Publications by authors named "Lisa K Micklesfield"

Background: Adolescence is a crucial period for establishing healthy behaviours that can reduce the risk of noncommunicable diseases. However, limited data exist on the clustering of health-related behaviours, in adolescents from low- and middle-income countries (LMICs). This study examined how diet and physical activity behaviours cluster and how they are influenced by home and school area-level deprivation.

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  • Understanding bone growth in adolescents with HIV could help improve their skeletal health and decrease fracture risk later in life.
  • The study compared bone mineral density and strength between children with HIV on antiretroviral therapy and those without HIV, revealing that children with HIV generally had lower bone measurements but similar increases over time.
  • Notably, height-for-age scores were found to influence how HIV affected bone growth, impacting females more significantly in terms of bone density and strength changes.
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Background: Angiotensin-converting enzyme inhibitor-induced angioedema (AE-ACEI) is a life-threatening adverse event and, globally, the commonest cause of emergency presentations with angioedema. Several large genome-wide association studies (GWAS) have found genomic associations with AE-ACEI. However, despite African Americans having a 5-fold increased risk of AE-ACEI, there are no published GWAS from Africa.

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Understanding how urban environments shape physical activity is critical in rapidly urbanizing countries such as South Africa. We assessed the reliability of virtual audits for characterizing urban features related to physical activity in Soweto, South Africa. We used the Microscale Audit of Pedestrian Streetscapes Global tool to characterize pedestrian-related features from Google Street View images in four neighborhoods of Soweto.

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Introduction: HIV infection and its treatment compromises skeletal development (growth and maturation). Skeletal maturity is assessed as bone age (BA) on hand and wrist radiographs. BA younger than chronological age (CA) indicates delayed development.

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Objectives: To investigate longitudinal changes in SHBG and free testosterone (free T) levels among Black middle-aged African men, with and without coexistent HIV, and explore associations with incident dysglycaemia and measures of glucose metabolism.

Design: This longitudinal study enrolled 407 Black South African middle-aged men, comprising primarily 322 men living without HIV (MLWOH) and 85 men living with HIV (MLWH), with normal fasting glucose at enrollment. Follow-up assessments were conducted after 3.

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Background: Menopause and HIV are associated with cardiometabolic disease. In sub-Saharan Africa there is a growing population of midlife women living with HIV and a high prevalence of cardiometabolic disease.

Objectives: The aim of this study was to determine whether menopause and HIV were associated with cardiometabolic disease risk factors in a population of midlife sub-Saharan African women.

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Objective: To explore depot-specific functional aspects of adipose tissue, examining the putative role for menopause and HIV status on insulin sensitivity (SI) and beta-cell function in Black South African women.

Methods: Women (n = 92) from the Middle-Aged Soweto Cohort, including premenopausal HIV-negative women (n = 21); premenopausal women living with HIV (LWH; n = 11); postmenopausal HIV-negative women (n = 42); and postmenopausal women LWH (n = 18) underwent the following tests: body composition (dual-energy x-ray absorptiometry); fasting bloods for sex hormones, inflammation, and adipokines; frequently sampled intravenous glucose tolerance test for SI and beta-cell function (disposition index, DI); abdominal (aSAT) and gluteal subcutaneous adipose tissue (gSAT) biopsies for cell size, and mRNA expression of adipokines, inflammation, and estrogen receptors (ER).

Results: Depot-specific associations between gene expression and insulin parameters did not differ by HIV or menopause status.

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Background: Polygenic prediction studies in continental Africans are scarce. Africa's genetic and environmental diversity pose a challenge that limits the generalizability of polygenic risk scores (PRS) for body mass index (BMI) within the continent. Studies to understand the factors that affect PRS variability within Africa are required.

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  • This study is the largest genome-wide association study (GWAS) focusing on urinary albumin-to-creatinine ratio (UACR) in Sub-Saharan African (SSA) populations, involving nearly 18,000 participants.
  • Researchers identified two significant genetic loci associated with UACR, one in residents of SSA and another in non-resident individuals of African ancestry.
  • The findings highlight the limited transferability of polygenic scores across different populations, underscoring the importance of diverse genetic studies to understand kidney disease susceptibility in underrepresented groups.
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  • There is a lack of randomized controlled trials (RCTs) investigating the impact of vitamin D on bone mineral content (BMC) and fracture risk in Black African children, leading to this sub-study among 450 Cape Town schoolchildren aged 6-11.
  • The study found that after a 3-year vitamin D supplementation of 10,000 IU weekly, participants had higher serum vitamin D levels and lower parathyroid hormone (PTH) levels, but no significant differences in BMC or bone turnover markers between the vitamin D and placebo groups.
  • Fractures were infrequent in both the vitamin D and placebo groups, suggesting that while vitamin D supplementation improved some biochemical markers, it did not significantly affect bone density or
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Objectives: Given the increasing prevalence of obesity and need for effective interventions, there is a growing interest in understanding how an individual's body image can inform obesity prevention and management. This study's objective was to examine the use of silhouette showcards to measure body size perception compared with measured body mass index, and assess body size dissatisfaction, in three different African-origin populations spanning the epidemiological transition. An ancillary objective was to investigate associations between body size perception and dissatisfaction with diabetes and hypertension.

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Introduction: This study aimed to, first, determine the clusters of sex hormones, liver enzymes, and cardiometabolic factors associated with postprandial glucose (PPG) and, second to evaluate the variation these clusters account for jointly and independently with polygenic risk scores (PRSs) in South Africans of African ancestry men and women.

Research Design And Methods: PPG was calculated as the integrated area under the curve for glucose during the oral glucose tolerance test (OGTT) using the trapezoidal rule in 794 participants from the Middle-aged Soweto Cohort. Principal component analysis was used to cluster sex hormones, liver enzymes, and cardiometabolic factors, stratified by sex.

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  • * Researchers identified two significant genetic loci associated with urinary albumin-to-creatinine ratio (UACR) — one on chromosome 6 and another on chromosome 11 — while confirming links to previously known regions associated with UACR.
  • * The findings highlight the genetic diversity in SSA populations and the limitations of polygenic scores from European ancestry studies, underscoring the need for more genetic research in diverse groups to better understand chronic kidney disease risk factors.
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Most hypertension-related genome-wide association studies (GWASs) focus on non-African populations, despite hypertension (a major risk factor for cardiovascular disease) being highly prevalent in Africa. The AWI-Gen study GWAS meta-analysis for blood pressure (BP)-related traits (systolic and diastolic BP, pulse pressure, mean-arterial pressure and hypertension) from three sub-Saharan African geographic regions (N = 10,775), identifies two novel genome-wide significant signals (p < 5E-08): systolic BP near P2RY1 (rs77846204; intergenic variant, p = 4.95E-08) and pulse pressure near LINC01256 (rs80141533; intergenic variant, p = 1.

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  • The study investigated the relationships between birth weight, postnatal growth, and the age of menarche in girls from five low- and middle-income countries (Brazil, Guatemala, India, the Philippines, and South Africa).
  • Results showed that while birth weight did not influence age at menarche, greater height and weight during early childhood correlated with earlier onset of menarche; stunted girls experienced a significantly later age at menarche.
  • The findings suggest that while promoting healthy growth is essential, the interactions between growth patterns and menarche timing are complex and warrant further investigation for global health strategies.
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Purpose: To review the rising prevalence of osteopenia and osteoporosis in sub-Saharan Africa and the challenges this poses to governments and healthcare services. Using existing studies, we compare the prevalence of osteopenia and osteoporosis in men and women from sub-Saharan Africa to US and UK cohorts. Context-specific disparities in healthcare are discussed particularly the challenges in diagnosis and treatment of osteoporosis.

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Objective: To compare the risk factors for cardiometabolic disease between pre- and postmenopausal women from four sub-Saharan African countries.

Study Design: This cross-sectional study included 3609 women (1740 premenopausal and 1869 postmenopausal) from sites in Ghana (Navrongo), Burkina Faso (Nanoro), Kenya (Nairobi), and South Africa (Soweto and Dikgale). Demographic, anthropometric and cardiometabolic variables were compared between pre- and postmenopausal women, within and across sites using multivariable regression analyses.

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Objectives: We investigated progression through the care cascade and associated factors for people with diabetes in sub-Saharan Africa to identify attrition stages that may be most appropriate for targeted intervention.

Design: Cross-sectional study.

Setting: Community-based study in four sub-Saharan African countries.

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The Pulvers' silhouette showcards provide a non-invasive and easy-to-use way of assessing an individual's body size perception using nine silhouette shapes. However, their utility across different populations has not been examined. This study aimed to assess: 1) the relationship between silhouette perception and measured anthropometrics, i.

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Objectives: To determine the prevalence of multimorbidity, to identify which chronic conditions cluster together and to identify factors associated with a greater risk for multimorbidity in sub-Saharan Africa (SSA).

Design: Cross-sectional, multicentre, population-based study.

Setting: Six urban and rural communities in four sub-Saharan African countries.

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Objectives: Bone age (BA) measurement in children is used to evaluate skeletal maturity and helps in the diagnosis of growth disorders in children. The two most used methods are Greulich and Pyle (GP), and Tanner and Whitehouse 3 (TW3), both based upon assessment of a hand-wrist radiograph. To our knowledge no study has compared and validated the two methods in sub-Saharan Africa (SSA), and only a few have determined BA despite it being a region where skeletal maturity is often impaired for example by HIV and malnutrition.

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Background: This study aimed to explore association of self-reported physical activity domains of work, leisure, and transport-related physical activity and body mass index (BMI) in 9388 adult men and women from the Africa-Wits-INDEPTH partnership for Genomic (AWI-Gen) study in Africa. Africa-Wits-INDEPTH partnership for Genomic is a large, population-based cross-sectional cohort with participants from 6 sites from rural and urban areas in 4 sub-Saharan African countries.

Methods: A sex-stratified meta-analysis of cross-sectional data from men and women aged 29-82 years was used to assess the association of physical activity with BMI.

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An estimated 25% of South African women live with human immunodeficiency virus (HIV). Antiretroviral therapy roll-out has improved life expectancy, so many more women now reach menopause. We aimed to quantify changes in bone mineral density (BMD) during the menopausal transition in urban-dwelling South African women with and without HIV and determine whether HIV infection modified the effect of menopause on BMD changes.

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