A slow rate of intrauterine growth is a major risk factor for several common noncommunicable diseases, which include the following: coronary heart disease (CHD), hypertension, and type 2 diabetes. Likewise, growth patterns in infancy and childhood have been identified as important factors linked to the pathogenesis of these disorders. In this overview, patterns of growth associated with CHD, type 2 diabetes, and related metabolic traits in adult life are presented on the basis of findings from the Helsinki Birth Cohort Study (HBCS) 1934-1944. Later risk of CHD was associated with small body size at birth and during infancy, followed by an increase in body size later in childhood. This pattern of growth has been associated with dyslipidemia in later life, which offers an explanation for the observed findings. Type 2 diabetes and CHD share several risk factors. The early growth of persons who later develop type 2 diabetes includes a small body size at birth as well as a small body size during infancy. An early age at adiposity rebound was associated with a markedly increased risk of type 2 diabetes in adulthood. The patterns of growth associated with type 2 diabetes are also associated with alterations in body composition, which predisposes to insulin resistance and the metabolic syndrome. The presented findings suggest that to be able to understand the pathogenesis of several noncommunicable diseases, the diseases need to be studied from a life-course perspective, and prenatal and childhood growth as well as adult characteristics need to be taken into account.
Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland ; Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland ; Department of Neurobiology, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland.
3% of the population develops saccular intracranial aneurysms (sIAs), a complex trait, with a sporadic and a familial form. Subarachnoid hemorrhage from sIA (sIA-SAH) is a devastating form of stroke. Certain rare genetic variants are enriched in the Finns, a population isolate with a small founder population and bottleneck events. As the sIA-SAH incidence in Finland is >2× increased, such variants may associate with sIA in the Finnish population. We tested 9.4 million variants for association in 760 Finnish sIA patients (enriched for familial sIA), and in 2,513 matched controls with case-control status and with the number of sIAs. The most promising loci (p
Cites: Stat Med. 2002 Jun 15;21(11):1539-5812111919
Cites: Stroke. 2005 Dec;36(12):2773-8016282541
Cites: Lancet. 1997 Feb 8;349(9049):380-49033463
Cites: Stroke. 1998 Feb;29(2):359-629472874
Cites: Nat Genet. 1998 Oct;20(2):171-49771710
Cites: N Engl J Med. 2005 Oct 27;353(17):1802-916251536
Cites: Am J Hum Genet. 2007 Sep;81(3):559-7517701901
Cites: J Biol Chem. 2006 Aug 11;281(32):22624-3416769727
Cites: Lancet. 2007 Jan 27;369(9558):306-1817258671
Cites: Nature. 2007 Jun 7;447(7145):661-7817554300
FK506-binding protein 51 is involved in hypothalamic-pituitary-adrenal axis regulation. Single nucleotide polymorphisms (SNPs) in the FKBP5 gene have been shown to interact with retrospectively self-reported early life stress (ELS) in patients with psychiatric disorders. We examined interactions between three selected FKBP5 SNPs and self-reported and objectively recorded ELS in relation to depressive symptoms in midlife.
This study comprised 1431 Helsinki Birth Cohort Study participants genotyped for FKBP5 SNPs shown to alter cortisol metabolism (rs1360780, rs9470080, and rs9394309). Participants completed the Beck Depression Inventory (BDI) at ages 61.5 years (time 1) and 63.4 years (time 2); 165 and 181 participants were separated from their parents in childhood as a result of evacuations during World War II as indicated by self-reports and the Finnish National Archives registry, respectively.
Associations between self-reported and objectively recorded ELS, but not stressful events in midlife, and the mean BDI score (average of time 1 and time 2) or mild to severe BDI scores (10-63 points at time 1 and time 2), or both, were moderated by the FKBP5 variants (p values for interactions .18). Mean BDI scores or odds for having mild to severe BDI scores, or both, increased according to number of minor alleles and haplotypes derived from these alleles in the separated groups, but not in the nonseparated groups.
FKBP5 variations in combination with self-reported and objectively recorded ELS predict more pronounced depressive symptoms in midlife. Our findings confirm previous retrospective findings in a prospective epidemiologic study setting.
School of Kinesiology (X.W., R.W., Y.L., P.C., S.C.), Shanghai University of Sport, Shanghai 200438, China; Department of Health Sciences (X.W., S.P., P.W., S.M.C., X.T., Y.L., S.C.), University of Jyväskylä, FIN-40014 Jyväskylä, Finland; National Center for Public Health Surveillance and Information Services (G.F.), Chinese Center for Disease Control and Prevention, Beijing 102206, China; Department of General Practice and Primary Health Care (J.G.E.), Helsinki University, and Unit of General Practice (J.G.E.), Helsinki University Central Hospital, FIN-00290 Helsinki, Finland; Folkhälsan Research Centre (J.G.E.), FIN-00250 Helsinki, Finland; Department of Medical Rehabilitation (P.W., S.M.C., M.A.), Oulu University Hospital, FIN-90221, Oulu, Finland; and Institute of Health Sciences, University of Oulu, FIN-90220 Oulu, Finland.
Knowledge about the interrelationship between adiposity and systemic low-grade inflammation during pubertal growth is important in detecting early signs of obesity-related metabolic disorders.
The objective of the study was to evaluate the developmental trajectories of fat mass (FM) and high sensitive C-reactive protein (hsCRP) levels and factors that could explain the relationship between FM and hsCRP in girls from prepuberty to early adulthood.
This was a 7.5-year longitudinal study.
The study was conducted at the University of Jyväskylä Sports and Health Science laboratory.
Three hundred ninety-six healthy Finnish girls aged 11.2 ± 0.8 years participated in the study.
Body composition was assessed by a dual-energy X-ray absorptiometry and serum concentrations of hsCRP, adipokines, and sex hormones by ELISA.
Both FM and hsCRP increased with age and had similar trajectories but different inter- and intravariance patterns. A joint analysis of fat distribution and hsCRP indicated that the linkage probabilities across different trajectory subgroups between regional FM and the corresponding hsCRP levels varied from 16% to 53%. In a longitudinal regression model, the common predictor for both FM and hsCRP was T (ß = .065, P
Hypertension associates with subarachnoid hemorrhage from saccular intracranial aneurysm (sIA-SAH) when compared to matched controls or general population. Few series compare hypertension in unruptured sIA versus sIA-SAH, so its impact on the sIA disease remains uncertain.
Kuopio sIA Database ( www.uef.fi/ns ) contains all cases of unruptured and ruptured sIAs admitted to Kuopio University Hospital from its Eastern Finnish catchment population. We compared the age-adjusted incidence of drug-treated hypertension in 467 unruptured and 1053 ruptured sIA patients admitted to Kuopio University Hospital from 1995 to 2007, using the national registry of prescribed medicines.
Antihypertensive medication was more frequent in the unruptured (73% versus 62%) with higher age-adjusted incidence. At sIA diagnosis, the sIA-SAH group had more often untreated hypertension (29% versus 23%). The size of unruptured sIAs increased with age at sIA diagnosis, independently of hypertension. Multiple sIAs, familial sIA, and sIA-SAH were not associated with hypertension in multivariate analysis. Results indicate that drug-treated hypertension associates with the formation of sIAs rather than their growth or rupture.
Hypertension is highly prevalent in the carriers of unruptured sIAs when compared to those with ruptured sIA. Hypertension may associate with the sIA formation, and may predispose to the rupture of sIA if untreated.
Adults who were born preterm with a very low birth weight have higher blood pressure and impaired glucose regulation later in life compared with those born at term. We investigated cardiometabolic risk factors in young adults who were born at any degree of prematurity in the Preterm Birth and Early Life Programming of Adult Health and Disease (ESTER) Study, a population-based cohort study of individuals born in 1985-1989 in Northern Finland. In 2009-2011, 3 groups underwent clinical examination: 134 participants born at less than 34 gestational weeks (early preterm), 242 born at 34-36 weeks (late preterm), and 344 born at 37 weeks or later (controls). Compared with controls, adults who were born preterm had higher body fat percentages (after adjustment for sex, age, and cohort (1985-1986 or 1987-1989), for those born early preterm, difference = 6.2%, 95% confidence interval (CI): 0.4, 13.2; for those born late preterm, difference = 8.0%, 95% CI: 2.4, 13.8), waist circumferences, blood pressure (for those born early preterm, difference = 3.0 mm Hg, 95% CI: 0.9, 5.1; for those born late preterm, difference = 1.7, 95% CI: -0.1, 3.4), plasma uric acid levels (for those born early preterm, difference = 20.1%, 95% CI: 7.9, 32.3; for those born late preterm, difference = 20.2%, 95% CI: 10.7, 30.5), alanine aminotransferase levels, and aspartate transaminase levels. They were also more likely to have metabolic syndrome (for those born early preterm, odds ratio = 3.7, 95% CI: 1.6, 8.2; for those born late preterm, odds ratio = 2.5, 95% CI: 1.2, 5.3). Elevated levels of conventional and emerging risk factors suggest a higher risk of cardiometabolic disease later in life. These risk factors are also present in the large group of adults born late preterm.
Cites: JAMA. 2000 May 10;283(18):2404-1010815083
Cites: Lancet. 2002 Dec 14;360(9349):1903-1312493255
Little is known about the mental health outcomes of very low-birth-weight (VLBW) ( or = -2 SDs according to Finnish birth weight charts), whose Center for Epidemiologic Studies Depression Scale scores were 29.1% (95% CI, -53.7% to -8.4%) lower than those of the controls (P =.004). Furthermore, VLBW participants born appropriate for gestational age were 4.8 (95% CI, 1.3-10.0) times less likely to report a depression diagnosis than controls (P =.02). In contrast, 52 VLBW participants born small for gestational age (birth weight
Small body size at birth and slow growth during the first 2 years after birth, leading to low body mass index (BMI) at 2 years, are associated with coronary heart disease and stroke in adult life. We tested the hypothesis that this path of growth is associated with an atherogenic lipid profile in later life.
We measured serum lipid concentrations at age 57-70 years in 1999 members of the Helsinki Birth Cohort. They were randomly selected from an original cohort of 8760 people and had on average 11 measurements of height and weight between birth and 2 years of age.
The 18% of subjects who used lipid-lowering medication had a lower BMI at birth and at 2 years. These subjects were excluded from the analyses of lipid profiles. A 1 kg/m(2) lower BMI at birth was associated with 0.051 mmol/l (95% CI -0.001 to 0.103; P = 0.05) higher non-HDL cholesterol and 0.018 g/l higher (0.005-0.031; P = 0.006) apolipoprotein B concentrations. A slower increase in BMI during the first 6 months after birth was associated with lower HDL and higher non-HDL cholesterol concentrations. A 1 kg/m(2) lower BMI at 2 years was associated with 0.020 mmol/l lower (0.004-0.036; P = 0.02) HDL cholesterol and 0.059 mmol/l (0.020-0.099; P = 0.003) higher non-HDL cholesterol and 0.018 mmol/l higher (0.008-0.028; P
Intensive lifestyle intervention significantly reduced diabetes incidence among the participants in the Finnish Diabetes Prevention Study. We investigated whether and to what extent risk factors for type 2 diabetes and other baseline characteristics of the study participants modified the effectiveness of the lifestyle intervention.
Overweight, middle-aged volunteers with impaired glucose tolerance were randomly assigned to intensive lifestyle intervention (n = 265) or to a control group (n = 257) for a median of 4 years. Diabetes status was ascertained annually with repeated oral glucose tolerance testing. Incidence rates of diabetes and hazard ratios (HRs) comparing the intervention group with the control group were calculated by sex and baseline tertiles of age, BMI, waist circumference, plasma glucose concentration at fasting and 2 h after a glucose load, fasting serum insulin and insulin resistance index, and categories of composite baseline Finnish Diabetes Risk Score (FINDRISC). Interactions between the intervention assignment and baseline risk factors on diabetes risk were analyzed.
The intervention was most effective among the oldest individuals (HRs 0.77, 0.49, and 0.36 by increasing age tertiles, respectively; P(interaction) = 0.0130) and those with a high baseline FINDRISC (HRs 1.09, 0.84, 0.34, and 0.22 by increasing risk score category, respectively; P(interaction) = 0.0400). The effect of the intervention on diabetes risk was not modified by other baseline characteristics or risk factors.
The FINDRISC may be useful in identifying high-risk groups most likely to benefit from intensive lifestyle intervention to prevent type 2 diabetes.