Tracking of secretory phospholipase A2 enzyme activity levels from childhood to adulthood: a 21-year cohort / Monitoramento dos níveis de atividade da enzima fosfolipase A2 secretória da infância à vida adulta: uma coorte de 21 anos

Abstract Objective: Secretory phospholipase A2 (sPLA2) enzyme activity is a potential inflammatory biomarker for cardiovascular disease. We examined the tracking, or persistence, of sPLA2 enzyme activity levels from childhood to adulthood, and identify potentially modifiable factors affecting tracking. Method: Prospective cohort of 1735 children (45% females) who had serum sPLA2 enzyme activity levels and other cardiovascular disease risk factors measured in 1980 that were followed-up in 2001. Results: sPLA2 activity tracked from childhood to adulthood for males (r = 0.39) and females (r = 0.45). Those who decreased body mass index relative to their peers were more likely to resolve elevated childhood sPLA2 levels than have persistent elevated sPLA2 levels in childhood and adulthood. Those who consumed less fruit, and gained more body mass index relative to their peers, began smoking or were a persistent smoker between childhood and adulthood were more likely to develop incident elevated sPLA2 levels than those with persistent not elevated sPLA2 levels. Conclusions: Childhood sPLA2 enzyme activity levels associate with adult sPLA2 levels 21 years later. Healthful changes in modifiable risk factors that occur between childhood and adulthood might prevent children from developing elevated sPLA2 levels in adulthood.

Resumo Objetivo: A atividade da enzima fosfolipase A2 secretória (sPLA2) é um possível biomarcador inflamatório de doença cardiovascular. Examinamos o monitoramento, ou a persistência, dos níveis de atividade da enzima sPLA2 da infância à vida adulta e identificamos fatores possivelmente modificáveis que afetam o monitoramento. Método: Coorte prospectiva de 1.735 crianças (45% do sexo feminino) cujos níveis de atividade da enzima sPLA2 no soro e outros fatores de risco para doença cardiovascular foram medidos em 1980 e acompanhados até 2011. Resultados: Atividade da enzima sPLA2 monitorada da infância à vida adulta para indivíduos do sexo masculino (r = 0,39) e sexo feminino (r = 0,45). Aqueles que diminuíram seus índices de massa corporal com relação a seus pares foram mais propensos à redução dos níveis elevados de sPLA2 na infância do que a manter níveis persistentemente elevados de sPLA2 na infância e vida adulta. Aqueles que consumiram menos frutas e ganharam mais índice de massa corporal com relação a seus pares, que começaram a fumar ou foram fumantes persistentes entre a infância e vida adulta foram mais propensos a desenvolver níveis de sPLA2 elevados do que aqueles com níveis de sPLA2 não elevados persistentes. Conclusões: Os níveis de atividade da enzima sPLA2 na infância estão associados aos níveis de sPLA2 na vida adulta, 21 anos mais tarde. As mudanças saudáveis nos fatores de risco modificáveis que ocorrem entre a infância e a vida adulta podem evitar que as crianças desenvolvam níveis elevados de sPLA2 na vida adulta.

Stressful Work Involvement and Inherited Long QT-Syndrome.

Aims: The long QT syndrome (LQTS) is an inherited cardiac disorder which predisposes the mutation carrier to ventricular arrhythmias that can lead to sudden death. The objective of the study was to study whether stressful work involvement (i.e. worrying about work and job dissatisfaction) is related to arrhythmic risk in LQTS. Study design: Cross-sectional study. Place and Duration of Study: The study took place in Finland in 2006 for the LQTS mutation carriers and 2007 for the general Finnish population. Methodology: The study subjects included 164 symptomatic and 229 asymptomatic LQTS mutation carriers from the Finnish LQTS registry and 1368 comparison subjects randomly derived from the population-based sample, Young Finns Study (YFS). Stressful work involvement was measured with questions derived from the Framingham type A scale. Results: Upon assessment of the stressful work involvement, symptomatic LQTS mutation carriers scored higher than asymptomatic LQTS mutation carriers (1.51 vs. 1.40, p=0.003, η²=0.022) and the general Finnish population (1.51 vs. 1.39, p<0.001, η²=0.012), while asymptomatic LQTS mutation carriers did not differ from the general Finnish population in the corresponding scores (1.40 vs. 1.39, p=0.374, η²<0.001). Conclusion: The results confirm the suggestion that perceived stress, in terms of stressful work involvement, may increase the likelihood of arrhythmic events in LQTS mutation carriers. Thus, individual stress proneness may be a risk factor for LQT symptoms, which should be taken into account in counseling LQTS patients. There is previous evidence that stress proneness can be modified by behavioral therapy.