Search

Your search keyword '"Reynolds, RM"' showing total 444 results
Start Over Author "Reynolds, RM"
444 results on '"Reynolds, RM"'

2. Maternal and Infant Research Electronic Data Analysis (MIREDA): A protocol for creating a common data model for federated analysis of UK birth cohorts and the life course.

Author

Seaborne, MJ, primary, Jones, HE, additional, Cockburn, N, additional, Durbaba, S, additional, Giles, TC, additional, González-Izquierdo, A, additional, Hough, A, additional, Mason, D, additional, Mendez-Villalon, A, additional, Sanchez-Soriano, C., additional, Orton, C., additional, Ford, D, additional, Quinlan, P, additional, Nirantharakumar, K, additional, Poston, L., additional, Reynolds, RM, additional, Santorelli, G, additional, and Brophy, S, additional

Published
2024
Full Text
View/download PDF

4. That which is between internal and external : a visual investigation

Author

Reynolds, RM

Abstract

In my research I have focused on what it is that is between opposites. I have considered the edge of the human body (the skin) as that which is between the opposites of internal and external. The understanding of what is inside and what is outside our skin is considered by many to underlie our acknowledgment of all other opposites and definitions. As well as being interpreted as a site of separation the skin can be considered a site where inside and outside converge. Because of this duality, it is often referenced by artists who associate this aspect of the body's edge with a meeting place between internal and external including Eva Hesse, Anna Mendieta, Yayoi Kusama and Doris Salcedo, to whom I have given particular attention in the theoretical and practical aspects of my investigation. My studio research has aimed to explore the subtle, smooth, fragile visual transitions between suggested internal and external forces. In sculpture and installation works I have experimented with materials associated with skin, in particular those that come through the skin, such as salt and water. I have also considered the use of fabric in order to represent the transition between inside and outside. I have mixed edible flour with talcum powder to confuse the two realms of inside and outside. I have approached my research through process, allowing my intentions to have a connection with my processes of making; this often results in ephemeral works. These latter works have been documented during the research project. Several further ephemeral works will have been created for the examination submission and these reflect my investigations into this particular aspect of the sculptural process. The research project is a significant investigation of the potential of ephemeral sculpture to represent the transition between inside and outside.

Published
2023
Full Text
View/download PDF

6. Effects of maternal obesity on early and long-term outcomes for offspring

Author

Stirrat LI and Reynolds RM

Subjects
Pediatrics, RJ1-570
Abstract

Laura I Stirrat,1,2 Rebecca M Reynolds2,3 1Medical Research Council Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK; 2Tommy's Centre for Maternal and Fetal Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK; 3Endocrinology Unit, University/British Heart Foundation Centre for Cardiovascular Science, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK Abstract: The prevalence of maternal obesity has increased significantly in recent years, and obesity is currently the most common comorbidity of pregnancy. Pregnancies of obese women are often defined as "high-risk" for the purposes of clinical care, with many well documented risks to the mother and developing baby. Maternal physiology and metabolism is dysregulated in the context of obesity, which may contribute to some of the adverse outcomes during pregnancy. Furthermore, maternal obesity has been hypothesized to cause harmful effects for the developing baby through "early life programming." This review will examine evidence from human studies for outcomes of offspring from obese women during pregnancy, during labor, during the neonatal period, and later in life. Keywords: pregnancy, short-term, physiology, metabolism, early life programming, neonatal complications, adverse intrauterine environment

Published
2014

8. Nutrition During Pregnancy, Lactation and Early Childhood and its Implications for Maternal and Long-Term Child Health

Author

Koletzko, B, Godfrey, KM, Poston, L, Szajewska, H, van Goudoever, JB, de Waard, M, Brands, B, Grivell, RM, Deussen, AR, Dodd, JM, Patro-Golab, B, Zalewski, BM, Alberdi, G, Buonocore, G, Campoy, C, Demmelmair, H, Desoye, G, Gomez, MD, Escribano, J, Geraghty, A, Gil, A, Hanson, M, Inskip, HM, Larque, E, Lassel, T, Luque, V, Mader, S, Manios, Y, Mearin, LM, Oddy, WH, Reynolds, RM, Rueda, R, Sherry, C, Socha, P, Taylor, P, Van der Beek, EM, Weber, M, Crespo-Escobar, P, Gutser, M, Kouwenhoven, SMP, Calvo-Lerma, J, Veldhorst, M, and EarlyNutr Project Systematic Revie

Subjects
0301 basic medicine, Gerontology, Infancy, PROTEIN-INTAKE, Maternal Health, Breastfeeding, Medicine (miscellaneous), Disease, Overweight, Recommendations, Nutrition Policy, 0302 clinical medicine, Pregnancy, FORMULA-FED INFANTS, AGE FOLLOW-UP, Medicine, Early childhood, Micronutrients, Infant Nutritional Physiological Phenomena, Prenatal Nutritional Physiological Phenomena, media_common, 2. Zero hunger, Child health, GESTATIONAL WEIGHT-GAIN, Nutrition and Dietetics, Preconception, 3. Good health, Systematic review, Breast Feeding, Child, Preschool, Female, LIFE-STYLE, medicine.symptom, VITAMIN-D DEFICIENCY, YOUNG-CHILDREN, 030209 endocrinology & metabolism, Early nutrition, Developmental programming, 03 medical and health sciences, Metabolic programming, media_common.cataloged_instance, Humans, Lactation, Obesity, European union, Life Style, 030109 nutrition & dietetics, business.industry, Infant, medicine.disease, Lifestyle, PERICONCEPTIONAL FOLIC-ACID, BODY-MASS INDEX, BREAST-FED INFANTS, business, Systematic Reviews as Topic
Abstract

Background: A considerable body of evidence accumulated especially during the last decade, demonstrating that early nutrition and lifestyle have long-term effects on later health and disease (“developmental or metabolic programming”). Methods: Researchers involved in the European Union funded international EarlyNutrition research project consolidated the scientific evidence base and existing recommendations to formulate consensus recommendations on nutrition and lifestyle before and during pregnancy, during infancy and early childhood that take long-term health impact into account. Systematic reviews were performed on published dietary guidelines, standards and recommendations, with special attention to long-term health consequences. In addition, systematic reviews of published systematic reviews on nutritional interventions or exposures in pregnancy and in infants and young children aged up to 3 years that describe effects on subsequent overweight, obesity and body composition were performed. Experts developed consensus recommendations incorporating the wide-ranging expertise from additional 33 stakeholders. Findings: Most current recommendations for pregnant women, particularly obese women, and for young children do not take long-term health consequences of early nutrition into account, although the available evidence for relevant consequences of lifestyle, diet and growth patterns in early life on later health and disease risk is strong. Interpretation: We present updated recommendations for optimized nutrition before and during pregnancy, during lactation, infancy and toddlerhood, with special reference to later health outcomes. These recommendations are developed for affluent populations, such as women and children in Europe, and should contribute to the primary prevention of obesity and associated non-communicable diseases.

Published
2019
Full Text
View/download PDF

12. Measuring the Exercise Component of Energy Availability during Arduous Training in Women.

Author

Gifford, RM, Greeves, JP, Wardle, SL, O'Leary, TJ, Double, RL, Venables, M, Boos, C, Langford, J, Woods, DR, Reynolds, RM, Gifford, RM, Greeves, JP, Wardle, SL, O'Leary, TJ, Double, RL, Venables, M, Boos, C, Langford, J, Woods, DR, and Reynolds, RM

Abstract

INTRODUCTION: Low energy availability (EA) may impede adaptation to exercise, suppressing reproductive function and bone turnover. Exercise energy expenditure (EEE) measurements lack definition and consistency. This study aimed to compare EA measured from moderate and vigorous physical activity from accelerometry (EEEmpva) with EA from total physical activity (EEEtpa) from doubly-labelled water in women. The secondary aim was to determine the relationship of EA with physical fitness, body composition by DXA, heartrate variability (HRV) and eating behavior (brief eating disorder in athletes-questionnaire, BEDA-Q). METHODS: Prospective, repeated measures study, assessing EA measures and training adaptation during 11-month basic military training. 47 women (23.9 ±2.6 years) completed 3 consecutive 10-d assessments of EEEmvpa, EEEtpa and energy intake (EI). EA measures were compared using linear regression and Bland-Altman analyses; relationships of EA with fat mass, heartrate variability, 1.5-mile run times and BEDA-Q were evaluated using partial correlations. RESULTS: EA from EEEmvpa demonstrated strong agreement with EA from EEEtpa across the measurement range (R=0.76, r=0.87, p<0.001) and was higher by 10 kcal/kg FFM/d. However, EA was low in absolute terms due to underreported EI. Higher EA was associated with improved 1.5 mile run time (r=0.28, p<0.001) fat mass loss (r=0.38, p<0.001) and lower BEDA-Q score (r=-0.37, p<0.001) but not HRV (all p>0.10). CONCLUSION: Accelerometry-based EEE demonstrated validity against DLW during multi-stressor training, the difference representing 10 kcal/kg FFM/d EEE from non-exercise activity. Beneficial physical but not autonomic adaptations were associated with higher EA. EAmvpa and BEDA-Q warrant consideration for low EA assessment and screening.

Published
2020

15. The Early Growth Genetics (EGG) and EArly Genetics and Lifecourse Epidemiology (EAGLE) consortia: design, results and future prospects

Author

Middeldorp, CM, Mahajan, A, Horikoshi, M, Robertson, NR, Beaumont, RN, Bradfield, JP, Bustamante, M, Cousminer, DL, Day, FR, De Silva, NM, Guxens, M, Mook-Kanamori, DO, St Pourcain, B, Warrington, NM, Adair, LS, Ahlqvist, E, Ahluwalia, TS, Almgren, P, Ang, W, Atalay, M, Auvinen, J, Bartels, M, Beckmann, JS, Bilbao, JR, Bond, T, Borja, JB, Cavadino, A, Charoen, P, Chen, Z, Coin, L, Cooper, C, Curtin, JA, Custovic, A, Das, S, Davies, GE, Dedoussis, GV, Duijts, L, Eastwood, PR, Eliasen, AU, Elliott, P, Eriksson, JG, Estivill, X, Fadista, J, Fedko, IO, Frayling, TM, Gaillard, R, Gauderman, WJ, Geller, F, Gilliland, F, Gilsanz, V, Granell, R, Grarup, N, Groop, L, Hadley, D, Hakonarson, H, Hansen, T, Hartman, CA, Hattersley, AT, Hayes, MG, Hebebrand, J, Heinrich, J, Helgeland, O, Henders, AK, Henderson, J, Henriksen, TB, Hirschhorn, JN, Hivert, M-F, Hocher, B, Holloway, JW, Holt, P, Hottenga, J-J, Hypponen, E, Iniguez, C, Johansson, S, Jugessur, A, Kahonen, M, Kalkwarf, HJ, Kaprio, J, Karhunen, V, Kemp, JP, Kerkhof, M, Koppelman, GH, Korner, A, Kotecha, S, Kreiner-Moller, E, Kulohoma, B, Kumar, A, Kutalik, Z, Lahti, J, Lappe, JM, Larsson, H, Lehtimaki, T, Lewin, AM, Li, J, Lichtenstein, P, Lindgren, CM, Lindi, V, Linneberg, A, Liu, X, Liu, J, Lowe, WL, Lundstrom, S, Lyytikainen, L-P, Ma, RCW, Mace, A, Magi, R, Magnus, P, Mamun, AA, Mannikko, M, Martin, NG, Mbarek, H, McCarthy, NS, Medland, SE, Melbye, M, Melen, E, Mohlke, KL, Monnereau, C, Morgen, CS, Morris, AP, Murray, JC, Myhre, R, Najman, JM, Nivard, MG, Nohr, EA, Nolte, IM, Ntalla, I, O'Reilly, P, Oberfield, SE, Oken, E, Oldehinkel, AJ, Pahkala, K, Palviainen, T, Panoutsopoulou, K, Pedersen, O, Pennell, CE, Pershagen, G, Pitkanen, N, Plomin, R, Power, C, Prasad, RB, Prokopenko, I, Pulkkinen, L, Raikkonen, K, Raitakari, OT, Reynolds, RM, Richmond, RC, Rivadeneira, F, Rodriguez, A, Rose, RJ, Salem, R, Santa-Marina, L, Saw, S-M, Schnurr, TM, Scott, JG, Selzam, S, Shepherd, JA, Simpson, A, Skotte, L, Sleiman, PMA, Snieder, H, Sorensen, TIA, Standl, M, Steegers, EAP, Strachan, DP, Straker, L, Strandberg, T, Taylor, M, Teo, Y-Y, Thiering, E, Torrent, M, Tyrrell, J, Uitterlinden, AG, van Beijsterveldt, T, van der Most, PJ, van Duijn, CM, Viikari, J, Vilor-Tejedor, N, Vogelezang, S, Vonk, JM, Vrijkotte, TGM, Vuoksimaa, E, Wang, CA, Watkins, WJ, Wichmann, H-E, Willemsen, G, Williams, GM, Wilson, JF, Wray, NR, Xu, S, Xu, C-J, Yaghootkar, H, Yi, L, Zafarmand, MH, Zeggini, E, Zemel, BS, Hinney, A, Lakka, TA, Whitehouse, AJO, Sunyer, J, Widen, EE, Feenstra, B, Sebert, S, Jacobsson, B, Njolstad, PR, Stoltenberg, C, Smith, GD, Lawlor, DA, Paternoster, L, Timpson, NJ, Ong, KK, Bisgaard, H, Bonnelykke, K, Jaddoe, VWV, Tiemeier, H, Jarvelin, M-R, Evans, DM, Perry, JRB, Grant, SFA, Boomsma, DI, Freathy, RM, McCarthy, MI, Felix, JF, Middeldorp, CM, Mahajan, A, Horikoshi, M, Robertson, NR, Beaumont, RN, Bradfield, JP, Bustamante, M, Cousminer, DL, Day, FR, De Silva, NM, Guxens, M, Mook-Kanamori, DO, St Pourcain, B, Warrington, NM, Adair, LS, Ahlqvist, E, Ahluwalia, TS, Almgren, P, Ang, W, Atalay, M, Auvinen, J, Bartels, M, Beckmann, JS, Bilbao, JR, Bond, T, Borja, JB, Cavadino, A, Charoen, P, Chen, Z, Coin, L, Cooper, C, Curtin, JA, Custovic, A, Das, S, Davies, GE, Dedoussis, GV, Duijts, L, Eastwood, PR, Eliasen, AU, Elliott, P, Eriksson, JG, Estivill, X, Fadista, J, Fedko, IO, Frayling, TM, Gaillard, R, Gauderman, WJ, Geller, F, Gilliland, F, Gilsanz, V, Granell, R, Grarup, N, Groop, L, Hadley, D, Hakonarson, H, Hansen, T, Hartman, CA, Hattersley, AT, Hayes, MG, Hebebrand, J, Heinrich, J, Helgeland, O, Henders, AK, Henderson, J, Henriksen, TB, Hirschhorn, JN, Hivert, M-F, Hocher, B, Holloway, JW, Holt, P, Hottenga, J-J, Hypponen, E, Iniguez, C, Johansson, S, Jugessur, A, Kahonen, M, Kalkwarf, HJ, Kaprio, J, Karhunen, V, Kemp, JP, Kerkhof, M, Koppelman, GH, Korner, A, Kotecha, S, Kreiner-Moller, E, Kulohoma, B, Kumar, A, Kutalik, Z, Lahti, J, Lappe, JM, Larsson, H, Lehtimaki, T, Lewin, AM, Li, J, Lichtenstein, P, Lindgren, CM, Lindi, V, Linneberg, A, Liu, X, Liu, J, Lowe, WL, Lundstrom, S, Lyytikainen, L-P, Ma, RCW, Mace, A, Magi, R, Magnus, P, Mamun, AA, Mannikko, M, Martin, NG, Mbarek, H, McCarthy, NS, Medland, SE, Melbye, M, Melen, E, Mohlke, KL, Monnereau, C, Morgen, CS, Morris, AP, Murray, JC, Myhre, R, Najman, JM, Nivard, MG, Nohr, EA, Nolte, IM, Ntalla, I, O'Reilly, P, Oberfield, SE, Oken, E, Oldehinkel, AJ, Pahkala, K, Palviainen, T, Panoutsopoulou, K, Pedersen, O, Pennell, CE, Pershagen, G, Pitkanen, N, Plomin, R, Power, C, Prasad, RB, Prokopenko, I, Pulkkinen, L, Raikkonen, K, Raitakari, OT, Reynolds, RM, Richmond, RC, Rivadeneira, F, Rodriguez, A, Rose, RJ, Salem, R, Santa-Marina, L, Saw, S-M, Schnurr, TM, Scott, JG, Selzam, S, Shepherd, JA, Simpson, A, Skotte, L, Sleiman, PMA, Snieder, H, Sorensen, TIA, Standl, M, Steegers, EAP, Strachan, DP, Straker, L, Strandberg, T, Taylor, M, Teo, Y-Y, Thiering, E, Torrent, M, Tyrrell, J, Uitterlinden, AG, van Beijsterveldt, T, van der Most, PJ, van Duijn, CM, Viikari, J, Vilor-Tejedor, N, Vogelezang, S, Vonk, JM, Vrijkotte, TGM, Vuoksimaa, E, Wang, CA, Watkins, WJ, Wichmann, H-E, Willemsen, G, Williams, GM, Wilson, JF, Wray, NR, Xu, S, Xu, C-J, Yaghootkar, H, Yi, L, Zafarmand, MH, Zeggini, E, Zemel, BS, Hinney, A, Lakka, TA, Whitehouse, AJO, Sunyer, J, Widen, EE, Feenstra, B, Sebert, S, Jacobsson, B, Njolstad, PR, Stoltenberg, C, Smith, GD, Lawlor, DA, Paternoster, L, Timpson, NJ, Ong, KK, Bisgaard, H, Bonnelykke, K, Jaddoe, VWV, Tiemeier, H, Jarvelin, M-R, Evans, DM, Perry, JRB, Grant, SFA, Boomsma, DI, Freathy, RM, McCarthy, MI, and Felix, JF

Abstract

The impact of many unfavorable childhood traits or diseases, such as low birth weight and mental disorders, is not limited to childhood and adolescence, as they are also associated with poor outcomes in adulthood, such as cardiovascular disease. Insight into the genetic etiology of childhood and adolescent traits and disorders may therefore provide new perspectives, not only on how to improve wellbeing during childhood, but also how to prevent later adverse outcomes. To achieve the sample sizes required for genetic research, the Early Growth Genetics (EGG) and EArly Genetics and Lifecourse Epidemiology (EAGLE) consortia were established. The majority of the participating cohorts are longitudinal population-based samples, but other cohorts with data on early childhood phenotypes are also involved. Cohorts often have a broad focus and collect(ed) data on various somatic and psychiatric traits as well as environmental factors. Genetic variants have been successfully identified for multiple traits, for example, birth weight, atopic dermatitis, childhood BMI, allergic sensitization, and pubertal growth. Furthermore, the results have shown that genetic factors also partly underlie the association with adult traits. As sample sizes are still increasing, it is expected that future analyses will identify additional variants. This, in combination with the development of innovative statistical methods, will provide detailed insight on the mechanisms underlying the transition from childhood to adult disorders. Both consortia welcome new collaborations. Policies and contact details are available from the corresponding authors of this manuscript and/or the consortium websites.

Published
2019

16. Integrated analysis of environmental and genetic influences on cord blood DNA methylation in new-borns

Author

Czamara, D, Eraslan, G, Page, CM, Lahti, J, Lahti-Pulkkinen, M, Hamalainen, E, Kajantie, E, Laivuori, H, Villa, PM, Reynolds, RM, Nystad, W, Haberg, SE, London, SJ, O'Donnell, KJ, Garg, E, Meaney, MJ, Entringer, S, Wadhwa, PD, Buss, C, Jones, MJ, Lin, DTS, MacIsaac, JL, Kobor, MS, Koen, N, Zar, HJ, Koenen, KC, Dalvie, S, Stein, DJ, Kondofersky, I, Mueller, NS, Theis, FJ, Raikkonen, K, Binder, EB, Wray, NR, Ripke, S, Mattheisen, M, Trzaskowski, M, Byrne, EM, Abdellaoui, A, Adams, MJ, Agerbo, E, Air, TM, Andlauer, TFM, Bacanu, S-A, Baekvad-Hansen, M, Beekman, ATF, Bigdeli, TB, Blackwood, DHR, Bryois, J, Buttenschon, HN, Bybjerg-Grauholm, J, Cai, N, Castelao, E, Christensen, JH, Clarke, T-K, Coleman, JR, Colodro-Conde, L, Couvy-Duchesne, B, Craddock, N, Crawford, GE, Davies, G, Deary, IJ, Degenhardt, F, Derks, EM, Direk, N, Dolan, C, Dunn, EC, Eley, TC, Escott-Price, V, Kiadeh, FFH, Finucane, HK, Forstner, AJ, Frank, J, Gaspar, HA, Gill, M, Goes, FS, Gordon, SD, Grove, J, Hall, LS, Hansen, CS, Hansen, TF, Herms, S, Hickie, IB, Hoffmann, P, Homuth, G, Horn, C, Hottenga, J-J, Hougaard, DM, Ising, M, Jansen, R, Jorgenson, E, Knowles, JA, Kohane, IS, Kraft, J, Kretzschmar, WW, Krogh, J, Kutalik, Z, Li, Y, Lind, PA, MacIntyre, DJ, MacKinnon, DF, Maier, RM, Maier, W, Marchini, J, Mbarek, H, McGrath, P, McGuffin, P, Medland, SE, Mehta, D, Middeldorp, CM, Mihailov, E, Milaneschi, Y, Milani, L, Mondimore, FM, Montgomery, GW, Mostafavi, S, Mullins, N, Nauck, M, Ng, B, Nivard, MG, Nyholt, DR, O'Reilly, PF, Oskarsson, H, Owen, MJ, Painter, JN, Pedersen, CB, Pedersen, MG, Peterson, RE, Pettersson, E, Peyrot, WJ, Pistis, G, Posthuma, D, Quiroz, JA, Qvist, P, Rice, JP, Riley, BP, Rivera, M, Mirza, SS, Schoevers, R, Schulte, EC, Shen, L, Shi, J, Shyn, S, Sigurdsson, E, Sinnamon, GCB, Smit, JH, Smith, DJ, Stefansson, H, Steinberg, S, Streit, F, Strohmaier, J, Tansey, KE, Teismann, H, Teumer, A, Thompson, W, Thomson, PA, Thorgeirsson, TE, Traylor, M, Treutlein, J, Trubetskoy, V, Uitterlinden, AG, Umbricht, D, Van der Auwera, S, van Hemert, AM, Viktorin, A, Visscher, PM, Wang, Y, Webb, BT, Weinsheimer, SM, Wellmann, J, Willemsen, G, Witt, SH, Wu, Y, Xi, HS, Yang, J, Zhang, F, Arolt, V, Baune, BT, Berger, K, Boomsma, D, Cichon, S, Dannlowski, U, de Geus, EJC, DePaulo, JR, Domenici, E, Domschke, K, Esko, T, Grabe, HJ, Hamilton, SP, Hayward, C, Heath, AC, Kendler, KS, Kloiber, S, Lewis, G, Li, QS, Lucae, S, Madden, PAF, Magnusson, PK, Martin, NG, McIntosh, AM, Metspalu, A, Mors, O, Mortensen, PB, Mueller-Myhsok, B, Nordentoft, M, Noethen, MM, O'Donovan, MC, Paciga, SA, Pedersen, NL, Penninx, BWJH, Perlis, RH, Porteous, DJ, Potash, JB, Preisig, M, Rietschel, M, Schaefer, C, Schulze, TG, Smoller, JW, Stefansson, K, Tiemeier, H, Uher, R, Voelzke, H, Weissman, MM, Werge, T, Lewis, CM, Levinson, DF, Breen, G, Borglum, AD, Sullivan, PF, Czamara, D, Eraslan, G, Page, CM, Lahti, J, Lahti-Pulkkinen, M, Hamalainen, E, Kajantie, E, Laivuori, H, Villa, PM, Reynolds, RM, Nystad, W, Haberg, SE, London, SJ, O'Donnell, KJ, Garg, E, Meaney, MJ, Entringer, S, Wadhwa, PD, Buss, C, Jones, MJ, Lin, DTS, MacIsaac, JL, Kobor, MS, Koen, N, Zar, HJ, Koenen, KC, Dalvie, S, Stein, DJ, Kondofersky, I, Mueller, NS, Theis, FJ, Raikkonen, K, Binder, EB, Wray, NR, Ripke, S, Mattheisen, M, Trzaskowski, M, Byrne, EM, Abdellaoui, A, Adams, MJ, Agerbo, E, Air, TM, Andlauer, TFM, Bacanu, S-A, Baekvad-Hansen, M, Beekman, ATF, Bigdeli, TB, Blackwood, DHR, Bryois, J, Buttenschon, HN, Bybjerg-Grauholm, J, Cai, N, Castelao, E, Christensen, JH, Clarke, T-K, Coleman, JR, Colodro-Conde, L, Couvy-Duchesne, B, Craddock, N, Crawford, GE, Davies, G, Deary, IJ, Degenhardt, F, Derks, EM, Direk, N, Dolan, C, Dunn, EC, Eley, TC, Escott-Price, V, Kiadeh, FFH, Finucane, HK, Forstner, AJ, Frank, J, Gaspar, HA, Gill, M, Goes, FS, Gordon, SD, Grove, J, Hall, LS, Hansen, CS, Hansen, TF, Herms, S, Hickie, IB, Hoffmann, P, Homuth, G, Horn, C, Hottenga, J-J, Hougaard, DM, Ising, M, Jansen, R, Jorgenson, E, Knowles, JA, Kohane, IS, Kraft, J, Kretzschmar, WW, Krogh, J, Kutalik, Z, Li, Y, Lind, PA, MacIntyre, DJ, MacKinnon, DF, Maier, RM, Maier, W, Marchini, J, Mbarek, H, McGrath, P, McGuffin, P, Medland, SE, Mehta, D, Middeldorp, CM, Mihailov, E, Milaneschi, Y, Milani, L, Mondimore, FM, Montgomery, GW, Mostafavi, S, Mullins, N, Nauck, M, Ng, B, Nivard, MG, Nyholt, DR, O'Reilly, PF, Oskarsson, H, Owen, MJ, Painter, JN, Pedersen, CB, Pedersen, MG, Peterson, RE, Pettersson, E, Peyrot, WJ, Pistis, G, Posthuma, D, Quiroz, JA, Qvist, P, Rice, JP, Riley, BP, Rivera, M, Mirza, SS, Schoevers, R, Schulte, EC, Shen, L, Shi, J, Shyn, S, Sigurdsson, E, Sinnamon, GCB, Smit, JH, Smith, DJ, Stefansson, H, Steinberg, S, Streit, F, Strohmaier, J, Tansey, KE, Teismann, H, Teumer, A, Thompson, W, Thomson, PA, Thorgeirsson, TE, Traylor, M, Treutlein, J, Trubetskoy, V, Uitterlinden, AG, Umbricht, D, Van der Auwera, S, van Hemert, AM, Viktorin, A, Visscher, PM, Wang, Y, Webb, BT, Weinsheimer, SM, Wellmann, J, Willemsen, G, Witt, SH, Wu, Y, Xi, HS, Yang, J, Zhang, F, Arolt, V, Baune, BT, Berger, K, Boomsma, D, Cichon, S, Dannlowski, U, de Geus, EJC, DePaulo, JR, Domenici, E, Domschke, K, Esko, T, Grabe, HJ, Hamilton, SP, Hayward, C, Heath, AC, Kendler, KS, Kloiber, S, Lewis, G, Li, QS, Lucae, S, Madden, PAF, Magnusson, PK, Martin, NG, McIntosh, AM, Metspalu, A, Mors, O, Mortensen, PB, Mueller-Myhsok, B, Nordentoft, M, Noethen, MM, O'Donovan, MC, Paciga, SA, Pedersen, NL, Penninx, BWJH, Perlis, RH, Porteous, DJ, Potash, JB, Preisig, M, Rietschel, M, Schaefer, C, Schulze, TG, Smoller, JW, Stefansson, K, Tiemeier, H, Uher, R, Voelzke, H, Weissman, MM, Werge, T, Lewis, CM, Levinson, DF, Breen, G, Borglum, AD, and Sullivan, PF

Abstract

Epigenetic processes, including DNA methylation (DNAm), are among the mechanisms allowing integration of genetic and environmental factors to shape cellular function. While many studies have investigated either environmental or genetic contributions to DNAm, few have assessed their integrated effects. Here we examine the relative contributions of prenatal environmental factors and genotype on DNA methylation in neonatal blood at variably methylated regions (VMRs) in 4 independent cohorts (overall n = 2365). We use Akaike's information criterion to test which factors best explain variability of methylation in the cohort-specific VMRs: several prenatal environmental factors (E), genotypes in cis (G), or their additive (G + E) or interaction (GxE) effects. Genetic and environmental factors in combination best explain DNAm at the majority of VMRs. The CpGs best explained by either G, G + E or GxE are functionally distinct. The enrichment of genetic variants from GxE models in GWAS for complex disorders supports their importance for disease risk.

Published
2019

17. Maternal and fetal genetic contribution to gestational weight gain

Author

Warrington, NM, Richmond, R, Fenstra, B, Myhre, R, Gaillard, Romy, Paternoster, L, Wang, CA, Beaumont, RN, Das, S, Murcia, M, Barton, SJ, Espinosa, A, Thiering, E, Atalay, M, Pitkanen, N, Ntalla, I, Jonsson, AE, Freathy, R, Karhunen, V, Tiesler, CMT, Allard, C, Crawford, A, Ring, SM, Melbye, M, Magnus, P, Rivadeneira, Fernando, Skotte, L, Hansen, T, Marsh, J, Guxens Junyent, Monica, Holloway, JW, Grallert, H, Jaddoe, Vincent, Lowe, WL, Roumeliotaki, T, Hattersley, AT, Lindi, V, Pahkala, K, Panoutsopoulou, K, Standl, M, Flexeder, C, Bouchard, L, Nohr, E, Marina, L, Kogevinas, M, Niinikoski, H, Dedoussis, G, Heinrich, J, Reynolds, RM, Lakka, T, Zeggini, E, Raitakari, OT, Chatzi, L, Inskip, HM, Bustamante, M, Hivert, MF, Jarvelin, MR, Sorensen, TIA, Pennell, C, Felix, Janine, Jacobsson, B, Geller, F, Evans, DM, Lawlor, DA, Warrington, NM, Richmond, R, Fenstra, B, Myhre, R, Gaillard, Romy, Paternoster, L, Wang, CA, Beaumont, RN, Das, S, Murcia, M, Barton, SJ, Espinosa, A, Thiering, E, Atalay, M, Pitkanen, N, Ntalla, I, Jonsson, AE, Freathy, R, Karhunen, V, Tiesler, CMT, Allard, C, Crawford, A, Ring, SM, Melbye, M, Magnus, P, Rivadeneira, Fernando, Skotte, L, Hansen, T, Marsh, J, Guxens Junyent, Monica, Holloway, JW, Grallert, H, Jaddoe, Vincent, Lowe, WL, Roumeliotaki, T, Hattersley, AT, Lindi, V, Pahkala, K, Panoutsopoulou, K, Standl, M, Flexeder, C, Bouchard, L, Nohr, E, Marina, L, Kogevinas, M, Niinikoski, H, Dedoussis, G, Heinrich, J, Reynolds, RM, Lakka, T, Zeggini, E, Raitakari, OT, Chatzi, L, Inskip, HM, Bustamante, M, Hivert, MF, Jarvelin, MR, Sorensen, TIA, Pennell, C, Felix, Janine, Jacobsson, B, Geller, F, Evans, DM, and Lawlor, DA

Published
2018

18. Reproductive dysfunction and associated pathology in women undergoing military training

Author

Gifford, RM, Reynolds, RM, Greeves, J, Anderson, RA, and Woods, D

Abstract

Evidence from civilian athletes raises the question of whether reproductive dysfunction may be seen in female soldiers as a result of military training. Such reproductive dysfunction consists of impaired ovulation with or without long term subfertility. We critically review pertinent evidence, which points towards reduced energy availability as the most likely explanation for exercise-induced reproductive dysfunction. Evidence also suggests reproductive dysfunction is mediated by activation of the hypothalamic-pituitary-adrenal axis and suppression of the hypothalamic-pituitary-gonadal axis, with elevated ghrelin and reduced leptin likely to play an important role. The observed reproductive dysfunction exists as part of a female athletic triad, together with osteopenia and disordered eating. If this phenomenon was shown to exist with UK military training this would be of significant concern. We hypothesise that the nature of military training and possibly field exercises may contribute to greater risk of reproductive dysfunction among female military trainees compared with exercising civilian controls. We discuss the features of military training and its participants, such as energy availability, age at recruitment, body phenotype, type of physical training, psychogenic stressors, altered sleep pattern and elemental exposure as contributors to reproductive dysfunction. We identify lines of future research to more fully characterise reproductive dysfunction in military women, and suggest possible interventions which, if indicated, could improve their future wellbeing.

Published
2017

19. The influence of maternal obesity on the long-term health of the offspring

Author

Godfrey, KM, Reynolds, RM, Prescott, SL, Nyirenda, M, Jaddoe, VWV, Eriksson, JG, Broekman, BFP, and Psychiatry

Abstract

In addition to immediate implications for pregnancy complications, increasing evidence implicates maternal obesity as a major determinant of off spring health during childhood and later adult life. Observational studies provide evidence for eff ects of maternal obesity on her off spring's risks of obesity, coronary heart disease, stroke, type 2 diabetes, and asthma. Maternal obesity could also lead to poorer cognitive performance and increased risk of neurodevelopmental disorders, including cerebral palsy. Preliminary evidence suggests potential implications for immune and infectious-disease-related outcomes. Insights from experimental studies support causal eff ects of maternal obesity on off spring outcomes, which are mediated at least partly through changes in epigenetic processes, such as alterations in DNA methylation, and perhaps through alterations in the gut microbiome. Although the off spring of obese women who lose weight before pregnancy have a reduced risk of obesity, few controlled intervention studies have been done in which maternal obesity is reversed and the consequences for off spring have been examined. Because the long-term eff ects of maternal obesity could have profound public health implications, there is an urgent need for studies on causality, underlying mechanisms, and eff ective interventions to reverse the epidemic of obesity in women of childbearing age and to mitigate consequences for off spring.

Published
2016

20. Care of Women with Obesity in Pregnancy: Green-top Guideline No. 72.

Author

Denison, FC, Aedla, NR, Keag, O, Hor, K, Reynolds, RM, Milne, A, Diamond, A, Denison, F C, Aedla, N R, Reynolds, R M, and Royal College of Obstetricians and Gynaecologists

Subjects
PRENATAL care, OBESITY, PREGNANT women, PREGNANCY complications, CHILDBIRTH, DIETARY supplements, BODY mass index, OBESITY treatment, MEDICAL screening, OBSTETRICS, PRECONCEPTION care
Abstract

The article discusses the guidelines on the care of pregnant women with obesity. Topics include the information on the risks of obesity during pregnancy and childbirth, the nutritional supplements to be recommended, the measurement of weight, height and body mass index and the factors to be considered in screening, diagnosing and managing maternal disease in obese pregnant women.

Published
2019
Full Text
View/download PDF

32. Diabetic retinopathy and cognitive decline in older people with type 2 diabetes: the Edinburgh Type 2 Diabetes Study.

Author

Ding J, Strachan MW, Reynolds RM, Frier BM, Deary IJ, Fowkes FG, Lee AJ, McKnight J, Halpin P, Swa K, Price JF, Edinburgh Type 2 Diabetes Study Investigators, Ding, Jie, Strachan, Mark W J, Reynolds, Rebecca M, Frier, Brian M, Deary, Ian J, Fowkes, F Gerald R, Lee, Amanda J, and McKnight, Janet

Abstract

Objective: Cerebral microvascular disease associated with type 2 diabetes may exacerbate the effects of aging on cognitive function. A considerable homology exists between the retinal and cerebral microcirculations; a hypothesized association between diabetic retinopathy (DR) and cognitive decline was examined in older people with type 2 diabetes.Research Design and Methods: In the population-based Edinburgh Type 2 Diabetes Study, 1,046 men and women aged 60-75 years with type 2 diabetes underwent standard seven-field binocular digital retinal photography and a battery of seven cognitive function tests. A general cognitive ability score (g) was generated by principal components analysis. The Mill-Hill Vocabulary Scale was used to estimate premorbid cognitive ability. DR was graded using a modification of the Early Treatment of Diabetic Retinopathy Scale.Results: After age and sex adjustment, a significant relationship was observed with increasing severity of DR (none, mild, and moderate to severe) for most cognitive measures. Participants with moderate-to-severe retinopathy had the worst g and the worst performances on the individual tests. There was a significant interaction between sex and retinopathy for g. In male subjects, the associations of retinopathy with g (and with tests of verbal fluency, mental flexibility, and processing speed but not memory and nonverbal reasoning) persisted (P < 0.05) when further adjusted for vocabulary (to estimate lifetime cognitive decline), depression, sociodemographic characteristics, cardiovascular risk factors, and macrovascular disease.Conclusions: DR was independently associated with estimated lifetime cognitive decline in older men with type 2 diabetes, supporting the hypothesis that cerebral microvascular disease may contribute to their observed accelerated age-related cognitive decline. A sex interaction with stronger findings in men requires further confirmation. [ABSTRACT FROM AUTHOR]

Published
2010
Full Text
View/download PDF

33. Morning cortisol levels and cognitive abilities in people with type 2 diabetes: the Edinburgh type 2 diabetes study.

Author

Reynolds RM, Strachan MW, Labad J, Lee AJ, Frier BM, Fowkes FG, Mitchell R, Seckl JR, Deary IJ, Walker BR, Price JF, Edinburgh Type 2 Diabetes Study Investigators, Reynolds, Rebecca M, Strachan, Mark W J, Labad, Javier, Lee, Amanda J, Frier, Brian M, Fowkes, F Gerald, Mitchell, Rory, and Seckl, Jonathan R

Abstract

Objective: People with type 2 diabetes are at increased risk of cognitive impairment but the mechanism is uncertain. Elevated glucocorticoid levels in rodents and humans are associated with cognitive impairment. We aimed to determine whether fasting cortisol levels are associated with cognitive ability and estimated lifetime cognitive change in an elderly population with type 2 diabetes.Research Design and Methods: This was a cross-sectional study of 1,066 men and women aged 60-75 years with type 2 diabetes, living in Lothian, Scotland (the Edinburgh Type 2 Diabetes Study). Cognitive abilities in memory, nonverbal reasoning, information processing speed, executive function, and mental flexibility were tested, and a general cognitive ability factor, g, was derived. Prior intelligence was estimated from vocabulary testing, and adjustment for scores on this test was used to estimate lifetime cognitive change. Relationships between fasting morning plasma cortisol levels and cognitive ability and estimated cognitive change were tested. Models were adjusted for potential confounding and/or mediating variables including metabolic and cardiovascular variables.Results: In age-adjusted analyses, higher fasting cortisol levels were not associated with current g or with performance in individual cognitive domains. However, higher fasting cortisol levels were associated with greater estimated cognitive decline in g and in tests of working memory and processing speed, independent of mood, education, metabolic variables, and cardiovascular disease (P < 0.05).Conclusions: High morning cortisol levels in elderly people with type 2 diabetes are associated with estimated age-related cognitive change. Strategies targeted at lowering cortisol action may be useful in ameliorating cognitive decline in individuals with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Published
2010
Full Text
View/download PDF

34. Association between raised inflammatory markers and cognitive decline in elderly people with type 2 diabetes: the Edinburgh Type 2 Diabetes Study.

Author

Marioni RE, Strachan MW, Reynolds RM, Lowe GD, Mitchell RJ, Fowkes FG, Frier BM, Lee AJ, Butcher I, Rumley A, Murray GD, Deary IJ, Price JF, Marioni, Riccardo E, Strachan, Mark W J, Reynolds, Rebecca M, Lowe, Gordon D O, Mitchell, Rory J, Fowkes, F Gerry R, and Frier, Brian M

Abstract

Objective: To determine whether circulating levels of the inflammatory markers C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-alpha are associated with cognitive ability and estimated lifetime cognitive decline in an elderly population with type 2 diabetes.Research Design and Methods: A cross-sectional study of 1,066 men and women aged 60-75 years with type 2 diabetes and living in Lothian, Scotland (the Edinburgh Type 2 Diabetes Study), was performed. Seven cognitive tests were used to measure abilities in memory, nonverbal reasoning, information processing speed, executive function, and mental flexibility. The results were used to derive a general intelligence factor (g). A vocabulary-based test was administered as an estimate of peak prior cognitive ability. Results on the cognitive tests were assessed for statistical association with inflammatory markers measured in a venous blood sample at the time of cognitive testing.Results: Higher IL-6 and TNF-alpha levels were associated with poorer age- and sex-adjusted scores on the majority of the individual cognitive tests. They were also associated with g using standardized regression coefficients -0.074 to -0.173 (P < 0.05). After adjusting for vocabulary, education level, cardiovascular dysfunction, duration of diabetes, and glycemic control, IL-6 remained associated with three of the cognitive tests and with g.Conclusions: In this representative population of people with type 2 diabetes, elevated circulating levels of inflammatory markers were associated with poorer cognitive ability. IL-6 levels were also associated with estimated lifetime cognitive decline. [ABSTRACT FROM AUTHOR]

Published
2010
Full Text
View/download PDF

36. Recommendations and conclusions from a minisymposium on self-blood glucose monitoring

Author

Reynolds, RM and Webb, DJ

Abstract

It is agreed that all patients with insulin-treated diabetes should regularly self-monitor their blood glucose to guide insulin doses and detect and avoid hypoglycaemia, but there remains little consensus as to the value of SBGM in patients with type 2 diabetes treated with diet and/or tablets. This Royal College of Physicians of Edinburgh mini-symposium brought together a panel of experts to examine the current evidence surrounding SBGM in this context. The aim of this document is to provide an overview of the points raised and where consensus was achieved. The document summarises the general situations where SBGM may or may not be useful, and it is hoped that this will be a platform for production of specific guidelines for healthcare professionals to use to advise a monitoring programme for an individual patient. These recommendations include results of evidence published since November 2004.

Published
2006
Full Text
View/download PDF

37. Genome-wide associations for birth weight and correlations with adult disease

Author

Horikoshi, M, Beaumont, RN, Day, FR, Warrington, NM, Kooijman, MN, Fernandez-Tajes, J, Feenstra, B, Van Zuydam, NR, Gaulton, KJ, Grarup, N, Bradfield, JP, Strachan, DP, Li-Gao, R, Ahluwalia, TS, Kreiner, E, Rueedi, R, Lyytikäinen, L-P, Cousminer, DL, Wu, Y, Thiering, E, Wang, CA, Have, CT, Hottenga, J-J, Vilor-Tejedor, N, Joshi, PK, Boh, ETH, Ntalla, I, Pitkänen, N, Mahajan, A, Van Leeuwen, EM, Joro, R, Lagou, V, Nodzenski, M, Diver, LA, Zondervan, KT, Bustamante, M, Marques-Vidal, P, Mercader, JM, Bennett, AJ, Rahmioglu, N, Nyholt, DR, Ma, RCW, Tam, CHT, Tam, WH, CHARGE Consortium Hematology Working Group, Ganesh, SK, Van Rooij, FJA, Jones, SE, Loh, P-R, Ruth, KS, Tuke, MA, Tyrrell, J, Wood, AR, Yaghootkar, H, Scholtens, DM, Paternoster, L, Prokopenko, I, Kovacs, P, Atalay, M, Willems, SM, Panoutsopoulou, K, Wang, X, Carstensen, L, Geller, F, Schraut, KE, Murcia, M, Van Beijsterveldt, CEM, Willemsen, G, Appel, EVR, Fonvig, CE, Trier, C, Tiesler, CMT, Standl, M, Kutalik, Z, Bonàs-Guarch, S, Hougaard, DM, Sánchez, F, Torrents, D, Waage, J, Hollegaard, MV, De Haan, HG, Rosendaal, FR, Medina-Gomez, C, Ring, SM, Hemani, G, McMahon, G, Robertson, NR, Groves, CJ, Langenberg, C, Luan, J, Scott, RA, Zhao, JH, Mentch, FD, MacKenzie, SM, Reynolds, RM, Early Growth Genetics (EGG) Consortium, Lowe, WL, Tönjes, A, Stumvoll, M, Lindi, V, Lakka, TA, Van Duijn, CM, Kiess, W, Körner, A, Sørensen, TIA, Niinikoski, H, Pahkala, K, Raitakari, OT, Zeggini, E, Dedoussis, GV, Teo, Y-Y, Saw, S-M, Melbye, M, Campbell, H, Wilson, JF, Vrijheid, M, De Geus, EJCN, Boomsma, DI, Kadarmideen, HN, Holm, J-C, Hansen, T, Sebert, S, Hattersley, AT, Beilin, LJ, Newnham, JP, Pennell, CE, Heinrich, J, Adair, LS, Borja, JB, Mohlke, KL, Eriksson, JG, Widén, E, Kähönen, M, Viikari, JS, Lehtimäki, T, Vollenweider, P, Bønnelykke, K, Bisgaard, H, Mook-Kanamori, DO, Hofman, A, Rivadeneira, F, Uitterlinden, AG, Pisinger, C, Pedersen, O, Power, C, Hyppönen, E, Wareham, NJ, Hakonarson, H, Davies, E, Walker, BR, Jaddoe, VWV, Järvelin, M-R, Grant, SFA, Vaag, AA, Lawlor, DA, Frayling, TM, Smith, GD, Morris, AP, Ong, KK, Felix, JF, Timpson, NJ, Perry, JRB, Evans, DM, McCarthy, MI, and Freathy, RM

Subjects
quantitative trait, hypertension, intrauterine growth, genome-wide association studies, metabolic disorders, 3. Good health
Abstract

Birth weight (BW) has been shown to be influenced by both fetal and maternal factors and in observational studies is reproducibly associated with future risk of adult metabolic diseases including type 2 diabetes (T2D) and cardiovascular disease. These life-course associations have often been attributed to the impact of an adverse early life environment. Here, we performed a multi-ancestry genome-wide association study (GWAS) meta-analysis of BW in 153,781 individuals, identifying 60 loci where fetal genotype was associated with BW ($\textit{P}$ < 5 × 10$^{-8}$). Overall, approximately 15% of variance in BW was captured by assays of fetal genetic variation. Using genetic association alone, we found strong inverse genetic correlations between BW and systolic blood pressure ($\textit{R}$ $_{g}$ = -0.22, $\textit{P}$ = 5.5 × 10$^{-13}$), T2D ($\textit{R}$ $_{g}$ = -0.27, $\textit{P}$ = 1.1 × 10$^{-6}$) and coronary artery disease ($\textit{R}$ $_{g}$ = -0.30, $\textit{P}$ = 6.5 × 10$^{-9}$). In addition, using large -cohort datasets, we demonstrated that genetic factors were the major contributor to the negative covariance between BW and future cardiometabolic risk. Pathway analyses indicated that the protein products of genes within BW-associated regions were enriched for diverse processes including insulin signalling, glucose homeostasis, glycogen biosynthesis and chromatin remodelling. There was also enrichment of associations with BW in known imprinted regions ($\textit{P}$ = 1.9 × 10$^{-4}$). We demonstrate that life-course associations between early growth phenotypes and adult cardiometabolic disease are in part the result of shared genetic effects and identify some of the pathways through which these causal genetic effects are mediated.

39. Approaches to screening for hyperglycaemia in pregnant women during and after the COVID‐19 pandemic

Author

David Simmons, David R. McCance, Jenny Myers, Robert S. Lindsay, Eleanor M. Scott, Helen R. Murphy, Rebecca M. Reynolds, Jennifer M. Yamamoto, Catherine E. Aiken, Claire L Meek, Meek, CL [0000-0002-4176-8329], Aiken, CE [0000-0002-6510-5626], Reynolds, RM [0000-0001-6226-8270], Simmons, D [0000-0003-0560-0761], Yamamoto, JM [0000-0002-3556-0820], Murphy, HR [0000-0001-6876-8727], and Apollo - University of Cambridge Repository

Subjects
Blood Glucose, Endocrinology, Diabetes and Metabolism, Hyperglycemia/diagnosis, Comorbidity, Fasting/blood, Glycated Hemoglobin A/analysis, 0302 clinical medicine, Endocrinology, Pregnancy, Risk Factors, Mass Screening, 030212 general & internal medicine, Research Articles, COVID-19/epidemiology, Glucose tolerance test, medicine.diagnostic_test, United Kingdom/epidemiology, Obstetrics, Pregnancy Outcome, Gestational age, Fasting, Gestational diabetes, Gestation, Female, Research Article, Adult, medicine.medical_specialty, Gestational Age, 030209 endocrinology & metabolism, Sensitivity and Specificity, Pregnancy Outcome/epidemiology, 03 medical and health sciences, Mass Screening/methods, Diabetes mellitus, Internal Medicine, medicine, Humans, Risk factor, Pandemics, Mass screening, Retrospective Studies, Glycated Hemoglobin, SARS-CoV-2, business.industry, COVID-19, Blood Glucose/analysis, Glucose Tolerance Test, medicine.disease, United Kingdom, Diabetes, Gestational/diagnosis, Coronavirus, Diabetes, Gestational, Hyperglycemia, business
Abstract

Aim: To evaluate the diagnostic and prognostic performance of alternative diagnostic strategies to oral glucose tolerance tests, including random plasma glucose, fasting plasma glucose and HbA 1c, during the COVID-19 pandemic. Methods: Retrospective service data (Cambridge, UK; 17 736 consecutive singleton pregnancies, 2004–2008; 826 consecutive gestational diabetes pregnancies, 2014–2019) and 361 women with ≥1 gestational diabetes risk factor (OPHELIA prospective observational study, UK) were included. Pregnancy outcomes included gestational diabetes (National Institute of Health and Clinical Excellence or International Association of Diabetes and Pregnancy Study Groups criteria), diabetes in pregnancy (WHO criteria), Caesarean section, large-for-gestational age infant, neonatal hypoglycaemia and neonatal intensive care unit admission. Receiver-operating characteristic curves and unadjusted logistic regression were used to compare random plasma glucose, fasting plasma glucose and HbA 1c performance. Results: Gestational diabetes diagnosis was significantly associated with random plasma glucose at 12 weeks [area under the receiver-operating characteristic curve for both criteria 0.81 (95% CI 0.79–0.83)], fasting plasma glucose [National Institute of Health and Clinical Excellence: area under the receiver-operating characteristic curve 0.75 (95% CI 0.65–0.85); International Association of Diabetes and Pregnancy Study Groups: area under the receiver-operating characteristic curve 0.92 (95% CI 0.85–0.98)] and HbA 1c at 28 weeks' gestation [National Institute of Health and Clinical Excellence: 0.83 (95% CI 0.75–0.90); International Association of Diabetes and Pregnancy Study Groups: 0.84 (95% CI 0.77–0.91)]. Each measure predicts some, but not all, pregnancy outcomes studied. At 12 weeks, ~5% of women would be identified using random plasma glucose ≥8.5 mmol/l (sensitivity 42%; specificity 96%) and at 28 weeks using HbA 1c ≥39 mmol/mol (sensitivity 26%; specificity 96%) or fasting plasma glucose ≥5.2–5.4 mmol/l (sensitivity 18–41%; specificity 97–98%). Conclusions: Random plasma glucose at 12 weeks, and fasting plasma glucose or HbA 1c at 28 weeks identify women with hyperglycaemia at risk of suboptimal pregnancy outcomes. These opportunistic laboratory tests perform adequately for risk stratification when oral glucose tolerance testing is not available.

Published
2020
Full Text
View/download PDF

40. Automated insulin delivery during the first 6 months postpartum (AiDAPT): a prespecified extension study.

Author

Lee TTM, Collett C, Bergford S, Hartnell S, Scott EM, Lindsay RS, Hunt KF, McCance DR, Reynolds RM, Wilinska ME, Sibayan J, Kollman C, Hovorka R, and Murphy HR

Subjects
Humans, Female, Pregnancy, Adult, Blood Glucose analysis, Blood Glucose drug effects, Pregnancy in Diabetics drug therapy, Pregnancy in Diabetics blood, United Kingdom, Blood Glucose Self-Monitoring, Insulin administration & dosage, Postpartum Period drug effects, Insulin Infusion Systems, Diabetes Mellitus, Type 1 drug therapy, Diabetes Mellitus, Type 1 blood, Hypoglycemic Agents administration & dosage, Hypoglycemic Agents therapeutic use
Abstract

Background: Clinical guidelines in the UK and elsewhere do not specifically address hybrid closed loop (HCL) use in the postpartum period when the demands of caring for a newborn are paramount. Our aim was to evaluate the safety and efficacy of HCL use during the first 6 months postpartum compared with standard care., Methods: In this prespecified extension to a multicentre, randomised controlled trial, pregnant women with type 1 diabetes at nine UK sites were followed up for 6 months postpartum. Eligible participants (AiDAPT participants recruited after the implementation of the postpartum protocol amendment approval, those still pregnant or within six months of delivery at the time of amendment implementation and still using HCL or continuous glucose monitoring [CGM] therapy) continued their randomly assigned treatment, either standard insulin therapy with CGM or HCL therapy (CamAPS FX system version 0.3.1, CamDiab, Cambridge, UK). Participants were randomised in a 1:1 ratio with stratification by clinical site using randomly permuted block sizes of 2 or 4. The primary outcome was the between-group difference in percentage time in range ([TIR] 3·9-10·0 mmol/L [70-180mg/dL]), measured during the periods of month 0 up to 3, months 3 to 6, and over 6 months postpartum. The study is registered at ClinicalTrials.gov (ISRCTN56898625) and is complete., Findings: Of the 124 AiDAPT trial participants, 66 (53%) were ineligible for inclusion in the postpartum extension, and 57 participants consented to continue their treatment per original random allocation. The mean age was 31 years (SD 4), and all participants had early pregnancy HbA 1c 59·4 mmol/mol (SD 10·5 [7·6% SD 1·0%]). In the 6 months postpartum, mean time with glucose levels within the target range was higher in the HCL group compared with the standard care group (72% [SD 12%] vs 54% [17%]), with an adjusted treatment difference of 15% (95% CI 7 to 22). Results for hyperglycaemia (>10·0 mmol/L) and mean CGM glucose also favoured HCL (-14% [95% CI -23% to -6%] and -1·3 mmol/L [-2·3 to -0·3], respectively). Hypoglycaemia rates were low, with no between-group differences (2·4% vs 2·6%). There were no treatment effect changes depending on postpartum period (0 up to 3 months vs 3 to 6 months) and no unanticipated safety problems., Interpretation: Participants in the HCL group maintained 70% TIR during the first 6 months postpartum, supporting continued use of HCL rather than standard insulin therapy for people with diabetes once they have given birth., Funding: National Institute for Health Research, Juvenile Diabetes Research Foundation, and Diabetes Research & Wellness Foundation. CGM devices were provided by Dexcom at a discounted price., Competing Interests: Declaration of interests HRM sits on the Medtronic European Scientific Advisory Board and reports speaker honoraria from Dexcom, Abbott, Medtronic, Novo Nordisk, and Ypsomed. EMS reports receiving speaker honoraria from Abbott Diabetes Care and Eli Lilly. RH reports receiving speaker honoraria from Eli Lilly, Dexcom, and Novo Nordisk, receiving license or consultancy fees from B Braun and Abbott Diabetes Care; patents related to closed‑loop systems, and being a director at CamDiab. MEW reports patents related to closed‑loop systems, and being a consultant at CamDiab. SH is a UK member of the Medtronic Advisory Board, reports being a consultant at CamDiab, and providing training for Dexcom. Dexcom was supplied continuous glucose monitoring (CGM) systems at reduced cost., (Copyright © 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Published
2025
Full Text
View/download PDF

42. Associations of Antenatal Corticosteroids With Neurodevelopment in Children Aged 27-30 Months: A Population-Based Cohort Study.

Author

Frier EM, Lahti-Pulkkinen M, Lin C, Decrue F, Zoega H, Allegaert K, Been JV, Burgner D, Duhig K, Einarsdóttir K, Florian L, Fraser A, Gissler M, Gyamfi-Bannerman C, Pedersen LH, Miller JE, Mol BW, Murray SR, Norman J, Roberts D, Schuit E, Shi T, Sheikh A, Vogel JP, Wood R, McGoldrick E, Jacobsson B, Krispin E, Reynolds RM, and Stock SJ

Abstract

Objective: To examine the associations of antenatal corticosteroid (ACS) exposure with neurodevelopment in early childhood, and how these vary with gestational age at birth., Design: Population-based cohort study., Setting: Scotland, UK., Population: 285 637 singleton children born at 28-41 weeks' gestation, between 1st January 2011 and 31st December 2017, who underwent health reviews at 27-30 months of age., Methods: Logistic and linear regression analyses, stratified by gestation at birth (28-33, 34-36, 37-38 and 39-41 weeks' gestation), were used to evaluate the associations between ACS exposure and neurodevelopmental outcomes, and adjusted for maternal age, body mass index, diabetes, antenatal smoking, parity, neighbourhood deprivation, birth year, child sex and age at review., Main Outcome Measures: Practitioner-identified concerns about any neurodevelopmental domain, and the average of five domain scores on neurodevelopmental milestones from the parent-rated Ages and Stages Questionnaire (ASQ-3)., Results: After adjustment for covariates, ACS exposure was associated with reduced neurodevelopmental concerns in children born at 28-33 weeks' gestation (OR = 0.79, 95% CI = 0.62-0.999) and with increased neurodevelopmental concerns in children born at 34-36 weeks' gestation (OR = 1.11, 95% CI = 1.01-1.21). No independent associations emerged in children born at later gestations. ACS exposure was not associated with ASQ-3 scores in any gestational age group., Conclusions: In early childhood, ACS exposure was associated with statistically significantly reduced neurodevelopmental concerns in children born at 28-33 weeks' gestation, and with statistically significantly increased neurodevelopment concerns in children born at 34-36 weeks' gestation. However, the effect sizes of these associations were small. No independent associations were found between ACS exposure and neurodevelopment in term-born children., (© 2025 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)

Published
2025
Full Text
View/download PDF

43. Metabolic biomarkers of clinical outcomes in severe mental illness (METPSY): protocol for a prospective observational study in the Hub for metabolic psychiatry.

Author

Rakshasa-Loots AM, Steyn C, Swiffen D, Marwick KFM, Semple RK, Reynolds RM, Burgess K, Lawrie SM, Lightman SL, Luz S, and Smith DJ

Subjects
Humans, Adult, Young Adult, Prospective Studies, Adolescent, Female, Male, Scotland, Metabolomics methods, Biomarkers blood, Schizophrenia blood, Schizophrenia metabolism, Bipolar Disorder blood, Depressive Disorder, Major blood
Abstract

People with severe mental illness have high rates of obesity, type 2 diabetes, and cardiovascular disease. Emerging evidence suggests that metabolic dysfunction may be causally linked to the risk of severe mental illness. However, more research is needed to identify reliable metabolic markers which may have an impact on mental health outcomes, and to determine the mechanisms behind their impact. In the METPSY research study, we will investigate the relationship between metabolic markers and clinical outcomes of severe mental illness in young adults. We will recruit 120 young adults aged 16-25 years living in Scotland with major depressive disorder, bipolar disorder, schizophrenia, or no severe mental illness (controls) for a prospective observational study. We will assess clinical symptoms at three in-person visits (baseline, 6 months, and 12 months) using the Structured Clinical Interview for DSM-5, and collect blood samples at each of these visits for agnostic profiling of metabolic biomarkers through an untargeted metabolomic screen, using the rapid hydrophilic interaction liquid chromatography ion mobility mass spectrometry method (RHIMMS). Participants will also complete remote assessments at 3 and 9 months after the baseline visit: Ecological Momentary Assessments to measure mental health, wrist actigraphy to measure rhythms of rest and activity, and continuous glucose monitoring to measure metabolic changes. Throughout the 12-month enrolment period, we will also measure objective markers of sleep using a radar sleep monitor (Somnofy). Using advanced statistical techniques and machine learning analysis, we will seek to better understand the mechanisms linking metabolic health with mental health in young adults with schizophrenia, bipolar disorder, and severe depression. Clinical trial number: Not applicable., Competing Interests: Declarations. Ethics approval and consent to participate: This study will be carried out in accordance with internationally recognised standards for ethical research and the Declaration of Helsinki. All participants will provide written informed consent to take part in the study. This study has received ethical approval from the NHS North of Scotland Research Ethics Committee (1) (REC reference: 24/NS/0138). Consent for publication: Not applicable. Competing interests: RKS has received consulting fees from Astra Zeneca and Alnylam, and speaking fees from Novo Nordisk, Eli Lilly, and Amryt, all relating to severe insulin resistance and/or lipodystrophy. SML has been paid to give an educational talk on cognition in schizophrenia to employees of Kynexis. SLL is a cofounder of Dynamic Therapeutics., (© 2025. The Author(s).)

Published
2025
Full Text
View/download PDF

44. Evaluation of the prevalence of the dog erythrocyte antigen 1 blood type in dogs of Sydney.

Author

Reynolds RM, Cooper JL, and Eurell TE

Abstract

Objective: This study aimed to evaluate the prevalence of dog erythrocyte antigen 1 (DEA 1) blood type in Sydney and to identify any associations between its prevalence and breed, sex and geographic location of these dogs., Methods: This was a retrospective study of 225 dogs that underwent DEA 1 blood typing while donating or receiving blood products at a single institution between 2020 and 2024. Dogs were DEA 1 positive or negative and blood donors or recipients. Logistic regression was used to evaluate differences in the prevalence of DEA 1 positive results between sex, breed and geographic location. Significance was set at P < 0.05. Reasons for blood transfusion, blood product administered and age were documented., Results: Of the dogs that were blood typed (n = 225), 48% (108/225) were DEA 1 positive and 52% (117/225) DEA 1 negative, 105 (46.7%) were donors and 120 (53.3%) recipients. The highest prevalence of DEA 1 type positivity was observed in the Golden Retriever (8/9, 88.9%). Recipients presented primarily for haemorrhage (57/120, 47.5%), most frequently receiving whole blood (89/120, 74.2%) with minimal adverse reactions (3/120, 2.5%). No significant differences were identified in prevalence of DEA 1 positive dogs between breed groups, six most common breeds, sex, geographical location or DEA 1 negative blood types., Conclusions: The prevalence of the DEA 1 blood type in this cohort of dogs in Sydney is comparable to other countries., (© 2025 Australian Veterinary Association.)

Published
2025
Full Text
View/download PDF

45. Availability of Lactation Policies and Facilities for ACGME-Accredited Surgical Residency Training Programs.

Author

Kruk MD, Malueg MD, Snyder KV, and Reynolds RM

Subjects
Humans, Female, General Surgery education, United States, Organizational Policy, Internship and Residency, Accreditation, Education, Medical, Graduate, Lactation
Abstract

Objective: We aimed to investigate availability of lactation policy and facility information among surgical residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME)., Design: Between March 1, 2023 and October 31, 2023, websites of surgical residency training programs on the ACGME Accreditation System List of Programs by Specialty were reviewed for department lactation policies, links to institutional graduate medical education (GME) websites with lactation policies, lists of lactation facilities, and links to institutional GME websites listing lactation facilities. Scatter plots were generated and Pearson correlation coefficients were calculated to assess relationships of the percentages of female residents, fellows, and faculty in each surgical specialty with the percentage of residency program websites with available lactation information., Results: In total, 1847 websites were reviewed. Seventeen (0.9%) had lactation policies, 31 (1.7%) had lists of lactation facilities, 231 (12.5%) had links to institutional websites with lactation policies, and 295 (16.%) had links to institutional websites with lists of lactation facilities. The percentage of female residents and fellows and percentage of female faculty were positively correlated with the percentage of residency program websites with available lactation information., Conclusion: Limited information on lactation policies and facilities is available to surgical residents., (Copyright © 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Published
2025
Full Text
View/download PDF

46. Assessing the impact of messages about reduced nicotine cigar products among people who use little cigar and cigarillo: Insights from a discrete choice experiment.

Author

Ntansah CA, Popova L, Hardin JW, Kim M, Sterling KL, Reynolds RM, Hackworth EE, Ashley DL, Henderson KC, Yang B, and Thrasher JF

Abstract

Introduction: The U.S. Food and Drug Administration's (FDA) pursuit of a low nicotine standard for cigarettes raises concerns that a focus on cigarettes may encourage people to use other combusted tobacco products, undermining the policy's effectiveness. The FDA is considering expanding the policy to include cigar products, which will require effective messages for people who use those products., Methods: In 2022, a discrete choice experiment was conducted with African American males and females and white males and females. Participants (n=1,722), aged 18-44 years and who had smoked little cigar and cigarillos (LCC) in the past 30 days, evaluated seven message attributes about reduced nicotine content (RNC) LCCs (presence or absence of information on source, chemicals, harm, nicotine, addiction, quitting efficacy, and enjoyment) across 20 choice sets. Participants assessed two of three outcomes: affect towards the policy, perceived harm of RNC LCCs, and motivation to quit smoking LCCs., Results: Messages listing the FDA as the source were selected as eliciting more positive affect towards the policy, increasing perceived harm and motivation to quit smoking LCCs. Source was the most influential attribute for selecting messages in terms of positive affect towards the policy and motivation to quit. Chemicals and harm attributes had the most substantial effect on selecting messages as increasing perceived harm., Conclusions: Citing the FDA as a source may improve the perceived effectiveness of RNC communications for people who use LCCs. Misperceptions about presumed lower harms of RNC products can be corrected with information about their harm and chemical properties., Implications: Our findings among people who use LCCs suggest that source information shown as the FDA logo can increase message effectiveness while also influencing risk perceptions and motivation to quit smoking LCCs. To address misperceptions about RNC LCC harms, educational messages should particularly consider incorporating information about chemicals and harms., (© The Author(s) 2025. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Published
2025
Full Text
View/download PDF

47. Problematic social media use in 3D? Relationships between traditional social media use, social virtual reality (VR) use, and mental health.

Author

Yao SX, Lee J, Reynolds RM, and Ellithorpe ME

Subjects
Humans, Male, Female, Young Adult, Adult, Adolescent, Anxiety psychology, Depression psychology, Social Media, Mental Health, Virtual Reality, Social Support
Abstract

This research expanded on prior work exploring the relationship between social media use, social support, and mental health by including the usage of social virtual reality (VR). In Study 1 (undergraduate students; n = 448) we examined divergent relationships between problematic social media use (e.g., Facebook, TikTok), total use, and users' mental health indicators (e.g., depression, anxiety, social isolation). To determine whether problematic social media use patterns extended to immersive 3-D environments, we sampled active social VR users (e.g., Rec Room) in Study 2 (n = 464). Problematic social VR use was related to decreased real-life social support (β = -.62, 95%CI [-.80, -.44]), but not to VR social support (β = -.06, 95%CI [-.25, .14]). Conversely, the amount of social VR use was only related to increased social VR (β = .06, 95%CI [.04, .15]) but not to real-life social support (β = -.02, 95%CI [-.05, .04]). Study 2 also revealed a finding that may be unique to the 3-D immersive environment: the amount of social VR use facilitated better mental health for VR users, but only through stronger perceived social support on social VR but not in real life. This result highlights the potential of immersive media to promote mental well-being by facilitating engaging and meaningful social interactions., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Yao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Published
2025
Full Text
View/download PDF

48. Sex-related hypothalamic-pituitary-gonadal and hypothalamic-pituitary-adrenal axis adaptation during military training.

Author

Gifford RM, O'Leary TJ, Knight RL, Wardle SL, Doig CL, Anderson RA, Greeves JP, Reynolds RM, and Woods DR

Subjects
Humans, Male, Female, Young Adult, Adult, Hair, Sex Characteristics, Hypothalamo-Hypophyseal System metabolism, Hypothalamo-Hypophyseal System physiopathology, Pituitary-Adrenal System metabolism, Pituitary-Adrenal System physiology, Hydrocortisone metabolism, Military Personnel, Adaptation, Physiological physiology, Saliva metabolism
Abstract

Reproductive endocrine function adapts to psychological, environmental, and energy-associated stressors. Multistressor environments upregulate hypothalamic-pituitary-adrenal (HPA) axis, causing suppression of the hypothalamic-pituitary-gonadal (HPG) axis, but it is not known if this pattern or its magnitude is sex biased. We compared HPG and HPA axis activity in 9 men and 34 women undergoing Army training. One-hour low-dose gonadorelin and Synacthen tests were conducted at 1 and 29 wk, measuring gonadotrophins and cortisol. Cortisol was measured from hair every 3 mo. Morning and evening salivary cortisol and psychometric questionnaires were measured at six timepoints. Sexes were compared over time by two-way ANOVA. Gonadotrophin responses were significantly higher in women than men in week 1 , but no sex difference was seen at week 29 (no significant sex × time interaction). Week 1 cortisol response was higher among men, but week 29 cortisol response was higher among women (sex × time F (1,44) = 18.0, P < 0.001). Hair cortisol was higher among women than men beforehand, not different between sexes during the first 3 mo, and significantly higher among women during training months 5 - 11 ( F (3,15) = 3.25, P = 0.024). Morning salivary cortisol was higher among women in weeks 8 and 14 , but higher among men in week 29 ( F (4,76) = 4.0, P = 0.005). No differences were seen in evening salivary cortisol. Psychometrics did not change or differ between sexes. HPA axis responses to military training were greater among women than men. HPG axis responses suggest greater downregulation among women. These findings will enable equitable and individualized management of people undergoing periods of intensive physical stress. NEW & NOTEWORTHY We conducted a comprehensive comparison of adrenal and reproductive function in men and women undergoing 11-mo military training. We found progressively elevated cortisol levels and dynamic cortisol response to stress among women, but not men, and suppression of reproductive function among women. The physiological impact of stressful military training was greater among women than men; this could not be explained by energy balance, and sex-specific effects of sleep, socio-ethnographic, or other stressors may be responsible.

Published
2025
Full Text
View/download PDF

49. Determination of steroid reference intervals in a pregnancy population.

Author

Lahti-Pulkkinen M, Räikkönen K, Basiukajc A, Lee P, Denham SG, Simpson JP, Villa P, Hämäläinen E, Laivuori H, Kajantie E, Heinonen K, Girchenko P, Reynolds RM, and Homer NZ

Subjects
Humans, Female, Pregnancy, Adult, Reference Values, Chromatography, Liquid methods, Steroids blood, Young Adult, Tandem Mass Spectrometry methods
Abstract

Steroids, including mineralocorticoids, glucocorticoids, and sex hormones play a critical role in pregnancy. Liquid chromatography tandem mass spectrometry (LC-MS/MS) analysis offers an opportunity to conduct simultaneous multiplex steroid analysis within a given sample. This paper describes the LC-MS/MS steroid analysis method developed for assessing plasma specific reference ranges of 18 steroids from plasma samples (200 µL) of pregnant women participating in the PREDO study. Samples were prepared using supported liquid extraction and analyzed on an Acquity I-Class UPLC and a QTrap6500 + mass spectrometer. Mass spectrometry parameters were optimized for each steroid and chromatographic separation of 18 steroids was developed. Changes in steroid levels across pregnancy were assessed. Samples were collected after an overnight fast between 07:00 and 09:00. Data from 257 samples from 96 women with uncomplicated pregnancy (women with pre-pregnancy normal weight and no diabetes or hypertensive disorders before or during pregnancy, who delivered a live child at ≥ 37 weeks of gestation with appropriate for gestational age birth weight) were analyzed to calculate steroid reference ranges over three time points, between 11.6 and 14.3, 17.7-22.9, and 25.6-29.0 pregnancy weeks. Levels of progestogens, glucocorticoids, mineralocorticoids, estrogens, their precursors, and metabolites increased significantly across pregnancy. Androgen levels remained stable, except for a decrease in 5α-dihydrotestosterone. The LC-MS/MS method also showed validity in analyses of 917 samples of 328 women with complicated pregnancies. The method is suitable for the analysis of 18 steroids in plasma during pregnancy and the investigation of pregnancy complications, fetal growth, and development after birth., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2025
Full Text
View/download PDF

50. Posterior fossa decompression in patients with Chiari malformation type 1: effect on sleep apnea and follow-up outcomes.

Author

Okai BK, Jaikumar V, Francois HB, Recker MJ, and Reynolds RM

Subjects
Humans, Male, Female, Child, Retrospective Studies, Child, Preschool, Treatment Outcome, Adolescent, Follow-Up Studies, Cranial Fossa, Posterior surgery, Sleep Apnea, Obstructive surgery, Sleep Apnea, Obstructive complications, Arnold-Chiari Malformation surgery, Arnold-Chiari Malformation complications, Decompression, Surgical methods, Sleep Apnea Syndromes surgery
Abstract

Purpose: Sleep apnea, posing significant health risks, is frequently associated with Chiari malformation (CM), characterized by cerebellar tonsil herniation through the foramen magnum. Central sleep apnea (CSA) in CM results from impaired brain-to-muscle signaling and requires treatment. Conversely, obstructive sleep apnea (OSA), arising from throat muscle relaxation, typically unrelated to CM, often coexists. This study evaluates the effectiveness of posterior fossa decompression (PFD) on sleep apnea., Methods: A retrospective chart review was conducted of pediatric patients with CM-1 and sleep apnea who underwent PFD between April 1, 2004, and September 30, 2022. Data collected included demographics, clinical characteristics, adenotonsillectomy status, PFD details, and sleep study parameters like the apnea-hypopnea index and respiratory disturbance index. Statistical analysis assessed the surgery's impact on sleep apnea severity., Results: The study included eleven patients, predominantly male (63.6%). All had OSA (100%), with 63.6% also having CSA. Preoperative sleep studies classified OSA severity as 36.4% mild, 18.2% moderate, and 45.5% severe, with no change post-surgery. CSA severity initially included seven mild cases, which became three mild, one moderate, and three resolved cases post-surgery. Among seven patients who had adenotonsillectomy before decompression, five showed no improvement in OSA severity post-surgery., Conclusion: This study elucidates the complex relationship between CM-1, sleep apnea, and PFD. The findings show the persistence of sleep apnea in some patients and highlight the need for continuous monitoring of these patients in order to optimize their care after surgery., Competing Interests: Declarations. Ethics approval: This study has been approved by the University at Buffalo institutional review board (STUDY00007892). At the time of hospital admission, informed consent for patient data to be published was provided by each patient or a legally authorized representative. Consent was obtained from each patient or a legally authorized representative before procedures were performed. Conflict of interest: The authors declare no competing interests. Participating center and location: John R. Oishei Children’s Hospital, Buffalo, NY. Previous presentation: Not previously presented., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Published
2024
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results