Relation between birth weight at term and systolic blood pressure in adolescence.

OBJECTIVE--To examine whether birth weight is related to systolic blood pressure during adolescence. DESIGN--Retrospective (comparative) cohort study. The observers who traced and studied the subjects were unaware of their case-control status. SUBJECTS--330 subjects were born in Cardiff in 1975-7. Cases who were low birth weight at term (< 2500 g) were matched with controls of normal birth weight (3000-3800 g) at term. MAIN OUTCOME MEASURES--Systolic blood pressure measured by random zero sphygmomanometry in the subject''s right arm with the subject supine, corrected for size and age. RESULTS--The mean age at examination was 15.7 years. The mean systolic blood pressure of the cases was 105.8 mm Hg and of the controls 107.5 mm Hg. The corrected difference (95% confidence interval) in systolic blood pressure between the cases and controls was 1 mm Hg (-3 to +1 mm Hg; two tailed probability 0.33). CONCLUSION--Systolic blood pressure in adolescents of low birth weight is not significantly different from that of adolescents of normal birth weights.     

Relation between birth weight and blood pressure: longitudinal study of infants and children.

OBJECTIVE--To study the relation between birth weight and systolic blood pressure in infancy and early childhood. DESIGN--Longitudinal study of infants from birth to 4 years of age. SETTING--A middle class community in the Netherlands. PARTICIPANTS--476 Dutch infants born in 1980 to healthy women after uncomplicated pregnancies. MAIN OUTCOME MEASURES--Systolic blood pressure and body weight measured at birth and at 3 months and 4 years of age; the relation between systolic blood pressure and birth weight as estimated by multiple regression models that include current weight and previous blood pressure and control for gestational age, length at birth, and sex. RESULTS--Complete data were available on 392 infants. At 4 years of age the relation between blood pressure and birth weight appeared to be U shaped; low and high birthweight infants had raised blood pressure. Current weight and previous blood pressure were also positively associated with blood pressure at that age. Low birthweight infants (birth weight < 3100 g) had a greater gain in blood pressure and weight in early infancy. High birthweight infants (birth weight > or = 3700 g) had high blood pressure at birth, and weight and blood pressure tended to remain high thereafter. CONCLUSIONS--Even among normal infants there seem to be subgroups defined by birth weight in which blood pressure is regulated differently. Future investigations are needed to examine the physiological basis of these differences. Studies of correlates of adult disease related to birth weight should investigate mechanisms related to increased risk separately in infants of low and high birth weight.     

Relation of size at birth to non-insulin dependent diabetes and insulin concentrations in men aged 50-60 years.

OBJECTIVE: To establish whether the relation between size at birth and non-insulin dependent diabetes is mediated through impaired beta cell function or insulin resistance. DESIGN: Cohort study. SETTING: Uppsala, Sweden. SUBJECTS: 1333 men whose birth records were traced from a cohort of 2322 men born during 1920-4 and resident in Uppsala in 1970. MAIN OUTCOME MEASURES: Intravenous glucose tolerance test at age 50 years and non-insulin dependent diabetes at age 60 years. RESULTS: There was a weak inverse correlation (r=-0.07, P=0.03) between ponderal index at birth and 60 minute insulin concentrations in the intravenous glucose tolerance test at age 50 years. This association was stronger (r=-0.19, P=0.001) in the highest third of the distribution of body mass index than in the other two thirds (P=0.01 for the interaction between ponderal index and the body mass index). Prevalence of diabetes at age 60 years was 8% in men whose birth weight was less than 3250 g compared with 5% in men with birth weight 3250 g or more (P=0.08; 95% confidence interval for difference -0.3% to 6.8%). There was a stronger association between diabetes and ponderal index: prevalence of diabetes was 12% in the lowest fifth of ponderal index compared with 4% in the other four fifths (P=0.001; 3.0% to 12.6%). CONCLUSION: These results confirm that reduced fetal growth is associated with increased risk of diabetes and suggest a specific association with thinness at birth. This relation seems to be mediated through insulin resistance rather than through impaired beta cell function and to depend on an interaction with obesity in adult life.     

Early influences on blood pressure: a study of children aged 5-7 years.

OBJECTIVE--To examine factors that influence blood pressure in children. DESIGN--Cross sectional study of children aged 5.0-7.0 years who had blood pressure measurements and for whom parental questionnaires were completed. SETTING--School based survey. SUBJECTS--3591 Children aged 5.0-7.5 years selected by stratified random sampling of primary schools in nine British towns (response rate 72%); 3591 were examined and their parental questionnaires were completed. Data were complete for birth rank in 3559, maternal age in 3542, maternal history of hypertension in 3524, and paternal history in 2633. RESULTS--Birth weight was inversely related to mean systolic blood pressure but only when standardised for current weight (weight standardised regression coefficient -1.83 mm Hg/kg (95% confidence interval -1.31 to -2.35). Mean diastolic pressure was similarly related to birth weight. Maternal age, birth rank, and a parental history of hypertension were all related to blood pressure. After standardisation for current weight a 10 year increase in maternal age was associated with a 1.0 mm Hg (0.4 to 1.6) rise in systolic pressure; first born children had systolic blood pressure on average 2.53 mm Hg (0.81 to 4.25) higher than those whose birth rank was greater than or equal to 4; and a maternal history of hypertension was associated with a systolic pressure on average 0.96 mm Hg (0.41 to 1.51) higher than in those with no such history. The effects described were largely independent of one another and of age and social class. The relation for birth rank was, however, closely related to that for family size. CONCLUSIONS--Influences acting in early life may be important determinants of blood pressure in the first decade. The relation between birth weight and blood pressure may reflect the rate of weight gain in infancy. The reasons for the relation with birth rank and maternal age are unknown; if confirmed they imply that delayed motherhood and smaller family size may be associated with higher blood pressure in offspring.     

Effect of hyperammonaemia on blood glucose and plasma insulin levels in sheep.

The effects of continuous intravenous infusions (6 h) of ammonium chloride (5.6; 11.2; and 16.8 mumol.kg-1.min) on plasma glucose and immunoreactive insulin (I.R.I.) levels were studied in three adult sheep. Infusions of 5.6 and 11.2 mumol.kg-1.min elevated ammonia levels in circulating blood from 100 to 150 and 300 microgram.100 ml-1, respectively, but showed no appreciable effect on plasma glucose and I.R.I. concentrations. Infusion of 16.8 mumol.kg-1.min-1 resulted in a blood ammonia concentration of about 400 microgram.100 ml-1 after six hours of infusion. Blood ammonia returned to normal 1 to 2 hours after the end of infusion. Plasma glucose concentration tended to increase slightly from 65 to 75 mg . 100 ml-1 when 16.8 mumol of NH4Cl were infused kg-1.min-1 and remained at the elevated level at least for two additional hours when ammonia infusions were stopped. Plasma I.R.I. tended to decrease from 48 to 38 microunits . ml-1 during the time of the NH4Cl infusion and increased continually to 82 microunits . ml-1 when NH4Cl infusions were stopped. It is concluded from the time courses of plasma glucose and plasma I.R.I. that the effect of ammonia infusion of these parameters cannot entirely be explained by a regulatory release of adrenaline.     

The relationships between serum copper levels and overweight/total obesity and central obesity in children and adolescents aged 6-18 years

ObjectiveTo explore the relationships between serum copper levels and overweight/total obesity and central obesity in children and adolescents.MethodsWe included 2,000 children and adolescents from the 2011-2016 US National Health and Nutrition Examination Surveys. The multivariable linear model, logistic model and restricted cubic splines were adopted to assess the relationships. Models were adjusted for data release cycle, age, sex, race/ethnicity, ratio of family income to poverty, and dietary intakes of protein, total sugars, total fat, fiber, energy, calcium, vitamin D, vitamin C, and hours watch television or videos.ResultsThe prevalences of overweight/total obesity and central obesity were 37.38% and 33.40%, respectively. For per-quintile increment in serum copper levels, body mass index increased by 1.06 (0.79-1.33) (kg/m²) and waist circumference increased by 2.43 (1.58-3.27) (cm). The odds ratios (95% confidence intervals) for overweight/total obesity and central obesity among participants with the highest quintile compared with those with the lowest quintile of serum copper levels were 5.46 (3.31-8.98) and 5.64 (3.31-9.58), respectively. The above-mentioned associations were not modified by age (children: 6-12 years, adolescents: 13-18 years) and sex. Dose-response analysis showed that the odds of overweight/total obesity and central obesity increased with increasing serum copper levels to a level of approximate 140 ug/dL where the association seemed to reach a plateau, respectively.ConclusionsSerum copper levels were positively associated with body mass index and waist circumference, and elevated serum copper levels were associated with higher odds of overweight/total obesity and central obesity in children and adolescents.     

Disparity between dietary iron intake and iron status of children aged 10-12 years

Iron status was assessed in a representative sample of 188 adolescents living in a medium-sized city in Poland. Dietary intakes were evaluated using records of diet over a period of seven consecutive days. Subjects were considered to be iron deficient when two or more of the following parameters were abnormal: serum ferritin, transferrin saturation or mean corpuscular haemoglobin concentration. Based on this definition, the prevalence of iron deficiency in the investigated sample of children aged from ten to twelve years was 12.7%. Iron deficiency anaemia was defined using the following criteria: haemoglobin values less than 12.0 g. dl (-1) in girls or less than 12.2 g. dl(-1) in boys, combined with an iron deficiency. With such a definition, the prevalence of iron deficiency anaemia in all subjects was 6.3%. Four boys (3.9%) and six girls (6.8%) were diagnosed as anaemic. The values for Hb in the anaemic boys ranged from 10.9 to 12.2 g. dl (-1) and in anaemic girls from 8.7 to 12.0 g. (-1). It was found that the majority of the individuals studied had a dietary haem-iron intake lower than that recommended. No relationship was found between the level of serum ferritin and total iron and vitamin C dietary intake, but there was positive correlation between serum ferritin and intake of haem iron. A seven-day dietary history questionnaire correctly identified children at risk of iron deficiency anaemia.     

Association of obesity,diabetes, serum lipids and blood pressure regulates insulin action

Insulin resistance is present in patients with Type 2 diabetes mellitus as well as in obese patients without diabetes. The aim of our study was to compare insulin action in diabetic and control persons with or without obesity and to evaluate the influence of serum cholesterol, serum triglyceride and blood pressure on metabolic variables of insulin action. We examined 42 Type 2 diabetic patients and 41 control persons with body mass index (BMI) from 21.1 to 64.5 kg x m(-2), and 33 to 71 years old. The isoglycemic hyperinsulinemic clamp technique was performed at an insulin infusion rate of 1 mU x kg(-1) x min(-1) during 120 min. We evaluated the metabolic clearance rate of glucose (MCR(G), ml x kg(-1) x min(-1)) as the most important indicator of insulin action by isoglycemic clamp. The Pearson's correlation and multiple regression models were used to compare studied factors with the insulin action. We found following predictors of insulin resistance expressed in the relationship with MCR(G): BMI (r = -0.68, p<0.001), plasma glucose concentration (r = -0.66, p<0.001), cholesterol (r=-0.55, p<0.001), triglycerides (r = -0.54, p<0.001) and mean blood pressure (r = -0.38, p<0.01). From the multiple regression analysis we conclude that obesity may have even greater influence on the insulin action than diabetes mellitus itself.     

Physical fitness of Czechoslovak population between the ages of 12 and 55 years. Pulse rate and blood pressure.

In loading test of a representative sample of the Czechoslovak population aged 12--55 years, the authors, examined the reaction of the pulse rate and blood pressure (in watts--W) to loading on a bicycle ergometer. On increasing the submaximal load, the pulse rate rose linearly with age--more gradually in the phase of growth and along an approximately the same trend from the age of 18. The course in adult women corresponded to the course in boys aged about 13. The maximum pulse rate fell linearly in correlation to age, by about 4--5 beats for every 10 years, from 195/min in 12-year-old boys and 198/min in girls. The working capacity at pulse rate 170 (W 170) attained the maximum at 25 years (men 198, women 112 W). The systolic pressure rose non-linearly with loading. It increased more rapidly at lower loads. Children had the smallest pressure reaction and the oldest subjects the greatest. Diastolic pressure fell gradually and non-linearly with loading. The maximum blood pressure values, according to age, rose from 138/56 torr in the oldest males and from 139/57 to 182/84 torr in females.