Cardiometabolic differences in children born after in vitro fertilization: follow-up study

CONTEXT: Increasing evidence suggests that adverse conditions during early prenatal life are associated with cardiometabolic dysfunction in postnatal life. In vitro fertilization (IVF) conception may be an early prenatal life event with long-term health consequences. OBJECTIVE: Our objective was to investigate several cardiometabolic measures in 8- to 18-yr-old IVF singletons and spontaneously conceived controls born from subfertile parents. DESIGN AND SETTING: This follow-up study was conducted at the VU University Medical Center, Amsterdam, The Netherlands. PARTICIPANTS: Blood pressure was examined in 225 IVF-conceived children and 225 age- and gender-matched spontaneously conceived control children. Several indicators of insulin resistance were studied in a pubertal subpopulation (131 IVF children and 131 controls). MAIN OUTCOME MEASURES: Blood pressure, fasting glucose, and fasting insulin were determined. RESULTS: Systolic and diastolic blood pressure levels were higher in IVF children than controls (109 +/- 11 vs. 105 +/- 10 mm Hg, P < 0.001; and 61 +/- 7 vs. 59 +/- 7 mm Hg, P < 0.001, respectively). Children born after IVF were also more likely to be in the highest systolic and diastolic blood pressure quartiles (odds ratio = 2.1, 95% confidence interval 1.4, 3.3; odds ratio = 1.9, 95% confidence interval 1.2, 3.0, respectively). Furthermore, higher fasting glucose levels were observed in pubertal IVF children (5.0 +/- 0.4 vs. 4.8 +/- 0.4 mmol/liter in controls; P = 0.005). Blood pressure and fasting glucose differences could not be explained by current body size, birth weight, and other early life factors or by parental characteristics, including subfertility cause. CONCLUSIONS: These findings highlight the importance of continued cardiometabolic monitoring of IVF-conceived children and might contribute to current knowledge about periconceptional influences and their consequences in later life.     

Total peptide YY is a correlate of postprandial energy expenditure but not of appetite or energy intake in healthy women

Peptide YY (PYY) and ghrelin have been associated with the regulation of energy balance. The objectives of this study were to determine whether total ghrelin and PYY after a standardized meal predict appetite scores and ad libitum energy intake (EI) and to examine the relationship between total ghrelin and PYY and postprandial energy expenditure (PEE). Twenty-five premenopausal women (age, 50.4 ± 2.0 years; body mass index, 23.5 ± 2.2 kg/m²) were studied. Total PYY, total ghrelin (enzyme-linked immunosorbent assay), EE (indirect calorimetry), and appetite scores (visual analogue scales) were measured fasting and every 30 minute for 3 hours after the ingestion of a standardized breakfast. Ad libitum EI was measured at lunch with a buffet-type meal. Peptide YY increased (P < .001) and total ghrelin decreased (P < .001) after breakfast. Significant changes in EE (P < .001) and appetite scores (P < .001) were noted postprandially. Appetite scores were consistently associated with ad libitum EI at lunch (r = −0.51 to 0.40, P < .05), whereas no association between EI and prelunch total ghrelin and PYY was observed. Finally, partial correlation analyses revealed that total PYY was a significant independent correlate of PEE at 60, 90, 120, and 150 minutes (r = 0.37-0.51, P ≤ .05). These findings provide evidence that appetite scores are better correlates of EI than are circulating levels of total PYY or ghrelin and that total PYY could be involved in the regulation of PEE.     

The second round of the Dutch colorectal cancer screening program: Impact of an increased fecal immunochemical test cut-off level on yield of screening

The Dutch colorectal cancer (CRC) screening program started in 2014, inviting the target population biennially to perform a fecal immunochemical test (FIT). We obtained prospectively collected data from the national screening information-system to present the results of the second round (2016) and evaluate the impact of increasing the FIT cut-off halfway through the first round from 15 to 47 μg Hb/g feces on outcomes in the second round. Second round screening was done with a 47 μg Hb/g feces FIT cut-off. Participants were classified based on first round participation status as either FIT (15,47) or FIT (47,47) participants, and previous nonparticipants. In total, 348,891 (75.9%) out of 459,740 invitees participated in the second round. Participation rates were 93.4% among previous participants and 21.0% among previous non-participants. FIT(47,47) participants had a significantly higher detection rate of AN (15.3 vs. 10.4 per 1,000 participants) compared to FIT(15,47) participants in the second round, while their cumulative detection rate of AN over two rounds was significantly lower (45.6 vs. 52.6 per 1,000 participants). Our results showed that participation in the Dutch CRC screening program was consistently high and that second round detection rates depended on the first round FIT cut-off. The cumulative detection over two rounds was higher among FIT(15,47) participants. These findings suggest that a substantial part of, but not all the missed findings in the first round due to the increased FIT cut-off were detected in the subsequent round.     

Patient-reported burden of intensified surveillance and surgery in high-risk individuals under pancreatic cancer surveillance

Familial Cancer - In high-risk individuals participating in a pancreatic cancer surveillance program, worrisome features warrant for intensified surveillance or, occasionally, surgery. Our...     

Hepatitis B-related hepatocellular carcinoma: surveillance strategy directed by immune- epidemiology

Hepatitis B infection (HBV) is one of the most common causes of hepatocellular carcinoma (HCC) worldwide. The age of occurrence, prognosis and incidence vary dr...