Cardiometabolic

The Cardiometabolic Special Interest Group focuses on examining relationships between an individual’s clinical, biochemical, and anthropometric characteristics, lifestyle factors and habits, family, environment and mental health, and long-term risk of overweight and obesity, premature diabetes, heart disease, liver and gastrointestinal health. The group has collected a wealth of clinical data from physical examination (e.g. blood pressure, heart rate, blood vessel function, liver ultrasound and liver transient elastography), blood tests (e.g. serum lipids including cholesterol and triglycerides, fasting glucose, insulin, liver and kidney biochemistry, adipokines and cytokines), full blood count, urine analysis, and faecal specimens for gut microbiome analysis and DNA and epigenetic markers. Other data include questionnaires (e.g. diet, exercise, smoking, alcohol consumption, bowel patterns and gastrointestinal symptoms), anthropometry (e.g. weight, height, skin fold thickness and waist circumference). A lot of the data has been collected across different ages and generations of the Raine Study.

It comprises a group of researchers with multidisciplinary interests including diabetes, cardiac and liver disease risk, overweight and obesity, and gastrointestinal health. The main interests of this group include pregnancy, childhood and adolescent risk factors for common health problems and disorders such as diabetes, cardiac disease, fatty liver, irritable bowel syndrome and obesity and genetic and environmental or lifestyle interactions.

 

SIG Leaders:

Prof Trevor Mori, The University of Western Australia

Dr Koya Ayonrinde, The University of Western Australia

 

Key findings over the last 30 years have included:

Using information collected from two generations of Raine Study participants (Gen1 and Gen2), researchers have shown that exposures at different stages of life affect subsequent health outcomes. For example:

  • Mothers’ exposure to stress during pregnancy predicts higher body weight, but lower blood pressure in offspring at early adulthood.
  • Adolescent children of mothers who smoke during pregnancy are more likely to show symptoms of depression or anxiety than children of nonsmoking mothers
  • A mother’s obesity at the start of pregnancy or excessive weight gain during pregnancy is associated with development of nonalcoholic fatty liver disease and increased cardiometabolic risk in offspring during adolescence and young adulthood.
  • Infants who breastfeed for less than six months before starting infant formula milk were more likely to have non-alcoholic fatty liver disease in adolescence, whereas breastfeeding for at least six months was associated with a reduced risk for this disease in adolescence.
  • Trajectories of fatness from birth to adolescence separate those at particularly high risk of diabetes and heart and vessels disease by the age of 3
  • By 14 years of age nearly 30% of adolescents have a high risk of a group of metabolic abnormalities predicting future risk of diabetes and heart disease. Measures of the body’s stress response system and vitamin D levels are associated with a range of factors related to risk of developing heart and blood vessel disease in adolescents.
  • A “Western” dietary pattern with excessive fats and sugar is associated with non-alcoholic fatty liver disease and increased cardiometabolic risk in adolescence.
  • Adolescents with polycystic ovary syndrome plus non-alcoholic fatty liver disease had worse cardiometabolic risk than other adolescents.

 

Maternal exposure to life stresses during pregnancy and in particular life stress related to financial problems is associated with lower blood pressure and a lower risk for the development of (pre)high blood pressure in offspring at 20 years.

Bhat SK, Beilin LJ, Robinson M, Burrows S, Mori TA. Contrasting effects of prenatal life stress on blood pressure and body mass index in young adults. Journal of Hypertension. 2015;33:711–19. doi: 10.1097/HJH.0000000000000476.

 

Daughters of women who were obese at the start of pregnancy or gained excess weight during the first half of pregnancy were at higher risk of non-alcoholic fatty liver disease than sons. This was apparent independent of obesity in the adolescent.

Ayonrinde OT, Adams LA, Mori TA, Beilin LJ, de Klerk N, Pennell CE, White S, Olynyk JK. Sex differences between parental pregnancy characteristics and non-alcoholic fatty liver disease in adolescents. Hepatology. 2018;67:108-22. doi: 10.1002/hep.29347.

 

Breastfeeding for at least six months prior to commencing infant formula milk is associated with reduced risk of non-alcoholic fatty liver disease in adolescents.

Ayonrinde OT, Oddy WH, Adams LA, Mori TA, Beilin LJ, de Klerk N, Olynyk JK.  Infant nutrition and maternal obesity prospectively influence the risk of non-alcoholic fatty liver disease in adolescents. Journal of Hepatology. 2017;67(3):568-576. doi: 10.1016/j.jhep.2017.03.029.

 

Risk for non-alcoholic fatty liver disease during adolescence is identifiable from trajectories of weight and body mass index (a measure of body fat) from age three years onwards.

Ayonrinde OT, Olynyk JK, Marsh JA, Beilin LJ, Mori TA, Oddy WH, Adams LA. Childhood adiposity trajectories and risk of non-alcoholic fatty liver disease in adolescents. Journal of Gastroenterology and Hepatology. 2015;30(1):163-171. doi: 10.1111/jgh.12666.

 

A positive association between handgrip strength and back muscle endurance with systolic blood pressure throughout childhood and adolescence contrasts with the beneficial effects on other related traditional cardiometabolic risk factors.

Demmer DL, Beilin LJ, Hands B, Burrows S, Cox K, Straker L, Mori TA. Effects of muscle strength and endurance on blood pressure and related cardio-metabolic risk factors from childhood to adolescence. Journal of Hypertension. 2016,34:2365-75. doi: 10.1097/HJH.0000000000001116.

 

In adolescents, measures of the body’s stress response system under resting conditions are associated with a range of factors, which point to an adverse risk of developing heart and vessels disease.

Le-Ha C, Herbison CE, Beilin LJ, Burrows S, Henley DE, Lye SJ; Matthews SG, Pennell CE, Mori TA. Hypothalamic-pituitary-adrenal axis activity under resting conditions and cardiovascular risk factors in adolescents. Psychoneuroendocrinology. 2016;66:118-24. doi: 10.1016/j.psyneuen.2016.01.002.

 

Most adolescents do not experience once a day bowel motions, though passage of stool that is not too hard and not too soft between once and three times per day was most common. Adolescents with gastrointestinal symptoms such as abdominal pain, bloating, nausea or constipation suffer more depression, anxiety and reduced quality of life than those without these symptoms.

Ayonrinde OT, Sanfilippo FM, O’Sullivan TA, Adams LA, Ayonrinde OA, Robinson M, Oddy WH, Olynyk JK. Bowel patterns, gastrointestinal symptoms and emotional well-being in adolescents – A cohort study. Journal of Gastroenterology and Hepatology. 2019. doi: 10.1111/jgh.14699. [Epub ahead of print]

 

Nonalcoholic fatty liver disease (NAFLD) affects 13% of adolescents in Perth and is associated with similar risk factors as NAFLD in adults. Adolescents with NAFLD had more body fatness, higher blood pressure, lipid abnormalities and insulin resistance than adolescents without NAFLD.

Ayonrinde OT, Olynyk JK, Beilin LJ, Mori TA, Pennell CE, de Klerk N, Oddy WH, Shipman P, Adams LA. Gender-specific differences in adipose distribution and adipocytokines influence adolescent nonalcoholic fatty liver disease. Hepatology. 2011;53(3):800-809. doi: 10.1002/hep.24097.

 

Vitamin D concentrations are inversely associated with body fat and insulin resistance in adolescents and young adults, suggesting a cardio-protective benefit.

Black, L. J.; Burrows, S.; Lucas, R. M.; Marshall, C. E.; Huang, R. C.; Chan She Ping-Delfos, W.; Beilin, L. J.; Holt, P. G.; Hart, P. H.; Oddy, W. H.; Mori, T. A. Serum 25-hydroxyvitamin D concentrations and cardiometabolic risk factors in adolescents and young adults. British Journal of Nutrition. 2016;115(11): 1994-2002. doi: 10.1017/S0007114516001185.

 

Working longer than 38hrs per week was associated with poor cardiometabolic health including increased waist circumference, higher fasting blood glucose and reduced HDL-cholesterol.

Reynolds AC, Bucks RS, Paterson JL, Ferguson SA, Mori TA, McArdle N, Straker L, Beilin LJ, Eastwood PR. Working (longer than) 9 to 5: are there cardiometabolic health risks for young Australian workers who report longer than 38-h working weeks? International Archives of Occupational and Environmental Health. 2018;91(4):403-12. doi: 10.1007/s00420-018-1289-4.

 

Studies of heritable changes in genes have identified DNA methylation (an alteration of DNA as a consequence of aging processes, environmental influences and lifestyle factors) related to being overweight or obese in young adulthood.

Huang RC, Galati JC, Burrows S et al. DNA Methylation of the IGF2/H19 Imprinting Control Region and Adiposity Distribution in Young Adults. Clinical Epigenetics. 2012;4(1):21. doi: 10.1186/1868-7083-4-21.

“Thanks to the Raine Study we have shown how maternal influences during pregnancy, as well as lifestyle, familial and socioeconomic factors, impact cardiovascular risk factors and the developmental health of the offspring from infancy through to adulthood.”

Professor Trevor A Mori, University of Western Australia

Explore Research