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Vlok J, Simm PJ, Lycett K, Clifford SA, Grobler AC, Lange K, Ismail N, Osborn W, Wake M. pQCT bone geometry and strength: population epidemiology and concordance in Australian children aged 11-12 years and their parents. BMJ Open 2019; 9:63-74. [PMID: 31273017 PMCID: PMC6624036 DOI: 10.1136/bmjopen-2018-022400] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To describe the epidemiology and concordance of bone health in a population-based sample of Australian parent-child dyads at child age 11-12 years. DESIGN Population-based cross-sectional study (the Child Health CheckPoint) nested between waves 6 and 7 of the Longitudinal Study of Australian Children (LSAC). SETTING Assessment centres in seven cities around Australia, February 2015-March 2016. PARTICIPANTS of all participating CheckPoint families (n=1874), bone data were available for 1222 dyads (1271 children, 50% girls; 1250 parents, 86% mothers). OUTCOME MEASURES Peripheral quantitative CT (pQCT) of the non-dominant leg scanned at the 4% (distal) and 66% (mid-calf) tibial sites. Stratec XCT 2000 software generated estimates of bone density, geometry and polar stress-strain index.Parent-child concordance were assessed using Pearson's correlation coefficients and multivariable linear regression models. Percentiles were determined using survey weights. Survey weights and methods accounted for LSAC's complex sampling, stratification and clustering within postcodes. RESULTS Concordances were greater for the geometric pQCT parameters (periosteal circumference 0.38, 95% CI 0.33 to 0.43; endosteal circumference 0.42, 95% CI 0.37 to 0.47; total cross-sectional area 0.37, 95% CI 0.32 to 0.42) than density (cortical density 0.25, 95% CI 0.19 to 0.30). Mother-child and father-child values were similar. Relationships attenuated only slightly on adjustment for age, sex and body mass index. Percentiles and concordance are presented for the whole sample and by sex. CONCLUSIONS There is strong parent-child concordance in bone geometry and, to a lesser extent, density even before the period of peak adolescent bone deposition. This geometrical concordance suggests that future intergenerational bone studies could consider using pQCT rather than the more commonly used dual X-ray absorptiometry (DXA).
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Affiliation(s)
- Jennifer Vlok
- Department of Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Peter J Simm
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Endocrinology, The Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Kate Lycett
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Susan A Clifford
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Katherine Lange
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Najmi Ismail
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - William Osborn
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
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Dascalu J, Liu M, Lycett K, Grobler AC, He M, Burgner DP, Wong TY, Wake M. Retinal microvasculature: population epidemiology and concordance in Australian children aged 11-12 years and their parents. BMJ Open 2019; 9:44-52. [PMID: 31273015 PMCID: PMC6624026 DOI: 10.1136/bmjopen-2018-022399] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To describe distributions and concordance of retinal microvasculature measurements in a population-based sample of Australian parent-child dyads at child age 11-12 years. DESIGN Cross-sectional Child Health CheckPoint study, between waves 6 and 7 of the national population-based Longitudinal Study of Australian Children (LSAC). SETTING Assessment centres in seven Australian cities, February 2015-March 2016. PARTICIPANTS Of the 1874 participating families, 1288 children (51% girls) and 1264 parents (87% mothers, mean age 43.7) were analysed. Diabetic participants and non-biological pairs were excluded from concordance analyses. OUTCOME MEASURES Retinal photographs were taken by non-mydriatic fundus camera. Trained graders scored vascular calibre using semi-automated software, yielding estimates of central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) and arteriolar-venular ratio (AVR). Pearson's correlation coefficients and multivariable linear regression models assessed parent-child concordance. Survey weights and methods accounted for LSAC's complex sampling, stratification and clustering within postcodes. RESULTS Mean (SD) of CRAE and CRVE were larger in children (159.5 (11.8) and 231.1 (16.5) μm, respectively) than parents (151.5 (14.0) and 220.6 (19.0) μm), yielding similar AVR (children 0.69 (0.05), parents 0.69 (0.06)). Correlation coefficients for parent-child pairs were 0.22 (95% CI 0.16 to 0.27) for CRAE, 0.23 (95% CI 0.17 to 0.28) for CRVE and 0.18 (95% CI 0.13 to 0.24) for AVR. Mother-child and father-child values were similar (0.20 and 0.32 for CRAE, 0.22 and 0.29 for CRVE, respectively). Relationships attenuated slightly on adjustment for age, sex, blood pressure, diabetes and body mass index. Percentiles and concordance are presented for the whole sample and by sex. CONCLUSIONS Arteriolar and venular calibre were similar to previously documented measures in midlife adult and late childhood populations. Population parent-child concordance values align with moderate polygenic heritability reported in smaller studies.
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Affiliation(s)
- Julian Dascalu
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Mengjiao Liu
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Kate Lycett
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Mingguang He
- Centre for Eye Research Australia, The University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - David P Burgner
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Tien Yin Wong
- Centre for Eye Research Australia, The University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
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Abstract
OBJECTIVES To describe the epidemiology of lung function in Australian children aged 11-12 years and their parents, and explore the degree of intergenerational concordance. DESIGN Cross-sectional study (the Child Health CheckPoint) nested in the Longitudinal Study of Australian Children (LSAC). SETTING Assessment centres in seven Australian cities and eight regional towns, February 2015 to March 2016. Families unable to attend a clinic appointment were offered a home visit during the same period. PARTICIPANTS 1874 families (53% of all eligible) participated in the study. Lung function data were available for 1759 children aged 11-12 years and 1774 parents (1668 biological pairs). OUTCOME MEASURES Participants completed spirometry with measures including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and mid expiratory flow (MEF), converted to z-scores using Global Lung Initiative equations. Parent-child concordance was assessed using Pearson's correlation coefficients and multivariable linear regression models. Survey weights and methods accounted for LSAC's complex sampling, stratification and clustering within postcodes. RESULTS All lung function measures followed approximately normal distributions. Mean (SD) for FEV1, FVC and MEF z-scores in children were 0.33 (1.07), 0.83 (1.14) and -0.48 (1.09), respectively. Mean (SD) in parents were 0.28 (1.10), 0.85 (1.15) and -0.45 (1.10), respectively. Parent FEV1, FVC and MEF were associated with child lung function with significant positive correlation coefficients (0.22, 95% CI 0.17 to 0.26; 0.24, 95% CI 0.20 to 0.29; and 0.24, 95% CI 0.20 to 0.29, respectively). CONCLUSIONS Mean lung volumes were larger but with smaller airway size than international standards for both parents and children in this population sample. Modest associations between parent and child lung function highlight the potential for better identification of 'at risk' populations. Therefore, these findings may aid the development of health policy that aims to prevent the onset or limit the progression of lung disease.
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Affiliation(s)
- Liam Welsh
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Respiratory Medicine, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Gayan Kathriachchige
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Tahmeed Raheem
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Grafton, Auckland, New Zealand
| | - Sarath Ranganathan
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Respiratory Medicine, The Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
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Kahn FK, Wake M, Lycett K, Clifford S, Burgner DP, Goldsmith G, Grobler AC, Lange K, Cheung M. Vascular function and stiffness: population epidemiology and concordance in Australian children aged 11-12 years and their parents. BMJ Open 2019; 9:34-43. [PMID: 31273014 PMCID: PMC6624058 DOI: 10.1136/bmjopen-2017-020896] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To describe the epidemiology and parent-child concordance of vascular function in a population-based sample of Australian parent-child dyads at child age 11-12 years. DESIGN Cross-sectional study (Child Health CheckPoint), nested within a prospective cohort study, the Longitudinal Study of Australian Children (LSAC). SETTING Assessment centres in seven major Australian cities and eight regional towns or home visits, February 2015-March 2016. PARTICIPANTS Of all participating CheckPoint families (n=1874), 1840 children (49% girls) and 1802 parents (88% mothers) provided vascular function data. Survey weights and methods were applied to account for LSAC's complex sample design and clustering within postcodes and strata. OUTCOME MEASURES The SphygmoCor XCEL assessed vascular function, generating estimates of brachial and central systolic blood pressure and diastolic blood pressure, central pulse pressure, augmentation index and carotid-femoral pulse wave velocity. Pearson's correlation coefficients and multivariable linear regression models estimated parent-child concordance. RESULTS Hypertension was present in 3.9% of children and 9.0% of parents. Mean child and parent values for augmentation index were 4.5% (SD 11.6) and 21.3% (SD 12.3), respectively, and those for carotid-femoral pulse wave velocity were 4.48 m/s (SD 0.59) and 6.85 m/s (SD 1.14), respectively. Parent-child correlation for brachial systolic blood pressure was 0.20 (95% CI 0.15 to 0.24), brachial diastolic blood pressure 0.21 (95% CI 0.16 to 0.26), central systolic blood pressure 0.21 (95% CI 0.16 to 0.25), central diastolic blood pressure 0.21 (95% CI0.17 to 0.26), central pulse pressure 0.19 (95% CI 0.14 to 0.24), augmentation index 0.28 (95% CI 0.23 to 0.32) and pulse wave velocity 0.22 (95% CI 0.18 to 0.27). CONCLUSIONS We report Australian values for traditional and more novel vascular function markers, providing a reference for future population studies. Cross-generational concordance in multiple vascular function markers is already established by age 11-12 years, with mechanisms of heritability remaining to be explored.
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Affiliation(s)
- Freya K Kahn
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Cardiology, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Kate Lycett
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Susan Clifford
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - David P Burgner
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Greta Goldsmith
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Katherine Lange
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Michael Cheung
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Cardiology, The Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
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Abstract
OBJECTIVES To describe objectively measured sleep characteristics in children aged 11-12 years and in parents and to examine intergenerational concordance of sleep characteristics. DESIGN Population-based cross-sectional study (the Child Health CheckPoint), nested within the Longitudinal Study of Australian Children. SETTING Data were collected between February 2015 and March 2016 across assessment centres in Australian major cities and selected regional towns. PARTICIPANTS Of the participating CheckPoint families (n=1874), sleep data were available for 1261 children (mean age 12 years, 50% girls), 1358 parents (mean age 43.8 years; 88% mothers) and 1077 biological parent-child pairs. Survey weights were applied and statistical methods accounted for the complex sample design, stratification and clustering within postcodes. OUTCOME MEASURES Parents and children were asked to wear a GENEActive wrist-worn accelerometer for 8 days to collect objective sleep data. Primary outcomes were average sleep duration, onset, offset, day-to-day variability and efficiency. All sleep characteristics were weighted 5:2 to account for weekdays versus weekends. Biological parent-child concordance was quantified using Pearson's correlation coefficients in unadjusted models and regression coefficients in adjusted models. RESULTS The mean sleep duration of parents and children was 501 min (SD 56) and 565 min (SD 44), respectively; the mean sleep onset was 22:42 and 22:02, the mean sleep offset was 07:07 and 07:27, efficiency was 85.4% and 84.1%, and day-to-day variability was 9.9% and 7.4%, respectively. Parent-child correlation for sleep duration was 0.22 (95% CI 0.10 to 0.28), sleep onset was 0.42 (0.19 to 0.46), sleep offset was 0.58 (0.49 to 0.64), day-to-day variability was 0.25 (0.09 to 0.34) and sleep efficiency was 0.23 (0.10 to 0.27). CONCLUSIONS These normative values for objective sleep characteristics suggest that, while most parents and children show adequate sleep duration, poor-quality (low efficiency) sleep is common. Parent-child concordance was strongest for sleep onset/offset, most likely reflecting shared environments, and modest for duration, variability and efficiency.
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Affiliation(s)
- Lisa Matricciani
- Sansom Institute, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Francois Fraysse
- Sansom Institute, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Josh Muller
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Timothy Olds
- Sansom Institute, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
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Ellul S, Wake M, Clifford SA, Lange K, Würtz P, Juonala M, Dwyer T, Carlin JB, Burgner DP, Saffery R. Metabolomics: population epidemiology and concordance in Australian children aged 11-12 years and their parents. BMJ Open 2019; 9:106-117. [PMID: 31273021 PMCID: PMC6624050 DOI: 10.1136/bmjopen-2017-020900] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Nuclear magnetic resonance (NMR) metabolomics is high throughput and cost-effective, with the potential to improve the understanding of disease and risk. We examine the circulating metabolic profile by quantitative NMR metabolomics of a sample of Australian 11-12 year olds children and their parents, describe differences by age and sex, and explore the correlation of metabolites in parent-child dyads. DESIGN The population-based cross-sectional Child Health CheckPoint study nested within the Longitudinal Study of Australian Children. SETTING Blood samples collected from CheckPoint participants at assessment centres in seven Australian cities and eight regional towns; February 2015-March 2016. PARTICIPANTS 1180 children and 1325 parents provided a blood sample and had metabolomics data available. This included 1133 parent-child dyads (518 mother-daughter, 469 mother-son, 68 father-daughter and 78 father-son). OUTCOME MEASURES 228 metabolic measures were obtained for each participant. We focused on 74 biomarkers including amino acid species, lipoprotein subclass measures, lipids, fatty acids, measures related to fatty acid saturation, and composite markers of inflammation and energy homeostasis. RESULTS We identified differences in the concentration of specific metabolites between childhood and adulthood and in metabolic profiles in children and adults by sex. In general, metabolite concentrations were higher in adults than children and sex differences were larger in adults than in children. Positive correlations were observed for the majority of metabolites including isoleucine (CC 0.33, 95% CI 0.27 to 0.38), total cholesterol (CC 0.30, 95% CI 0.24 to 0.35) and omega 6 fatty acids (CC 0.28, 95% CI 0.23 to 0.34) in parent-child comparisons. CONCLUSIONS We describe the serum metabolite profiles from mid-childhood and adulthood in a population-based sample, together with a parent-child concordance. Differences in profiles by age and sex were observed. These data will be informative for investigation of the childhood origins of adult non-communicable diseases and for comparative studies in other populations.
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Affiliation(s)
- Susan Ellul
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Susan A Clifford
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Katherine Lange
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Peter Würtz
- Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
- Nightingale Health Ltd., Helsinki, Finland
| | - Markus Juonala
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Terence Dwyer
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- The George Institute for Global Health, Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, United Kingdom
- Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - John B Carlin
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - David P Burgner
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Richard Saffery
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
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Abstract
OBJECTIVES Overweight and obesity remain at historically high levels, cluster within families and are established risk factors for multiple diseases. We describe the epidemiology and cross-generational concordance of body composition among Australian children aged 11-12 years and their parents. DESIGN The population-based cross-sectional Child Health CheckPoint study, nested within the Longitudinal Study of Australian Children (LSAC). SETTING Assessment centres in seven major Australian cities and eight regional cities, or home visits; February 2015-March 2016. PARTICIPANTS Of all participating CheckPoint families (n=1874), body composition data were available for 1872 children (49% girls) and 1852 parents (mean age 43.7 years; 88% mothers), including 1830 biological parent-child pairs. MEASURES Height, weight, body mass index (BMI), waist circumference and waist-to-height ratio for all participants; body fat and fat-free mass by four-limb bioimpedence analysis (BIA) at assessment centres, or body fat percentage by two-limb BIA at home visits. Analysis: parent-child concordance was assessed using (i) Pearson's correlation coefficients, and (ii) partial correlation coefficients adjusted for age, sex and socioeconomic disadvantage. Survey weights and methods accounted for LSAC's complex sample design. RESULTS 20.7% of children were overweight and 6.2% obese, as were 33.5% and 31.6% of parents. Boys and girls showed similar distributions for all body composition measures but, despite similar BMI and waist-to-height ratio, mothers had higher proportions of total and truncal fat than fathers. Parent-child partial correlations were greatest for height (0.37, 95% CI 0.33 to 0.42). Other anthropometric and fat/lean measures showed strikingly similar partial correlations, ranging from 0.25 (95% CI 0.20 to 0.29) for waist circumference to 0.30 (95% CI 0.25 to 0.34) for fat-free percentage. Whole-sample and sex-specific percentile values are provided for all measures. CONCLUSIONS Excess adiposity remains prevalent in Australian children and parents. Moderate cross-generational concordance across all measures of leanness and adiposity is already evident by late childhood.
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Affiliation(s)
- Susan A Clifford
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Alanna N Gillespie
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Timothy Olds
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
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Smith J, Wang J, Grobler AC, Lange K, Clifford SA, Wake M. Hearing, speech reception, vocabulary and language: population epidemiology and concordance in Australian children aged 11 to 12 years and their parents. BMJ Open 2019; 9:85-94. [PMID: 31273019 PMCID: PMC6624023 DOI: 10.1136/bmjopen-2018-023196] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To describe the epidemiology and parent-child concordance of hearing, speech reception, vocabulary and language in Australian parent-child dyads at child age 11 to 12 years. DESIGN Population-based cross-sectional study (Child Health CheckPoint) nested within the Longitudinal Study of Australian Children. SETTING Assessment centres in seven Australian cities and eight regional towns or home visits around Australia, February 2015 to March 2016. PARTICIPANTS Of all participating CheckPoint families (n=1874), 1516 children (50% female) and 1520 parents (87% mothers, mean age 43.8 years) undertook at least one of four measurements of hearing and language. OUTCOME MEASURES Hearing threshold (better ear mean of 1, 2 and 4 kHz) from pure-tone audiometry, speech reception threshold, receptive vocabulary, expressive and receptive languages using a sentence repetition task. Parent-child concordance was examined using Pearson's correlation coefficients and adjusted linear regression models. Survey weights and methods accounted for Longitudinal Study of Australian Children's complex sampling and stratification. RESULTS Children had a similar speech reception threshold to parents (children mean -14.3, SD 2.4; parents -14.9, SD 3.2 dB) but better hearing acuity (children 8.3, SD 6.3; parents 13.4, SD 7.0 decibels hearing level). Standardised sentence repetition scores were similar (children 9.8, SD 2.9; parents 9.1, SD 3.3) but, as expected, parents had superior receptive vocabularies. Parent-child correlations were higher for the cognitively-based language measures (vocabulary 0.31, 95% CI 0.26 to 0.36; sentence repetition 0.29, 95% CI 0.24 to 0.34) than the auditory measures (hearing 0.18, 95% CI 0.13 to 0.23; speech reception threshold 0.18, 95% CI 0.13 to 0.22). Mother-child and father-child concordances were similar for all measures. CONCLUSIONS We provide population reference values for multiple measures spanning auditory and verbal communication systems in children and mid-life adults. Concordance values aligned with previous twin studies and offspring studies in adults, in keeping with polygenic heritability that is modest for audition but around 60% for language by late childhood.
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Affiliation(s)
- Julia Smith
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Jing Wang
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Katherine Lange
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Susan A Clifford
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
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9
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Abstract
In an ambitious undertaking, Growing Up in Australia's Child Health CheckPoint streamlined and implemented wide-ranging population phenotypes and biosamples relevant to non-communicable diseases in nearly 1900 parent-child dyads throughout Australia at child aged 11-12 years. This BMJ Open Special Issue describes the methodology, epidemiology and parent-child concordance of 14 of these phenotypes, spanning cardiovascular, respiratory, bone, kidney, hearing and language, body composition, metabolic profiles, telomere length, sleep, physical activity, snack choice and health-related quality of life. The Special Issue also includes a cohort summary and study methodology paper.
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Affiliation(s)
- Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Susan A Clifford
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
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Liu RS, Dunn S, Grobler AC, Lange K, Becker D, Goldsmith G, Carlin JB, Juonala M, Wake M, Burgner DP. Carotid artery intima-media thickness, distensibility and elasticity: population epidemiology and concordance in Australian children aged 11-12 years old and their parents. BMJ Open 2019; 9:23-33. [PMID: 31273013 PMCID: PMC6624035 DOI: 10.1136/bmjopen-2017-020264] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To describe a well-established marker of cardiovascular risk, carotid intima-media thickness (IMT) and related measures (artery distensibility and elasticity) in children aged 11-12 years old and mid-life adults, and examine associations within parent-child dyads. DESIGN Cross-sectional study (Child Health CheckPoint), nested within a prospective cohort study, the Longitudinal Study of Australian Children (LSAC). SETTING Assessment centres in seven Australian major cities and eight selected regional towns, February 2015 to March 2016. PARTICIPANTS Of all participating CheckPoint families (n=1874), 1489 children (50.0% girls) and 1476 parents (86.8% mothers) with carotid IMT data were included. Survey weights and methods were applied to account for LSAC's complex sample design and clustering within postcodes and strata. OUTCOME MEASURES Ultrasound of the right carotid artery was performed using standardised protocols. Primary outcomes were mean and maximum far-wall carotid IMT, quantified using semiautomated edge detection software. Secondary outcomes were carotid artery distensibility and elasticity. Pearson's correlation coefficients and multivariable linear regression models were used to assess parent-child concordance. Random effects modelling on a subset of ultrasounds (with repeated measurements) was used to assess reliability of the child carotid IMT measure. RESULTS The average mean and maximum child carotid IMT were 0.50 mm (SD 0.06) and 0.58 mm (SD 0.05), respectively. In adults, average mean and maximum carotid IMT were 0.57 mm (SD 0.07) and 0.66 mm (SD 0.10), respectively. Mother-child correlations for mean and maximum carotid IMT were 0.12 (95% CI 0.05 to 0.23) and 0.10 (95% CI 0.03 to 0.21), respectively. For carotid artery distensibility and elasticity, mother-child correlations were 0.19 (95% CI 0.10 to 0.25) and 0.11 (95% CI 0.02 to 0.18), respectively. There was no strong evidence of father-child correlation in any measure. CONCLUSIONS We provide Australian values for carotid vascular measures and report a modest mother-child concordance. Both genetic and environmental exposures are likely to contribute to carotid IMT.
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Affiliation(s)
- Richard S Liu
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Sophie Dunn
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Emergency Department, Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Katherine Lange
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Denise Becker
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Greta Goldsmith
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - John B Carlin
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Melissa Wake
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics and the Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - David P Burgner
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
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Larkins NG, Kim S, Carlin JB, Grobler AC, Burgner DP, Lange K, Craig JC, Wake M. Albuminuria: population epidemiology and concordance in Australian children aged 11-12 years and their parents. BMJ Open 2019; 9:75-84. [PMID: 31273018 PMCID: PMC6624040 DOI: 10.1136/bmjopen-2017-020262] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES To describe the distribution of albuminuria among Australian children aged 11-12 years and their parents, and assess its intergenerational concordance within parent-child dyads. DESIGN Population-based cross-sectional study (the Child Health CheckPoint), nested within the Longitudinal Study of Australian Children. SETTING Assessment centres (seven Australian cities and eight regional towns) and home visits across Australia, February 2015 to March 2016. PARTICIPANTS Of all participating CheckPoint families (n=1874), 1557 children (46.2% girls) and 1454 parents (85.5% mothers) provided random urine samples at the visit; samples from menstruating females were excluded. OUTCOME MEASURES Urine albumin-to-creatinine ratio (ACR) and its components (urine albumin and creatinine concentration); albuminuria was defined as an ACR ≥3.4 mg/mmol. Pearson's correlation coefficients and multivariable linear regression models assessed parent-child concordance, using log-transformed data due to skewing. Survey weights and methods were applied to account for the complex sample design. RESULTS The median ACR for children was 1.03 mg/mmol (IQR 0.65-1.97) and 1.01 mg/mmol (IQR 0.60-2.09) for adults. The median ACR was higher in girls (1.20, IQR 0.71-2.65) than boys (0.90, IQR 0.61-1.65) and in mothers (1.13, IQR 0.63-2.33) than fathers (0.66, IQR 0.41-1.05). Albuminuria was detected in 15.1% of children (girls 20.8%, boys 10.1%) and 13.5% of adults (15.1% mothers, 4.0% fathers) had albuminuria. There was a small correlation between parent and child ACR (Pearson correlation coefficient 0.06, 95% CI 0.01 to 0.12). CONCLUSIONS Albuminuria is common among Australian children and adults, which is of concern because it predicts risk for kidney and cardiovascular disease, and mortality. The weak concordance among intergenerational pairs for urine ACR suggests either that genetic heritability is low or that it becomes evident only at later offspring life stages.
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Affiliation(s)
- Nicholas G Larkins
- Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Department of Nephrology, Perth Children’s Hospital, Nedlands, Western Australia, Australia
| | - Siah Kim
- Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
- School of Women’s and Children’s Health, University of New South Wales, Sydney, New South Wales, Australia
| | - John B Carlin
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - David P Burgner
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Katherine Lange
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Jonathan C Craig
- Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
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Abstract
OBJECTIVES To describe the epidemiology and parent-child concordance of objectively measured physical activity in a population-based sample of Australian parent-child dyads. DESIGN Cross-sectional study (Child Health CheckPoint) nested within the Longitudinal Study of Australian Children. SETTING Assessment centres in seven Australian cities and eight regional towns or home visits; February 2015-March 2016. PARTICIPANTS Of all CheckPoint families (n=1874), 1261 children (50% girls) and 1358 parent (88% mothers) provided objectively measured activity data, comprising 1077 parent-child dyads. OUTCOME MEASURES Activity behaviour was assessed by GENEActiv accelerometer. Duration of moderate-to-vigorous physical activity (MVPA) and vigorous physical activity and sedentary behaviour (SB) were derived using Cobra custom software, along with MVPA/SB fragmentation and mean daily activity. Pearson's correlation coefficients and linear regression estimated parent-child concordance. Survey weights and methods accounted for the complex sample design and clustering. RESULTS Although parents had average lower accelerometry counts than children (mean [SD] 209 [46] vs 284 [71] g.min), 93% of parents met MVPA daily duration guidelines on published cutpoints (mean [SD] 125 [63] min/day MVPA), compared with only 15% of children (mean 32 [27] min). Parents showed less daily SB duration (parents: 540 [101], children: 681 [69] minutes) and less fragmented accumulation of MVPA (parents: α=1.85, children: α=2.00). Parent-child correlation coefficients were 0.16 (95% CI 0.11 to 0.22) for MVPA duration, 0.10 (95% CI 0.04 to 0.16) for MVPA fragmentation, 0.16 (95% CI 0.11 to 0.22) for SB duration and 0.18 (95% CI 0.12 to 0.23) for SB fragmentation. CONCLUSIONS Standardised cutpoints are needed for objective activity measures to inform activity guidelines across the lifecourse. This may reflect large amounts of time in non-shared environments (school and work).
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Affiliation(s)
- François Fraysse
- Sansom Institute, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Josh Muller
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Timothy Olds
- Sansom Institute, Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
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Abstract
OBJECTIVES 'Growing Up in Australia: The Longitudinal Study of Australian Children' (LSAC) is Australia's only nationally representative children's longitudinal study, focusing on social, economic, physical and cultural impacts on health, learning, social and cognitive development. LSAC's first decade collected wide-ranging repeated psychosocial and administrative data; here, we describe the Child Health CheckPoint, LSAC's dedicated biophysical module. DESIGN, SETTING AND PARTICIPANTS LSAC recruited a cross-sequential sample of 5107 infants aged 0-1 year and a sample of 4983 children aged 4-5 years in 2004, since completing seven biennial visits. CheckPoint was a cross-sectional wave that travelled Australia in 2015-2016 to reach LSAC's younger cohort at ages 11-12 years between LSAC waves 6 and 7. Parent-child pairs participated in comprehensive assessments at 15 Assessment Centres nationwide or, if unable to attend, a shorter home visit. MEASURES CheckPoint's intergenerational, multidimensional measures were prioritised to show meaningful variation within normal ranges and capture non-communicable disease (NCD) phenotype precursors. These included anthropometry, physical activity, fitness, time use, vision, hearing, and cardiovascular, respiratory and bone health. Biospecimens included blood, saliva, buccal swabs (also from second parent), urine, hair and toenails. The epidemiology and parent-child concordance of many measures are described in separate papers. RESULTS 1874 (54% of eligible) parent-child pairs and 1051 second parents participated. Participants' geographical distribution mirrored the broader Australian population; however, mean socioeconomic position and parental education were higher and fewer reported non-English-speaking or Indigenous backgrounds. Application of survey weights partially mitigates that the achieved sample is less population representative than previous waves of LSAC due to non-random attrition. Completeness was uniformly high for phenotypic data (>92% of eligible), biospecimens (74%-97%) and consent (genetic analyses 98%, accessing neonatal blood spots 97%, sharing 96%). CONCLUSIONS CheckPoint enriches LSAC to study how NCDs develop at the molecular and phenotypic levels before overt disease emerges, and clarify the underlying dimensionality of health in childhood and mid-adulthood.
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Affiliation(s)
- Susan A Clifford
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Sarah Davies
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
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Abstract
OBJECTIVES Snack foods-typically high in salt, sugar, fat and/or energy-are likely important to the obesity epidemic. In the context of a population-based health assessment involving parent-child dyads at child age 11-12 years, we report cross-generational concordance in intake at a controlled snack food observation. DESIGN Cross-sectional study (Child Health CheckPoint), nested within the Longitudinal Study of Australian Children. SETTING Assessment centres in seven Australian cities, February 2015-March 2016. PARTICIPANTS Of all participating CheckPoint families (n=1874), 1299 children (50.3% girls) and 1274 parents (85.9% mothers) with snack data were included. Survey weights and methods were applied to account for the clustered multistage sample design. OUTCOME MEASURES Partway through the 3.5-hour assessment, parents and children attended Food Stop separately for a timed 15 min 'snack break'. One of four standardised box size/content combinations was randomly provided to all participants on any given day. Total food mass, energy, nutrients and sodium consumed was measured to the nearest 1 g. Pearson's correlation coefficients and adjusted multivariable linear regression models assessed parent-child concordance in each variable. RESULTS Children consumed less grams (151 g [SD 80] vs 165 g [SD 79]) but more energy (1393 kJ [SD 537] vs 1290 kJ [SD 658]) than parents. Parent-child concordance coefficients were small, ranging from 0.07 for sodium intake to 0.17 for carbohydrate intake. Compared with children with parents' energy intake on the 10th centile, children whose parents were on the 90th centile ate on average 227 kJ more. If extrapolated to one similar unsupervised snack on a daily basis, this equates to an additional 83 050 kJ per year, which could have a cumulative impact on additional body fat. CONCLUSIONS Although modest at an individual level, this measured parent-child concordance in unsupervised daily snack situations could account for substantial annual population differences in energy, fat and sodium intake for children aged 11-12 years. TRIAL REGISTRATION NUMBER ISRCTN12538380.
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Affiliation(s)
- Prudence Vivarini
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Jessica A Kerr
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Susan A Clifford
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Pauline W Jansen
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University, Rotterdam, The Netherlands
| | - Fiona K Mensah
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Louise A Baur
- Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kay Gibbons
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Institute of Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and Liggins Institute, University of Auckland, Auckland, New Zealand
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Abstract
OBJECTIVES To describe the distribution of health-related quality of life (HRQL) in a national sample of Australian children aged 11-12 years and their parents, and examine associations within parent-child dyads. DESIGN The Child Health CheckPoint, a population-based cross-sectional study nested between waves 6 and 7 of the Longitudinal Study of Australian Children (LSAC). SETTING Assessment centres in seven Australian cities and eight regional towns, or home visit; February 2015 to March 2016. PARTICIPANTS Of all participating CheckPoint families (n=1874), 1853 children (49.0% girls) and 1863 parents (87.7% mothers) with HRQL data were included (1786 pairs). OUTCOME MEASURES HRQL was self-reported using preference-based (Child Health Utility 9Dimension, CHU9D) and non-preference-based (Pediatric Quality of Life, PedsQL V.4.0) measures for children and preference-based measures for parents (CHU9D; Assessment of Quality of Life 8 Dimension, AQoL-8D). Utility scores from preference-based measures were calculated using existing Australian algorithms to present a score on a 0-1 scale, where 1 represents full health. Parent-child concordance was assessed using Pearson's correlation coefficients and adjusted linear regression models. Survey weights and methods were applied to account for LSAC's complex sample design, stratification and clustering within postcodes. RESULTS Children's means and SD were 0.81 (SD 0.16) for CHU9D and 78.3 (SD 13.03) for PedsQL. In adults, mean HRQL for AQoL-8D and CHU9D were 0.78 (SD 0.16) and 0.89 (SD 0.10), respectively. Mean HRQL was similar for boys and girls, but slightly higher for fathers than mothers. The Pearson correlation coefficient for parent-child CHU9D values was 0.13 (95% CI 0.09 to 0.18). Percentiles and concordance are presented for both samples for males and females separately and together. CONCLUSIONS We provide Australian paediatric population values for HRQL measures, and the first national CHU9D values for mid-life adults. At age 11-12 years in this relatively healthy sample, parent-child concordance in HRQL was small.
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Affiliation(s)
- Max Catchpool
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Lisa Gold
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Susan A Clifford
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and the Liggins Institute, The University of Auckland, Auckland, New Zealand
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Nguyen MT, Lycett K, Vryer R, Burgner DP, Ranganathan S, Grobler AC, Wake M, Saffery R. Telomere length: population epidemiology and concordance in Australian children aged 11-12 years and their parents. BMJ Open 2019; 9:118-126. [PMID: 31273022 PMCID: PMC6624044 DOI: 10.1136/bmjopen-2017-020263] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To (1) describe the epidemiology of child and adult telomere length, and (2) investigate parent-child telomere length concordance. DESIGN Population-based cross-sectional study within the Longitudinal Study of Australian Children. SETTING Assessment centres in seven major Australian cities and eight selected regional towns; February 2015 to March 2016. PARTICIPANTS Of 1874 participating families, telomere data were available for analysis for 1206 children and 1343 parents, of whom 1143 were parent-child pairs. There were 589 boys and 617 girls; 175 fathers and 1168 mothers. OUTCOME MEASURES Relative telomere length (T/S ratio), calculated by comparing telomeric DNA (T) level with the single copy (S) beta-globin gene in venous blood-derived genomic DNA by quantitative real-time PCR. RESULTS Mean T/S ratio for all children, boys and girls was 1.09 (SD 0.56), 1.05 (SD 0.53) and 1.13 (SD 0.59), respectively. Mean T/S ratio for all parents, fathers and mothers was 0.81 (SD 0.37), 0.82 (SD 0.36) and 0.81 (SD 0.38), respectively. Parent-child T/S ratio concordance was moderate (correlation 0.24). In adjusted regression models, one unit higher parent T/S ratio was associated with 0.36 (estimated linear regression coefficient (β); 95% CI 0.28 to 0.45) higher child T/S ratio. Concordance was higher in the youngest parent-age tertile (β 0.49; 95% CI 0.34 to 0.64) compared with the middle (β 0.35; 95% CI 0.21 to 0.48) and oldest tertile (β 0.26; 95% CI 0.11 to 0.41; p-trend 0.04). Father-child concordance was 0.34 (95% CI 0.18 to 0.48), while mother-child was 0.22 (95% CI 0.17 to 0.28). CONCLUSIONS We provide telomere length population values for children aged 11-12 years and their mid-life parents. Relative telomere length was shorter in adults than children, as expected. There was modest evidence of parent-child concordance, which diminished with increasing parent age.
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Affiliation(s)
- Minh Thien Nguyen
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kate Lycett
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Regan Vryer
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - David P Burgner
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Sarath Ranganathan
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Respiratory Medicine, Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Melissa Wake
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, University of Auckland, Auckland, Grafton, New Zealand
| | - Richard Saffery
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
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Hoq M, Karlaftis V, Mathews S, Burgess J, Donath SM, Carlin J, Monagle P, Ignjatovic V. A prospective, cross-sectional study to establish age-specific reference intervals for neonates and children in the setting of clinical biochemistry, immunology and haematology: the HAPPI Kids study protocol. BMJ Open 2019; 9:e025897. [PMID: 30948591 PMCID: PMC6500200 DOI: 10.1136/bmjopen-2018-025897] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION The clinical interpretation of laboratory tests is reliant on reference intervals. However, the accuracy of a reference interval is dependent on the selected reference population, and in paediatrics, the ability of the reference interval to reflect changes associated with growth and age, as well as sex and ethnicity. Differences in reagent formulations, methodologies and analysers can also impact on a reference interval. To date, no direct comparison of reference intervals for common analytes using different analysers in children has been published. The Harmonising Age Pathology Parameters in Kids (HAPPI Kids) study aims to establish age-appropriate reference intervals for commonly used analytes in the routine clinical care of neonates and children, and to determine the feasibility of paediatric reference interval harmonisation by comparing age-appropriate reference intervals in different analysers for multiple analytes. METHODS AND ANALYSIS The HAPPI Kids study is a prospective cross-sectional study, collecting paediatric blood samples for analysis of commonly requested biochemical, immunological and haematological tests. Venous blood samples are collected from healthy premature neonates (32-36 weeks of gestation), term neonates (from birth to a maximum of 72 hours postbirth) and children aged 30 days to ≤18 years (undergoing minor day surgical procedures). Blood samples are processed according to standard laboratory procedures and, if not processed immediately, stored at -80°C. A minimum of 20 samples is analysed for every analyte for neonates and then each year of age until 18 years. Analytical testing is performed according to the standard operating procedures used for clinical samples. Where possible, sample aliquots from the same patients are analysed for an analyte across multiple commercially available analysers. ETHICS AND DISSEMINATION The study protocol was approved by The Royal Children's Hospital, Melbourne, Ethics in Human Research Committee (34183 A). The study findings will be published in peer-reviewed journals and shared with clinicians, laboratory scientists and laboratories.
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Affiliation(s)
- Monsurul Hoq
- Department of Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Vicky Karlaftis
- Department of Haematology Research, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Susan Mathews
- Department of Biochemistry, Laboratory Services, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Janet Burgess
- Department of Pathology Collection, Laboratory Services, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Susan M Donath
- Department of Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - John Carlin
- Department of Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Paul Monagle
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Haematology Research, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Vera Ignjatovic
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Haematology Research, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
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