Proposal summaries

These are research proposals that have been approved by the ALSPAC exec. The titles include a B number which identifies the proposal and the date on which the proposals received ALSPAC exec approval.

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B1046 - Functional mapping of Quantitative Trait Loci underlying childrens growth - 14/09/2010

B number: 
B1046
Principal applicant name: 
Rongling Wu (Pennsylvania State University, USA)
Co-applicants: 
Li Wang (Not used 0, Not used 0), Dr Nic Timpson (Not used 0, Not used 0)
Title of project: 
Functional mapping of Quantitative Trait Loci underlying children?s growth
Proposal summary: 

Many traits, such as body height and body weight, undergo a developmental change. Traditional genetic analyses of these traits are based on the association between the genotype and phenotype measured at individual times. But this approach does not consider the dynamic feature of the traits and, therefore, limits the scope of its inference about genetic control. A natural way is to connect the genotype with the dynamic trajectories of a trait, enabling geneticists and clinicians to study the temporal pattern of genetic control.

Such a dynamic model has been developed in our group at Penn State University. This model 1 integrates mathematical aspects of trait formation and progression with genetic variation within the framework of genome-wide association studies (GWAS). It thus shows substantial biological relevance of the results and, meanwhile, possesses significant statistical merits because of parsimonious modeling of the time-dependent genetic effects and longitudinal covariance structure. We have performed extensive simulation studies to test and validate the usefulness of this new model. Although favorable statistical properties have been detected, we have a keen interest in applying this model to a large-scale longitudinal data set. By reading your article published in PLoS Medicine 2 and looking at your webpage, we are very confident that our model matches your data extremely well. If we get your data, we will commit our time to analyze and interpret them, and write papers for publication jointly.

Our specific data needs are:

(1) genotype data for all the SNPs you may have in cohort studies.

(2) phenotypic data measured at multiple time points. In your case, body height and weight from birth to ages 11 years were measured. We are also interested in other longitudinal measures, such as blood pressure, but we will request these data later.

Our plan: Once we get these data, we will analyze them in a couple of weeks and report the results to you at various stages. Meanwhile, we will be drafting a manuscript together with your group and publish it jointly in a top journal. In particular, we will be collaborating closely throughout this project with Nicholas Timpson from the Department of Social Medicine, University of Bristol.

As to the authorship, the following is our suggestion: If the results are from reanalyzing your data with our new model, we suggest that we are the first author and you are coauthors. A leader from each group (Penn State and Bristol) can be jointly a corresponding author. If your data are new and we simply help you analyze, you should be the first and corresponding authors, but we request the coauthorship.

Date proposal received: 
Tuesday, 14 September, 2010
Date proposal approved: 
Tuesday, 14 September, 2010
Keywords: 
Genetics
Primary keyword: 

B1044 - A Genome-wide association study for the use of tobacco using cotinine levels - 14/09/2010

B number: 
B1044
Principal applicant name: 
Prof Matt Hickman (Not used 0, Not used 0)
Co-applicants: 
Prof John Macleod (Not used 0, Not used 0), Prof Marcus Munafo (Not used 0, Not used 0), Dr Nic Timpson (Not used 0, Not used 0)
Title of project: 
A Genome-wide association study for the use of tobacco using cotinine levels
Proposal summary: 

Not available

Date proposal received: 
Tuesday, 14 September, 2010
Date proposal approved: 
Tuesday, 14 September, 2010
Keywords: 
Genetics
Primary keyword: 

B1043 - What are the pre and postnatal determinants of volumetric bone density and geometry in the child from 8 to 17 years - 14/09/2010

B number: 
B1043
Principal applicant name: 
Nicholas Harvey (MRC Lifecourse Epidemiology Unit, University of Southampton, UK)
Co-applicants: 
Chris Holyroyd (Not used 0, Not used 0), Elaine Dennison (Not used 0, Not used 0), Cyrus Cooper (Not used 0, Not used 0), Dr Jon Tobias (Not used 0, Not used 0)
Title of project: 
What are the pre and postnatal determinants of volumetric bone density and geometry in the child from 8 to 17 years?
Proposal summary: 

AIM: To model the pre and postnatal determinants of volumetric bone density and geometry in the child at 8 to 17 years.

BACKGROUND

Osteoporotic fractures constitute a huge public health burden, with a currently estimated annual cost of 1.7 billion in the UK(1). The peak bone mass achieved in early adulthood is a major determinant of osteoporosis risk in older age(2). Peak bone mass is partly inherited, but the nature of the inheritance from either parent in terms of site specificity, size, geometry and volumetric density is uncertain. Additionally, evidence is accruing that environmental factors early in life may have long term influences on childhood bone development to peak(3). Thus poor growth in early life is associated with reduced bone mineral content and increased risk of hip fracture in adulthood(4;5). Maternal lifestyle, body build, physical activity, diet and circulating 25(OH)-vitamin D status during pregnancy are associated with offspring bone mass(6;7). Animal studies have demonstrated similar effects(8;9) and suggested epigenetic processes such as DNA methylation as potential mechanistic explanations for these gene-environment interactions(10-12). However, in humans, it is not clear whether influences on bone mass in the neonate retain a persisting effect through childhood, and secondly whether these effects are mediated through bone size, geometry or true volumetric density. Existing data from mother-offspring cohorts have mainly utilised DXA(13;14), which, as a two-dimensional construct, does not allow measurement of true volumetric density, or differentiation of effects on cortical vs trabecular bone. Maternal behaviour before and during pregnancy is likely to influence how she feeds and looks after her child. In order to elucidate a model of pre and postnatal genetic and environmental determinants of childhood bone size, density and geometry, it is therefore necessary to address several issues:

1) Inheritance (genetic) of bone size, geometry and density from mother and father.

2) Environmental factors acting before and during pregnancy (e.g. maternal diet) which might act on fetal bone development in utero and potentially alter the long term growth trajectory.

3) Environmental factors observed before and during pregnancy which merely act as markers of later behaviour and child rearing (e.g. an influence of maternal diet in pregnancy on offspring bone development could act through an association between maternal diet in pregnancy and that of the child postnatally).

4) Postnatal environmental factors which may have temporary or permanent effects on bone (e.g. physical activity and calcium/ vitamin D exposure).

In this proposal we aim to use two large, well established mother-offspring cohorts to attempt to address these problems (SWS and ALSPAC).

Summary of Southampton Women's Survey (SWS): The SWS(15) is a unique ongoing prospective population cohort 12,583 non-pregnant women aged 20-34 years, resident in the city of Southampton and recruited through their general practitioners. Each woman was visited at home for an interview, which involved a questionnaire enquiring about diet, employment, physical activity, general health, alcohol consumption and cigarette smoking. Nutrition was assessed from a previously validated 100-item food frequency questionnaire. Detailed anthropometric measurements of the women (height, weight, leg length, skinfold thickness at the triceps, biceps, subscapular and supra-iliac regions) were made in order to assess body composition. From these 12,583 women, 3156 became pregnant and delivered infants within three years of initial interview. At early (11 weeks) and late (34 weeks) pregnancy further assessments were made. 1003 of these neonates underwent DXA of their whole body and lumbar spine within two weeks of delivery. Subsequent follow up at 4 (n=900, complete) and 6 (n=600, ongoing) years has included DXA (Hologic Discovery: whole body, lumbar spine and hip) and objective physical activity (combined accelerometer and heart rate monitor: Actiheart, Cambridge Neurotechnology, Cambridge, UK) assessment over 7 days continuously. Simultaneous recording of maternal physical activity by Actiheart is available at 4 years.

METHODS

The SWS 8-year follow-up is underway. Children are invited to attend for whole body, lumbar spine and hip DXA measurements (Hologic Discovery instrument). Anthropometry and grip strength measurements will also be made and a lifestyle/dietary questionnaire completed.

In order to model the influence of parental bone mass, and demarcate relationships by bone size, geometry and true volumetric density, we now propose to assess the parents of the SWS children, in addition to further refining the bone phenotype of the offspring. Interested parents will be invited to attend a research clinic at the Osteoporosis Centre at Southampton General Hospital. Here, a lifestyle questionnaire will be administered; height, weight, skinfold thickness and grip strength will then be recorded. Bone mass will be assessed in two ways: A DXA scan (Hologic Discovery) will be performed and measurements made of whole body, lumbar spine and hip bone area, bone mineral content and areal BMD in addition to total and regional lean and fat mass. Peripheral QCT at the tibia (4 sites to assess areas of predominantly cortical and trabecular bone) using a Stratec XCT 2000 machine. Measurements will be made of cortical and trabecular volumetric density, cortical thickness and cross sectional area, periosteal and endosteal circumference, bending strength and fracture load in the x and y axis. Muscle mass measurements will also be made. At this visit the 8 year old child will also undergo the same pQCT assessment yielding 500 mother-father-child triplets with DXA and pQCT indices generated on the same instruments. In a subset of 250 triplets, an Actiheart monitor will be fitted to each of mother, father and child, to be worn continuously for 7 days and posted back in a padded reply paid envelope at the end of this period.

ANALYSIS

1) SWS: All data will be checked for validity and outliers. Variables will be assessed for normality and transformed in necessary. The relationships between the exposures and the bone outcomes will be initially explored in univariate models. Associations found to be statistically significant (pless than 0.05) will be included in multivariate models to generate the set of maternal, paternal and childhood variables which best explain the bone outcomes at 8 years. Collinearity between parental and childhood environment, e.g. diet, will also be investigated to distinguish between true early life effects and inherited environmental factors.

2) ALSPAC: This will utilise existing data which will already be have been cleaned. Variables will be assessed for normality and transformed in necessary. The analysis will comprise two phases:

The initial analysis will again employ univariate models to explore the associations between parental and childhood factors and childhood bone size, areal density and size corrected density at 9 years. A multivariate model will then be generated (incorporating a variables where pless than 0.05 for the relationship with child bone outcomes) to compare with that derived from the SWS.

The second phase will include a similar process of univariate then multivariate modelling with qQCT derived indices of tibial size, geometry and volumetric density at 15 and 17 years. The aim of this analysis will be to confirm whether influences observed at 8 years in SWS persist after puberty.

Date proposal received: 
Tuesday, 14 September, 2010
Date proposal approved: 
Tuesday, 14 September, 2010
Keywords: 
Bone
Primary keyword: 

B1042 - Genes and happiness is there scope for Mendelian randomisation in the study of how well-being affects outcomes - 14/09/2010

B number: 
B1042
Principal applicant name: 
Anita Ratcliffe (University of Bristol, UK)
Co-applicants: 
Title of project: 
Genes and happiness: is there scope for Mendelian randomisation in the study of how well-being affects outcomes?
Proposal summary: 

The proposed research will build on research that attempts to replicate the association found between the serotonin transporter gene (SLC6A4) - specifically variation in the transcriptional control region (the 5-HTT-linked polymorphic region (5-HTTLPR)) - and well-being.

If an association is found, this research proposes to investigate whether Mendelian randomisation can be applied to study the effects of well-being on educational outcomes and social networks. There are a number of considerations to take into account before using genetic markers as instruments (see inter alia Lawlor et al. 2007[1], Lawlor et al. 2008[2], von Hinke Kessler Scholder et al. 2010[3]). An in depth study of whether the 5-HTTLPR and rs25531 can plausibly be used as instruments for well-being is warranted given an increasing interest in genes in economics literature.

While many studies investigate the determinants of well-being, positing that income, health and relationships can explain why some people are happier than others but Lyubomirsky et al. (2005)[4] argue that well-being is important in shaping outcomes - happier people are more successful at cultivating personal relationships and do better in the workplace. However, the bulk of evidence suggesting that well-being affects outcomes comes from cross-section or longitudinal studies and experimental studies. Cross-sectional studies document whether a correlation exists but not the direction of causality. On the other hand, if well-being is measured prior to the outcome, a more convincing case can be made that well-being caused the outcome, which is an advantage of longitudinal data. But this approach falters if well-being is highly correlated over time and it says little about what is driving changes in lagged well-being and therefore if lagged well-being is truly exogenous. Experimental studies provide a gold standard for studying the direction of causation, but by design these studies focus only on short-term changes in well-being. A suitable instrument for well-being would shed light on how long-term well-being affects outcomes and therefore assessing whether the 5-HTTLPR and rs25531 can be used as instruments for well-being, focusing on two different applications is a worthwhile exercise.

The focus on educational outcomes is motivated by the fact that educational outcomes are linked to job prospects and earnings and are therefore informative of the likely impact of well-being on economic circumstances. However, it is also an outcome where the exclusion restriction required for instrumental variable estimation may fail. Frisch et al. (2005)[5] previously show that well-being can predict academic retention. This research will examine whether the 5-HTTLPR and rs25531 are potentially useful instruments in an application to national exam scores.

The formation of social networks is an interesting area to verify whether mendelian randomisation is feasible because previous research on homophily shows that people with similar characteristics flock together (McPherson et al. 2001)[6] and research cited in Lyubomirsky et al. (2005)suggests that happier people are more appealing to others. The research will therefore examine whether this approach can be used to answer questions such as are people with similar levels of well-being more likely to befriend each other, does well-being influence the number of friends one has and position in friendship networks?

If an association is not found, the proposed research would investigate whether there is a gene-environment interaction using plausibly exogenous life stresses such as a death in the family.

Date proposal received: 
Tuesday, 14 September, 2010
Date proposal approved: 
Tuesday, 14 September, 2010
Keywords: 
Genetics
Primary keyword: 

B1040 - Obesity and obesity-related hypertension early genetic risk factors - 13/09/2010

B number: 
B1040
Principal applicant name: 
Prof Zdenka Pausova (Not used 0, Not used 0)
Co-applicants: 
Daniel Gaudet (Not used 0, Not used 0), Michal Abrahamowicz (Not used 0, Not used 0), Pavel Hamet (Not used 0, Not used 0)
Title of project: 
Obesity and obesity-related hypertension: early genetic risk factors
Proposal summary: 

1. RATIONALE

The proposed work is aimed at identifying genes contributing to blood pressure (BP) elevation related to excess body-fat in adolescence (i.e. preclinical obesity-induced hypertension). It builds on our previous research and is motivated by the following three overarching themes:

1.1 Adolescence is a period of preclinical disease: Adolescence is a period of human development when adult body composition and physiology develop and initial stages of cardiovascular disease, including hypertension, emerge1. Importantly for public health, this early preclinical stage may also be a period when disease trajectories can still be altered and full-blown diseases prevented.

1.2 Obesity is the leading risk factor for hypertension: Obesity has become a major health problem worldwide due to its growing prevalence and causal relationship to common chronic diseases, such as hypertension. It is spreading across all age groups, including children and adolescents. Epidemiological studies suggest that 65-78% of hypertension is due to obesity and that obesity-induced hypertension, as compared with obesity-unrelated hypertension, is associated with a greater risk for cardiovascular disease6. Despite the high public-health importance, our understanding of how excess body fat increases BP is still limited. We do know that the underlying mechanisms relate to not only excess but also intra-abdominal deposition of adipose tissue, and they commonly involve central sympathetic activation, insulin resistance, oxidative stress and augmented activity of the renin-angiotensin-aldosterone system.

1.3 Identification of genetic risk factors is a tool to uncover mechanisms of obesity-induced hypertension: The causal role of environment in the current epidemic of obesity and obesity-induced co-morbidities is undeniable. Genes, however, play a critical role in that they modify individuals' susceptibility to these disorders by regulating underlying mechanistic pathways. Therefore, identifying these genes may help us to uncover the pathways and thus open new avenues for prevention and treatment.

2. AIMS

Recent advances in high-through-put genotyping made significant inroads vis-a-vis the genetic architecture of hypertension, but preclinical stages and obesity-related hypertension have not been studied. To fill this gap, we propose to identify genes (and the underlying mechanisms) of preclinical stages of obesity-induced hypertension and to examine them across different ages. We propose to achieve this overarching goal by realizing Aims 1 and 2:

Aim 1: To identify genes and underlying mechanisms of adiposity and related BP variations in adolescence, we will perform genome-wide association studies (GWAS) with the Illumina Human610W-Quad BeadChip containing probes for greater than 550K single nucleotide polymorphisms (SNPs) in the Saguenay Youth Study (SYS). The SYS is an ongoing population-based investigation of 1,000 adolescents recruited from a French-Canadian founder population who undergo detailed cardiovascular, metabolic and behavioral phenotyping (15-hour protocol) . The SYS is ideally suited for the proposed studies for the following reasons: (1) it is an adolescent cohort allowing us to investigate preclinical stages of obesity-induced hypertension; (2) all adolescents are recruited from a genetic founder population where power of genetic analyses is expected to be higher (compared with regular outbred populations) due to more homogenous genetic background (and environment) and, hence, fewer genes contributing to the expression of complex traits, such as adiposity and BP; and (3) all adolescents undergo extensive high-fidelity phenotyping not only of adiposity and BP but also of variables that may provide additional mechanistic insight (e.g. sympathetic modulation of vasomotor tone) and characterize environment (diet, physical activity and psychosocial environment). To our knowledge, the SYS is currently the largest sample of adolescents (n=1,000) in whom intra-abdominal, visceral fat is measured directly with magnetic resonance imaging (MRI) and in whom sympathetic modulation of vasomotor tone is assessed with power spectral analysis of beat-to-beat BP. Furthermore, as we study predominantly disease-free adolescents (not yet hypertensive and still free of co-morbidities), this high-fidelity phenotyping is not confounded by e.g. BP-lowering medication. To date, we have phenotyped 750 adolescents and genotyped (610K SNPs) 600 of them, and we have published 19 peer-reviewed papers (with 2 additional being currently under review). We have also obtained encouraging results in our initial GWAS. The funds requested to meet Aim 1 are to support phenotyping of the remaining 250 adolescents, genotyping of the remaining 400 adolescents, as well as data management and performance of statistical analyses in all 1,000 adolescents. Note that we request funding for only cardiovascular and metabolic phenotyping of the remaining 250 adolescents, as the cost of their recruitment and both MRI and behavioral phenotyping is already covered by another CIHR grant (see Letter of Collaboration from Dr. Tomas Paus).

Aim 2: To replicate genotype-phenotype associations identified in Aim 1 across different ages (n=13,244 individuals). To achieve this aim we will test the associations in the SYS in the following replication cohorts: (1) the Avon Longitudinal Study of Parents and Children study (ALSPAC; 6,863 adolescents), which is a longitudinal birth cohort established in England (see Letter of Collaboration from Dr. George Davey-Smith); (2) the 1966 Northern Finland Birth Cohort (NFBC1966; 4,936 young adults), which is also a longitudinal birth cohort established in a Finish founder population (see Letter of Collaboration from Dr. Jarvelin Marjo-Riitta), and (3) the Quebec Hypertensive Family Study (QHFS; 897 older adults), which is a cross-sectional sample of adults recruited as members of hypertensive families from the same French-Canadian founder population as the SYS adolescents. All individuals to be analyzed in replication studies have already been phenotyped (BP and adiposity) and most of them were also genome-wide genotyped (317K SNPs in ALSPAC; 370K SNPs in NFBC1966). Therefore, the funds requested for Aim 2 are mainly to support data manipulation and management, and genetic analyses.

Date proposal received: 
Monday, 13 September, 2010
Date proposal approved: 
Monday, 13 September, 2010
Keywords: 
Endocrine, Obesity, Weight
Primary keyword: 

B1038 - Eating behaviour measurement using the mandometer A pilot study in ALSPAC - 10/09/2010

B number: 
B1038
Principal applicant name: 
Dr Julian Hamilton-Shield (University of Bristol, UK)
Co-applicants: 
Dr Nic Timpson (Not used 0, Not used 0), Prof George Davey Smith (Not used 0, Not used 0)
Title of project: 
Eating behaviour measurement using the mandometer ? A pilot study in ALSPAC
Proposal summary: 

Not available

Date proposal received: 
Friday, 10 September, 2010
Date proposal approved: 
Friday, 10 September, 2010
Keywords: 
Primary keyword: 

B1039 - Testing pathways between prenatal risks and child disruptive behaviour disorders - 08/09/2010

B number: 
B1039
Principal applicant name: 
Dr Kate Langley (University of Cardiff, UK)
Co-applicants: 
Prof George Davey Smith (Not used 0, Not used 0), Prof Anita Thapar (Not used 0, Not used 0), Ms Luisa Zuccolo (Not used 0, Not used 0), Prof Debbie A Lawlor (Not used 0, Not used 0)
Title of project: 
Testing pathways between prenatal risks and child disruptive behaviour disorders
Proposal summary: 

Attention deficit hyperactivity disorder (ADHD) and antisocial behaviour are common, extremely disabling disorders which have major adverse sequalae in childhood and later life. Despite being such an important clinical problem, their aetiology and pathogenesis are poorly understood. Available evidence suggests that both genetic and environmental risk factors are important.

Many studies have demonstrated significant association between prenatal exposure to alcohol, tobacco, marijuana and diabetes mellitus and child behaviour outcomes including ADHD and CD, although such findings are equivocal.

Each prenatal exposure has been shown by some animal studies to result in biological alterations to the developing foetus which could, in turn, influence child behaviour.

However, each of these prenatal risk factors is also associated with additional familial characteristics including social adversity, parental psychopathology and other social deficits, each of which have been associated with childhood behaviour problems. Furthermore, willingness to engage in risky behaviours during pregnancy is also associated with antisocial behaviour, impulsivity and ADHD symptoms in the mother.

Therefore, it is currently unknown whether these prenatal exposures lead to direct intrauterine effects on the developing foetus with long term consequences for childhood behavioural problems, or if observed associations arise instead via confounding inheritance of familial factors.

The aim of this proposal is to further explore the causal pathways for association between prenatal exposures and childhood ADHD and antisocial behaviour.

To this end, the aim of this proposal is to test the contrasting hypotheses that either:

1) Associations between prenatal exposure to alcohol, tobacco and marijuana, diabetes and childhood developmental disorders are the result of direct intrauterine effects OR

2) Such associations are due to genetic or other confounding factors.

The project will utilise data from three different samples, ALSPAC, the Cardiff IVF sample and data from the Swedish population registries.

Specifically in the ALSPAC sample, I propose to:

1. Test for associations between prenatal exposure to alcohol, tobacco, marijuana use, diabetes mellitus and offspring symptoms and diagnoses of ADHD and CD using regression analyses. Where this work has previously been undertaken, I will utilise previously published data or collaborate with other researchers.

2. Test which of the competing hypotheses account for these associations using methods comparing: Maternal and paternal exposure; pre and postnatal exposure; and a mendelian randomisation instrumental variable approach

3. Based on the findings of the earlier aims and suggestions from previous literature, I will investigate:

a. Whether causal associations arise via their influences on cognitive or other phenotypes or

b. Which confounding factors appear to best account for non-causal associations.

I propose to investigate genetic variants which are robustly associated with the risk exposures (smoking, alcohol and substance use and diabetes) which have been identified through GWAS and candidate gene studies. As this is a constantly changing field of research and much of the work is currently being undertaken by ALSPAC collaborators, I will nominate the proposed genetic variants at a later stage (of course with additional approval by the executive committee). However, it is anticipated that these will be variants previously genotyped within the ALSPAC sample, mainly on the Illumina 550k chip. I will also include funding in my proposal for additional genotyping of candidate variants which might not already be genotyped within the ALSPAC sample.

Current data required:

Parent & Teacher reports of ADHD & DAWBA diagnoses at 7 & 11 years

Parent & Teacher reports of antisocial behaviour & DAWBA CD diagnoses at 7 & 11 years

Child antisocial behaviour measures from focus visits

Age (parents & child at assessments)

Gender

Birth weight

Maternal & Paternal smoking during pregnancy

Current Maternal & Paternal smoking (current to ADHD diagnoses)

Mother & Father alcohol use during pregnancy and current (7 years)

Mother and father marijuana and other substance use during and after pregnancy

Mother and father diabetes diagnoses during pregnancy (maternal report and data from antenatal notes) and since birth

SES & Mother's education

Mother & Father psychopathology (time of pregnancy and current); ADHD, CD, Anxiety & Depression

Child cognitive assessments (IQ & neuropsychological test data, Key stage 1 & 2 results)

Mother & Child genotypes chosen from GWAS and association studies

Date proposal received: 
Wednesday, 8 September, 2010
Date proposal approved: 
Wednesday, 8 September, 2010
Keywords: 
ADHD, Behavioural Problems
Primary keyword: 

B1037 - Maternal risky behaviour during pregnancy and child outcomes - 07/09/2010

B number: 
B1037
Principal applicant name: 
Miss Stephanie von Hinke Kessler Scholder (University of Bristol, UK)
Co-applicants: 
George Wehby (Not used 0, Not used 0), Dr Sarah J Lewis (Not used 0, Not used 0)
Title of project: 
Maternal risky behaviour during pregnancy and child outcomes.
Proposal summary: 

This project has two aims:

1. To examine the causal effect of maternal smoking and drinking during pregnancy, and maternal BMI before pregnancy, on child development. More specifically, we are interested in outcomes relating to the child's birth, such as birth weight, as well as measures later in life such as academic outcomes, behavioural problems and child health (e.g. blood pressure).

2. To examine the effect of smoking and drinking on BMI or fat mass, both at the mother and child level.

As the relationships between (maternal) smoking, drinking, BMI and (child) development are likely to be subject to confounding in observational studies, we will identify the causal effect by using specific genetic markers that have been robustly identified to affect smoking, drinking or BMI as instrumental variables in a Mendelian randomization set-up.

We are aware that other researchers are also currently working on similar research questions using the ALSPAC data. For example, Sarah Lewis is involved in a project on alcohol led by Ron Gray, and we are aware that Rachel Freathy is looking at smoking-related variants. Hence, our aim is to explore this research question from a slightly different angle than that used in these existing projects. First, rather than examining the effect of these risky behaviours at the mean, we are specifically interested in their effects at different points in the outcome distribution. We will explore this distributional aspect with an instrumental variable quantile regression (IVQR) approach (Chernozhukov and Hansen, 2005, 2006). This will allow us to examine whether smoking and drinking has differential effects at different points in the (e.g.) birth weight or academic attainment distribution. Second, we are interested in the effect of different timings of smoking and drinking. For example, Freathy et al. (2009) show that the common polymorphismrs1051730 in the nicotinic acetylcholine receptor gene cluster (CHRNA5-CHRNA3-CHRNB4) is associated with heavier smoking in the first, but not third trimester. We will explore the effects of these different timings on our outcomes of interest.

We will use the variants CHRNA3 (rs1051730) and ADH1B (rs1229984) as instruments for smoking and alcohol consumption respectively. Finally, FTO (rs9939609) and MC4R (rs17782313) will be used as instruments for maternal BMI. Within the ALSPAC cohort, data have already been collected on a series of SNPs, with robust evidence that these SNPs affect these risky behaviours, which has been replicated in different independent samples (see e.g. Freathy et al., 2009; Zuccolo et al, 2009; Frayling et al., 2007; Loos et al., 2008). As such, we wish to use these in IVQR analyses, allowing us to specifically examine the distributional effects on these outcomes of interest.

We will also discuss the potential limitations of power within this setting. We are aware that (a) the minor allele rs1229984 is relatively rare in the ALSPAC population (MAF 2.4%), and that (b) the genetic effects on the intermediate trait are relatively small. Hence, depending on the variation required to shift the outcome of interest, this may lead to low power. The implications will differ depending on the outcome of interest, which is something we will discuss in the paper. For example, it may be easier to find effects on child birth weight compared to effects on their educational outcomes.

As the principle applicant already has access to the ALSPAC data on child and family background characteristics, we only wish to obtain (a) the more detailed measures of maternal smoking and drinking and (b) the genetic markers related to mother's BMI, smoking and drinking.

Date proposal received: 
Tuesday, 7 September, 2010
Date proposal approved: 
Tuesday, 7 September, 2010
Keywords: 
Obstetrics, Pregnancy
Primary keyword: 

B1036 - Longitudinal modelling of adiposity its determinants and its health consequences across childhood and adolescence Fellowship - 07/09/2010

B number: 
B1036
Principal applicant name: 
Dr Laura Howe (University of Bristol, UK)
Co-applicants: 
Prof Debbie A Lawlor (Not used 0, Not used 0), Prof Kate Tilling (Not used 0, Not used 0)
Title of project: 
Longitudinal modelling of adiposity, its determinants and its health consequences across childhood and adolescence (Fellowship)
Proposal summary: 

Background

Obesity is associated with increased risks of morbidity and mortality, and globally it represents a considerable burden for healthcare systems. The prevalence of obesity in children and adolescents has risen dramatically in recent decades across most western countries and several low-income countries.1 Although some recent data suggest prevalence may have stabilised in the USA, UK and Sweden,2-4 it is too soon to know whether this is a true abating of the epidemic and levels remain high in all of these countries. A life course perspective is essential in the study of obesity, as emphasised by the MRC obesity research strategy published in 2010. There are many unanswered questions in the field of life course influences on obesity, which it is important to address in order to further the understanding of the aetiology of obesity and therefore to inform the design of prevention and treatment initiatives. Although we know that overweight tends to track across the life course5 and that childhood overweight and obesity is associated with adverse health outcomes in adulthood6, few studies have had sufficiently detailed longitudinal data to model individual trajectories of adiposity across childhood and adolescence and therefore to examine in detail the nature of adiposity changes across childhood and adolescence and how these changes relate to the determinants and health consequences of obesity. There is evidence to suggest that obesity-related cardiovascular risk factors such as blood pressure and lipids track across the life course within individuals7, 8, and that the associations of these risk factors with atherosclerosis in adulthood are similar regardless of whether the risk factors are measured in childhood or in adulthood at the same time as assessment of atherosclerosis.9 Again, however, few studies have had sufficient data to model the development of these obesity-related cardiovascular risk factors across childhood and adolescence and to relate them to patterns of adiposity change. Longitudinal models of behavioural risk factors for obesity such as diet and physical activity are also relatively rare in the literature, and the interplay between multiple genetic, lifestyle, and socioeconomic risk factors for obesity and longitudinal trajectories of adiposity has not been well explored. It would be of great public health interest to use longitudinal models of changes in adiposity, obesity-related cardiovascular risk factors, and lifestyle risk factors for obesity to identify whether there are subgroups of the population who could be identified in early life as at risk of extreme obesity and associated cardiovascular risk in adolescence. Furthermore, little is known about why some obese individuals remain metabolically healthy; patterns of change in adiposity, cardiovascular risk factors and lifestyle factors could be explored in such individuals to explore the issue of 'protective phenotypes' in obesity - identified as a priority area in the MRC obesity research strategy. I propose to address these areas of life course epidemiology of obesity using longitudinal modelling of adiposity, its determinants and its health consequences across childhood and adolescence using data from prospective cohort studies.

Aim 1: To characterise patterns of change in adiposity and its associated cardiovascular risk factors across childhood and adolescence

Specific research questions:

1. How does adiposity change across childhood and adolescence, as measured by BMI (0-18 years), waist circumference (7-18 years) and directly determined total body fat mass (9-18 years)?

2. Do changes in BMI, waist circumference and directly determined fat mass from age 9 to 18 mirror each other or are there periods where change between these differs? For example does timing of change in waist differ from that in general adiposity (BMI or total fat mass) around the time of puberty?

3. How does blood pressure change from age 7-18 years?

4. How do lipids, insulin, and inflammatory markers change from age 9-18 years?

Aim 2: To identify lifestyle and socioeconomic determinants of adiposity changes across childhood and adolescence

Specific research questions:

1. What are the joint effects of trajectories of physical activity (measured using accelerometers) and diet (measured using food frequency questionnaires and diet diaries) from ages 7-13 years on changes in adiposity from ages 7-18 years?

2. What are the associations of changes in socioeconomic position (e.g. differences between grandparental, parental and own education) on changes in adiposity from birth to 18 years?

3. Are there socioeconomic differences in trajectories of physical activity (measured by accelerometer) and diet (measured by diet diaries and food frequency questionnaires) across childhood and adolescence? Are these inequalities of consistent magnitude across childhood and adolescence and to what extent do they mediate socioeconomic inequalities in adiposity trajectories?

Aim 3: To identify how changes in adiposity relate to changes in cardiovascular risk factors in childhood and adolescence

1. How do changes in BMI (birth to 18), waist circumference (ages 9-18), and fat mass (ages 9-18) relate to changes in blood pressure (ages 7-18), insulin, lipids and inflammatory markers (ages 9-18) in childhood and adolescence?

2. Do increases in markers of adiposity precede increases in cardiovascular risk factors (blood pressure, insulin, lipids and inflammatory markers) and if so what is the lag period between adiposity change and risk factor change for each risk factor?

Aim 4: To develop predictive models of extreme obesity and of metabolic resilience to obesity

Specific research questions:

1. Are there specific subgroups of children/adolescents with particularly adverse changes in adiposity, cardiovascular risk factors and lifestyle factors who could be identified in early life as at risk of extreme obesity?

2. Are there some overweight adolescents who remain more metabolically healthy than other overweight adolescents? If so, what characterises these individuals with respect to individual trajectories of adiposity, cardiovascular risk factors and lifestyle factors across childhood and adolescence?

Statistical analysis:

As part of my current role, I have modelled trajectories of height, weight, and ponderal index/BMI from birth to ten years using random effects linear spline models (in application put references to your papers here). In order to extend the models for BMI to age 18 and to model trajectories of waist circumference from ages 7-18 and DXA-determined total body fat mass from ages 9-18, a different modelling strategy will be required owing to individual variation in the timing of puberty onset. A number of potential modelling strategies could be used for these changes, with each having different strengths and limitations. I therefore propose to model BMI, waist circumference and fat mass from their earliest age of measurement (birth, 7 and 9 respectively) through to age 18 in several different ways. I will compare how trajectories derived by these different approaches associate with potential determinants and consequences. Trajectories of blood pressure, lipids, insulin and inflammatory markers will be modelled using random effects linear spline models in a similar way to the models I have already constructed for height, weight and adiposity to age 10. Trajectories of physical activity are currently being modelled by a colleague (Alex Griffiths); these will be available for use by the start of this fellowship. I will analyse longitudinal diet patterns in multilevel models using repeat scores from principal component analysis of dietary patterns using data from diet diaries and food frequency questionnaires. Associations between adiposity and cardiovascular risk factor trajectories and their determinants (physical activity, diet, etc) will be modelled using multivariate models. The relationship between adiposity trajectories and cardiovascular risk factor trajectories will be modelled in a joint multivariate model. Predictive models for 1) extreme obesity in adolescence and 2) metabolic resilience to obesity will be developed and internally validated. Accuracy of prediction will be assessed by discrimination using area under the receiver operator curves (AUROC) and calibration by comparing observed to predicted risk by tenths of the predicted risk score.

Relation to existing ALSPAC approved projects:

Aims 1-3 are already have approval under the ALSPAC exec approval for the health strand of the ESRC large grant (strand leader: Debbie Lawlor). The aims of that strand were somewhat ambitious and it will not be possible to complete all of them during the period of the grant and hence this application sensibly extends the aspect of that grant related to child obesity. The additional analyses proposed for this fellowship build on work that I have already completed in my position as RA on the ESRC large grant. Aim 1 is also already partly covered by the MRC life course grant for which Kate Tilling is PI and which already has ALSPAC exec approval. Only Aim 4 is completely novel and not covered by the existing approval.

Plan for completing work:

1. LH, DL and KT will agree specific objectives and analysis methods

2. LH will put together datasets and conduct analyses (LH already has approved access to ALSPAC built datasets)

3. LH will draft initial manuscripts

4. LH, DL, KT and other co-authors will be involved in study design, and critical evaluation of manuscripts as appropriate for each paper

All derived variables from the trajectories work will be returned to the exec. with appropriate documentation so that they can be widely used by others (as we have already done with the growth data from birth to 10).

Date proposal received: 
Tuesday, 7 September, 2010
Date proposal approved: 
Tuesday, 7 September, 2010
Keywords: 
Endocrine, Obesity, Weight
Primary keyword: 

B1035 - EAGLE Motor Development GWAS meta-analysis - 07/09/2010

B number: 
B1035
Principal applicant name: 
Prof Marjo-Riitta Jarvelin (Imperial College London, UK)
Co-applicants: 
Mr Demetris Pillas (Not used 0, Not used 0), Dr Beate Glaser (Not used 0, Not used 0)
Title of project: 
EAGLE Motor Development GWAS meta-analysis
Proposal summary: 

1. Background

The aim of this study is to perform a meta-analysis of GWAS results on the date of achievement of independent locomotion during infancy. Understanding the processes underlying the timing and achievement of developmental motor milestones is critical, since they are considered to be important indicators of the child's neurological, psychomotor, and socio-emotional integrity and subsequent development. Finnish and UK longitudinal cohort studies have highlighted the importance of infant motor development by demonstrating that failure to achieve this developmental milestone at the expected age is a strong predictor of neuropsychiatric conditions, reduced physical performance and fitness over the lifecourse1,2,3,4,5,6.

Due to the relatively brief exposure of the infant to environmental influences (compared to later periods of life) most studies focusing on early developmental milestones have estimated high heritabilities. For example, although motor development throughout childhood and adolescence is expected to be a process that develops through interactions of the individual with the environment7, twin studies on infants have estimated that over 90% of the variation in motor milestone achievement is influenced by genetic factors8. This was also recently highlighted through the first GWAS study on an aspect of infant development, tooth development, a study which demonstrated the potential to identify a large number of genetic variants through GWAS meta-analysis of relatively small sample sizes9.

The study will focus on the complete, normal, distribution of the date of achievement of independent locomotion (analysis I), but also examine the delayed achievement of independent locomotion (analysis II). This is because there is support for a larger genetic contribution to delayed as compared to non-delayed development, as heritability estimates, e.g. for early language development, increase from 21% to 48% when shifting the focus from normal to delayed development10.

2. Traits of interest

For analysis I: Walking without support/unaided (age in months)

For analysis II: Walking without support unaided at 18 months (can walk - yes/no)

3. Participating studies and sample numbers

Table 1. Individuals with GWAS and phenotype data (as of 11-07-2010)

Study

Analysis I

Analysis II

NFBC1966

4000

4000

RAINE

1500

1500

MoBa

630

630

NCDS1958

-

4500

ALSPAC

-

3000

Generation R

-

2650

Tweeligenregister

?

?

Total projected sample

6130

16280

https://spreadsheets.google.com/ccc?key=0AgoCkeBwIrX4dDVjWFYtR1NQM1pfUVBrQXAyYlBBZEE&hl=nl#gid=8

2. Phenotypes / variables necessary from ALSPAC dataset

i) At 18 months: F4(d) -greater than child ' can walk alone for at least 5 steps' (Motor milestones,Denver)

ii) For exclusion:

- intellectual disability (which infants are intellectually disabled) (if availlable)

- cerebral palsy (which infants suffered from cerebral palsy) (if availlable)

iii) gestational age (covariate to be adjusted)

Date proposal received: 
Tuesday, 7 September, 2010
Date proposal approved: 
Tuesday, 7 September, 2010
Keywords: 
Genetics
Primary keyword: 

B1033 - Early feeding of cows milk in relation to growth and bone development in ALSPAC - 07/09/2010

B number: 
B1033
Principal applicant name: 
Dr Pauline Emmett (Not used 0, Not used 0)
Co-applicants: 
Mr Colin Steer (Not used 0, Not used 0), David Hopkins (Not used 0, Not used 0), Dr Jon Tobias (Not used 0, Not used 0)
Title of project: 
Early feeding of cows? milk in relation to growth and bone development in ALSPAC
Proposal summary: 

Early feeding of cows' milk in relation to growth and bone development in ALSPAC

The current guidelines on infant feeding state that cows'milk should not be given as the main milk drink to infants before the age of 12 months. Despite this in the latest infant feeding survey 6% of 9 month olds were being fed in this way. In ALSPAC when the CIF children were 8 months old diet records were provided for 1178 infants - 13% of these were having cows' milk as their only source of milk at this age and half of these were having more than 600 mg per day. In this group, in particular, the diet was much higher in energy, protein and fat than breast fed infants and there was evidence that these children grew faster up to 61 months of age. This group also had a very high calcium intake compared to the breast fed group and this might lead to greater bone density in later life. However we showed that levels of anaemia were high in the cows' milk fed infants and their intakes of many other nutrients were low. Therefore it is important to investigate further the long-term effects of early introduction of cows' milk in a longitudinal cohort.

Planned analysis

Using questionnaire data at 15 months we will devise feeding groups in relation to the early introduction of cows' milk. The groups identified will be mutually exclusive

1. Breast feeding at 6 month or beyond (reference category)

2. Cows' milk introduced by 6 months (breast feeding stopped before 6 months)

3. Cows' milk introduced between 7-12 months (breast feeding stopped before 6 months)

4. Cows' milk introduced at or after 12 months (breast feeding stopped before 6 months)

We will use CIF diet data at 8 months to verify that these questionnaire identified groups are likely to be associated with meaningful dietary differences in the way infants were fed.

We will investigate the following outcomes in relation to these milk groups:

Bone density at 9 and 11 years from DXA measurements made in focus clinics

Anthropometric measurements at 7, 9 and 11 years

Confounding variables such a sex of the child, parity, maternal smoking in pregnancy and education level will be included

Date proposal received: 
Tuesday, 7 September, 2010
Date proposal approved: 
Tuesday, 7 September, 2010
Keywords: 
Bones
Primary keyword: 

B1031 - Genome-wide meta-analysis of brachial circumference - 06/09/2010

B number: 
B1031
Principal applicant name: 
Dr Ele Zeggini (Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK)
Co-applicants: 
Vesna Boraska (Not used 0, Not used 0), Dr Nic Timpson (Not used 0, Not used 0), Prof Debbie A Lawlor (Not used 0, Not used 0), Prof George Davey Smith (Not used 0, Not used 0)
Title of project: 
Genome-wide meta-analysis of brachial circumference
Proposal summary: 

RATIONALE

Brachial circumference (BC), also known as upper arm or mid arm circumference, can be used as an indicator of muscle mass and fat tissue. There are differences in the amounts of soft tissue and their pattern of distribution between genders. In addition, men have larger BC compared to women due to their larger muscle mass. Men show lower percent body fat whereas women have higher total body fat and a lower proportion of lean tissue distributed in the upper body.

The purpose of this study is to identify gender-specific and common effects underlying BC through GWAS meta-analysis on males, females and on the combined set of all individuals. Two types of association analyses will be performed: adjusted for age and adjusted for age and BMI.

ALSPAC data will add substantially to our current set of ~12k GWAS.

Date proposal received: 
Monday, 6 September, 2010
Date proposal approved: 
Monday, 6 September, 2010
Keywords: 
Genetics
Primary keyword: 

B1030 - Weight faltering in infancy and psychological outcomes in the Avon Longitudinal Study of Parents and Children - 06/09/2010

B number: 
B1030
Principal applicant name: 
Prof Alan Emond (University of Bristol, UK)
Co-applicants: 
Dr Amelia Holme (Not used 0, Not used 0)
Title of project: 
Weight faltering in infancy and psychological outcomes in the Avon Longitudinal Study of Parents and Children
Proposal summary: 

BACKGROUND

Failure to thrive is a term which describes children who fail to grow at the expected rate, with various definitions, including 'infants and young children whose growth is substantially less than that of their peers' (4). One factor which all definitions have in common is that cases are defined by weight gain, so the term weight faltering is preferred as it avoids the prejoritive use of 'failure' . Anthropometric measures are used to identify cases, with the development of conditional standards (5-7) taking into consideration an infant's weight gain compared with the weight gain of other infants of the same sex and initial weight, and regression towards the mean.

Analysis of the epidemiology of growth faltering in the ALSPAC cohort has identified significant correlations with parental height, and found that the condition is more common not in poorer families as traditionally thought, but in larger families (1). The most important postnatal factors associated with growth faltering were found to be the type and efficiency of feeding (2). Further work has confirmed deficits in IQ at 8 years amongst the ALSPAC cohort of infants with weight faltering (3), in keeping with existing and extensive literative on adverse cognitive and developmental outcomes. One may predict that these adverse effects extend to emotional and psychological development, but such outcomes have been less widely investigated and these findings have not been confirmed in the existing, albeit limited literature.

The most relevant UK study followed up 89 cases of children who failed to thrive as infants and 91 controls at 12 years (8). Cases were significantly shorter and lighter at 12 and had significantly lower BMIs, but did not enter puberty any later. They were more likely to rate their appetite as lower than their best friend's, were more satisfied with their body shape and had significantly lower eating behaviour restraint scores. No significant difference existed in any measures of anxiety, depression and self esteem, and the authors concluded that failure to thrive in infancy is not associated with any adverse emotional development in childhood. Indeed, some of the outcomes could even be perceived as positive, such as greater satisfaction with body shape. However, other literature is suggestive of negative psychological sequalae of weight faltering, with Chung et al finding higher psychological distress scores in adults with a lower weight gain up to 7 years old (9), and Barker et al finding that men and women who commit suicide had low rates of weight gain in infancy, taking account of social class and infant feeding (10). A more recent study based in Jamaica reported early childhood stunting was associated with more anxiety, depression and hyperactive behaviour, and lower self-esteem in late adolescence (11). Although this study focussed on a more extreme form of weight faltering due to undernutrition in a developing country, it is feasible that the effect, albeit smaller, could be extrapolated to less severe weight faltering in the developed world. Evidence linking growth faltering with insecure attachment (12-14) also adds support to the hypothesis for adverse effects on later emotional development.

Historically, 'catch up growth' was encouraged in the management of weight faltering. However evidence now suggests that rapid weight gain in infancy is associated with later obesity and subsequent increased risk for cardiovascular disease and diabetes (15-16). Recommendations for the management of weight faltering therefore need re-evaluating, with a view to balancing the risks to the child (17). In order to do this we need a comprehensive picture of the consequences of weight faltering, including the psychological outcomes as well as the growth outcomes.

The conflicting and limited literature on this topic highlights the need for further research. Use of the ALSPAC dataset would address this need, and would comprise the largest group studied with respect to the psychological and emotional consequences of weight faltering.

METHODOLOGY

The project will be undertaken as part of an academic foundation programme and supervised by Professor Alan Emond. No extra funding is required. As existing data only will be used, generic ALSPAC ethical approval will apply.

Data analysis will be conducted using STATA and statistical support will be provided by Colin Steer and Peter Blair

Cases of weight faltering will be defined as the slowest gaining 5% of infants using a weight gain criterion conditional on initial weight from birth to 6-8 weeks, 6-8 weeks to 9 months, and birth to 9 months, as used in the existing studies on weight faltering in the ALSPAC. Cases of 'early' and 'late' weight faltering in infancy will be further stratified according to BMI at 8 years- ie whether growth had caught up or not. Associations between growth faltering and psychological outcomes will be adjusted for family socio-demographic factors, age of onset of puberty, and child's IQ

Statistical methods will include univariate analysis, multivariate modelling and missing data inputation.

Date proposal received: 
Monday, 6 September, 2010
Date proposal approved: 
Monday, 6 September, 2010
Keywords: 
Primary keyword: 

B1028 - Predictors of Persistence and Psychological Impact of childhood Eczema POPPIE - 06/09/2010

B number: 
B1028
Principal applicant name: 
Dr Matthew Ridd (University of Bristol, UK)
Co-applicants: 
Dr Giles Dunnill (Not used 0, Not used 0), Dr Sarah Sullivan (Not used 0, Not used 0), Dr Sarah Purdy (Not used 0, Not used 0)
Title of project: 
Predictors of Persistence and Psychological Impact of childhood Eczema (POPPIE)
Proposal summary: 

AIM: To identify factors that predict persistent atopic eczema and/or negative psychological outcomes in children with atopic eczema.

BACKGROUND: Atopic eczema (AE, otherwise known as atopic dermatitis) is one of the commonest disorders in childhood. The disease is characterized by generalized dry skin, pruritis, and typically flexural erythema. Symptoms usually start before two years of age, and in the UK, most children will be diagnosed and treated by their general practitioner. Whilst the majority of children will have mild symptoms that improve as they get older, a significant proportion of those affected will have more severe and persistent eczema.

Our knowledge about the natural history of AE and factors that might predict persistence beyond the pre-school years is limited by the methodological imperfections of research conducted to date. Most studies have either been small, retrospective case series; suffered from a short duration of follow-up; or recruited participants from hospital in or out-patients.1 As a consequence the findings may be unrepresentative of children in the community and subject to the many biases that are associated with a retrospective study design. The only two significant cohort studies are by Williams and Strachan2 and Illi.3 Early onset of disease, severity, atopic sensitization and a strong atopic family history were associated with a worse prognosis.

As well as the physical burden of the disease, a series of studies have suggested AE can have a significant psychological impact as well. However, nearly all of these studies have serious limitations of one form or another, related to size of the study, the population from which their sample was drawn (mainly hospital out-patients), the design of the study (most are cross-sectional) and/or the outcome examined (the majority examine the psychological effect of AE on the child only). Only one recently published study by Schmitt et al4 followed-up a sizeable cohort of children for a reasonable length of time. It reported that children with infant-onset eczema were more likely to have emotional disturbance, but data on psychological health were collected just at one time-point (age 10 years) and only on the affected child.

This project will build on earlier research that has examined children in ALSPAC who have AE5-8 and address many of the limitations of previous studies that have examined prognostic factors and the psychological consequences of AE. Specifically, participants in ALSPAC were recruited from the community rather than specialist care settings; relevant data has been collected prospectively from several sources (parent, school and physical examination) with good rates of follow-up; data are available into adolescence and beyond; and clear definitions of AE can be applied using previously described criteria.5,6 For the first time will we link data available on both child and parental mental health to persistent eczema, to assess the impact of AE on both the child and the family.

In addition to answering the research questions posed, one of the outputs from this project will be to produce a map all of the questions relevant to AE. Serial questionnaires are the main source of data in ALSPAC and a detailed manual identifies which psychological instruments and have been used when. Unfortunately there in no comparable document that describes the all the different questions relating to AE. By comprehensively documenting for the first time the method of collection, timing and nature of data on AE, a valuable resource will be made available to future researchers wanting to interrogate ALSPAC for studies of AE.

Finally, we will extend the analysis performed by Wadonda-Kabondo et al5 on the prevalence and incidence of AE between to include children up to 128 months old.

PLAN OF INVESTIGATION:

We will examine data on data on parents and children both antenatal and up to 12 years of age. We have chosen this upper age limit because it is a natural watershed between childhood and early adolescence; it fits with age range of the 2007 NICE guidance; and because it represents a significant amount of data that can be explored, with potential for important findings, within the proposed research timeframe and budget. Also, previous work suggests that after the age of 11 years, the proportion of children whose eczema persists is relatively constant.2 However, once the methods have been established, dependent of course upon the findings of this study and subject to application for further funding, the approach applied to the 0-12 year age group could of course be extended to look at the 13-18 year age group and upwards.

Definition of AE: We will adopt the case of definition of AE used by Wadonda-Kabondo et al:5,6 children with a reported rash on at least two separate occasions. This was found to give estimates of the prevalence and cumulative incidence of AE similar to those from other studies.9,10 We will further sub-divide children with AE into three groups on the basis of whether AE is reported before or after 2 years of age: infant onset clearing (present before age 2 years but not after), infant onset persistent (present before age 2 years and after), or late onset (present after age 2 years but not before). Similar categories have been adopted by Illi et al3 and Schmitt et al4 and permits analysis of data and reporting of these sub-groups in a way that is reflects the patterns of AE clinicians commonly see.

Psychological measures: The psychological health of the child will be assessed using the Strength and Difficulties Questionnaire (SDQ),11 which was completed by parents at 4, 7, 8 and 11 years and the child's school at 8 and 10 years. SDQ scores above the 90th centile indicate problem behaviours and are associated with a substantially increased risk of psychiatric disorder.11 Parental psychological (depression and anxiety) health will be assessed using the Edinburgh Post-Natal Depression Score (EPDS)12 and the anxiety items from Crown-Crisp Experiential Index (CCEI).13 Mothers and father complete EPDS and CCEI approximately annually up to 11 years of age.

Analysis: 1) All of the questionnaires will be reviewed for questions pertaining AE and previously described risk factors for onset and persistence of AE. Undertaking this preliminary work will be important to both this study but also in establishing a map of atopy and skin questions in the ALSPAC dataset that will be of use in future ALSPAC-based research of AE. 2) Based on parental report, we will calculate and report the incidence and prevalence of AE at different time-points. We will also examine the reliability of the reporting of eczema. First, by comparing responses to items in earlier questionnaires that ask about skin rashes with later data that asks about "ever diagnosis" of eczema. Second, by comparing reported prevalence of AE with that recorded at clinic examination. In doing this, we will extend the analysis performed by Wadonda-Kabondo and colleagues.5 3) Using the definitions of AE given above, using simple descriptive statistics we will describe the different groups of children with and without AE. Next will we examine the data for associations between AE and characteristics which may be risk factors for AE, including birth weight, gestational age, breast-feeding, early age of onset, flexural site at disease onset, female sex, allergy (peanut, egg, fish or dust mite), hay fever or asthma, social class, family size, and family history of atopy. 4) The prevalence of child and parental psychological distress at different time-points will be reported. We will compare psychological measures for children with and without AE, adjusting for known confounders; and compare psychological measures for parents (mother and partner if available) of children with and without AE, adjusting for known confounders. These analyses will be repeated for the different sub-types of AE described. Sensitivity analyses will be conducted to examine the influence of missing data on the findings

DISSEMINATION OF FINDINGS:

A final report will be sent to the British Skin Foundation and other interested professional and patient representative bodies, including the National Institute of Health and Clinical Excellence (NICE, the guideline "Atopic eczema in children" is due to be revised in 2011), relevant Royal Colleges, the University of Nottingham Centre for Evidence Based Medicine, British Association of Dermatologists, the Primary Care Dermatology Society, and the National Eczema Society. The findings will also be published in peer-reviewed scientific journals.

ABOUT THE STUDY TEAM:

Matthew Ridd is an GP and lecturer in primary care, with an interest in promoting research to understand the nature and best management of common dermatological problems seen in primary care. He will be responsible for supervising an RA who will lead on the project; monitoring budgets and progress; and producing the final report.

Sarah Purdy is a consultant senior lecturer and practicing GP. She has conducted primary research on the epidemiology and management of acne in primary care and secondary research on the management of acne and eczema in primary care. She is a clinical epidemiologist and has extensive experience of working with large datasets.

Sarah Sullivan has experience of using the ALSPAC data set, especially in relation to measures of mental health. Her PhD is using the ALSPAC cohort to examine Psychosis-like Symptoms (PLIKS) and Social Functioning.

GD is a consultant dermatologist who co-supervised Dr Wadonda-Kabondo's PhD, from which two of the most significant studies of AE using the ALSPAC dataset have been published.

Date proposal received: 
Monday, 6 September, 2010
Date proposal approved: 
Monday, 6 September, 2010
Keywords: 
Skin
Primary keyword: 

B266 - Long-term effects of exposure to oxytocin - 06/09/2010

B number: 
B266
Principal applicant name: 
Prof Jean Golding (University of Bristol, UK)
Co-applicants: 
Prof John Davis (University of Illinois at Chicago, USA), Dr Sue Carter (University of Illinois at Chicago, USA)
Title of project: 
Long-term effects of exposure to oxytocin.
Proposal summary: 

The research question concerns the use of oxytocin and the way in which that might affect the mother's interaction with her child. This requires assessment of details available in medical records [the obstetric record extraction only obtained a yes/no answer to this, but duration and dose are required].

Date proposal received: 
Tuesday, 1 November, 2005
Date proposal approved: 
Monday, 6 September, 2010
Keywords: 
Autism, Pregnancy
Primary keyword: 

B526 - Investigating the development of romantic and sexual activity in early adolescence - 23/08/2010

B number: 
B526
Principal applicant name: 
Dr Nicola Low (University of Bern, Switzerland, Europe)
Co-applicants: 
Dr J Cassell (Not used 0, Not used 0), Dr Andrea Waylen (University of Bristol, UK), Prof Andy Ness (University of Bristol, UK), Prof Jonathan Sterne (University of Bristol, UK), Prof Dieter Wolke (University of Warwick, UK)
Title of project: 
Investigating the development of romantic and sexual activity in early adolescence
Proposal summary: 

Risky sexual behaviour is a key strand in ALSPAC's newly funded ESRC programme. Sexual behaviour is a part of normal human development. Although early sexual activity has adverse outcomes, including unwanted pregnancy, sexually transmitted infections including HIV, and psychological disturbances, the vast majority of adolescents do not experience these consequences. Investigating the origins of risky behaviour should therefore take place within the overall context of the development of romantic and sexual behaviours. Developmental theories suggest a number of potential risk factors for early sexual behaviours but these hypotheses have not been tested extensively in large prospective studies.

Data about romantic and sexual behaviours have been collected by computer assisted self interview in ALSPAC since age 11+. The questionnaire was adapted from the Adolescent Sexual Activity Index. This instrument asks a child about their participation in a hierarchy of ten romantic and sexual activities, and has additional questions about the context of encounters.

Preliminary analyses at 11+ and 12+ clinics have included data from 6856/7218 (95%) children aged 11-12 years and 6801/7011 (97%) aged 12-13 years. Amongst 11-12 year olds 16.2% (95% CI 15.3-17.1) had kissed another person. One year later, 32.6, 95% (CI 31.5-33.8) had kissed another person. More intimate behaviours (asked only at 12+) were much less frequent. For girls and boys combined, 11.8% (95% CI 11.0-12.6) of 12-13 year olds had lain down together with someone of the opposite sex and 4.9% (95%CI 4.5-5.5) reported petting or coital behavior of some sort. No analyses of factors associated with these behaviours has yet been done.

Objectives

1. To document trajectories of romantic and sexual development in 11-13 year old children;

2. To determine indicators of social position, family and neighbourhood environment, parental and child behaviours in early and middle childhood that are associated with the early onset of intimate sexual behaviour in 11-13 year olds;

Date proposal received: 
Monday, 23 August, 2010
Date proposal approved: 
Monday, 23 August, 2010
Keywords: 
ADHD, Antisocial Behaviour, Behavioural Problems
Primary keyword: 

B965 - The contributions of phonological and morphological knowledge to achievement in English KS2 and 3 - 20/08/2010

B number: 
B965
Principal applicant name: 
Terezinha Nunes (University of Oxford, UK)
Co-applicants: 
Rosina Barros (Not used 0, Not used 0), Peter Bryant (Not used 0, Not used 0)
Title of project: 
The contributions of phonological and morphological knowledge to achievement in English KS2 and 3
Proposal summary: 

The contributions of phonological and morphological knowledge to achievement in English KS2 and 3

Abstract

English orthography uses letters to represent sounds (phonemes) and to represent units of meaning, called morphemes. The word magician exemplifies this well. M and GI in magician represent the same sounds as they do in other words; the rest of the word would seem irregular if analysed in letter-sound correspondences. However, it is a regular word, formed by two morphemes: magic, the stem, and the suffix -ian. There is a growing body of evidence that students' knowledge of morphemes is important for spelling and reading comprehension in English. Using a large data set (over 2,500 students) and advanced statistical analyses, this project will investigate whether students' knowledge of both phonemes and morphemes are related to their later English achievement in standardised school assessments, and whether these two aspects of linguistic knowledge are associated with the students' socio-economic background. The results will contribute to a better understanding of literacy learning in primary school and will have implications for the democratisation of education.

Proposed programme

The project has two aims. First, to analyse the relative role of children's phonological and morphological skills in their English attainment in school and their reading comprehension. Second, to analyse the relationships between these cognitive factors and the children's socio-economic background.

The ALSPAC data base has measures of students' SES, general intelligence, vocabulary, working memory (WM), and their reading and spelling skills at ages 8 and 9. The reading and spelling measures (Nunes et al., 2003) include two groups of words and pseudowords: one group can be read or spelled using only phonological knowledge (e.g. slide and smape) but the second group requires the use of morphological knowledge (e.g. dishonest and mishammer). These measures will be used a predictors of three outcome measures: reading comprehension, obtained at age 9, and English achievement at KS2 and KS3. ) We propose to test whether the students' phonological and morphological knowledge at age 9 predicts their reading comprehension, and their later English KS2 & 3 achievement, after controlling for general intelligence, vocabulary and WM. The relationships between these measures and the students' SES will be further analysed in structural equation models. We hypothesise that students' linguistic knowledge is directly related to their English KS 2 & 3 achievement, and also mediates the connection between SES and their KS 2 & 3 achievement in English: SES differences affects the children's linguistic knowledge which in turn determines their KS 2 & 3 achievement.

These analyses will make significant contributions to knowledge about the development of reading and spelling and reading comprehension as well as English achievement in school. First, they will provide the first evidence on the separate contributions made by phonological and morphological knowledge to reading comprehension in the U.K. context. Second, KS assessments are an ecologically valid measure of school achievement; this will be the first analysis of how morphological and phonological knowledge relate to later English achievement in school designed measured. Third, the contribution of analyses of large data sets is unique: they offer a much more secure basis for generalisations and the development of educational policy. There are no previous large scale studies of the relationships between measures of phonological and morphological knowledge and later English achievement. Finally, if linguistic knowledge is shown to mediate the effects of SES on students' KS2 & 3 English attainment, this entirely new result will have important implications for curriculum development and should lead to better democratisation of education.

Date proposal received: 
Friday, 20 August, 2010
Date proposal approved: 
Friday, 20 August, 2010
Keywords: 
Education
Primary keyword: 

B1023 - GWAS of blood pressure in children of early genetics and lifecourse epidemiology EAGLE consortium - 05/08/2010

B number: 
B1023
Principal applicant name: 
Priyakumari Parmar (Not used 0, Not used 0)
Co-applicants: 
Dr Nic Timpson (Not used 0, Not used 0), Prof Lyle Palmer (Not used 0, Not used 0), Prof Craig Pennell (Not used 0, Not used 0), Dr Vincent Jaddoe (Not used 0, Not used 0), Rob Taal (Not used 0, Not used 0), Dr Joachim Heinrich (Not used 0, Not used 0), Prof Laurie Beilin (Not used 0, Not used 0)
Title of project: 
GWAS of blood pressure in children of early genetics and lifecourse epidemiology (EAGLE) consortium
Proposal summary: 

This proposal aims initially to undertake meta-analyses of GWAS data for cross-sectional BP. Nicholas Timpson is representing ALSPAC with regards to the EAGLE Blood Pressure Working Group and has already agreed to complete these analyses. We are planning to run meta-analyses of cross-sectional GWAS across the participating cohorts of EAGLE which include Raine, GenR and Lisa Plus in children aged between 5 and 15 years of age.

From here we hope to identify specific SNPs and genes associated with the elevated measures SBP and DBP and additionally take these significant SNPs and investigate their association in adult blood pressure consortiums to provide further insight in to the underlying genetic determinants of adult hypertension.

We also intend to analyse both the intercept and slope of longitudinally measured BP in childhood. We will utilise a range of statistical methods, including Bayesian techniques, to investigate gene:gene interactions and longitudinal blood pressure trajectories during the postnatal period. This research will produce best linear unbiased predictors (BLUPs) for blood pressure trajectories for all eligible studies within the EAGLE Consortium for future genetic and epidemiological investigations.

Date proposal received: 
Thursday, 5 August, 2010
Date proposal approved: 
Thursday, 5 August, 2010
Keywords: 
Cardiovascular , Genetics
Primary keyword: 

B1029 - Associations of a polymorphism in the ACTN3 gene and physical capability - 17/07/2010

B number: 
B1029
Principal applicant name: 
Prof Ian Day (University of Bristol, UK)
Co-applicants: 
Prof Yaov Ben-Schlomo (Not used 0, Not used 0), Tamuno Alfred (Not used 0, Not used 0)
Title of project: 
Associations of a polymorphism in the ACTN3 gene and physical capability
Proposal summary: 

Muscle performance plays a direct role in measures of physical capability, such as grip strength, and indirectly influences the ability to balance and walking speed. It is therefore hypothesised that genes involved in muscle function affect physical capability.

The protein ACTN3 is expressed in fast twitch muscle fibers and a polymorphism in ACTN3 has been linked to athletic performance (Ahmetov et al. 2008, Enyon et al 2009). Whilst some studies have investigated the association between this polymorphism and measures of physical functioning in the general population (Moran et al. 2007, Delmonico et al. 2008, Walsh et al 2008), with, for example, no associations observed with grip strength in older adults (Delmonico et al. 2008) or adolescents (Moran et al), there have also been conflicting gender differences found with regards to other physical functioning traits (Delmonico et al 2008, Walsh et al. 2008). Thus it is proposed that a larger sample size will be able to provide stronger evidence of any positive or null associations.

The objective is to use available genotypic information for ACTN3 (rs1815739/ r577X) in ALSPAC and investigate associations with measures of physical capability. The analyses will then be pooled in a meta-analysis with 7 HALCyon cohorts (www.halcyon.ac.uk) containing around 12,000 middle-aged UK men and women.

Date proposal received: 
Saturday, 17 July, 2010
Date proposal approved: 
Saturday, 17 July, 2010
Keywords: 
Genetics
Primary keyword: 

B1021 - An investigation of common and unique maternal influences on the development of social communication deficits and hyperactivity in children during later life - 09/07/2010

B number: 
B1021
Principal applicant name: 
Dr Beate St Pourcain (University of Bristol, UK)
Co-applicants: 
Prof George Davey Smith (University of Bristol, UK), Prof David Skuse (King's College London, UK), Prof Jean Golding (University of Bristol, UK), Dr William Mandy (King's College London, UK)
Title of project: 
An investigation of common and unique maternal influences on the development of social communication deficits and hyperactivity in children during later life
Proposal summary: 

The aim of this study is to investigate the influence of maternal risk factors before and/or during pregnancy on the development of social communication deficits and hyperactivity in children during later life. At the extreme end of each phenotypic spectrum, characterised by Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) respectively, considerable comorbidity has been reported 1. 20-50% of children with ADHD meet diagnostic criteria for ASD, and 30-80% of ASD children meet diagnostic criteria for ADHD1. Both conditions, ASD and ADHD, share variance at a behavioural level (e.g.2,3), and the identification of shared structural brain abnormalities (e.g. 4) and genetic risk factors (e.g. 5) implies the presence of some underlying shared disease aetiology (e.g. 6).

The overlap in characteristics between ADHD and ASD, both at a behavioural and at a neural level, raises the question of whether environmental or familial exposures that have previously been associated with ASD(e.g. 7,8,9) also confer risk of ADHD symptoms (specifically, hyperactivity in this context). Are those risks found in children with ASD who lack ADHD symptoms? Establishing differences in environmental risk factor profiles is an important step towards the identification of the role of specific environmental risk within GxE interactions (as proposed in B954) and the detection of critical time windows during child development where environmental or familial exposures may exacerbate genetically mediated risk.

Using the phenotypic richness and power of the ALSPAC cohort, we will focus on the investigation of broad ASD and ADHD phenotypes during the course of child and adolescent development. Specifically,we will model individual and joint trajectories for the development of social communication deficits (mother-reported SCDC measurements: 91, 128, 166, 198 mns) and hyperactive behaviour (mother-reported SDQ scores: 47, 81, 97, 115, 140, 157, 198 mns). We will examine risk of the child following one or other trajectory in relation to reports of maternalsubstance use (smoking, marijuana use and alcohol use) during and before pregnancy, maternal infections (influenza) during and before pregnancy and a maternal history of psychiatric disorders.

We will also investigate whether these trajectories, and any associated risk, are moderated by parenting influences, such as parental warmth 10 (aggregated parenting measure at 8 months and 33 months derived by Andrea Waylen and Sarah Stewart-Brown)

Using structural equation modelling, weseek to identify risk factors that are unique with respect to the expression of the individualbroad ASD and ADHD phenotypesand, if possible, to distinguish them from risk factors that are shared, and likely to indicate a common aetiology.

Date proposal received: 
Friday, 9 July, 2010
Date proposal approved: 
Friday, 9 July, 2010
Keywords: 
ADHD, Behavioural Problems
Primary keyword: 

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