Global supply chains play a critical role in many of the most pressing environmental stresses and social struggles identified by the United Nations’ Sustainable Development Goals (SDGs). Responding ...to calls from the global community, companies are adopting a variety of voluntary practices to improve the environmental and/or social management of their suppliers’ activities. We develop a global survey of 449 publicly listed companies in the food, textile, and wood-products sectors with annual reports in English to provide insight into how the private sector contributes to advancing the SDGs via such sustainable-sourcing practices. We find that while 52% of companies use at least one sustainable-sourcing practice, these practices are limited in scope; 71% relates to only one or a few input materials and 60.5% apply to only first-tier suppliers. We also find that sustainable-sourcing practices typically address a small subset of the sustainability challenges laid out by the SDGs, primarily focusing on labor rights and compliance with national laws. Consistent with existing hypotheses, companies that face consumer and civil society pressure are associated with a significantly higher probability of adopting sustainable-sourcing practices. Our findings highlight the opportunities and limitations of corporate sustainable-sourcing practices in addressing the myriad sustainability challenges facing our world today.
Introduction
Adolescent polycystic ovary syndrome (PCOS) is characterized by androgen excess and oligo-amenorrhea, and often results from ectopic lipid storage due to a mismatch between early ...adipogenesis and later lipogenesis. Endogenous HOX transcript antisense RNA (HOTAIR) and exogenous pioglitazone are enhancers of subcutaneous adipogenesis, particularly in the gluteofemoral region. The A allele of
HOTAIR rs1443512
is an equivalent of a natural knock-down and is, thus, a candidate to influence the distribution of fat mass, and also the redistribution of fat mass by pioglitazone in adolescent PCOS-without-obesity.
Subjects and methods
We performed two post hoc analyses by
HOTAIR rs1443512
genotype. In the first, we analyzed the pooled pre-treatment data (auxology; endocrinology; body composition by dual X-ray absorptiometry; abdominal fat distribution by magnetic resonance imaging) of 65 adolescent girls with PCOS-without-obesity in three reported studies (ISRCTN45546616; ISRCTN29234515; ISRCTN11062950). In the second, we analyzed the results of 24 adolescent girls with PCOS-without-obesity, who received pioglitazone (7.5 mg/d for 1 year) as part of a randomized combination treatment (with spironolactone and metformin) in two reported studies (ISRCTN29234515; ISRCTN11062950). All data had been obtained in a blinded-to-genotype way.
Results
The pre-treatment data disclosed that the girls-with-A-allele of
HOTAIR rs1443512
had developed PCOS with a lower BMI (22.3 ± 2.3 kg/m
2
;
N
= 17) than the other girls (24.1 ± 2.7 kg/m
2
;
N
= 48), this difference being essentially attributable to a lower fat mass (mean difference 4.6 kg;
P
< 0.01). On low-dose pioglitazone, girls-with-A-allele (
N
= 12) raised their fat mass while the other girls (
N
= 12) did not (total fat mass + 2.2 ± 1.8 kg vs – 0.9 ± 2.2 kg;
P
< 0.001), particularly in the gynoid area (gluteofemoral fat + 0.6 ± 0.4 kg vs – 0.1 ± 0.5 kg; hip circumference + 2.3 ± 1.9 cm vs – 1.7 ± 3.1 cm; both
P
< 0.001).
Conclusion
The present findings suggest that the
HOTAIR rs1443512
genotype influences not only the distribution of fat mass in adolescent girls with PCOS-without-obesity but also the redistribution of fat mass during prolonged treatment with low-dose pioglitazone.
Trial registration
ISRCTN45546616 (
https://doi.org/10.1186/ISRCTN45546616
).
ISRCTN29234515 (
https://doi.org/10.1186/ISRCTN29234515
).
ISRCTN11062950 (
https://doi.org/10.1186/ISRCTN11062950
).
Summary
Background
Infants born small‐for‐gestational‐age (SGA) who develop post‐natal weight catch‐up are at risk for insulin resistance, central adiposity and cardiovascular disease in later life, ...even in the absence of overweight.
Objective
In young (age 3–6 years) non‐obese SGA children, we assessed arterial health (as judged by intima‐media thickness IMT) and abdominal fat distribution (subcutaneous, visceral, preperitoneal and hepatic components by magnetic resonance imaging MRI and/or ultrasound US) besides a selection of endocrine markers.
Methods
Comparisons of measures in SGA (n = 27) vs. appropriate‐for‐GA (AGA) children (n = 19) of similar height, weight and body mass index. Longitudinal outcomes (age 3–6 years) were carotid IMT (cIMT); fasting glucose, circulating insulin, IGF‐I and high‐molecular‐weight (HMW) adiponectin; abdominal fat partitioning by US. Cross‐sectional outcomes (age 6 years) were aortic IMT (aIMT) and abdominal fat partitioning by MRI.
Results
At 3 and 6 years, cIMT and IGF‐I results were higher and HMW adiponectin lower in SGA than AGA children; at 6 years, SGA subjects had also a thicker aIMT and more pre‐peritoneal and hepatic fat, and were less insulin sensitive (all P values between <0.05 and <0.0001). cIMT correlated positively with pre‐peritoneal fat, particularly at 6 years. Post‐SGA status and weight gain in early childhood (between 3 and 6 years) were independent predictors of cIMT at 6 years, explaining 48 % of its variance.
Conclusion
SGA children aged 3–6 years were found to have a thicker intima‐ media and more pre‐peritoneal and hepatic fat than AGA children of comparable size.
Summary
Background
Telomere length at birth is a major determinant of telomere length in late adulthood. However, the prenatal setting of telomere length is poorly understood. Individuals born large ...from non‐diabetic mothers are at lower risk for later‐life disorders than those born small, a feature of their longer health span being a higher lean mass that provides more muscle strength and that is already present in infancy.
Methods
At birth, we studied leukocyte telomere length (by quantitative polymerase chain reaction) in 103 small‐for‐gestational‐age, appropriate‐for‐gestational‐age or large‐for‐gestational‐age (SGA, AGA or LGA) infants born after uncomplicated, term, singleton pregnancies. All infants were breastfed for ≥4 months. At 2 weeks and 12 months, body composition was assessed by dual X‐ray absorptiometry.
Results
Telomere lengths were shorter in SGA newborns and longer in LGA newborns than in AGA newborns (P < 0.001), also after adjustment for maternal age, pre‐gestational body mass index, gestational weight gain and gestational age. Telomere length at birth associated (all P ≤ 0.001) to birthweight (r = 0.50) and to both lean mass (r = 0.43) and fat mass (r = 0.48) at age 2 weeks, but only to lean mass at 12 months (r = 0.51).
Conclusion
Higher weight and longer telomeres at birth are followed by more lean mass in late infancy. Relatively large, breastfed infants from non‐diabetic mothers may become models of how to make a healthy start.
Fibroblast growth factor 19 (FGF19) and 21 (FGF21) have been linked to obesity and type 2 diabetes in adults. We assessed the circulating concentrations of these factors in human neonates and ...infants, and their association with the endocrine-metabolic changes associated to prenatal growth restraint.
Circulating FGF19 and FGF21, selected hormones (insulin, insulin-like growth factor I and high- molecular-weight (HMW) adiponectin) and body composition (absorptiometry) were assessed longitudinally in 44 infants born appropriate- (AGA) or small-for-gestational-age (SGA). Measurements were performed at 0, 4 and 12 months in AGA infants; at 0 and 4 months in SGA infants; and cross-sectionally in 11 first-week AGA newborns.
Circulating FGF19 and FGF21 surged >10-fold in early infancy from infra- to supra-adult concentrations, the FGF19 surge appearing slower and more pronounced than the FGF21 surge. Whereas the FGF21 surge was of similar magnitude in AGA and SGA infants, FGF19 induction was significantly reduced in SGA infants. In AGA and SGA infants, cord-blood FGF21 and serum FGF19 at 4 months showed a positive correlation with HMW adiponectin (r=0.49, P=0.013; r=0.43, P=0.019, respectively).
Our results suggest that these early FGF19 and FGF21 surges are of a physiological relevance that warrants further delineation and that may extend beyond infancy.
A 3-month-old infant was examined for inconsolable crying with polydipsia, polyuria, and rapid weight gain. Unexpectedly, the symptoms resolved spontaneously during hospitalization but were ...aggravated 2 weeks after discharge, with the patient presenting a Cushingoid appearance. Investigations ruled out diabetes mellitus and nephrogenic diabetes insipidus but indicated adrenocortical suppression by exogenous glucocorticoids, which were discovered via toxicologic analysis of her previously compounded omeprazole suspension. After discontinuing the omeprazole suspension, the infant recovered fully and the laboratory results normalized. This case shows us that the assumption of appropriate medication intake may conceal unexpected medication errors.
Following this case, the current literature on the benefits and risks of compounding and its impact on patient health is discussed.
Summary
Background
Increased uric acid is an independent biomarker for cardiovascular disease in obese adolescents and adults.
Objective
We investigated whether uric acid relates to carotid ...intima‐media thickness (cIMT) in prepubertal children, and whether body mass index (BMI) and preperitoneal fat modulate this association.
Methods
359 asymptomatic prepubertal Caucasian children were stratified according to BMI categories (171 with BMI‐SDS < 0; 188 with BMI‐SDS ≥ 0) and according to preperitoneal fat levels (180 with preperitoneal fat <50th centile; 179 with preperitoneal fat >50th centile). Uric acid levels, insulin resistance (homeostasis model assessment insulin resistance; HOMA‐IR), C‐reactive protein (CRP), triacylglycerol (TG), systolic blood pressure (SBP), abdominal fat and cIMT (both by ultrasound) were assessed.
Results
Uric acid was associated with several cardiovascular risk factors, namely higher HOMA‐IR, CRP, TG, BMI, waist, SBP, preperitoneal fat and cIMT (all P < 0.001 to P < 0.0001). Significant BMI and preperitoneal fat interactions were documented in the relationship between uric acid and cIMT (both P < 0.05), as uric acid was preferentially related to cIMT in heavier children (β = 0.247, P < 0.001, r2 = 9.1%) and in children with more preperitoneal fat (β = 0.263, P < 0.0001, r2 = 11.9%).
Conclusions
Serum uric acid is associated with cIMT in asymptomatic prepubertal children. Both higher BMI and preperitoneal fat aggravate the potential risk of atherosclerotic disease imposed by higher concentrations of uric acid.
Hyperinsulinemic hyperandrogenism with anovulation, the so-called polycystic ovary syndrome (PCOS), is the most frequent endocrine disorder of young women. One of the stigmata of PCOS is a deficit of ...lean mass and an excess of fat, in particular, abdominal fat, even in the absence of obesity. Adiponectin and IL-6 are among the adipocytokines that have recently been related to abdominal fat excess, insulin resistance states, and cardiovascular disease risk. We studied the effects of two new treatment options, ethinylestradiol-drospirenone and flutamide-metformin, and of their combination on adipocytokinemia and body adiposity in adolescents and women with PCOS.
Adolescents with PCOS (n = 32; age, ∼15 yr; body mass index, ∼22 kg/m2) were randomly assigned to receive the oral contraceptive (OC) ethinylestradiol-drospirenone, or the low-dose generic duo of flutamide (62.5 mg/d) plus metformin (850 mg/d). Young women with PCOS (n = 22; age, ∼19 yr; body mass index, ∼22 kg/m2) were randomized to receive the same OC, either alone or with flutamide-metformin. Fasting blood glucose, serum insulin, lipids, androgens, IL-6, adiponectin, and body composition (by absorptiometry) were assessed at the start, and after 3 and/or 9 months.
At the start, serum concentrations of the proinflammatory IL-6 were high, and those of the antiinflammatory adiponectin were low; body composition was adipose in each subpopulation. Abnormal adipocytokine levels, hypertriglyceridemia, and body adiposity diverged further from the norm in adolescents on OC; in contrast, girls on flutamide-metformin reverted all study indices toward normal, lost part of their fat excess, and reduced their lean mass deficit. In comparison to the girls on OC, those on flutamide-metformin lost a mean of approximately 4 kg of fat and gained approximately 4 kg of lean mass. Similarly, abnormal adipocytokine levels and adiposity were aggravated in women on OC alone and improved in women on OC plus flutamide-metformin; within 9 months, the latter subgroup lost a mean of approximately 3 kg of fat and gained approximately 3 kg of lean mass, in comparison to women on OC alone.
In conclusion, young and nonobese PCOS patients were found to be in a low-grade, chronic inflammation state, and to have a body adiposity that evolves according to the balance of circulating adipocytokines and lipids, rather than to androgen excess or fasting hyperinsulinemia. Monotherapy with ethinylestradiol-drospirenone may not be a prime choice for PCOS, given its inefficacy to attenuate abnormal adipocytokine levels and body adiposity; ethinylestradiol-drospirenone plus flutamide-metformin, however, is a first OC combination that was found capable of reverting both the adipocytokine balance and the body composition toward normal, and that may therefore improve the long-term cardiovascular perspectives of women with PCOS.
Recent studies have highlighted the need for improved methods of monitoring glucose control in intensive care to reduce hyperglycaemia, without increasing the risk of hypoglycaemia. Continuous ...glucose monitoring is increasingly used in children with diabetes, but there are little data regarding its use in the preterm infant, particularly at extremes of glucose levels and over prolonged periods. This study aimed to assess the accuracy of the continuous glucose monitoring sensor (CGMS) across the glucose profile, and to determine whether there was any deterioration over a 7 day period.
Prospectively collected CGMS data from the NIRTURE Trial was compared with the data obtained simultaneously using point of care glucose monitors.
An international multicentre randomised controlled trial.
One hundred and eighty-eight very low birth weight control infants.
Optimal accuracy, performance goals (American Diabetes Association consensus), Bland Altman, Error Grid analyses and accuracy.
The mean (SD) duration of CGMS recordings was 156.18 (29) h (6.5 days), with a total of 5207 paired glucose levels. CGMS data correlated well with point of care devices (r=0.94), with minimal bias. It met the Clarke Error Grid and Consensus Grid criteria for clinical significance. Accuracy of single readings to detect set thresholds of hypoglycaemia, or hyperglycaemia was poor. There was no deterioration over time from insertion.
CGMS can provide information on trends in glucose control, and guidance on the need for blood glucose assessment. This highlights the potential use of CGMS in optimising glucose control in preterm infants.
Summary
Background
The sequence of prenatal growth restraint and postnatal catch‐up growth leads to a thicker intima‐media and more pre‐peritoneal fat by age 3–6 years.
Objectives
To study whether ...carotid intima‐media thickness (cIMT) and pre‐peritoneal fat differ already between catch‐up small‐for‐gestational‐age (SGA) infants and appropriate‐for‐gestational‐age (AGA) controls in late infancy (ages 1 and 2 years) and whether such differences – if any – are accompanied by differences in cardiac morphology and function.
Methods
Longitudinal assessments included body height and weight; fasting glucose, insulin, Insulin‐like growth factor (IGF‐I), high‐molecular‐weight adiponectin; body composition (by absorptiometry); cIMT, aortic IMT, pre‐peritoneal fat partitioning (by ultrasound); cardiac morphometry and function (by echocardiography) in AGA and SGA infants at birth, at age 1 year (N = 87), and again at age 2 years (N = 68).
Results
Catch‐up SGA infants had already a thicker cIMT than AGA controls at ages 1 and 2 years, and more pre‐peritoneal fat by age 2 years (all p values between <0.01 and <0.0001); all cardiac and endocrine‐metabolic results were similar in AGA and SGA infants at ages 1 and 2 years.
Conclusions
From late infancy onwards, catch‐up SGA infants have a thicker cIMT and more pre‐peritoneal fat than AGA controls, but their cardiac morphology and function remain reassuringly similar.
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