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Biomedical subjects

Han C G Kemper

Publications and source records attributed to Han C G Kemper.

At least 19 recordsLinked to original sources

Functioning description according to the icf model in chronic back pain: disablement appears even more complex with decreasing symptom-specificity.

OBJECTIVE: To determine the significance of degree of symptom-specificity in the disablement condition in chronic back pain. DESIGN: Cross-sectional design. SUBJECTS: All inhabitants of a restricted geographical area of Norway, who had had 8 weeks of sick-leave due to back pain during a 2-year period, were included in this study. Following examination they were diagnosed as having "specific back pain" (n=34), "non-specific back pain" (n=113) or "widespread pain" (n=49). METHODS: Functioning of the 3 diagnostic subgroups was described and compared. Functioning assessment was guided by the concepts of the International Classification of Functioning, Disability and Health (ICF): health condition, body function and structure, activity, participation and contextual factors. RESULTS: Pain components and final participation restriction did not differ among the diagnostic subgroups. However, with increasing symptom-specificity, loss of physical body functions and structures and subsequent activity limitation tended to increase. On the other hand, with decreasing symptom-specificity, mental distress, unfavourable contextual factors and dissatisfaction with various factors of life tend to increase, which may raise the impact of pain on restricting participation in activities. CONCLUSION: Functioning description according to the components of the ICF model indicated that the disablement condition in patients with back pain who had been on sick-leave for 8 weeks may appear more complex with decreasing symptom-specificity.

Adolescent↗

Association between an IGF-I gene polymorphism and body fatness: differences between generations.

OBJECTIVE: A polymorphism near the promoter region of the IGF-I gene has been associated with serum IGF-I levels, body height and birth weight. In this study, we investigated whether this polymorphism is associated with body composition in young healthy subjects in two cohorts of different generations. DESIGN: Observational study with repeated measurements. METHODS: The study group consisted of two comparable young Dutch cohorts with a generational difference of around 20 years. The older cohort consisted of 359 subjects born between 1961 and 1965. Measurements were performed from 13 until 36 years of age. The younger cohort consisted of 258 subjects born between 1981 and 1989. Measurements were performed from 8 until 14 years of age. Height, body mass index (BMI), fat mass, fat-free mass, waist and hip circumference were compared between wild-type carriers and variant type carriers of the IGF-I polymorphism. RESULTS: In the younger cohort, body weight, BMI, fat mass and waist circumference were significantly higher in female variant carriers of the IGF-I polymorphism. A similar trend was observed in male variant carriers. In contrast, these differences were not observed in the older cohort. Irrespective of genotype, the younger cohort showed a significantly higher total fat mass, body weight and BMI compared with the older cohort. CONCLUSIONS: Because the differences between both genotypes were small, it seems likely that the genetic variability due to this IGF-I polymorphism impacts only slightly on body composition. Importantly, our study suggested that associations between this IGF-I promoter polymorphism and body composition possibly reflect a gene-environmental interaction of this polymorphism and that an environment that promotes obesity leads to a slightly more pronounced fat accumulation in variant carriers of this IGF-I polymorphism.

Adolescent↗

A birth-weight questionnaire indicated that life style modifies the birth weight and metabolic syndrome relationship at age 36.

OBJECTIVE: Investigating the relationship between birth weight and the metabolic syndrome and the modifying effects of lifestyle in adults (36.5 years). STUDY DESIGN AND SETTING: 273 subjects completed a birth-weight questionnaire; waist circumference, HDL and triglyceride concentrations, blood pressure and HbA1c, physical activity and fitness, smoking status and dietary intake were measured. Risks for the metabolic syndrome and for having at least two of the components of the metabolic syndrome were calculated and the modifying effect of lifestyle factors was assessed by comparing four groups based on birth weight and a lifestyle factor. RESULTS: Birth weight was not associated with the metabolic syndrome (odds ratio OR = 0.67, 95% confidence interval CI = 0.25-1.79). Birth weight lower than the median increased the risk for having at least two components (OR = 2.28, 95% CI = 1.15-4.50). Subjects who smoked and had a birth weight lower than the median had a 6.9 times increased risk. Modification by lifestyle measured at age 36 was not observed, although effect modification using lifestyle data from 32 years was found. CONCLUSIONS: Lower birth weight increased the risk for having at least two components of the metabolic syndrome. Smoking, being less physical active or fit, have an unfavorable diet at age 32 adds to this risk.

Adult↗

An IGF-I promoter polymorphism modifies the relationships between birth weight and risk factors for cardiovascular disease and diabetes at age 36.

OBJECTIVE: To investigate whether IGF-I promoter polymorphism was associated with birth weight and risk factors for cardiovascular disease (CVD) and type 2 diabetes (T2DM), and whether the birth weight--risk factor relationship was the same for each genotype. DESIGN AND PARTICIPANTS: 264 subjects (mean age 36 years) had data available on birth weight, IGF-I promoter polymorphism genotype, CVD and T2DM risk factors. Student's t-test and regression analyses were applied to analyse differences in birth weight and differences in the birth weight--risk factors relationship between the genotypes. RESULTS: Male variant carriers (VCs) of the IGF-I promoter polymorphism had a 0.2 kg lower birth weight than men with the wild type allele (p = 0.009). Of the risk factors for CVD and T2DM, solely LDL concentration was associated with the genotype for the polymorphism. Most birth weight--risk factor relationships were stronger in the VC subjects; among others the birth weight--systolic blood pressure relationship: 1 kg lower birth weight was related to an 8.0 mmHg higher systolic blood pressure CONCLUSION: The polymorphism in the promoter region of the IGF-I gene is related to birth weight in men only, and to LDL concentration only. Furthermore, the genotype for this polymorphism modified the relationships between birth weight and the risk factors, especially for systolic and diastolic blood pressure.

Journal Article↗

The metabolic syndrome, cardiopulmonary fitness, and subcutaneous trunk fat as independent determinants of arterial stiffness: the Amsterdam Growth and Health Longitudinal Study.

BACKGROUND: The mechanisms that link the metabolic syndrome to increased cardiovascular risk are incompletely understood, especially in young people. We therefore examined whether the metabolic syndrome was associated with arterial stiffness and whether any such associations were independent of cardiopulmonary fitness and subcutaneous trunk fat. METHODS: Cross-sectional analyses of data on 364 men and women aged 36 years from the Amsterdam Growth and Health Longitudinal Study (ninth follow-up measurement, year 2000). The prevalence of the metabolic syndrome was defined by a slightly modified National Cholesterol Education Program (NCEP) definition. Arterial stiffness was ultrasonically estimated by distensibility and compliance of the carotid, femoral, and brachial arteries and by the carotid elastic modulus. RESULTS: The prevalence of the metabolic syndrome in this young adult population was 18.3% in men and 3.2% in women. Individuals with the syndrome compared with individuals without risk factors had 11.2% and 17.0% less distensibility and 9.0% and 18.2% less compliance of the carotid and femoral arteries, respectively, and 15.9% higher carotid elastic modulus. After adjustment for cardiopulmonary fitness and subcutaneous trunk fat, the metabolic syndrome remained significantly associated with stiffness of the carotid but not the femoral artery. In addition, poor cardiopulmonary fitness and high subcutaneous trunk fat were associated with arterial stiffness, and this was independent of the metabolic syndrome. CONCLUSIONS: A modified NCEP definition of the metabolic syndrome identified young individuals with increased arterial stiffness. The mechanisms that link the metabolic syndrome, poor cardiopulmonary fitness, and high subcutaneous trunk fat to greater arterial stiffness overlap but are partly independent of each other.

Adolescent↗

Development of fatness, fitness, and lifestyle from adolescence to the age of 36 years: determinants of the metabolic syndrome in young adults: the amsterdam growth and health longitudinal study.

BACKGROUND: Among young adults, the metabolic syndrome is an increasingly frequent risk factor for cardiovascular disease. Its determinants are, however, incompletely understood. We investigated the time course, from adolescence (age, 13 years) to young adulthood (age, 36 years), of important potential determinants (body fatness and fat distribution, cardiopulmonary fitness, and lifestyle) in 364 individuals (189 women). METHODS: Data were derived from the Amsterdam Growth and Health Longitudinal Study and analyzed with the use of generalized estimating equations. RESULTS: The prevalence of the metabolic syndrome at the age of 36 years, as identified with a modified National Cholesterol Education Program definition of the syndrome, was 10.4%. Subjects with the metabolic syndrome at the age of 36 years, compared with those without the syndrome, had (from adolescence to the age of 36 years) the following: (1) a more marked increase in total body fatness and in subcutaneous trunk fat; (2) a more marked decrease in cardiopulmonary fitness levels; (3) a more marked increase in physical activities of light-to-moderate intensity, but a more marked decrease in hard physical activities; (4) a trend toward a higher energy intake throughout the years; and (5) a decreased likelihood of drinking alcoholic beverages. CONCLUSIONS: Fatness, fitness, and lifestyle are important determinants of the metabolic syndrome in young adults. More important, these associations were independent of each other and, therefore, represent separate potential targets for the prevention of the metabolic syndrome. Our study further suggests that intervening early in life (eg, in the period of transition from adolescence to adulthood) may be a fruitful area for prevention of the metabolic syndrome.

Adipose Tissue↗

In a prospective study in young people, associations between changes in smoking behavior and risk factors for cardiovascular disease were complex.

OBJECTIVE: This study investigates how voluntary changes in tobacco consumption are related to changes in biological risk factors for cardiovascular disease in 21- to 36-year-old men and women. STUDY DESIGN AND SETTING: Data of the Amsterdam Growth and Health Longitudinal Study (AGAHLS) were used to study the association between voluntary changes in tobacco consumption and changes in biological risk factors for cardiovascular disease (CVD) during 4-6 years of follow-up in 165 men and 195 women aged 21-36 years. We used multiple linear regression analyses with corrections for age and changes in other lifestyles. RESULTS: In both sexes, we found trends for a reduction in blood pressure, high-density lipoprotein cholesterol (HDL-C), body weight, and waist-to-hip ratio (WHR) and a rise in the ratio between total serum cholesterol (TC) and HDL-C (TC/HDL-C) with increasing tobacco consumption. Opposite trends were found with reducing tobacco consumption. In women, body weight, WHR, and waist circumference reduced significantly and independently with increasing tobacco consumption and increased significantly with decreasing tobacco consumption. CONCLUSION: These results suggest that voluntary changes in tobacco consumption go together with both healthy and unhealthy changes in biological risk factors for CVD.

Adult↗

Smoking and quantitative ultrasound parameters in the calcaneus in 36-year-old men and women.

Little is known regarding the association between smoking and quantitative ultrasound (QUS) parameters. Broadband ultrasound attenuation (BUA) and speed of sound (SOS) are believed to provide information on bone quality besides information on bone mineral density (BMD). The aim of this study was to investigate (1) current tobacco smoking; (2) lifetime tobacco smoking; and (3) years since smoking cessation, in relation to QUS and BMD parameters in 36-year-old men and women. Data came from the ninth measurement of the Amsterdam Growth and Health Longitudinal Study (AGAHLS), in which 165 men (36 smokers and 129 nonsmokers) and 178 women (33 smokers and 145 nonsmokers) participated, with an average age of 36 years (SD = 0.7). BUA (dB/MHz) and SOS (m/s) of the calcaneus were assessed by using the CUBA Clinical instrument. BMD of the lumbar spine (L1-L4), total hip, and total body were measured with dual-energy X-ray absorptiometry (DXA). We used multiple linear regression analyses with correction for body weight, physical activity, calcium intake, and alcohol consumption. We found no significant associations between smoking and any of the BMD parameters in 36-year-old men and women. However, both current and lifetime tobacco smoking were significantly and negatively associated with BUA in women but not in men. Lifetime tobacco smoking was significantly and negatively associated with SOS in both sexes. The latter association was independent of body weight, calcium intake, physical activity, and alcohol consumption in women, but not in men. Our results suggest that both current and lifetime tobacco smoking are associated with a deterioration in bone quality but not with a reduction in BMD. However, since BMD parameters and QUS parameters were not measured at the same sites, our results may also simply suggest that the calcaneus is affected by smoking at an earlier stage than the lumbar spine, hip, and total body.

Adult↗

Comparison of short questionnaires on alcohol drinking behavior in a nonclinical population of 36-year-old men and women.

Little is known on the diagnostic characteristics of brief questionnaires on alcohol drinking behaviors. This report investigates the determinants of three short alcohol questionnaires and investigates their diagnostic utility as screening tools for alcohol-related problems in a general population from The Netherlands. This report uses cross-sectional data obtained in the year 2000 from 36-year-old healthy male (N=166) and female (N=165) volunteers who reported to drink alcohol at least occasionally. Since they were 13-years-old these volunteers have been members of the Amsterdam Growth And Health Longitudinal Study, which started as a school-based study in 1977. Among many other variables, quantity-frequency questions (QF), the CAGE questionnaire, and a question on the highest number of alcoholic units consumed on one occasion during the previous month (MAX) were asked. The sensitivity, specificity, Cohen's kappa, and diagnostic odds ratio of QF, CAGE, MAX, and combinations of these three brief questionnaires were calculated using a 7-item questionnaire on alcohol-related problems as reference. Both in women and men, the prevalence of most alcohol-related problems and of a high QF, CAGE, and MAX was low. QF, CAGE, and MAX, as well as all possible combinations of the three questionnaires, were poor in detecting last-year alcohol-related problems. The CAGE appeared to perform worse than the even shorter and easier-to-interpret QF and MAX. In this healthy population of 36-year-old men and women, using the QF, MAX, and especially the CAGE questionnaire as screening instruments for alcohol-related problems resulted in many false positive and false negative classifications.

Adult↗

Birthweight and arterial stiffness and blood pressure in adulthood--results from the Amsterdam Growth and Health Longitudinal Study.

BACKGROUND: The association between low birthweight and increased blood pressure in later life has repeatedly been confirmed. Increased arterial stiffness may be an underlying mechanism for this phenomenon. This study investigated whether birthweight was related to blood pressure and local and regional arterial stiffness. METHODS: In 281 subjects (161 women), with a mean age of 36, blood pressure was measured. The diameter, distension, and local pulse pressure of three large arteries were measured simultaneously using ultrasound imaging. Local and regional arterial compliance and distensibility were calculated. Information on birthweight was retrieved with a questionnaire. RESULTS: Linear regression analyses showed a 3.3 mmHg lower systolic blood pressure (SBP) and a 1.8 mmHg lower diastolic blood pressure (DBP), per 1kg higher birthweight. These associations were statistically significant after adjustment for adult weight. Birthweight was significantly and positively related to carotid arterial compliance (P = 0.050), but less so to brachial (P = 0.114) and femoral arterial compliance (P = 0.058). However, after adjustment for adult height, the strength of these associations decreased. Birthweight was not related to arterial distensibility. The association between birthweight and arterial compliance could only partly explain the association between birthweight and blood pressure. CONCLUSIONS: Lower birthweight is related to increased blood pressure, and increased arterial stiffness. However, the latter relationship can only partly explain the association between birthweight and blood pressure. Therefore, mechanisms other than arterial stiffness contribute to the birthweight-blood pressure relationship.

Adult↗

Current and adolescent body fatness and fat distribution: relationships with carotid intima-media thickness and large artery stiffness at the age of 36 years.

OBJECTIVE: Body fat and its distribution are determinants of cardiovascular disease but the underlying mechanisms of these adverse effects are poorly understood. We therefore investigated (1) the cross-sectional relationship between estimates of body fatness and its distribution on the one hand and carotid atherosclerosis and stiffness of the carotid, femoral and brachial arteries and the carotido-femoral segment on the other (336 subjects, 175 women); (2) the relationship between estimates of body fatness and its distribution during adolescence (13-16 years) and the same arterial properties at age 36- prospective analyses (subpopulation of 159 subjects, 84 girls). DESIGN: Cross-sectional and prospective analyses within an ongoing observational longitudinal study: The Amsterdam Growth and Health Longitudinal Study. METHODS: Body fatness and its distribution were assessed by anthropometry and dual-energy X-ray absorptiometry (DXA); arterial properties were assessed non-invasively by ultrasound imaging. RESULTS: Total adiposity and, in men, truncal subcutaneous fat accumulation during adolescence, were positively and independently associated with carotid intima-media thickness at age 36, a pre-clinical indicator of atherosclerosis. Adolescent truncal subcutaneous fat accumulation but not total adiposity was associated with increased arterial stiffness at age 36. At age 36, both abdominal and truncal subcutaneous fat were independently associated with arterial stiffness, while the associations between total adiposity and arterial stiffness appeared to be mediated by other cardiovascular risk factors. CONCLUSIONS: Body fatness and body fat distribution are associated with large artery structural and functional properties at age 36 and the roots of these associations may already be present in adolescence.

Adipose Tissue↗

Comparison between self-report and a dipstick method (NicCheck 1) to assess nicotine intake.

The purpose of this study was to investigate the agreement between self-reported tobacco consumption and NicCheck 1 (Dynagen Inc. Cambridge, Mass., USA) regarding smoking status and nicotine intake in a population of smokers (20.8%) and non-smokers. NicCheck 1 is a dipstick that changes colour in the presence of urinary nicotine metabolites. Smoking was assessed by self-report and NicCheck 1 in 169 males and 191 females (mean age 36.0 SD 0.7). Self-report and NicCheck 1 agreed highly on smoking status, especially in moderate to heavy smokers. With regard to nicotine intake, there was a large overlap in self-reported tobacco consumption between NicCheck 1 levels, despite a relatively high correlation coefficient between self-report and NicCheck 1 in smokers (i.e. 0.74). No effect modification by gender or BMI was found. When both methods were validated against two blood lipid parameters, self-report seemed to do equally well as NicCheck 1 in assessing nicotine intake.

Adult↗

The ER22/23EK polymorphism in the glucocorticoid receptor gene is associated with a beneficial body composition and muscle strength in young adults.

Glucocorticoids play an important role in determining body composition. A polymorphism of the glucocorticoid receptor gene (in codons 22 and 23) has previously been found to be associated with relative glucocorticoid resistance, low cholesterol levels, and increased insulin sensitivity. In this study, we investigated whether this ER22/23EK polymorphism is associated with differences in body composition and muscle strength. We studied a cohort of 350 subjects who were followed from age 13 until 36 yr. We compared noncarriers and carriers of the ER22/23EK variant in anthropometric parameters, body composition, and muscle strength, as measured by arm pull tests and high jump from standing. We identified 27 (8.0%) heterozygous ER22/23EK carriers. In males at 36 yr of age, we found that ER22/23EK carriers were taller, had more lean body mass, greater thigh circumference, and more muscle strength in arms and legs. We observed no differences in body mass index or fat mass. In females, waist and hip circumferences tended to be smaller in ER22/23EK carriers at the age of 36 yr, but no differences in body mass index were found. Thus, the ER22/23EK polymorphism is associated with a sex-specific, beneficial body composition at young-adult age, as well as greater muscle strength in males.

Adolescent↗

Central fat mass versus peripheral fat and lean mass: opposite (adverse versus favorable) associations with arterial stiffness? The Amsterdam Growth and Health Longitudinal Study.

Central and peripheral fatness seem to confer opposite (i.e. adverse vs. protective) effects on cardiovascular risk, but how this occurs is not clear. In addition, the role of peripheral lean mass needs to be elucidated. We therefore investigated, in 336 (175 women) 36-yr-old and apparently healthy adults, the relationship between trunk fat, peripheral fat, and peripheral lean mass on the one hand, and estimates of stiffness of three large arteries on the other. Body composition was assessed by dual-energy x-ray absorptiometry. Arterial properties were assessed by ultrasound imaging. We found that 1) trunk fat was positively (i.e. adversely) associated with stiffness of the carotid and femoral arteries, whereas peripheral fat was inversely (i.e. favorably) associated with stiffness of the brachial and the carotido-femoral segment; 2) peripheral lean mass was positively associated with arterial diameter and carotid compliance and inversely associated with stiffness of the carotido-femoral segment; and 3) after adjustment for the other body composition variables, the above-mentioned associations remained, but peripheral fat in addition became, if anything, favorably associated with stiffness of the femoral artery. We conclude that trunk fat is adversely associated with large artery stiffness, whereas some degree of protection is conferred by peripheral fat and lean mass.

Adipose Tissue↗

Birth weight and musculoskeletal health in 36-year-old men and women: results from the Amsterdam Growth and Health Longitudinal Study.

The results of recent epidemiological studies suggest that birth weight is related to adult bone mineral status. Since birth weight might also be related to muscle strength and fat-free mass, which are important determinants of bone health, the aim of this study was to investigate the following: is birth weight related to bone mineral content (BMC) and bone mineral density (BMD) at the lumbar level, at the hip and of the total body, and to structural properties of the heel bone, to fat-free mass (FFM) and to muscle strength, at the age of 36 years? Two hundred and eighty-two subjects (162 women) underwent dual X-ray absorptiometry (DEXA) measurement for the assessment of BMC and BMD at different sites and the FFM and/or measurement of the structural properties of the heel bone, which were estimated with speed of sound (H-SOS) and broadband ultrasound attenuation. Muscle strength was assessed with two fitness tests (static arm-pull, and high jump). Information on birth weight was gathered by means of a questionnaire. The data were analyzed by application of multiple linear regression. Birth weight was positively related to FFM. In a crude model, birth weight was found to be positively associated with BMC, but not after adjustment for adult body weight. No significant associations were found between birth weight and muscle strength or birth weight and BMD. Furthermore, birth weight was inversely related to H-SOS. No other relationships were observed. Results support the fetal origins hypothesis that lower birth weight is related to lower BMC and FFM, but not that birth weight is associated with BMD and muscle strength. Furthermore, FFM was not identified as a link between birth weight and musculoskeletal health.

Absorptiometry, Photon↗

Birth weight, adult body composition, and subcutaneous fat distribution.

OBJECTIVES: To investigate if birth weight is related to both body mass index (BMI) and distribution of subcutaneous fat at adult age. RESEARCH METHODS AND PROCEDURES: A 9-year longitudinal study was performed in 229 subjects (192 women) with ages ranging from 27 to 36 years. Birth weight was retrieved by a questionnaire, and adult weight, height, skinfold thicknesses, and waist-to-hip ratio (WHR) were repeatedly measured at mean ages 27, 29, 31, and 36 years. BMI, sum of four skinfolds (S4S), the ratio between two truncal skinfolds and S4S (SS/S4S), and the ratio between WHR and the cross-sectional area of the left thigh were calculated with the available data. RESULTS: The adjusted model showed that in women, birth weight was significantly negatively related to adult S4S [beta = -5.211; (-9.768 to -0.654)], waist circumference [beta = -1.449; (-2.829 to -0.069)], and SS/S4S ratio [beta = -3.579; (-5.296 to -1.862)]. In men, a significant negative association was observed between birth weight and adult WHR [beta = -1.096; (-2.092 to -0.100)] only. Other relationships showed, although not significantly, the same negative trend, namely that lower birth weight is related to higher adult body fat mass (S4S) and a more truncal subcutaneous fat distribution (SS/S4S). No associations were found between birth weight and either adult BMI or the cross-sectional area of the thigh. DISCUSSION: Lower birth weight is, in both adult men and women, related to a higher adult subcutaneous fat mass and a more truncal distribution of subcutaneous fat, indicating a higher risk for obesity.

Adipose Tissue↗

Fat-free body mass is the most important body composition determinant of 10-yr longitudinal development of lumbar bone in adult men and women.

The purpose of this study was to analyze the longitudinal relationship between body composition and lumbar bone mineral density (LBMD) and lumbar bone mineral content (LBMC) in (young) adults over a 10-yr period. The data are from the Amsterdam Growth and Health Longitudinal Study. Two hundred twenty-five men and 241 women were measured at 27, 32, and/or 36 yr of age. Nine body composition components were explored: total body weight, standing height, body mass index, waist circumference, hip circumference, waist to hip ratio, sum of four skinfolds, fat mass, and fat-free mass (FFM). Stratified analyses were performed by gender and adjustment was made for physical activity and calcium intake. Univariate multilevel analyses indicated that FFM was significantly positively related to the 10-yr development of both LBMD and LBMC in both sexes. Total body weight, standing height, and body mass index also showed a significant positive univariate relationships with LBMD and LBMC in both sexes, fat mass only with female LBMD. All best predictive multiple regression models included FFM, explaining 4-27% of the variation in bone mineral over this 10-yr period. Because FFM can be interpreted as a proxy for skeletal muscle mass, these results indicate the importance of muscle contractions on bone to increase bone strength in (young) adults.

Adipose Tissue↗