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| 2. |
- Albertsson-Wikland, Kerstin, et al.
(författare)
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Mortality Is Not Increased in Recombinant Human Growth Hormone-treated Patients When Adjusting for Birth Characteristics
- 2016
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : ENDOCRINE SOC. - 0021-972X .- 1945-7197. ; 101:5, s. 2149-2159
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aimed to investigate whether reported high mortality in childhood recombinant human GH (rhGH)-treated patients was related to birth-characteristics and/or rhGH treatment. Design and Setting: We sought to develop a mortality model of the Swedish general population born between 1973 and 2010, using continuous-hazard functions adjusting for birth characteristics, sex, age intervals, and calendar year to estimate standardized mortality ratio (SMR) and to apply this model to assess expected deaths in Swedish rhGH-treated patients with idiopathic isolated GH deficiency (IGHD), idiopathic short stature (155) or born small for gestational age (SGA). Participants:The general population: Swedish Medical Birth Register (1973-2010: 1 880 668 males; 1 781 131 females) and Cause of Death Register (1985-2010). Intervention Population: Three thousand eight hundred forty-seven patients starting rhGH treatment between 1985 and 2010 and followed in the National GH Register and/or in rhGH trials diagnosed with IGHD (n = 1890), ISS (n = 975), or SGA (n=982). Main Outcome Measures: Death. Results: Using conventional models adjusting for age, sex, and calendar-year, the SMR was 1.43 (95% confidence interval, 0.89-2.19), P = .14, observed/expected deaths 21/14.68. The rhGH population differed (P amp;lt; .001) from the general population regarding birth weight, birth length, and congenital malformations. Application of an Advanced Model: When applying the developed mortality model of the general population, the ratio of observed/expected deaths in rhGH-treated patients was 21/21.99; SMR = 0.955 (0.591-1.456)P = .95. Model Comparison: Expected number of deaths were 14.68 (14.35-14.96) using the conventional model, and 21.99 (21.24-22.81) using the advanced model, P amp;lt; .001, which had at all ages a higher gradient of risk per SD of the model, 24% (range, 18-42%; P amp;lt; .001). Conclusions: Compared with the general Swedish population, the ratio of observed/expected deaths (21/21.99) was not increased in childhood rhGH-treated IGHD, ISS, and SGA patients when applying an advanced sex-specific mortality model adjusting for birth characteristics.
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| 3. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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Mortality is not increased in rhGH-treated patients when adjusting for birth characteristics.
- 2016
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 1945-7197 .- 0021-972X. ; 101:5, s. 2149-2159
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aimed to investigate whether reported high mortality in childhood recombinant human GH (rhGH)-treated patients was related to birth-characteristics and/or rhGH treatment. Design and Setting: We sought to develop a mortality model of the Swedish general population born between 1973 and 2010, using continuous-hazard functions adjusting for birth characteristics, sex, age intervals, and calendar year to estimate standardized mortality ratio (SMR) and to apply this model to assess expected deaths in Swedish rhGH-treated patients with idiopathic isolated GH deficiency (IGHD), idiopathic short stature (155) or born small for gestational age (SGA). Participants:The general population: Swedish Medical Birth Register (1973-2010: 1 880 668 males; 1 781 131 females) and Cause of Death Register (1985-2010). Intervention Population: Three thousand eight hundred forty-seven patients starting rhGH treatment between 1985 and 2010 and followed in the National GH Register and/or in rhGH trials diagnosed with IGHD (n = 1890), ISS (n = 975), or SGA (n=982). Main Outcome Measures: Death. Results: Using conventional models adjusting for age, sex, and calendar-year, the SMR was 1.43 (95% confidence interval, 0.89-2.19), P = .14, observed/expected deaths 21/14.68. The rhGH population differed (P < .001) from the general population regarding birth weight, birth length, and congenital malformations. Application of an Advanced Model: When applying the developed mortality model of the general population, the ratio of observed/expected deaths in rhGH-treated patients was 21/21.99; SMR = 0.955 (0.591-1.456)P = .95. Model Comparison: Expected number of deaths were 14.68 (14.35-14.96) using the conventional model, and 21.99 (21.24-22.81) using the advanced model, P < .001, which had at all ages a higher gradient of risk per SD of the model, 24% (range, 18-42%; P < .001). Conclusions: Compared with the general Swedish population, the ratio of observed/expected deaths (21/21.99) was not increased in childhood rhGH-treated IGHD, ISS, and SGA patients when applying an advanced sex-specific mortality model adjusting for birth characteristics.
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| 4. |
- Ali, Sara, et al.
(författare)
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Ocular Fundus Morphology and Visual Function in Adolescents Born Moderate-to-Late Preterm
- 2023
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Ingår i: Investigative Ophthalmology and Visual Science. - : Association for Research in Vision and Ophthalmology. - 0146-0404 .- 1552-5783. ; 64:8
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: Previous studies have mostly focused on ophthalmological complications associated with being born extremely preterm despite that moderate-to-late preterm (MLP) account for 85% of all preterm births. The aim was to examine fundus morphology and visual function in adolescents born MLP, in comparison with controls born full-term.Methods: A prospective population-based cohort study of 247 MLP individuals (110 girls, gestational age 32-36 weeks) with no syndromes or history of retinopathy of prematurity participated in a neonatal study in 2002-2004. Later on, they have been included in ophthalmological follow-up studies at age 8 (n=50) and 12 (n=22). In the present study, 50 adolescents (26 girls; mean age 16.5 years) were examined regarding best corrected visual acuity (BCVA), refraction, and ocular morphology, measured by optical coherence tomography (Topcon, Japan). A group of 50 adolescents (30 girls, mean age 16.7 years) born full-term served as controls. Participants with refraction outside +/-6 diopters were excluded. T-test was used for statistical analysis.Results: The MLP-group (n=48) showed a thinner macular retinal nerve fibre layer (RNFL) inner mean in right eye (RE) (26.4±1.5 vs 27.1±1.7 μm; p=0.029) and in left eye (LE) (26.3±1.5 vs 27.0±1.5 μm; p=0.022) compared with controls. A thinner macular RNFL outer mean was found both in RE (40.2±4.4 vs 42.6±4.2 μm; p=0.011) and LE (40.3±4.0 vs 42.1±4.3 μm; p=0.034) (Fig.1A-B). A thicker central macular retinal thickness (MRT) (249.3±20.9 vs 239.9±16.4 μm; p=0.016) and a thinner total peripapillary (pp)RNFL (104.8±8.8 vs 109.1±8.3 μm; p=0.027) were found in RE. The BCVA in best eye was lower in the MLP-group (n=50) compared with controls (-0.09±0.08 vs -0.12±0.09 logMAR; p=0.022). At age 8, MLP births showed a thinner total macular volume and a thicker foveal minimum, central MRT, and central macular RNFL in RE. At age 12, a thicker foveal minimum and thinner outer macular RNFL were found in LE.Conclusions: MLP-birth may be associated with ophthalmological macular and ppRNFL changes as well as lower BCVA in adolescence. Similar morphology findings have been shown at younger ages, thus the fundus results persist into young adulthood.
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| 6. |
- Allvin, Kerstin, 1970, et al.
(författare)
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Altered umbilical sex steroids in preterm infants born small for gestational age.
- 2020
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Ingår i: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. - : Informa UK Limited. - 1476-4954. ; 33:24, s. 4164-4170
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Tidskriftsartikel (refereegranskat)abstract
- Boys born small for gestational age (SGA) are at increased risk of testicular dysgenesis syndrome, and girls born SGA face the risk of polycystic ovary syndrome later in life. Our aim was to study whether neonates born SGA have an altered profile of steroid hormones at birth.A total of 168 singletons (99 boys, 69 girls) born at 32.0-36.9 gestational weeks were recruited to a population-based, university hospital, single-center study. Of these, 31 infants (17 boys, 14 girls) were born SGA. The concentrations of dehydroepiandrosterone sulfate (DHEAS), androstenedione, testosterone, dihydrotestosterone, estrone, estradiol, cortisone, and cortisol were analyzed in umbilical cord serum with mass spectrometry.Girls born SGA had higher levels of androstenedione than girls born appropriate for gestational age (AGA) (4.0 versus 2.6 nmol/L, p = 0.002). Boys born SGA had lower levels of estrone than boys born AGA (33 822 versus 62 471 pmol/L, p = 0.038). Infants born SGA had lower levels of cortisone than infants born AGA, both in girls (340 versus 579 nmol/L, p = 0.010) and in boys (308 versus 521 nmol/L, p = 0.045). Furthermore, boys born SGA had a higher cortisol/cortisone ratio than boys born AGA (0.41 versus 0.25, p = 0.028). Gestational age correlated with DHEAS (boys r = 0.48, p = 0.000, girls r = 0.35, p = 0.013), and cortisol (boys r = 0.48, p = 0.000, girls r = 0.29, p = 0.039).In moderate-to-late preterm infants born SGA we observed a different steroid hormone profile in cord serum. Girls born SGA show increased levels of androstenedione and boys born SGA show decreased levels of estrone in cord serum, which could be related to placental aromatase deficiency in intrauterine growth restriction.
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| 7. |
- Allvin, Kerstin, 1970, et al.
(författare)
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Birth weight is the most important predictor of abnormal retinal vascularisation in moderately preterm infants
- 2014
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Ingår i: Acta Paediatrica. - : Wiley-Blackwell Publishing Inc.. - 0803-5253 .- 1651-2227. ; 103:6, s. 594-600
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To find predictors of abnormal retinal vascularisation in moderately to late preterm newborn infants considered to have no risk of developing retinopathy of prematurity.METHODS: Seventy-eight infants (34 girls) were recruited from a longitudinal study of otherwise healthy premature children born at a gestational age of 32 + 0-36 + 6 weeks. Retinal vessel morphology was evaluated at mean postnatal age 7 days. Insulin-like growth factor-I (IGF-I) levels were analysed in umbilical cord blood.RESULTS: Of the 78 infants, 21 (27%) had abnormal retinal vessel morphology; they had significantly lower median (range) birth weight [1850 g, (1190-3260), vs. 2320, (1330-3580), p < 0.0001], shorter birth length [43.0 cm, (38-49), vs. 46.0, (40-50), p < 0.0001] and smaller head circumference [31.0 cm, (27.7-34.0), vs. 32.0, (27.5-36.5), p = 0.003]. They also had significantly lower gestational age [34 + 1 weeks, (32 + 2-35 + 3), vs. 34 + 6, (32 + 2-36 + 6), p = 0.004] and mean ± SD IGF-I levels (24.6 ± 17.0 μg/L vs. 46.7 ± 21.5, p < 0.0001). A higher percentage of these infants were small for gestational age (57.1% vs. 15.8%, p = 0.001), and maternal hypertension/preeclampsia rates were also higher (47.6% vs. 19.3%, p = 0.03). Step-wise logistic regression showed that birth weight was the strongest predictor of abnormal retinal vascularisation (p < 0.0001, odds ratio 0.040, 95% confidence interval 0.007-0.216).CONCLUSION: In this population of moderately to late preterm newborns, birth weight appeared to affect the retinal vascular system.
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| 8. |
- Allvin, Kerstin, 1970, et al.
(författare)
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Elevated serum levels of estradiol, dihydrotestosterone, and inhibin B in adult males born small for gestational age
- 2008
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Ingår i: Journal of Clinical Endocrinology & Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 93:4, s. 1464-9
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: Prenatal growth restriction may affect future fertility in both females and males. Studies have shown that growth-retarded male rats have different sexual behavior and disturbed steroidogenesis. OBJECTIVE: We hypothesized that adult human males born small for gestational age (SGA) have an altered sex hormone profile. DESIGN, SETTING, AND PATIENTS: Twenty-five adult males born SGA with median birth weight -2.2 sd scores (SDS) and birth length -2.4 SDS were studied. Median age was 23.1 yr and final height -0.5 SDS. They were compared with 44 male controls with median age 20.5 yr and final height 0.4 SDS. MAIN OUTCOME MEASURE: The primary outcome before the study started was 17beta-estradiol (E(2)) levels in SGA males. RESULTS: The SGA group showed significantly higher median levels of E(2), 17.9 pg/ml (P < 0.001), and dihydrotestosterone (DHT), 0.543 ng/ml (P < 0.05), compared with controls, 12.6 pg/ml and 0.423 ng/ml, respectively. Testosterone (T) levels did not differ between groups. E(2) to T ratio correlated negatively to birth weight (r = -0.40, P < 0.01) and birth length (r = -0.44, P < 0.001). DHT to T ratio correlated negatively to birth weight (r = -0.51, P < 0.001) and birth length (r = -0.38, P < 0.01). Males born SGA also had significantly higher median levels of inhibin B, 164 pg/ml (P < 0.05), compared with controls, 137 pg/ml. Inhibin B correlated negatively to birth length (r = -0.34, P < 0.01). CONCLUSION: SGA males of normal stature have higher levels of E(2), DHT, and inhibin B than controls, indicating a disturbed steroid synthesis or metabolism. Aromatase activity, calculated as E(2) to T ratio, and 5alpha-reductase activity, calculated as DHT to T ratio, is negatively correlated to size at birth.
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| 9. |
- Allvin, Kerstin, 1970, et al.
(författare)
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Longitudinal Sex Steroid Data in Relation to Birth Weight in Preterm Boys
- 2022
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Ingår i: Journal of Clinical Endocrinology & Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 107:10, s. E4212-E4221
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Tidskriftsartikel (refereegranskat)abstract
- Context There is a lack of knowledge on longitudinal sex steroid patterns during infancy, especially for boys born preterm or with low birth weight (LBW). Objective To find out whether LBW boys have a disturbed sex steroid profile during infancy. Design and setting Population-based longitudinal study performed at Sahlgrenska University Hospital, Gothenburg, Sweden. Participants Ninety-eight singleton boys (47 LBW) born at gestational age 32.0 to 36.9 weeks were included. Because of dropout, 83 of the boys were still in the study at 10 months' corrected age. Main outcome measures Serum androgen and estrogen concentrations were analyzed by gas chromatography-tandem mass spectrometry and IGF-I was determined with radioimmunoassay in umbilical cord and at 0, 2, 5, and 10 months' corrected age. Results Serum levels of androstenedione, estrone, and estradiol declined gradually from birth to 10 months corrected age. In both LBW boys and their counterparts, a surge was seen at 2 months' corrected age (3 months' chronological age) for testosterone, median (range) 6.5 (2.0-18.9) nmol/L, and in dihydrotestosterone 1.2 (0.4-4.3) nmol/L. At birth, LBW boys had higher median testosterone (0.7 vs 0.4 nmol/L, P = 0.019), and at 0 months' corrected age, both had higher testosterone (5.7 vs 3.5 nmol/L, P = 0.003) and dihydrotestosterone (1.2 vs 0.9 nmol/L, P = 0.006) than their counterparts. At 10 months' corrected age, catch-up in weight SD score from birth correlated with testosterone (rho = 0.27, P = 0.044) and androstenedione (rho = 0.29, P = 0.027). Conclusions Moderately to late preterm LBW boys showed a disturbed sex hormone profile, with elevated concentrations of androgens in early infancy.
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| 10. |
- Almquist-Tangen, Gerd, et al.
(författare)
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Consuming milk cereal drinks at one year of age was associated with a twofold risk of being overweight at the age of five
- 2019
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Ingår i: Acta Paediatrica. - Chichester : Wiley-Blackwell Publishing Inc.. - 0803-5253 .- 1651-2227. ; 108:6, s. 1115-1121
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Tidskriftsartikel (refereegranskat)abstract
- Aim: We previously reported that consuming milk cereal drinks at six months of age was associated with a high body mass index (BMI) at 12 and 18 months. This study examined the association between daily consumption at 12 months of age and BMI at the age of five.Methods: We followed up 1870/2666 (70%) children recruited at birth in 2007–2008 for the Swedish longitudinal population‐based Halland Health and Growth Study a mean of 5.09 ± 0.28 years. Feeding practices were obtained from parental questionnaires, and anthropometric data were collected by child health nurses.Results: At five years, 11.6% were overweight and 2.3% were obese. Milk cereal drinks were consumed by about 85% and 10% at one and five years of age, respectively. Consumption at 12 months was associated with almost double the risk of being overweight at five years of age (adjusted odds ratio 1.94, 95% confidence interval 1.08–3.50). Other risk factors were a family history of obesity, low paternal educational level and paternal smoking.Conclusion: Consuming milk cereal drinks daily at 12 months was associated with a twofold risk of being overweight at five years. These findings may affect the counselling guidelines used at child healthcare centres. Copyright © 2019 John Wiley & Sons, Inc. All rights reserved
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