C Cramer

Heinrich-Heine-Universität Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany

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Publications (7)13.87 Total impact

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    ABSTRACT: Objective:To develop a prediction model that quantifies the risk of being overweight at 10 years of age.Subjects/Methods:In total, 3121 participants from the GINIplus (German Infant Nutritional Intervention plus environmental and genetic influences on allergy development) and LISAplus (Influences of Lifestyle-Related Factors on the Immune System and the Development of Allergies in Childhood plus Air Pollution and Genetics) German birth cohorts were recruited. We predicted standardized body mass index (BMI) at 10 years of age using standardized BMIs from birth to 5 years. Parental education, family income and maternal smoking during pregnancy were considered as covariates. Linear and logistic regression models were used to evaluate the impact of risk factors on BMI and on being overweight at 10 years of age, respectively.Results:Birth weight, standardized BMI at 5 years (60-64 months) (β=0.77; 95% confidence interval (CI): 0.73-0.81) and maternal smoking during pregnancy were positively associated with standardized BMI at 10 years of age. Standardized BMI and overweight at 5 years were strongest predictors of being overweight at 10 years. Conversely, high parental education conferred a protective effect (β=-0.15; 95% CI: -0.29 to -0.01). Being overweight at 5 years (60-64 months) increased the risk of being overweight at 10 years of age with odds ratios above 10. Among children who were predicted to be overweight at 10 years, cross-validation results showed that 76.8% of female subjects and 68.1% of male subjects would be overweight at 10 years of age.Conclusion:BMI and being overweight at 5 years of age are strong predictors of being overweight at 10 years of age. The effectiveness of targeted interventions in children who are overweight at 5 years of age should be explored.European Journal of Clinical Nutrition advance online publication, 24 April 2013; doi:10.1038/ejcn.2013.80.
    European journal of clinical nutrition 04/2013; · 3.07 Impact Factor
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    ABSTRACT: Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) and polychlorinated biphenyls (PCB) are postulated to act as endocrine disrupters. In the ongoing Duisburg birth cohort study, started in 2000-2002, influence of persistent organic pollutants (POP) on child development was monitored. For the first time, associations were reported between prenatal and postnatal PCDD/F and PCB exposures and early endocrinological changes concerning adrenarchal development. PCDD/F and PCB concentrations were measured in blood samples taken in wk 32 of pregnancy and in breast milk using gas chromatography and high-resolution mass spectrometry (GC/HRMS). At the age of 6-7 and 8-9 yr, serum samples were collected from 111 children. The samples were assayed for the sex hormones testosterone, estradiol, dehydroepiandrosterone sulfate (DHEA-S), and 17-OH-progesterone (17-OHP) by using an automated chemiluminescence assay system. Analyses of repeated measurements of DHEA-S serum levels were performed by linear regression analysis using generalized estimating equations (GEE). Linear regression analysis showed a positive association between DHEA-S and breast milk levels of PCDD/F and PCB expressed as toxicity equivalents according to toxicity equivalent factors published by the World Health Organization (WHO) in 2005 (WHO(2005)-TEq) (increase of 29%, geometric mean ratio, GMR: 1.29, 95% CI 1.06-1. 58 per doubling of PCDD/F + PCB WHO(2005)-TEq levels). Results for the association with the WHO(2005)-TEq levels in blood of mothers were in the same direction (increase of 15%, GMR 1.15, 95% CI 0.93-1.42 per doubling of PCDD/F + PCB WHO(2005)-TEq levels), but not significant. Data indicate that PCDD/F and PCB exposure in infancy may influence DHEA-S serum levels in prepubertal children. Increased DHEA-S serum levels are considered to indicate acceleration of the adrenal maturation.
    Journal of Toxicology and Environmental Health Part A 10/2012; 75(19-20):1232-40. · 1.73 Impact Factor
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    ABSTRACT: Numerous chronic diseases in childhood and adulthood have their origins in perinatal life and are potentially influenced by trans-generational epigenetic processes. Therefore, prospective birth cohorts can substantially contribute to our knowledge about the etiology of diseases including modifiable risk factors. The two population-based German birth cohorts GINIplus and LISAplus aim to describe the natural course of chronic diseases and intermediate phenotypes in childhood and its determinants, and to identify potential genetic effect modifications. In the mid-1990s, 5,991 (GINIplus) and 3,097 (LISAplus) healthy, term newborns were recruited for long-term follow-up in four regions of Germany. The follow-up rate for the first 10 years was about 55%. We analyzed the growth and development of overweight, infections and allergic diseases, mental and oral health, metabolic and inflammatory parameters and the role of potential risk factors including genetics. The results of these two birth cohorts substantially contribute to the current knowledge about the natural course of these health parameters. These data were included in many international projects and consortia for purposes of international comparisons of prevalence and consistency of findings, and to increase the power of the analyses.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 06/2012; 55(6-7):864-74. · 0.72 Impact Factor
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    ABSTRACT: This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand, or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.
    Journal of Toxicology and Environmental Health Part A 01/2012; 75:19-20. · 1.73 Impact Factor
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    ABSTRACT: Zahlreiche chronische Erkrankungen in der Kindheit und im Erwachsenenalter haben ihren Ursprung in der perinatalen Entwicklungsphase und sind zudem möglicherweise transgenerational, epigenetisch beeinflusst. Daher tragen gerade prospektive Geburtskohorten maßgeblich zum Verständnis der Ätiologie von Erkrankungen bei und können veränderbare Risikofaktoren identifizieren. Die beiden populationsbasierten deutschen Geburtskohorten GINIplus und LISAplus verfolgen als Hauptziele den natürlichen Verlauf chronischer Erkrankungen im Kindesalter sowie intermediäre Phänotypen und Funktionseinschränkungen zu beschreiben, deren Determinanten zu analysieren und mögliche Effektmodifikationen durch genetische Polymorphismen zu identifizieren. Mitte der 1990er-Jahre wurden in vier Regionen Deutschlands 5991 (GINIplus) beziehungsweise 3097 (LISAplus) gesunde reife Neugeborene für ein Langzeit-Follow-up-Programm rekrutiert und bislang mit einer Response von etwa 55% über zehn Jahre hinweg beobachtet. Es wurden Wachstums- und Gewichtsentwicklung, Infektionskrankheiten und Allergien, seelische Gesundheit, Mundgesundheit, metabolische und inflammatorische Parameter teils im Längsschnitt auf potenzielle Risikofaktoren hin untersucht und der Einfluss genetischer Varianten analysiert. Ergebnisse dieser beiden Geburtskohorten haben den Wissensstand zum Verlauf häufiger Erkrankungen und intermediärer Phänotypen im Längsschnitt maßgeblich bereichert. Ergebnisse dieser Studien sind in zahlreiche internationale Projekte und Konsortien mit dem Ziel eingeflossen, deutsche Daten in den europäischen Kontext zu stellen und gemeinsam auszuwerten. Auf diese Weise wurde die Konsistenz der Ergebnisse untersucht und die Power für gemeinsame Analysen erhöht.
    Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 01/2012; 55(6-7). · 0.72 Impact Factor
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    ABSTRACT: Day care centre attendance is much more common in East than in West Germany. Although there is evidence that early day care might be protective against atopic diseases, several studies have shown a higher prevalence of childhood eczema in East Germany compared to West Germany. To compare prevalence and cumulative incidence of eczema in a birth cohort study in East and West Germany and to identify risk factors that are associated with eczema, which might explain regional differences. We used data from the ongoing population-based birth cohort study Influence of Life-style factors on the development of the Immune System and Allergies in East and West Germany Plus the influence of traffic emissions and genetics. In 1997, 3097 children from study areas in East and West Germany were recruited. Cumulative incidence and 1-year prevalences of eczema up to the age of 6 years were determined from yearly questionnaires. Cox regression and generalized estimating equations/logistic regression were used to quantify regional differences and to identify risk factors that might explain them. Prevalence and incidence of eczema were higher in children living in East Germany than those living in West Germany. We identified 11 risk factors that showed significant regional differences. From these factors, only 'day care attendance during the first 2 years of life' was significantly associated with eczema (odds ratio 1.56, 95% confidence interval CI 1.31-1.86). The regional differences in eczema could be explained by differences in early day care utilization. Day care centre attendance is associated with an increased prevalence and incidence of eczema. Regional differences in eczema prevalence could be explained by regional differences in utilization of early day care.
    Allergy 01/2011; 66(1):68-75. · 5.88 Impact Factor
  • Gesundheitswesen. 01/2010; 72.

Publication Stats

15 Citations
13.87 Total Impact Points


  • 2011–2013
    • Heinrich-Heine-Universität Düsseldorf
      • Institute of Environmental Health Research at the HHU
      Düsseldorf, North Rhine-Westphalia, Germany
  • 2011–2012
    • Leibniz Research Institute for Environmental Medicine
      Düsseldorf, North Rhine-Westphalia, Germany