Alyssa M. Bartlett, Ali M. Boone, Jordan A. Bays, Youngsil Kim, Sirish K. Palle, Kevin R. Short
Background
Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly common in the pediatric population and may increase risk for developing cardiovascular disease (CVD) in people with MASLD. Oxidized high-density lipoprotein (oxHDL) and oxidized low-density lipoprotein (oxLDL) are modified, pro-atherosclerotic lipoproteins that are increased in adults with MASLD and CVD but have not been reported in adolescents with MASLD.
Purpose
To determine if oxLDL and oxHDL are increased in adolescents with MASLD.
Methods
Fasting oxHDL and oxLDL were measured in adolescents (11–20 years) with obesity and biopsy-confirmed MASLD (n = 47), and peers without MASLD but with obesity (Ob; n = 28), or normal weight (NW; n = 29).
Results
oxHDL was 27% higher (p < 0.05) in the MASLD group (mean ± SD: 11.9 ± 4.7 ng/mL) compared to the Ob group (9.3 ± 3.7 ng/mL, p < 0.05) but only 7% higher than the NW group (11.1 ± 3.8 ng/mL, p > 0.05). However, HDL-C was 19% and 32% lower in the MASLD group than in the Ob and NW groups, respectively. Thus, oxHDL/HDL-C ratio was 55% and 66% higher in MASLD compared to the Ob group (p < 0.004) and the NW group (p < 0.001), respectively. oxLDL (52.4 ± 16.0, 46.7 ± 10.1 and 47.1 ± 15.2 U/L for MASLD, Ob and NW, respectively), LDL-C and the oxLDL/LDL-C ratio did not differ among groups.
Conclusions
The elevated oxHDL and oxHDL/HDL-C in adolescents with MASLD compared to peers with Ob or NW suggests that there is some oxidative stress in MASLD independent of obesity and potential for increased CVD risk in the future.
{"title":"Oxidized high-density lipoprotein and low-density lipoprotein in adolescents with obesity and metabolic dysfunction-associated steatotic liver disease","authors":"Alyssa M. Bartlett, Ali M. Boone, Jordan A. Bays, Youngsil Kim, Sirish K. Palle, Kevin R. Short","doi":"10.1111/ijpo.13194","DOIUrl":"10.1111/ijpo.13194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly common in the pediatric population and may increase risk for developing cardiovascular disease (CVD) in people with MASLD. Oxidized high-density lipoprotein (oxHDL) and oxidized low-density lipoprotein (oxLDL) are modified, pro-atherosclerotic lipoproteins that are increased in adults with MASLD and CVD but have not been reported in adolescents with MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To determine if oxLDL and oxHDL are increased in adolescents with MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fasting oxHDL and oxLDL were measured in adolescents (11–20 years) with obesity and biopsy-confirmed MASLD (<i>n</i> = 47), and peers without MASLD but with obesity (Ob; <i>n</i> = 28), or normal weight (NW; <i>n</i> = 29).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>oxHDL was 27% higher (<i>p</i> < 0.05) in the MASLD group (mean ± SD: 11.9 ± 4.7 ng/mL) compared to the Ob group (9.3 ± 3.7 ng/mL, <i>p</i> < 0.05) but only 7% higher than the NW group (11.1 ± 3.8 ng/mL, <i>p</i> > 0.05). However, HDL-C was 19% and 32% lower in the MASLD group than in the Ob and NW groups, respectively. Thus, oxHDL/HDL-C ratio was 55% and 66% higher in MASLD compared to the Ob group (<i>p</i> < 0.004) and the NW group (<i>p</i> < 0.001), respectively. oxLDL (52.4 ± 16.0, 46.7 ± 10.1 and 47.1 ± 15.2 U/L for MASLD, Ob and NW, respectively), LDL-C and the oxLDL/LDL-C ratio did not differ among groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The elevated oxHDL and oxHDL/HDL-C in adolescents with MASLD compared to peers with Ob or NW suggests that there is some oxidative stress in MASLD independent of obesity and potential for increased CVD risk in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142826851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angela C. B. Trude, Lauren B. Covington, Bridget Armstrong, Gabriela M. Vedovato, Maureen M. Black
Background
Cross-sectional research has suggested associations between diet, sleep and obesity, with sparse longitudinal research.
Objectives
To identify longitudinal mechanistic associations between sleep, diet and obesity.
Methods
We used longitudinal data from a sample of Black adolescent girls. At T1 (enrolment), 6 months (T2) and 18 months (T3), we estimated sleep duration and quality (7-day accelerometry), diet quality (Healthy Eating Index [HEI-2020]) and body mass z-scores (zBMI) from measured height and weight. Longitudinal mediation using structural equation models examined the mechanistic roles of sleep, diet quality and zBMI.
Results
At enrolment, girls (n = 441) were mean age 12.2 years (±0.71), 48.3% had overweight/obesity, and mean HEI 55.8 (±7.49). The association between sleep and diet quality did not vary over time. Sleep duration at T1 was not associated with diet quality at T2 nor was diet associated with zBMI at T3. The bootstrapped indirect effect was not significant. Sleep quality at T1 was not associated with diet quality at T2 nor was diet associated with zBMI at T3. The bootstrapped indirect effect was not significant.
Conclusions
Diet was not a mediator between sleep and obesity. Study strengths are the longitudinal design and direct measures of sleep and zBMI among a homogeneous sample.
{"title":"Assessing the longitudinal association between sleep, diet quality and BMI z-score among Black adolescent girls","authors":"Angela C. B. Trude, Lauren B. Covington, Bridget Armstrong, Gabriela M. Vedovato, Maureen M. Black","doi":"10.1111/ijpo.13189","DOIUrl":"10.1111/ijpo.13189","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cross-sectional research has suggested associations between diet, sleep and obesity, with sparse longitudinal research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To identify longitudinal mechanistic associations between sleep, diet and obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used longitudinal data from a sample of Black adolescent girls. At T1 (enrolment), 6 months (T2) and 18 months (T3), we estimated sleep duration and quality (7-day accelerometry), diet quality (Healthy Eating Index [HEI-2020]) and body mass <i>z</i>-scores (zBMI) from measured height and weight. Longitudinal mediation using structural equation models examined the mechanistic roles of sleep, diet quality and zBMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At enrolment, girls (<i>n</i> = 441) were mean age 12.2 years (±0.71), 48.3% had overweight/obesity, and mean HEI 55.8 (±7.49). The association between sleep and diet quality did not vary over time. Sleep duration at T1 was not associated with diet quality at T2 nor was diet associated with zBMI at T3. The bootstrapped indirect effect was not significant. Sleep quality at T1 was not associated with diet quality at T2 nor was diet associated with zBMI at T3. The bootstrapped indirect effect was not significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Diet was not a mediator between sleep and obesity. Study strengths are the longitudinal design and direct measures of sleep and zBMI among a homogeneous sample.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maternal obesity and excessive weight gain during pregnancy are associated with higher birth weight and increased risk of childhood obesity.
Objective
This study investigated the effect of a high-protein and low-glycaemic-index (HPLGI) diet during pregnancy on offspring body composition and metabolic health.
Methods
We conducted a dietary intervention study in pregnant women with a pre-pregnancy BMI of 28–45 kg/m2 who were randomly assigned to an HPLGI diet or a moderate-protein moderate-glycaemic-index (MPMGI) diet. A total of 208 offspring born to these women were followed-up from birth to 5 years of age.
Results
No differences were found on BMI z-scores at different ages; however, offspring born to women on the HPLGI diet exhibited 0.43 mmol/L higher glucose levels (p = 0.017) at birth compared with the MPMGI diet. At 3 years of age, HPLGI offspring had 0.09 mmol/L lower levels of HDL-cholesterol (p = 0.018) and 16% higher levels of triglycerides (p = 0.044). At 5 years of age, they had 0.25 mmol/L higher total cholesterol levels (p = 0.027) and 0.27 mmol/L higher LDL-cholesterol levels (p = 0.003) compared with the MPMGI diet.
Conclusion
An HPLGI diet during pregnancy may lead to adverse metabolic outcomes in the offspring, necessitating further investigation into long-term health implications.
{"title":"Effect of a high-protein and low-glycaemic index diet during pregnancy in women with overweight or obesity on offspring metabolic health—A randomized controlled trial","authors":"Christina Sonne Mogensen, Faidon Magkos, Helle Zingenberg, Nina Rica Wium Geiker","doi":"10.1111/ijpo.13191","DOIUrl":"10.1111/ijpo.13191","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Maternal obesity and excessive weight gain during pregnancy are associated with higher birth weight and increased risk of childhood obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigated the effect of a high-protein and low-glycaemic-index (HPLGI) diet during pregnancy on offspring body composition and metabolic health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a dietary intervention study in pregnant women with a pre-pregnancy BMI of 28–45 kg/m<sup>2</sup> who were randomly assigned to an HPLGI diet or a moderate-protein moderate-glycaemic-index (MPMGI) diet. A total of 208 offspring born to these women were followed-up from birth to 5 years of age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No differences were found on BMI z-scores at different ages; however, offspring born to women on the HPLGI diet exhibited 0.43 mmol/L higher glucose levels (<i>p</i> = 0.017) at birth compared with the MPMGI diet. At 3 years of age, HPLGI offspring had 0.09 mmol/L lower levels of HDL-cholesterol (<i>p</i> = 0.018) and 16% higher levels of triglycerides (<i>p</i> = 0.044). At 5 years of age, they had 0.25 mmol/L higher total cholesterol levels (<i>p</i> = 0.027) and 0.27 mmol/L higher LDL-cholesterol levels (<i>p</i> = 0.003) compared with the MPMGI diet.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>An HPLGI diet during pregnancy may lead to adverse metabolic outcomes in the offspring, necessitating further investigation into long-term health implications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.13191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142764937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim was to assess ultra-processed food (UPF) consumption, its impact on overweight and its association with weight trends from childhood and adolescence to young adulthood.
Methods
Long-term UPF consumption (13.3 years) by NOVA was analysed (children/adolescents and adults, n = 182) in the Kiel Obesity Prevention Study (KOPS, n = 10 750).
Results
In children/adolescents (13.1 ± 1.9 years), a UPF-based dietary pattern showed an inverse association with BMI-SDS and fat mass index (males: r = −0.301, p = 0.01; r = −0.376, p = 0.001; females: r = −0.315, p < 0.001; r = −0.282, p = 0.003). Longitudinal analysis indicated that UPF consumption in childhood and adolescence was correlated with UPF consumption in adulthood among females (r = 0.272; p = 0.004) but not among males. In young adults (26.7 ± 2.2 years), UPF consumption accounted for nearly 50% of daily energy intake and was higher with overweight compared to normal weight and in incident overweight compared to persistent normal weight (both p < 0.05). High UPF consumption was associated with markers of poor diet quality (lower intake of fibre, higher intake of salt and energy-dense food, all p < 0.05).
Conclusions
High UPF consumption in young adults was associated with both prevalence and incidence of overweight from childhood and adolescence to adulthood.
目的：目的是评估超加工食品（UPF）的消费，其对超重的影响及其与儿童期和青春期到青年期体重趋势的关系。方法：在Kiel肥胖预防研究（KOPS, n = 10 750）中分析了NOVA长期UPF消费（13.3年）（儿童/青少年和成人，n = 182）。结果：在儿童/青少年（13.1±1.9岁）中，以upf为基础的饮食模式与BMI-SDS和脂肪质量指数呈负相关(男性：r = -0.301, p = 0.01；R = -0.376, p = 0.001；结论：青壮年高UPF摄入量与儿童期、青春期至成年期超重的患病率和发病率相关。
{"title":"Ultra-processed food consumption and overweight in children, adolescents and young adults: Long-term data from the Kiel Obesity Prevention Study (KOPS)","authors":"Svenja Fedde, Annalena Stolte, Sandra Plachta-Danielzik, Manfred James Müller, Anja Bosy-Westphal","doi":"10.1111/ijpo.13192","DOIUrl":"10.1111/ijpo.13192","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim was to assess ultra-processed food (UPF) consumption, its impact on overweight and its association with weight trends from childhood and adolescence to young adulthood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Long-term UPF consumption (13.3 years) by NOVA was analysed (children/adolescents and adults, <i>n</i> = 182) in the Kiel Obesity Prevention Study (KOPS, <i>n</i> = 10 750).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In children/adolescents (13.1 ± 1.9 years), a UPF-based dietary pattern showed an inverse association with BMI-SDS and fat mass index (males: <i>r</i> = −0.301, <i>p</i> = 0.01; <i>r</i> = −0.376, <i>p</i> = 0.001; females: <i>r</i> = −0.315, <i>p</i> < 0.001; <i>r</i> = −0.282, <i>p</i> = 0.003). Longitudinal analysis indicated that UPF consumption in childhood and adolescence was correlated with UPF consumption in adulthood among females (<i>r</i> = 0.272; <i>p</i> = 0.004) but not among males. In young adults (26.7 ± 2.2 years), UPF consumption accounted for nearly 50% of daily energy intake and was higher with overweight compared to normal weight and in incident overweight compared to persistent normal weight (both <i>p</i> < 0.05). High UPF consumption was associated with markers of poor diet quality (lower intake of fibre, higher intake of salt and energy-dense food, all <i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High UPF consumption in young adults was associated with both prevalence and incidence of overweight from childhood and adolescence to adulthood.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.13192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142764941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiovascular health is a crucial aspect of overall health. The aim of this study was to estimate the prevalence of cardiovascular risk factors among children and adolescents during the COVID-19 pandemic based on the Life's Essential 8 domains.
Methods
PubMed, Scopus and Web of Science were systematically searched until 24 February 2023. Studies had to meet the following criteria: (1) observational studies, (2) studies reporting proportion of selected risk factors, (3) studies involving children or adolescents, (4) studies that collected data during the COVID-19 pandemic and (5) studies with representative samples. The outcomes included were diet, physical activity, nicotine exposure, sleep health, obesity, dyslipidaemia, diabetes and elevated blood pressure.
Results
Sixty-two studies with 1 526 173 participants from 42 countries were included. Of these, 41 studies were used in the meta-analyses. The overall pooled prevalence of risk factors in the behavioural domain was as follows: poor quality diet 26.69% (95% CI 0.00%–85.64%), inadequate physical activity 70.81% (95% CI 64.41%–76.83%), nicotine exposure 9.24% (95% CI 5.53%–13.77%) and sleep disorders 33.49% (95% CI 25.24%–42.28%). The overall pooled prevalence of risk factors in the health domain was as follows: obesity 16.21% (95% CI 12.71%–20.04%), dyslipidaemia 1.87% (95% CI 1.73%–2.01%), diabetes 1.17% (95% CI 0.83%–1.58%) and elevated blood pressure 11.87% (95% CI 0.26%–36.50%).
Conclusions
These results highlight the need for prevention strategies to maintain better cardiovascular health from an early age, particularly by increasing physical activity levels, sleep time and promoting the consumption of more fruits and vegetables.
心血管健康是整体健康的一个重要方面。本研究的目的是基于生命基本8个域估计COVID-19大流行期间儿童和青少年心血管危险因素的流行情况。方法：系统检索PubMed、Scopus和Web of Science，截止到2023年2月24日。研究必须符合以下标准：(1)观察性研究，(2)报告选定危险因素比例的研究，(3)涉及儿童或青少年的研究，(4)在COVID-19大流行期间收集数据的研究，以及(5)具有代表性样本的研究。研究结果包括饮食、身体活动、尼古丁暴露、睡眠健康、肥胖、血脂异常、糖尿病和血压升高。结果：共纳入62项研究，来自42个国家的1526173名受试者。其中41项研究被用于荟萃分析。行为领域风险因素的总体流行率如下：饮食质量差26.69% (95% CI 0.00%-85.64%)，身体活动不足70.81% (95% CI 64.41%-76.83%)，尼古丁暴露9.24% （95% CI 5.53%-13.77%）和睡眠障碍33.49% （95% CI 25.24%-42.28%）。健康领域危险因素的总流行率如下：肥胖16.21% (95% CI 12.71%-20.04%)，血脂异常1.87% (95% CI 1.73%-2.01%)，糖尿病1.17% （95% CI 0.83%-1.58%）和高血压11.87% （95% CI 0.26%-36.50%）。结论：这些结果强调需要采取预防策略，从早期开始保持更好的心血管健康，特别是通过增加身体活动水平，睡眠时间和促进更多水果和蔬菜的消费。
{"title":"Prevalence of cardiovascular risk factors according to Life's Essential 8 in children and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis including 1 526 173 participants from 42 countries","authors":"Rodrigo Núñez-Cortés, Rubén López-Bueno, Rodrigo Torres-Castro, Joaquín Calatayud, Borja del Pozo Cruz","doi":"10.1111/ijpo.13190","DOIUrl":"10.1111/ijpo.13190","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cardiovascular health is a crucial aspect of overall health. The aim of this study was to estimate the prevalence of cardiovascular risk factors among children and adolescents during the COVID-19 pandemic based on the Life's Essential 8 domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Scopus and Web of Science were systematically searched until 24 February 2023. Studies had to meet the following criteria: (1) observational studies, (2) studies reporting proportion of selected risk factors, (3) studies involving children or adolescents, (4) studies that collected data during the COVID-19 pandemic and (5) studies with representative samples. The outcomes included were diet, physical activity, nicotine exposure, sleep health, obesity, dyslipidaemia, diabetes and elevated blood pressure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-two studies with 1 526 173 participants from 42 countries were included. Of these, 41 studies were used in the meta-analyses. The overall pooled prevalence of risk factors in the behavioural domain was as follows: poor quality diet 26.69% (95% CI 0.00%–85.64%), inadequate physical activity 70.81% (95% CI 64.41%–76.83%), nicotine exposure 9.24% (95% CI 5.53%–13.77%) and sleep disorders 33.49% (95% CI 25.24%–42.28%). The overall pooled prevalence of risk factors in the health domain was as follows: obesity 16.21% (95% CI 12.71%–20.04%), dyslipidaemia 1.87% (95% CI 1.73%–2.01%), diabetes 1.17% (95% CI 0.83%–1.58%) and elevated blood pressure 11.87% (95% CI 0.26%–36.50%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results highlight the need for prevention strategies to maintain better cardiovascular health from an early age, particularly by increasing physical activity levels, sleep time and promoting the consumption of more fruits and vegetables.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nikos Papadimitriou, Neil Murphy, Mazda Jenab, Zhishan Chen, Hermann Brenner, Sun-Seog Kweon, Loic Le Marchand, Victor Moreno, Elizabeth A. Platz, Fränzel J. B. van Duijnhoven, Iona Cheng, Rish K. Pai, Amanda I. Phipps, Ulrike Peters, Wei Zheng, David J. Hughes
Background
Varying obesogenic inherited predisposition in early to later life may differentially impact colorectal cancer (CRC) development. Previous Mendelian randomization (MR) studies, conducted in populations of European genetic similarity, have not observed any significant associations between early life body weight with CRC risk. However, it remains unclear whether body mass index (BMI) at different early lifetime points is causally related with CRC risk in both Europeans and East Asian populations.
Objectives
We conducted a two-sample MR study to investigate potential causal relationships between genetically predicted BMI during early life (birth to 8 years old) and at specific periods (birth, transient, early rise and late rise) and CRC risk.
Methods
Summary data were obtained from genome-wide association study (GWAS) of BMI in 28 681 children from the Norwegian Mother, Father and Child Cohort Study (MoBa) study and applied to CRC GWAS data from European and East Asian descent populations (102 893 cases and 485 083 non-cases).
Results
There were no significant associations observed between early life BMI and CRC risk in European or East Asian populations. The effect estimates were similar in European studies (odds ratio [OR] per a 1-standard deviation [SD] increase: 1.01, 95% confidence interval [CI]: 0.95, 1.07) and in East Asians (OR per a 1-SD increase: 1.02, 95% CI: 0.91, 1.14). Similar nonsignificant associations were found between time of BMI measurement during childhood and cancer-site-specific analyses.
Conclusions
We found little evidence of any associations between early life adiposity on later life CRC risk.
{"title":"Body mass index at birth and early life and colorectal cancer: A two-sample Mendelian randomization analysis in European and East Asian genetic similarity populations","authors":"Nikos Papadimitriou, Neil Murphy, Mazda Jenab, Zhishan Chen, Hermann Brenner, Sun-Seog Kweon, Loic Le Marchand, Victor Moreno, Elizabeth A. Platz, Fränzel J. B. van Duijnhoven, Iona Cheng, Rish K. Pai, Amanda I. Phipps, Ulrike Peters, Wei Zheng, David J. Hughes","doi":"10.1111/ijpo.13186","DOIUrl":"10.1111/ijpo.13186","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Varying obesogenic inherited predisposition in early to later life may differentially impact colorectal cancer (CRC) development. Previous Mendelian randomization (MR) studies, conducted in populations of European genetic similarity, have not observed any significant associations between early life body weight with CRC risk. However, it remains unclear whether body mass index (BMI) at different early lifetime points is causally related with CRC risk in both Europeans and East Asian populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We conducted a two-sample MR study to investigate potential causal relationships between genetically predicted BMI during early life (birth to 8 years old) and at specific periods (birth, transient, early rise and late rise) and CRC risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Summary data were obtained from genome-wide association study (GWAS) of BMI in 28 681 children from the Norwegian Mother, Father and Child Cohort Study (MoBa) study and applied to CRC GWAS data from European and East Asian descent populations (102 893 cases and 485 083 non-cases).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no significant associations observed between early life BMI and CRC risk in European or East Asian populations. The effect estimates were similar in European studies (odds ratio [OR] per a 1-standard deviation [SD] increase: 1.01, 95% confidence interval [CI]: 0.95, 1.07) and in East Asians (OR per a 1-SD increase: 1.02, 95% CI: 0.91, 1.14). Similar nonsignificant associations were found between time of BMI measurement during childhood and cancer-site-specific analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We found little evidence of any associations between early life adiposity on later life CRC risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142714825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sam J. Neally, Elizabeth M. Widen, Cathrine Hoyo, Chantel L. Martin
Objective
This study aimed to examine associations between prenatal neighbourhood socioeconomic deprivation (NSD) with early offspring weight status and to assess potential modification by race and ethnicity.
Methods
We used data from the Newborn Epigenetics STudy (NEST) cohort. Gestational NSD was assessed as neighbourhood deprivation index (NDI) tertiles. Offspring height and weight were assessed at 6 months (N = 1023), 1 year (N = 1268), 2 years (N = 1033) and 3 years (N = 1038). Multilevel logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for the relationship of NDI with overweight or obesity and rapid infant weight gain, adjusting for gestational parent age, race/ethnicity, marital status and educational attainment. Models were estimated in the total sample and also stratified by race and ethnicity.
Results
Children exposed to NDI in the highest (compared to the lowest) tertile had increased odds of having overweight/obesity at 1 year (OR = 1.53, 95%CI = 1.09–2.15). In stratified models, children of NH Black gestational parents residing in the highest tertile of NDI (compared to the lowest) had increased odds of having overweight/obesity at 1 year (OR = 1.67, 95%CI = 1.00–2.77).
Conclusions
This findings suggest that higher gestational exposure to NSD may play a role in early childhood weight status, which has important implications for later development and health.
{"title":"Associations between gestational exposure to neighbourhood socioeconomic deprivation and early childhood weight status","authors":"Sam J. Neally, Elizabeth M. Widen, Cathrine Hoyo, Chantel L. Martin","doi":"10.1111/ijpo.13188","DOIUrl":"10.1111/ijpo.13188","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to examine associations between prenatal neighbourhood socioeconomic deprivation (NSD) with early offspring weight status and to assess potential modification by race and ethnicity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used data from the Newborn Epigenetics STudy (NEST) cohort. Gestational NSD was assessed as neighbourhood deprivation index (NDI) tertiles. Offspring height and weight were assessed at 6 months (<i>N</i> = 1023), 1 year (<i>N</i> = 1268), 2 years (<i>N</i> = 1033) and 3 years (<i>N</i> = 1038). Multilevel logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for the relationship of NDI with overweight or obesity and rapid infant weight gain, adjusting for gestational parent age, race/ethnicity, marital status and educational attainment. Models were estimated in the total sample and also stratified by race and ethnicity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Children exposed to NDI in the highest (compared to the lowest) tertile had increased odds of having overweight/obesity at 1 year (OR = 1.53, 95%CI = 1.09–2.15). In stratified models, children of NH Black gestational parents residing in the highest tertile of NDI (compared to the lowest) had increased odds of having overweight/obesity at 1 year (OR = 1.67, 95%CI = 1.00–2.77).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This findings suggest that higher gestational exposure to NSD may play a role in early childhood weight status, which has important implications for later development and health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142714821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eyitayo O. Owolabi, Micah L. Olson, Houchun H. Hu, Armando Peña, Janiel L. Pimentel, Keenan A. Pituch, Smita S. Bailey, Gabriel Q. Shaibi
Introduction
To examine whether within-person changes in total, regional and organ fat were associated with within-person changes in type 2 diabetes (T2D)-related biomarkers following interventions.
Methods
A secondary analysis from a randomised trial among Latino youth (30 males, 25 females) aged 12–16 years with obesity. The study sample combined participants randomised to either lifestyle intervention (N = 39) or usual care (N = 16). Total body composition was assessed by DEXA. Hepatic and pancreatic fat fractions were assessed using MRI. T2D risk factors included insulin sensitivity, beta-cell function and post-challenge glucose.
Results
Significant changes in %body fat, lean mass, insulin sensitivity and 2-h glucose were observed. Changes in fat mass were associated with changes in insulin sensitivity (β = −0.45, p < 0.001), while changes in lean mass were associated with changes in 2-h glucose concentrations (β = −0.50, p = 0.02). No association between changes in total, regional, or organ fat and beta cell function were noted.
Conclusions
Our study revealed that within-person changes in fat mass and lean mass were associated with increased insulin sensitivity and reduced 2-h glucose concentrations, respectively, among high-risk Latino youth. The impact of reductions in regional and organ fat deposition on T2D risk factors warrants further examination.
{"title":"Association between total, regional and organ fat and type 2 diabetes risk factors among Latino youth: A longitudinal study","authors":"Eyitayo O. Owolabi, Micah L. Olson, Houchun H. Hu, Armando Peña, Janiel L. Pimentel, Keenan A. Pituch, Smita S. Bailey, Gabriel Q. Shaibi","doi":"10.1111/ijpo.13185","DOIUrl":"10.1111/ijpo.13185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>To examine whether within-person changes in total, regional and organ fat were associated with within-person changes in type 2 diabetes (T2D)-related biomarkers following interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A secondary analysis from a randomised trial among Latino youth (30 males, 25 females) aged 12–16 years with obesity. The study sample combined participants randomised to either lifestyle intervention (<i>N</i> = 39) or usual care (<i>N</i> = 16). Total body composition was assessed by DEXA. Hepatic and pancreatic fat fractions were assessed using MRI. T2D risk factors included insulin sensitivity, beta-cell function and post-challenge glucose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant changes in %body fat, lean mass, insulin sensitivity and 2-h glucose were observed. Changes in fat mass were associated with changes in insulin sensitivity (<i>β</i> = −0.45, <i>p</i> < 0.001), while changes in lean mass were associated with changes in 2-h glucose concentrations (<i>β</i> = −0.50, <i>p</i> = 0.02). No association between changes in total, regional, or organ fat and beta cell function were noted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study revealed that within-person changes in fat mass and lean mass were associated with increased insulin sensitivity and reduced 2-h glucose concentrations, respectively, among high-risk Latino youth. The impact of reductions in regional and organ fat deposition on T2D risk factors warrants further examination.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miguel Angelo Duarte Junior, Arthur Eumann Mesas, Sitong Chen, Júlio B. Mello, Jorge Olivares-Arancibia, Aamir Raoof Memon, Rodrigo Yáñez-Sepúlveda, Ran Bao, Lee Smith, José Francisco López-Gil
Objective
This study aimed to assess associations between chronotype and obesity-related indicators in a sample of Spanish adolescents.
Methods
This cross-sectional study used data from The Eating Healthy and Daily Life Activities (EHDLA) Study, which included a representative sample of adolescents from Spain. A total of 820 adolescents (54.7% girls) aged 12–17 years were included in the analyses. The adolescents' chronotype was determined using the Morningness/Eveningness Scale in Children. Obesity-related indicators included body mass index, waist circumference, waist-to-height ratio, triceps and medial calf skinfolds, sum of skinfolds, and body fat percentage. Generalized linear models were used to examine the relationship between the Morningness-Eveningness score and chronotype status and the above-mentioned obesity-related indicators in adolescents. All analyses were adjusted for sex, age, socioeconomic status, sleep duration, physical activity, sedentary behaviour, adherence to the Mediterranean diet, and energy intake.
Results
The morningness chronotype was associated with higher abdominal obesity (odds ratio [OR] = 1.67, 95% confidence interval (CI) 1.12 to 2.50; p = 0.001), waist-to-height ratio (unstandardized beta coefficient [B] = 0.01, 95% CI 0.01 to 0.05; p = 0.029) and skinfold calves (B = 1.04 95% CI 0.24 to 1.94; p = 0.011), compared with the intermediate chronotype.
Conclusion
Adolescents with a morningness chronotype may be more prone to abdominal obesity than their counterparts with an intermediate chronotype. Effective intervention-related approaches can be applied to those with a morningness chronotype.
{"title":"Adolescents' chronotype and its association with obesity-related outcomes: The EHDLA study","authors":"Miguel Angelo Duarte Junior, Arthur Eumann Mesas, Sitong Chen, Júlio B. Mello, Jorge Olivares-Arancibia, Aamir Raoof Memon, Rodrigo Yáñez-Sepúlveda, Ran Bao, Lee Smith, José Francisco López-Gil","doi":"10.1111/ijpo.13184","DOIUrl":"10.1111/ijpo.13184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to assess associations between chronotype and obesity-related indicators in a sample of Spanish adolescents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study used data from The Eating Healthy and Daily Life Activities (EHDLA) Study, which included a representative sample of adolescents from Spain. A total of 820 adolescents (54.7% girls) aged 12–17 years were included in the analyses. The adolescents' chronotype was determined using the Morningness/Eveningness Scale in Children. Obesity-related indicators included body mass index, waist circumference, waist-to-height ratio, triceps and medial calf skinfolds, sum of skinfolds, and body fat percentage. Generalized linear models were used to examine the relationship between the Morningness-Eveningness score and chronotype status and the above-mentioned obesity-related indicators in adolescents. All analyses were adjusted for sex, age, socioeconomic status, sleep duration, physical activity, sedentary behaviour, adherence to the Mediterranean diet, and energy intake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The morningness chronotype was associated with higher abdominal obesity (odds ratio [OR] = 1.67, 95% confidence interval (CI) 1.12 to 2.50; <i>p</i> = 0.001), waist-to-height ratio (unstandardized beta coefficient [<i>B</i>] = 0.01, 95% CI 0.01 to 0.05; <i>p</i> = 0.029) and skinfold calves (<i>B</i> = 1.04 95% CI 0.24 to 1.94; <i>p</i> = 0.011), compared with the intermediate chronotype.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adolescents with a morningness chronotype may be more prone to abdominal obesity than their counterparts with an intermediate chronotype. Effective intervention-related approaches can be applied to those with a morningness chronotype.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"20 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.13184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142542414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anita Morandi, Elena Fornari, Massimiliano Corradi, Giuseppina Rosaria Umano, Francesca Olivieri, Claudia Piona, Alice Maguolo, Carola Panzeri, Federica Emiliani, Grazia Cirillo, Paolo Cavarzere, Emanuele Miraglia Del Giudice, Claudio Maffeis
Background
The diagnosis of monogenic obesity is burdened by frequent variants of uncertain significance (VUS). We describe our real-life approach of variant reassessment over time and we assess whether inconclusive variants are decreasing in monogenic obesity.
Methods
We tested for monogenic obesity (genes: LEPR, POMC, ADCY3, PCSK1, CARTPT, SIM1, MRAP2, LEP, NTRK2, BDNF, KSR2, MAGEL2, SH2B1, MC4R, MC3R) in 101 children/adolescents (11.7 [7.3–13.7] years, 3.6 [3.3–4.0] z-BMI) in Verona and 183 (11.3 [8.4–12.2] years, 3.2 [2.7–3.9] z-BMI) in Naples from January 2020 to February 2023. In March–July 2024 we reassessed the baseline variants by updated software interpretation and literature renavigation.
Results
We initially found 20 VUS, 4 Likely Pathogenic (LP), 5 Likely Benign (LB) and 1 benign variant in 33 individuals. At follow-up, 6 VUS were reclassified as benign/LB, one LP as pathogenic and 3 LB as benign. Overall, 10/30 variants (6/18 in Verona, 3/11 in Naples and a variant found in both centres) were reclassified, leading to a less uncertain report for 13 of 33 variant-carrying patients. Monogenic obesity was diagnosed in 3 probands in Verona and 4 in Naples, carrying variants at MC4R or NTRK2.
Conclusion
Our variant reassessment was effective to improve classification certainty for the 39% of patients and suggested that the molecular diagnosis of monogenic obesity is becoming more accurate over time.
{"title":"Variant reclassification over time decreases the level of diagnostic uncertainty in monogenic obesity: Experience from two centres","authors":"Anita Morandi, Elena Fornari, Massimiliano Corradi, Giuseppina Rosaria Umano, Francesca Olivieri, Claudia Piona, Alice Maguolo, Carola Panzeri, Federica Emiliani, Grazia Cirillo, Paolo Cavarzere, Emanuele Miraglia Del Giudice, Claudio Maffeis","doi":"10.1111/ijpo.13183","DOIUrl":"10.1111/ijpo.13183","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The diagnosis of monogenic obesity is burdened by frequent variants of uncertain significance (VUS). We describe our real-life approach of variant reassessment over time and we assess whether inconclusive variants are decreasing in monogenic obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We tested for monogenic obesity (genes: <i>LEPR</i>, <i>POMC</i>, <i>ADCY3</i>, <i>PCSK1</i>, <i>CARTPT</i>, <i>SIM1</i>, <i>MRAP2</i>, <i>LEP</i>, <i>NTRK2</i>, <i>BDNF</i>, <i>KSR2</i>, <i>MAGEL2</i>, <i>SH2B1</i>, <i>MC4R</i>, <i>MC3R</i>) in 101 children/adolescents (11.7 [7.3–13.7] years, 3.6 [3.3–4.0] z-BMI) in Verona and 183 (11.3 [8.4–12.2] years, 3.2 [2.7–3.9] z-BMI) in Naples from January 2020 to February 2023. In March–July 2024 we reassessed the baseline variants by updated software interpretation and literature renavigation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We initially found 20 VUS, 4 Likely Pathogenic (LP), 5 Likely Benign (LB) and 1 benign variant in 33 individuals. At follow-up, 6 VUS were reclassified as benign/LB, one LP as pathogenic and 3 LB as benign. Overall, 10/30 variants (6/18 in Verona, 3/11 in Naples and a variant found in both centres) were reclassified, leading to a less uncertain report for 13 of 33 variant-carrying patients. Monogenic obesity was diagnosed in 3 probands in Verona and 4 in Naples, carrying variants at <i>MC4R</i> or <i>NTRK2</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our variant reassessment was effective to improve classification certainty for the 39% of patients and suggested that the molecular diagnosis of monogenic obesity is becoming more accurate over time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":217,"journal":{"name":"Pediatric Obesity","volume":"19 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijpo.13183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142491755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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