Early life influences on adult organ function, health, and diseases risk in four Swedish Cohorts

Early life programming is associated with the onset and prognosis of non-communicable diseases in adulthood, such as cardiovascular disease, hypertension, obesity, and type 2 diabetes, but also breast cancer, prostatic cancer, etc. Sweden has many carefully sampled population-based cohorts and a variety of high-quality national registries on morbidity and mortality, active for decades. The aim of our project is to elucidate on the influence of birth parameters such as birth weight, birth length, gestational age, and head circumference, on adult cardiovascular functions, cardio-metabolic traits and cancer, based on data from four population-based cohorts.
The four databases include Malmö Birth Data Cohort (MBDC), Malmö Offspring Study (MOS), LifeGene Study, and the Helsingborg Birth Cohort (HbgBC). In total, there are 9340, 1401, 22000, and 4982 individuals in MBDC, MOS, LifeGene Study, and HbgBC, respectively. The MBDC cohort consists of individuals from two nested case-control studies, namely the Malmö Preventive Project and Malmö Diet Cancer Study. The birth cohorts in MBDC and Helsingborg [1] are older than the other two cohorts (LifeGene and MOS). The exposures in our study include a variety of birth parameters (maternal as well as offspring). The first set of outcomes of interest are adult vascular functions, which include arterial stiffness [2], reactive hyperaemia, intima-media thickness of carotid walls, atherosclerotic carotid plaques. The second set of outcomes of interests are adult cardio-metabolic traits, which include fasting blood glucose, systolic and diastolic pressure, and serum lipids (total cholesterol, Low-Density Lipoprotein Cholesterol, and triglycerides), but advanced glycation end (AGE) products, as measured through skin autofluorescence. The third set of outcomes of interest include risks and prognosis of any cancer, prostate, and breast cancers. Finally, risk prediction of cardio-metabolic clinical events will be carried out, based on data from national, regional and local registers.
We use multiple tests of significance, including t-test, chi-square test, Pearson correlation test, linear regression, logistic regression, and cox-proportional hazard regression, etc. Statistical analyses have been performed using IBM SPPS statistics for windows version 24.0 (IBM Corp., Armonk, N.Y., USA). Preliminary analyses of the associations between birth parameters and cancer risks, cancer prognosis, and cardio-metabolic traits have been done within my PhD project. These preliminary analyses have been presented at regional and international-level conferences.
We have recently published a paper, entitled ‘Birth size and cancer prognosis: A systematic review and meta-analysis’ based on the data from eleven studies [3]. Besides, I have been working closely with other colleagues on investigating the associations of birth parameters with adult lung functions (forced expiratory volumes and forced vital capacity), kidney function (blood urea and serum creatinine), gastrointestinal disorder (irritable bowel syndrome) and cognitive function.
References:
1. Nilsson PM, Hofvendahl S, Hofvendahl E, Brandt L, Ekbom A. Smoking in pregnancy in relation to gender and adult mortality .lrisk in offspring: the Helsingborg Birth Cohort Study. Scand J Public Health. 2006;34(6):660-4.
2. Sperling J, Nilsson PM. Does early life programming influence arterial stiffness and central hemodynamics in adulthood? J Hypertens. 2019 Oct 16. doi: 10.1097/HJH.0000000000002292. [Epub ahead of print]
3. Sharma S, Kohli C, Johnson L, Bennet L, Brusselaers N, Nilsson PM. Birth size and cancer prognosis: a systematic review and meta-analysis. J Dev Orig Health Dis. 2019 Oct 24:1-8. doi: 10.1017/S2040174419000631. [Epub ahead of print]