Consequences of intrauterine growth restriction for the kidney

Low birth weight due to intrauterine growth restriction is associated with various diseases in adulthood, such as hypertension, cardiovascular disease, insulin resistance and end-stage renal disease. The purpose of this review is to describe the effects of intrauterine growth restriction on the kidney. Nephrogenesis requires a fine balance of many factors that can be disturbed by intrauterine growth restriction, leading to a low nephron endowment. The compensatory hyperfiltration in the remaining nephrons results in glomerular and systemic hypertension. Hyperfiltration is attributed to several factors, including the renin-angiotensin system (RAS), insulin-like growth factor (IGF-I) and nitric oxide. Data from human and animal studies are presented, and suggest a faltering IGF-I and an inhibited RAS in intrauterine growth restriction. Hyperfiltration makes the kidney more vulnerable during additional kidney disease, and is associated with glomerular damage and kidney failure in the long run. Animal studies have provided a possible therapy with blockage of the RAS at an early stage in order to prevent the compensatory glomerular hyperfiltration, but this is far from being applicable to humans. Research is needed to further unravel the effect of intrauterine growth restriction on the kidney

Body size in five-year-old twins: Heritability and comparison to singleton standards

The aim of this study is to examine causes of individual differences in height, weight and body mass index (BMI) in 5-year-old children registered with the Netherlands Twin Register. In addition, we examine whether the results of twin studies can be expanded to the singleton population by comparing the data from twins to Dutch reference growth data and by looking at the twins' target height, which was derived from parental height. For 2996 5-year-old twin pairs, information on height and weight and on parental height was available. Univariate and bivariate genetic analyses of height and weight and univariate analyses of BMI were conducted. In order to compare the twins to the singleton population, standard deviation scores (SDS) for height, BMI and target height were calculated based on Dutch reference growth charts for the general population from 1997. Genetic influences were an important source of variation in height, weight and BMI and the main source of covariation between height and weight. Additive genetic factors accounted for 69% and 66% of the individual differences in height in boys and girls, respectively. For weight, heritability estimates were 59% in boys and 78% in girls and for BMI 34% and 74%. The influence of common environment on height was 25% and 27%, on weight 24% and 10% and on BMI 44% and 12% in boys and girls. The bivariate model showed a large overlap between the genes influencing height and weight. Genes explain 78% (in boys) and 76% (in girls) of the covariance between weight and height. At the age of 5 years, female twins were as tall as singleton children, while male twins were shorter than singletons. For both boys and girls, however, mean height SDS was 0.6 standard deviation scores below the mean target height. All twins had lower BMI than singletons. Twins grow fairly well compared to singletons, but they grow below their target height. This may be due to the above average height of twin parents

School functioning in 8- to 18-year-old children born after in vitro fertilization

The aim of this study was to examine the school functioning of 8- to 18-year-old children born after in vitro fertilization (IVF). We compared 233 children born after IVF to 233 matched control children born spontaneously from parents with fertility problems on measures of education level, general cognitive ability, school performance (need for extra help, repeating a grade, special education), and rates of learning and developmental disorders. No differences were found between IVF and control children on these measures of school functioning. More than 60% of adolescents at secondary school attended high academic levels (with access to high school or university). We conclude that children and adolescents born after IVF show good academic achievement and general cognitive ability. They do not experience any more educational limitations than the naturally conceived children and adolescents of the control group. The tendency of reassuring school functioning already found in younger IVF children has been shown to continue at secondary school age

The association between low birth weight and high levels of cholesterol is not due to increased cholesterol synthesis or absorption: analysis in twins

Low birth weight may be associated with high levels of cholesterol in later life through genetic factors that affect both birth weight and cholesterol metabolism. Alterations in cholesterol synthesis and absorption may play an important role in this association. We examined birth weight and plasma ratios of a precursor of cholesterol, lathosterol (an estimate of cholesterol synthesis), and plant sterols, campesterol and �-sitosterol (estimates of cholesterol absorption), to cholesterol in 53 dizygotic and 58 monozygotic adolescent twin pairs. After adjustment for current weight, birth weight was not associated with the ratios of lathosterol, campesterol, and �-sitosterol either in the overall sample [�0.07 �mol/mmol/kg (95 % confidence interval: �0.11 to 0.25), p � 0.5; �0.02 �mol/mmol/kg (�0.33 to 0.37), p � 0.9; and �0.04 �mol/mmol/kg (�0.23 to 0.15), p � 0.8, respec-Low birth weight is associated with an increased risk o

Kind en ziekte: onderzoek voor gezondheid

Het onderzoek in Nederland dat zich richt op ziekte bij kinderen zou veel meer \ud kunnen opleveren wanneer de betrokkenen in een gezamenlijke inspanning een \ud aantal knelpunten uit de weg zouden ruimen en de aanwezige kansen zouden grijpen. Dat is de centrale boodschap van dit advies van de Raad voor Gezondheidsonderzoek \ud (RGO). Ter voorbereiding van het advies voerde een commissie van de RGO gesprekken met vertegenwoordigers van de disciplines die bij de preventie en behandeling van ziekten bij kinderen betrokken zijn. De commissie zond vragenlijsten naar de onderzoeksgroepen op dit gebied om zich een beeld te vormen van het lopende onderzoek. Om dat te completeren en zicht te krijgen op gehonoreerde voorstellen voor onderzoek bij kinderen, sprak de commissie met vertegenwoordigers van ZonMw, de Centrale Commissie Mensgebonden Onderzoek (CCMO) en de farmaceutische industrie (Nefarma). Zij verdiepte zich in de kwaliteit van het huidige onderzoek op het gebied van jeugdgezondheidszorg en kindergeneeskunde door middel van een bibliometrische analyse. Voorts ging de commissie na welke plaats het thema ‘kind en ziekte’ heeft in het beleid van de ministeries van Volksgezondheid, Welzijn en Sport (VWS), Jeugd en Gezin (J&G) en Sociale Zaken en Werkgelegenheid (SZW). Op basis van dit voorwerk en bestudering van relevante wetenschappelijke literatuur komt de RGO in dit advies tot een aantal conclusies