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- Bergdahl, Ebba, et al.
(author)
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Longitudinal follow-up on vascular morphology and function in children with kidney transplants.
- 2022
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In: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253. ; 112:3, s. 557-568
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Journal article (peer-reviewed)abstract
- Our aim was to evaluate cardiovascular risk profile in 42 children with kidney transplants (KT) at the Queen Silvia Children's Hospital, Gothenburg Sweden.Forty-two children (7.1-18years) with KT, time from transplantation 3.5 (0.9-13) years, were examined at inclusion and annually for three consecutive years. Eighteen matched controls were examined once. Cardiovascular phenotyping included ultra-high frequency ultrasound (UHFUS), pulse wave velocity (PWV) and endothelial function.Children with KT had higher body mass index (BMI) z-score and blood pressure (BP) z-score than healthy controls (BMI z-score: 0.4 ±1.0 and -0.2 ±0.9, respectively, p=0.02; SBP z-score: 0.5 ± 0.9 and -0.8 ± 0.7; DBP z-score: 0.7 ± 0.7 and -0.3 ± 0.5, respectively, p<0.001). BP z-score decreased significantly over three years, other vascular markers remained unchanged. PWV and Carotid intima thickness (IT) was higher in children with KT compared to healthy controls. Children with preemptive KT had lower radial IT and dorsal pedal media thickness (MT) compared to children with preceding dialysis.Children with KT show increased cardiovascular risk parameters, not increasing over time. Children on dialysis before KT have more pronounced vascular changes than those with preemptive KT, suggesting preemptive transplantation more beneficial for cardiovascular health.
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- Chen, Yun, 1966, et al.
(author)
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Age- and sex-related differences in vascular function and vascular response to mental stress Longitudinal and cross-sectional studies in a cohort of healthy children and adolescents.
- 2012
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In: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 220:1, s. 269-274
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Journal article (peer-reviewed)abstract
- Objective: Limited data, especially from longitudinal studies, are available regarding vascular health assessment in childhood. In this study, we performed longitudinal and cross-sectional studies in healthy children and adolescents to investigate age- and sex-related differences in vascular functions and vascular response to mental stress. Methods: Pulse wave velocity (PWV) was measured by tonometry. Endothelial function and vascular response to mental arithmetic test were assessed using a peripheral artery tonometry device. Data were obtained in 162 adolescents (mean age of 17 years, 94 girls) in a 3-year follow-up study and 241 children (mean age of 10 years, 115 girls) in a first-time investigation. Physical activity was assessed in adolescents by a self-report questionnaire. Results: Our 3-year follow-up study revealed that the increased PWV was greater in male adolescents (0.79 ± 0.79 m/s) than in females (0.27 ± 0.89 m/s, p < 0.001). Adolescents who reported decreased physical activity over the 3-year period had increased arterial stiffness. Comparing the cross-sectional data, we found that sex-related differences in reactive hyperemic response was more apparent by evaluating the overall response curve than measuring the reactive hyperemic index from one arbitrary time point, with lower peak response and smaller area-under-curve found in boys. Moreover, we found that, in response to mental stress, male adolescents had a more vasoconstrictive response, followed by a less vasodilatory response, and needed longer time to return to baseline level than the females. Conclusion: These findings suggest that boys are likely to have adverse changes in vascular health earlier than the age-matched girls.
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- Chen, Yun, 1966, et al.
(author)
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Association between childhood BMI trajectories and cardiometabolic risk and mental health problems at the age of 13 years: the cohort STudy of Adolescence Resilience and Stress (STARS)
- 2023
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In: The Lancet. Global health. - 2214-109X. ; 11
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Journal article (peer-reviewed)abstract
- BACKGROUND: Research on BMI trajectories has been focused mainly on childhood and adolescence, missing birth and infancy, which are also relevant in the development of cardiometabolic disease in adulthood. We aimed to identify trajectories of BMI from birth throughout childhood, and to examine whether BMI trajectories predict health outcomes at the age of 13 years; and, if so, whether differences exist among trajectories regarding timeframes during which BMI in early life influences health outcomes. METHODS: Participants recruited from schools in the Västra Götaland region of Sweden completed questionnaires of perceived stress and psychosomatic symptoms and were examined for the following cardiometabolic risk factors: BMI, waist circumference, systolic blood pressure, pulse-wave velocity, and white blood cell counts. We collected ten retrospective measures of weight and height, from birth to the age of 12 years. Participants with at least five measures (at birth, one at age 6-18 months, two at age 2-8 years, and one at age 10-13 years) were included in the analyses. We used group-based trajectory modelling to identify BMI trajectories, ANOVA to compare different trajectories, and linear regression to assess associations. FINDINGS: We recruited 1902 participants (829 [44%] boys and 1073 [56%] girls, median age 13·6 years (IQR 13·3-13·8). We identified and named three BMI trajectories, and categorised participants accordingly: normal gain (847 [44%] participants), moderate gain (815 [43%] participants), and excessive gain (240 [13%] participants). Differences distinguishing these trajectories were established before the age of 2 years. After adjustments for sex, age, migrant background, and parental income, respondents with excessive gain had a higher waist circumference (mean difference 19·2 cm [95% CI 18·4-20·0]), higher systolic blood pressure (mean difference 3·6 mm Hg [95% CI 2·4-4·4]), more white blood cells (mean difference 0·7×10⁹ cells per L [95% CI 0·4-0·9]), and higher stress scores (mean difference 1·1 [95% CI 0·2-1·9]), but similar pulse-wave velocity compared with adolescents with normal gain. Higher waist circumference (mean difference 6·4 cm [95% CI 5·8-6·9]), higher systolic blood pressure (mean difference 1·8 mm Hg [95% CI 1·0-2·5]), and a higher stress score (mean difference 0·7 [95% CI 0·1-1·2]) were also found in adolescents with moderate gain, compared with adolescents with normal gain. Regarding timeframes, we observed that a significant positive correlation of early life BMI with systolic blood pressure started approximately at the age 6 years for participants with excessive gain, much earlier than for participants with normal gain and moderate gain, for which it started at the age of 12 years. For waist circumference, white blood cell counts, stress, and psychosomatic symptoms, the timeframes were similar across the three BMI trajectories. INTERPRETATION: Excessive gain BMI trajectory from birth can predict both cardiometabolic risk and stress and psychosomatic symptoms in adolescents before the age of 13 years.
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- Chen, Yun, 1978, et al.
(author)
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Childhood BMI trajectories predict cardiometabolic risk and perceived stress at age 13 years: the STARS cohort
- 2023
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In: Obesity. - 1930-7381 .- 1930-739X.
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Journal article (peer-reviewed)abstract
- Objective: The aim of this study was to examine BMI trajectories from birth throughout childhood, associations with health outcomes at age 13 years, and time frames during which early-life BMI influenced adolescent health. Methods: Participants (1902, 44% male) reported perceived stress and psychosomatic symptoms and were examined for waist circumference (WC), systolic blood pressure (SBP), pulse wave velocity, and white blood cell counts (WBC). BMI trajectory was analyzed using group-based trajectory modeling of retrospective data of weight/height from birth throughout childhood. The authors performed linear regression to assess associations between BMI trajectories and health outcomes at age 13 years, presented as estimated mean differences with 95% CI among trajectories. Results: Three BMI trajectories were identified: normal; moderate; and excessive gain. Adjusting for covariates, adolescents with excessive gain had higher WC (19.2 [95% CI: 18.4–20.0] cm), SBP (3.6 [95% CI: 2.4–4.4] mm Hg), WBC (0.7 [95% CI: 0.4–0.9] × 109/L), and stress (1.1 [95% CI: 0.2–1.9]) than adolescents with normal gain. Higher WC (6.4 [95% CI: 5.8–6.9] cm), SBP (1.8 [95% CI: 1.0–2.5] mm Hg), and stress (0.7 [95% CI: 0.1–1.2]) were found in adolescents with moderate versus normal gain. The association of early-life BMI with SBP started around age 6 years with the excessive gain group, which was earlier than in the normal and moderate gain groups, in which it started at age 12 years. Conclusions: An excessive gain BMI trajectory from birth predicts cardiometabolic risk and stress in 13-year-old individuals.
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| 7. |
- Chen, Yun, 1966, et al.
(author)
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High levels of soluble intercellular adhesion molecule-1, insulin resistance and saturated fatty acids are associated with endothelial dysfunction in healthy adolescents.
- 2010
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In: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 211:2, s. 638-42
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Atherosclerosis begins and progresses during childhood and adolescence. Endothelial dysfunction is one of the earliest abnormalities that can be detected in the development of atherosclerosis. As the determinants of endothelial function in childhood are unknown, we investigated the influence of cardiovascular risk factors on endothelial function in a cohort of healthy adolescents. METHODS: A total of 257 adolescents (age: 14.5+/-1.0 years, 138 girls) participated in this study. Endothelial function was measured as reactive hyperemic index (RHI) using a fingertip peripheral arterial tonometry device. Blood samples were collected for analysis of lipids, insulin, glucose, fatty acid composition of plasma phospholipids, and markers of inflammation and endothelial function. RESULTS: There was no gender difference in RHI. Boys had higher plasma level of vascular cellular adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), P-selectin and monocyte chemoattractant protein-1, and lower level of insulin, total cholesterol, high-density lipoprotein-cholesterol (HDL), low-density lipoprotein-cholesterol (LDL), ApoA1, ApoB, and docosahexaenoic acid of plasma phospholipids than girls. There was no gender difference regarding triacylglycerol, triacylglycerol/HDL, LDL/HDL and ApoB/ApoA. The RHI was inversely associated with plasma ICAM-1 (p=0.0003), HOMA index for insulin resistance (HOMA-IR, p=0.001) and saturated fatty acids of plasma phospholipids (SFA, p=0.001). The associations remained significant after adjusting for age, height, BMI-z-score, sex, blood pressure, HDL and smoking. CONCLUSION: In healthy adolescents impaired endothelial function is significantly associated with high level of soluble ICAM-1, HOMA-IR and SFA.
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| 8. |
- Chen, Yun, 1966, et al.
(author)
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Impact of psychological health on peripheral endothelial function and the HPA-axis activity in healthy adolescents
- 2017
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In: Atherosclerosis. - : Elsevier BV. - 0021-9150 .- 1879-1484. ; 261, s. 131-137
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Journal article (peer-reviewed)abstract
- Background and aims: The development of adolescence psychological health over a 3-year period and its relationship to peripheral endothelial function and the hypothalamic-pituitary-adrenal (HPA)-axis activity were examined in a cohort of healthy adolescents in a longitudinal study. Methods: A total of 162 adolescents (94 females) participated in both baseline (mean age 14.5 +/- 1 years) and three-year follow-up studies. Psychological health was evaluated by self-report using the Beck Youth Inventories of Emotional and Social Impairment and the psychosomatic problem scale. Peripheral endothelial function was assessed using a peripheral artery tonometry device. The HPA-axis activity measured as cortisol awakening response (CAR) was assessed only at follow-up by collecting two saliva samples, immediately after awakening and 15 min later. Physical activity, smoking and parental education were assessed by questionnaires. Results: Adolescents reported increased depression and decreased anger over three years, while only females reported increased psychosomatic complaints. Reduced peripheral endothelial function was associated with high level of anger (beta = -0.332, p = 0.018) and disruptive behaviour (beta = -0.390, p = 0.006) over three years in males, but not in females, after adjusting for covariates. Blunted cortisol awakening response was associated with high level of anxiety (beta = -0.235, p = 0.017), depression (beta = -0.203, p = 0.038), anger (beta = -0.185, p = 0.048), and low level of self-concept (beta = 0.289, p = 0.002) after adjusting for covariates. Conclusions: High level of negative emotions during adolescence may have adverse effects on peripheral endothelial function and the regulation of the HPA- axis activity, while high level of self- concept might be protective. (C) 2017 Elsevier B.V. All rights reserved.
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| 9. |
- Chiesa, Scott T, et al.
(author)
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Determinants of Intima-Media Thicknessin the Young: The ALSPAC Study.
- 2021
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In: JACC. Cardiovascular imaging. - : Elsevier BV. - 1876-7591 .- 1936-878X. ; 14:2, s. 468-478
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Journal article (peer-reviewed)abstract
- This study characterized the determinants of carotid intima-media thickness (cIMT) in a large (n > 4,000) longitudinal cohort of healthy young people age 9 to 21 years.Greater cIMT is commonly used in the young as a marker of subclinical atherosclerosis, but its evolution at this age is still poorly understood.Associations between cardiovascular risk factors and cIMT were investigated in both longitudinal (ages 9 to 17 years) and cross-sectional (ages 17 and 21 years) analyses, with the latter also related to other measures of carotid structure and stress. Additional use of ultra-high frequency ultrasound in the radial artery at age 21 years allowed investigation of the distinct layers (i.e., intima or media) that may underlie observed differences.Fat-free mass (FFM) and systolic blood pressure were the only modifiable risk factors positively associated with cIMT (e.g., mean difference in cIMT per 1-SD increase in FFM at age 17: 0.007mm: 95% confidence interval [CI]: 0.004 to 0.010; p<0.001), whereas fat mass was negatively associated with cIMT (difference:-0.0032; 95%CI: 0.004 to-0.001; p=0.001). Similar results were obtained when investigating cumulative exposure to these factors throughout adolescence. An increase in cIMT maintained circumferential wall stress in the face of increased mean arterial pressure when increases in body mass were attributable to increased FFM, but not fat mass. Risk factor-associated differences in the radial artery occurred in the media alone, and there was little evidence of a relationship between intimal thickness and any risk factor.Subtle changes in cIMT in the young may predominantly involve the media and represent physiological adaptations as opposed to subclinical atherosclerosis. Other vascular measures might be more appropriate for the identification of arterial disease before adulthood.
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