Our results suggest that improvements in fitness from childhood to adolescence are associated with a lower risk of becoming overweight/obese in adolescence. The current findings highlight the importance of promoting fitness through physical exercise from early stages in life, as a promising strategy to fight against overweight and obesity. Gender and country differences observed in this study require social and political attention.
BackgroundLow to moderate agreement between self-reported and directly measured anthropometry is shown in studies for adults and children. However, this issue needs further evaluation during puberty, a period marked by several transitions. We examined the correspondence of BMI status based on self-reported versus measured anthropometric data among Estonian adolescents with a specific focus on gender and age differences.MethodsSelf-reported height and weight were determined in a national representative sample of Estonian schoolchildren collected within the framework of the HBSC (health behaviour of school-aged children) survey. Self-reported and directly measured height and weight were collected from 3379 students (1071 aged 11, 1133 aged 13 and 1175 aged 15 years). The standardized HBSC questionnaire was used for collecting self-reported data; direct anthropometric measures were taken after the HBSC questionnaires were completed. The accuracy of the self-reported values by age and gender groups were determined by comparing mean differences, Bland–Altman plots with limits of agreement, Kappa statistics, and by estimation of the sensitivity and positive predictive value for detecting overweight.ResultsMean self-reported weight, height and body mass index (BMI) values were significantly lower than corresponding values obtained using direct measurements. Mean differences between self-reported and directly measured weight, height and BMI were largest among 11-year-olds and smallest among students aged 15 years. Underestimation of overweight prevalence (includes obese) showed a graded trend which decreased in older age groups; the difference was greater among girls than boys in all age groups. The mean underestimation of overweight prevalence based on self-reported anthropometry was 3.6 percentage points. The positive predictive value was 72.3 % for boys and 63.4 % for girls.ConclusionA distinct age-related pattern in underestimation of weight, height and prevalence of overweight was found; the bias decreased with increasing age. The mean underestimation of overweight prevalence based on self-reports was small, 3.6 %. Self-reported height and weight remain the method of choice in large surveys for practical and logistical reasons.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1587-9) contains supplementary material, which is available to authorized users.
Hydatidiform mole is an aberrant human pregnancy characterized by early embryonic arrest and excessive trophoblastic proliferation. Recurrent hydatidiform moles are defined by the occurrence of at least two hydatidiform moles in the same patient. Fifty to eighty percent of patients with recurrent hydatidiform moles have biallelic pathogenic variants in NLRP7 or KHDC3L. However, in the remaining patients, the genotypic types of the moles are unknown. We characterized 80 new hydatidiform mole tissues, 57 of which were from patients with no mutations in the known genes, and we reviewed the genotypes of a total of 123 molar tissues. We also reviewed mutation analysis in 113 patients with recurrent hydatidiform moles. While all hydatidiform moles from patients with biallelic NLRP7 or KHDC3L mutations are diploid biparental, we demonstrate that those from patients without mutations are highly heterogeneous and only a small minority of them are diploid biparental (8%). The other mechanisms that were found to recur in patients without mutations are diploid androgenetic monospermic (24%) and triploid dispermic (32%); the remaining hydatidiform moles were misdiagnosed as moles due to errors in the analyses and/or their unusual mechanisms. We compared three parameters of genetic susceptibility in patients with and without mutations and show that patients without mutations are mostly from non-familial cases, have fewer reproductive losses, and more live births. Our data demonstrate that patients with recurrent hydatidiform moles and no mutations in the known genes are, in general, different from those with mutations; they have a milder genetic susceptibility and/or a multifactorial etiology underlying their recurrent hydatidiform moles. Categorizing these patients according to the genotypic types of their recurrent hydatidiform moles may facilitate the identification of novel genes for this entity.
Fetal overgrowth and numerous congenital malformations can be detected in every trimester of pregnancy. New technologies in molecular testing, such as chromosomal microarray analysis and next-generation sequencing, continually demonstrate advantages for definitive diagnosis in fetal life. Simpson-Golabi-Behmel (SGB) syndrome is a rare but well-known overgrowth condition that is rarely diagnosed in the prenatal setting. We report 3 cases of SGB syndrome in 2 consecutive pregnancies. In our series, distinctive prenatal sonographic findings led to molecular diagnosis. Exome sequencing from fetal DNA revealed a hemizygous splice site variant in the GPC3 gene: NM_004484.3:c.1166+ 1G>T. The mother is a heterozygous carrier. We also provide an overview of the previously published 57 prenatal cases of SGB syndrome with prevalence estimation of the symptoms to aid prenatal differential diagnosis of fetal overgrowth syndromes.
Seventy children aged 6 years (34 boys, 36 girls) were studied for cardiovascular risk factors. Among the children 40 had also been investigated at birth. The aim of the study was to determine changes in serum lipoprotein parameters from birth up to preschool age and to assess the role of some relevant factors that might affect the process. An obvious association was found between serum apolipoprotein (apo) B levels, the apoB/apoA-I ratio and lipoprotein(a) (Lp(a)) levels at birth and at 6 years of age (r = 0.43; p<0.05, r = 0.73; p<0.0001 and r = 0.81; p<0.0001, respectively). Thirty percent of children who were in the top quartile by apoB or total cholesterol levels and 66.7% of those in this quartile by apoB/apoA-I ratio at birth remained in the top quartiles also in the follow-up study. The significantly higher apoB/apoA-I ratio in newborns and the apoB/apoA-I and apoB values in the 6-year-old children were observed in the carrier apoE4 isoform as compared to E3 homozygotes. A significant influence of apoE polymorphism on serum apoB/apoA-I ratio and apoB level in preschool children was confirmed by ANOVA one-way analysis of variance. In a multiple regression analysis from all the studied factors, the independent determinants of apoB level in preschool age were apoE phenotype, gestational age and Apgar score in the first minute of life. Thus, tracking of serum Lp(a), apoB, apoB/apoA-I ratio and total cholesterol levels from birth up to 6 years of age was demonstrated. The association between apoE polymorphism and serum lipoprotein parameters became more obvious after the first 6 years of life.
Environmental as well as genetic factors are involved in the pathogenesis of myocardial infarction. The disease is a frequent cause of mortality in the middle-aged male population of Estonia. The high prevalence of premature myocardial infarction (PMI) in this country is not fully understood. The association of atherogenic and thrombogenetic risk factors with lifestyle was evaluated in men who had suffered myocardial infarction at 55 years of age (n = 71) and in randomly selected corresponding controls (n = 85). Serum routine lipids, apolipoprotein (apo)A-I, apoB, apoE polymorphism, lipoprotein(a) and fibrinogen levels were determined. Behavioural risk factors, indices of obesity, blood pressure and pedigree data were registered. In 80.6 % of PMI subjects some type of hyperlipidaemia was observed (European Atherosclerosis Society Classification) and lipid-lowering drugs were taken by 13.9 % of patients. In PMI patients the most common positive determinants of atherogenic lipoprotein indices were waist-to-hip ratio and physical inactivity, and in controls, waist-to-hip ratio and apoE phenotype. The odds ratio (OR) of PMI was 8.9-fold greater in the highest tertile of apoB/apoA-I distribution compared with the lowest tertile. The OR of PMI in the highest tertile of fibrinogen distribution versus the lowest tertile was 6.2 (95 % CI 2.46-15.44), and OR of PMI in the highest Lp(a) tertile versus the lowest was 3.1 (95 % CI 1.31-7.40). Thus, atherogenic dyslipidaemia was the most serious cardiovascular risk factor among PMI patients. From two thrombogenesis-related markers, the levels of fibrinogen and Lp(a), the first one was more strongly associated with PMI status.
A cohort of young families from Tallinn was studied for coronary risk factors. In sera from 239 adults and cord blood from 138 of their newborns, TC, HDL-C, LDL-C, TG, Lp(a) and apo-B levels were determined, and body mass index (BMI) and lifestyle factors were registered. In newborns, characteristics of maturity were assessed by Dubowitz and Apgar scores after birth. The aim of the study was to investigate the risk factors for atherosclerosis in young families and to reveal the main determinants of atherogenic lipoprotein parameters in adults and newborns. Using the criteria of the International Lipid Information Bureau, it was found that 24.4% of the men and 9.8% of the women were hypercholesterolemic, 31.5% of the men and 9.6% of the women had low HDL-C, TG levels were elevated accordingly in 5.3% and 1.2% of subjects. The independent determinants of TG level in males were BMI and age, and for LDL-C and apo-B levels--BMI, age and nationality. Female neonates had higher TC, HDL-C and apo-B levels than male neonates, the differences seeming to be associated with the different physiological requirements of male and female fetuses. Newborns' HDL-C levels were correlated positively with their TCs (r=0.72; p<0.001), LDL-C (r=0.47; p<0.001) and apo B (r=0.23; p<0.05). A negative linear correlation was found between neonates' TC levels and the Dubowitz maturity score (r=-0.22; p=0.038). Serum Lp(a) levels did not differ significantly between males and females, either in adults or in newborns. The independent determinants of neonates' serum Lp(a) concentrations were parents' serum levels of Lp(a) and nationality.
The most informative predictors of future coronary attacks during childhood are apoB-100 and apoB/apoA-I ratio; serum hsCRP and lipoprotein(a) do not have predictive value in childhood.
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