's and Children's Hospital, Singapore; Duke-National University of Singapore Graduate Medical School, Lee Kong Chian School of Medicine, Singapore; and
| | - Rob M van Dam
- Department of Medicine, Yong Loo Lin School of Medicine, and Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Department of Paediatrics, and Division of Paediatric Endocrinology and Diabetes, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
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Li LJ, Aris I, Su LL, Tint MT, Cheung CYL, Ikram MK, Gluckman P, Godfrey KM, Tan KH, Yeo G, Yap F, Kwek K, Saw SM, Chong YS, Wong TY, Lee YS. Associations of maternal retinal vasculature with subsequent fetal growth and birth size. PLoS One 2015; 10:e0118250. [PMID: 25909909 PMCID: PMC4409150 DOI: 10.1371/journal.pone.0118250] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 12/18/2014] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE We aimed to study the maternal retinal microvasculature at mid-trimester and its relationship with subsequent fetal growth and birth size. METHODS We recruited 732 pregnant women aged 18-46 years in the first trimester with singleton pregnancies. All had retinal photography and fetal scan performed at 26-28 weeks gestation, and subsequent fetal scan at 32-34 weeks gestation. Infant anthropometric measurements were done at birth. Retinal microvasculature was measured using computer software from the retinal photographs. RESULTS In multiple linear regression models, each 10 μm narrowing in maternal retinal arteriolar caliber was associated with decreases of 1.36 mm in fetal head circumference at 32-34 weeks gestation, as well as decreases of 1.50 mm and 2.30 mm in infant head circumference and birth length at delivery, respectively. Each standard deviation decrease in maternal retinal arteriolar fractal dimension was associated with decreases of 1.55 mm in fetal head circumference at 32-34 weeks gestation, as well as decreases of 1.08 mm and 46.42 g in infant head circumference and birth weight at delivery, respectively. CONCLUSIONS Narrower retinal arteriolar caliber and a sparser retinal vascular network in mothers, reflecting a suboptimal uteroplacental microvasculature during mid-pregnancy, were associated with poorer fetal growth and birth size.
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Affiliation(s)
- Ling-Jun Li
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Izzuddin Aris
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lin Lin Su
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mya Thway Tint
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Carol Yim-Lui Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- DUKE-NUS Graduate Medical School, Singapore
| | - M. Kamran Ikram
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Departments of Epidemiology & Ophthalmology, Erasmus Medical Centre, Rotterdam, The Netherlands
- Memory Aging & Cognition Centre, National University Health System, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and NIHR Southampton, Biomedical Research Centre, University of Southampton, Southampton, United Kingdom
| | | | - George Yeo
- KK Women’s and Children’s Hospital, Singapore
| | - Fabian Yap
- KK Women’s and Children’s Hospital, Singapore
| | - Kenneth Kwek
- Medical Research Council Lifecourse Epidemiology Unit and NIHR Southampton, Biomedical Research Centre, University of Southampton, Southampton, United Kingdom
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tien-Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yung Seng Lee
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
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41
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Affiliation(s)
- Peter Gluckman
- Office of the Prime Minister's Chief Science Advisor, Auckland 1150, New Zealand.
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Gluckman P. Science policy: From Brookhaven to Bush. Nature 2015. [DOI: 10.1038/517268a] [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: 11/10/2022]
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Abstract
Many forms of developmental plasticity have been observed and these are usually beneficial to the organism. The Predictive Adaptive Response (PAR) hypothesis refers to a form of developmental plasticity in which cues received in early life influence the development of a phenotype that is normally adapted to the environmental conditions of later life. When the predicted and actual environments differ, the mismatch between the individual's phenotype and the conditions in which it finds itself can have adverse consequences for Darwinian fitness and, later, for health. Numerous examples exist of the long-term effects of cues indicating a threatening environment affecting the subsequent phenotype of the individual organism. Other examples consist of the long-term effects of variations in environment within a normal range, particularly in the individual's nutritional environment. In mammals the cues to developing offspring are often provided by the mother's plane of nutrition, her body composition or stress levels. This hypothetical effect in humans is thought to be important by some scientists and controversial by others. In resolving the conflict, distinctions should be drawn between PARs induced by normative variations in the developmental environment and the ill effects on development of extremes in environment such as a very poor or very rich nutritional environment. Tests to distinguish between different developmental processes impacting on adult characteristics are proposed. Many of the mechanisms underlying developmental plasticity involve molecular epigenetic processes, and their elucidation in the context of PARs and more widely has implications for the revision of classical evolutionary theory.
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Affiliation(s)
- Patrick Bateson
- Department of Zoology, University of Cambridge, Cambridge, UK
| | - Peter Gluckman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Mark Hanson
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton and NIHR Nutrition Biomedical Research Centre, Universazity Hospital Southampton, Southampton, UK
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Carroll SP, Jørgensen PS, Kinnison MT, Bergstrom CT, Denison RF, Gluckman P, Smith TB, Strauss SY, Tabashnik BE. Applying evolutionary biology to address global challenges. Science 2014; 346:1245993. [PMID: 25213376 PMCID: PMC4245030 DOI: 10.1126/science.1245993] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Two categories of evolutionary challenges result from escalating human impacts on the planet. The first arises from cancers, pathogens, and pests that evolve too quickly and the second, from the inability of many valued species to adapt quickly enough. Applied evolutionary biology provides a suite of strategies to address these global challenges that threaten human health, food security, and biodiversity. This Review highlights both progress and gaps in genetic, developmental, and environmental manipulations across the life sciences that either target the rate and direction of evolution or reduce the mismatch between organisms and human-altered environments. Increased development and application of these underused tools will be vital in meeting current and future targets for sustainable development.
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Affiliation(s)
- Scott P Carroll
- Department of Entomology, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA. Institute for Contemporary Evolution, Davis, CA 95616, USA.
| | - Peter Søgaard Jørgensen
- Center for Macroecology, Evolution and Climate, Department of Biology, University of Copenhagen, 2100 Copenhagen, Denmark. Center for Macroecology, Evolution and Climate, Natural History Museum of Denmark, University of Copenhagen, 2100 Copenhagen, Denmark.
| | - Michael T Kinnison
- School of Biology and Ecology, University of Maine, Orono, ME 04469, USA
| | - Carl T Bergstrom
- Department of Biology, University of Washington, Seattle, WA 98195, USA
| | - R Ford Denison
- Department of Ecology, Evolution, and Behavior, University of Minnesota, Minneapolis, MN 55108, USA
| | - Peter Gluckman
- Centre for Human Evolution, Adaptation and Disease, Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Thomas B Smith
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA 90095, USA. Center for Tropical Research, Institute of the Environment and Sustainability, University of California, Los Angeles, 619 Charles E. Young Drive East, Los Angeles, 90095-1496, CA
| | - Sharon Y Strauss
- Department of Evolution and Ecology and Center for Population Biology, University of California, Davis, One Shields Avenue, CA 95616, USA
| | - Bruce E Tabashnik
- Department of Entomology, University of Arizona, Tucson, AZ 85721, USA
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Chong MFF, Wong JXY, Colega M, Chen LW, van Dam RM, Tan CS, Lim AL, Cai S, Broekman BFP, Lee YS, Saw SM, Kwek K, Godfrey KM, Chong YS, Gluckman P, Meaney MJ, Chen H. Relationships of maternal folate and vitamin B12 status during pregnancy with perinatal depression: The GUSTO study. J Psychiatr Res 2014; 55:110-6. [PMID: 24774647 DOI: 10.1016/j.jpsychires.2014.04.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [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: 02/06/2014] [Revised: 04/02/2014] [Accepted: 04/04/2014] [Indexed: 11/18/2022]
Abstract
UNLABELLED Studies in the general population have proposed links between nutrition and depression, but less is known about the perinatal period. Depletion of nutrient reserves throughout pregnancy and delayed postpartum repletion could increase the risk of perinatal depression. We examined the relationships of plasma folate and vitamin B12 concentrations during pregnancy with perinatal depression. At 26th-28th weeks of gestation, plasma folate and vitamin B12 were measured in women from the GUSTO mother-offspring cohort study in Singapore. Depressive symptoms were measured with the Edinburgh Postnatal Depression Scale (EPDS) during the same period and at 3-month postpartum. EPDS scores of ≥15 during pregnancy or ≥13 at postpartum were indicative of probable depression. Of 709 women, 7.2% (n = 51) were identified with probable antenatal depression and 10.4% (n = 74) with probable postnatal depression. Plasma folate concentrations were significantly lower in those with probable antenatal depression than those without (mean ± SD; 27.3 ± 13.8 vs 40.4 ± 36.5 nmol/L; p = 0.011). No difference in folate concentrations was observed in those with and without probable postnatal depression. In adjusted regression models, the likelihood of probable antenatal depression decreases by 0.69 for every unit variation (increase) in folate (OR = 0.69 per SD increase in folate; 95% CI: 0.52, 0.94). Plasma vitamin B12 concentrations were not associated with perinatal depression. Lower plasma folate status during pregnancy was associated with antenatal depression, but not with postnatal depression. Replication in other studies is needed to determine the direction of causality between low folate and antenatal depression. CLINICAL TRIAL REGISTRY NCT01174875.
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Affiliation(s)
- Mary F F Chong
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore; Singapore Institute for Clinical Sciences, A*STAR, Singapore; Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
| | | | | | - Ling-Wei Chen
- Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Ai Lin Lim
- Singapore Institute for Clinical Sciences, A*STAR, Singapore
| | - Shirong Cai
- Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Yung Seng Lee
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore; Singapore Institute for Clinical Sciences, A*STAR, Singapore; Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Kenneth Kwek
- KK Women's and Children's Hospital, Singapore; McGill University, Montreal, Canada
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton; University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Peter Gluckman
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, A*STAR, Singapore; Singapore Institute for Clinical Sciences, A*STAR, Singapore; Liggins Institute, Auckland, New Zealand
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences, A*STAR, Singapore; McGill University, Montreal, Canada
| | - Helen Chen
- KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore, Singapore
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Ngo S, Li X, O'Neill R, Bhoothpur C, Gluckman P, Sheppard A. Elevated S-adenosylhomocysteine alters adipocyte functionality with corresponding changes in gene expression and associated epigenetic marks. Diabetes 2014; 63:2273-83. [PMID: 24574043 DOI: 10.2337/db13-1640] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Maternal deficiencies in micronutrients affecting one-carbon metabolism before and during pregnancy can influence metabolic status and the degree of insulin resistance and obesity of the progeny in adulthood. Notably, maternal and progeny plasma S-adenosylhomocysteine (SAH) levels are both elevated after vitamin deficiency in pregnancy. Therefore, we investigated whether this key one-carbon cycle intermediate directly affects adipocyte differentiation and function. We found that expansion and differentiation of murine 3T3-L1 preadipocytes in the presence of SAH impaired both basal and induced glucose uptake as well as lipolysis compared with untreated controls. SAH did not alter preadipocyte factor 1 (Dlk1) or peroxisome proliferator-activated receptor-γ 2 (Pparγ2) but significantly reduced expression of CAAT enhancer-binding protein-α (Cebpα), Cebpβ, and retinoid x receptor-α (Rxrα) compared with untreated adipocytes. SAH increased Rxrα methylation on a CpG unit (chr2:27,521,057+, chr2:27,521,049+) and CpG residue (chr2:27,521,080+), but not Cebpβ methylation, relative to untreated adipocytes. Trimethylated histone H3-Lys27 occupancy was significantly increased on Cebpα and Rxrα promoters in SAH-treated adipocytes, consistent with the reduction in gene expression. In conclusion, SAH did not affect adipogenesis per se but altered adipocyte functionality through epigenetic mechanisms, such that they exhibited altered glucose disposal and lipolysis. Our findings implicate micronutrient imbalance in subsequent modulation of adipocyte function.
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Affiliation(s)
- Sherry Ngo
- Developmental Epigenetics Group, Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Xiaoling Li
- Developmental Epigenetics Group, Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Renelle O'Neill
- Developmental Epigenetics Group, Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Chandrakanth Bhoothpur
- Developmental Epigenetics Group, Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Peter Gluckman
- Developmental Epigenetics Group, Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Allan Sheppard
- Developmental Epigenetics Group, Liggins Institute, The University of Auckland, Auckland, New Zealand
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Venkataraman K, Khoo CM, Leow MKS, Khoo EYH, Isaac AV, Zagorodnov V, Sadananthan SA, Velan SS, Chong YS, Gluckman P, Lee J, Salim A, Tai ES, Seng Lee Y. New measure of insulin sensitivity predicts cardiovascular disease better than HOMA estimated insulin resistance. PLoS One 2013; 8:e74410. [PMID: 24098646 PMCID: PMC3787028 DOI: 10.1371/journal.pone.0074410] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 08/02/2013] [Indexed: 12/22/2022] Open
Abstract
Context Accurate assessment of insulin sensitivity may better identify individuals at increased risk of cardio-metabolic diseases. Objectives To examine whether a combination of anthropometric, biochemical and imaging measures can better estimate insulin sensitivity index (ISI) and provide improved prediction of cardio-metabolic risk, in comparison to HOMA-IR. Design and participants Healthy male volunteers (96 Chinese, 80 Malay, 77 Indian), 21 to 40 years, body mass index 18−30 kg/m2. Predicted ISI (ISI-cal) was generated using 45 randomly selected Chinese through stepwise multiple linear regression, and validated in the rest using non-parametric correlation (Kendall's tau τ). In an independent longitudinal cohort, ISI-cal and HOMA-IR were compared for prediction of diabetes and cardiovascular disease (CVD), using ROC curves. Setting The study was conducted in a university academic medical centre. Outcome measures ISI measured by hyperinsulinemic euglycemic glucose clamp, along with anthropometric measurements, biochemical assessment and imaging; incident diabetes and CVD. Results A combination of fasting insulin, serum triglycerides and waist-to-hip ratio (WHR) provided the best estimate of clamp-derived ISI (adjusted R2 0.58 versus 0.32 HOMA-IR). In an independent cohort, ROC areas under the curve were 0.77±0.02 ISI-cal versus 0.76±0.02 HOMA-IR (p>0.05) for incident diabetes, and 0.74±0.03 ISI-cal versus 0.61±0.03 HOMA-IR (p<0.001) for incident CVD. ISI-cal also had greater sensitivity than defined metabolic syndrome in predicting CVD, with a four-fold increase in the risk of CVD independent of metabolic syndrome. Conclusions Triglycerides and WHR, combined with fasting insulin levels, provide a better estimate of current insulin resistance state and improved identification of individuals with future risk of CVD, compared to HOMA-IR. This may be useful for estimating insulin sensitivity and cardio-metabolic risk in clinical and epidemiological settings.
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Affiliation(s)
- Kavita Venkataraman
- Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and NUHS, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and NUHS, Singapore, Singapore
| | - Chin Meng Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and NUHS, Singapore, Singapore
| | - Melvin K. S. Leow
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Eric Y. H. Khoo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and NUHS, Singapore, Singapore
| | - Anburaj V. Isaac
- Neuroscience and Behavioral Disorders Program, Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Vitali Zagorodnov
- School of Computer Engineering, Nanyang Technological University, Singapore, Singapore
| | - Suresh A. Sadananthan
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and NUHS, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Sendhil S. Velan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Singapore BioImaging Consortium, NUS-A*STAR, Singapore, Singapore
- Clinical Imaging Research Centre, NUS-A*STAR, Singapore, Singapore
| | - Yap Seng Chong
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and NUHS, Singapore, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
| | - Jeannette Lee
- Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and NUHS, Singapore, Singapore
| | - Agus Salim
- Saw Swee Hock School of Public Health, Yong Loo Lin School of Medicine, National University of Singapore and NUHS, Singapore, Singapore
| | - E. Shyong Tai
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and NUHS, Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore and NUHS, Singapore, Singapore
- * E-mail:
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Gluckman P. Syme oration to the Annual Scientific Congress of the Royal Australasian College of Surgeons. ANZ J Surg 2013; 83:606-8. [PMID: 23998464 DOI: 10.1111/ans.12326] [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: 11/29/2022]
Affiliation(s)
- Peter Gluckman
- Centre for Human Evolution, Adaptation and Disease, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Cornell P, Trehane A, Thompson P, Rahmeh F, Greenwood M, Baqai TJ, Cambridge S, Shaikh M, Rooney M, Donnelly S, Tahir H, Ryan S, Kamath S, Hassell A, McCuish WJ, Bearne L, Mackenzie-Green B, Price E, Williamson L, Collins D, Tang E, Hayes J, McLoughlin YM, Chamberlain V, Campbell S, Shah P, McKenna F, Cornell P, Westlake S, Thompson P, Richards S, Homer D, Gould E, Empson B, Kemp P, Richards AG, Walker J, Taylor S, Bari SF, Alachkar M, Rajak R, Lawson T, O'Sullivan M, Samant S, Butt S, Gadsby K, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Edwards KR, Rowe I, Sanders T, Dunn K, Konstantinou K, Hay E, Jones LE, Adams J, White P, Donovan-Hall M, Hislop K, Barbosa Boucas S, Nichols VP, Williamson EM, Toye F, Lamb SE, Rodham K, Gavin J, Watts L, Coulson N, Diver C, Avis M, Gupta A, Ryan SJ, Stangroom S, Pearce JM, Byrne J, Manning VL, Hurley M, Scott DL, Choy E, Bearne L, Taylor J, Morris M, Dures E, Hewlett S, Wilson A, Adams J, Larkin L, Kennedy N, Gallagher S, Fraser AD, Shrestha P, Batley M, Koduri G, Scott DL, Flurey CA, Morris M, Hughes R, Pollock J, Richards P, Hewlett S, Kumar K, Raza K, Nightingale P, Horne R, Chapman S, Greenfield S, Gill P, Ferguson AM, Ibrahim F, Scott DL, Lempp H, Tierney M, Fraser A, Kennedy N, Barbosa Boucas S, Hislop K, Dziedzic K, Arden N, Burridge J, Hammond A, Stokes M, Lewis M, Gooberman-Hill R, Coales K, Adams J, Nutland H, Dean A, Laxminarayan R, Gates L, Bowen C, Arden N, Hermsen L, Terwee CB, Leone SS, vd Zwaard B, Smalbrugge M, Dekker J, vd Horst H, Wilkie R, Ferguson AM, Nicky Thomas V, Lempp H, Cope A, Scott DL, Simpson C, Weinman J, Agarwal S, Kirkham B, Patel A, Ibrahim F, Barn R, Brandon M, Rafferty D, Sturrock R, Turner D, Woodburn J, Rafferty D, Paul L, Marshall R, Gill J, McInnes I, Roderick Porter D, Woodburn J, Hennessy K, Woodburn J, Steultjens M, Siddle HJ, Hodgson RJ, Hensor EM, Grainger AJ, Redmond A, Wakefield RJ, Helliwell PS, Hammond A, Rayner J, Law RJ, Breslin A, Kraus A, Maddison P, Thom JM, Newcombe LW, Woodburn J, Porter D, Saunders S, McCarey D, Gupta M, Turner D, McGavin L, Freeburn R, Crilly A, Lockhart JC, Ferrell WR, Goodyear C, Ledingham J, Waterman T, Berkin L, Nicolaou M, Watson P, Lillicrap M, Birrell F, Mooney J, Merkel PA, Poland F, Spalding N, Grayson P, Leduc R, Shereff D, Richesson R, Watts RA, Roussou E, Thapper M, Bateman J, Allen M, Kidd J, Parsons N, Davies D, Watt KA, Scally MD, Bosworth A, Wilkinson K, Collins S, Jacklin CB, Ball SK, Grosart R, Marks J, Litwic AE, Sriranganathan MK, Mukherjee S, Khurshid MA, Matthews SM, Hall A, Sheeran T, Baskar S, Muether M, Mackenzie-Green B, Hetherington A, Wickrematilake G, Williamson L, Daniels LE, Gwynne CE, Khan A, Lawson T, Clunie G, Stephenson S, Gaffney K, Belsey J, Harvey NC, Clarke-Harris R, Murray R, Costello P, Garrett E, Holbrook J, Teh AL, Wong J, Dogra S, Barton S, Davies L, Inskip H, Hanson M, Gluckman P, Cooper C, Godfrey K, Lillycrop K, Anderton T, Clarke S, Rao Chaganti S, Viner N, Seymour R, Edwards MH, Parsons C, Ward K, Thompson J, Prentice A, Dennison E, Cooper C, Clark E, Cumming M, Morrison L, Gould VC, Tobias J, Holroyd CR, Winder N, Osmond C, Fall C, Barker D, Ring S, Lawlor D, Tobias J, Davey Smith G, Cooper C, Harvey NC, Toms TE, Afreedi S, Salt K, Roskell S, Passey K, Price T, Venkatachalam S, Sheeran T, Davies R, Southwood TR, Kearsley-Fleet L, Hyrich KL, Kingsbury D, Quartier P, Patel G, Arora V, Kupper H, Mozaffarian N, Kearsley-Fleet L, Baildam E, Beresford MW, Davies R, Foster HE, Mowbray K, Southwood TR, Thomson W, Hyrich KL, Saunders E, Baildam E, Chieng A, Davidson J, Foster H, Gardner-Medwin J, Wedderburn L, Thomson W, Hyrich K, McErlane F, Beresford M, Baildam E, Chieng SE, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Thomson W, Hyrich K, Rooney M, Finnegan S, Gibson DS, Borg FA, Bale PJ, Armon K, Cavelle A, Foster HE, McDonagh J, Bale PJ, Armon K, Wu Q, Pesenacker AM, Stansfield A, King D, Barge D, Abinun M, Foster HE, Wedderburn L, 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BHPR: Audit and Clinical Evaluation * 103. Dental Health in Children and Young Adults with Inflammatory Arthritis: Access to Dental Care. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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