Serum Insulin and Other Cardiovascular Risk Indicators in Children, Adolescents and Young Adults

Rönnemaa, Tapani; Knip, Mikael; Lautala, Pentti; Viikari, Jorma; Uhari, Matti; Leino, Aila; Kaprio, Eero A.; Salo, Matti K.; Dahl, M.; Nuutinen, E M

doi:10.3109/07853899109147933

Cited by 108 publications

(68 citation statements)

References 30 publications

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“…Adult women who had early menarche may have hyperinsulinemia, since tracking of serum insulin is observed especially in females. 35) There are only a few studies on the effect of abortion or in- Adjusted relative risk (RR) for colon cancer by age at menarche, gravida, parity, age at first birth, and the number of abortions, JACC study, 1988-1997 Person-years 1) No …”

Section: Discussionmentioning

confidence: 99%

A prospective study of reproductive and menstrual factors and colon cancer risk in Japanese women: Findings from the JACC study

et al. 2004

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The effects of reproductive factors on the etiology of colon cancer in Asian populations remain unexplored. So we examined 38,420 Japanese women aged 40-79 years who responded to a questionnaire on reproductive and other lifestyle factors from 1988 to 1990 in the Japan Collaborative Cohort Study for Evaluation of Cancer Risk. During an average 7.6 years of follow-up, we documented 207 incident colon cancers. Multivariate analysis indicated that colon cancer risk was likely to be lower among parous women than among nulliparous. Women who had two abortions or more had a 72% higher risk of developing colon cancer [relative risk (RR) 1.72; 95% confidence interval (CI) 1.16-2.55; trend P < < < <0.01] compared with women who never had an abortion. The RR of colon cancer among postmenopausal women significantly decreased with increasing age at menarche (trend P = = = =0.01). No apparent association between colon cancer and gravida, age at first birth, age at menopause, or duration of menstruation was seen. These prospective data support the hypothesis that female reproductive events modify colon cancer risk, and suggest that reproductive factors, particularly age at menarche and having an abortion, may be of importance in the etiology of colon cancer among Japanese women. (Cancer Sci 2004; 95: 602-607) n 1980, McMichael and Potter 1) reviewed the results of two earlier case-control studies of colorectal cancer together with other epidemiologic, metabolic, and animal studies, and suggested that reproductive events and endogenous and exogenous sex hormones may affect carcinogenesis in the large bowel via their effects on hepatic function and bile acid formation. Briefly, endogenous estrogens increase bile acid production. Progestin, pregnancy, and high-dose oral contraceptives reduce bile acid production; therefore, they decrease the risk of colon cancer. Since then, the results of several further studies, most of which were conducted in high-risk Western countries using a case-control design, [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] dealing with this issue have been published. These studies suggested that some aspects of reproductive history including parity, age at first birth, age at menarche, and estrogen use after menopause may affect the development of colon cancer. However, these studies are inconsistent as to whether such reproductive factors are surrogates for hormonal effects or for some other lifestyle characteristics, such as diet or physical activity. Furthermore, the effects of reproductive factors on the etiology of colon cancer in Asian populations remain unexplored. Here, we report the findings from a large prospective study conducted among Japanese. Our study offers further evidence in support of the hypothesis proposed by McMichael and Potter. 1) Materials and MethodsThe JACC study. The Japan Collaborative Cohort Study for Evaluation of Cancer Risk, the JACC Study (sponsored by the Ministry of Education, Culture, Sports, Science and Technology of Japan) is a nationwide multi...

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Section: Discussionmentioning

confidence: 99%

A prospective study of reproductive and menstrual factors and colon cancer risk in Japanese women: Findings from the JACC study

et al. 2004

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Section: Introductionmentioning

confidence: 99%

“…9 Obesity has been reported to correlate positively with serum insulin even in childhood, 10,11 and it has been suggested that the metabolic syndrome may already exist in children. 11 Since there appears to be a lot of clinical evidence for deleterious effects of childhood obesity on the cardiovascular system, it would be of great importance to know the actual degree of obesity-related arterial and myocardial pathology to be found in children. Newman et al 1 reported that coronary or aortic fatty streaks in 35 autopsied persons with a mean age of 18 y (the majority being 15±19 y) were not related to obesity, but larger autopsy surveys on the cardiovascular system in children are few in number and have not concentrated on the effects of childhood obesity or body fat distribution patterns.…”

Section: Introductionmentioning

confidence: 99%

Adiposity, cardiac size and precursors of coronary atherosclerosis in 5 to 15-year-old children: a retrospective study of 210 violent deaths

Kortelainen

1997

Int J Obes

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OBJECTIVE: To determine the relationship between cardiac size and various measures of adiposity in children and the occurrence of coronary fatty streaks in relation to childhood obesity. DESIGN: A retrospective study based on 210 medico-legal autopsies of 5±15 y old children who had suffered violent death in the Province of Oulu, Finland, in 1970±1995. METHODS: Autopsy reports with attached clinical data and police records were recovered from the archives of the Department of Forensic Medicine, University of Oulu, Finland. All 5±15 y old individuals who had died of external trauma and were not documented as having had any chronic illnesses were chosen for investigation. The following data were extracted from the papers: age, sex, height, body weight, heart weight, liver weight, total weight of the kidneys, thickness of the abdominal subcutaneous fat and description of the coronary arteries. Heart weight was indexed to height 2.7 , and liver weight and kidney weight were indexed to body weight, body surface area and height. The ponderal index (body weight/height 3 ) was calculated, and relative body weight was determined as the percentage deviation of the weight from the mean weight for height according to a growth chart developed for Finnish children. RESULTS: The average absolute heart weight and heart weight/height 2.7 were signi®cantly higher in the boys than in the girls over 12 y of age. Abdominal subcutaneous fat was thicker in the girls, but there were no signi®cant differences in the other indicators of obesity. After adjusting for age, there were signi®cant positive correlations between the ponderal index and heart weight/height 2.7 in both the boys (P 5 0.000) and the girls (P 5 0.038), between relative body weight and heart weight/height 2.7 in the boys (P 5 0.000) and the girls (P 5 0.027), and between abdominal subcutaneous fat thickness and heart weight/height 2.7 in the boys (P 5 0.045) but not in the girls (P 5 0.234). Multiple linear regression analysis showed the ponderal index to be a signi®cant predictor of heart weight/height 2.7 . Coronary intimal fatty streaks were documented in six individuals (2.9%), ®ve of them having a ponderal index above the average and all of them having a relative weight above the average. Kidney weights were higher in the boys and were positively correlated with the measures of obesity and with heart weight/height 2.7 . CONCLUSIONS: The results point to an important role of excess body weight and adiposity in the development of early myocardial and coronary changes in childhood: coronary fatty streaks were not found at all in the leanest individuals in this relatively large group and the cardiac size adjusted for body size indicated hypertrophy with increasing adiposity. Prospective autopsy studies are needed in order to determine whether adiposity and the regional distribution of fat, especially intra-abdominal fat accumulation, are associated with the earliest signs of myocardial hypertrophy and the initial phase of lesion development in the arterial intima of c...

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“…18 ± 28 This relationship has not been thoroughly examined among children, yet insulin resistance in children may be related to chronic disease later in life. 7,29,30 One complication of studying the effects of leptin on insulin is that the relationship between leptin and insulin may be bidirectional and may be modi®ed by extent of obesity and insulin resistance. 31,32 Even if elevated leptin is a consequence rather than a predictor of insulin resistance, it still may be a useful screening tool for children with early metabolic disorders.…”

Section: Introductionmentioning

confidence: 99%

Plasma leptin concentrations and obesity in relation to insulin resistance syndrome components among school children in Taiwan—The Taipei Children Heart Study

et al. 2000

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OBJECTIVE: Leptin, an adipose tissue-derived product of the obesity (OB) gene, is an important regulator of energy metabolism and may be associated with the occurrence of insulin resistance and diabetes in humans. The purpose of this study was to evaluate the association of plasma leptin concentration with obesity and the components of insulin resistance syndrome (IRS) among school children in Taiwan. METHODS: After multistage sampling of 85 junior high schools in Taipei, we randomly selected 1264 children (617 boys and 647 girls) aged 12 ± 16 y. Obesity measurements included body mass index (BMI) and waist-to-hip circumference ratio (WHR). We calculated an IRS summary score for each individual by adding the quartile ranks from the distribution of systolic blood pressure (BP), serum triglyceride (TG), HDL-cholesterol (inverse), and insulin levels. RESULTS: Boys had a higher BMI and WHR, BP and IRS score and lower leptin, insulin, TG and HDL-C levels than girls. BMI, WHR and plasma leptin levels were signi®cantly associated with the IRS summary score and each of its components in both genders. Children with higher plasma leptin levels ( b 75th percentiles) have signi®cantly higher BP, TG, insulin levels and IRS score than children with low leptin levels. The associations between plasma leptin level and the IRS components and score were still signi®cant after adjusting for BMI in boys, but less so in girls. In both genders, after adjusting for WHR, plasma leptin levels were still signi®cantly associated with the IRS components and summary score (P`0.001). The ®nal model that included the standard covariates, BMI and leptin, but not WHR, was the most predictive of the IRS summary score among school children. CONCLUSIONS: Insulin resistance syndrome in childhood, characterized by high blood pressure, dyslipidemia, and hyperinsulinemia, may be an early marker of cardiovascular risk. From the present BMI and leptin in combination are the most predictive markers of insulin resistance syndrome among school children in Taiwan.

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Serum Insulin and Other Cardiovascular Risk Indicators in Children, Adolescents and Young Adults

Cited by 108 publications

References 30 publications

A prospective study of reproductive and menstrual factors and colon cancer risk in Japanese women: Findings from the JACC study

A prospective study of reproductive and menstrual factors and colon cancer risk in Japanese women: Findings from the JACC study

Adiposity, cardiac size and precursors of coronary atherosclerosis in 5 to 15-year-old children: a retrospective study of 210 violent deaths

Plasma leptin concentrations and obesity in relation to insulin resistance syndrome components among school children in Taiwan—The Taipei Children Heart Study

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