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INTRODUCTION:Traditional cardiovascular risk factors such as central obesity, high blood pressure and insulin resistance, all constituents of metabolic syndrome, have been associated with increased levels of C-reactive protein (CRP). Therefore, this marker of low-grade inflammation may play a major role in the pathogenesis of cardiovascular diseases. In this study, data from a representative sample of urban adults was used to evaluate the association between CRP and metabolic syndrome, accounting for the type and number of its constituents. METHODS: Using random digit dialing, 1022 participants, aged 18-92 y, were selected. All participants completed a structured questionnaire comprising of information on social, demographic, behavioral and clinical aspects. Anthropometrics and blood pressure were recorded and a fasting blood sample collected. Metabolic syndrome was defined, according to the Third Report of the Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults, as the presence of three or more of the following characteristics: waist circumference greater than 102 cm in men and 88 cm in women; triglyceride levels Z150 mg/dl; high-density lipoprotein cholesterol levels o40 mg/dl in men and o50 mg/dl in women; blood pressure Z130/ 85 mm Hg; and serum glucose Z110 mg/dl. High-sensitivity CRP was assessed by immunonephelometric assay. After excluding 65 participants with CRP Z10 mg/l, 957 subjects (599 women and 358 men) remained for analysis. Geometric means were compared after adjustment for age, sex, alcohol consumption and smoking. RESULTS: Higher mean levels of CRP (2.34 vs 1.36, Po0.001) were observed when metabolic syndrome was present. Also, mean CRP levels were significantly higher in the presence of central obesity (2.45 vs 1.24, Po0.001), high blood pressure (1.76 vs 1.12, Po0.001), hypertriglyceridemia (2.17 vs 1.32, Po0.001) and high fasting glucose (1.96 vs 1.46, P ¼ 0.032). We found a significant increasing trend (Po0.001) in mean levels of CRP as the number of features of metabolic syndrome increased. The major contributing features for high CRP levels were central obesity and high blood pressure. CONCLUSIONS: Present data show that increasing severity of metabolic syndrome is associated with increasing CRP. Additionally, we found that central obesity and high blood pressure are the most important determinants of the low-grade chronic inflammation present in metabolic syndrome.

Background: Many pregnancy and birth cohort studies investigate the health effects of early-life environmental contaminant exposure. An overview of existing studies and their data is needed to improve collaboration, harmonization, and future project planning.Objectives: Our goal was to create a comprehensive overview of European birth cohorts with environmental exposure data.Methods: Birth cohort studies were included if they a) collected data on at least one environmental exposure, b) started enrollment during pregnancy or at birth, c) included at least one follow-up point after birth, d) included at least 200 mother–child pairs, and e) were based in a European country. A questionnaire collected information on basic protocol details and exposure and health outcome assessments, including specific contaminants, methods and samples, timing, and number of subjects. A full inventory can be searched on www.birthcohortsenrieco.net.Results: Questionnaires were completed by 37 cohort studies of > 350,000 mother–child pairs in 19 European countries. Only three cohorts did not participate. All cohorts collected biological specimens of children or parents. Many cohorts collected information on passive smoking (n = 36), maternal occupation (n = 33), outdoor air pollution (n = 27), and allergens/biological organisms (n = 27). Fewer cohorts (n = 12–19) collected information on water contamination, ionizing or nonionizing radiation exposures, noise, metals, persistent organic pollutants, or other pollutants. All cohorts have information on birth outcomes; nearly all on asthma, allergies, childhood growth and obesity; and 26 collected information on child neurodevelopment.Conclusion: Combining forces in this field will yield more efficient and conclusive studies and ultimately improve causal inference. This impressive resource of existing birth cohort data could form the basis for longer-term and worldwide coordination of research on environment and child health.

Background: Studies that addressed social and economic determinants of cardiovascular diseases, consistently showed an increase prevalence of the individual features of metabolic syndrome in the lower socio-economic strata. Thus, this study aimed to evaluate the association between social class and metabolic syndrome in a sample of urban middle-aged and old Portuguese adults.

Background:Women of reproductive age can be exposed to endocrine-disrupting chemicals (EDCs) at work, and exposure to EDCs in pregnancy may affect fetal growth.Objectives:We assessed whether maternal occupational exposure to EDCs during pregnancy as classified by application of a job exposure matrix was associated with birth weight, term low birth weight (LBW), length of gestation, and preterm delivery.Methods:Using individual participant data from 133,957 mother–child pairs in 13 European cohorts spanning births from 1994 through 2011, we linked maternal job titles with exposure to 10 EDC groups as assessed through a job exposure matrix. For each group, we combined the two levels of exposure categories (possible and probable) and compared birth outcomes with the unexposed group (exposure unlikely). We performed meta-analyses of cohort-specific estimates.Results:Eleven percent of pregnant women were classified as exposed to EDCs at work during pregnancy, based on job title. Classification of exposure to one or more EDC group was associated with an increased risk of term LBW [odds ratio (OR) = 1.25; 95% CI: 1.04, 1.49], as were most specific EDC groups; this association was consistent across cohorts. Further, the risk increased with increasing number of EDC groups (OR = 2.11; 95% CI: 1.10, 4.06 for exposure to four or more EDC groups). There were few associations (p < 0.05) with the other outcomes; women holding job titles classified as exposed to bisphenol A or brominated flame retardants were at higher risk for longer length of gestation.Conclusion:Results from our large population-based birth cohort design indicate that employment during pregnancy in occupations classified as possibly or probably exposed to EDCs was associated with an increased risk of term LBW.Citation:Birks L, Casas M, Garcia AM, Alexander J, Barros H, Bergström A, Bonde JP, Burdorf A, Costet N, Danileviciute A, Eggesbø M, Fernández MF, González-Galarzo MC, Gražulevičienė R, Hanke W, Jaddoe V, Kogevinas M, Kull I, Lertxundi A, Melaki V, Andersen AM, Olea N, Polanska K, Rusconi F, Santa-Marina L, Santos AC, Vrijkotte T, Zugna D, Nieuwenhuijsen M, Cordier S, Vrijheid M. 2016. Occupational exposure to endocrine-disrupting chemicals and birth weight and length of gestation: a European meta-analysis. Environ Health Perspect 124:1785–1793; http://dx.doi.org/10.1289/EHP208

A B S T R A C TBackground: The role of persistent organic pollutants (POPs) with endocrine disrupting activity in the aetiology of obesity and other metabolic dysfunctions has been recently highlighted. Adipose tissue (AT) is a common site of POPs accumulation where they can induce adverse effects on human health. Objectives: To evaluate the presence of POPs in human visceral (vAT) and subcutaneous (scAT) adipose tissue in a sample of Portuguese obese patients that underwent bariatric surgery, and assess their putative association with metabolic disruption preoperatively, as well as with subsequent body mass index (BMI) reduction. Methods: AT samples (n¼ 189) from obese patients (BMI Z35) were collected and the levels of 13 POPs were determined by gas chromatography with electroncapture detection (GC-ECD). Anthropometric and biochem-ical data were collected at the time of surgery. BMI variation was evaluated after 12 months and adipocyte size was measured in AT samples. Results: Our data confirm that POPs are pervasive in this obese population (96.3% of detection on both tissues), their abundance increasing with age (RS ¼ 0.310, po0.01) and duration of obesity (RS ¼ 0.170, po0.05). We observed a difference in AT depot POPs storage capability, with higher levels of ΣPOPs in vAT (213.97204.2 compared to 155.17147.4 ng/g of fat, po0.001), extremely relevant when evaluating their metabolic impact. Furthermore, there was a positive correlation between POP levels and the presence of metabolic syndrome components, namely dysglycaemia and hypertension, and more importantly with cardiovascular risk (RS ¼ 0.277, po0.01), with relevance for vAT (RS ¼ 0.315, po0.01). Finally, we observed an interesting relation of higher POP levels with lower weight loss in older patients. Conclusion: Our sample of obese subjects allowed us to highlight the importance of POPs stored in AT on the development of metabolic dysfunction in a context of obesity, shifting the focus to their metabolic effects and not only for their recognition as environmental obesogens.

Background: We aimed to assess whether we could identify a graded association between increasing number of components of the metabolic syndrome and cardiac structural and functional abnormalities independently of predicted risk of coronary heart disease by the Framingham risk score.

BackgroundUnhealthy lifestyle choices tend to cluster, but controversy remains regarding relationships between smoking and dietary habits. The aim of this study was to compare dietary intake and alcohol consumption, according to smoking status, in the Portuguese population.MethodsThe study sample included all participants in the third Portuguese National Health Survey who were older than 19 years (20,302 women and 17,923 men).Participants were selected from households in the five regions of Portugal (NUTS II classification), using a multi-stage random probability design. Trained interviewers conducted face-to-face interviews in each household and obtained information on social and demographic characteristics, lifestyle and health, smoking, and intakes of selected food and beverages. Age-adjusted and education-adjusted binomial and multinomial logistic regression models were fitted separately for males and females, to estimate the magnitude of the association between smoking and the consumption of various food and beverage groups.ResultsWhen heavy smokers were compared with non-smokers, the odds ratio (OR) favouring soup consumption was 0.60 (95% Confidence Interval [95%CI]: 0.54–0.68) in males and 0.46 (95% CI: 0.33–0.65) in females. Similar ORs were observed for vegetables (males: OR = 0.56, 95%CI: 0.49–0.64; females: OR = 0.47, 95%CI: 0.32–0.69) and fruit (males: OR = 0.36, 95%CI: 0.31–0.41; females: OR = 0.29, 95%CI: 0.19–0.44). Overall, these food items were consumed at significantly lower levels as cigarette consumption increased. Heavy male smokers, compared to non-smokers, presented lower odds favouring milk consumption (OR = 0.89; 95%CI: 0.67–0.89). When heavy smokers were compared with non-smokers, the ORs favouring wine drinking, among heavy drinkers, were 1.47 (95%CI: 1.27–1.70) in men and 3.97 (95%CI: 2.07–7.61) in women. Similar ORs were observed for beer (males: OR = 3.30; 95%CI: 2.87–3.78; females: OR = 23.1; 95%CI: 12.2–43.6), Port wine (males: OR = 2.21 95%CI: 1.65–2.98; females: OR = 2.85; 95%CI: 0.68–12.1), brandy (males: OR = 3.67 95%CI: 2.98–4.52; females: OR = 13.2; 95%CI: 3.72–46.6) and whisky (males: OR = 3.31; 95%CI: 2.71–4.03; females: OR = 41.4; 95%CI: 18.5–92.5).ConclusionThis study showed that smokers have a higher intake of alcoholic beverages and a lower consumption of food items rich in fibre, antioxidants, or phytochemicals, which are suspected to have beneficial roles in the prevention of multiple chronic diseases.