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Fernández-Iglesias R, Martinez-Camblor P, Fernández-Somoano A, Rodríguez-Dehli C, Venta-Obaya R, Karagas MR, Tardón A, Riaño-Galán I. Tracking between cardiovascular-related measures at 4 and 8 years of age in the INMA-Asturias cohort. Eur J Pediatr 2023; 182:3893-3906. [PMID: 37338691 PMCID: PMC10570156 DOI: 10.1007/s00431-023-05051-8] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/25/2023] [Accepted: 05/31/2023] [Indexed: 06/21/2023]
Abstract
Identifying cardiovascular-related measures that track from early childhood into later ages may help inform early prevention targets for cardiovascular disease. In this study, the tracking of triglycerides (TG), high-density cholesterol (HDL-c), atherogenic coefficient (AC), waist circumference to height ratio (WC/Height), mean arterial pressure (MAP), and homeostatic model assessment of insulin resistance (HOMA-IR) was examined in the INMA-Asturias cohort between 4 and 8 years of age. The analysis was conducted in 307 children who participated in the INMA-Asturias cohort (Spain) at 4 and at 8 years of age. Quantile regression models were used to evaluate tracking between measures at both ages, with each measure at 8 years as the dependent variable and the rank transformation of the same measure at 4 years as the independent variable. We found a positive association between HDL-c rank at 4 years and higher quantiles of the HDL-c distribution at 8 years, with an increase of 2.93 mg/dL (95% CI: 1.98, 3.87) per decile in the 0.9 quantile. A positive association was also found for WC/Height, with an increase of 0.008 (95% CI: 0.004, 0.012) per decile in the 0.9 quantile. We observed that tracking for AC increased in the higher quantiles of the distribution at 8 years, with an increase of 0.11 (95% CI: 0.09, 0.14) in the 0.6 quantile compared to an effect of 0.15 (95% CI: 0.09, 0.21) in the 0.9 quantile. Conclusions: Adult markers of dyslipidemia and central obesity tracked between ages 4 and 8 years. For AC, tracking increased in the higher quantiles of the distribution. What is Known: • Atherosclerosis begins in early life, so preventive efforts that start in childhood may delay progression to clinical disease. Determine what cardiovascular risk factors track into time since childhood bring the opportunity to identified those subjects at risk for later cardiovascular disease. • The study of risk factors in health populations and, particularly in children, copes with not clear and/or controversial thresholds definition. This makes it challenging to study tracking in pediatric ages. What is New: • Quantile regression is a useful tool for assessing the tracking of risk factors for which there are no clinically meaningful thresholds. The increasing trend observed in the tracking of dyslipidemia suggests the possible difficulty that children with abnormal values at 4 years of age might have in normalizing them in future years. • The findings of this article may help to determine which cardiovascular-related measures could be screened and followed-up in children.
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Affiliation(s)
- Rocío Fernández-Iglesias
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain
- Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julian Clavería Street S/N, 33006, Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue S/N, 33001, Oviedo, Asturias, Spain
| | - Pablo Martinez-Camblor
- Biomedical Data Science Department, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Faculty of Health Sciences, Universidad Autonoma de Chile, 7500912, Providencia, Chile
| | - Ana Fernández-Somoano
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain.
- Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julian Clavería Street S/N, 33006, Oviedo, Asturias, Spain.
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue S/N, 33001, Oviedo, Asturias, Spain.
| | - Cristina Rodríguez-Dehli
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue S/N, 33001, Oviedo, Asturias, Spain
- Servicio de Pediatría, Hospital San Agustín, Heros Street, 4, 33410, Avilés, Asturias, Spain
| | - Rafael Venta-Obaya
- Servicio de Bioquímica, Hospital San Agustín, Heros Street, 4, 33410, Avilés, Asturias, Spain
- Departamento de Bioquímica y Biología Molecular, University of Oviedo, Fernando Bongera Street, S/N, 33006, Oviedo, Asturias, Spain
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Adonina Tardón
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain
- Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Julian Clavería Street S/N, 33006, Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue S/N, 33001, Oviedo, Asturias, Spain
| | - Isolina Riaño-Galán
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029, Madrid, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue S/N, 33001, Oviedo, Asturias, Spain
- Endocrinología Pediátrica, Servicio de Pediatría, HUCA, Roma Avenue S/N, 33001, Oviedo, Asturias, Spain
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Fernández-Iglesias R, Fernández-Somoano A, Rodríguez-Dehli C, Venta-Obaya R, Riaño-Galán I, Tardón A. Cardiovascular risk factors and its patterns of change between 4 and 8 years of age in the INMA-Asturias cohort. PLoS One 2023; 18:e0283799. [PMID: 37043453 PMCID: PMC10096221 DOI: 10.1371/journal.pone.0283799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/18/2023] [Indexed: 04/13/2023] Open
Abstract
AIM This study aimed to investigate whether there are subgroups of children with different clusters of cardiovascular disease (CVD) risk factors at 4 and 8 years of age, and their patterns of change between these two time points. METHODS The analysis was conducted in 332 children who participated in the INMA-Asturias cohort (Spain) at 4 and at 8 years of age. The CVD risk factors were central obesity, dyslipidaemia, hyperglycaemia, and hypertension. Latent transition analysis was used to identify the different clusters and their probabilities of change. RESULTS At 4 years, three subgroups were identified: no disorders (prevalence of 55.9%); some disorders (21.2%), and central obesity (22.9%). Three distinct subgroups were identified at 8 years: no disorders (59.8%); hypertension (17.9%), and central obesity (22.3%). Central obesity at 4 years tends to appear simultaneously with dyslipidaemia, while at 8 years it tends to appear simultaneously with dyslipidaemia and/or hypertension. Children aged 4 years with no disorders had a 93.7% probability of remaining in the same status at 8 years of age. Children aged 4 who had some disorders had a 67.7% of probability of having only hypertension and a 32.3% of probability of having central obesity. Children aged 4 in the central obesity subgroup had a 32.4% of probability of having no disorders at 8 years of age, while 67.6% still had central obesity. CONCLUSIONS These exploratory findings suggest that children who do not present any disorder at 4 years of age tend to remain in that state at 8 years of age. And also that central obesity may play a major role in the development of other disorders, as the number of disorders with which it concomitantly occurs increases between the ages of 4 and 8 years.
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Affiliation(s)
- Rocío Fernández-Iglesias
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
| | - Ana Fernández-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
| | - Cristina Rodríguez-Dehli
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Servicio de Pediatría, Hospital San Agustín, Avilés, Asturias, Spain
| | - Rafael Venta-Obaya
- Servicio de Bioquímica, Hospital San Agustín, Avilés, Asturias, Spain
- Departamento de Bioquímica y Biología Molecular, University of Oviedo, Oviedo, Asturias, Spain
| | - Isolina Riaño-Galán
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Servicio de Pediatría, Endocrinología pediátrica, HUCA, Oviedo, Asturias, Spain
| | - Adonina Tardón
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA), Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
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Fernández-Iglesias R, Álvarez-Pereira S, Tardón A, Fernández-García B, Iglesias-Gutiérrez E. Adherence to the Mediterranean Diet in a School Population in the Principality of Asturias (Spain): Relationship with Physical Activity and Body Weight. Nutrients 2021; 13:nu13051507. [PMID: 33946967 PMCID: PMC8145401 DOI: 10.3390/nu13051507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 03/26/2021] [Revised: 04/22/2021] [Accepted: 04/27/2021] [Indexed: 01/13/2023] Open
Abstract
The Mediterranean diet (MD), despite its multiple benefits, presents low levels of adherence among children. Moreover, childhood is a key stage in the acquisition of healthy habits. The aim of this study was to describe adherence to MD in school-age children from Asturias, Spain, and to evaluate the association with weight status and several lifestyle behaviors. A cross-sectional study was conducted on 309 children aged between 8 and 13 years old. The level of adherence to MD was evaluated through the KIDMED questionnaire. Descriptive analysis and logistic regression models were used to analyze the association between adherence to MD and weight status, frequency of out-of-school exercise, frequency of school canteen attendance, and sleep habits. We found that 54.4% of children had optimal adherence to MD and 29.9% of the sample was overweight or obese. Frequency of exercise practice was positively associated with optimal adherence to MD (95% CI: 1.02, 1.33). A positive association was found between some KIDMED items and frequency of out-of-school exercise practice and attendance at the school canteen. This study shows the need for an improvement in the adherence to MD in youth considering the concomitant occurrence of other related healthy behaviors.
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Affiliation(s)
- Rocío Fernández-Iglesias
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029 Madrid, Spain;
- Department of Medicine, Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IOUPA), University of Oviedo, Julian Clavería Street s/n, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001 Oviedo, Spain; (B.F.-G.); (E.I.-G.)
- Correspondence:
| | - Sonia Álvarez-Pereira
- Department of Morphology and Cell Biology, University of Oviedo, Julian Clavería Street s/n, 33006 Oviedo, Spain;
| | - Adonina Tardón
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Monforte de Lemos Avenue, 3-5, 28029 Madrid, Spain;
- Department of Medicine, Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IOUPA), University of Oviedo, Julian Clavería Street s/n, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001 Oviedo, Spain; (B.F.-G.); (E.I.-G.)
| | - Benjamín Fernández-García
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001 Oviedo, Spain; (B.F.-G.); (E.I.-G.)
- Department of Morphology and Cell Biology, University of Oviedo, Julian Clavería Street s/n, 33006 Oviedo, Spain;
| | - Eduardo Iglesias-Gutiérrez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Roma Avenue s/n, 33001 Oviedo, Spain; (B.F.-G.); (E.I.-G.)
- Department of Functional Biology, University of Oviedo, Julian Clavería Street s/n, 33006 Oviedo, Spain
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