Browsing by Subject "Children"
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(2020)Background: In adults, vegetarian and vegan diets have been associated with decreased cardiovascular disease (CVD) risk. At the same time, lower plasma LDL-concentrations are reported in vegans than in omnivores. Classification of a vegetarian diet can be challenging, as the diets vary in the degree and categories of the avoided food products. Recently, plant-based diet indices (PDI), such as the provegetarian food pattern, have been introduced as a priori method to study vegetarianism as a continuum. Plant-based dietary indices weigh positively foods derived from plant sources, whereas animal foods are weighed negatively. Greater adherence to PDI has been associated with lower CVD mortality and lower incidence of coronary heart disease (CHD). Meanwhile, little is known about the associations of plant-based eating and the risk of CVD in children. Aims: The aim of this thesis is to study plant-based eating as a continuous phenomenon in a group of Finnish preschoolers. Furthermore, the focus is on the animal source energy and its associations with dietary intakes, and cholesterol and bile acid metabolism. Materials and methods: In this thesis, the data from the cross-sectional MIRA Helsinki Study is used. In 2017, City of Helsinki started a pilot project, in which a vegan food option was offered in municipal daycare. At the same year, MIRA Helsinki Study was started to examine the nutritional status of children following a vegan diet. Altogether 42 children, aged 1–7-years, participated. At daycare, 18 of the children consumed a vegan diet, whereas 24 were omnivores. However, these diet categories did not apply to the child’s diet outside daycare. Children’s diet was assessed with 4-day food records and with food frequency questionnaires (FFQs). Anthropometric measurements were taken and fasting blood samples collected. Blood samples were analysed with standard laboratory tests. Gas-liquid chromatography (GLC) and liquid chromatography with tandem mass spectrometry (HPLC-MS/MS) methods were used to examine serum cholesterol metabolism biomarkers and bile acids, respectively. For each food item (n=719) in the food record data, the weight proportion of animal content was estimated. The animal-origin energy content of each food item was calculated by multiplying the known energy content of the food item with the aforementioned score. The proportion of animal source energy (ASE) per subject across the 4-day food record was calculated by dividing the energy derived from animal sources with total energy intake. The correlations of ASE proportion with dietary intakes and surrogate markers of cholesterol and bile acid metabolism were investigated with the Pearson correlation analysis. A multiple linear regression model was used to test whether the ASE proportion explained the plasma LDL-cholesterol (LDL-C) concentration when controlling for the child’s sex and maternal education. In addition, the associations between the ASE proportion and serum concentrations of 20 bile acid variables were examined with the Pearson correlation coefficient. The Benjamini-Hochberg procedure was used to correct for multiple analyses. Results: Among all of the participants, ASE proportions ranged from 0.00 to 0.52, with a median value of 0.275 (that is, 27.5% of total energy derived from animal sources). Intake of animal source energy correlated positively with SAFA (r=0.815, p<0.000), cholesterol (r=0.707, p<0.000) and protein (r=0.493, p<0.001) intakes. There was a strong negative correlation between the ASE proportion and fibre intake (r=–0.836, p<0.000). In a linear regression model, adjusted for child’s sex and mother’s educational level, the model explained 44% (p<.000) of the variance in the plasma LDL-C concentration. Every 0.1 increase in the ASE proportion (10E% increase in energy derived from animal sources) was associated with a 0.32 mmol/L higher plasma LDL-C concentration. Associations of ASE proportion and cholesterol surrogate markers were present: a higher intake of ASE correlated with lower concentrations of cholesterol absorption markers. A similar negative association with ASE proportion was present for two out of four cholesterol synthesis biomarkers. In addition, the bile acid synthesis biomarker (7α-hydroxy-4-cholesten-3-one) correlated negatively with the ASE proportion. From the 20 serum bile acid variables studied only the ratio of tauro- to glyco-conjugated bile acids was significantly associated with the ASE proportion after correcting for multiple analyses. Conclusion: Among the study participants, animal source energy ratio was a powerful predictor of plasma LDL-C concentrations. Dietary patterns characterised by high intake of animal source energy were less likely to meet the dietary recommendations of fatty acid (SAFA and PUFA) intake. Our results on cholesterol metabolism need to be confirmed and replicated in future studies, which should include data on absolute measurements of cholesterol synthesis and absorption.
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(2016)Aims/hypothesis To characterise rapid progressors to type 1 diabetes among children recruited from the general population based on HLA-conferred disease susceptibility. Methods We observed 7410 HLA-predisposed children participating in the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Study from birth for development of beta cell autoimmunity and type 1 diabetes over a median follow-up time of 16.2 (range 0.9-21.1) years. Islet cell antibodies, and autoantibodies to insulin (IAA), GAD (GADA), and islet antigen 2 (IA-2A) were analysed as markers of beta cell autoimmunity. Rapid progression was defined as progression to clinical type 1 diabetes within 1.5 years after autoantibody seroconversion. We analysed the association between rapid progression and demographic and autoantibody characteristics as well as genetic markers including 25 non-HLA single nucleotide polymorphisms (SNPs) predisposing to type 1 diabetes. Results Altogether 1645 children (22%) tested positive for at least one diabetes-associated autoantibody, and 248 (15%) of the seroconverters progressed to type 1 diabetes by the end of 2015. The median time from seroconversion to diagnosis was 0.51 years in rapid progressors (n=42, 17%), and 5.4 years in slower progressors. Rapid progression was observed both among young and early pubertal children. Compared to slower progressors, rapid progressors had higher frequency of multipositivity, higher titres of ICA, IAA, and IA-2A at seroconversion, and higher prevalence of the secretor genotype in the FUT2 gene. Compared to autoantibody-positive non-progressors, rapid progressors were younger, carried more often the high-risk HLA genotype, the FUT2 secretor genotype, and a predisposing SNP in the PTPN22 gene, had higher frequency of ICA, IAA, GADA, IA-2A, and multipositivity, and higher titres of all four autoantibodies at seroconversion. Conclusions At seroconversion, individuals with rapid progression to type 1 diabetes are characterised by young age, higher autoantibody titres, positivity for multiple autoantibodies, and higher prevalence of a FUT2 SNP. The double-peak profile of seroconversion age among the rapid progressors demonstrates for the first time that rapid progression may take place not only in young children, but also in children in early puberty. Rapid progressors might benefit from careful clinical follow-up and early preventive measures.
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(2015)Lasten autoimmuunihypertyreoosi eli Gravesin tauti on kilpirauhasen liikatoimintaa aiheuttava harvinainen autoimmuunisairaus. Sitä voidaan hoitaa vähentämällä kilpirauhasen toimintaa lääkehoidolla, tuhoamalla kilpirauhaskudosta radiojodilla tai poistamalla kilpirauhanen leikkauksella. Kaikkien hoitomuotojen tavoitteena on liikatoiminnan saaminen hallintaan. Tässä tutkielmassa selvitettiin, millaista hoitoa saivat Gravesin tautia sairastaneet lapset, joita seurattiin Lastenklinikalla vuosien 2000-2007 aikana ja millaisia tuloksia eri hoitomuodoilla saatiin aikaan. Lisäksi tutkittiin, miten hoito jatkui Lastenklinikan hoitojakson jälkeen. Kaikki Lastenklinikalla hoidetut potilaat saivat taudin toteamisen jälkeen sairauden alkuvaiheessa lääkehoidon tyreostaateilla, jolla noin puolet potilaista pääsi remissioon. Muut potilaat tarvitsivat remission saavuttamiseksi lääkityksen lisäksi joko radiojodihoidon tai kilpirauhasen poistoleikkauksen. Leikkaushoito oli radiojodia suositumpi hoitomuoto. Suurin osa kilpirauhasleikkauksista tehtiin vasta Lastenklinikan hoitojakson jälkeen ja pääosa potilaista hoidettiin lapsuudessa ainoastaan lääkehoidolla. Kaikilla hoitomuodoilla ilmeni joitakin haittavaikutuksia, jotka olivat kaikki tunnettuja kirjallisuudesta. Vakavat haitat olivat tutkimuksen potilailla harvinaisia. Pelkän lääkehoidon saaneet potilaat tarvitsivat pidemmän seuranta-ajan sairaalassa hoidon lopettamisen jälkeen verrattuna radiojodihoidon tai leikkaushoidon saaneisiin potilaisiin. Hoitomenetelmästä riippumatta kaikki potilaat pääsivät pysyvään remissioon suurin piirtein saman ikäisinä.
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(2015)Lasten autoimmuunihypertyreoosi eli Gravesin tauti on kilpirauhasen liikatoimintaa aiheuttava harvinainen autoimmuunisairaus. Sitä voidaan hoitaa vähentämällä kilpirauhasen toimintaa lääkehoidolla, tuhoamalla kilpirauhaskudosta radiojodilla tai poistamalla kilpirauhanen leikkauksella. Kaikkien hoitomuotojen tavoitteena on liikatoiminnan saaminen hallintaan. Tässä tutkielmassa selvitettiin, millaista hoitoa saivat Gravesin tautia sairastaneet lapset, joita seurattiin Lastenklinikalla vuosien 2000-2007 aikana ja millaisia tuloksia eri hoitomuodoilla saatiin aikaan. Lisäksi tutkittiin, miten hoito jatkui Lastenklinikan hoitojakson jälkeen. Kaikki Lastenklinikalla hoidetut potilaat saivat taudin toteamisen jälkeen sairauden alkuvaiheessa lääkehoidon tyreostaateilla, jolla noin puolet potilaista pääsi remissioon. Muut potilaat tarvitsivat remission saavuttamiseksi lääkityksen lisäksi joko radiojodihoidon tai kilpirauhasen poistoleikkauksen. Leikkaushoito oli radiojodia suositumpi hoitomuoto. Suurin osa kilpirauhasleikkauksista tehtiin vasta Lastenklinikan hoitojakson jälkeen ja pääosa potilaista hoidettiin lapsuudessa ainoastaan lääkehoidolla. Kaikilla hoitomuodoilla ilmeni joitakin haittavaikutuksia, jotka olivat kaikki tunnettuja kirjallisuudesta. Vakavat haitat olivat tutkimuksen potilailla harvinaisia. Pelkän lääkehoidon saaneet potilaat tarvitsivat pidemmän seuranta-ajan sairaalassa hoidon lopettamisen jälkeen verrattuna radiojodihoidon tai leikkaushoidon saaneisiin potilaisiin. Hoitomenetelmästä riippumatta kaikki potilaat pääsivät pysyvään remissioon suurin piirtein saman ikäisinä.
Now showing items 1-4 of 4