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Hypertension 04/2013; 61(4):e34-5. · 6.21 Impact Factor
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ABSTRACT: Most asthma starts early in life. Defining phenotypes of asthma at this age is difficult as many preschool children have asthma-like respiratory symptoms. This review discusses progress in defining early wheezing phenotypes and describes genetic factors associated with the age of onset of asthma.
Latent class analyses confirmed transient and persistent wheezing phenotypes, and identified a novel intermediate-onset wheezing phenotype that was strongly associated with atopy and asthma at age 8 years. However, no single cross-sectional or longitudinal definition of respiratory symptoms in childhood strongly predicts asthma later in life. Genome-wide association (GWA) studies have identified a locus on chromosome 17q12-21 (encoding ORMDL3 and GSDMB) as a risk factor for predominantly childhood-onset asthma, but not for atopy, and overall not for adult-onset asthma. Other loci found by GWA studies appear to increase asthma risk both in children and adults. Atopy genes do not explain early-onset asthma.
Although most asthma starts early in life, no valid test is able to identify asthma at that age period. GWA studies have provided more insight into the unique and common genetic origins of adult-onset and childhood-onset asthma. The 17q12-21 locus is predominantly associated with childhood-onset asthma.
Current Opinion in Allergy and Clinical Immunology 04/2013; 13(2):193-202. · 4.11 Impact Factor
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ABSTRACT: We studied the associations of maternal prepregnancy body mass index and gestational weight gain with risks of preschool wheezing in offspring and explored the role of growth, infectious and atopic mechanisms.This sub-study of 4,656 children was embedded in a population-based birth cohort. Information about maternal prepregnancy weight, gestational weight gain and wheezing at the ages 1 to 4 was obtained by physical measurements or questionnaires.Among mothers with a history of asthma or atopy, maternal prepregnancy obesity was associated with an overall increased risk of preschool wheezing (OR 1.47 (1.12, 1.95)). Also, each SD increase of gestational weight gain was associated with an increased overall risk of preschool wheezing (OR 1.09 (1.04, 1.14)), independent of prepregnancy body mass index and not different between mothers with and without a history of asthma or atopy. Child's growth, respiratory tract infections or eczema did not alter the results.Mothers with prepregnancy obesity and a history of asthma or atopy, and higher gestational weight gain showed higher risks of wheezing in their offspring. These associations could not be explained by growth, infectious or atopic mechanisms. Further research is needed to identify underlying mechanisms and long term consequences.
European Respiratory Journal 03/2013; · 5.89 Impact Factor
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ABSTRACT: OBJECTIVE: International guidelines recommend measuring fractional exhaled nitric oxide (FeNO) during a single slow exhalation with a constant flow of 50 ml/sec. We developed a new algorithm to compute FeNO at 50 ml/sec from tidal breathing measurements. The main objective is to assess the correlation and agreement of this algorithm with the conventional single breath FeNO measurements. METHODS: We recruited children aged 6-18 years, who performed both a single breath and a tidal breathing FeNO measurement in random order. Both maneuvers were performed on the Eco Medics NO-analyser (Eco Physics AG, Duernten, Switzerland). RESULTS: We included 109 patients between January 2011 and April 2011. Geometric mean (95% CI) FeNO values did not differ significantly between single breath and tidal breathing technique: 21.0 (17.7-24.8) ppb and 20.0 (17.0-23.6) ppb (P = 0.18), respectively. We found an excellent intraclass correlation coefficient of 0.96 (0.94-0.97) and moderate agreement with a mean difference of 4% (95% limits of agreement -43% and +90%). CONCLUSION: Tidal breathing FeNO values could be transformed with a new algorithm to match single breath FeNO at a constant flow of 50 ml/sec. This algorithm opens the way to standardized FeNO measurements in preschool children and uncooperative patients. Pediatr Pulmonol. © 2013 Wiley Periodicals, Inc.
Pediatric Pulmonology 02/2013; · 2.53 Impact Factor
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Alet H Wijga,
Marjan Kerkhof,
Ulrike Gehring, Johan C de Jongste,
Dirkje S Postma,
Rob C Aalberse,
Ada Ph Wolse,
Gerard H Koppelman,
Lenie van Rossem,
Marieke Oldenwening,
Bert Brunekreef,
Henriëtte A Smit
International Journal of Epidemiology 01/2013; · 6.41 Impact Factor
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ABSTRACT: OBJECTIVES: Evidence for a relationship between gas cooking and childhood respiratory health is inconsistent and few longitudinal studies have been reported. Our aim was to examine the association between gas cooking and the development of respiratory and allergic outcomes longitudinally in a prospective birth cohort study. METHODS: The Prevention and Incidence of Asthma and Mite Allergy birth cohort study followed children from birth (1996/1997) until age 8. Annual questionnaires were used to document respiratory and allergic symptoms. Allergic sensitisation and bronchial hyper-responsiveness (BHR) were measured at age 8 in subpopulations. A total of 3590 children were included in the present analysis. We used generalised estimating equations and discrete-time hazard models to study the overall and age-specific associations between exposure to gas cooking and the risk of developing respiratory illnesses. Sensitivity analyses of intermittent, always, current and early exposure to gas cooking were conducted. RESULTS: Ever gas cooking exposure was associated with nasal symptoms (sneezing, runny/blocked nose without a cold) during the first 8 years of life (OR=1.32, 95% CI 1.09 to 1.59), but not with lower respiratory tract infections, eczema, allergic sensitisation and BHR. Associations with nasal symptoms were similar among children with intermittent, always, current and early exposure. Among girls only, prevalent asthma was associated with ever gas cooking (OR=1.97, 95% CI 1.05 to 3.72). CONCLUSIONS: Overall, our findings provide little evidence for an adverse effect of exposure to gas cooking on the development of asthma and allergies.
Occupational and environmental medicine 12/2012; · 3.64 Impact Factor
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Agnes Mm Sonnenschein-van der Voort,
Yvonne de Kluizenaar,
Vincent Wv Jaddoe,
Carmelo Gabriele,
Hein Raat,
Henriëtte A Moll,
Albert Hofman,
Frank H Pierik,
Henk Me Miedema, Johan C de Jongste,
Liesbeth Duijts
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ABSTRACT: BACKGROUND: Air pollution is associated with asthma exacerbations. We examined the associations of exposure to ambient particulate matter (PM10) and nitrogen dioxide (NO2) with the risk of wheezing in preschool children, and assessed whether these associations were modified by tobacco smoke exposure. METHODS: This study was embedded in the Generation R Study, a population-based prospective cohort study among 4,634 children. PM10 and NO2 levels were estimated for the home addresses using dispersion modeling. Annual parental reports of wheezing until the age of 3 years and fetal and infant tobacco smoke exposure was obtained by questionnaires. RESULTS: Average annual PM10 or NO2 exposure levels per year were not associated with wheezing in the same year. Longitudinal analyses revealed non-significant tendencies towards positive associations of PM10 or NO2 exposure levels with wheezing during the first 3 years of life (overall odds ratios (95% confidence interval): 1.21 (0.79, 1.87) and 1.06 (0.92, 1.22)) per 10 mug/m3 increase PM10 and NO2, respectively). Stratified analyses showed that the associations were stronger and only significant among children who were exposed to both fetal and infant tobacco smoke (overall odds ratios 4.54 (1.17, 17.65) and 1.85 (1.15, 2.96)) per 10 mug/m3 increase PM10 and NO2, respectively (p-value for interactions <0.05). CONCLUSIONS: Our results suggest that long term exposure to traffic-related air pollutants is associated with increased risks of wheezing in children exposed to tobacco smoke in fetal life and infancy. Smoke exposure in early life might lead to increased vulnerability of the lungs to air pollution.
Environmental Health 12/2012; 11(1):91. · 2.65 Impact Factor
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ABSTRACT: OBJECTIVE:To assess whether timing of introduction of fish and the amount of fish consumption in infancy were associated with asthmalike symptoms at preschool age.METHODS:This study was embedded in the Generation R study (a population-based birth cohort in Rotterdam, Netherlands). At the age of 12 and 14 months, timing of introduction of fish into the infant's diet was assessed. The amount of fish consumption at 14 months was assessed by a semiquantitative food frequency questionnaire. Presence of asthmalike symptoms in the past year was assessed at the child's age of 36 and 48 months.RESULTS:Relative to no introduction in the first year of life, introduction between age 6 and 12 months was significantly associated with a lower risk of wheezing at 48 months (odds ratio [OR]: 0.64; 95% CI: 0.43-0.94). When compared with introduction between 6 and 12 months, no introduction in the first year and introduction between 0 and 6 months were associated with an increased risk of wheezing at 48 months (OR: 1.57; 95% CI: 1.07-2.31 and OR: 1.53; 95% CI: 1.07-2.19, respectively). The amount of fish at age 14 months was not associated with asthmalike symptoms (P > .15).CONCLUSIONS:Introduction of fish between 6 and 12 months but not fish consumption afterward is associated with a lower prevalence of wheezing. A window of exposure between the age of 6 and 12 months might exist in which fish might be associated with a reduced risk of asthma.
PEDIATRICS 11/2012; · 4.47 Impact Factor
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ABSTRACT: BACKGROUND: Body mass index (BMI) and waist circumference (WC) may be associated with lung function in children, as observed in adults. METHODS: Height, weight, waist circumference, and lung function (FVC and FEV(1) ) were measured during a medical examination in 1,058 eight-year-old children participating in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study. RESULTS: After adjusting for height, age and other potential confounders large WC or high BMI (>90th percentile) were not associated with forced expiratory volume in 1 sec (FEV(1) ) or forced vital capacity (FVC). In girls only, large WC was, independently of BMI, associated with 3.5% (95% confidence interval (CI): -6.4, -0.6) lower FEV(1) /FVC ratio in the model including WC and BMI. Girls with low BMI (<10th percentile) had 4.6% lower FEV(1) (95% CI: -8.4, -0.6) and 5.1% lower FVC (95% CI: -8.8, -1.2) than girls with normal BMI. In boys, we did not observe associations between low or high BMI and lung function independent of WC, or between small or large WC and lung function after adjustment for BMI. CONCLUSION: At 8 years of age, a high BMI or large WC are not yet associated with FEV(1) and FVC, indicating that this association may change over the course of life from childhood to adulthood. Pediatr Pulmonol. © 2012 Wiley Periodicals, Inc.
Pediatric Pulmonology 11/2012; · 2.53 Impact Factor
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ABSTRACT: To characterize lung function and broncho-alveolar lavage sphingolipid profile of newborn mice during hyperoxia exposure and recovery in room air, and to examine the effect of D-sphingosine supplementation during recovery.Newborn mice were exposed to 80% O2 for 4 weeks and allowed to recover in room air for another 4 weeks. Lung function measurements and morphometrical analysis of lung tissue were performed and BAL fluid was collected during hyperoxia and recovery with and without D-sphingosine supplementation.Hyperoxia exposure altered lung function, which partially recovered in room air. Lungs had fewer and enlarged alveoli which persisted during recovery. Multiple sphingolipids were significantly increased after hyperoxia. Ceramides were increased after 2 weeks of recovery, but normalized to control values after 4 weeks. Addition of D-sphingosine during the first 5 days of recovery accelerated the normalization of ceramide levels at 2 weeks and partially reversed the hyperoxia-induced increase in alveolar size and arrest in alveolarization at 4 weeks.Exposure of newborn mice to hyperoxia caused restrictive and obstructive lung function changes that partially recovered in room air, while alveolar morphology remained abnormal. Hyperoxia increased ceramide levels, with normalization after recovery. D-sphingosine addition during recovery reduced ceramide levels and ameliorated hyperoxia-induced alveolar arrest.
European Respiratory Journal 11/2012; · 5.89 Impact Factor
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Esther Eenhuizen,
Ulrike Gehring,
Alet H Wijga,
Henriette A Smit,
Paul H Fischer,
Michael Brauer,
Gerard H Koppelman,
Marjan Kerkhof, Johan C de Jongste,
Bert Brunekreef,
Gerard Hoek
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ABSTRACT: Outdoor air pollution has been associated with decrements in lung function and lung function growth in school-age children. Lung function effects have not been examined in preschoolers, with the exception of one study on minute ventilation in newborns. Our goal was to assess the relationship between long- and short term exposure to traffic-related air pollution and interrupter resistance in four-year old children.Lung function was measured using the interrupter resistance method in children participating in a Dutch birth cohort study. Long-term average air pollution concentrations of fine particulate matter, nitrogen dioxide and soot at the residential address at birth were assessed with land-use regression models. Daily average air pollution concentrations on the clinical examination day were obtained from the National Air Quality Monitoring Network.Significant associations were found between long-term average air pollution concentrations and interrupter resistance. Interrupter resistance increased by 0.04 kPa.l(-1).s (95% confidence interval 0.01-0.07) per interquartile range increase (3.3 μg·m(-3)) in fine particle concentration. Short-term exposure was not associated with interrupter resistance.Long-term exposure to traffic-related air pollution was associated with increased interrupter resistance in 4-year old children, supporting previous birth cohort studies reporting effects of air pollution on subjectively reported respiratory symptoms in pre-school children.
European Respiratory Journal 11/2012; · 5.89 Impact Factor
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ABSTRACT: Respiratory morbidity has been described in patients who underwent repair of esophageal atresia as a neonate. We compared the influence of open thoracotomy or thoracoscopy on lung function, respiratory symptoms, and growth.
Functional residual capacity (FRC(p)), indicative of lung volume, and maximal expiratory flow at functional residual capacity (V'max(FRC)), indicative of airway patency, of 37 infants operated for esophageal atresia were measured with Masterscreen Babybody at 6 and 12 months. SD scores were calculated for V'max(FRC).
Repair was by thoracotomy in 21 cases (57%) and by thoracoscopy in 16 cases (43%). Lung function parameters did not differ between the types of surgery (FRC(p); P = .384 and V'max(FRC); P = .241). FRC(p) values were in the upper normal range and increased from 6 to 12 months (22.5 and 25.4 mL/kg respectively, P = .010). Mean (SD) V'max(FRC) was below the norm without significant change in SD scores from 6 to 12 months (-1.9 and -2.3, respectively, P = .248). Neither lung function nor type of repair was associated with clinical evolution up to 2 years.
Lung function during the first year was similar in EA infants repaired by thoracotomy or thoracoscopy. Ongoing follow-up including pulmonary function testing is needed to determine whether differences occur at a later age in this cohort.
Journal of Pediatric Surgery 11/2012; 47(11):1975-83. · 1.45 Impact Factor
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Vincent W V Jaddoe,
Cornelia M van Duijn,
Oscar H Franco,
Albert J van der Heijden,
Marinus H van Iizendoorn, Johan C de Jongste,
Aad van der Lugt,
Johan P Mackenbach,
Henriëtte A Moll,
Hein Raat,
Fernando Rivadeneira,
Eric A P Steegers,
Henning Tiemeier,
Andre G Uitterlinden,
Frank C Verhulst,
Albert Hofman
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ABSTRACT: The Generation R Study is a population-based prospective cohort study from fetal life until adulthood. The study is designed to identify early environmental and genetic causes and causal pathways leading to normal and abnormal growth, development and health during fetal life, childhood and adulthood. The study focuses on six areas of research: (1) maternal health; (2) growth and physical development; (3) behavioural and cognitive development; (4) respiratory health and allergies; (5) diseases in childhood; and (6) health and healthcare for children and their parents. Main exposures of interest include environmental, endocrine, genetic and epigenetic, lifestyle related, nutritional and socio-demographic determinants. In total, n = 9,778 mothers with a delivery date from April 2002 until January 2006 were enrolled in the study. Response at baseline was 61 %, and general follow-up rates until the age of 6 years exceed 80 %. Data collection in mothers, fathers and children include questionnaires, detailed physical and ultrasound examinations, behavioural observations, and biological samples. A genome and epigenome wide association screen is available in the participating children. From the age of 5 years, regular detailed hands-on assessments are performed in a dedicated research center including advanced imaging facilities such as Magnetic Resonance Imaging. Eventually, results forthcoming from the Generation R Study contribute to the development of strategies for optimizing health and healthcare for pregnant women and children.
European Journal of Epidemiology 10/2012; · 4.71 Impact Factor
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ABSTRACT: BACKGROUND: In well-child care it is difficult to determine whether preschool children with asthma symptoms actually have or will develop asthma at school age. The PIAMA (Prevention and Incidence of Asthma and Mite Allergy) Risk Score has been proposed as an instrument that predicts asthma at school age, using eight easy obtainable parameters, assessed at the time of first asthma symptoms at preschool age. AIMS: Present the rationale and design of a study 1) to externally validate and update the PIAMA Risk Score, 2) to develop an Asthma Risk Appraisal Tool to predict asthma at school age in (specific subgroups of) preschool children with asthma symptoms and 3) to test implementation of the Asthma Risk Appraisal Tool in well-child care. Methods and design The study will be performed within the framework of Generation R, a prospective multi-ethnic cohort study. In total, consent for postnatal follow-up was obtained from 7893 children, born between 2002 and 2006. At preschool age the PIAMA Risk Score will be assessed and used to predict asthma at school age. Discrimination (C-index) and calibration will be assessed for the external validation. We will study whether the predictive ability of the PIAMA Risk Score can be improved by removing or adding predictors (e.g. preterm birth). The (updated) PIAMA Risk Score will be converted to the Asthma Risk Appraisal Tool- to predict asthma at school age in preschool children with asthma symptoms. Additionally, we will conduct a pilot study to test implementation of the Asthma Risk Appraisal Tool in well-child care. DISCUSSION: Application of the Asthma Risk Appraisal Tool in well-child care will help to distinguish preschool children at high- and low-risk of developing asthma at school age when asthma symptoms appear. CONCLUSION: This study will increase knowledge about the validity of the PIAMA risk score and might improve risk assessment of developing asthma at school age in (specific subgroups of) preschool children, who present with asthma symptoms at well-child care.
BMC Pulmonary Medicine 10/2012; 12(1):65. · 1.33 Impact Factor
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ABSTRACT: BACKGROUND: Invasive pulmonary aspergillosis (IPA) is a life-threatening complication in immunocompromised patients. Early diagnosis and therapy improves outcome. Assessment of galactomannan (GM) in bronchoalveolar lavage (BAL) fluid is a proposed tool to diagnose IPA. Little is known about the diagnostic value of BAL GM in children. MATERIALS AND METHODS: Retrospectively, 72 bronchoscopies were analyzed for GM in patients fulfilling the host factor criteria as defined by the EORTC/MSG. A cut-off index value GM of ≥0.5 was used. Clinical data, results of chest CT-scans and BAL cultures were collected. RESULTS: Sensitivity, specificity, PPV, and NPV of BAL GM for a diagnosis of proven and probable IPA (n = 41) were 82.4%, 87.5%, 82.4%, and 87.5% respectively. A significant relation was found for BAL GM and abnormal chest CT (P = 0.01). No significant relationship was observed between BAL Aspergillus sp. culture and chest CT (n = 47). BAL GM and serum GM correlated significantly. In 9 out of 12 patients classified as possible IPA, antifungal therapy was continued or started, despite a negative BAL GM. CONCLUSIONS: BAL GM test had good diagnostic value in children suspected of IPA. However, the decision to continue or start antifungal therapy was mainly determined by the clinical suspicion of IPA based on chest CT-outcome, serum GM index values and failure of antibiotic therapy. Pediatr Pulmonol. © 2012 Wiley Periodicals, Inc.
Pediatric Pulmonology 09/2012; · 2.53 Impact Factor
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ABSTRACT: Breastfed individuals have a lower blood pressure than formula-fed individuals. Supplementation with n-3 long-chain polyunsaturated fatty acids in adults is also associated with a lower blood pressure. We studied whether children receiving human milk with a relatively high content of n-3 long-chain polyunsaturated fatty acids have a lower blood pressure at age 12 years, and, if so, whether this association is explained by the n-3 long-chain polyunsaturated fatty acids content in erythrocyte membranes at age 12 years. Within a 12-year follow-up of a population-based birth cohort, we compared blood pressure of 205 never-breastfed children and 109 children who had fatty acid composition of their mothers' breast milk measured during lactation. In addition, 973 children had information on erythrocyte fatty acid composition and blood pressure at age 12 years. Children who received human milk with an n-3 long-chain polyunsaturated fatty acids content above the median (ie, 0.51 weight percentage) had a 4.79-mm Hg lower systolic (95% CI, -7.64 to -1.94) and a 2.47-mm Hg lower diastolic (95% CI, -4.45 to -0.49) blood pressure at age 12 years than never-breastfed children. N-3 long-chain polyunsaturated fatty acids levels in human milk below the median value and current n-3 long-chain polyunsaturated fatty acid status were not associated with blood pressure at age 12 years. Thus, a relatively high content of n-3 long-chain polyunsaturated fatty acids in human milk is associated with a lower blood pressure in children at age 12 years, a finding not explained by current n-3 long-chain polyunsaturated fatty acids status.
Hypertension 08/2012; 60(4):1055-60. · 6.21 Impact Factor
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ABSTRACT: We assessed whether dynamic preschool wheezing patterns affect health-related quality of life (HRQOL) at age 4 years.The study included 3878 children participating a prospective cohort study. Information on preschool wheezing was obtained by questionnaires and children were categorised into: never, early, late and persistent wheezing. At age 4 years HRQOL was measured, using the Child Health Questionnaire (CHQ).Persistent wheezing was associated with reduced scores for 9 out of 13 CHQ scales. No differences in psychosocial CHQ scores (p>0.05), but lower physical CHQ scores were found in children with late and persistent wheezing, compared to children who never wheezed (p<0.001). Mean scores on general health perceptions were respectively 8 and 12 points lower (on a 0-100 scale) in children with late and persistent wheezing (p<0.001), and children with 1-3 episodes and ≥4 episodes of wheezing in the 4(th) year respectively scored 7 and 24 points lower (p<0.001), compared to children who never wheezed.Persistent wheezing during preschool age independently affects child's HRQOL, particularly general health perceptions and physical domains at age 4 years. HRQOL was more affected by frequent wheezing episodes in the 4(th) year of life, rather than by duration of wheezing at age 0-4 years.
European Respiratory Journal 07/2012; · 5.89 Impact Factor
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ABSTRACT: To assess lung function longitudinally after neonatal ECMO, and to identify any effects of diagnosis and perinatal characteristics.121 neonatal ECMO-treated children (70 meconium aspiration syndrome, 20 congenital diaphragmatic hernia, 31 other diagnoses) performed altogether 191 lung function measurements at 5, 8 and/or 12 years. We assessed dynamic and static lung volumes, reversibility of airway obstruction and diffusion capacity.Mean SDS FEV1 at 5 years before and after bronchodilation (-0.51 and 0.07) was significantly higher than at 8 (-0.79 and -0.4, p<0.04) and 12 years (-1.10 and -0.52, p<0.003). Mean SDS for all spirometric parameters before and after bronchodilation were significantly lower in the congenital diaphragmatic hernia group compared the other diagnostic groups (all p≤0.025). A significant volume of trapped air was observed in 86% patients with congenital diaphragmatic hernia, 50% with meconium aspiration syndrome and 58% with other diagnoses. After bronchodilation mean SDS FEV1 and FVC were negatively influenced by duration of ventilation (both p<0.001) and duration of ECMO (p=0.003 and p=0.02 respectively).Long-term pulmonary sequelae after neonatal ECMO-treatment mainly occur in congenital diaphragmatic hernia patients and tend to deteriorate over time.
European Respiratory Journal 04/2012; · 5.89 Impact Factor
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Jonathan P Bradfield,
H Rob Taal,
Nicholas J Timpson,
André Scherag,
Cecile Lecoeur,
Nicole M Warrington,
Elina Hypponen,
Claus Holst,
Beatriz Valcarcel,
Elisabeth Thiering, [......],
I Sadaf Farooqi,
Mark I McCarthy,
Philippe Froguel,
David Meyre,
Johannes Hebebrand,
Marjo-Riitta Jarvelin,
Vincent W V Jaddoe,
George Davey Smith,
Hakon Hakonarson,
Struan F A Grant
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ABSTRACT: Multiple genetic variants have been associated with adult obesity and a few with severe obesity in childhood; however, less progress has been made in establishing genetic influences on common early-onset obesity. We performed a North American, Australian and European collaborative meta-analysis of 14 studies consisting of 5,530 cases (≥95th percentile of body mass index (BMI)) and 8,318 controls (<50th percentile of BMI) of European ancestry. Taking forward the eight newly discovered signals yielding association with P < 5 × 10(-6) in nine independent data sets (2,818 cases and 4,083 controls), we observed two loci that yielded genome-wide significant combined P values near OLFM4 at 13q14 (rs9568856; P = 1.82 × 10(-9); odds ratio (OR) = 1.22) and within HOXB5 at 17q21 (rs9299; P = 3.54 × 10(-9); OR = 1.14). Both loci continued to show association when two extreme childhood obesity cohorts were included (2,214 cases and 2,674 controls). These two loci also yielded directionally consistent associations in a previous meta-analysis of adult BMI(1).
Nature Genetics 04/2012; 44(5):526-31. · 35.53 Impact Factor
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ABSTRACT: Ethnic disparities in the prevalence of asthma symptoms in children have been described. We evaluated to what extent the association between ethnic background and respiratory symptoms during the first 2 years of life could be explained by the mediating effect of risk factors for respiratory morbidity. The Generation R Study is a multiethnic, population-based birth cohort study. Pre and postnatal risk factors for respiratory morbidity were prospectively assessed by questionnaires. Information about ethnicity was available for 5,684 infants. The associations between ethnic background and lower respiratory symptoms at 12 and 24 months were evaluated with log-binomial regression models. Relative risks and 95 % confidence intervals (RR [95 % CI]) were computed for Cape Verdean, Moroccan, Antillean, Surinamese and Turkish ethnicity with Dutch ethnicity as the reference category. We found an increased risk of lower respiratory symptoms at 24 months in Antillean infants (1.32 [95 % CI 1.12-1.57]) that was mediated by early postnatal exposures (pets keeping, siblings, breastfeeding, daycare attendance, smoke exposure). Turkish infants also had an increased risk of lower respiratory symptoms at 12 and 24 months (1.14 [95 % CI 1.02-1.27] and 1.21 [95 % CI 1.07-1.38], respectively), partly explained by previous morbidity (eczema, infections and upper respiratory symptoms). There were no differences for Cape Verdean, Moroccan or Surinamese, as compared to Dutch infants. Hence, ethnic background was associated with respiratory symptoms during the first 2 years of life and this association was largely explained by mediating effects of known pre and postnatal risk factors for respiratory morbidity.
European Journal of Epidemiology 04/2012; 27(6):453-62. · 4.71 Impact Factor
