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- Chen, Yun, 1966, et al.
(författare)
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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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Ingår i: Atherosclerosis. - : Elsevier BV. - 0021-9150 .- 1879-1484. ; 261, s. 131-137
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Tidskriftsartikel (refereegranskat)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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- Dangardt, Frida, 1977, et al.
(författare)
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Association between fat mass through adolescence and arterial stiffness: a population-based study from The Avon Longitudinal Study of Parents and Children
- 2019
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Ingår i: Lancet Child & Adolescent Health. - : Elsevier BV. - 2352-4642. ; 3:7, s. 474-481
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Tidskriftsartikel (refereegranskat)abstract
- Background The link between adiposity, metabolic abnormalities, and arterial disease progression in children and adolescents remains poorly defined. We aimed to assess whether persistent high adiposity levels are associated with increased arterial stiffness in adolescence and any mediation effects by common metabolic risk factors. Methods We included participants from the Avon Longitudinal Study of Parents and Children (ALSPAC) who had detailed adiposity measurements between the ages 9-17 years and arterial stiffness (carotid to femoral pulse wave velocity [PWV]) measured at age 17 years. Body-mass index (BMI) and waist-to-height ratio were calculated from weight, height, and waist circumference measurements whereas fat mass was assessed using repeated dual-energy x-ray absorptiometry (DEXA) scans. We used total and trunk fat mass indices (FMIs) to classify participants as normal (< 75th percentile) or high (> 75th percentile) FMI. We classified participants as being metabolically unhealthy if they had three or more of the following risk factors: high levels of systolic blood pressure, triglycerides, or glucose (all > 75th percentile) or low levels of high-density lipoprotein (< 25th percentile). We used multivariable linear regression analysis to assess the relationship between PWV and exposure to adiposity, and tested for linear trend of PVW levels across ordinal groups. We used latent class growth mixture modelling analysis to assess the effect of longitudinal changes in adiposity indices through adolescence on arterial stiffness. Findings We studied 3423 participants (1866 [54.5%] female and 1557 [45.5%] male). Total fat mass was positively associated with PWV at age 17 years (0.004 m/s per kg, 95% CI 0.001-0.006; p= 0.0081). Persistently high total FMI and trunk FMI between ages 9 and 17 years were related to greater PWV (0.15 m/s per kg/m(2), 0.05-0.24; p= 0.0044 and 0.15 m/s per kg/m(2), 0.06-0.25; p= 0.0021) compared with lower FMI. Metabolic abnormalities amplified the adverse effect of high total FMI on arterial stiffness (PWV 6.0 m/s [95% CI 5.9-6.0] for metabolically healthy participants and 6.2 m/s [5.9-6.4] for metabolically unhealthy participants). Participants who restored normal total FMI in adolescence (PWV 5.8 m/s [5.7-5.9] for metabolically healthy and 5.9 m/s [5.6-6.1] for metabolically unhealthy) had comparable PWV to those who had normal FMI throughout (5.7 m/s [5.7-5.8] for metabolically healthy and 5.9 m/s [5.8-5.9] for metabolically unhealthy). Interpretation Persistently high fat mass during adolescence was associated with greater arterial stiffness and was further aggravated by an unfavourable metabolic profile. Reverting to normal FMI in adolescence was associated with normal PWV, suggesting adolescence as an important period for interventions to tackle obesity in the young to maximise long-term vascular health. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.
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- Dangardt, Frida, 1977, et al.
(författare)
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Intimal and medial arterial changes defined by ultra-high-frequency ultrasound: Response to changing risk factors in children with chronic kidney disease
- 2018
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:6
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Tidskriftsartikel (refereegranskat)abstract
- Background Patients with chronic kidney disease (CKD) are exposed to both traditional 'Framingham' and uremia related cardiovascular risk factors that drive atherosclerotic and arteriosclerotic disease, but these cannot be differentiated using conventional ultrasound. We used ultrahigh-frequency ultrasound (UHFUS) to differentiate medial thickness (MT) from intimal thickness (IT) in CKD patients, identify their determinants and monitor their progression. Fifty-four children and adolescents with CKD and 12 healthy controls underwent UHFUS measurements using 55-70MHz transducers in common carotid and dorsal pedal arteries. Annual follow-up imaging was performed in 31 patients. CKD patients had higher carotid MT and dorsal pedal IT and MT compared to controls. The carotid MT in CKD correlated with serum phosphate (p<0.001, r = 0.42), PTH (p = 0.03, r = 0.36) and mean arterial pressure (p = 0.03, r = 0.34). Following multivariable analysis, being on dialysis, serum phosphate levels and mean arterial pressure remained the only independent predictors of carotid MT (R-2 64%). Transplanted children had lower carotid and dorsal pedal MT compared to CKD and dialysis patients (p = 0.02 and p = 0.01 respectively). At 1-year follow-up, transplanted children had a decrease in carotid MT (p = 0.01), but an increase in dorsal pedal IT (p = 0.04) that independently correlated with annualized change in BMI. Using UHFUS, we have shown that CKD is associated with exclusively medial arterial changes that attenuate when the uremic milieu is ameliorated after transplantation. In contrast, after transplantation intimal disease develops as hypertension and obesity become prevalent, representing rapid vascular remodeling in response to a changing cardiovascular risk factor profile.
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- Naimi, Timothy S, et al.
(författare)
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Selection biases in observational studies affect associations between 'moderate' alcohol consumption and mortality.
- 2017
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Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 112:2, s. 207-214
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Tidskriftsartikel (refereegranskat)abstract
- Selection biases may lead to systematic overestimate of protective effects from 'moderate' alcohol consumption. Overall, most sources of selection bias favor low-volume drinkers in relation to non-drinkers. Studies that attempt to address these types of bias generally find attenuated or non-significant relationships between low-volume alcohol consumption and cardiovascular disease, which is the major source of possible protective effects on mortality from low-volume consumption. Furthermore, observed mortality effects among established low-volume consumers are of limited relevance to health-related decisions about whether to initiate consumption or to continue drinking purposefully into old age. Short of randomized trials with mortality end-points, there are a number of approaches that can minimize selection bias involving low-volume alcohol consumption.
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