Biomedical subjects

C Osmond

Publications and source records attributed to C Osmond.

At least 19 recordsLinked to original sources

PubMed2006

Patterns of growth among children who later develop type 2 diabetes or its risk factors.

AIMS/HYPOTHESIS: We studied fetal and childhood growth patterns that are associated with IGT and type 2 diabetes in adult life. METHODS: We examined clinically 2,003 subjects born in Helsinki between 1934 and 1944. They had on average 11 measurements of height and weight between birth and 2 years of age, and seven measurements between 2 and 11 years of age. Glucose tolerance in adult life was assessed by a 75-g oral glucose tolerance test. RESULTS: We identified 311 subjects with type 2 diabetes and 496 with IGT. Both IGT and type 2 diabetes were associated with low birthweight (p < 0.0001 adjusting for current BMI). The risk of these conditions was increased by low weight gain between birth and 2 years. A 1 SD increase in weight at 2 years was associated with an odds ratio for either type 2 diabetes or IGT of 0.76 (95% CI 0.69-0.84). This effect was greatest in people who had low birthweight. Low growth in the first 6 months after birth was a critical period for the development of insulin resistance in later life; other critical periods were associated with slow fetal growth and rapid increase in BMI between age 2 and 11 years. CONCLUSIONS/INTERPRETATION: Low weight gain during infancy increases the risk of IGT and type 2 diabetes. The effect is greater in people who had low birthweight. The first 6 months after birth may be the most critical period for growth, in relation to development of glucose intolerance.

Aged↗

PubMed2006

Reduced intima media thickness in adults after prenatal exposure to the Dutch famine.

BACKGROUND: Restricted prenatal growth is associated with an increased risk of coronary heart disease morbidity and mortality. We studied the effects of exposure to famine during gestation on intima media thickness (IMT) in later life. METHODS AND RESULTS: We studied 730 people aged 58 years who were born as term singletons around the time of the 1944-45 Dutch famine. Persons exposed to famine during gestation (n=293) had reduced carotid artery IMT compared to people who had not been exposed to famine in utero (n=437) (mean 0.71 mm, S.D. 0.16 mm compared to 0.75 mm, S.D. 0.15 mm, sex adjusted p=0.001). Femoral artery IMT was also thinner among people exposed to famine during gestation compared to people unexposed in utero (mean 0.64 mm, S.D. 0.20mm, compared to 0.68 mm, S.D. 0.24), although the difference did not achieve statistical significance. CONCLUSION: Exposure to famine in utero may reduce IMT. However, it does not reduce the risk of coronary heart disease among famine exposed people.

Blood Vessels↗

PubMed2006

Body composition in pregnancies of adolescents and mature women and the relationship to birth anthropometry.

OBJECTIVE: To investigate differences in body composition between adolescent girls and mature women during pregnancy and the relationship to newborn anthropometry. DESIGN: A prospective study. SETTING: The antenatal clinic at the University Hospital of the West Indies, Kingston, Jamaica. SUBJECTS: Four hundred and twenty-five women were invited to join the study. Three hundred and sixty-one women (84.9%) completed the study. INTERVENTIONS: Study participants were divided into two groups: adolescents and mature women, who were all less than 15 weeks pregnant and had no systemic illness at the time of entry into the study. A questionnaire was administered which retrieved information on demographics, age, marital status, menstrual history, parity, socio-economic status, medical history and smoking/drinking habits. Anthropometric measurements including weight, height, triceps, biceps, subscapular and suprailiac skinfolds, as well as blood pressure measurements and urine analysis were performed at the first antenatal visit and repeated at 15, 25 and 35 weeks gestation. Anthropometric measurements of the newborn were performed at birth. RESULTS: There were significant differences between anthropometry and skinfold thickness at the first antenatal visit between the adolescents and the mature women where the adolescents had lower measurements compared to the mature women. In the newborn anthropometry, the only significant difference seen was in the triceps skinfold thickness and the mid-upper arm circumference where the newborn of the adolescents had significantly smaller values (P=0.04; P=0.02, respectively). The percentage fat, fat mass and lean body mass were significantly lower in the adolescent compared to the mature women (P<0.0001), both at the first antenatal visit and at 35 weeks gestation. A greater gain was seen in these measurements throughout the pregnancy in the adolescents (P<0.0001). Linear regression analyses showed that the gain in lean body mass was the most important predictor of birth anthropometry. CONCLUSION: Body composition differs in pregnancy between adolescents and mature woman, and if adequate weight and lean body mass are attained, it impacts positively on birth size irrespective of age.

Adolescent↗

PubMed2006

Glucose tolerance at age 58 and the decline of glucose tolerance in comparison with age 50 in people prenatally exposed to the Dutch famine.

AIMS/HYPOTHESIS: People who were small at birth have an increased risk of type 2 diabetes in later life. People who were in utero during the Dutch famine had decreased glucose tolerance and raised insulin concentrations at age 50. We aimed to evaluate whether prenatal famine exposure leads to more rapid progression of impaired glucose/insulin homeostasis with increasing age. METHODS: We performed an OGTT in 702 men and women at age 50 and in 699 men and women at age 58, all born as term singletons immediately before, during or after the 1944-1945 Dutch famine. RESULTS: People who had been exposed to famine in utero had significantly higher 120-min glucose concentrations at age 58 compared with people who had not been exposed to famine (difference=0.4 mmol/l, 95% CI 0.1 to 0.7, adjusted for sex and BMI). Glucose tolerance deteriorated between the age of 50 and 58. The unadjusted 120-min glucose concentrations rose by 0.2 mmol/l (95% CI 0.0 to 0.4), while 120-min insulin concentrations had increased by 64 pmol/l (95% CI 48 to 82). There were no differences in the rates of glucose and insulin level increase between the famine-exposed group and the unexposed group (p=0.28 for the difference in increase in glucose concentrations and p=0.09 for insulin concentrations). CONCLUSIONS/INTERPRETATION: Although we confirmed that undernutrition during gestation is linked to decreased glucose tolerance, the effect does not seem to become more pronounced at age 58 as compared with age 50.

Adult↗

PubMed2005

Birth weight, infant weight gain, and cause-specific mortality: the Hertfordshire Cohort Study.

Low birth weight, a marker of adverse intrauterine circumstances, is known to be associated with a range of disease outcomes in later life, including coronary heart disease, hypertension, type 2 diabetes, and osteoporosis. However, it may also decrease the risk of other common conditions, most notably neoplastic disease. The authors describe the associations between birth weight, infant weight gain, and a range of mortality outcomes in the Hertfordshire Cohort. This study included 37,615 men and women born in Hertfordshire, United Kingdom, in 1911-1939; 7,916 had died by the end of 1999. For men, lower birth weight was associated with increased risk of mortality from circulatory disease (hazard ratio per standard deviation decrease in birth weight = 1.08, 95% confidence interval: 1.04, 1.11) and from accidental falls but with decreased risk of mortality from cancer (hazard ratio per standard deviation decrease in birth weight = 0.94, 95% confidence interval: 0.90, 0.98). For women, lower birth weight was associated with a significantly (p < 0.05) increased risk of mortality from circulatory and musculoskeletal disease, pneumonia, injury, and diabetes. Overall, a one-standard-deviation increase in birth weight reduced all-cause mortality risk by age 75 years by 0.86% for both men and women.

Adult↗

PubMed2005

Statistical analysis of data in support of the Barker hypothesis, advantages of using random effects regression model in hierarchical data.

In a recent note by Walters and Edwards (2004), the authors argued that summary statistics should be used in analysing hierarchical data from our earlier analysis of a rat model of developmental programming and the Barker hypothesis (Kwong et al., 2000, 2004). We reiterate here why such a view is inappropriate. Hierarchical data merits multilevel analysis using a 'random effects' model to enable estimation of variances at different levels and easy assessment of other parameters in a complex data structure.

Analysis of Variance↗

PubMed2005

Cold-induced elevation of forearm vascular resistance is inversely related to birth weight.

Fetal growth retardation has been linked to elevated blood pressure in adult life. This association between birth weight and blood pressure is present in childhood and is amplified with age. However, the mechanisms that underlie this association are largely unknown. We examined the relationship between birth weight and forearm vascular resistance and forearm blood flow in children aged 9-12.7 years. A total of 58 children were randomly selected from a cohort of 1610 born at the University Hospital of the West Indies in Jamaica where adequate antenatal and delivery records were available. Blood pressure, heart rate and forearm blood flow (by venous occlusion plethysmography) were measured at rest and after cold pressor and mental arithmetic tests. There was a significant inverse correlation between birth weight and the change in the vascular resistance for the cold pressor test (r=-0.47; P<0.001) and the mental arithmetic stress test (r=-0.26; P=0.05). The log ratio of vascular resistance under stress to resting decreased by 0.289 units per kg of birth weight (95% CI: 0.145-0.434; P=0.0002). Lower birth weight is associated with increased vascular responsiveness. Increased vascular resistance might be one mechanism linking fetal growth to subsequent elevated blood pressure.

Birth Weight↗

PubMed2005

Infant growth and income 50 years later.

Among 4630 boys, irrespective of the social class into which they were born, those who grew slowly during infancy had poor educational achievements and had lower incomes than those who grew more rapidly. One interpretation of this is that biological processes linked to slow infant growth may lead to lifelong impairment of cognitive function.

Body Height↗

PubMed2004

Support for Barker hypothesis upheld in rat model of maternal undernutrition during the preimplantation period: application of integrated 'random effects' statistical model.

In response to a recent paper published in Reproductive BioMedicine Online by Walters and Edwards (2003), this study reports the application of a random effects regression analysis for evaluation of integrated data involving maternal and embryo/offspring components. Using this method, it is possible to confirm the conclusions of an earlier study that rat maternal undernutrition during the preimplantation period results in blastocyst cell number reduction and post-natal outcomes, including altered growth rates and elevated blood pressure.

Animals↗

PubMed2004

Fetal growth is directly related to maternal anthropometry and placental volume.

OBJECTIVE: To describe the influence of maternal weight and weight gain, placental volume and the rate of placental growth in early pregnancy on fetal dimensions measured sonographically. DESIGN: In a prospective study, 712 women were recruited from the antenatal clinic of the University Hospital of the West Indies. Data analysis was confined to 374 women on whom measurements of the placental volume at 14, 17 and 20 weeks gestation were complete. Measurements of maternal anthropometry and fetal size (by ultrasound) were performed. Weight gain in pregnancy between the first antenatal visit (8-10 weeks) and 20 weeks gestation, and the rate of growth of the placenta between 14-17 and 17-20 weeks gestation were calculated. MAIN OUTCOME MEASURES: Fetal anthropometry (abdominal and head circumferences, femoral length, and biparietal diameter) at 35 weeks gestation. RESULTS: Lower maternal weight at the first antenatal visit was associated with a significantly smaller placental volume at 17 and 20 weeks gestation (P<0.002 and <0.0001 respectively). In all women, maternal weight gain was directly related to fetal anthropometry. Placental volume at 14 weeks gestation and the rate of growth of the placenta between 17 and 20 weeks gestation were significantly related to all four fetal measurements. CONCLUSION: This study has provided evidence that both placental volume, and the rate of placental growth may influence fetal size. These effects are evident in the first half of pregnancy, and appear to be mediated through maternal weight and weight gain.

Adult↗

PubMed2004

Growth of girls who later develop coronary heart disease.

OBJECTIVE: To determine the path of growth of girls who later develop coronary heart disease. DESIGN: Follow up study of girls whose body size at birth, during infancy, and childhood up to age 12 years was recorded. SETTING: Helsinki, Finland. PARTICIPANTS: 4130 girls who were born between 1934 and 1944, attended child welfare clinics in Helsinki, and were still resident in Finland in 1971. MAIN OUTCOME MEASURE: Hospital admission or death from coronary heart disease. RESULTS: In comparison with boys in the same cohort who later developed coronary heart disease the 87 girls were short at birth, rather than thin, had compensatory growth in height during infancy, became thin, and thereafter had a rapid increase in weight and body mass index. In a combined analysis the hazard ratios for coronary heart disease were 1.17 (95% confidence interval (CI) 1.03 to 1.32, p = 0.02) for each 1 cm decrease in length at birth, 1.52 (95% CI 1.23 to 1.89, p < 0.001) for each standard deviation score increase in body mass index after age 3 years, and 1.63 (95% CI 1.09 to 2.42, p = 0.02) for each decrease in level of education. CONCLUSIONS: Though broadly similar, the paths of growth associated with the later development of coronary heart disease differ in girls and boys. This may be because girls are less vulnerable to undernutrition in utero and are better able to sustain postnatal growth in an adverse environment.

Adolescent↗

PubMed2003

Early adiposity rebound in childhood and risk of Type 2 diabetes in adult life.

AIMS/HYPOTHESIS: Type 2 diabetes is associated with a small body size at birth and a high BMI in adult life. The aim of our study was to assess the associations between Type 2 diabetes and birth size, infant growth and age at adiposity rebound. METHODS: We carried out a longitudinal study of 8760 subjects born in Helsinki during 1934 to 1944. On average, they had 18 measurements of height and weight between birth and 12 years of age. In western countries BMI usually decreases after the age of 2 years and rises again at around 6 years--the so-called adiposity rebound. We defined age at adiposity rebound by the age of lowest BMI between one and 12 years. We identified people with Type 2 diabetes using a national register. RESULTS: A total of 290 individuals developed Type 2 diabetes in adult life. The cumulative incidence of Type 2 diabetes decreased progressively from 8.6% in persons whose adiposity rebound occurred before the age of 5 years to 1.8% in those in whom it occurred after 7 years ( p<0.001). Early adiposity rebound was preceded by low weight gain between birth and 1 year ( p<0.001). CONCLUSION/INTERPRETATION: Large differences in the incidence of Type 2 diabetes are associated with growth rates in utero, weight gain in infancy and age at adiposity rebound.

Adipose Tissue↗

PubMed2003

The effects of the Pro12Ala polymorphism of the PPARgamma-2 gene on lipid metabolism interact with body size at birth.

Body size at birth is an indicator of the intrauterine environment. The effects of the Pro12Pro genotype and the 12Ala allele of the PPARgamma-2 gene on glucose and insulin metabolism in adult life depend on body size at birth. A low birth weight is associated with insulin resistance and type 2 diabetes. The peroxisome proliferator-activated receptor-gamma (PPARgammas) are also regulators of adipocyte differentiation, and the PPARgamma-2 gene could also contribute to the development of dyslipidemia. Therefore, the effects of the Pro12Ala polymorphisms of the PPARgamma-2 gene on lipid metabolism were measured in 476 elderly persons whose birth weight was known. The Ala12 allele was associated with increased serum total, low-density lipoprotein (LDL), and non-high-density lipoprotein (non-HDL) cholesterol concentrations but only among those who had birth weights below 3000 g. These interactions between the effects of the PPARgamma-2 gene on adult traits and the effects of birth weight may be interpreted as examples of gene-environmental interactions, which underlie plasticity during development.

Aged↗

PubMed2003

Obesity from cradle to grave.

BACKGROUND: Obesity is known to track from early life into adult life. OBJECTIVE: To examine the relation of obesity in adult life to growth and living conditions during childhood. DESIGN: Birth cohort study. PARTICIPANTS: A total of 4515 people (2135 men and 2380 women) who were born at Helsinki University Central Hospital between 1934 and 1944, who attended child welfare clinics and were still resident in Finland in the year 2000. MEASUREMENTS: Incidence of obesity based upon lifetime maximum body mass index (BMI) ascertained from a postal questionnaire and defined as a BMI>or=30 kg/m(2). The main explanatory measurements were size at birth, childhood growth, and socioeconomic status in childhood and in adult life. RESULTS: The cumulative incidence of obesity was 33.8% in men and 32.4% in women. The incidence rose with increasing body size at birth. From birth the mean weight and BMI of people who later became obese exceeded the average and remained above average at a statistically significant level at all ages from 6 months to 12 y. Childhood BMI was a stronger predictor of adult obesity than body size at birth. A higher maternal BMI in pregnancy was associated with a more rapid childhood growth and an increased risk of becoming obese in adult life. Higher socioeconomic status and better educational attainment were associated with a lower prevalence of obesity. There was no association between the duration of breastfeeding and later obesity. CONCLUSIONS: These results emphasize the importance of early life factors in the pathogenesis of adult obesity.

Adolescent↗

PubMed2003

Ultrasound derived fetal growth curves for a Jamaican population.

The objective of this study was to develop fetal growth curves and percentile growth charts for a Jamaican population. Four hundred and ninety-nine Jamaican women of African origin were enrolled in a prospective study from the antenatal clinic of the University Hospital of the West Indies, Kingston, Jamaica. Serial ultrasound scans were performed between 14 and 37 weeks gestation to measure fetal growth. The ultrasound measurements performed were biparietal diameter, head and abdominal circumference and femoral length. A total of 2574 ultrasound scans were performed on the 499 women (mean 5.2 per woman). From these data, centiles for fetal growth curves for the four fetal measurements were constructed and percentile tables were created for a Jamaican population. Birthweight varies between ethnic groups and, therefore, so must fetal growth rates. At present, fetal growth in Jamaica is assessed using standards which are based on data derived from Caucasian populations. Fetal growth curves using data from this study would more accurately identify a fetus that is at risk and hence, provide information which could improve obstetric care. These new growth curves should provide data, which will improve obstetric decision making.

Adolescent↗

PubMed2002

Effects of size at birth and childhood growth on the insulin resistance syndrome in elderly individuals.

AIMS/HYPOTHESIS: A study of 7086 men and women born in Helsinki, Finland, has shown that the development of Type II (non-insulin-dependent) diabetes mellitus is associated with low birth weight followed by accelerated gain in height and weight during childhood and with high maternal BMI but the processes which underlie these associations are largely not known. METHODS: We carried out standard oral glucose tolerance tests, and measured plasma insulin and proinsulin, serum lipid concentrations and blood pressure in 474 patients from the Helsinki cohort. RESULTS: We used four indices of insulin resistance: fasting and 2-h plasma insulin, and fasting proinsulin and 32-33 split proinsulin concentrations. These were associated with small body size at birth and during childhood, rapid growth in height and low maternal BMI. CONCLUSION/INTERPRETATION: Insulin resistance and Type II diabetes share common associations with retarded fetal growth and accelerated growth during childhood. They are dissimilar, however, in that insulin resistance is associated with thinness in childhood and low maternal BMI, while Type II diabetes is associated with high BMI in childhood and high maternal BMI.

Adult↗

PubMed2002

Shortness at birth is associated with insulin resistance in pre-pubertal Jamaican children.

AIM: To investigate the relationship between anthropometry at birth and glucose/insulin metabolism in childhood using the response to an oral glucose challenge. METHOD: Four hundred mother/child pairs on whom gestational and birth data were available were studied. After an overnight fast, anthropometric measurements were made on the children and an oral glucose tolerance test performed. The plasma concentrations of insulin, pro-insulin and 32-33 split pro-insulin were also measured. Skinfold thicknesses were used to calculate percentage body fat and fat mass was derived from the percentage fat and absolute weight. RESULTS: The mean age of the children was 8 y (range 7.5-10.5), and six exhibited impaired glucose tolerance based on WHO criteria. Insulin concentration 120 min after the oral glucose load (a measure of insulin resistance) was inversely related to length at birth (P<0.005). The children who were in the shortest quartile at birth and were heaviest at 8 y old had the highest insulin concentration. CONCLUSION: Shortness at birth is related to insulin resistance. Such insensitivity to the action of insulin is greater in heavier children.

Blood Glucose↗

PubMed2002

Size at birth, fat-free mass and resting metabolic rate in adult life.

Resting metabolic rate is an important predictor of obesity and is closely related to fat-free mass. There is evidence that fat-free mass may be partly determined during critical periods of growth before and after birth. The objective of this study was to examine the relationship between size at birth, childhood growth and fat-free mass and resting metabolic rate in adult life. 318 men and women with detailed records of body size at birth and growth during school years participated in the study. Fat-free mass correlated positively with birth weight among both sexes (r = 0.264, p < 0.001). Those having a higher birth weight had a higher fat-free mass at any adult BMI. Fat-free mass among men increased by 2.2 kg (95 % Cl 0.5 to 3.9; p = 0.01) for every kg increase in birth weight and by 1.5 kg (95 % Cl 1.3 to 1.7, p < 0.0001) for every kg/m(2) BMI in adult life. In women, fat-free mass increased by 2.7 kg (95 % Cl 1.6 - 3.9; p < 0.001) for every kg increase in birth weight and by 0.8 kg (95 % CI 0.7 to 1.0, p < 0.001) for every kg/m(2) of BMI in adult life. Height, weight and body mass index at each age from 7 to 15 years were also strongly, positively associated with fat-free mass. A negative correlation between birth weight and resting metabolic rate expressed per unit of fat-free mass (r = - 0.158; p < 0.001) was found. Fat-free mass may be determined during critical periods of muscle growth in utero and during childhood. The muscle tissue of people who had a lower birth weight is more metabolically active than those with a higher birth weight. This may protect them from the increased risk of obesity associated with low fat-free mass.

Adolescent↗