Neighbourhood deprivation in childhood and adulthood and risk of arterial stiffness: the Cardiovascular Risk in Young Finns study

PURPOSE: Individual socioeconomic status is associated with increased arterial stiffness, but limited data are available on the relations of neighbourhood deprivation with this vascular measure. We prospectively examined whether neighbourhood deprivation in childhood and adulthood predicts arterial stiffness indicated by pulse wave velocity (PWV). MATERIALS AND METHODS: The study population comprised 1,761 participants aged 3-18 years at baseline (1980) from the longitudinal Cardiovascular Risk in Young Finns cohort study. PWV was measured in 2007 by whole-body impedance cardiography at ages 30-45 years. Cumulative lifetime neighbourhood deprivation was assessed using data from socioeconomic circumstances in participants' lifetime residential neighbourhoods, categorised as low versus high deprivation. RESULTS: High deprivation in childhood and adulthood was associated with higher PWV in adulthood after adjustment for age, sex, and place of birth (mean difference = 0.57 m/s, 95%CI = 0.26-0.88, P for trend = 0.0004). This association was attenuated but remained statistically significant after further adjustment for childhood parental socioeconomic status and adulthood individual socioeconomic status (mean difference = 0.37 m/s, 95%CI = 0.05-0.70, P for trend 0.048). Also, low individual socioeconomic status in adulthood was associated with higher PWV when adjusted for age, sex, place of birth, parental socioeconomic status in childhood, and lifetime neighbourhood deprivation (mean difference = 0.54 m/s, 95%CI = 0.23-0.84, P for trend 0.0001). CONCLUSION: These findings suggest that lifetime neighbourhood deprivation and low adulthood socioeconomic status are independent risk factors for increased arterial stiffness in adulthood

Alkuraskauden raskausdiabeetikoiden elintavat ja terveydentila sekä alkuraskauden raskausdiabetesta selittävät tekijät

Ensimmäisen kerran raskauden aikana todettavaa, tietyt diagnostiset kriteerit täyttävää, glukoosiaineenvaihdunnan häiriötä kutsutaan raskausdiabetekseksi tai gestaatiodiabetekseksi (GDM). Vuonna 2014 Suomessa 16 %:lla synnyttäjistä todettiin poikkeava sokerirasitustesti (OGTT), jonka avulla GDM diagnosoidaan. GDM-esiintyvyyden kasvua selittää paljolti synnyttäjien painoindeksin kohoaminen. GDM altistaa äidin ja vastasyntyneen komplikaatioille sekä lisää myöhempää sairastuvuusriskiä. Suomessa osa raskausdiabeetikoista tunnistetaan jo alkuraskaudessa suoritetun OGTT:n avulla ja osa vasta loppuraskaudessa. Alkuraskauden GDM:n diagnosoinnin oikeutuksesta ei ole maailmanlaajuisesti yksimielisyyttä. Tutkittua tietoa alkuraskauden raskausdiabeetikoista on toistaiseksi niukasti. Pro gradu -tutkielman tavoitteena oli kuvailla alkuraskaudessa (rvo 8–12) poikkeavan OGTT-tuloksen saaneiden eli alkuraskauden raskausdiabeetikoiden elintapoja (ravitsemus, fyysinen aktiivisuus) ja terveydentilaa sekä tarkastella erosivatko nämä muiden tutkittavien elintavoista ja terveydentilasta. Lisäksi tavoitteena oli tarkastella mitkä tekijät olivat yhteydessä alkuraskauden poikkeavaan OGTT-tulokseen. Tutkimuksen aineisto on peräisin NELLI-tutkimuksesta (Neuvonta, elintavat ja liikunta neuvolassa) vuosilta 2007–10. Sisäänottokriteereiksi asetettiin kohonnutta GDM-riskiä ennakoivat tekijät. Tutkimuksesta poissulkemiseen johti mm. poikkeava OGTT alkuraskaudessa. Tutkittavien ruoankäyttöä ja vapaa-ajan fyysistä aktiivisuutta (validoidut kyselyt) sekä terveydentilaa (verikokeet, paino, verenpaine) seurattiin. Vuoden kuluttua synnytyksestä suoritettiin seurantatutkimus. Aineisto koostui sekä interventiotutkimukseen osallistuneista tutkittavista että tutkittavista, joilla alkuraskauden OGTT todettiin poikkeavaksi ja jotka poissuljettiin interventiotutkimuksesta. Alkuraskauden raskausdiabeetikkojen osalta oli aineistoa saatavilla raskautta edeltävästi (elintavat) tai alkuraskaudessa (terveydentila) sekä vuosi synnytyksestä (elintavat, terveydentila). Näissä aikapisteissä suoritettiin vertailua alkuraskauden raskausdiabeetikkojen ja NELLI-tutkimukseen osallistuneiden tutkittavien välillä. Tilastollisina menetelminä ryhmien väliseen vertailuun käytettiin Pearsonin khiin neliö -testiä, Fisherin tarkkaa testiä, riippumattomien otosten T-testiä tai Mann-Whitney U -testiä. Vakioiduissa malleissa käytettiin lineaarista regressioanalyysiä sekä (ordinaalista) logistista regressioanalyysiä. Alkuraskauden GDM-riskiä ennakoivat raskautta edeltävän painoindeksin kohoaminen, ≥ 35 vuoden ikä raskauden alussa sekä aiemmassa raskaudessa todettu vastasyntyneen makrosomia tai aiempi GDM. Alkuraskauden raskausdiabeetikoiden HDL-pitoisuus alkuraskaudessa oli pienempi kuin muiden tutkittavien. Lisäksi heidän ruokavaliossaan raskautta edeltävästi rasvan osuus (E%) oli suurempi, vähärasvaisten maitotuotteiden sekä juustojen osuus pienempi ja ravitsemustavoitteet (≥ 4/5) täyttyivät harvemmin kuin muiden tutkittavien. Seurantatutkimukseen osallistuneiden alkuraskauden raskausdiabeetikoiden ryhmä oli valikoitunut, joten tuloksia vuosi synnytyksestä tulee tulkita varoen. Alkuraskauden GDM-riskiä selittivät pitkälti tekijät, joiden tiedetään olevan yhteydessä GDM-riskiin loppuraskaudessa. Painonhallinta raskautta edeltävästi on ensiarvoista alkuraskauden GDM-riskin pienentämiseksi. Alkuraskauden raskausdiabeetikoiden elintavat ja terveydentila erosivat muiden tutkittavien elintavoista ja terveydentilasta merkitsevästi ainoastaan muutamien muuttujien osalta. Elintapoja ja terveydentilaa kuvaavien muuttujien havainnointi antoi kuitenkin viitteitä, joiden mukaan alkuraskauden raskausdiabeetikot erottuivat epäsuotuisasti muista tutkittavista. Alkuraskaudessa raskausdiabetekseen sairastuneiden elintapaohjaukseen ja terveydentilan seurantaan sekä raskauden aikana että sen jälkeen tulisi kohdentaa erityistä panostusta.Diabetes first time detected during pregnancy is called gestational diabetes (GDM). Diagnostic criteria for gestational diabetes differ from those of diabetes outside of pregnancy. In the year 2014 16 % of Finnish pregnant women had abnormal OGTT (oral glucose tolerance test) result. OGTT is the standard method for diagnosing GDM. GDM prevalence is increasing and it is mainly accounted for increasing body mass index among pregnant women. GDM predisposes both mother and child for perinatanal complications as well as health problems in their later life. In Finland GDM is diagnosed during early pregnancy or in general at the turn of the second and third trimester. There is no worldwide consensus of the justification of the early GDM diagnosis. Little is known about the patients with early GDM. The main goal of my master´s thesis was to describe lifestyle (nutrition and physical activity) and health of the early (pregnancy week 8−12) GDM study subjects and to compare these to other study subjects´ lifestyle and health. In addition the study examined which factors were accounted for the early GDM. The data of the master´s thesis came from the NELLI intervention study (Neuvonta, elintavat ja liikunta neuvolassa) which covered years 2007–10. The inclusion criteria of the study were factors known to increase the risk of GDM. The exclusion criteria included for example abnormal OGTT result during early pregnancy. Study subjects´ nutrition and leisure time physical activity (valid surveys) and health (anthropometric measures, blood pressure, blood tests) were followed during pregnancy. One year after delivery follow-up study was carried out. Master´s thesis data consisted of the records of the study subjects participating in the NELLI intervention study and subjects excluded from the study due to the abnormal early pregnancy OGTT. Data relative to early GDM subjects existed only for before bregnancy (lifestyle) or early pregnancy (health) and one year after delivery (lifestyle, health). In these time points variables representing early GDM and NELLI study subjects´ lifestyle and health were compared. Statistical methods used were Pearson´s chi-square test, Fisher´s exact test, independent samples T-test and Mann-Whitney U test, linear regression analysis, ordinal logistic regression analysis and logistic regression analysis. The factors accounting for risk of early GDM were increasing body mass index before pregnancy, age of at least 35 years before pregnancy and GDM or macrosomic newborn during previous pregnancies. High-density lipoprotein concentration of early GDM subjects during early pregnancy was lower than that of other study subjects. In addition total fat contributed more of the daily energy intake (E%) and low-fat dairy products and cheeses smaller portion of the diet before pregnancy of early GDM subjects than of other study subjects. Furthermore the nutritional goals (≥ 4/5) were fulfilled less frequently before pregnancy in the diet of early GDM subjects than in the diet of other study subjects. The group of early GDM subjects participating in the follow-up study was assorted hence the results of follow-up study have to consider cautiously. Mainly the same factors which are known to increase GDM risk at the turn of the second and third trimester accounted also for the risk of early GDM. Weight management before pregnancy seems to be the most important way to reduce the risk of early GDM. Some signals were also be noticed according to which early GDM subjects´ lifestyle and health markers differed unfavourably from those of other study subjects. In conclusion strong attention should be paid to counseling on lifestyle factors and follow-up of the health of early GDM patients both during pregnancy and thereafter

New Real-Time Quantitative PCR Procedure for Quantification of Bifidobacteria in Human Fecal Samples

The application of a real-time quantitative PCR method (5′ nuclease assay), based on the use of a probe labeled at its 5′ end with a stable, fluorescent lanthanide chelate, for the quantification of human fecal bifidobacteria was evaluated. The specificities of the primers and the primer-probe combination were evaluated by conventional PCR and real-time PCR, respectively. The results obtained by real-time PCR were compared with those obtained by fluorescent in situ hybridization, the current gold standard for intestinal microbiota quantification. In general, a good correlation between the two methods was observed. In order to determine the detection limit and the accuracy of the real-time PCR procedure, germfree rat feces were spiked with known amounts of bifidobacteria and analyzed by both methods. The detection limit of the method used in this study was found to be about 5 × 10(4) cells per g of feces. Both methods, real-time PCR and fluorescent in situ hybridization, led to an accurate quantification of the spiked samples with high levels of bifidobacteria, but real-time PCR was more accurate for samples with low levels. We conclude that the real-time PCR procedure described here is a specific, accurate, rapid, and easy method for the quantification of bifidobacteria in feces

Are habitat loss, predation risk and climate related to the drastic decline in a Siberian flying squirrel population? A 15 year study

To devise effective conservation actions, it is important to know which factors are associated with the population parameters of a declining population. Using mark–recapture methods, we estimated the annual population size, growth rate and survival probability of an ear-tagged flying squirrel population over a 15-year period in a 4,500 ha study area in western Finland. The species is considered vulnerable, but detailed knowledge concerning population sizes or trends is lacking. The population parameters and changes therein were regressed against habitat availability, an indicator of predation pressure, and mean winter temperature (an indicator of climate change), to reveal potential reasons for trends in the population. The best-fit models suggested the annual growth rate to be below one, and on average it was 0.93 (±0.06; SE) across the 15-year period. The survival probability was about 0.22 (±0.03) for juveniles and 0.50 (±0.03) for adults. The population size of adult flying squirrels decreased from 65 (±11) individuals in 1995 to 29 (±6) individuals in 2009. The number of flying squirrels was associated with the amount of available habitat, but the decline in population size was more rapid than the loss of habitat area. If the current decreasing trend in habitat availability continues, the population might become extinct by the year 2020. To halt the population decline, it is necessary to refrain from clear-cutting mature spruce stands until new suitable habitats develop from the maturation of younger forests.peerReviewe