Modelling repeat exposures: some examples from life course epidemiology

Wills, Andrew K.; Tilling, Kate

doi:10.1093/acprof:oso/9780199656516.003.0007

Cited by 3 publications

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“…We thus used a conditional change approach, as there is little or nothing to be gained from more complex modelling of the growth trajectory which is more beneficial with age-heterogeneous measurements. 30 The conditional change model can be interpreted as the change in body size above or below that expected given earlier BMI or height, and is useful in identifying accelerated or restricted growth. 29 LV size is known to scale in proportion to body size but the appropriate mode of indexation remains contentious; indexing LVM to BSA underestimates LVH among those who are obese.…”

Section: Discussionmentioning

confidence: 99%

Birthweight, childhood growth and left ventricular structure at age 60–64 years in a British birth cohort study

et al. 2016

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Background: High left ventricular mass (LVM) is an independent predictor of cardiovascular disease and mortality, but information relating LVM in older age to growth in early life is limited. We assessed the relationship of birthweight, height and body mass index (BMI) and overweight across childhood and adolescence with later life left ventricular (LV) structure. Methods: We used data from the MRC National Survey of Health and Development (NSHD) on men and women born in 1946 in Britain and followed up ever since. We use regression models to relate prospective measures of birthweight and height and BMI from ages 2–20 years to LV structure at 60–64 years. Results: Positive associations of birthweight with LVM and LV end diastolic volume (LVEDV) at 60–64 years were largely explained by adult height. Higher BMI, greater changes in BMI and greater accumulation of overweight across childhood and adolescence were associated with higher LVM and LVEDV and odds of concentric hypertrophy. Those who were overweight at two ages in early life had a mean LVM 11.5 g (95% confidence interval: -2.19,24.87) greater, and a mean LVEDV 10.0 ml (3.7,16.2) greater, than those who were not overweight. Associations were at least partially mediated through adult body mass index. Body size was less consistently associated with relative wall thickness (RWT), with the strongest association being observed with pubertal BMI change [0.007 (0.001,0.013) per standard deviation change in BMI 7–15 years]. The relationships between taller childhood height and LVM and LVEDV were explained by adult height. Conclusions: Given the increasing levels of overweight in contemporary cohorts of children, these findings further emphasize the need for effective interventions to prevent childhood overweight.

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Section: Discussionmentioning

confidence: 99%

Birthweight, childhood growth and left ventricular structure at age 60–64 years in a British birth cohort study

et al. 2016

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“…To examine changes in dietary pattern z -scores between periods over the life course in relation to type 2 diabetes risk, a conditional model of change ( 31 ) was used. Dietary pattern z -score changes for the periods 36–53, 36–43 and 43–53 years were calculated conditional on earlier z -score using the residual method.…”

Section: Methodsmentioning

confidence: 99%

A high-fat, high-glycaemic index, low-fibre dietary pattern is prospectively associated with type 2 diabetes in a British birth cohort

et al. 2016

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The combined association of dietary fat, glycaemic index (GI) and fibre with type 2 diabetes has rarely been investigated. The objective was to examine the relationship between a high-fat, high-GI, low-fibre dietary pattern across adult life and type 2 diabetes risk using reduced rank regression. Data were from the MRC National Survey of Health and Development. Repeated measures of dietary intake estimated using 5-d diet diaries were available at the age of 36, 43 and 53 years for 1180 study members. Associations between dietary pattern scores at each age, as well as longitudinal changes in dietary pattern z-scores, and type 2 diabetes incidence (n 106) from 53 to 60-64 years were analysed. The high-fat, high-GI, low-fibre dietary pattern was characterised by low intakes of fruit, vegetables, low-fat dairy products and whole-grain cereals, and high intakes of white bread, fried potatoes, processed meat and animal fats. There was an increasing trend in OR for type 2 diabetes with increasing quintile of dietary pattern z-scores at the age of 43 years among women but not among men. Women in the highest z-score quintile at the age of 43 years had an OR for type 2 diabetes of 5·45 (95 % CI 2·01, 14·79). Long-term increases in this dietary pattern, independently of BMI and waist circumference, were also detrimental among women: for each 1 SD unit increase in dietary pattern z-score between 36 and 53 years, the OR for type 2 diabetes was 1·67 (95 % CI 1·20, 2·43) independently of changes in BMI and waist circumference in the same periods. A high-fat, high-GI, low-fibre dietary pattern was associated with increased type 2 diabetes risk in middle-aged British women but not in men.

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“…The difficulties in practice of empirically teasing out the particular life course models have been highlighted [13,14]. More generally, the statistical models used for the testing of life-course hypotheses are complex due to repeated and correlated outcome and exposure measures and the methods are still developing and evolving [15,16]. Whatever the statistical approach, an understanding of the underlying biology and careful consideration of confounding variables and other potential biases are required.…”

Section: Life Course Epidemiologymentioning

confidence: 99%

A Life Course Approach to Cardiovascular Aging

Hardy

Lawlor

Kuh³

2015

Future Cardiol.

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A life course approach in epidemiology investigates the biological, behavioral and social pathways that link physical and social exposures and experiences during gestation, childhood, adolescence and adult life, and across generations, to later-life health and disease risk. We illustrate how a life course approach has been applied to cardiovascular disease, highlighting the evidence in support of the early origins of disease risk. We summarize how trajectories of cardiometabolic risk factors change over the life course and suggest that understanding underlying 'normal' or 'healthy' trajectories and the characteristics that drive deviations from such trajectories offer the potential for early prevention and for identifying means of preventing future disease.

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Modelling repeat exposures: some examples from life course epidemiology

Cited by 3 publications

References 0 publications

Birthweight, childhood growth and left ventricular structure at age 60–64 years in a British birth cohort study

Birthweight, childhood growth and left ventricular structure at age 60–64 years in a British birth cohort study

A high-fat, high-glycaemic index, low-fibre dietary pattern is prospectively associated with type 2 diabetes in a British birth cohort

A Life Course Approach to Cardiovascular Aging

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