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Wuni R, Curi-Quinto K, Liu L, Espinoza D, Aquino AI, Del Valle-Mendoza J, Aguilar-Luis MA, Murray C, Nunes R, Methven L, Lovegrove JA, Penny M, Favara M, Sánchez A, Vimaleswaran KS. Interaction between genetic risk score and dietary carbohydrate intake on high-density lipoprotein cholesterol levels: Findings from the study of obesity, nutrition, genes and social factors (SONGS). Clin Nutr ESPEN 2025; 66:83-92. [PMID: 39800136 DOI: 10.1016/j.clnesp.2024.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2024] [Revised: 12/18/2024] [Accepted: 12/30/2024] [Indexed: 01/15/2025]
Abstract
BACKGROUND & AIMS Cardiometabolic traits are complex interrelated traits that result from a combination of genetic and lifestyle factors. This study aimed to assess the interaction between genetic variants and dietary macronutrient intake on cardiometabolic traits [body mass index, waist circumference, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, triacylglycerol, systolic blood pressure, diastolic blood pressure, fasting serum glucose, fasting serum insulin, and glycated haemoglobin]. METHODS This cross-sectional study consisted of 468 urban young adults aged 20 ± 1 years, and it was conducted as part of the Study of Obesity, Nutrition, Genes and Social factors (SONGS) project, a sub-study of the Young Lives study. Thirty-nine single nucleotide polymorphisms (SNPs) known to be associated with cardiometabolic traits at a genome-wide significance level (P < 5 × 10-8) were used to construct a genetic risk score (GRS). RESULTS There were no significant associations between the GRS and any of the cardiometabolic traits. However, a significant interaction was observed between the GRS and carbohydrate intake on HDL-C concentration (Pinteraction = 0.0007). In the first tertile of carbohydrate intake (≤327 g/day), participants with a high GRS (>37 risk alleles) had a higher concentration of HDL-C than those with a low GRS (≤37 risk alleles) [Beta = 0.06 mmol/L, 95 % confidence interval (CI), 0.01-0.10; P = 0.018]. In the third tertile of carbohydrate intake (>452 g/day), participants with a high GRS had a lower concentration of HDL-C than those with a low GRS (Beta = -0.04 mmol/L, 95 % CI -0.01 to -0.09; P = 0.027). A significant interaction was also observed between the GRS and glycaemic load (GL) on the concentration of HDL-C (Pinteraction = 0.002). For participants with a high GRS, there were lower concentrations of HDL-C across tertiles of GL (Ptrend = 0.017). There was no significant interaction between the GRS and glycaemic index on the concentration of HDL-C, and none of the other GRS∗macronutrient interactions were significant. CONCLUSIONS Our results suggest that young adults who consume a higher carbohydrate diet and have a higher GRS have a lower HDL-C concentration, which in turn is linked to cardiovascular diseases, and indicate that personalised nutrition strategies targeting a reduction in carbohydrate intake might be beneficial for these individuals.
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Affiliation(s)
- Ramatu Wuni
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, Reading, RG6 6DZ, UK.
| | - Katherine Curi-Quinto
- Instituto de Investigación Nutricional (IIN), Av. La Molina 1885, Lima, 15024, Peru.
| | - Litai Liu
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, Reading, RG6 6DZ, UK.
| | - Dianela Espinoza
- Group for the Analysis of Development (GRADE), Lima, 15063, Peru.
| | - Anthony I Aquino
- Instituto de Investigación Nutricional (IIN), Av. La Molina 1885, Lima, 15024, Peru
| | - Juana Del Valle-Mendoza
- Instituto de Investigación Nutricional (IIN), Av. La Molina 1885, Lima, 15024, Peru; Biomedicine Laboratory, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, 15087, Peru.
| | - Miguel Angel Aguilar-Luis
- Instituto de Investigación Nutricional (IIN), Av. La Molina 1885, Lima, 15024, Peru; Biomedicine Laboratory, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, 15087, Peru.
| | - Claudia Murray
- Department of Real Estate and Planning, University of Reading, Reading, RG6 6UD, UK.
| | - Richard Nunes
- Department of Real Estate and Planning, University of Reading, Reading, RG6 6UD, UK.
| | - Lisa Methven
- Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, Reading, RG6 6DZ, UK.
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, Reading, RG6 6DZ, UK; Institute for Food, Nutrition, and Health (IFNH), University of Reading, Reading, RG6 6AP, UK.
| | - Mary Penny
- Instituto de Investigación Nutricional (IIN), Av. La Molina 1885, Lima, 15024, Peru.
| | - Marta Favara
- Oxford Department of International Development, University of Oxford, Oxford, OX1 3TB, UK.
| | - Alan Sánchez
- Group for the Analysis of Development (GRADE), Lima, 15063, Peru; Oxford Department of International Development, University of Oxford, Oxford, OX1 3TB, UK.
| | - Karani Santhanakrishnan Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences and Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, Reading, RG6 6DZ, UK; Institute for Food, Nutrition, and Health (IFNH), University of Reading, Reading, RG6 6AP, UK.
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Haley J, Woo JG, Jacobs DR, Bazzano L, Daniels S, Dwyer T, Juonala M, Raitakari O, Sinaiko A, Steinberger J, Venn A, Whitaker KM, Urbina EM. A Clinical Tool to Relate Youth Risk Factors to Adult Cardiovascular Events and Type 2 Diabetes: The International Childhood Cardiovascular Cohort Consortium. J Pediatr 2025; 276:114277. [PMID: 39233120 DOI: 10.1016/j.jpeds.2024.114277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 08/22/2024] [Accepted: 08/26/2024] [Indexed: 09/06/2024]
Abstract
OBJECTIVE To translate data relating childhood cardiovascular (CV) risk factors and adult CV disease and type 2 diabetes mellitus (T2DM) to clinically actionable values. STUDY DESIGN This was a prospective observational study (n = 38 589) in the International Childhood Cardiovascular Cohort Consortium. Children at age 3 through 19 years were enrolled in the 1970s and 1980s and followed for more than 30 years. Five childhood CV risk factors (smoking, body mass index [BMI], systolic blood pressure, triglycerides, and total cholesterol) were related to adult CV events. Secondary analyses in a subset included low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, glucose, and insulin level. Age- and sex-specific z scores were calculated for each risk factor, and a combined-risk z score was calculated by averaging z scores for the 5 key CV risk factors. Risk factor z scores were back-transformed to natural units for clinical interpretation, with hazard ratios for adult CV events presented in color-coded tables (green: no increased risk; orange: 1.4 to <2.0-fold increased risk; red: at least doubling of risk). Risk levels for development of adult T2DM on the basis of BMI, glucose, and insulin were similarly calculated and presented. RESULTS Increased risk for CV events was observed at levels lower than currently defined abnormal clinical thresholds except for TC. Doubling of risk was observed at high normal levels just below the clinical cut point for abnormality. Risk for adult T2DM began at levels of BMI and glucose currently considered normal. CONCLUSIONS On the basis of data showing significant relationships between childhood CV risk factors and adult CV events and T2DM, this study shows that risk in childhood begins below levels currently considered normal.
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Affiliation(s)
- Jessica Haley
- Rady Children's Hospital, Pediatric Cardiology, San Diego, CA; Department of Pediatrics, University of California, San Diego, CA.
| | - Jessica G Woo
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Lydia Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Stephen Daniels
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO; Children's Hospital Colorado, Pediatric Cardiology, Aurora, CO
| | - Terry Dwyer
- The Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Heart Group, Murdoch Children's Research Institute, Melbourne, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku, Turku Finland; Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Alan Sinaiko
- Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Kara M Whitaker
- Department of Health and Human Physiology and Department of Epidemiology, University of Iowa, Iowa City, IA
| | - Elaine M Urbina
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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Meng Y, Mynard JP, Smith KJ, Juonala M, Urbina EM, Niiranen T, Daniels SR, Xi B, Magnussen CG. Pediatric Blood Pressure and Cardiovascular Health in Adulthood. Curr Hypertens Rep 2024; 26:431-450. [PMID: 38878251 PMCID: PMC11455673 DOI: 10.1007/s11906-024-01312-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2024] [Indexed: 10/06/2024]
Abstract
PURPOSE OF REVIEW This review summarizes current knowledge on blood pressure in children and adolescents (youth), with a focus on primary hypertension-the most common form of elevated blood pressure in this demographic. We examine its etiology, progression, and long-term cardiovascular implications. The review covers definitions and recommendations of blood pressure classifications, recent developments in measurement, epidemiological trends, findings from observational and clinical studies, and prevention and treatment, while identifying gaps in understanding and suggesting future research directions. RECENT FINDINGS Youth hypertension is an escalating global issue, with regional and national variations in prevalence. While the principles of blood pressure measurement have remained largely consistent, challenges in this age group include a scarcity of automated devices that have passed independent validation for accuracy and a generally limited tolerance for ambulatory blood pressure monitoring. A multifaceted interplay of factors contributes to youth hypertension, impacting long-term cardiovascular health. Recent studies, including meta-analysis and sophisticated life-course modelling, reveal an adverse link between youth and life-course blood pressure and subclinical cardiovascular outcomes later in life. New evidence now provides the strongest evidence yet linking youth blood pressure with clinical cardiovascular events in adulthood. Some clinical trials have expanded our understanding of the safety and efficacy of antihypertensive medications in youth, but this remains an area that requires additional attention, particularly regarding varied screening approaches. This review outlines the potential role of preventing and managing blood pressure in youth to reduce future cardiovascular risk. A global perspective is necessary in formulating blood pressure definitions and strategies, considering the specific needs and circumstances in low- and middle-income countries compared to high-income countries.
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Affiliation(s)
- Yaxing Meng
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia
- Baker Department of Cardiometabolic Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Jonathan P Mynard
- Heart Research Group, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, Australia
| | - Kylie J Smith
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia
- Menzies Institute for Medical Research, University of Tasmania, TAS, Hobart, Australia
| | - Markus Juonala
- Division of Medicine, Turku University Hospital, Turku, Finland
- Department of Medicine, University of Turku, Turku, Finland
| | - Elaine M Urbina
- Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Teemu Niiranen
- Department of Public Health Solutions, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Department of Internal Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Stephen R Daniels
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Costan G Magnussen
- Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
- Baker Department of Cardiometabolic Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
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Morcel J, Béghin L, Michels N, De Ruyter T, Drumez E, Cailliau E, Polito A, Le Donne C, Barnaba L, Azzini E, De Henauw S, Miguel Berges ML, Cacau LT, Moreno LA, Gottrand F. Nutritional and physical fitness parameters in adolescence impact cardiovascular health in adulthood. Clin Nutr 2024; 43:1857-1864. [PMID: 38959665 DOI: 10.1016/j.clnu.2024.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/30/2024] [Accepted: 06/21/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND & AIMS Cardiovascular diseases are the leading cause of mortality worldwide, originating in the first decades of life. A better understanding of their early determinants would allow for better prevention. This study aimed to evaluate the impact of nutritional and activity-related characteristics during adolescence on young adult cardiovascular risk factors. METHODS The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study included adolescents (aged 12.5-17.5 years) in 10 European centres. Four centres designed a nested cohort including 236 participants who were reassessed as young adults (21-32 years). Food consumption was evaluated by dietary recalls, physical activity by accelerometers, physical fitness using physical tests and nutritional knowledge by questionnaires. Cardiovascular health was assessed by Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Study risk scores and its components. Factors associated with cardiovascular risk were identified using a multivariable regression model. RESULTS Higher Diet Quality Index (DQI, P = 0.012) and nutritional knowledge (P = 0.015) were significantly associated with lower modified PDAY risk scores. Ultra-processed foods were associated with a lower non-high-density lipoprotein (non-HDL) cholesterol (P = 0.003), whereas DQI (P = 0.014) and Planetary Health Diet Index (P = 0.016) were associated with a higher HDL cholesterol. Higher DQI was also related to a lower body mass index (BMI, P = 0.006). In addition, cardiorespiratory fitness was related to a lower BMI (P = 0.004). CONCLUSIONS Nutritional knowledge, diet quality and adherence to a sustainable diet in adolescence decrease cardiovascular risk in adulthood, whereas ultra-processed food consumption increases risk. These factors appear as targeted prevention tools for promoting a healthier adolescent lifestyle to decrease long-term cardiovascular risk. CLINICAL TRIAL REGISTRY NUMBER Clinicaltrials.gov NCT02899416.
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Affiliation(s)
- Jules Morcel
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, and CIC 1403 - Clinical Investigation Center, F-59000 Lille, France.
| | - Laurent Béghin
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, and CIC 1403 - Clinical Investigation Center, F-59000 Lille, France
| | - Nathalie Michels
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Thaïs De Ruyter
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Elodie Drumez
- CHU Lille, Département de Biostatistiques, F-59000 Lille, France
| | - Emeline Cailliau
- CHU Lille, Département de Biostatistiques, F-59000 Lille, France
| | - Angela Polito
- Agricultural Research Council - Research Center on Food and Nutrition - (formerly INRAN), Rome, Italy
| | - Cinzia Le Donne
- Agricultural Research Council - Research Center on Food and Nutrition - (formerly INRAN), Rome, Italy
| | - Lorenzo Barnaba
- Agricultural Research Council - Research Center on Food and Nutrition - (formerly INRAN), Rome, Italy
| | - Elena Azzini
- Agricultural Research Council - Research Center on Food and Nutrition - (formerly INRAN), Rome, Italy
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Maria Luisa Miguel Berges
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Escuela Universitaria de Ciencas de la Salud, Universidad de Zaragoza, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Leandro Teixeira Cacau
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, 01246-904, Brazil
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Escuela Universitaria de Ciencas de la Salud, Universidad de Zaragoza, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, and CIC 1403 - Clinical Investigation Center, F-59000 Lille, France
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Long J, Huang H, Tang P, Liang J, Liao Q, Chen J, Pang L, Yang K, Wei H, Chen M, Wu X, Huang D, Pan D, Liu S, Zeng X, Qiu X. Associations between maternal exposure to multiple metals and metalloids and blood pressure in preschool children: A mixture-based approach. J Trace Elem Med Biol 2024; 84:127460. [PMID: 38703538 DOI: 10.1016/j.jtemb.2024.127460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/23/2024] [Accepted: 04/16/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Exposure to metals during pregnancy can potentially influence blood pressure (BP) in children, but few studies have examined the mixed effects of prenatal metal exposure on childhood BP. We aimed to assess the individual and combined effects of prenatal metal and metalloid exposure on BP in preschool children. METHODS A total of 217 mother-child pairs were selected from the Zhuang Birth Cohort in Guangxi, China. The maternal plasma concentrations of 20 metals [e.g. lead (Pb), rubidium (Rb), cesium (Cs), and zinc (Zn)] in early pregnancy were measured by inductively coupled plasmamass spectrometry. Childhood BP was measured in August 2021. The effects of prenatal metal exposure on childhood BP were explored by generalized linear models, restricted cubic spline and Bayesian kernel machine regression (BKMR) models. RESULTS In total children, each unit increase in the log10-transformed maternal Rb concentration was associated with a 10.82-mmHg decrease (95% CI: -19.40, -2.24) in childhood diastolic BP (DBP), and each unit increase in the log10-transformed maternal Cs and Zn concentrations was associated with a 9.67-mmHg (95% CI: -16.72, -2.61) and 4.37-mmHg (95% CI: -8.68, -0.062) decrease in childhood pulse pressure (PP), respectively. The log10-transformed Rb and Cs concentrations were linearly related to DBP (P nonlinear=0.603) and PP (P nonlinear=0.962), respectively. Furthermore, an inverse association was observed between the log10-transformed Cs concentration and PP (β =-12.18; 95% CI: -22.82, -1.54) in girls, and between the log10-transformed Rb concentration and DBP (β =-12.54; 95% CI: -23.87, -1.21) in boys, while there was an increasing association between the log10-transformed Pb concentration and DBP there was an increasing in boys (β =6.06; 95% CI: 0.36, 11.77). Additionally, a U-shaped relationship was observed between the log10-transformed Pb concentration and SBP (P nonlinear=0.015) and DBP (P nonlinear=0.041) in boys. Although there was no statistically signiffcant difference, there was an inverse trend in the combined effect of maternal metal mixture exposure on childhood BP among both the total children and girls in BKMR. CONCLUSIONS Prenatal exposure to both individual and mixtures of metals and metalloids influences BP in preschool children, potentially leading to nonlinear and sex-specific effects.
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Affiliation(s)
- Jinghua Long
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China; Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Huishen Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Peng Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Jun Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Qian Liao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Jiehua Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Lixiang Pang
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Kaiqi Yang
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Huanni Wei
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Manlin Chen
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Xiaolin Wu
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Dongping Huang
- Department of Sanitary Chemistry, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Dongxiang Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Shun Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Xiaoyun Zeng
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Xiaoqiang Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China.
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Song Y, Wade H, Zhang B, Xu W, Wu R, Li S, Su Q. Polymorphisms of Fat Mass and Obesity-Associated Gene in the Pathogenesis of Child and Adolescent Metabolic Syndrome. Nutrients 2023; 15:2643. [PMID: 37375547 DOI: 10.3390/nu15122643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 06/29/2023] Open
Abstract
Childhood metabolic syndrome (MetS) is prevalent around the world and is associated with a high likelihood of suffering from severe diseases such as cardiovascular disease later in adulthood. MetS is associated with genetic susceptibility that involves gene polymorphisms. The fat mass and obesity-associated gene (FTO) encodes an RNA N6-methyladenosine demethylase that regulates RNA stability and molecular functions. Human FTO contains genetic variants that significantly contribute to the early onset of MetS in children and adolescents. Emerging evidence has also uncovered that FTO polymorphisms in intron 1, such as rs9939609 and rs9930506 polymorphisms, are significantly associated with the development of MetS in children and adolescents. Mechanistic studies reported that FTO polymorphisms lead to aberrant expressions of FTO and the adjacent genes that promote adipogenesis and appetite and reduce steatolysis, satiety, and energy expenditure in the carriers. The present review highlights the recent observations on the key FTO polymorphisms that are associated with child and adolescent MetS with an exploration of the molecular mechanisms underlying the development of increased waist circumference, hypertension, and hyperlipidemia in child and adolescent MetS.
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Affiliation(s)
- Yongyan Song
- Central Laboratory, Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu 610106, China
| | - Henry Wade
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast BT9 5DL, UK
| | - Bingrui Zhang
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast BT9 5DL, UK
| | - Wenhao Xu
- Clinical Medical College, Chengdu University, Chengdu 610106, China
| | - Rongxue Wu
- Section of Cardiology, Department of Medicine, Biological Sciences Division, University of Chicago, Chicago, IL 60637, USA
| | - Shujin Li
- Central Laboratory, Clinical Medical College & Affiliated Hospital of Chengdu University, Chengdu 610106, China
| | - Qiaozhu Su
- Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast BT9 5DL, UK
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Dollar JM, Perry NB, Calkins SD, Shanahan L, Keane SP, Shriver L, Wideman L. Longitudinal associations between specific types of emotional reactivity and psychological, physical health, and school adjustment. Dev Psychopathol 2023; 35:509-523. [PMID: 35034683 PMCID: PMC9288564 DOI: 10.1017/s0954579421001619] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Using a multimethod, multiinformant longitudinal design, we examined associations between specific forms of positive and negative emotional reactivity at age 5, children's effortful control (EC), emotion regulation, and social skills at age 7, and adolescent functioning across psychological, academic, and physical health domains at ages 15/16 (N = 383). We examined how distinct components of childhood emotional reactivity directly and indirectly predict domain-specific forms of adolescent adjustment, thereby identifying developmental pathways between specific types of emotional reactivity and adjustment above and beyond the propensity to express other forms of emotional reactivity. Age 5 high-intensity positivity was associated with lower age 7 EC and more adolescent risk-taking; age 5 low-intensity positivity was associated with better age 7 EC and adolescent cardiovascular health, providing evidence for the heterogeneity of positive emotional reactivity. Indirect effects indicated that children's age 7 social skills partially explain several associations between age 5 fear and anger reactivity and adolescent adjustment. Moreover, age 5 anger reactivity, low-, and high-intensity positivity were associated with adolescent adjustment via age 7 EC. The findings from this interdisciplinary, long-term longitudinal study have significant implications for prevention and intervention work aiming to understand the role of emotional reactivity in the etiology of adjustment and psychopathology.
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Affiliation(s)
- Jessica M. Dollar
- Department of Kinesiology and Psychology, University of North Carolina at Greensboro
| | - Nicole B. Perry
- Department of Human Development and Family Sciences, University of Texas at Austin
| | - Susan D. Calkins
- Department of Human Development and Family Studies, University of North Carolina at Greensboro
| | - Lilly Shanahan
- Department of Psychology and Jacobs Center for Productive Youth Development, University of Zurich
| | - Susan P. Keane
- Department of Psychology, University of North Carolina at Greensboro
| | - Lenka Shriver
- Department of Nutrition, University of North Carolina at Greensboro
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina at Greensboro
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Koskinen JS, Kytö V, Juonala M, Viikari JSA, Nevalainen J, Kähönen M, Lehtimäki T, Hutri‐Kähönen N, Laitinen TP, Tossavainen P, Jokinen E, Magnussen CG, Raitakari OT. Childhood Dyslipidemia and Carotid Atherosclerotic Plaque in Adulthood: The Cardiovascular Risk in Young Finns Study. J Am Heart Assoc 2023; 12:e027586. [PMID: 36927037 PMCID: PMC10122878 DOI: 10.1161/jaha.122.027586] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/12/2023] [Indexed: 03/18/2023]
Abstract
Background Childhood exposure to dyslipidemia is associated with adult atherosclerosis, but it is unclear whether the long-term risk associated with dyslipidemia is attenuated on its resolution by adulthood. We aimed to address this question by examining the links between childhood and adult dyslipidemia on carotid atherosclerotic plaques in adulthood. Methods and Results The Cardiovascular Risk in Young Finns Study is a prospective follow-up of children that began in 1980. Since then, follow-up studies have been conducted regularly. In 2001 and 2007, carotid ultrasounds were performed on 2643 participants at the mean age of 36 years to identify carotid plaques and plaque areas. For childhood lipids, we exploited several risk factor measurements to determine the individual cumulative burden for each lipid during childhood. Participants were categorized into the following 4 groups based on their childhood and adult dyslipidemia status: no dyslipidemia (reference), incident, resolved, and persistent. Among individuals with carotid plaque, linear regression models were used to study the association of serum lipids with plaque area. The prevalence of plaque was 3.3% (N=88). In models adjusted for age, sex, and nonlipid cardiovascular risk factors, the relative risk for carotid plaque was 2.34 (95% CI, 0.91-6.00) for incident adult dyslipidemia, 3.00 (95% CI, 1.42-6.34) for dyslipidemia resolved by adulthood, and 5.23 (95% CI, 2.57-10.66) for persistent dyslipidemia. Carotid plaque area correlated with childhood total, low-density lipoprotein, and non-high-density lipoprotein cholesterol levels. Conclusions Childhood dyslipidemia, even if resolved by adulthood, is a risk factor for adult carotid plaque. Furthermore, among individuals with carotid plaque, childhood lipids associate with plaque size. These findings highlight the importance of primordial prevention of dyslipidemia in childhood to reduce atherosclerosis development.
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Affiliation(s)
- Juhani S. Koskinen
- Research Centre of Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland
- Centre for Population Health ResearchUniversity of Turku and Turku University HospitalTurkuFinland
- Division of MedicineTurku University HospitalTurkuFinland
- Department of MedicineSatakunta Central HospitalPoriFinland
| | - Ville Kytö
- Research Centre of Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland
- Centre for Population Health ResearchUniversity of Turku and Turku University HospitalTurkuFinland
- Heart CentreTurku University Hospital and University of TurkuTurkuFinland
| | - Markus Juonala
- Research Centre of Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland
- Centre for Population Health ResearchUniversity of Turku and Turku University HospitalTurkuFinland
- Division of MedicineTurku University HospitalTurkuFinland
- Department of MedicineUniversity of TurkuTurkuFinland
| | - Jorma S. A. Viikari
- Division of MedicineTurku University HospitalTurkuFinland
- Department of MedicineUniversity of TurkuTurkuFinland
| | | | - Mika Kähönen
- Department of Clinical PhysiologyTampere University HospitalTampereFinland
- Faculty of Medicine and Health Technology and Finnish Cardiovascular Research Center TampereTampere UniversityTampereFinland
| | - Terho Lehtimäki
- Faculty of Medicine and Health Technology and Finnish Cardiovascular Research Center TampereTampere UniversityTampereFinland
- Department of Clinical ChemistryFimlab LaboratoriesTampereFinland
| | - Nina Hutri‐Kähönen
- Tampere Centre for Skills Training and SimulationTampere University, Faculty of Medicine and Health TechnologyTampereFinland
| | - Tomi P. Laitinen
- Department of Clinical Physiology and Nuclear MedicineKuopio University HospitalKuopioFinland
- Institute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
| | - Päivi Tossavainen
- Department of Pediatrics and Adolescent MedicineOulu University HospitalOuluFinland
- PEDEGO Research UnitUniversity of OuluOuluFinland
| | - Eero Jokinen
- Department of PediatricsUniversity of HelsinkiFinland
- Hospital for Children and AdolescentsHelsinki University HospitalHelsinkiFinland
| | - Costan G. Magnussen
- Research Centre of Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland
- Centre for Population Health ResearchUniversity of Turku and Turku University HospitalTurkuFinland
- Baker Heart and Diabetes InstituteMelbourneVictoriaAustralia
| | - Olli T. Raitakari
- Research Centre of Applied and Preventive Cardiovascular MedicineUniversity of TurkuTurkuFinland
- Centre for Population Health ResearchUniversity of Turku and Turku University HospitalTurkuFinland
- Department of Clinical Physiology and Nuclear MedicineTurku University HospitalTurkuFinland
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9
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Raitakari O, Kartiosuo N, Pahkala K, Hutri-Kähönen N, Bazzano LA, Chen W, Urbina EM, Jacobs DR, Sinaiko A, Steinberger J, Burns T, Daniels SR, Venn A, Woo JG, Dwyer T, Juonala M, Viikari J. Lipoprotein(a) in Youth and Prediction of Major Cardiovascular Outcomes in Adulthood. Circulation 2023; 147:23-31. [PMID: 36440577 PMCID: PMC9797445 DOI: 10.1161/circulationaha.122.060667] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/17/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Elevated lipoprotein(a) [Lp(a)] is a common risk factor for cardiovascular disease outcomes with unknown mechanisms. We examined its potential role in identifying youths who are at increased risk of developing adult atherosclerotic cardiovascular disease (ASCVD). METHODS Lp(a) levels measured in youth 9 to 24 years of age were linked to adult ASCVD and carotid intima-media thickness in the YFS (Cardiovascular Risk in Young Finns Study), in which 95 of the original 3596 participants (2.7%) recruited as children have been diagnosed with ASCVD at a median of 47 years of age. Results observed in YFS were replicated with the use of data for White participants from the BHS (Bogalusa Heart Study). In BHS, 587 White individuals had data on youth Lp(a) (measured at 8-17 years of age) and information on adult events, including 15 cases and 572 noncases. Analyses were performed with the use of Cox proportional hazard regression. RESULTS In YFS, those who had been exposed to high Lp(a) level in youth [defined as Lp(a) ≥30 mg/dL] had ≈2 times greater risk of developing adult ASCVD compared with nonexposed individuals (hazard ratio, 2.0 [95% CI, 1.4-2.6]). Youth risk factors, including Lp(a), low-density lipoprotein cholesterol, body mass index, and smoking, were all independently associated with higher risk. In BHS, in an age- and sex-adjusted model, White individuals who had been exposed to high Lp(a) had 2.5 times greater risk (95% CI, 0.9-6.8) of developing adult ASCVD compared with nonexposed individuals. When also adjusted for low-density lipoprotein cholesterol and body mass index, the risk associated with high Lp(a) remained unchanged (hazard ratio, 2.4 [95% CI, 0.8-7.3]). In a multivariable model for pooled data, individuals exposed to high Lp(a) had 2.0 times greater risk (95% CI, 1.0-3.7) of developing adult ASCVD compared with nonexposed individuals. No association was detected between youth Lp(a) and adult carotid artery thickness in either cohort or pooled data. CONCLUSIONS Elevated Lp(a) level identified in youth is a risk factor for adult atherosclerotic cardiovascular outcomes but not for increased carotid intima-media thickness.
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Affiliation(s)
- Olli Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland (O.R., N.K., K.P.)
- Research Centre of Applied and Preventive Cardiovascular Medicine (O.R., N.K., K.P.), University of Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine (O.R.), Turku University Hospital, Finland
| | - Noora Kartiosuo
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland (O.R., N.K., K.P.)
- Research Centre of Applied and Preventive Cardiovascular Medicine (O.R., N.K., K.P.), University of Turku, Finland
| | - Katja Pahkala
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland (O.R., N.K., K.P.)
- Research Centre of Applied and Preventive Cardiovascular Medicine (O.R., N.K., K.P.), University of Turku, Finland
- Paavo Nurmi Centre and Unit for Health and Physical Activity (K.P.), University of Turku, Finland
| | - Nina Hutri-Kähönen
- Tampere Centre for Skills Training and Simulation, Tampere University, Finland (N.H.-K.)
| | - Lydia A Bazzano
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.A.B., W.C.)
| | - Wei Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.A.B., W.C.)
| | - Elaine M Urbina
- Department of Pediatrics, University of Cincinnati College of Medicine, OH (E.M.U., J.G.W.)
- The Heart Institute (E.M.U.), Cincinnati Children's Hospital Medical Center, OH
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (D.R.J.)
| | - Alan Sinaiko
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis (A.S., J.S.)
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis (A.S., J.S.)
| | - Trudy Burns
- Department of Medicine (M.J., J.V.), University of Turku, Finland
| | - Stephen R Daniels
- Department of Pediatrics, University of Colorado School of Medicine, Aurora (S.R.D.)
- Children's Hospital Colorado, Anschutz Medical Campus, Aurora (S.R.D.)
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (A.V., T.D.)
| | - Jessica G Woo
- Department of Pediatrics, University of Cincinnati College of Medicine, OH (E.M.U., J.G.W.)
- Division of Biostatistics and Epidemiology (J.G.W.), Cincinnati Children's Hospital Medical Center, OH
| | - Terry Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (A.V., T.D.)
- Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia (T.D.)
- Nuffield Department of Women's & Reproductive Health, University of Oxford, United Kingdom (T.D.)
| | - Markus Juonala
- Department of Medicine (M.J., J.V.), University of Turku, Finland
- Division of Medicine (M.J., J.V.), Turku University Hospital, Finland
| | - Jorma Viikari
- Department of Medicine (M.J., J.V.), University of Turku, Finland
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Razavi AC, Mortensen MB, Blaha MJ, Dzaye O. Coronary artery calcium testing in young adults. Curr Opin Cardiol 2023; 38:32-38. [PMID: 36598447 PMCID: PMC9830553 DOI: 10.1097/hco.0000000000001006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE OF REVIEW To provide a summary of recent literature on coronary artery calcium testing (CAC) for risk stratification in young adults <45 years old. RECENT FINDINGS One of every ten young adults in the general population, and one out of every three young adults with traditional atherosclerotic cardiovascular disease (ASCVD) risk factors, have CAC. While the definition of premature CAC has yet to be formally defined in guidelines, it has become increasingly clear that any prevalent CAC among adults <45 years old should be considered premature. Traditional risk factors are strong predictors of CAC in young adults; however, this association has been found to wane over the life course which suggests that the onset and severity of risk factors for calcific atherosclerosis varies as individuals age. Though CAC is a robust predictor of both ASCVD and cancer-related mortality in old age, CAC in young adults confers a stepwise higher risk uniquely for incident ASCVD mortality, and not for non-ASCVD causes. New tools are available to assist in interpretation of CAC in the young, and for estimating the ideal age to initiate CAC scoring. SUMMARY The identification of premature CAC is important because it suggests that calcific plaque can be detected with modern imaging earlier in the natural history than previously thought. Taken together, these findings underline a utility of selective use of CAC scoring on non-contrast computed tomography among at-risk young adults to facilitate timely lifestyle modification and pharmacotherapies for the prevention of later life ASCVD.
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Affiliation(s)
- Alexander C. Razavi
- Center for Heart Disease Prevention, Emory University Hospital, Atlanta, Georgia, United States of America
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Hospital, Baltimore, Maryland, United States of America
| | | | - Michael J. Blaha
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Hospital, Baltimore, Maryland, United States of America
| | - Omar Dzaye
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Hospital, Baltimore, Maryland, United States of America
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Yim G, Reynaga L, Nunez V, Howe CG, Romano ME, Chen Y, Karagas MR, Toledo-Corral C, Farzan SF. Perinatal Metal and Metalloid Exposures and Offspring Cardiovascular Health Risk. Curr Environ Health Rep 2022; 9:714-734. [PMID: 35980568 PMCID: PMC11559654 DOI: 10.1007/s40572-022-00377-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW Toxic metal exposures have been associated with cardiovascular disease in adults and growing evidence suggests metal exposures also adversely affect cardiovascular phenotypes in childhood and adolescence. However, to our knowledge, the influence of perinatal metals exposure, particularly metal mixtures, in relation to cardiovascular-related outcomes have not been comprehensively reviewed. RECENT FINDINGS We summarized 17 contemporary studies (2017-2021) that investigated the impact of perinatal metal exposures on measures of cardiovascular health in children. Accumulating evidence supports a potential adverse impact of perinatal Pb exposure on BP in children. Fewer recent studies have focused on perinatal As, Hg, and Cd; thus, the cardiovascular impacts of these metals are less clear. Studies of metal mixtures demonstrate that interactions between metals may be complex and have identified numerous understudied elements and essential metals, including Mo, Co, Ni, Se, Zn, and Mn, which may influence cardiovascular risk. A key question that remains is whether perinatal metals exposure influences cardiovascular health into adulthood. Comparisons across studies remain challenging due to several factors, including differences in the timing of exposure/outcome assessments and exposure biomarkers, as well as variability in exposure levels and mixture compositions across populations. Future studies longitudinally investigating trajectories of cardiovascular outcomes could help determine the influence of perinatal metals exposure on long-term effects of clinical relevance in later life and whether interventions, which reduce metals exposures during this key developmental window, could alter disease development.
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Affiliation(s)
- Gyeyoon Yim
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Lorena Reynaga
- Department of Health Sciences, California State University at Northridge, Northridge, CA, USA
| | - Velia Nunez
- Department of Health Sciences, California State University at Northridge, Northridge, CA, USA
| | - Caitlin G Howe
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Megan E Romano
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Yu Chen
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Claudia Toledo-Corral
- Department of Health Sciences, California State University at Northridge, Northridge, CA, USA
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto Street, Los Angeles, CA, 90032, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto Street, Los Angeles, CA, 90032, USA.
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12
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Zeng H, Wang Q, Wang H, Guo L, Fang B, Zhang L, Wang X, Wang Q, Yang W, Wang M. Exposure to barium and blood pressure in children and adolescents: results from the 2003-2018 National Health and Nutrition Examination Survey. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:68476-68487. [PMID: 35538347 DOI: 10.1007/s11356-022-20507-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/25/2022] [Indexed: 06/14/2023]
Abstract
Barium (Ba) is ubiquitous in the environment, and humans are primarily exposed to it through ingestion of drinking water. Previous studies focused on the exposure to lead, cadmium, and arsenic, but have not focused on exposure to Ba. Recent studies found a significant association between Ba exposure and elevated blood pressure in pregnant women and adults. However, there are no studies regarding the effect of Ba exposure on blood pressure in children and adolescents, and the potential biological mechanisms remain unclear. We evaluated the associations between urinary Ba and systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) among 8- to 17-year-old participants (n = 3707) of the 2003-2018 National Health and Nutrition Examination Survey. Furthermore, the potential roles of inflammation in these associations were explored. Weighted linear regression was used to analyze the association between urinary Ba and blood pressure, and mediation analyses were used to estimate the potential role of white blood cell count (WBC) in these associations. Quantile g-computation models were used to explore the effect of co-exposure to Ba and other metals on blood pressure. After adjusting for covariates, a two-fold increase in urinary Ba concentration was associated with a 0.41 (95% CI 0.12, 0.70) mmHg increase in SBP, a 1.04 (95% CI 0.55, 1.53) mmHg increase in PP, but a -0.63 (95% CI -1.04, -0.22) mmHg decrease in DBP. WBC significantly mediated 6% of the association between urinary Ba and SBP. Quantile g-computation models suggested that urinary Ba was the main contributor to the elevation of SBP and PP in the urinary metal mixture. Our findings revealed that exposure to Ba was associated with elevated SBP and PP among children and adolescents. Inflammation may play an important role in the associations of Ba exposure with SBP.
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Affiliation(s)
- Hao Zeng
- School of Public Health, North China University of Science and Technology, No.21 Bohai Road, Caofeidian, Tangshan, 063210, Hebei, China
| | - Qiong Wang
- Heart Diagnosis and Treatment Center, The First People's Hospital of Yinchuan, No.2 Liqun West Street, Ningxia, 750001, Yinchuan, China
| | - Haotian Wang
- School of Public Health, North China University of Science and Technology, No.21 Bohai Road, Caofeidian, Tangshan, 063210, Hebei, China
| | - Linan Guo
- School of Public Health, North China University of Science and Technology, No.21 Bohai Road, Caofeidian, Tangshan, 063210, Hebei, China
| | - Bo Fang
- School of Public Health, North China University of Science and Technology, No.21 Bohai Road, Caofeidian, Tangshan, 063210, Hebei, China
- Affiliated Huaihe Hospital, Henan University, 115 Ximen Street, Kaifeng, 475000, Henan, China
| | - Lei Zhang
- School of Public Health, North China University of Science and Technology, No.21 Bohai Road, Caofeidian, Tangshan, 063210, Hebei, China
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, China
| | - Xuesheng Wang
- School of Public Health, North China University of Science and Technology, No.21 Bohai Road, Caofeidian, Tangshan, 063210, Hebei, China
- Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Qian Wang
- School of Public Health, North China University of Science and Technology, No.21 Bohai Road, Caofeidian, Tangshan, 063210, Hebei, China.
- Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China.
| | - Wenqi Yang
- Affiliated Hospital, North China University of Science and Technology, Tangshan, 063000, China
| | - Manman Wang
- School of Public Health, North China University of Science and Technology, No.21 Bohai Road, Caofeidian, Tangshan, 063210, Hebei, China
- Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
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13
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14
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Identification of Lifestyle Risk Factors in Adolescence Influencing Cardiovascular Health in Young Adults: The BELINDA Study. Nutrients 2022; 14:nu14102089. [PMID: 35631230 PMCID: PMC9146351 DOI: 10.3390/nu14102089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 12/03/2022] Open
Abstract
Cardiovascular diseases are the leading cause of mortality worldwide. These diseases originate in childhood, and a better understanding of their early determinants and risk factors would allow better prevention. The BELINDA (BEtter LIfe by Nutrition During Adulthood) study is a 10−14-year follow-up of the HEalthy Lifestyle in Europe by Nutrition in Adolescence study (the HELENA study, a European cross-sectional study in adolescents). The study aims to evaluate cardiovascular risk using the PDAY (Pathobiological Determinants of Atherosclerosis in Youth) risk score during young adulthood (21−32 years), and to examine the impact of risk factors identified during adolescence (12.5−17.5 years). Our secondary objective is to compare the characteristics of the BELINDA study population with the HELENA population not participating in the follow-up study. The HELENA study recruited 3528 adolescents during 2006−2007 and reassessed 232 of them 10−14 years later as young adults. We assessed clinical status, anthropometry, nutrition, physical activity (including sedentary behavior), physical fitness, and mental health parameters, and collected biological samples (blood, stool, and hair). Dietary intake, and physical activity and fitness data were also collected. A multivariable linear regression model will be used for the analysis of the primary outcome. A Chi-square and T-test were conducted for the comparison of the descriptive data (gender, age, weight, height, body mass index (BMI), and maternal school level) between participating and non-participating BELINDA adolescents. When comparing the 1327 eligible subjects with the 232 included in the BELINDA study, no significant differences regarding gender (p = 0.72), age (p = 0.60), height (p = 0.11), and weight (p = 0.083) at adolescence were found. However, the participating population had a lower BMI (20.4 ± 3.1 kg/m2 versus 21.2 ± 3.6 kg/m2; p < 0.001) and a higher maternal educational level (46.8% high school or university level versus 38.6%; p = 0.027) than the HELENA population who did not participate in the BELINDA study. The complete phenotyping obtained at adolescence through the HELENA study is a unique opportunity to identify adolescent risk factors for cardiovascular diseases. This paper will serve as a methodological basis for future analysis of this study.
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Dollar JM, Calkins SD, Shriver L, Keane SP, Shanahan L, Wideman L. Emerging self-regulatory skills in childhood predict cardiometabolic risk in adolescence. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 7. [PMID: 35509493 PMCID: PMC9063855 DOI: 10.1016/j.cpnec.2021.100070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Cardiometabolic risk (CMR) has increased among adolescents. A growing literature shows that childhood self-regulatory skills are associated with obesity and CMR. However, the developmental nature of self-regulation has not been considered in existing studies. Therefore, it is unclear how specific types of self-regulation (i.e., attentional, emotional, behavioral, cognitive) at different points in development, may differentially predict CMR. Using a multi-method longitudinal design, we assessed a sample of 117 children repeatedly between ages 2 and 16. At ages 2, 4, and 7 years, self-regulation (emotional, attentional, behavioral, and cognitive) skills that were hypothesized to have emerged were assessed. Adolescent CMR indicators were assessed at age 16. Latent profile analyses identified three profiles of adolescent CMR: Low Risk (41%), Dyslipidemia Risk (49.6%), and High Risk (9.4%). Distinct self-regulation skills at each childhood age predicted CMR during adolescence. Specifically, emotional regulation skills at ages 2 and 4, food-related behavioral regulation and attentional regulation at age 4, and attentional and cognitive regulation skills at age 7 predicted adolescent CMR. Self-regulation skills are modifiable, and thus, childhood interventions aimed at improving self-regulation could reduce CMR for decades to come. However, these results suggest that the multifaceted, developmental nature of self-regulation must be considered to most effectively inform preventive interventions aimed at lowering CMR. Additionally, our study highlights the need for additional research on adolescents who show elevations of CMR without meeting criteria for obesity.
Three person-centered profiles of cardiometabolic risk were identified. Four domains of childhood self-regulation predicted adolescent cardiometabolic risk. Research is needed on adolescents with high cardiometabolic risk without obesity. Childhood self-regulation interventions could ultimately reduce cardiometabolic risk.
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Affiliation(s)
- Jessica M. Dollar
- Departments of Human Development and Family Studies and Psychology, University of North Carolina at Greensboro, USA
- Corresponding author. The University of North Carolina at Greensboro 248 Stone Building Greensboro, NC 27402, USA.
| | - Susan D. Calkins
- Office of Research and Engagement, University of North Carolina at Greensboro, USA
| | - Lenka Shriver
- Department of Nutrition, University of North Carolina at Greensboro, USA
| | - Susan P. Keane
- Department of Psychology, University of North Carolina at Greensboro, USA
| | - Lilly Shanahan
- Department of Psychology and Jacobs Center for Productive Youth Development, University of Zurich, USA
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina at Greensboro, USA
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Kusumi K, Kremsdorf R, Kakajiwala A, Mahan JD. Pediatric Mineral and Bone Disorder of Chronic Kidney Disease and Cardiovascular Disease. Adv Chronic Kidney Dis 2022; 29:275-282. [PMID: 36084974 DOI: 10.1053/j.ackd.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 03/29/2022] [Accepted: 04/05/2022] [Indexed: 11/11/2022]
Abstract
Chronic kidney disease is common and causes significant morbidity including shortened lifespans and decrease in quality of life for patients. The major cause of mortality in chronic kidney disease is cardiovascular disease. Cardiovascular disease within the chronic kidney disease population is closely tied with disordered calcium and phosphorus metabolism and driven in part by renal bone disease. The complex nature of renal, bone, and cardiovascular diseases was renamed as mineral and bone disorder of chronic kidney disease to encompass how bone disease drives vascular calcification and contributes to the development of long-term cardiovascular disease, and recent data suggest that managing bone disease well can augment and improve cardiovascular disease status. Pediatric nephrologists have additional obstacles in optimal mineral and bone disorder of chronic kidney disease management such as linear growth and skeletal maturation. In this article, we will discuss cardiovascular and bone diseases in chronic kidney disease and end-stage kidney disease patients with a focus on pediatric issues and concerns.
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Affiliation(s)
- Kirsten Kusumi
- Department of Pediatric Nephrology, Akron Children's Hospital, Akron, OH.
| | - Robin Kremsdorf
- Pediatric Nephrology and Hypertension, Hasbro Children's Hospital, Providence, RI
| | - Aadil Kakajiwala
- Departments of Pediatric Critical Care Medicine and Nephrology, Children's National Hospital, Washington, DC
| | - John D Mahan
- Division of Nephrology and Hypertension at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH
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17
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Oh E, Choi KH, Kim SR, Kwon HJ, Bae S. Association of indoor and outdoor short-term PM2.5 exposure with blood pressure among school children. INDOOR AIR 2022; 32:e13013. [PMID: 35347791 DOI: 10.1111/ina.13013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/10/2022] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
The association between particulate matter and children's increased blood pressure is inconsistent, and few studies have evaluated indoor exposure, accounting for time-activity. The present study aimed to examine the association between personal short-term exposure to PM2.5 and blood pressure in children. We conducted a panel study with up to three physical examinations during different seasons of 2018 (spring, summer, and fall) among 52 children. The indoor PM2.5 concentration was continuously measured at home and classroom of each child using indoor air quality monitors. The outdoor PM2.5 concentration was measured from the nearest monitoring station. We constructed a mixed effect model to analyze the association of short-term indoor and outdoor PM2.5 exposure accounting for time-activity of each participant with blood pressure. The average PM2.5 concentration was 34.3 ± 9.2 μg/m3 and it was highest in the spring. The concentration measured at homes was generally higher than that measured at outdoor monitoring station. A 10-μg/m3 increment of the up to previous 3-day mean (lag0-3) PM2.5 concentration was associated with 2.7 mmHg (95%CI = 0.8, 4.0) and 2.1 mmHg (95%CI = 0.3, 4.0) increases in systolic and diastolic blood pressure, respectively. In a panel study comprehensively evaluating both indoor and outdoor exposures, which enabled more accurate exposure assessment, we observed a statistically significant association between blood pressure and PM2.5 exposure in children.
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Affiliation(s)
- Eunjin Oh
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung-Hwa Choi
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Korea
| | - Sung Roul Kim
- Department of Environmental Health Science, Soon Chun Hyang University, Asan, Korea
| | - Ho-Jang Kwon
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Korea
| | - Sanghyuk Bae
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Environmental Health Center, The Catholic University of Korea, Seoul, Korea
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Leopold JA, Antman EM. Ideal Cardiovascular Health in Young Adults With Established Cardiovascular Diseases. Front Cardiovasc Med 2022; 9:814610. [PMID: 35252395 PMCID: PMC8893279 DOI: 10.3389/fcvm.2022.814610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
There has been an increase in the prevalence of cardiovascular diseases among young adults in the United States that has been attributed, in part, to a rise in overweight and obesity, use of combustible tobacco and unhealthy diet and exercise patterns. These factors are influenced further by socioeconomic status and other social determinants of health. In the My Research Legacy study, we examined ideal cardiovascular health in young adults aged 18– <50 years with cardiovascular disease using the Life's Simple 7 survey and data from digital health devices. Young adults with cardiovascular disease (n = 349) were older, had a lower socioeconomic status, a higher prevalence of risk factors, and lower Life's Simple 7 Health Scores (6.4 ± 1.5 vs. 7.1 ± 1.5, p < 0.01) compared to young adults without cardiovascular disease (n = 696). Analysis of digital health device data revealed that young adults with cardiovascular disease performed a similar number of weekly minutes of moderate and vigorous exercise as those without disease leading to similar ideal activity scores. Young adults with cardiovascular disease also shared similarities in modifiable risk factors with adults aged ≥50 years with cardiovascular disease (n = 217), including weight, dietary habits, and weekly minutes of exercise. Latent class analysis identified two phenogroups of young adults with cardiovascular disease: phenogroup 1 was characterized by more advantageous cardiovascular health factors and behaviors resulting in higher Life's Simple 7 Health Scores than phenogroup 2 (7.4 ± 1.2 vs. 5.5 ± 1.1, p < 0.01). These findings in young adults with cardiovascular disease may inform the design of behavioral and therapeutic interventions in the future to decrease cardiovascular morbidity and mortality.
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Abstract
Cardiovascular diseases caused by atherosclerosis do not typically manifest before middle age; however, the disease process begins early in life. Preclinical atherosclerosis can be quantified with imaging methods in healthy populations long before clinical manifestations present. Cohort studies have shown that childhood exposure to risk factors, such as dyslipidaemia, elevated blood pressure and tobacco smoking, are associated with adult preclinical atherosclerotic phenotypes. Importantly, these long-term effects are substantially reduced if the individual becomes free from the risk factor by adulthood. As participants in the cohorts continue to age and clinical end points accrue, the strongest evidence linking exposure to risk factors in early life with cardiovascular outcomes has begun to emerge. Although science has deciphered the natural course of atherosclerosis, discovered its causal risk factors and developed effective means to intervene, we are still faced with an ongoing global pandemic of atherosclerotic diseases. In general, atherosclerosis goes undetected for too long, and preventive measures, if initiated at all, are inadequate and/or come too late. In this Review, we give an overview of the available literature suggesting the importance of initiating the prevention of atherosclerosis in early life and provide a summary of the major paediatric programmes for the prevention of atherosclerotic disease. We also highlight the limitations of current knowledge and indicate areas for future research.
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20
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Saydam CD. Subclinical cardiovascular disease and utility of coronary artery calcium score. IJC HEART & VASCULATURE 2021; 37:100909. [PMID: 34825047 PMCID: PMC8604741 DOI: 10.1016/j.ijcha.2021.100909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 10/14/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022]
Abstract
ASCVD are the leading causes of mortality and morbidity among Globe. Evaluation of patients' comprehensive and personalized risk provides risk management strategies and preventive interventions to achieve gain for patients. Framingham Risk Score (FRS) and Systemic Coronary Risk Evaluation Score (SCORE) are two well studied risk scoring models, however, can miss some (20-35%) of future cardiovascular events. To obtain more accurate risk assessment recalibrating risk models through utilizing novel risk markers have been studied in last 3 decades and both ESC and AHA recommends assessing Family History, hs-CRP, CACS, ABI, and CIMT. Subclinical Cardiovascular Disease (SCVD) has been conceptually developed for investigating gradually progressing asymptomatic development of atherosclerosis and among these novel risk markers it has been well established by literature that CACS having highest improvement in risk assessment. This review study mainly selectively discussing studies with CACS measurement. A CACS = 0 can down-stratify risk of patients otherwise treated or treatment eligible before test and can reduce unnecessary interventions and cost, whereas CACS ≥ 100 is equivalent to statin treatment threshold of ≥ 7.5% risk level otherwise statin ineligible before test. Since inflammation, insulin resistance, oxidative stress, dyslipidemia and ongoing endothelial damage due to hypertension could lead to CAC, ASCVD linked with comorbidities. Recent cohort studies have shown a CACS 100-300 as a sign of increased cancer risk. Physical activity, dietary factors, cigarette use, alcohol consumption, metabolic health, family history of CHD, aging, exposures of neighborhood environment and non-cardiovascular comorbidities can determine CACs changes.
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21
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Jakubowski KP, Murray V, Stokes N, Thurston RC. Sexual violence and cardiovascular disease risk: A systematic review and meta-analysis. Maturitas 2021; 153:48-60. [PMID: 34654528 DOI: 10.1016/j.maturitas.2021.07.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/22/2021] [Accepted: 07/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is a leading cause of death among adults. Over 35% of women worldwide report lifetime exposure to sexual violence. While psychosocial factors broadly have been linked to CVD risk, it is unclear if a history of sexual violence is associated with increased risk for CVD. This study employed quantitative meta-analysis to investigate the association between sexual violence and CVD risk. METHODS PubMed and PsycINFO databases were searched through March 1, 2021. Included articles had a measure of sexual violence and at least one cardiovascular outcome (i.e., clinical CVD, subclinical CVD, select CVD risk factors) in women and men aged 18 years or older. Data were expressed as odds ratios (OR) or hazard ratios (HR) with 95% confidence intervals (CI) extracted from fully-adjusted models. OR and HR effects were pooled separately, given the inability to statistically harmonize these effects and differences in interpretation, using random effects meta-analysis. Heterogeneity of effects was tested using Cochran's Q test. RESULTS Overall, 45 articles based on 830,579 adults (77.1% women) were included (113 individual effects expressed as OR and 9 individual effects expressed as HR). Results indicated that sexual violence was related to adult CVD risk (OR [95%CI] = 1.25 [1.11-1.40]; HR [95%CI] = 1.17 [1.05-1.31]). Results varied by outcome type and measurement, and timing of violence. CONCLUSIONS Adults with a history of sexual violence demonstrate greater CVD risk relative to those without this history. The results highlight the importance of addressing sexual violence in CVD risk reduction efforts.
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Affiliation(s)
- Karen P Jakubowski
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Vanessa Murray
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Natalie Stokes
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Rebecca C Thurston
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
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22
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Climie RE, Park C, Avolio A, Mynard JP, Kruger R, Bruno RM. Vascular Ageing in Youth: A Call to Action. Heart Lung Circ 2021; 30:1613-1626. [PMID: 34275753 DOI: 10.1016/j.hlc.2021.06.516] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 12/18/2022]
Abstract
Extensive evidence shows that risk factors for cardiovascular disease (CVD) begin to develop early in life. Childhood obesity and elevated blood pressure (BP) have become overwhelmingly challenging, with 57% of today's children predicted to be obese by the age of 35 years, and global rates of hypertension in children and adolescents increasing by 75% from 2000 to 2015. Thus, there is an urgent need for tools that can assess early CVD risk in youth, which may lead to better risk stratification, preventative intervention, and personalised medicine. Vascular ageing (the deterioration in vascular structure and function) is a pivotal progenitor of health degeneration associated with elevated BP. Exposure to adverse environmental and genetic factors from fetal life promotes the development and accumulation of subclinical vascular changes that direct an individual towards a trajectory of early vascular ageing (EVA)-an independent predictor of target organ damage in the heart, brain, and kidneys. Therefore, characterising vascular ageing from youth may provide a window into cardiovascular risk later in life. However, vascular ageing measurements only have value when techniques are accurate/validated and when reliable thresholds are available for defining normal ranges and ranges that signal increased risk of disease. The aim of this paper is to summarise current evidence on the importance of vascular ageing assessment in youth and the impact of interventions to prevent or delay EVA, to highlight the need for standardisation and validation of measurement techniques in children and adolescents, and the importance of establishing reference values for vascular ageing measures in this population.
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Affiliation(s)
- R E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas, Australia; Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), Paris, France.
| | - C Park
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, UCL, London, UK
| | - A Avolio
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - J P Mynard
- Heart Research, Murdoch Children's Research Institute, Melbourne, Vic, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Vic, Australia; Department of Biomedical Engineering, University of Melbourne, Melbourne, Vic, Australia; Department of Cardiology, Royal Children's Hospital, Melbourne, Vic, Australia
| | - R Kruger
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - R-M Bruno
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), Paris, France. https://twitter.com/rosam_bruno
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23
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Armstrong MK, Fraser BJ, Hartiala O, Buscot MJ, Juonala M, Wu F, Koskinen J, Hutri-Kähönen N, Kähönen M, Laitinen TP, Lehtimäki T, Viikari JSA, Raitakari OT, Magnussen CG. Association of Non-High-Density Lipoprotein Cholesterol Measured in Adolescence, Young Adulthood, and Mid-Adulthood With Coronary Artery Calcification Measured in Mid-Adulthood. JAMA Cardiol 2021; 6:661-668. [PMID: 33502454 PMCID: PMC7841578 DOI: 10.1001/jamacardio.2020.7238] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/03/2020] [Indexed: 12/14/2022]
Abstract
Importance Elevated non-high-density lipoprotein cholesterol (non-HDL-C) is associated with the presence of coronary artery calcification (CAC), a marker of heart disease in adulthood. However, the relative importance of non-HDL-C levels at specific life stages for CAC remains unclear. Objective To identify the relative association of non-HDL-C measured at distinct life stages (adolescence, young adulthood, mid-adulthood) with the presence of CAC measured in mid-adulthood. Design, Setting, and Participants The Cardiovascular Risk in Young Finns Study is a population-based prospective cohort study that started in 1980 with follow-up over 28 years. Participants from 3 population centers (Kuopio, Tampere, and Turku in Finland) represent a convenience sample drawn from the 3 oldest cohorts at baseline (aged 12-18 years in 1980). Data were collected from September 1980 to August 2008. Analysis began February 2020. Exposures Non-HDL-C levels were measured at 3 life stages including adolescence (aged 12-18 years), young adulthood (aged 21-30 years), and mid-adulthood (aged 33-45 years). Main Outcomes and Measures In 2008, CAC was determined from computed tomography and dichotomized as 0 (no CAC, Agatston score = 0) and 1 (presence of CAC, Agatston score ≥1) for analysis. Using a bayesian relevant life course exposure model, the relative association was determined between non-HDL-C at each life stage and the presence of CAC in mid-adulthood. Results Of 589 participants, 327 (56%) were female. In a model adjusted for year of birth, sex, body mass index, systolic blood pressure, blood glucose level, smoking status, lipid-lowering and antihypertensive medication use, and family history of heart disease, cumulative exposure to non-HDL-C across all life stages was associated with CAC (odds ratio [OR], 1.50; 95% credible interval [CrI], 1.14-1.92). At each life stage, non-HDL-C was associated with CAC and exposure to non-HDL-C during adolescence had the strongest association (adolescence: OR, 1.16; 95% CrI, 1.01-1.46; young adulthood: OR, 1.14; 95% CrI, 1.01-1.43; mid-adulthood: OR, 1.12; 95% CrI, 1.01-1.34). Conclusions and Relevance These data suggest that elevated non-HDL-C levels at all life stages are associated with coronary atherosclerosis in mid-adulthood. However, adolescent non-HDL-C levels showed the strongest association with the presence of CAC in mid-adulthood, and greater awareness of the importance of elevated non-HDL-C in adolescence is needed.
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Affiliation(s)
- Matthew K. Armstrong
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Brooklyn J. Fraser
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Olli Hartiala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Marie-Jeanne Buscot
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Juha Koskinen
- Heart Center, Kymenlaakso Central Hospital, Kotka, Finland
| | - Nina Hutri-Kähönen
- Tampere University Hospital, Department of Pediatrics, Tampere University, Tampere, Finland
| | - Mika Kähönen
- Tampere University Hospital, Department of Clinical Physiology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Tomi P. Laitinen
- Kuopio University Hospital, Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland, Kuopio, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Health Technology, Finnish Cardiovascular Research Center–Tampere, Tampere University, Tampere, Finland
| | - Jorma S. A. Viikari
- Department of Medicine, University of Turku, Turku, Finland
- Division of Medicine, Turku University Hospital, Turku, Finland
| | - Olli T. Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
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24
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Breton CV, Farzan SF. Invited Perspective: Metal Mixtures and Child Health: The Complex Interplay of Essential and Toxic Elements. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:61301. [PMID: 34160248 PMCID: PMC8312474 DOI: 10.1289/ehp9629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- Carrie V. Breton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Shohreh F. Farzan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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25
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Pool LR, Aguayo L, Brzezinski M, Perak AM, Davis MM, Greenland P, Hou L, Marino BS, Van Horn L, Wakschlag L, Labarthe D, Lloyd-Jones D, Allen NB. Childhood Risk Factors and Adulthood Cardiovascular Disease: A Systematic Review. J Pediatr 2021; 232:118-126.e23. [PMID: 33516680 PMCID: PMC11583247 DOI: 10.1016/j.jpeds.2021.01.053] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To conduct a comprehensive review of the literature on childhood risk factors and their associations with adulthood subclinical and clinical cardiovascular disease (CVD). STUDY DESIGN A systematic search was performed using the MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science databases to identify English-language articles published through June 2018. Articles were included if they were longitudinal studies in community-based populations, the primary exposure occurred during childhood, and the primary outcome was either a measure of subclinical CVD or a clinical CVD event occurring in adulthood. Two independent reviewers screened determined whether eligibility criteria were met. RESULTS There were 210 articles that met the predefined criteria. The greatest number of publications examined associations of clinical risk factors, including childhood adiposity, blood pressure, and cholesterol, with the development of adult CVD. Few studies examined childhood lifestyle factors including diet quality, physical activity, and tobacco exposure. Domains of risk beyond "traditional" cardiovascular risk factors, such as childhood psychosocial adversity, seemed to have strong published associations with the development of CVD. CONCLUSIONS Although the evidence was fairly consistent in direction and magnitude for exposures such as childhood adiposity, hypertension, and hyperlipidemia, significant gaps remain in the understanding of how childhood health and behaviors translate to the risk of adulthood CVD, particularly in lesser studied exposures like glycemic indicators, physical activity, diet quality, very early life course exposure, and population subgroups.
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Affiliation(s)
- Lindsay R Pool
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Liliana Aguayo
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Michal Brzezinski
- Department of Public Health and Social Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Amanda M Perak
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Matthew M Davis
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Bradley S Marino
- Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lauren Wakschlag
- Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Darwin Labarthe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Norrina B Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
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26
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Farzan SF, Habre R, Danza P, Lurmann F, Gauderman WJ, Avol E, Bastain T, Hodis HN, Breton C. Childhood traffic-related air pollution and adverse changes in subclinical atherosclerosis measures from childhood to adulthood. Environ Health 2021; 20:44. [PMID: 33853624 PMCID: PMC8048028 DOI: 10.1186/s12940-021-00726-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/08/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND Chronic exposure to air pollutants is associated with increased risk of cardiovascular disease (CVD) among adults. However, little is known about how air pollution may affect the development of subclinical atherosclerosis in younger populations. Carotid artery intima-media thickness (CIMT) is a measure of subclinical atherosclerosis that provides insight into early CVD pathogenesis. METHODS In a pilot study of 70 participants from the Southern California Children's Health Study, we investigated CIMT progression from childhood to adulthood. Using carotid artery ultrasound images obtained at age 10 and follow-up images at age 21-22, we examined associations between childhood ambient and traffic-related air pollutants with changes in CIMT over time and attained adult CIMT using linear mixed-effects models adjusted for potential confounders. Average residential childhood exposures (i.e., birth to time of measurement at 10-11 years) were assigned for regional, ambient pollutants (ozone, nitrogen dioxide, particulate matter, interpolated from regulatory air monitoring data) and traffic-related nitrogen oxides (NOx) by road class (modeled using the CALINE4 line source dispersion model). Traffic density was calculated within a 300-m residential buffer. RESULTS For each 1 standard deviation (SD) increase in childhood traffic-related total NOx exposure, we observed greater yearly rate of change in CIMT from childhood to adulthood (β: 2.17 μm/yr, 95% CI: 0.78-3.56). Increases in annual rate of CIMT change from childhood to adulthood also were observed with freeway NOx exposure (β: 2.24 μm/yr, 95% CI: 0.84-3.63) and traffic density (β: 2.11 μm/yr, 95% CI: 0.79-3.43). Traffic exposures were also related to increases in attained CIMT in early adulthood. No associations of CIMT change or attained level were observed with ambient pollutants. CONCLUSIONS Overall, we observed adverse changes in CIMT over time in relation to childhood traffic-related NOx exposure and traffic density in our study population. While these results must be cautiously interpreted given the limited sample size, the observed associations of traffic measures with CIMT suggest a need for future studies to more fully explore this relationship.
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Affiliation(s)
- Shohreh F. Farzan
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90089 USA
| | - Rima Habre
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90089 USA
| | - Phoebe Danza
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90089 USA
| | | | - W. James Gauderman
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90089 USA
| | - Edward Avol
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90089 USA
| | - Theresa Bastain
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90089 USA
| | - Howard N. Hodis
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90089 USA
- Department of Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA 90089 USA
- Atherosclerosis Research Unit, University of Southern California, Los Angeles, CA 90089 USA
| | - Carrie Breton
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, 2001 N. Soto Street, Los Angeles, CA 90089 USA
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Within-visit SBP variability from childhood to adulthood and markers of cardiovascular end-organ damage in mid-life. J Hypertens 2021; 39:1865-1875. [PMID: 34397629 DOI: 10.1097/hjh.0000000000002855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Within-visit SBP variability is associated with age and SBP, but its long-term clinical significance is unknown. We examined the association between child, adult, and life-time within-visit SBP variability with markers of end-organ damage using data from a 31-year longitudinal study. METHODS Within-visit SBP variability was calculated as the standard deviation of three sitting SBP readings among up to 3010 participants aged 6-18 years (childhood) who were re-measured up to seven times to mid-adulthood. Markers of cardiovascular end-organ damage in adulthood were carotid intima--media thickness, brachial flow-mediated dilatation, carotid distensibility, pulse wave velocity, left ventricular mass index, carotid plaque, and coronary artery calcification. RESULTS The mean (standard deviation) cumulative within-visit SBP variability was 2.7 (1.5) mmHg in childhood, 3.9 (1.9) mmHg in adulthood and 3.7 (1.5) mmHg across the observed life-time. Childhood within-visit SBP variability was not correlated with its subsequent values measured from 3 to 31 years later. With adjustment for age, sex, cumulative SBP, BMI and serum lipids, neither child, adult, or life-time cumulative within-visit SBP variability associated with markers of cardiovascular end-organ damage. However, higher child, adult, and life-time cumulative SBP significantly associated with higher carotid intima--media thickness, higher pulse wave velocity, lower brachial flow-mediated dilatation, lower carotid distensibility in adulthood. CONCLUSION Within-visit SBP variability from childhood to adulthood does not provide additional predictive utility over SBP over the same period of the life course.
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Hardy ST, Sakhuja S, Jaeger BC, Urbina EM, Suglia SF, Feig DI, Muntner P. Trends in Blood Pressure and Hypertension Among US Children and Adolescents, 1999-2018. JAMA Netw Open 2021; 4:e213917. [PMID: 33792732 PMCID: PMC8017470 DOI: 10.1001/jamanetworkopen.2021.3917] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/09/2021] [Indexed: 12/30/2022] Open
Abstract
Importance Higher blood pressure (BP) levels in children are associated with an increased risk for hypertension and subclinical cardiovascular disease in adulthood. Identifying trends in BP could inform the need for interventions to lower BP. Objective To determine whether systolic BP (SBP) and diastolic BP (DBP) levels among US children have changed during the past 20 years. Design, Setting, and Participants This serial cross-sectional analysis of National Health and Nutrition Examination Survey data included 9117 children aged 8 to 12 years and 10 156 adolescents aged 13 to 17 years, weighted to the US population from 1999-2002 to 2015-2018. Data were collected from March 1999 to December 2018 and analyzed from March 26, 2020, to February 2, 2021. Exposures Calendar year. Main Outcomes and Measures The primary outcomes were mean SBP and mean DBP. Results A total of 19 273 participants were included in the analysis. Among children aged 8 to 12 years in 2015-2018 (mean age, 10.5 [95% CI, 10.5-10.6] years), 48.7% (95% CI, 45.2%-52.2%) were girls and 51.3% (95% CI, 47.8%-54.8%) were boys; 49.7% (95% CI, 42.2%-57.1%) were non-Hispanic White; 13.7% (95% CI, 10.3%-18.1%) were non-Hispanic Black; 25.5% (95% CI, 19.9%-32.0%) were Hispanic; 4.7% (95% CI, 3.2%-6.7%) were non-Hispanic Asian; and 6.5% (95% CI, 4.9%-8.5%) were other non-Hispanic race/ethnicity. Among those aged 13 to 17 years in 2015-2018 (mean age, 15.5 [95% CI, 15.5-15.5] years), 49.1% (95% CI, 46.1%-52.2%) were girls and 50.9% (95% CI, 47.8%-53.9%) were boys; 53.3% (95% CI, 46.4%-60.1%) were non-Hispanic White; 13.9% (95% CI, 10.3%-18.7%) were non-Hispanic Black; 21.9% (95% CI, 16.6%-28.2%) were Hispanic; 4.6% (95% CI, 3.2%-6.5%) were non-Hispanic Asian; and 6.3% (95% CI, 4.7%-8.5%) were other non-Hispanic race/ethnicity. Among children aged 8 to 12 years, age-adjusted mean SBP decreased from 102.4 (95% CI, 101.7-103.1) mm Hg in 1999-2002 to 101.5 (95% CI, 100.8-102.2) mm Hg in 2011-2014 and then increased to 102.5 (95% CI, 101.9-103.2) mm Hg in 2015-2018. Age-adjusted mean DBP decreased from 57.2 (95% CI, 56.5-58.0) mm Hg in 1999-2002 to 51.9 (95% CI, 50.1-53.7) mm Hg in 2011-2014 and increased to 53.2 (95% CI, 52.2-54.1) mm Hg in 2015-2018. Among adolescents aged 13 to 17 years, age-adjusted mean SBP decreased from 109.2 (95% CI, 108.7-109.7) mm Hg in 1999-2002 to 108.4 (95% CI, 107.8-109.1) mm Hg in 2011-2014 and remained unchanged in 2015-2018 (108.4 [95% CI, 107.8-109.1] mm Hg). Mean DBP decreased from 62.6 (95% CI, 61.7-63.5) mm Hg in 1999-2002 to 59.6 (95% CI, 58.2-60.9) mm Hg in 2011-2014 and then increased to 60.8 (95% CI, 59.8-61.7) mm Hg in 2015-2018. Among children aged 8 to 12 years, mean SBP was 3.2 (95% CI, 1.7-4.6) mm Hg higher among those with overweight and 6.8 (95% CI, 5.6-8.1) mm Hg higher among those with obesity compared with normal weight; mean DBP was 3.2 (95% CI, 0.7-5.6) mm Hg higher among those with overweight and 3.5 (95% CI, 1.9- 5.1) mm Hg higher among those with obesity compared with normal weight. Among adolescents aged 13 to 17 years, mean SBP was 3.5 (95% CI 1.9-5.1) mm Hg higher among those with overweight and 6.6 (95% CI, 5.2-8.0) mm Hg higher among those with obesity compared with normal weight, 4.8 (95% CI, 3.8-5.8) mm Hg higher among boys compared with girls, and 3.0 (95% CI, 1.7-4.3) mm Hg higher among non-Hispanic Black compared with non-Hispanic White participants. Conclusions and Relevance Despite an overall decline in mean SBP and DBP from 1999-2002 to 2015-2018, BP levels among children and adolescents may have increased from 2011-2014 to 2015-2018.
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Affiliation(s)
- Shakia T. Hardy
- Department of Epidemiology, University of Alabama at Birmingham
| | - Swati Sakhuja
- Department of Epidemiology, University of Alabama at Birmingham
| | - Byron C. Jaeger
- Department of Biostatistics, University of Alabama at Birmingham
| | - Elaine M. Urbina
- The Heart Institute, Cincinnati Children’s Hospital, University of Cincinnati, Cincinnati, Ohio
| | | | - Daniel I. Feig
- Division of Pediatric Nephrology, University of Alabama at Birmingham
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham
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Farzan SF, Howe CG, Chen Y, Gilbert-Diamond D, Korrick S, Jackson BP, Weinstein AR, Karagas MR. Prenatal and postnatal mercury exposure and blood pressure in childhood. ENVIRONMENT INTERNATIONAL 2021; 146:106201. [PMID: 33129000 PMCID: PMC7775884 DOI: 10.1016/j.envint.2020.106201] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/29/2020] [Accepted: 10/08/2020] [Indexed: 05/25/2023]
Abstract
Elevated blood pressure in childhood is an important risk factor for hypertension in adulthood. Environmental exposures have been associated with elevated blood pressure over the life course and exposure to mercury (Hg) has been linked to cardiovascular effects in adults. As subclinical vascular changes begin early in life, Hg may play a role in altered blood pressure in children. However, the evidence linking early life Hg exposure to altered blood pressure in childhood has been largely inconsistent. In the ongoing New Hampshire Birth Cohort Study, we investigated prenatal and childhood Hg exposure at multiple time points and associations with blood pressure measurements in 395 young children (mean age 5.5 years, SD 0.4). Hg exposure was measured in children's toenail clippings at age 3 and in urine at age 5-6 years, as well as in maternal toenail samples collected at ∼28 weeks gestation and 6 weeks postpartum, the latter two samples reflecting early prenatal and mid-gestation exposures, respectively. Five measurements of systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were averaged for each child using a standardized technique. In covariate-adjusted linear regression analyses, we observed that a 0.1 μg/g increase in child toenail Hg at age 3 or a 0.1 μg/L urine Hg at age 5-6 were individually associated with greater DBP (toenail β: 0.53 mmHg; 95% CI: -0.02, 1.07; urine β: 0.48 mmHg; 95% CI: 0.10, 0.86) and MAP (toenail β: 0.67 mmHg; 95% CI: 0.002, 1.33; urine β: 0.55 mmHg; 95% CI: 0.10, 1.01). Neither early prenatal nor mid-gestation Hg exposure, as measured by maternal toenails, were related to any changes to child BP. Simultaneous inclusion of both child urine Hg and child toenail Hg in models suggested a potentially stronger relationship of urine Hg at age 5-6 with DBP and MAP, as compared to toenail Hg at age 3. Our findings suggest that Hg exposure during childhood is associated with alterations in BP. Childhood may be an important window of opportunity to reduce the impacts of Hg exposure on children's blood pressure, and in turn, long-term health.
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Affiliation(s)
- Shohreh F Farzan
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.
| | - Caitlin G Howe
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA; Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Yu Chen
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Children's Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, NH, USA
| | - Susan Korrick
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Brian P Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, NH, USA
| | - Adam R Weinstein
- Department of Medical Education and Pediatrics, Geisel School of Medicine, Hanover, NH, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Children's Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, NH, USA
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30
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Cardiometabolic risk and health behaviours in adolescents with normal-weight obesity: a systematic review. Public Health Nutr 2020; 24:870-881. [PMID: 33256881 DOI: 10.1017/s1368980020004863] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To analyse the presence of cardiometabolic risk factors in adolescents with normal-weight obesity (NWO), as well as to investigate health behaviours related to the phenotype. DESIGN The study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and the bibliographic search was carried out in the PubMed, Scielo and ScienceDirect databases. SETTING School, university and population. PARTICIPANTS Adolescents between 10 and 19 years old. RESULTS A total of eight papers were included. Most studies have found a relationship between NWO and the presence of cardiometabolic risk factors, such as high waist circumference, unfavourable lipid and glycid profile. As for health behaviours, three of the eight studies included evaluated eating habits; however, the results were not conclusive. In addition, four studies analysed the practice of physical activity or physical fitness, which was lower in NWO. CONCLUSIONS The available evidence indicates that NWO is related to the early development of cardiometabolic changes, physical inactivity and less physical fitness in adolescents. The results also reveal the importance of early detection of the phenotype, as well as the need for further research on the associated factors to prevent future diseases. Registration (PROSPERO: CRD42020161204).
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31
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Murthy VL, Reis JP, Pico AR, Kitchen R, Lima JAC, Lloyd-Jones D, Allen NB, Carnethon M, Lewis GD, Nayor M, Vasan RS, Freedman JE, Clish CB, Shah RV. Comprehensive Metabolic Phenotyping Refines Cardiovascular Risk in Young Adults. Circulation 2020; 142:2110-2127. [PMID: 33073606 PMCID: PMC7880553 DOI: 10.1161/circulationaha.120.047689] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/17/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Whereas cardiovascular disease (CVD) metrics define risk in individuals >40 years of age, the earliest lesions of CVD appear well before this age. Despite the role of metabolism in CVD antecedents, studies in younger, biracial populations to define precise metabolic risk phenotypes are lacking. METHODS We studied 2330 White and Black young adults (mean age, 32 years; 45% Black) in the CARDIA study (Coronary Artery Risk Development in Young Adults) to identify metabolite profiles associated with an adverse CVD phenome (myocardial structure/function, fitness, vascular calcification), mechanisms, and outcomes over 2 decades. Statistical learning methods (elastic nets/principal components analysis) and Cox regression generated parsimonious, metabolite-based risk scores validated in >1800 individuals in the Framingham Heart Study. RESULTS In the CARDIA study, metabolite profiles quantified in early adulthood were associated with subclinical CVD development over 20 years, specifying known and novel pathways of CVD (eg, transcriptional regulation, brain-derived neurotrophic factor, nitric oxide, renin-angiotensin). We found 2 multiparametric, metabolite-based scores linked independently to vascular and myocardial health, with metabolites included in each score specifying microbial metabolism, hepatic steatosis, oxidative stress, nitric oxide modulation, and collagen metabolism. The metabolite-based vascular scores were lower in men, and myocardial scores were lower in Black participants. Over a nearly 25-year median follow-up in CARDIA, the metabolite-based vascular score (hazard ratio, 0.68 per SD [95% CI, 0.50-0.92]; P=0.01) and myocardial score (hazard ratio, 0.60 per SD [95% CI, 0.45-0.80]; P=0.0005) in the third and fourth decades of life were associated with clinical CVD with a synergistic association with outcome (Pinteraction=0.009). We replicated these findings in 1898 individuals in the Framingham Heart Study over 2 decades, with a similar association with outcome (including interaction), reclassification, and discrimination. In the Framingham Heart Study, the metabolite scores exhibited an age interaction (P=0.0004 for a combined myocardial-vascular score with incident CVD), such that young adults with poorer metabolite-based health scores had highest hazard of future CVD. CONCLUSIONS Metabolic signatures of myocardial and vascular health in young adulthood specify known/novel pathways of metabolic dysfunction relevant to CVD, associated with outcome in 2 independent cohorts. Efforts to include precision measures of metabolic health in risk stratification to interrupt CVD at its earliest stage are warranted.
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Affiliation(s)
| | - Jared P. Reis
- National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Alexander R. Pico
- Institute of Data Science and Biotechnology, Gladstone Institutes, University of California at San Francisco, San Francisco, CA
| | - Robert Kitchen
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Joao A. C. Lima
- Cardiology Division, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD
| | | | | | | | - Gregory D. Lewis
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Matthew Nayor
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Ramachandran S. Vasan
- Sections of Preventive Medicine and Epidemiology and Cardiovascular Medicine, Department of Medicine, and Department of Epidemiology, Boston University Schools of Medicine and Public Health, Boston, MA, and the Framingham Heart Study, Framingham, MA
| | - Jane E. Freedman
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | | | - Ravi V. Shah
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA
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32
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Laitinen TT, Nuotio J, Niinikoski H, Juonala M, Rovio SP, Viikari JSA, Rönnemaa T, Magnussen CG, Sabin M, Burgner D, Jokinen E, Lagström H, Jula A, Simell O, Raitakari OT, Pahkala K. Attainment of Targets of the 20-Year Infancy-Onset Dietary Intervention and Blood Pressure Across Childhood and Young Adulthood: The Special Turku Coronary Risk Factor Intervention Project (STRIP). Hypertension 2020; 76:1572-1579. [PMID: 32921196 DOI: 10.1161/hypertensionaha.120.15075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We examined whether success in achieving the key targets of an infancy-onset 20-year dietary intervention was associated with blood pressure (BP) from infancy to young adulthood. In the prospective randomized STRIP (Special Turku Coronary Risk Factor Intervention Project; n=877 children), dietary counseling was provided biannually based on the Nordic Nutrition Recommendations primarily to improve the quality of dietary fat in children's diets and secondarily to promote intake of vegetables, fruits, and whole grains. Dietary data and BP were accrued annually from the age of 13 months to 20 years. The dietary targets for fat quality were defined as the ratio of saturated fatty acids to monounsaturated and polyunsaturated fatty acids <1:2 and intake of saturated fatty acids <10 E%, dietary fiber intake in the top age-specific quintile, and dietary sucrose intake as being in the lowest age-specific quintile. Attaining a higher number of the dietary targets was associated with lower systolic BP (mean [SE] systolic BP, 107.3 [0.3], 107.6 [0.3], 106.8 [0.3], and 106.7 [0.5] mm Hg in participants meeting 0, 1, 2, and 3 to 4 targets, respectively; P=0.03) and diastolic BP (mean [SE] diastolic BP, 60.4 [0.2], 60.5 [0.2], 59.9 [0.2], and 59.9 [0.3] mm Hg; P=0.02). When the lowest age-specific quintile of dietary cholesterol was added as an additional target, the association with systolic BP remained significant (P=0.047), but the association with diastolic BP attenuated (P=0.13). Achieving the key targets of an infancy-onset 20-year dietary intervention, reflecting dietary guidelines, was favorably albeit modestly associated with systolic and diastolic BP from infancy to young adulthood. Registration- URL: https://www.clinicaltrials.gov; Unique identifier: NCT00223600.
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Affiliation(s)
- Tomi T Laitinen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (T.T.L., J.N., S.P.R., C.G.M., O.T.R., K.P.), University of Turku, Finland.,Sports and Exercise Medicine Unit, Department of Physical Activity and Health, Paavo Nurmi Centre (T.T.L., K.P.), University of Turku, Finland.,Centre for Population Health Research (T.T.L., J.N., H.N., S.P.R., C.G.M., H.L., O.T.R., K.P.), Turku University Hospital, University of Turku, Finland.,Murdoch Children's Research Institute (T.T.L., J.N., M.S., D.B.), The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Joel Nuotio
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (T.T.L., J.N., S.P.R., C.G.M., O.T.R., K.P.), University of Turku, Finland.,Centre for Population Health Research (T.T.L., J.N., H.N., S.P.R., C.G.M., H.L., O.T.R., K.P.), Turku University Hospital, University of Turku, Finland.,Heart Center (J.N.), Turku University Hospital, University of Turku, Finland.,Murdoch Children's Research Institute (T.T.L., J.N., M.S., D.B.), The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Harri Niinikoski
- Centre for Population Health Research (T.T.L., J.N., H.N., S.P.R., C.G.M., H.L., O.T.R., K.P.), Turku University Hospital, University of Turku, Finland.,Department of Paediatrics and Adolescent Medicine (H.N., O.S.), Turku University Hospital, University of Turku, Finland
| | - Markus Juonala
- Department of Medicine (M.J., J.S.A.V., T.R.), University of Turku, Finland.,Division of Medicine, Turku University Hospital, Finland (M.J., J.S.A.V., T.R.)
| | - Suvi P Rovio
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (T.T.L., J.N., S.P.R., C.G.M., O.T.R., K.P.), University of Turku, Finland.,Centre for Population Health Research (T.T.L., J.N., H.N., S.P.R., C.G.M., H.L., O.T.R., K.P.), Turku University Hospital, University of Turku, Finland
| | - Jorma S A Viikari
- Department of Medicine (M.J., J.S.A.V., T.R.), University of Turku, Finland.,Division of Medicine, Turku University Hospital, Finland (M.J., J.S.A.V., T.R.)
| | - Tapani Rönnemaa
- Department of Medicine (M.J., J.S.A.V., T.R.), University of Turku, Finland.,Division of Medicine, Turku University Hospital, Finland (M.J., J.S.A.V., T.R.)
| | - Costan G Magnussen
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (T.T.L., J.N., S.P.R., C.G.M., O.T.R., K.P.), University of Turku, Finland.,Centre for Population Health Research (T.T.L., J.N., H.N., S.P.R., C.G.M., H.L., O.T.R., K.P.), Turku University Hospital, University of Turku, Finland.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (C.G.M.)
| | - Matthew Sabin
- Murdoch Children's Research Institute (T.T.L., J.N., M.S., D.B.), The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Endocrinology (M.S.), The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia (M.S., D.B.)
| | - David Burgner
- Murdoch Children's Research Institute (T.T.L., J.N., M.S., D.B.), The Royal Children's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia (M.S., D.B.).,Department of Paediatrics, Monash University, Clayton, Victoria, Australia (D.B.)
| | - Eero Jokinen
- Department of Pediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Finland (E.J.)
| | - Hanna Lagström
- Centre for Population Health Research (T.T.L., J.N., H.N., S.P.R., C.G.M., H.L., O.T.R., K.P.), Turku University Hospital, University of Turku, Finland.,Department of Public Health (H.L.), Turku University Hospital, University of Turku, Finland
| | - Antti Jula
- Department of Chronic Disease Prevention, Institute for Health and Welfare, Turku, Finland (A.J.)
| | - Olli Simell
- Department of Paediatrics and Adolescent Medicine (H.N., O.S.), Turku University Hospital, University of Turku, Finland
| | - Olli T Raitakari
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (T.T.L., J.N., S.P.R., C.G.M., O.T.R., K.P.), University of Turku, Finland.,Centre for Population Health Research (T.T.L., J.N., H.N., S.P.R., C.G.M., H.L., O.T.R., K.P.), Turku University Hospital, University of Turku, Finland.,Department of Public Health (H.L.), Turku University Hospital, University of Turku, Finland
| | - Katja Pahkala
- From the Research Centre of Applied and Preventive Cardiovascular Medicine (T.T.L., J.N., S.P.R., C.G.M., O.T.R., K.P.), University of Turku, Finland.,Sports and Exercise Medicine Unit, Department of Physical Activity and Health, Paavo Nurmi Centre (T.T.L., K.P.), University of Turku, Finland.,Centre for Population Health Research (T.T.L., J.N., H.N., S.P.R., C.G.M., H.L., O.T.R., K.P.), Turku University Hospital, University of Turku, Finland
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Harris KC, McCrindle BW. “The Child Is the Father of the Man”—Pediatric Preventive Cardiology. Can J Cardiol 2020; 36:1329-1332. [DOI: 10.1016/j.cjca.2020.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022] Open
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Laitinen TT, Saner C, Nuotio J, Sabin MA, Fraser BJ, Harcourt B, Juonala M, Burgner DP, Magnussen CG. Lower grip strength in youth with obesity identifies those with increased cardiometabolic risk. Obes Res Clin Pract 2020; 14:286-289. [PMID: 32402765 DOI: 10.1016/j.orcp.2020.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/11/2020] [Accepted: 04/14/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND We examined whether grip strength differentiates youth with obesity with increased cardiometabolic risk. METHODS The sample comprised 43 youth with severe obesity (mean age 14.8, standard deviation 3.0 years) enrolled in the Childhood Overweight BioRepository of Australia. Grip strength was normalized to body mass and categorized as low and moderate/high. RESULTS Youth with low grip strength had higher systolic blood pressure (mean difference 13mmHg), low-density lipoprotein cholesterol (0.26mmol/l), continuous metabolic syndrome score (0.36), and carotid intima-media thickness (0.05mm) compared with those with moderate/high grip strength. CONCLUSIONS Low grip strength may differentiate youth with obesity with increased cardiometabolic risk.
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Affiliation(s)
- Tomi T Laitinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland; Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Christoph Saner
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Joel Nuotio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital Turku, Finland; Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland; Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Matthew A Sabin
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Brooklyn J Fraser
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Brooke Harcourt
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - David P Burgner
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
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35
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Childhood risk factors and carotid atherosclerotic plaque in adulthood: The Cardiovascular Risk in Young Finns Study. Atherosclerosis 2020; 293:18-25. [DOI: 10.1016/j.atherosclerosis.2019.11.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/18/2019] [Accepted: 11/27/2019] [Indexed: 12/28/2022]
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36
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Königstein K, Klenk C, Appenzeller-Herzog C, Hinrichs T, Schmidt-Trucksäss A. Impact of sedentary behavior on large artery structure and function in children and adolescents: a systematic review. Eur J Pediatr 2020; 179:17-27. [PMID: 31773330 DOI: 10.1007/s00431-019-03497-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 01/25/2023]
Abstract
Sedentary behavior contributes to increased atherosclerotic risk in adults. Whether or not this can be extended to pediatric populations is unclear. This systematic review assessed associations of sedentary behavior with large artery structure and function in pediatric populations. MEDLINE, EMBASE, CENTRAL, and Web of Science were searched from the earliest available date to 31st of December 2018. Analyses of associations of sedentary behavior with large artery structure or function in a pediatric (sub-)population were included, adhering to the PRISMA guidelines. The protocol was published in advance on PROSPERO (CRD42018112996). Study quality and quality of evidence were analyzed using NHLBI Study Quality assessment tools and GRADE. Six observational studies found no association of exposure and outcome variables, and one had contradicting results. One intervention found reduced flow-mediated dilation after 3 h of uninterrupted sitting. Exposure and outcome measures were highly heterogeneous. Study quality was low to moderate. Quality of evidence was very low or low in the observational studies and high in the intervention.Conclusion: In pediatric populations, current evidence is limited and of low quality about how acute effects of sedentary behavior translate into early vascular aging and the long-term development of vascular dysfunction and atherosclerotic risk. Future studies should emphasize a careful choice of the adequate type and measurement site of a biomarker for large artery structure and function as well as conduct a detailed assessment of sedentary behavior patterns.Trial registration: PROSPERO Registration Number: CRD42018112996What is known: • An independent association of sedentary behavior and biomarkers of large artery structure and function has been demonstrated in adults. • In children, sedentary behavior is directly associated with classical cardiovascular risk factors like elevated blood glucose levels, insulin resistance, high blood pressure, obesity, and elevated blood lipids.What is new: • Currently, only few studies of low quality in children and adolescents provide limited evidence about how acute effects of sedentary behavior translate into early vascular aging and the long-term development of atherosclerosis. • The type and measurement site of vascular biomarker need to be chosen carefully, and a detailed assessment of sedentary behavior patterns is important to minimize the methodological bias.
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Affiliation(s)
- Karsten Königstein
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland.
| | - Christopher Klenk
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | | | - Timo Hinrichs
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland.
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de Ferranti SD, Steinberger J, Ameduri R, Baker A, Gooding H, Kelly AS, Mietus-Snyder M, Mitsnefes MM, Peterson AL, St-Pierre J, Urbina EM, Zachariah JP, Zaidi AN. Cardiovascular Risk Reduction in High-Risk Pediatric Patients: A Scientific Statement From the American Heart Association. Circulation 2019; 139:e603-e634. [PMID: 30798614 DOI: 10.1161/cir.0000000000000618] [Citation(s) in RCA: 231] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This scientific statement presents considerations for clinical management regarding the assessment and risk reduction of select pediatric populations at high risk for premature cardiovascular disease, including acquired arteriosclerosis or atherosclerosis. For each topic, the evidence for accelerated acquired coronary artery disease and stroke in childhood and adolescence and the evidence for benefit of interventions in youth will be reviewed. Children and adolescents may be at higher risk for cardiovascular disease because of significant atherosclerotic or arteriosclerotic risk factors, high-risk conditions that promote atherosclerosis, or coronary artery or other cardiac or vascular abnormalities that make the individual more vulnerable to the adverse effects of traditional cardiovascular risk factors. Existing scientific statements and guidelines will be referenced when applicable, and suggestions for risk identification and reduction specific to each setting will be described. This statement is directed toward pediatric cardiologists, primary care providers, and subspecialists who provide clinical care for these young patients. The focus will be on management and justification for management, minimizing information on pathophysiology and epidemiology.
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38
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Subclinical Organ Damage in Children and Adolescents with Hypertension: Current Guidelines and Beyond. High Blood Press Cardiovasc Prev 2019; 26:361-373. [PMID: 31650516 DOI: 10.1007/s40292-019-00345-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 10/10/2019] [Indexed: 01/20/2023] Open
Abstract
High blood pressure (BP) is becoming a growing health issue even in children and adolescents. Moreover, BP elevation in youth frequently translates into children and adult hypertension contributing to the development of cardiovascular disease. The detection of early markers of vascular damage, potentially leading to overt cardiovascular disease, is important for clinical decisions about if and how to treat hypertension and can be useful in monitoring the effectiveness of the treatment. The purpose of this review is to summarize the actual knowledge about subclinical organ damage (SOD) in hypertensive children and adolescents and its association with cardiovascular disease in children and young adults. Our focus is especially put on left ventricular mass, pulse wave velocity, carotid intima-media thickness and microalbuminuria. We also want to address the scientific evidence about possible regression of SOD and cardiovascular risk with the use of behavioural and specific anti-hypertensive therapy. Indications from current guidelines are critically discussed.
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Zickler D, Luecht C, Willy K, Chen L, Witowski J, Girndt M, Fiedler R, Storr M, Kamhieh-Milz J, Schoon J, Geissler S, Ringdén O, Schindler R, Moll G, Dragun D, Catar R. Tumour necrosis factor-alpha in uraemic serum promotes osteoblastic transition and calcification of vascular smooth muscle cells via extracellular signal-regulated kinases and activator protein 1/c-FOS-mediated induction of interleukin 6 expression. Nephrol Dial Transplant 2019; 33:574-585. [PMID: 29228352 DOI: 10.1093/ndt/gfx316] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 09/24/2017] [Indexed: 12/15/2022] Open
Abstract
Background Vascular calcification is enhanced in uraemic chronic haemodialysis patients, likely due to the accumulation of midsize uraemic toxins, such as interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF-α). Here we have assessed the impact of uraemia on vascular smooth muscle cell (VSMC) calcification and examined the role of IL-6 and TNF-α as possible mediators and, most importantly, its underlying signalling pathway in VSMCs. Methods VSMCs were incubated with samples of uraemic serum obtained from patients treated with haemodialysis for renal failure in the Permeability Enhancement to Reduce Chronic Inflammation-I clinical trial. The VSMCs were assessed for IL-6 gene regulation and promoter activation in response to uraemic serum and TNF-α with reporter assays and electrophoretic mobility shift assay and for osteoblastic transition, cellular calcification and cell viability upon osteogenic differentiation. Results Uraemic serum contained higher levels of TNF-α and IL-6 compared with serum from healthy individuals. Exposure of VSMCs to uraemic serum or recombinant TNF-α lead to a strong upregulation of IL-6 mRNA expression and protein secretion, which was mediated by activator protein 1 (AP-1)/c-FOS-pathway signalling. Uraemic serum induced osteoblastic transition and calcification of VSMCs could be strongly attenuated by blocking TNF-α, IL-6 or AP-1/c-FOS signalling, which was accompanied by improved cell viability. Conclusion These results demonstrate that uraemic serum contains higher levels of uraemic toxins TNF-α and IL-6 and that uraemia promotes vascular calcification through a signalling pathway involving TNF-α, IL-6 and the AP-1/c-FOS cytokine-signalling axis. Thus treatment modalities aiming to reduce systemic TNF-α and IL-6 levels in chronic haemodialysis patients should be evaluated in future clinical trials.
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Affiliation(s)
- Daniel Zickler
- Clinic for Nephrology and Critical Care Medicine, Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Christian Luecht
- Clinic for Nephrology and Critical Care Medicine, Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Kevin Willy
- Clinic for Nephrology and Critical Care Medicine, Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Lei Chen
- Clinic for Nephrology and Critical Care Medicine, Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Janusz Witowski
- Department of Pathophysiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Matthias Girndt
- Department of Internal Medicine II, Martin-Luther-University Halle, Germany
| | - Roman Fiedler
- Department of Internal Medicine II, Martin-Luther-University Halle, Germany
| | - Markus Storr
- Department of Research and Development, Gambro Dialysatoren GmbH, Hechingen, Germany
| | | | - Janosch Schoon
- Berlin-Brandenburg Center and School for Regenerative Therapies(BCRT/BSRT)
- Julius Wolff Institute for Biomechanics and Muskuloskeletal Regeneration (JWI), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sven Geissler
- Berlin-Brandenburg Center and School for Regenerative Therapies(BCRT/BSRT)
- Julius Wolff Institute for Biomechanics and Muskuloskeletal Regeneration (JWI), Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Olle Ringdén
- Division of Therapeutic Immunology (TIM), Department of Laboratory Medicine (LABMED), Karolinska Institutet, Stockholm, Sweden
| | - Ralf Schindler
- Clinic for Nephrology and Critical Care Medicine, Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Guido Moll
- Berlin-Brandenburg Center and School for Regenerative Therapies(BCRT/BSRT)
- Julius Wolff Institute for Biomechanics and Muskuloskeletal Regeneration (JWI), Charité-Universitätsmedizin Berlin, Berlin, Germany
- Division of Therapeutic Immunology (TIM), Department of Laboratory Medicine (LABMED), Karolinska Institutet, Stockholm, Sweden
| | - Duska Dragun
- Clinic for Nephrology and Critical Care Medicine, Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Rusan Catar
- Clinic for Nephrology and Critical Care Medicine, Charite-Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
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Polenova NV, Kosura SD, Varaeva YR, Livancova EN, Starodubova AV. [Non-pharmaceutical treatment of dyslipidemia: review of current methods of diet and nutraceuticals]. ACTA ACUST UNITED AC 2019; 59:4-14. [PMID: 31441736 DOI: 10.18087/cardio.2549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 11/18/2022]
Abstract
The role of nutrition in the development and progression of atherosclerosis is well known. The correction of diet in patients with dyslipidemia is important as an independent intervention (in the group of patients with low and, partially, moderate cardiovascular risk), and as an addition to drug therapy in patients with at higher risk of cardiovascular events. The current review describes the effect of modern methods of diet therapy, as well as the use of a number of nutraceutical agents in terms of evidence-based medicine.
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Affiliation(s)
- N V Polenova
- Federal Research Center of Nutrition and Biotechnology
| | - S D Kosura
- Federal Research Center of Nutrition and Biotechnology
| | - Yu R Varaeva
- Federal Research Center of Nutrition and Biotechnology
| | - E N Livancova
- Federal Research Center of Nutrition and Biotechnology
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41
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Ayabe M, Kumahara H, Yamaguchi-Watanabe A, Chiba H, Kobayashi N, Sakuma I, Ishii K. Appendicular muscle mass and exercise/sports participation history in young Japanese women. Ann Hum Biol 2019; 46:335-339. [DOI: 10.1080/03014460.2019.1641221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Makoto Ayabe
- Laboratory of Physical Fitness and Sports Medicine, Graduate School of Education, Hokkaido University, Sapporo, Japan
- Faculty of Computer Science and Systems Engineering, Okayama Prefectural University, Okayama, Japan
| | - Hideaki Kumahara
- Laboratory of Physical Fitness and Sports Medicine, Graduate School of Education, Hokkaido University, Sapporo, Japan
- Faculty of Nutritional Sciences, Nakamura Gakuen University, Fukuoka, Japan
| | - Ayako Yamaguchi-Watanabe
- Laboratory of Physical Fitness and Sports Medicine, Graduate School of Education, Hokkaido University, Sapporo, Japan
| | - Hitoshi Chiba
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Noriko Kobayashi
- Department of Gynecology, Hokkaido University Hospital, Sapporo, Japan
| | - Ichiro Sakuma
- Caress Sapporo, Hokko Memorial Clinic, Sapporo, Japan
| | - Kojiro Ishii
- Laboratory of Physical Fitness and Sports Medicine, Graduate School of Education, Hokkaido University, Sapporo, Japan
- Faculty of Health and Sports Science, Doshisha University, Kyoto, Japan
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42
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Calkins SD, Dollar JM, Wideman L. Temperamental vulnerability to emotion dysregulation and risk for mental and physical health challenges. Dev Psychopathol 2019; 31:957-970. [PMID: 31097043 PMCID: PMC8186844 DOI: 10.1017/s0954579419000415] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Emotion dysregulation characterizes many forms of psychopathology. Patterns of dysregulation occur as a function of a developmental process in which normative and adaptive emotion regulation skills fail to become part of the child's behavioral repertoire due to biological, psychological, and contextual processes and experiences. Here we highlight the processes involved in the dysregulation of temperamental anger and frustration that become core features of externalizing problems and place children at risk for more serious forms of psychopathology. We imbed these processes in a larger self-regulatory framework, and we discuss how they influence mental as well as physical health, using data from our 20-year longitudinal study following a large cohort of children into young adulthood. Recommendations are made for future research involving the integration of biological systems with mental and physical health outcomes.
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Affiliation(s)
- Susan D. Calkins
- Department of Human Development and Family Studies, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Jessica M. Dollar
- Department of Human Development and Family Studies, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
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Kutkienė S, Petrulionienė Ž, Laucevičius A, Čerkauskienė R, Kasiulevičius V, Samuilis A, Augaitienė V, Gedminaitė A, Bieliauskienė G, Šaulytė-Mikulskienė A, Staigytė J, Petrulionytė E, Gargalskaitė U, Skiauterytė E, Matuzevičienė G, Kovaitė M, Nedzelskienė I. Is the coronary artery calcium score the first-line tool for investigating patients with severe hypercholesterolemia? Lipids Health Dis 2019; 18:149. [PMID: 31279347 PMCID: PMC6612412 DOI: 10.1186/s12944-019-1090-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 06/18/2019] [Indexed: 12/18/2022] Open
Abstract
Background Coronary artery calcium (CAC) is known as a reliable tool for estimating risk of myocardial infarction, coronary death, all-cause mortality and is even used to evaluate suitable asymptomatic patients. We therefore aimed to evaluate whether CAC scoring can be applied in the algorithm for clinical examination of patients with severe hypercholesterolemia (SH). Methods During the period of 2016–2017 a total of 213 asymptomatic adults, underwent computed tomography angiography to evaluate their CAC scoring. The sample consisted of 110 patients with SH and 103 age and sex matched controls without dyslipidemia and established cardiovascular disease. Results In total there were 79 (37.2%) subjects with elevated (≥25th) CAC percentiles. Out of them 47 (59.5%) had SH and 32 (40.5%) did not. CAC score did not differ between groups (SH (+) 140.30 ± 185.72 vs SH (−) 87.84 ± 140.65, p = 0.146), however there was a comparable difference in how the participants of these groups distributed among different percentile groups (p = 0.044). Gender, blood pressure, tabaco use, physical activity, family history of coronary artery disease and diabetes mellitus were not associated with CAC score (p > 0.05). There were no significant correlations between biochemical parameters and CAC percentiles except for increase in lipoprotein(a) (p = 0.038). Achilles tendon pathology, visceral obesity, body mass index and increased waist-hip ratio were not associated with CAC percentiles either (p > 0.05). Conclusions CAC score is not associated with presence of SH. CAC score is not an appropriate diagnostic tool in the algorithm for clinical examination of patients with SH. Further larger studies are needed to support our findings.
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Affiliation(s)
- Sandra Kutkienė
- Faculty of Medicine Clinic of Cardiac and Vascular Diseases, Vilnius University, Vilnius, Lithuania.,Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania
| | - Žaneta Petrulionienė
- Faculty of Medicine Clinic of Cardiac and Vascular Diseases, Vilnius University, Vilnius, Lithuania.,Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania
| | - Aleksandras Laucevičius
- Faculty of Medicine Clinic of Cardiac and Vascular Diseases, Vilnius University, Vilnius, Lithuania.,Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania
| | - Rimantė Čerkauskienė
- Vilnius University Hospital Santaros Klinikos, Children's hospital, Vilnius, Lithuania.,Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Vytautas Kasiulevičius
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania.,Faculty of Medicine Clinic of Internal Diseases Family Medicine and Oncology, Vilnius University, Vilnius, Vilnius, Lithuania
| | - Artūras Samuilis
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania.,Department of Radiology Nuclear Medicine and Medical Physics, Vilnius University Institute of Biomechanical Sciences, Vilnius, Lithuania
| | - Virginija Augaitienė
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania.,Department of Radiology Nuclear Medicine and Medical Physics, Vilnius University Institute of Biomechanical Sciences, Vilnius, Lithuania
| | - Aurelija Gedminaitė
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania.,Department of Radiology Nuclear Medicine and Medical Physics, Vilnius University Institute of Biomechanical Sciences, Vilnius, Lithuania
| | - Gintarė Bieliauskienė
- Faculty of Medicine Clinic of Cardiac and Vascular Diseases, Vilnius University, Vilnius, Lithuania.,Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania
| | - Akvilė Šaulytė-Mikulskienė
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania. .,Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania.
| | - Justina Staigytė
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania
| | | | - Urtė Gargalskaitė
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania
| | - Eglė Skiauterytė
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania
| | - Gabija Matuzevičienė
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania
| | - Milda Kovaitė
- Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania
| | - Irena Nedzelskienė
- Vilnius University Hospital Santaros Klinikos, Children's hospital, Vilnius, Lithuania
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Tajfard M, Tavakoly Sany SB, Avan A, Latiff LA, Rahimi HR, Moohebati M, Hasanzadeh M, Ghazizadeh H, Esmaeily H, Doosti H, Taghipour A, Ghayour-Mobarhan M, Ferns GA, Emamian M, Bin Abd Mutalib MS. Relationship between serum high sensitivity C-reactive protein with angiographic severity of coronary artery disease and traditional cardiovascular risk factors. J Cell Physiol 2018; 234:10289-10299. [PMID: 30548615 DOI: 10.1002/jcp.27945] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 10/09/2018] [Indexed: 12/25/2022]
Abstract
Serum high-sensitivity C-reactive protein (hs-CRP) is predictive of coronary artery disease (CAD). The aim of this study was to examine the possible association of hs-CRP with presence and severity of CAD and traditional CAD risk factors. This case-control study was carried out on 2,346 individuals from September 2011 to May 2013. Of these 1,187 had evidence of coronary disease, and were subject to coronary angiography, and the remainder were healthy controls (n = 1,159). Characteristics were determined using standard laboratory techniques and serum Hs-CRP levels were estimated using enzyme-linked immunosorbent assay (ELISA) kits, and severity of CAD was assessed according to the score of obstruction in coronary artery. Serum hs-CRP levels were higher in those with severe coronary disease, who had stenosis ≥ 50% stenosis of at least one coronary artery (all p < 0.001 vs. individuals in healthy control), and correlated significantly with the score for coronary artery disease (all p < 0.01). After adjustment for conventional risk factors, regression analysis revealed that smoking habits, fasting blood glucose, total cholesterol, high-density lipoprotein, hs-CRP, blood pressure, anxiety, dietary intake of vitamin E, and cholesterol remained as independent determinants for angiographic severity of CAD. The area under the receiving operating characteristic (ROC) curve for serum hs-CRP was 0.869 (CI 95% 0.721-0.872, p < 0.001). The optimal values for the cut-off point was a serum hs-CRP of 2.78 mg/l (sensitivity 80.20%, specificity 85%) to predict severity of CAD. Increased serum hs-CRP levels are significantly associated with angiographic severity of CAD, suggesting its value as a biomarkers for predicting CAD.
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Affiliation(s)
- Mohammad Tajfard
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Health Education and Health Promotion, School of Health, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyedeh Belin Tavakoly Sany
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Health Education and Health Promotion, School of Health, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Avan
- Metabolic Syndrome Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Latiffah A Latiff
- Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Seri Kembangan, Malaysia
| | - Hamid Reza Rahimi
- Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Vascular and Endovascular Surgery Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Moohebati
- Department of Cardiology, Ghaem Educational Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Hasanzadeh
- Department of Biostatistics and Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Ghazizadeh
- Metabolic Syndrome Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaeily
- Department of Biostatistics and Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hassan Doosti
- Department of Statistics, School of Health, Macquarie University, Sydney, Australia
| | - Ali Taghipour
- Department of Biostatistics and Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK
| | - Marzie Emamian
- Biochemistry Department, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Mohd Sokhini Bin Abd Mutalib
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, University Putra Malaysia, Malaysia
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Racial Disparities in the Cardiac Computed Tomography Assessment of Coronary Artery Disease: Does Gender Matter. Cardiol Rev 2018; 27:14-22. [PMID: 30520779 DOI: 10.1097/crd.0000000000000206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Coronary heart disease (CHD) represents a significant healthcare burden in terms of hospital resources, morbidity, and mortality. Primary prevention and early detection of risk factors for the development of CHD are pivotal to successful intervention programs and prognostication. Yet, there remains a paucity of evidence regarding differences in the assessment of these risk factors and the tools of assessment among different ethnicities. We conducted a narrative review to assess the utility of cardiac computed tomography, particularly coronary artery calcification (CAC), in different ethnicities. We also looked to see whether age, sex, comorbidities, and genetic background have peculiar influences on CAC. In this review, we highlight some of the pivotal studies regarding the question of CAC in relation to the development of CHD among different ethnicities. We identify several key trends in the literature showing that although African Americans have high rates of CHD, their risk of CAC may be relatively lower compared with other ethnicities. Similarly, South Asian patients may be at a high risk for adverse cardiac events due to elevated CAC. We also note that several studies are limited by small sample size and were based on 1 large cohort study. Future studies should include a large international prospective cohort to truly evaluate the effects of ethnicity on CAC and CHD risk. To appropriately apply CAC in the clinical practice, the variations in its scoring based on a subject's age, sex, comorbidity, and ethnicity should be addressed and interpreted beforehand.
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Farzan SF, Howe CG, Chen Y, Gilbert-Diamond D, Cottingham KL, Jackson BP, Weinstein AR, Karagas MR. Prenatal lead exposure and elevated blood pressure in children. ENVIRONMENT INTERNATIONAL 2018; 121:1289-1296. [PMID: 30389381 PMCID: PMC6279470 DOI: 10.1016/j.envint.2018.10.049] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/25/2018] [Accepted: 10/24/2018] [Indexed: 05/19/2023]
Abstract
Growing evidence suggests that environmental exposures can influence blood pressure over the course of a lifetime. Exposure to toxic metals, such as lead (Pb) and arsenic (As), has been associated with increased blood pressure in adults, but few studies have examined the impacts of in utero and early life toxic metals exposure on blood pressure in childhood. As subclinical vascular changes are thought to begin early in life, it is possible that in utero toxic metals exposure may play a role in blood pressure homeostasis. In the ongoing New Hampshire Birth Cohort Study, we investigated whether in utero exposure to Pb and As was associated with measures of blood pressure in a total of 323 young children (mean age 5.5 years, SD 0.4). Pb and As were measured in maternal toenail samples collected at ~28 weeks gestation (n = 257) and/or 6 weeks postpartum (n = 285), which represent exposures ~6 to 12 months prior to collection and therefore reflect the early prenatal and late prenatal exposures, respectively. Five measurements of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were averaged for each child using a standardized technique. In linear regression analyses, where log2-transformed prenatal toenail Pb and As were modeled jointly and adjusted for child age, sex, height, weight and maternal smoking during pregnancy, we observed that a doubling of maternal prenatal toenail Pb was associated with statistically significant increases in child SBP (β: 0.58 mm Hg, 95% CI: 0.05, 1.11). We did not observe any association of prenatal or postpartum As, or postpartum Pb, with SBP or DBP. Exploratory sex-stratified analyses suggest that associations of prenatal Pb with BP may be stronger among boys (SBP β: 0.72 mm Hg: 95% CI: -0.01, 1.44; DBP β: 0.37; 95% CI: -0.09, 0.84), compared to girls (SBP β: 0.48 mm Hg: 95% CI: -0.31, 1.26; DBP β: -0.05; 95% CI: -0.52, 0.41), though tests for interaction did not reach statistical significance (p-interaction SBP = 0.059; DBP = 0.057). Our preliminary results suggest that in utero toxic metals exposures may be associated with early life increases in blood pressure in children, which could have consequences for long-term health.
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Affiliation(s)
- Shohreh F Farzan
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.
| | - Caitlin G Howe
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Yu Chen
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Diane Gilbert-Diamond
- Children's Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, NH, USA; Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Kathryn L Cottingham
- Children's Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, NH, USA; Department of Biological Sciences, Dartmouth College, Hanover, NH, USA
| | - Brian P Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, NH, USA
| | - Adam R Weinstein
- Department of Pediatrics, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Margaret R Karagas
- Children's Environmental Health & Disease Prevention Research Center at Dartmouth, Hanover, NH, USA; Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
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Hamoen M, Vergouwe Y, Wijga AH, Heymans MW, Jaddoe VWV, Twisk JWR, Raat H, de Kroon MLA. Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study. BMJ Open 2018; 8:e023912. [PMID: 30467134 PMCID: PMC6252684 DOI: 10.1136/bmjopen-2018-023912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To develop a dynamic prediction model for high blood pressure at the age of 9-10 years that could be applied at any age between birth and the age of 6 years in community-based child healthcare. DESIGN, SETTING AND PARTICIPANTS Data were used from 5359 children in a population-based prospective cohort study in Rotterdam, the Netherlands. OUTCOME MEASURE High blood pressure was defined as systolic and/or diastolic blood pressure ≥95th percentile for gender, age and height. Using multivariable pooled logistic regression, the predictive value of characteristics at birth, and of longitudinal information on the body mass index (BMI) of the child until the age of 6 years, was assessed. Internal validation was performed using bootstrapping. RESULTS 227 children (4.2%) had high blood pressure at the age of 9-10 years. Final predictors were maternal hypertensive disease during pregnancy, maternal educational level, maternal prepregnancy BMI, child ethnicity, birth weight SD score (SDS) and the most recent BMI SDS. After internal validation, the area under the receiver operating characteristic curve ranged from 0.65 (prediction at age 3 years) to 0.73 (prediction at age 5-6 years). CONCLUSIONS This prediction model may help to monitor the risk of developing high blood pressure in childhood which may allow for early targeted primordial prevention of cardiovascular disease.
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Affiliation(s)
- Marleen Hamoen
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
- Erasmus University Medical Center, The Generation R Study Group, Rotterdam, Netherlands
| | - Yvonne Vergouwe
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Alet H Wijga
- National Institute for Public Health and the Environment, Center for Nutrition, Prevention and Health Services, Bilthoven, Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, Netherlands
| | - Vincent W V Jaddoe
- Erasmus University Medical Center, The Generation R Study Group, Rotterdam, Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Marlou L A de Kroon
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Health Sciences, University Medical Center Groningen, Groningen, Netherlands
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48
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Abstract
BACKGROUND Hypertension, even during childhood, increases the risk of developing atherosclerosis and cardiovascular disease. Therefore, starting prevention of hypertension early in the life course could be beneficial. Prediction models might be useful for identifying children at increased risk of developing hypertension, which may enable targeted primordial prevention of cardiovascular disease. OBJECTIVE To provide an overview of childhood prediction models for future hypertension. METHODS Embase and Medline were systematically searched. Studies were included that were performed in the general population, and that reported on development or validation of a multivariable model for children to predict future high blood pressure, prehypertension or hypertension. Data were extracted using the CHARMS checklist for prediction modelling studies. RESULTS Out of 12 780 reviewed records, six studies were included in which 18 models were presented. Five studies predicted adulthood hypertension, and one predicted adolescent prehypertension/hypertension. BMI and current blood pressure were most commonly included as predictors in the final models. Considerable heterogeneity existed in timing of prediction (from early childhood to late adolescence) and outcome measurement. Important methodological information was often missing, and in four studies information to apply the model in new individuals was insufficient. Reported area under the ROC curves ranged from 0.51 to 0.74. As none of the models were validated, generalizability could not be confirmed. CONCLUSION Several childhood prediction models for future hypertension were identified, but their value for practice remains unclear because of suboptimal methods, limited information on performance, or the lack of external validation. Further validation studies are indicated.
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Jakubowski KP, Cundiff JM, Matthews KA. Cumulative childhood adversity and adult cardiometabolic disease: A meta-analysis. Health Psychol 2018; 37:701-715. [PMID: 30024227 PMCID: PMC6109976 DOI: 10.1037/hea0000637] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Adverse childhood experiences may be associated with cardiometabolic morbidity and mortality in adulthood. There is heterogeneity in this literature regarding the type of items in cumulative adversity indices, sample sizes, demographics, and covariates. The present review used quantitative meta-analysis to examine this association and potential moderators. METHOD Included studies had a measure of cumulative adversity (an index of at least 2 adverse childhood experiences from age 0 to 18) and a measure of cardiometabolic disease: cardiovascular disease (CVD) clinical outcomes (hypertension, coronary heart disease, ischemic heart disease, myocardial infarction, stroke, cerebrovascular disease) and metabolic outcomes (diabetes, metabolic syndrome) at age 18 or older. Given different interpretations of odds ratios (OR) versus hazard ratios (HR), effects were pooled separately. Overall, 9 HR studies (15 effects) based on 179,612 participants and 29 OR studies (62 effects) based on 247,393 participants were included. RESULTS On the basis of retrospectively assessed adversity, combined studies showed a significant estimated effect of cumulative childhood adversity on adult cardiometabolic disease (HR = 1.42, 95% CI [1.20, 1.67]; OR = 1.36 [1.27, 1.46]). Results varied somewhat by type of cardiometabolic disease, analytic strategy, and number and type of covariates. CONCLUSIONS The literature suggests that cumulative childhood adversity is modestly related to adult cardiometabolic disease, with effects somewhat stronger for CVD clinical outcomes. The absence of a consistent operational and conceptual definition of adversity and paucity of prospective designs temper the conclusions. It is time for further evaluation of the types and timing of childhood events that have maximal impact on adult cardiometabolic disease. (PsycINFO Database Record
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Simonyte S, Kuciene R, Dulskiene V, Lesauskaite V. Association between ATP2B1 and CACNB2 polymorphisms and high blood pressure in a population of Lithuanian children and adolescents: a cross-sectional study. BMJ Open 2018; 8:e019902. [PMID: 29982197 PMCID: PMC6042568 DOI: 10.1136/bmjopen-2017-019902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Recently, genome-wide associated studies have identified several genetic loci that are associated with elevated blood pressure and could play a critical role in intracellular calcium homeostasis. The aim of this study was to assess the associations of ATP2B1 rs2681472 and CACNB2 rs12258967 gene polymorphisms with high blood pressure (HBP) among Lithuanian children and adolescents aged 12-15 years. STUDY DESIGN AND PARTICIPANTS This was a cross-sectional study of a randomly selected sample of 646 12-15-year-old adolescents who participated in the survey 'The Prevalence and Risk Factors of HBP in 12-15 Year-Old Lithuanian Children and Adolescents (from November 2010 to April 2012)'. Anthropometric parameters and BP were measured. The participants with HBP were screened on two separate occasions. Subjects were genotyped ATP2B1 rs2681472 and CACNB2 rs12258967 gene polymorphisms using real-time PCR method. RESULTS The prevalence of HBP was 36.7%, significantly higher for boys than for girls. In the multivariate analysis, after adjustment for body mass index and waist circumference, boys with CACNB2 CG genotype, CACNB2 GG genotype and CACNB2 CG +GG genotype had higher odds of having HBP in codominant (adjusted OR (aOR)=1.92; 95% CI 1.16 to 3.18, p=0.011; and aOR=2.64; 95% CI 1.19 to 5.90, p=0.018) and in dominant (aOR=2.05; 95% CI 1.27 to 3.30, p=0.003) inheritance models. Girls carrying CACNB2 CG genotype and CACNB2 CG +GG genotype had increased odds of HBP in codominant (aOR=1.82; 95% CI 1.02 to 3.24, p=0.044) and in dominant (aOR=1.89; 95% CI 1.09 to 3.28, p=0.023) inheritance models. Furthermore, significant associations were found in additive models separately for boys (aOR=1.72; 95% CI 1.20 to 2.46, p=0.003) and girls (aOR=1.52; 95% CI 1.05 to 2.20, p=0.027). No significant association was found between ATP2B1 gene polymorphism and the odds of HBP. CONCLUSIONS Our results indicate that CACNB2 gene polymorphism was significantly associated with higher odds of HBP in Lithuanian adolescents aged 12-15 years.
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Affiliation(s)
- Sandrita Simonyte
- Institute of Cardiology of the Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Renata Kuciene
- Institute of Cardiology of the Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Virginija Dulskiene
- Institute of Cardiology of the Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vaiva Lesauskaite
- Institute of Cardiology of the Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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