Background The main underlying risk factors associated with coronary heart disease (CHD) are modifiable and oxidative injury and systemic inflammatory damage represent key aetiological factors associated with the development and... more
Background The main underlying risk factors associated with coronary heart disease (CHD) are modifiable and oxidative injury and systemic inflammatory damage represent key aetiological factors associated with the development and progression of CHD and premature mortality. Objective To examine associations of plasma antioxidant status with all-cause mortality and fatal or non-fatal cardiovascular events. Design The PRIME study prospectively evaluated 9709 men aged 50–59 years between 1991 and 1993 in Northern Ireland and France who were free of CHD at recruitment and followed annually for deaths and cardiovascular events for 10 years. Serum concentrations of vitamin C, retinol, two forms of vitamin E (α- and γ-tocopherol) and six carotenoids were quantified by high-performance liquid chromatography. Baseline conventional risk factors were considered, as well as socioeconomic differences and lifestyle behaviours including diet, smoking habit, physical activity, and alcohol consumption...
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The association between dietary patterns (DP) and prevalence of hearing loss in men enrolled in the Caerphilly Prospective Study was investigated. During 1979–1983, the study recruited 2512 men aged 45–59 years. At baseline, dietary data... more
The association between dietary patterns (DP) and prevalence of hearing loss in men enrolled in the Caerphilly Prospective Study was investigated. During 1979–1983, the study recruited 2512 men aged 45–59 years. At baseline, dietary data were collected using a semi-quantitative FFQ, and a 7-d weighed food intake (WI) in a 30 % subsample. Five years later, pure-tone unaided audiometric threshold was assessed at 0·5, 1, 2 and 4 kHz. Principal component analysis (PCA) identified three DP and multiple logistic and ordinal logistic regression models examined the association with hearing loss (defined as pure-tone average of frequencies 0·5, 1, 2 and 4 kHz >25 dB). Traditional, healthy and high-sugar/low-alcohol DP were found with both FFQ and WI data. With the FFQ data, fully adjusted models demonstrated significant inverse association between the healthy DP and hearing loss both as a dichotomous variable (OR=0·83; 95 % CI 0·77, 0·90; P<0·001) and as an ordinal variable (OR=0·87; 9...
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Behavioral factors are important in disease incidence and mortality and may explain associations between mortality and various psychological traits. These analyses investigated the impact of behavioral factors on the associations between... more
Behavioral factors are important in disease incidence and mortality and may explain associations between mortality and various psychological traits. These analyses investigated the impact of behavioral factors on the associations between depression, hostility and cardiovascular disease(CVD) incidence, CVD mortality, and all-cause mortality. Data from the PRIME Study (N = 6953 men) were analyzed using Cox proportional hazards models, following adjustment for demographic and biological CVD risk factors, and other psychological traits, including social support. Following initial adjustment, both depression and hostility were significantly associated with both mortality outcomes (smallest SHR = 1.24, p < 0.001). Following adjustment for behavioral factors, all relationships were attenuated both when accounting for and not accounting for other psychological variables. Associations with all-cause mortality remained significant (smallest SHR = 1.14, p = 0.04). Of the behaviors included,...
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Retinal vessel abnormalities are associated with cardiovascular disease (CVD) risk. To date, there are no trials investigating the effect of dietary factors on the retinal microvasculature. This study examined the dose response effect of... more
Retinal vessel abnormalities are associated with cardiovascular disease (CVD) risk. To date, there are no trials investigating the effect of dietary factors on the retinal microvasculature. This study examined the dose response effect of fruit and vegetable (FV) intake on retinal vessel caliber in overweight adults at high CVD risk. Following a 4 week washout period, participants were randomized to consume either 2 or 4 or 7 portions of FV daily for 12 weeks. Retinal vessel caliber was measured at baseline and post-intervention. A total of 62 participants completed the study. Self-reported FV intake indicated good compliance with the intervention, with serum concentrations of zeaxanthin and lutein increasing significantly across the groups in a dose-dependent manner (P for trend < 0.05). There were no significant changes in body composition, 24-h ambulatory blood pressure or fasting blood lipid profiles in response to the FV intervention. Increasing age was a significant determin...
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Loci contributing to complex disease have been identified by focusing on genome-wide scans utilising non-synonymous single nucleotide polymorphisms (nsSNPs). We employed Illumina’s HNS12 BeadChip (13,917 high-value SNPs) which was... more
Loci contributing to complex disease have been identified by focusing on genome-wide scans utilising non-synonymous single nucleotide polymorphisms (nsSNPs). We employed Illumina’s HNS12 BeadChip (13,917 high-value SNPs) which was specifically designed to capture nsSNPs and ideally complements more dense genome-wide association studies that fail to consider many of these putatively functional variants. The HNS12 panel also includes 870 tag SNPs covering the major histocompatibility region. All individuals genotyped in this study were Caucasians with (cases) and without (controls) diabetic nephropathy. About 449 individuals with type 2 diabetes (203 cases, 246 controls) were genotyped in the initial study. 1,467 individuals with type 1 diabetes (718 cases, 749 controls) were genotyped in the follow up study. 11,152 SNPs were successfully analysed and ranked for association with diabetic nephropathy based on significance (P) values. The top ranked 32 SNPs were subsequently genotyped u...
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Ischaemic heart disease (IHD) is a complex disease due to the combination of environmental and genetic factors. Mutations in the MEF2A gene have recently been reported in patients with IHD. In particular, a 21 base pair deletion... more
Ischaemic heart disease (IHD) is a complex disease due to the combination of environmental and genetic factors. Mutations in the MEF2A gene have recently been reported in patients with IHD. In particular, a 21 base pair deletion (Delta7aa) in the MEF2A gene was identified in a family with an autosomal dominant pattern of inheritance of IHD. We investigated this region of the MEF2A gene using an Irish family-based study, where affected individuals had early-onset IHD. A total of 1494 individuals from 580 families were included (800 discordant sib-pairs and 64 parent-child trios). The Delta7aa region of the MEF2A gene was investigated based on amplicon size. The Delta7aa mutation was not detected in any individual. Variation in the number of CAG (glutamate) and CCG (proline) residues was detected in a nearby region. However, this was not found to be associated with IHD. The Delta7aa mutation was not detected in any individual within the study population and is unlikely to play a signi...
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Human Geography, Nephrology, Acute kidney injury, Medicine, Acute renal failure, and 15 moreHumans, Internal Medicine, Northern Ireland, Female, Renal failure, Male, Renal Function, Aged, Middle Aged, Adult, Public health systems and services research, Age Factors, Creatinine, Referral and consultation, and Referral
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Ophthalmology, Gastroenterology, Folic acid, Medicine, Biological Sciences, and 15 moreHumans, Internal Medicine, Female, Male, Polymerase Chain Reaction, Homocysteine, Aged, Genotype, Risk Factors, Retinal Vein Occlusion, Case Control Studies, DNA mutational analysis, hyperhomocysteinemia, Methylenetetrahydrofolate Reductase, and Medical and Health Sciences
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Medicine, Biological Sciences, Humans, Glaucoma, Female, and 15 moreMigraine, Male, Intraocular Pressure, Aged, Middle Aged, Nitric Oxide Synthase, Blood Flow, Allele, Allele Frequency, Normal Tension Glaucoma, Gene frequency, Endothelial nitric oxide synthase, Medical and Health Sciences, Migraine disorders, and Nitric oxide synthase type II
Background Cardiovascular disease (CVD) occurs more frequently in individuals with a family history of premature CVD. Within families the demographics of CVD are poorly described. Design We examined the risk estimation based on the... more
Background Cardiovascular disease (CVD) occurs more frequently in individuals with a family history of premature CVD. Within families the demographics of CVD are poorly described. Design We examined the risk estimation based on the Systematic Coronary Risk Evaluation (SCORE) system and the Joint British Guidelines (JBG) for older unaffected siblings of patients with premature CVD (onset ≤ 55 years for men and ≤ 60 years for women). Methods Between August 1999 and November 2003 laboratory and demographic details were collected on probands with early-onset CVD and their older unaffected siblings. Siblings were screened for clinically overt CVD by a standard questionnaire and 12-lead electrocardiogram (ECG). Results A total of 790 siblings was identified and full demographic details were available for 645. The following siblings were excluded: 41 with known diabetes mellitus; seven with random plasma glucose of 11.1 mmol/l or greater; and eight with ischaemic ECG. Data were analysed fo...
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Risk assessment, Cardiovascular disease, Medicine, Family history, Electrocardiography, and 15 moreHumans, Internal Medicine, Diabetes mellitus, Female, Disease, Male, Middle Aged, Questionnaires, Adult, Cardiovascular Diseases, Risk Factors, Risk Assessment, Asymptomatic, Predictive value of tests, and Cardiovascular medicine and haematology
Coronary heart disease (CHD) remains a leading cause of death across the world. A region on chromosome 9p21.3 has been recently reported to be associated with CHD. We evaluated 3 SNPs and 3 common haplotypes in the 9p21.3 region in 1494... more
Coronary heart disease (CHD) remains a leading cause of death across the world. A region on chromosome 9p21.3 has been recently reported to be associated with CHD. We evaluated 3 SNPs and 3 common haplotypes in the 9p21.3 region in 1494 individuals from 580 Irish families, where at least 1 member had early-onset (males ≤55yr, females ≤60yr) CHD. Genotypes were determined by multiplex SNaPshot technology. Using the combined TDT/S-TDT test, the 3 single nucleotide polymorphisms (SNP), rs10757274, rs2383206 and rs1333049, were strongly associated with early-onset CHD (p= 2.7 × 10-6, 2.7 × 10-6, 3.8 × 10-7, respectively). Analysis of haplotypes by the TRANSMIT program also showed that the GGC haplotype was associated with early-onset CHD (p= 7.9 × 10-7). In conclusion, using a family-based approach in the Irish population, we have confirmed previous reports of association between a region on chromosome 9p21.3 and early-onset CHD.
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Genetics, Molecular Biology, Biology, Clinical Biochemistry, Medicine, and 15 moreIreland, Humans, Female, Male, Medical Biochemistry, Medical Physiology, Risk factors, Middle Aged, Single Nucleotide Polymorphism, Risk Factors, Coronary Artery Disease, Age of Onset, Haplotype, Case Control Studies, and Genetic predisposition to disease
Matrix metalloproteinase-3 (MMP-3) has been proposed as an important mediator of the atherosclerotic process. The possible role of the functional -1612 5A/6A polymorphism of the MMP-3 gene in the susceptibility to ischaemic heart disease... more
Matrix metalloproteinase-3 (MMP-3) has been proposed as an important mediator of the atherosclerotic process. The possible role of the functional -1612 5A/6A polymorphism of the MMP-3 gene in the susceptibility to ischaemic heart disease (IHD) was investigated in a well-defined Irish population using two recently described family based tests of association. One thousand and twelve individuals from 386 families with at least one member prematurely affected with IHD were genotyped. Using the combined transmission disequilibrium test (TDT)/sib-TDT and the pedigree disequilibrium test (PDT), no association between the MMP-3 -1612 5A/6A polymorphism and IHD was found. Our data demonstrate that, in an Irish population, the MMP-3 -1612 5A/6A polymorphism is not associated with IHD.
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Genetics, Biology, Clinical Biochemistry, Medicine, Ireland, and 15 moreIschaemic heart disease, Humans, Female, Male, Medical Physiology, Middle Aged, Family Health, Genotype, Adult, Linkage Disequilibrium, Age of Onset, Matrix Metalloproteinase, Heart Diseases, alleles, and Genetic predisposition to disease
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Adolescent, Humans, Child, Internal Medicine, Diabetes mellitus, and 15 moreFemale, Male, Control Design, Diabetic Nephropathy, Clinical Sciences, Genotype, Adult, Calcium Binding Proteins, HES, Haplotype, Association Analysis, Differential expression, Jag, Diabetic nephropathies, and Genetic predisposition to disease
OBJECTIVE The aim if the study was to investigate whether children born to older mothers have an increased risk of type 1 diabetes by performing a pooled analysis of previous studies using individual patient data to adjust for recognized... more
OBJECTIVE The aim if the study was to investigate whether children born to older mothers have an increased risk of type 1 diabetes by performing a pooled analysis of previous studies using individual patient data to adjust for recognized confounders. RESEARCH DESIGN AND METHODS Relevant studies published before June 2009 were identified from MEDLINE, Web of Science, and EMBASE. Authors of studies were contacted and asked to provide individual patient data or conduct prespecified analyses. Risk estimates of type 1 diabetes by maternal age were calculated for each study, before and after adjustment for potential confounders. Meta-analysis techniques were used to derive combined odds ratios and to investigate heterogeneity among studies. RESULTS Data were available for 5 cohort and 25 case-control studies, including 14,724 cases of type 1 diabetes. Overall, there was, on average, a 5% (95% CI 2–9) increase in childhood type 1 diabetes odds per 5-year increase in maternal age (P = 0.006...
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Short interbirth interval has been associated with maternal complications and childhood autism and leukemia, possibly due to deficiencies in maternal micronutrients at conception or increased exposure to sibling infections. A possible... more
Short interbirth interval has been associated with maternal complications and childhood autism and leukemia, possibly due to deficiencies in maternal micronutrients at conception or increased exposure to sibling infections. A possible association between interbirth interval and subsequent risk of childhood type 1 diabetes has not been investigated. A secondary analysis of 14 published observational studies of perinatal risk factors for type 1 diabetes was conducted. Risk estimates of diabetes by category of interbirth interval were calculated for each study. Random effects models were used to calculate pooled odds ratios (ORs) and investigate heterogeneity between studies. Overall, 2,787 children with type 1 diabetes were included. There was a reduction in the risk of childhood type 1 diabetes in children born to mothers after interbirth intervals <3 years compared with longer interbirth intervals (OR 0.82 [95% CI 0.72–0.93]). Adjustments for various potential confounders little ...
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Genetics, Biology, Medicine, Humans, Northern Ireland, and 15 moreHaplotypes, Male, Risk factors, Age related macular degeneration, Clinical Sciences, Middle Aged, Coronary heart disease, Analysis of Variance, Linkage Disequilibrium, Genetic variation, Risk Factors, Complement Factor H, Genetic Markers, Age of Onset, and Haplotype
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Demography, Macular Degeneration, Longevity, Humans, Internal Medicine, and 15 moreMathematical Sciences, Female, Male, Cohort Study, American, Apolipoprotein E, Cohort, Age related macular degeneration, Aged, Genotype, DDC, Age Factors, European Continental Ancestry Group, Gene frequency, and Medical and Health Sciences
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Epidemiology, Atherosclerosis, Medicine, France, Humans, and 15 moreInternal Medicine, Northern Ireland, Male, Paraoxonase, Cohort, Clinical Sciences, Prime, Middle Aged, Risk Factor, Genotype, Myocardial Infarction, Prospective Study, Case Control Studies, Cardiovascular medicine and haematology, and Genetic predisposition to disease
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Aim of this study was to examine secular trends in the incidence of type 1 diabetes in children aged 0–14 years in Hungary over the period 1989–2009. Methods: Newly diagnosed children with type 1 diabetes aged 0–14 years in Hungary were... more
Aim of this study was to examine secular trends in the incidence of type 1 diabetes in children aged 0–14 years in Hungary over the period 1989–2009. Methods: Newly diagnosed children with type 1 diabetes aged 0–14 years in Hungary were prospectively registered from 1989 to 2009. Standardized incidence rates were calculated and secular trends were estimated using Poisson regression analysis. Results: Between 1989 and 2009 a total number of 3432 children were identified, giving a standardized incidence rate of 12.5 (95%CI 12.1–12.9) per 100 000 person/year. The overall incidence rate has doubled from 7.7 (95%CI 6.4–9.15) per 100 000 per year in 1989 to 18.2 (95%CI 15.7–20.9) per 100 000 per year in 2009. A significant linear trend in incidence (p<0.001) has been observed over time, with a mean annual increase of 4.4%. The increase in incidence was present in both genders and in all age groups, with the largest relative increase in the youngest age group (6.2%; p<0.001). Conclus...
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Demography, Incidence Geometry, Forecasting, Adolescent, Medicine, and 15 moreHumans, Child, Internal Medicine, Hungary, Female, Male, Poisson regression, Infant, Incidence, Likelihood Functions, Pediatric Diabetes, Age of Onset, Confidence Interval, Child preschool, and Paediatrics and reproductive medicine
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Background— Few studies have examined whether hemostatic markers contribute to risk of coronary disease and ischemic stroke independently of conventional risk factors. This study examines 11 hemostatic markers that reflect different... more
Background— Few studies have examined whether hemostatic markers contribute to risk of coronary disease and ischemic stroke independently of conventional risk factors. This study examines 11 hemostatic markers that reflect different aspects of the coagulation process to determine which have prognostic value after accounting for conventional risk factors. Methods and Results— A total of 2398 men aged 49 to 65 years were examined in 1984 to 1988, and the majority gave a fasting blood sample for assay of lipids and hemostatic markers. Men were followed up for a median of 13 years, and cardiovascular disease (CVD) events were recorded. There were 486 CVD events in total, 353 with prospective coronary disease and 133 with prospective ischemic stroke. On univariable analysis, fibrinogen, low activated protein C ratio, D-dimer, tissue plasminogen activator (tPA), and plasminogen activator inhibitor-1 (PAI-1) were associated significantly with risk of CVD. On multivariable analyses with con...
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Cardiology, Medicine, Fibrinogen, Humans, Internal Medicine, and 15 moreMale, Ischemic Stroke, Clinical Sciences, Aged, Great Britain, Middle Aged, Coronary heart disease, Hemostasis, Circulation, Biological markers, factor VIII, Plasminogen Activator Inhibitor, Plasminogen Activator, Myocardial Ischemia, and Cardiovascular medicine and haematology
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Atherosclerosis, Inflammation, Cardiovascular disease, Medicine, Cardiovascular Risk, and 15 moreFibrinogen, Humans, Internal Medicine, Male, Clinical Sciences, Great Britain, Middle Aged, C reactive protein, Blood Viscosity, Coronary heart disease, Biological markers, Ischaemic Stroke, Interleukin, Cardiovascular medicine and haematology, and leukocyte Count
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Cognitive Science, Epidemiology, Incidence Geometry, Medicine, Amyotrophic Lateral Sclerosis, and 15 moreMotor Neurone Disease, Population, Humans, Northern Ireland, Female, Male, Data Collection, Incidence, Clinical Sciences, Prevalence, Capture recapture, Cross Sectional Studies, Neurosciences, Cohort Studies, and Motor neuron disease
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Medicine, Family history, Humans, Northern Ireland, Blood Pressure, and 15 moreFemale, Alcohol Drinking, Male, Body Mass Index, Aged, Middle Aged, Parents, Adult, Public health systems and services research, Age Factors, Offspring, Adult Children, Case Control Studies, Medical History Taking, and mass Screening
After 20 years of data collection, pregnancy registers have informed prescribing practice. Various populations show trends for a reduction in valproate prescribing, which is associated with an increased risk of anatomical teratogenesis... more
After 20 years of data collection, pregnancy registers have informed prescribing practice. Various populations show trends for a reduction in valproate prescribing, which is associated with an increased risk of anatomical teratogenesis and neurodevelopmental effects in those exposed in utero. Our aim was to determine if any shifts in prescribing trends have occurred in the UK and Ireland Epilepsy and Pregnancy Register cohort and to assess if there had been any change in the overall major congenital malformation (MCM) rate over time. The UK and Ireland Epilepsy and Pregnancy Register, a prospective, observational, registration and follow-up study established in 1996, was used to determine the changes in antiepileptic drugs (AEDs) utilised during pregnancy and the MCM rate between 1996 and 2016. Linear regression analysis was used to assess changes in AED utilisation, and Poisson regression was used for the analysis of trends in the MCM rates. Outcome data for 9247 pregnancies showed...
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Health Behavior, Focus Groups, Medicine, Motivation, Cities, and 15 moreHumans, Northern Ireland, Intervention, Female, Male, Exercise, cluster RCT, Cost effectiveness, Adult, Cost Benefit Analysis, Economic evaluation, Financial Incentives, Mediation Analyses, Behavioural Economics, and Interviews as topic
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Vitamin D deficiency is a common occurrence globally, and particularly so in pregnancy. There is conflicting evidence regarding the role of vitamin D during pregnancy in non-skeletal health outcomes for both the mother and the neonate.... more
Vitamin D deficiency is a common occurrence globally, and particularly so in pregnancy. There is conflicting evidence regarding the role of vitamin D during pregnancy in non-skeletal health outcomes for both the mother and the neonate. The aim of this study was to investigate the associations of maternal total 25-hydroxy vitamin D (25OHD) with neonatal anthropometrics and markers of neonatal glycaemia in the Belfast centre of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. Serological samples (n 1585) were obtained from pregnant women in the Royal Jubilee Maternity Hospital, Belfast, Northern Ireland, between 24 and 32 weeks' gestation as part of the HAPO study. 25OHD concentrations were measured by liquid chromatography tandem-MS. Cord blood and neonatal anthropometric measurements were obtained within 72 h of birth. Statistical analysis was performed. After adjustment for confounders, birth weight standard deviation scores (SDS) and birth length SDS were signific...
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Treatment of severe asthma may include high dose systemic-corticosteroid therapy which is associated with substantial comorbidity. There is evidence to suggest that this burden is not evenly distributed across age, gender and... more
Treatment of severe asthma may include high dose systemic-corticosteroid therapy which is associated with substantial comorbidity. There is evidence to suggest that this burden is not evenly distributed across age, gender and corticosteroid exposure levels. Examine the associations between age, gender, comorbidity, and patterns of healthcare cost across groups differentiated by corticosteroid exposure. Patients with severe asthma (n=808) were matched by age and gender to patients with mild/moderate asthma (n=3,975) and non-asthma control subjects (n=2,412) from the Optimum Patient Care Research Database (OPCRD). Regression analysis was used to investigate the odds of a number of corticosteroid-induced comorbidities as it varied by cohort, age-group, and gender. Prescribed drugs and publicly funded healthcare activity were monetised and annual costs per patient estimated. Patients aged 60 years or less with high oral corticosteroid (OCS) exposure had greater odds of osteopenia, osteo...
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To examine the association between fatty acid binding protein 4 (FABP4) and pre-eclampsia risk in women with type 1 diabetes. Serum FABP4 was measured in 710 women from the Diabetes and Pre-eclampsia Intervention Trial (DAPIT) in early... more
To examine the association between fatty acid binding protein 4 (FABP4) and pre-eclampsia risk in women with type 1 diabetes. Serum FABP4 was measured in 710 women from the Diabetes and Pre-eclampsia Intervention Trial (DAPIT) in early pregnancy and in the second trimester (median 14 and 26 weeks' gestation, respectively). FABP4 was significantly elevated in early pregnancy (geometric mean 15.8 ng/mL [interquartile range 11.6-21.4] vs. 12.7 ng/mL [interquartile range 9.6-17]; P < 0.001) and the second trimester (18.8 ng/mL [interquartile range 13.6-25.8] vs. 14.6 ng/mL [interquartile range 10.8-19.7]; P < 0.001) in women in whom pre-eclampsia later developed. Elevated second-trimester FABP4 level was independently associated with pre-eclampsia (odds ratio 2.87 [95% CI 1.24-6.68], P = 0.03). The addition of FABP4 to established risk factors significantly improved net reclassification improvement at both time points and integrated discrimination improvement in the second tri...
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Endocrinology, Medicine, Pregnancy, Humans, Internal Medicine, and 12 moreFemale, Body Mass Index, Risk factors, Risk Factors, Type 2 Diabetes Mellitus, Genetic Markers, Logistic Models, Diabetes Care, Pre Eclampsia, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, and Medical and Health Sciences
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Genetics, Cognitive Science, Australia, Medicine, Birth Weight, and 15 moreHumans, Europe, Blood Pressure, Female, Male, Obstetrics and Gynaecology, Heritability, Lipid metabolism, Risk factors, Registries, Clinical Sciences, Coronary heart disease, Risk Factors, Environment, and Paediatrics and reproductive medicine
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Type 2 Diabetes, Medicine, Humans, Child, Vaccination, and 10 moreRisk factors, Meta Analysis, Clinical Sciences, Public health systems and services research, Pertussis Vaccine, Risk Factors, Type 2 Diabetes Mellitus, Hepatitis B Vaccines, Paediatrics and reproductive medicine, and Influenza vaccines
Gestational diabetes mellitus (GDM) is associated with a sevenfold increased lifetime risk of type 2 diabetes. Excessive gestational weight gain and postpartum weight retention are established predictors of long-term obesity. To determine... more
Gestational diabetes mellitus (GDM) is associated with a sevenfold increased lifetime risk of type 2 diabetes. Excessive gestational weight gain and postpartum weight retention are established predictors of long-term obesity. To determine the impact of a postnatal lifestyle intervention program for overweight women with previous gestational diabetes mellitus (PAIGE). Postnatal overweight women with previous GDM participated in a multicenter randomized controlled trial between June 2013 and December 2014. The intervention comprised a 1-hour educational program, a free 3-month referral to a commercial weight management organization (Slimming World), a pedometer, and structured telephone and text support, in addition to usual care. The control group received usual care only. The primary outcome was weight loss at 6 months. Sixty women were randomized (29 intervention; 31 control) in two centers based on their week of attendance. The intervention group demonstrated significant weight lo...