Biomedical subjects

C Osmond

Publications and source records attributed to C Osmond.

At least 109 records · Page 6Linked to original sources

PubMed1995

Weight in infancy and prevalence of coronary heart disease in adult life.

OBJECTIVE: To determine whether low birth weight and low weight at 1 year are followed by an increased prevalence of coronary heart disease in adult life. DESIGN: A follow up study of men born during 1920-30 whose birth weights and weights at 1 year were recorded. SETTING: Hertfordshire, England. SUBJECTS: 290 men born and still living in East Hertfordshire. MAIN OUTCOME MEASURE: The prevalence of coronary heart disease, defined by the Rose/WHO chest pain questionnaire, standard electrocardiographic criteria, or history of coronary artery angioplasty or graft surgery. RESULTS: 42 (14%) men had coronary heart disease. Their mean birth weight, 7.9 lb (3600 g), was the same as that of the other men. Their mean weight at 1 year, 21.8 lb (9.9 kg), was 1 lb (454 g) lower (95% confidence interval 0.1 to 1.8, P = 0.02). Percentages of men with coronary heart disease fell from 27% in those who weighed 18 lb (8.2 kg) or less at 1 year to 9% in those who weighed more than 26 lb (11.8 kg) (P value for trend = 0.03). This trend occurred in both smokers and non-smokers and within each social class. CONCLUSION: These findings add to the evidence that coronary heart disease is "programmed" during early growth.

Birth Weight↗

PubMed1995

Parkinson's disease and the environment in early life.

To explore a possible relationship between environmental factors encountered during fetal life and infancy and the later risk of developing Parkinson's disease, a case-control study (172 cases, 343 age- and sex-matched controls) was carried out in 42 general practices in the eastern part of Hertfordshire, England. Information about birthweight and growth during the first year of life was obtained for subjects who had been born in Hertfordshire from records made by health visitors in the first part of the century. Information concerning size of sibship, position in the birth order, type of housing, other features of the environment in early life and experience of the common infections of childhood was obtained by questionnaire. Neither birthweight, weight at 1 year of age nor any aspect of the childhood domestic environment were associated with an altered risk of Parkinson's disease. Cases were more likely to recall suffering from croup (odds ratio 4.1, 95% CI 1.1 to 16.1) or diphtheria (odds ratio 2.3, 95% CI 1.2 to 4.7) in childhood than controls but no other infection was associated with an increased relative risk for Parkinson's disease. Cases were more likely than controls never to have smoked cigarettes (odds ratio 2.0, 95% CI 1.1 to 3.6). The results of this study do not suggest that poor growth in fetal life or infancy is important in the aetiology of Parkinson's disease but they hint that early infection might partly determine susceptibility to the disease.

Aged↗

PubMed1995

Relationships between the uterine environment and maternal plasma concentrations of insulin-like growth factor binding protein-1 and placental protein 14 in early pregnancy.

Blood was obtained from 218 women between 6 and 13 weeks of gestation. Measurements of serum insulin-like growth factor binding protein-1 (IGFBP-1) and placental protein 14 (PP14) concentrations were compared with maternal weight and height, maternal smoking habit, indices of maternal haematological status and two placental hormones [human chorionic gonadotrophin (HCG) and human placental lactogen (HPL)]. IGFBP-1 concentration was negatively correlated with maternal weight (P < 0.001) and body mass index (P < 0.001); PP14 concentration was not correlated with these measurements. PP14 concentration was negatively correlated with maternal haemoglobin concentration (P = 0.010), mean corpuscular volume (P = 0.003) and serum ferritin concentration (P = 0.016). The concentrations of PP14 were significantly less among smokers (P < 0.001); IGFBP-1 concentrations were uninfluenced by smoking. IGFBP-1 concentration was positively correlated with maternal serum HCG (P = 0.003) and maternal serum HPL (P = 0.002). PP14 concentration was positively correlated with maternal serum HCG (P < 0.0001) but not with HPL. These findings demonstrate that the maternal environment has an early influence on both endometrial and placental function.

Body Mass Index↗

PubMed1995

Fetal growth and glucose and insulin metabolism in four-year-old Indian children.

Studies in Britain have shown that adults who had a low birthweight have high plasma glucose concentrations 30 and 120 min after an oral glucose load, and an increased risk of Type 2 diabetes and impaired glucose tolerance. Both Type 2 diabetes and low birthweight are common in India. To determine whether low birthweight is associated with reduced glucose tolerance in Indian children, glucose tolerance tests were carried out on 379 4-year-old children, whose birthweights were recorded, in Pune, India. Among 201 children who had been looked after on the routine postnatal wards at birth, those with lower birthweights had higher plasma glucose and insulin concentrations 30 min after an oral glucose load, independently of their current size (p = 0.01 and 0.04, respectively). Mean glucose and insulin concentrations were 8.1 mmol l-1 and 321 pmol l-1 in children whose birthweight had been 2.4 kg or less, compared with 7.5 mmol l-1 and 289 pmol l-1 in those who weighted more than 3.0 kg. Among 178 children who had been looked after in the Special Care Baby Unit, those with lower birthweights also had higher plasma insulin concentrations at 30 min but there were no trends with plasma glucose. Our findings suggest that Indian children with reduced intra-uterine growth have reduced glucose homeostasis after a glucose challenge. This is consistent with the hypothesis that Type 2 diabetes mellitus in India may be programmed in fetal life.

Adult↗

PubMed1995

Fetal growth and insulin resistance in adult life: role of plasma triglyceride and non-esterified fatty acids.

Reduced fetal growth is associated with insulin resistance and a high prevalence of glucose intolerance in adult life. Because babies who are growth retarded have elevated levels of triglyceride and non-esterified fatty acids (NEFA), and because similar abnormalities are observed in subjects with the insulin resistance syndrome, impaired regulation of lipid metabolism could be one of the mechanisms explaining the link between reduced fetal growth and insulin resistance. We have, therefore, measured fasting plasma triglyceride and NEFA, and the insulin-mediated suppression of NEFA during an oral glucose tolerance test in 93 men and women aged 50, born in Preston, whose birthweight and body size at birth had been recorded. Elevated fasting plasma triglycerides and reduced NEFA suppression during the oral glucose tolerance test were associated with the male sex, glucose intolerance, central obesity as indicated by a high waist to hip ratio and insulin resistance as measured by a short insulin tolerance test. However there were no statistically significant relationships between the birth measurements and the circulating lipid levels. Moreover in regression analyses the relationships between thinness at birth and insulin resistance or glucose intolerance in adult life were unaffected by the addition of triglyceride or NEFA in the models. These results suggest that the link between reduced fetal growth and insulin resistance in the adult is not mediated by an abnormal regulation of lipid metabolism.

Administration, Oral↗

PubMed1995

The influence of maternal haemoglobin and ferritin on mid-pregnancy placental volume.

OBJECTIVE: To investigate whether low maternal haemoglobin and ferritin levels are associated with increased placental volume by mid-pregnancy. DESIGN: Prospective study of women attending hospital for shared antenatal care. SETTING: A teaching hospital in the south of England. SUBJECTS: Five hundred and sixty-eight women booking for delivery in the hospital. MAIN OUTCOME MEASURES: Placental volume measured by ultrasound at 18 weeks gestation. RESULTS: At 14 weeks gestation 9% of women had haemoglobin levels < or = 11 g/dl and 26% had ferritin levels < 13 micrograms/l. Placental volume at 18 weeks was inversely related to the maternal haemoglobin and ferritin levels. The influence of haemoglobin and ferritin concentrations was independent of maternal social class, parity, smoking, and weight. Larger placentae were found in taller women, those who had previously been pregnant, and in those who were smoking more than 15 cigarettes daily at the time of their last menstrual period. CONCLUSION: These data suggest that placental development is influenced from early in pregnancy by the intrauterine environment provided by the mother. In conjunction with other studies they support the proposal that, as a result of these changes, programming of adult blood pressure may be initiated in early pregnancy.

Adolescent↗

PubMed1995

Size at birth and plasma insulin-like growth factor-1 concentrations.

OBJECTIVE: To test the hypothesis that reduced fetal growth leads to altered plasma insulin-like growth factor-1 (IGF-1) concentrations in childhood. DESIGN: A follow up study of 4 year old children whose birth weights were recorded, and of 7 year old children whose weight, length, head circumference, and placental weight were measured at birth. SETTING: Pune, India, and Salisbury, England. SUBJECTS: 200 children born during October 1987 to April 1989 in the King Edward Memorial Hospital, Pune, weighing over 2.0 kg at birth and not requiring special care, and 244 children born during July 1984 to February 1985 in the Salisbury Health District and still living there. MAIN OUTCOME MEASURE: Plasma IGF-1 concentrations. RESULTS: In both groups of children, and consistent with findings in other studies, plasma IGF-1 concentrations were higher in taller and heavier children, and higher in girls than boys. Allowing for sex and current size, concentrations were inversely related to birth weight (Pune p = 0.002; Salisbury p = 0.003). Thus at any level of weight or height, children of lower birth weight had higher IGF-1 concentrations. The highest concentrations were in children who were below average birth weight and above average weight or height when studied. Systolic blood pressures were higher in children with higher IGF-1 concentrations (Pune p = 0.01; Salisbury p = 0.04). CONCLUSIONS: Children of lower birth weight develop higher circulating concentrations of IGF-1 than expected for their height and weight. This is consistent with the hypothesis that under-nutrition in utero leads to reprogramming of the IGF-1 axis. The increase of plasma IGF-1 concentrations in low birthweight children may also be linked to postnatal catch-up growth. High IGF-1 concentrations may be one of the mechanisms linking reduced fetal growth and high blood pressure in later life.

Anthropometry↗

PubMed1995

Growth in utero, adult blood pressure, and arterial compliance.

OBJECTIVES: To examine the relation between disproportionate fetal growth and adult blood pressure and to investigate whether arterial compliance in adult life is related to early development. DESIGN: A follow up study of a group of men and women whose birth weights and other measurements of body size had been recorded at birth. SETTING: Home and outpatient study. SUBJECTS: 337 men and women born in the Jessop Hospital, Sheffield, between 1939 and 1940. MAIN OUTCOME: Adult systolic and diastolic blood pressures and arterial compliance as measured by pulse wave velocity in two arterial segments. RESULTS: Both systolic and diastolic blood pressures were higher in people whose birth weight was low, who were short or who had small abdominal or head circumferences at birth. Systolic blood pressure decreased by 2.7 mm Hg (95% CI 0.8 to 4.6) for each pound (454 g) gain in birth weight and by 3.4 mm Hg (95% CI 1.4 to 5.4) for each inch (2.54 cm) increase in crown-heel length. Diastolic pressure fell by 1.9 mm Hg (95% CI 0.9 to 2.9) for each pound (454 g) gain in birth weight and by 2.4 mm Hg (95% CI 1.4 to 3.5) for each inch (2.54 cm) increase in length. Systolic blood pressure was also higher in individuals whose mother's intercristal pelvic diameter was small or whose mother's blood pressure had been raised during pregnancy but these effects were statistically independent of the effects of low birth weight and other measurements that indicate fetal growth retardation. Arterial compliance was lower in those who had been small at birth. CONCLUSION: Impairment of fetal growth is associated with raised blood pressure in adult life and decreased compliance in the conduit arteries of the trunk and legs.

Arteries↗

PubMed1995

Birth weight, weight at one year, and left ventricular mass in adult life.

OBJECTIVE: To examine how fetal and infant growth are related to left ventricular mass in adult life. DESIGN: A follow up study of men born during 1920-30 whose birth weights and weights at 1 year were recorded. SETTING: Hertfordshire, England. SUBJECTS: 290 men born and still living in East Hertfordshire, England. MAIN OUTCOME MEASURE: Left ventricular mass calculated from measurements of interventricular septal thickness and left ventricular posterior wall thickness and left ventricular internal diameter at end diastole measured by M mode echocardiography. RESULTS: Left ventricular mass was highest in men with the lowest weight at 1 year and fell with increasing weight at 1 year (r = 0.18, P = 0.01). Left ventricular mass was not related to birth weight. The relation with weight at 1 year was independent of factors in adult life known to influence left ventricular mass, including body size, systolic blood pressure, and age. The enlarged left ventricular mass associated with reduced growth in infancy was concentric, affecting both the interventricular septum and the left ventricular posterior wall. Concentric left ventricular hypertrophy is known to be associated with increased death rates from coronary artery disease. CONCLUSION: Low weight at 1 year is associated with concentric enlargement of the left ventricle in adult life. This is consistent with a previous finding of higher mortality from cardiovascular disease in men of low weight at 1 year, and provides further evidence that cardiovascular disease may be partly programmed in early life. The left ventricular enlargement may be a long term result of haemodynamic changes in utero or of persisting changes in growth factor concentrations.

Aged↗

PubMed1995

Coronary heart disease mortality trends in England and Wales, 1952-1991.

BACKGROUND: The 'programming' hypothesis for the causation of heart disease suggests that there are critical periods of development in early life during which a stimulus or insult has permanent effects on the subject's organ or tissue structure and physiology. Exposure to such effects might be expected to be linked to year of birth and produce cohort (generation) effects in heart disease death rates. Evidence is sought for such effects in data from England and Wales. METHODS: The age- and period-specific heart disease death rates for men and women aged 30-69 in England and Wales have declined recently in both men and women. The trends have two components. The first is described by a peak in rates during 1977-1981 that applies to both sexes and all age-groups. This is consistent with risk conferred by adult diet and lifestyle. The second component required to explain the trends also applies to both sexes and is described by a risk that is lower in each successive year of birth. This is consistent with risk linked to poor growth in early life. CONCLUSION: Poor early growth has become less common as maternal health, physique and nutritional status have improved through the century. The trends are therefore consistent with the'programming' hypothesis for the causation of coronary heart disease.

Adult↗

PubMed1994

Relation between maternal haemoglobin and placental hormone concentrations in early pregnancy.

Environmental factors that influence placental development are of particular interest because of the reported association between adult hypertension, low birthweight, and large placental size. Maternal anaemia is one environmental factor that is associated with an increase in placental size at birth. We have examined the relation between haematological status and plasma concentrations of chorionic gonadotropin (hCG) and placental lactogen (hPL) in 175 women at about 10 weeks of pregnancy. There were significant negative correlations between maternal haemoglobin concentration and the levels of hCG (p = 0.03) and hPL (p = 0.02). Although 21% of women had low iron stores (ferritin < 13 micrograms/L), no relation was found between serum ferritin and the two placental hormones. There was no association between plasma volume (calculated from maternal weight and height) and hCG or hPL concentrations. We conclude that our observations reflect an influence of the maternal environment on the placenta. The fact that negative correlations with placental hormone concentrations exist across the normal haemoglobin range suggest that they reflect a normal aspect of placental development. We speculate that placental growth is, in part, determined by maternal factors that prevail before conception. One possibility is that these factors modify angiogenesis within the trophoblastic villi.

Adolescent↗

PubMed1994

Fetal growth and insulin secretion in adult life.

Recent studies suggest that NIDDM is linked with reduced fetal and infant growth. Observations on malnourished infants and studies of experimental animals exposed to protein energy or protein deficiency in fetal or early neonatal life suggest that the basis of this link could lie in the detrimental effects of poor early nutrition on the development of the beta cells of the islets of Langerhans. To test this hypothesis we have measured insulin secretion following an IVGTT in a sample of 82 normoglycaemic and 23 glucose intolerant subjects who were born in Preston, England, and whose birthweight and body size had been recorded at birth. The subjects with impaired glucose tolerance had lower first phase insulin secretion than the normoglycaemic subjects (mean plasma insulin concentrations 3 min after intravenous glucose 416 vs 564 pmol/l, p = 0.04). Insulin secretion was higher in men than women (601 vs 457 pmol/l, p = 0.02) and correlated with fasting insulin level (p = 0.04). However, there was no relationship between insulin secretion and the measurements of prenatal growth in either the normoglycaemic or glucose intolerant subjects. These results argue against a major role for defective insulin secretion as a cause of glucose intolerance in adults who were growth retarded in prenatal life.

Blood Glucose↗

PubMed1994

Thinness at birth and insulin resistance in adult life.

Type 2 (non-insulin-dependent) diabetes mellitus may originate through impaired development in fetal life. Both insulin deficiency and resistance to the action of insulin are thought to be important in its pathogenesis. Although there is evidence that impaired fetal development may result in insulin deficiency, it is not known whether insulin resistance could also be a consequence of reduced early growth. Insulin resistance was therefore measured in 81 normoglycaemic subjects, and 22 subjects with impaired glucose tolerance, who were born in Preston, UK, between 1935 and 1943. Their birth measurements had been recorded in detail. Insulin resistance was measured by the insulin tolerance test which uses the rate of fall in blood glucose concentrations after intravenous injection of insulin as an index of insulin resistance. Men and women who were thin at birth, as measured by a low ponderal index, were more insulin resistant. The association was statistically significant (p = 0.01) and independent of duration of gestation, adult body mass index and waist to hip ratio and of confounding variables including social class at birth or currently. Thinness at birth and in adult life has opposing effects such that resistance fell with increasing ponderal index at birth but rose with increasing adult body mass index. It is concluded that insulin resistance is associated with impaired development in fetal life.

Adult↗

PubMed1994

Disproportionate fetal growth and raised IgE concentration in adult life.

A follow-up study was carried out to determine whether either impaired or disproportionate fetal growth are associated with a raised total serum IgE concentration in men and women aged 50 years. The serum IgE concentration was measured in 146 men and 134 women born in Preston (Lancashire, UK) between 1935 and 1943, whose size at birth had been measured in detail. Sixty-two subjects were found to have an IgE concentration above 80 IU/ml. Compared with subjects with a normal IgE on average they had a 0.30 inch larger head circumference at birth (P = 0.004) and weighted 5.6 ounces more at birth (P = 0.04). People with a raised and with a normal IgE were of similar crown-heel length at birth, indicating that in utero those with a raised IgE had had disproportionate growth of the head in relation to the trunk and limbs. The prevalence of a raised IgE rose from 14% in subjects whose head circumference at birth was 13 inches or less to 37% in those whose head circumference was more than 14 inches. This association was independent of gestational age at birth and of the mother's pelvic size and parity. It was also independent of adult physique, social class and smoking, and was similar in men and women. In multiple logistic regression analyses odds ratios of a raised IgE rose progressively to more than 4 as head circumference at birth increased from 13 inches or less to more than 14 inches.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Constitution↗

PubMed1994

Understanding oral glucose tolerance: comparison of glucose or insulin measurements during the oral glucose tolerance test with specific measurements of insulin resistance and insulin secretion.

The extent to which the oral glucose tolerance test can be used to estimate insulin secretion and insulin resistance has been evaluated by comparing glucose and insulin concentrations during an oral glucose tolerance test with specific measurements of insulin secretion and insulin resistance in 85 normoglycaemic subjects and 23 subjects with impaired glucose tolerance (IGT). Insulin secretion was measured by the first phase insulin response to intravenous glucose and insulin resistance by the insulin tolerance test which measures the decline of plasma glucose after the injection of a bolus of insulin. The best measure of insulin secretion was the ratio of the 30 min increment in insulin concentration to the 30 min increment in glucose concentration following oral glucose loading. This correlated with the first phase insulin release following intravenous glucose (r = 0.61, p < 0.001) but not insulin resistance (r = -0.05, p > 0.05). Insulin resistance could be estimated by the fasting insulin, proinsulin, or split proinsulin concentrations. However, fasting split proinsulin appeared to discriminate best between insulin resistance (r = -0.53, p < 0.001) and insulin secretion (r = 0.07, p > 0.05). Relative insulin resistance estimated by homeostasis model assessment (HOMA) also correlated well with insulin resistance (r = -0.57, p < 0.001) but not insulin secretion (r = 0.01, p > 0.05). We conclude that the oral glucose tolerance test can be used to derive estimates of the relative roles of insulin secretion and insulin resistance in population studies of glucose tolerance.

Blood Glucose↗

PubMed1994

Maternal nutritional status in pregnancy and blood pressure in childhood.

OBJECTIVE: To examine the relation between indices of maternal nutrition during pregnancy, including haemoglobin concentration, skinfold thickness and body weight, and the child's blood pressure at 10 to 12 years of age. DESIGN: Follow up study of children whose mothers had haemoglobin estimations, weights and skinfold thicknesses recorded during pregnancy. SETTING: Kingston, Jamaica. SUBJECTS: Seventy-seven children whose mothers took part in a prospective study of nutrition during pregnancy in relation to fetal growth. MAIN OUTCOME MEASURE: Blood pressure at 10 to 12 years of age. RESULTS: The child's mean systolic pressure adjusted for current weight rose by 2.6 mmHg (95% CI 0.5-4.6, P = 0.01) for each 1 g/dl fall in the mother's lowest haemoglobin during pregnancy. Mothers with a lower haemoglobin had thinner skinfold thicknesses, especially over the triceps (P = 0.005). In multiple regression analyses, taking account of the child's sex and current weight, there was a strong association between thin maternal triceps skinfold thickness at 15 weeks of gestation and raised blood pressure in the offspring. Taking account of the mother's triceps skinfold thickness abolished the relation between lower haemoglobin and raised blood pressure in the child. Lower weight gain between 15 and 35 weeks of gestation was independently associated with raised children's blood pressure. Systolic pressure rose by 10.7 mmHg (95% CI 5.7 to 15.6, P = 0.0001) for each log mm decrease in the mother's triceps skinfold thickness, and by 0.6 mmHg (95% CI 0.1 to 1.0, P = 0.02) for each 1 kg decrease in the mother's weight gain during pregnancy. CONCLUSIONS: These results parallel animal experiments suggesting that impaired maternal nutrition may underlie the programming of adult hypertension during fetal life.

Blood Pressure↗

PubMed1994

Determinants of breastfeeding in Salisbury and Durham.

BACKGROUND: The practice of breastfeeding is related to socio-demographic characteristics: both show marked variation by place within the United Kingdom. This study set out to test the commonly held assumption that geographical variations in breastfeeding practices are explained by socio-demographic differences. METHODS: The mothers of 326 six-week-old babies living in Salisbury or Durham Health Districts were interviewed to determine attitudes to breastfeeding practice. RESULTS: More mothers in Salisbury breastfed than mothers in Durham, both immediately after birth (Salisbury 79 per cent, Durham 54 per cent) and at six weeks (50 per cent and 26 per cent). Higher rates of breastfeeding after birth were associated with higher level of qualification, encouragement to breastfeed antenatally and the mother having been breastfed herself. Higher rates at six weeks were associated with higher level of qualification, higher parity and willingness to breastfeed away from home. The differences between districts persisted after adjustment for these variables, but were diminished when willingness to breastfeed away from home was taken into account. CONCLUSION: Differences between the two districts in breastfeeding practice cannot be wholly explained by traditional socio-demographic characteristics, and may be related to local culture. Health education is unlikely to change breastfeeding practices unless prevailing cultural attitudes also change.

Adolescent↗

PubMed1993

Early growth and death from cardiovascular disease in women.

OBJECTIVE: To determine whether the link suggested between growth in utero and during infancy and death from cardiovascular disease in men is also present in women. DESIGN: Follow up study of women and men whose birth weight and weight at 1 year of age had been recorded. SETTING: Hertfordshire, England. SUBJECTS: 5585 women and 10,141 men born during 1911-30. MAIN OUTCOME MEASURES: Standardised mortality ratios for cardiovascular disease. RESULTS: Among women and men death rates from cardiovascular disease fell progressively between the low and high birth weights groups (chi 2 = 4.3, p = 0.04 for women, chi 2 = 8.5, p < 0.005 for men). Cardiovascular deaths in men but not women were also strongly related to weight at 1 year, falling progressively between the low and high weight groups (chi 2 = 27.5, p < 0.0001). The highest cardiovascular death rates in women were among those with below average birth weight but above average weight at 1 year. In men the highest rates were among those with below average birth weight and below average weight at 1 year. CONCLUSION: Relations between cardiovascular disease and birth weight are similar in men and women. In men cardiovascular disease is also related to weight gain in infancy.

Aged↗