The effect of childhood stunting and wasting on adolescent cardiovascular diseases risk and educational achievement in rural Uganda : a retrospective cohort study

Background: Little is known about the long-term effects of early childhood undernutrition on adolescent cardiovascular disease risk and educational performance in low-income countries. We examined this in a rural Ugandan population. Objective: To investigate if stunting or wasting among children aged 2-5 years is associated with cardiovascular disease risk or educational achievement during adolescence. Methods: We conducted analyses using data from a cohort of children followed from early childhood to adolescence. Weight and height were measured in 1999-2000 when the children were 2-5 years of age and repeated in 2004/2005 and 2011. We compared cardiovascular disease risk parameters (mean blood pressure, lipids, HbA1c) and schooling years achieved in 2011 among 1054 adolescents categorised into four groups: those who experienced stunting or wasting throughout follow-up; those who recovered from stunting or wasting; those who were normal but later became stunted or wasted; and those who never experienced stunting or wasting from childhood up to adolescence. We controlled for possible confounding using multiple generalised linear regression models along with Generalised Estimating Equations to account for clustering of children within households. Results: Wasting was negatively associated with systolic blood pressure (-7.90 95%CI [-14.52,-1.28], p = 0.02) and diastolic blood pressure (-3.92, 95%CI [-7.42, -0.38], p = 0.03). Stunting had borderline negative association with systolic blood pressure (-2.90, 95%CI [-6.41, 0.61] p = 0.10). Recovery from wasting was positively associated with diastolic blood pressure (1.93, 95%CI [0.11, 3.74] p = 0.04). Stunting or wasting was associated with fewer schooling years. Conclusion: Recovery from wasting rather than just an episode in early childhood is associated with a rise in blood pressure while educational achievement is compromised regardless of whether recovery from undernutrition happens. These findings are relevant to children exposed to undernutrition in low-income settings

The effects of vitamin D-2 or D-3 supplementation on glycaemic control and related metabolic parameters in people at risk of type 2 diabetes: protocol of a randomised double-blind placebo-controlled trial

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.London – Block grant from Tower Hamlets Primary Care NHS Trust and East London CLRN. Cambridge – From the operational budget of Medical Research Council Epidemiology Unit (MC_UP_A100_1003)

Associations between body mass index-related genetic variants and adult body composition: the Fenland cohort study

Background/Objective: Body mass index (BMI) is a surrogate measure of adiposity but does not distinguish fat from lean or bone mass. The genetic determinants of BMI are thought to predominantly influence adiposity but this has not been confirmed. Here we characterise the association between BMI-related genetic variants and body composition in adults. Subjects/Methods: Among 9667 adults aged 29-64 years from the Fenland study, a genetic risk score for BMI (BMI-GRS) was calculated for each individual as the weighted sum of BMI-increasing alleles across 96 reported BMI-related variants. Associations between the BMI-GRS and body composition, estimated by DXA scans, were examined using age-adjusted linear regression models, separately by sex. Results: The BMI-GRS was positively associated with all fat, lean and bone variables. Across body regions, associations of the greatest magnitude were observed for adiposity variables e.g. for each standard deviation (SD) increase in BMI-GRS predicted BMI, we observed a 0.90 SD (95% CI: 0.71, 1.09) increase in total fat mass for men (P=3.75×10‾²¹) and a 0.96 SD (95% CI: 0.77, 1.16) increase for women (P=6.12×10‾²²). Associations of intermediate magnitude were observed with lean variables e.g. total lean mass: men: 0.68 SD (95% CI: 0.49, 0.86) (P=1.91×10‾¹²); women: 0.85 SD (95% CI: 0.65, 1.04) (P=2.66×10‾¹⁷) and of a lower magnitude with bone variables e.g. total bone mass: men: 0.39 SD (95% CI: 0.20, 0.58) (P=5.69×10‾⁵); women: 0.45 SD (95% CI: 0.26, 0.65) (P=3.96×10‾⁶). Nominally significant associations with BMI were observed for 28 SNPs. All 28 were positively associated with fat mass and 13 showed adipose-specific effects. Conclusion: In adults, genetic susceptibility to elevated BMI influences adiposity more than lean or bone mass. This mirrors the association between BMI and body composition. The BMI-GRS can be used to model the effects of measured BMI and adiposity on health and other outcomes.The Fenland Study is supported by the Medical Research Council (MC_U106179471). This work was supported by the Medical Research Council [Unit Programme numbers MC_UU_12015/2 and MC_UU_12015/1]. Genotyping was supported by the Medical Research Council (MC_PC_13046

Corrigendum: Integrative genomic analysis implicates limited peripheral adipose storage capacity in the pathogenesis of human insulin resistance.

PublishedJournal ArticleThis is the author accepted manuscript. The final version is available from Nature Publishing Group via the DOI in this record.