RESUMO
OBJECTIVE: To compare serum uric acid levels in adolescents born prematurely and adolescents born at term and to assess the correlation between serum uric acid and blood pressure (BP) in those born prematurely. STUDY DESIGN: In this observational cohort study, 124 adolescents born prematurely and 44 adolescents born at term were studied at 14 years of age. Multivariate analyses were used to describe the relationship of premature birth to serum uric acid while adjusting for confounding variables. Pearson correlation was used to describe the relationship between uric acid and systolic BP among those born prematurely. RESULTS: Adjusting for race, sex, maternal hypertension, and fetal growth, we found that preterm adolescents had greater serum uric acid levels than adolescents born at term (adjusted mean difference 0.46, 95% CI 0.10-0.81 mg/dL; 27.4, 6-48.2 µmol/L; P = .012). Among those born prematurely, uric acid was positively correlated with systolic BP (Pearson correlation coefficient: 0.29, 0.12-0.44; P = .0013). CONCLUSIONS: Serum uric acid levels are greater in adolescents born prematurely than in those born at term, and this difference could contribute to greater BP among individuals born prematurely.
Assuntos
Nascimento Prematuro , Ácido Úrico/sangue , Adolescente , Pressão Sanguínea , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Masculino , Sístole , Nascimento a TermoRESUMO
Insulin sensitivity, insulin secretion, insulin clearance, and glucose effectiveness exhibit strong genetic components, although few studies have examined their genetic architecture or influence on type 2 diabetes (T2D) risk. We hypothesized that loci affecting variation in these quantitative traits influence T2D. We completed a multicohort genome-wide association study to search for loci influencing T2D-related quantitative traits in 4,176 Mexican Americans. Quantitative traits were measured by the frequently sampled intravenous glucose tolerance test (four cohorts) or euglycemic clamp (three cohorts), and random-effects models were used to test the association between loci and quantitative traits, adjusting for age, sex, and admixture proportions (Discovery). Analysis revealed a significant (P < 5.00 × 10(-8)) association at 11q14.3 (MTNR1B) with acute insulin response. Loci with P < 0.0001 among the quantitative traits were examined for translation to T2D risk in 6,463 T2D case and 9,232 control subjects of Mexican ancestry (Translation). Nonparametric meta-analysis of the Discovery and Translation cohorts identified significant associations at 6p24 (SLC35B3/TFAP2A) with glucose effectiveness/T2D, 11p15 (KCNQ1) with disposition index/T2D, and 6p22 (CDKAL1) and 11q14 (MTNR1B) with acute insulin response/T2D. These results suggest that T2D and insulin secretion and sensitivity have both shared and distinct genetic factors, potentially delineating genomic components of these quantitative traits that drive the risk for T2D.
Assuntos
Glicemia/genética , Diabetes Mellitus Tipo 2/metabolismo , Variação Genética , Homeostase/fisiologia , Glicemia/metabolismo , Bases de Dados Factuais , Diabetes Mellitus Tipo 2/etnologia , Regulação da Expressão Gênica/fisiologia , Genoma , Estudo de Associação Genômica Ampla , Genótipo , Hispânico ou Latino , Homeostase/genética , HumanosRESUMO
OBJECTIVE: To evaluate the relationship between maternal preeclampsia resulting in premature delivery and adiposity in the offspring during adolescence. STUDY DESIGN: The 172 study participants were 14 years old and had very low birth weight. We compared height, weight, body mass index (BMI), percent fat, waist circumference, and triceps and subscapular skin fold thicknesses between those born prematurely secondary to preeclampsia (n = 51; 22 male) and those born prematurely after normotensive pregnancies (n = 121; 55 male). Multiple linear regression analysis was used to adjust for potential confounders (maternal BMI, antenatal steroid exposure, and race) and to evaluate potential explanatory variables (fetal, infancy, and childhood weight gain, and caloric intake, level of fitness, and physical activity at 14 years). RESULTS: When adjusted for potential prenatal confounders (antenatal steroid exposure and race), adolescent male offspring of preeclamptic pregnancies had higher BMI (4.0 kg/m(2) [1.5, 6.6]) (mean difference [95% CI]), waist circumference (11.8 cm [3.8, 19.7]), triceps (4.6 mm [0.6, 8.6]) and subscapular skinfold thicknesses (6.2 mm [1.5, 10.9]), and percent body fat (4.1% [-0.1, 8.3]). Adjusting for infancy and childhood weight gain attenuated these group differences. There were no group differences among females. CONCLUSION: Male adolescent offspring born prematurely of women with preeclampsia have higher measures of adiposity than those born prematurely of normotensive pregnancies.
Assuntos
Adiposidade , Doenças do Prematuro/etiologia , Obesidade/etiologia , Pré-Eclâmpsia/epidemiologia , Efeitos Tardios da Exposição Pré-Natal , Adolescente , Composição Corporal , Índice de Massa Corporal , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Recém-Nascido de muito Baixo Peso , Masculino , Mães , Obesidade/epidemiologia , Gravidez , Fatores de RiscoRESUMO
OBJECTIVE: To determine the prevalence and correlates of elevated blood pressure (BP) in youth with type 1 or type 2 diabetes mellitus by using data from the SEARCH Study. STUDY DESIGN: The analysis included youth aged 3 to 17 years with type 1 (n = 3691) and type 2 diabetes mellitus (n = 410) who attended a research visit. Elevated BP was defined as systolic or diastolic values >or=95 percentile, regardless of drug use. In youth with elevated BP, awareness was defined as self-report of an earlier diagnosis. Control was defined as BP values <90th percentile and <120/90 mm Hg in youth with an earlier diagnosis who were taking BP medications. RESULTS: The prevalence of elevated BP in youth with type 1 diabetes mellitus was 5.9%; minority ethnic groups, obese adolescents, and youth with poor glycemic control were disproportionately affected. In contrast, 23.7% of adolescents with type 2 diabetes mellitus had elevated BP (P < .0001), Similarly, 31.9% of youth with type 2 diabetes mellitus and elevated BP were aware, compared with only 7.4% of youth with type 1 diabetes mellitus (P < .0001). Once BP was diagnosed and treated, control was similar in type 1 (57.1%) and type 2 diabetes mellitus (40.6%). CONCLUSIONS: Our findings identify high-risk groups of youth with diabetes mellitus at which screening and treatment efforts should be directed.
Assuntos
Pressão Sanguínea , Complicações do Diabetes/diagnóstico , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Hipertensão/epidemiologia , Adolescente , Índice de Massa Corporal , Criança , Pré-Escolar , Complicações do Diabetes/epidemiologia , Feminino , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Masculino , Prevalência , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: To discuss vascular stiffness commonly encountered in children with type 1 diabetes mellitus (T1DM). STUDY DESIGN: We examined 535 subjects with T1DM (14.6 years; 53% male, 88% non-Hispanic white) and 241 healthy control subjects (17.8 years; 42% male, 39% non-Hispanic white). Abnormalities in brachial distensibility (BrachD), pulse wave velocity, and augmentation index corrected to a HR of 75 (AIx-75) were examined. RESULTS: Subjects with T1DM had higher body mass index, LDL-cholesterol, fasting glucose, and blood pressure than control subjects. Diabetic subjects had lower BrachD and higher AIx-75 indicating increased stiffness. Age-adjusted pulse wave velocity-trunk (aorto-femoral) was higher in cases (all P Assuntos
Artérias/fisiopatologia
, Diabetes Mellitus Tipo 1/fisiopatologia
, Adolescente
, Braço/irrigação sanguínea
, Velocidade do Fluxo Sanguíneo
, Pressão Sanguínea
, Artéria Braquial/fisiopatologia
, Elasticidade
, Feminino
, Frequência Cardíaca
, Humanos
, Perna (Membro)/irrigação sanguínea
, Masculino
, Fluxo Pulsátil