Dietary intake in young adults born small or appropriate for gestational age: data from the Haguenau cohort.

OBJECTIVES: Compare the dietary intake of young adults born small for gestational age (SGA) versus those born appropriate for gestational age (AGA). DESIGN: Cross-sectional analysis. SETTING: Data at the 8-year follow-up Haguenau cohort (France). Data from 229 AGA-born adults and 172 SGA-born adults with available dietary information are presented. METHODS: Dietary intake was based on a food questionnaire including 19 items. The χ(2) test was run to compare intake between SGA-born and AGA-born individuals. An a priori score was calculated based on the adherence to recommendations from the French Nutrition and Health Program and included 8 components with the lowest value indicating a lower adherence to recommendations. The score was then divided into quartiles. Relative risks and 95% CIs, controlling for age and sex in multivariate analysis, were calculated in order to determine the risk of belonging to the first versus the second to the fourth quartiles in SGA-born and AGA-born individuals. RESULTS: Intakes of SGA-born adults indicated that they consumed more meat, sugar and less fish than AGA-born individuals (all p<0.05). Multivariate analyses with adjustment for age and sex showed that the relative risk of belonging to the first quartile versus the other three quartiles did not disclose any significant difference in SGA-born versus AGA-born participants: RR=0.92 (95% CI 0.65 to 1.30). CONCLUSIONS: Aside from the differences found by univariate analyses, no significant differences were obtained in multivariate analyses. Findings suggest that parameters of fetal programming are more associated with the development of metabolic syndrome in adulthood rather than dietary patterns.

Promoting the place of the allied health professions in clinical research.

Clinical research is of major importance to today's society, as scientific evidence is increasingly demanded as a basis for progress, whether this involves developing new healthcare products, improving clinical practice and care protocols or progress in prevention. Clinical research therefore requires professionals who are both experienced and increasingly well trained. Against this background, allied health professionals are becoming involved more and more, both as team members supporting clinical research projects and as managers or coordinators of projects in their own field. Clinical research activities provide an ideal opportunity for continuing professional development. All of this means that the professional skills of the allied health professions and clinical research support professions must be enhanced, their role promoted in the context of lecturer status and in the longer term, their status recognised by the supervisory authorities.

Genetic and functional assessment of the role of the rs13431652-A and rs573225-A alleles in the G6PC2 promoter that are strongly associated with elevated fasting glucose levels.

OBJECTIVE: Genome-wide association studies have identified a single nucleotide polymorphism (SNP), rs560887, located in a G6PC2 intron that is highly correlated with variations in fasting plasma glucose (FPG). G6PC2 encodes an islet-specific glucose-6-phosphatase catalytic subunit. This study examines the contribution of two G6PC2 promoter SNPs, rs13431652 and rs573225, to the association signal. RESEARCH DESIGN AND METHODS: We genotyped 9,532 normal FPG participants (FPG <6.1 mmol/l) for three G6PC2 SNPs, rs13431652 (distal promoter), rs573225 (proximal promoter), rs560887 (3rd intron). We used regression analyses adjusted for age, sex, and BMI to assess the association with FPG and haplotype analyses to assess comparative SNP contributions. Fusion gene and gel retardation analyses characterized the effect of rs13431652 and rs573225 on G6PC2 promoter activity and transcription factor binding. RESULTS: Genetic analyses provide evidence for a strong contribution of the promoter SNPs to FPG variability at the G6PC2 locus (rs13431652: ß = 0.075, P = 3.6 × 10(-35); rs573225 ß = 0.073 P = 3.6 × 10(-34)), in addition to rs560887 (ß = 0.071, P = 1.2 × 10(-31)). The rs13431652-A and rs573225-A alleles promote increased NF-Y and Foxa2 binding, respectively. The rs13431652-A allele is associated with increased FPG and elevated promoter activity, consistent with the function of G6PC2 in pancreatic islets. In contrast, the rs573225-A allele is associated with elevated FPG but reduced promoter activity. CONCLUSIONS: Genetic and in situ functional data support a potential role for rs13431652, but not rs573225, as a causative SNP linking G6PC2 to variations in FPG, though a causative role for rs573225 in vivo cannot be ruled out.

Incidence data of childhood-onset type I diabetes in France during 1988-1997: the case for a shift toward younger age at onset.

The objective was to test whether the pattern of increase in incidence of type I diabetes in children under 20 y of age varies with age at onset in France during 1988-1997. The French register of insulin-dependent diabetes was based on the direct identification of new cases by a prospective registration in children under the age of 20 y. Data from the French Social Security were used as a secondary independent source of cases. The rate of ascertainment was >/=95% over the 10-y period studied. Data were analyzed using linear regression; departure from a linear trend was tested in each age group. A total of 1,867 children under 20 y of age at the time of diagnosis were included. The incidence rate of type I diabetes in children rose significantly between 1988 and 1997, from 7.41 per 100,000 per year (95% confidence interval: 6.55-8.27) to 9.58 per 100,000 per year (95% confidence interval: 8.64-10.52) with p = 0.0001. The percentage increase was greater in the 0-4 y age group, with a significant departure from linear trend (p = 0.036), reflecting an acceleration of the increase. Incidence rates rose linearly in 5-9 y (average increase 0.43 per 100,000 per year, p = 0.011) and 10-14 y (average increase 0.40 per 100,000 per year, p = 0.002) age groups, whereas it remained stable in the 15-19 y age group (p = 0.77). The incidence rate was significantly higher in boys than in girls (p = 0.005), but the rise in incidence did not differ between the two genders. The rise in incidence of type I diabetes in France was of the same magnitude as observed in the rest of Europe over 10 y. A specific pattern was observed in children under 5 y of age, contrasting with stable rates over 15 y. These data suggest a shift toward a younger age at onset of type I diabetes in childhood, contributing, at least in part, to the observed increase in incidence of type I diabetes in children.