Ultrasound Assessment of Endothelial Function in Children

Although the clinical complications of atherosclerosis arise from developed lesions in old age, the atherosclerotic disease is a lifelong process with roots in childhood. Endothelial dysfunction is currently considered an early stage in the pathogenesis of atherosclerosis, which precedes the formation of structural atherosclerotic changes. Improvements in noninvasive imaging modalities, mainly in ultrasound imaging, have made it possible to assess the endothelial health of asymptomatic children with or without cardiovascular risk factors. By using noninvasive ultrasound for endothelial function, important insights have been gained into the early stages of atherosclerosis and the effects of cardiovascular risk factors on vasculature in childhood. The ultrasound test of endothelial function is affordable, available, and safe and may be considered a potent aid in clinical risk stratification of children at high risk for subsequent clinical atherosclerosis in adulthood. At present, this methodology serves only research purposes, as many issues including reproducibility and normal values for healthy children need to be solved before clinical use can be considered. In adults, however, recent studies have shown that attenuated endothelial function predicts the occurrence of future cardiovascular events

Schizophrenia polygenic risk score and long-term success in the labour market : A cohort study

Publisher Copyright: © 2022 The AuthorsEmployment is rare among people with a schizophrenia diagnosis. Meanwhile, a genetic liability for schizophrenia may hinder labour market performance. We studied how the polygenic risk score (PGS) for schizophrenia related to education and labour market outcomes. We found that a higher PGS was linked to lower educational levels and weaker labour market outcomes as well as a higher likelihood of receiving social income transfers, particularly among men. Assuming that the link is causal, our results indicate that individuals with schizophrenia or schizophrenia-related traits have a weakened ability to fully participate in the labour market, potentially reinforcing social exclusion.Peer reviewe

Response by Hakala et al to Letter Regarding Article, "Cardiovascular Risk Factor Trajectories Since Childhood and Cognitive Performance in Midlife: The Cardiovascular Risk in Young Finns Study"

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Early signs of sleep-disordered breathing in healthy women predict carotid intima-media thickening after 10 years

Background: Cardiovascular disease (CVD) is the leading cause of death in women. The risk of CVD increases in women after menopause. The aim was to study how sleep parameters and cardiovascular risk factors in 46-year-old women predict future carotid intima-media thickness (IMT) 10 years after. Methods: Prospective study of 92 healthy women, aged 46 years, were studied at baseline and at 10-year follow-up. Polysomnography for sleep and breathing; blood samples for cholesterol, glucose and follicle stimulating hormone; blood pressure (BP), weight and height measurements; questionnaires for background variables and vasomotor symptoms were carried out at both time points. Carotid ultrasound was scanned for IMT at 10-year follow-up. Results: After adjusting for conventional risk factors, apnea-hypopnea index (AHI) during rapid-eye movement (REM) sleep was the only parameter at baseline that predicted IMT 10 years after (IMT mean: 13 81.4 [95% CI, 14.0-148.8]; IMT max: 13 104.7 [95% CI, 15.4-194.1]). At 10-year follow-up, higher arousal index (IMT mean: 13 55.6 [95% CI, 19.5-91.8]; IMT max 13 59.9 [95% CI, 11.4-108.4]) and lower vasomotor symptoms (IMT max: 13-60.5 [95% CI,-119.0 to-2.0]) were associated with concurrent higher IMT. The conventional risk factors at baseline did not associate with future IMT but 10 years after higher concurrent HbA1c (IMT mean: 13 11.0 [95% CI, 3.4-18.5]; IMT max 13 14.0 [95% CI, 4.1-23.8]) and systolic BP (IMT mean: 13 2.4 [95% CI, 1.1-3.7]; IMT max: 13 2.7 [95% CI, 1.03 to 4.53]) were associated with higher IMT. Conclusions: In healthy 46-year-old women, AHI during REM sleep predicted IMT 10 years after. The conventional risk factors (HbA1c and BP) only associated with the concurrent IMT at 10-year follow-up. (c) 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).</p

Oral vitamin C and endothelial function in smokers: short-term improvement, but no sustained beneficial effect

AbstractOBJECTIVESTo test the hypothesis that antioxidant therapy would improve endothelial function in smokers.BACKGROUNDSeveral studies have documented a beneficial effect of short-term oral or parenteral vitamin C on endothelial physiology in subjects with early arterial dysfunction. Possible long-term effects of vitamin C on endothelial function, however, are not known.METHODSWe studied the effects of short- and long-term oral vitamin C therapy on endothelial function in 20 healthy young adult smokers (age 36 ± 6 years, 8 male subjects, 21 ± 10 pack-years). Each subject was studied at baseline, 2 h after a single dose of 2 g vitamin C and 8 weeks after taking 1 g vitamin C daily, and after placebo, in a randomized double-blind crossover study. Blood samples were analyzed for plasma ascorbate levels and endothelial function was measured as flow-mediated dilation of the brachial artery, using high resolution ultrasound. Nitroglycerin-mediated dilation (endothelium-independent) was also measured at each visit.RESULTSAt baseline, plasma ascorbate level was low in the smokers (42 ± 21 μmol/liter; normal range, 50 to 150 μmol/liter), increased with vitamin C therapy after 2 h to 120 ± 54 μmol/liter (p < 0.001) and remained elevated after eight weeks of supplementation at 92 ± 32 μmol/liter (p < 0.001, compared with placebo). Flow-mediated dilation, however, increased at 2 h (from 2.8 ± 2.0% to 6.3 ± 2.8%, p < 0.001), but there was no sustained beneficial effect after eight weeks (3.9 ± 3.2%, p = 0.26). Nitroglycerin-mediated dilation was unchanged throughout.CONCLUSIONOral vitamin C therapy improves endothelial dysfunction in the short term in healthy young smokers, but it has no beneficial long-term effect, despite sustained elevation of plasma ascorbate levels

Work participation and physicality of work in young adulthood and the development of unhealthy lifestyle habits and obesity later in life : a prospective cohort study

Objective To determine the effects of early entry into the labour market and physicality of work in young adulthood on the development of obesity and unhealthy lifestyle habits later in life. Methods This study is a part of the Young Finns Study. Entry into the labour market and physicality of work were measured at baseline, when participants were aged 18, 21, or 24 years in 1986 or 18 years in 1989. Follow-up of lifestyle habits were conducted in 2001, 2007 and 2011. The outcomes were obesity (n=5558 observations), abdominal obesity (n=4060 observations), daily smoking (n=5628) and leisure time physical activity (n=5946) and analysed with generalised estimating equation. Results Compared with sedentary work, physicality of work in young adulthood increased the odds of future obesity (adjusted OR=1.32, 95% CI 1.01 to 1.74 for light/moderate work and OR=1.44, 95% CI 0.99 to 2.08 for heavy manual work (particularly in women OR=2.03, 95% CI 1.07 to 3.84)) and future smoking (OR=1.79, 95% CI 1.39 to 2.30 for light/moderate work and OR=2.01, 95% CI 1.47 to 2.76 for heavy manual work (particularly in women OR=2.81, 95% CI 1.60 to 4.91)). For those who entered the labour market at ages 18-21 or younger, the odds of smoking was 1.85 times (95% CI 1.26 to 2.73) and that of obesity 1.45 times (95% CI 1.01 to 2.10) higher, and the rate of leisure time physical activity was 0.73 times (95% CI 0.58 to 0.93) lower compared with those who entered the labour market at ages 22-24 years. Conclusion Early entry into the labour market and physicality of work in young adulthood shape the development of obesity and unhealthy behaviours in later adulthood.Peer reviewe

Tracking of secretory phospholipase A2 enzyme activity levels from childhood to adulthood: a 21-year cohort.

OBJECTIVE: Secretory phospholipase A2 (sPLA2) enzyme activity is a potential inflammatory biomarker for cardiovascular disease. We examined the tracking, or persistence, of sPLA2 enzyme activity levels from childhood to adulthood, and identify potentially modifiable factors affecting tracking. METHOD: Prospective cohort of 1735 children (45% females) who had serum sPLA2 enzyme activity levels and other cardiovascular disease risk factors measured in 1980 that were followed-up in 2001. RESULTS: sPLA2 activity tracked from childhood to adulthood for males (r=0.39) and females (r=0.45). Those who decreased body mass index relative to their peers were more likely to resolve elevated childhood sPLA2 levels than have persistent elevated sPLA2 levels in childhood and adulthood. Those who consumed less fruit, and gained more body mass index relative to their peers, began smoking or were a persistent smoker between childhood and adulthood were more likely to develop incident elevated sPLA2 levels than those with persistent not elevated sPLA2 levels. CONCLUSIONS: Childhood sPLA2 enzyme activity levels associate with adult sPLA2 levels 21 years later. Healthful changes in modifiable risk factors that occur between childhood and adulthood might prevent children from developing elevated sPLA2 levels in adulthood

Does neuregulin-1 play a role in Type A behavior? The cardiovascular risk in young Finns study

BACKGROUND: Neuregulin-1 proteins are related to physiological correlates of Type A in terms of cardiac reactivity. Furthermore, neuregulin-1 gene (NRG1) may play a role in cardiovascular disease such as atherosclerosis and coronary heart disease i.e. the suggested "outcomes" of Type A behavior. Therefore, NRG1 is hypothesized to be associated with Type A behavior. METHODS: The study examined whether Type A behavior pattern is associated with the single nucleotide polymorphism (SNP) SNP8NRG221533 of the NRG1. The subjects were 631 men and women participating in the population-based Cardiovascular Risk in Young Finns study in 1992 and 2001. Type A was self-assessed with the Framingham Type A Scale and reassessed nine years later. RESULTS: Type A was associated with NRG1 genotype. Carriers of genotype CC scored lower on Type A compared to the others. CONCLUSION: Our study has pinpointed a SNP in NRG1 that predicts Type A behavior. As previous evidence suggests an association for NRG1 with beta-adrenergic stimulation, its role underlying Type A is discussed

Accumulation of Depressive Symptoms and Carotid Intima-Media Thickness : the Cardiovascular Risk in Young Finns Study

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Does higher education protect against obesity? Evidence using Mendelian randomization

Objectives. The aim of this explorative study was to examine the effect of education on obesity using Mendelian randomization. Methods. Participants (N = 2011) were from the on- going nationally representative Young Finns Study (YFS) that began in 1980 when six cohorts (aged 30, 33, 36, 39, 42 and 45 in 2007) were recruited. The average value of BMI (kg/m(2)) measurements in 2007 and 2011 and genetic information were linked to comprehensive register based information on the years of education in 2007. We first used a linear regression (Ordinary Least Squares, OLS) to estimate the relationship between education and BMI. To identify a causal relationship, we exploited Mendelian randomization and used a genetic score as an instrument for education. The genetic score was based on 74 genetic variants that genome- wide association studies (GWASs) have found to be associated with the years of education. Because the genotypes are randomly assigned at conception, the instrument causes exogenous variation in the years of education and thus enables identification of causal effects. Results. The years of education in 2007 were associated with lower BMI in 2007/2011 (regression coefficient (b) = -0.22; 95% Confidence Intervals [CI] = -0.29,-0.14) according to the linear regression results. The results based on Mendelian randomization suggests that there may be a negative causal effect of education on BMI (b = -0.84; 95% CI = -1.77, 0.09). Conclusion. The findings indicate that education could be a protective factor against obesity in advanced countries. (C) 2017 Elsevier Inc. All rights reserved.Peer reviewe