The Magnitude of Familial Associations of Cardiovascular Risk Factor Variables between Parents and Offspring Are Influenced by Age: The Bogalusa Heart Study

PURPOSE: Although parent-offspring associations of cardiovascular risk factor variables are known, the age-specific nature of this familial relationship is not clear.

METHODS: This aspect was examined in 727 unrelated children (mean age: 11.2 years) and their parents who participated in the Bogalusa Heart Study during their childhood (mean age: 11.3 years) and adulthood (mean age: 25.5 years).

RESULTS: After adjusting for covariates, the mothers' childhood-offspring correlations were consistently higher than mothers' adulthood-offspring correlations for body mass index (BMI) [r = 0.45 vs. 0.32], systolic blood pressure (SBP) [r = 0.30 vs. 0.10], diastolic blood pressure (DPB) [r = 0.22 vs. 0.13] and low-density lipoprotein cholesterol (LDLC) [r = 0.20 vs. 0.11]. In contrast, high-density lipoprotein cholesterol (HDLC) and triglycerides did not show such age-specific trends in mother-offspring correlations. Corresponding father-offspring correlations showed similar patterns, but the differences were of lesser magnitude. Multiple regression analyses using offspring's risk factor variables as dependent variables revealed that parents' childhood obesity, blood pressure and LDLC levels were better predictors of the corresponding variables in the young offspring than parents' adulthood values. Further, sex of either parents or offspring made no difference in the above findings.

CONCLUSIONS: The magnitude of the familial associations of cardiovascular risk factor variables between parents and offspring are influenced by age. Intrinsic genetic make-up, duration of exposure to environment and gene-environment interactions may play a role in this association.     

Risk of type 2 diabetes mellitus in young adults from a biracial community: the Bogalusa Heart Study

BACKGROUND: Since type 2 diabetes has a strong familial component, characteristics of young adult offspring of type 2 diabetics were examined in a community sample to determine early abnormalities in black and white persons at risk. METHODS: The sample consisted of 1,338 fasting young adults (72% white, 28% black) aged 19 to 37 years from a biracial community, including those with positive parental history of type 2 diabetes (one offspring per family, n = 230) or conditions of impaired fasting glucose and type 2 diabetes (n = 22). RESULTS: Positive family history of diabetes or impaired fasting glucose and type 2 diabetes in young adults of both races were significantly associated with adverse profiles of measures of obesity and abdominal fat (body mass index, triceps and subscapular skinfolds, waist circumference, and abdominal height), systolic and diastolic blood pressures, serum total cholesterol, triglycerides, VLDL cholesterol, and HDL cholesterol, and indicators of glucose homeostasis (plasma glucose and insulin and insulin resistance index). The magnitude of the differences in obesity and abdominal fat measures and plasma glucose between individuals with and without parental diabetes was greater among blacks versus whites (P = 0. 047-0.004). Further, black offspring of both diabetics and non-diabetics had unfavorable profiles of obesity and abdominal fat measures, blood pressure, insulin, and insulin resistance index (P = 0.0001). In a multivariate analysis, adiposity measured as body mass index (P = 0.03) and plasma glucose (P = 0.003) emerged as the two independent characteristics that distinguished those with parental diabetes from those without parental disease. Insulin (P = 0.0001) and the insulin resistance index (P = 0.0001) were independently associated with conditions of impaired fasting glucose or type 2 diabetes. CONCLUSIONS: The risk factors of young adults with parental type 2 diabetes or conditions of impaired fasting glucose and type 2 diabetes can be detected early. These observations have implications for early prevention and intervention, especially for blacks.     

Parental influences predict adolescent smoking in the United States, 1989–1993

Purpose: To examine parental influences on two transitions in the adolescent smoking uptake process: from never having smoked to experimentation and from experimentation to established smoking.

Methods: Using data from the longitudinal Teenage Attitudes and Practices Survey of 1989-1993, we related perceived parental concern about their adolescents' future smoking, parental smoking status, problem-solving communication between parent and adolescent, demographics, and other factors at baseline to experimentation by follow-up among those who had never puffed on a cigarette (n = 4149). We also related these factors at baseline to reaching a lifetime level of smoking of at least 100 cigarettes by follow up among those who had experimented but smoked <100 cigarettes (n = 2684) in univariate and multivariate analyses.

Results: Among never-smokers, baseline susceptibility to smoking and having male best friends who smoke predicted experimentation in the next 4 years. Among experimenters, susceptibility to smoking, having male or female best friends who smoked, and lack of parental concern about future smoking distinguished those who progressed to established smoking by follow-up. Furthermore, communicating with parents first about serious problems was protective against progression from experimentation to established smoking.

Conclusion: Interventions aimed at reducing adolescent smoking should encourage cessation for parents who smoke and help parents communicate strong anti-smoking norms to children and adolescents and maintain strong lines of communication with them.     

儿童期血压偏高对成年期高血压的影响研究

目的 本研究旨在探讨儿童期血压偏高对成年期高血压的影响,为成人高血压的早期防控提供科学依据。方法 基于“中国居民健康与营养调查”资料(1991-2011年),纳入儿童期(6~17岁)和成年期(18~38岁)均进行至少1次随访的研究对象。儿童期血压偏高前期定义采用中国儿童青少年血压参考值性别和年龄的第90百分位(P₉₀)至第95百分位(P₉₅),儿童期血压偏高采用≥P₉₅。成年期高血压前期为收缩压/舒张压≥120/80 mmHg且<140/90 mmHg;成年期高血压为收缩压/舒张压≥140/90 mmHg,或有高血压史,或目前正服用降压药物。采用协方差分析和Cox比例风险回归模型分析儿童期血压偏高对成年期高血压前期和高血压的影响,控制混杂因素包括儿童期性别和年龄,成年期的体重指数(BMI)、吸烟和饮酒。结果 本研究共纳入1 984名数据完整的研究对象,中位随访时间为11.7年。基线儿童期共有108人(5.4%)为血压偏高前期,199人(10.0%)为血压偏高。随访成年期共有697人(35.1%)为高血压前期,104人(5.2%)为高血压。协方差分析表明,成年期收缩压和舒张压水平均随着儿童期血压百分位的增加而增加(P_趋势<0.001)。多因素Cox回归分析显示,儿童期血压偏高者成年后为高血压前期的风险增加(HR=1.41,95%CI:1.12~1.77)。儿童期血压偏高者成年后为高血压的风险显著增加(HR=1.73,95%CI:1.01~2.98)。结论 儿童期血压偏高会增加成年期罹患高血压的风险。应该重视儿童青少年血压监测,对血压偏高的高危儿童应及时采取干预措施。     

Parents,Television and Children's Weight Status

This study scrutinizes the long-term effects of parental television socialization activities on their children's weight status measured through body mass index (BMI-score). We address the question how parental television habits and parental television mediation in childhood relate to a person's weight status in adulthood. To analyze this issue we employed data from the 2009 Family Survey of the Dutch Population with extensive retrospective information on 1,377 Dutch respondents and their parents. Structural equation models were estimated and showed long-term effects of parental television role modeling and mediation on their children's weight status in adulthood. A parental example of frequent television viewing and social coviewing lastingly increases children's weight status through two distinct pathways: via weight status in young adulthood and via educational attainment and adult television habits. Parental instructional television mediation, however, is related to a lower-weight status of their children later in life.     

血清网膜素-1水平与儿童非酒精性脂肪肝的关系

目的 探索网膜素-1与儿童非酒精性脂肪肝(NAFLD)的相关性,为儿童脂肪肝的防治提供参考。方法 将116名肥胖儿童分为肥胖伴脂肪肝组(61名)、肥胖不伴脂肪肝组(55名),同时选择正常体重儿童55名作为对照组,对每位儿童进行身高、体重、腰围、血压等测量,并行血脂、血糖、肝功等化验,留取静脉血清标本测血清胰岛素、网膜素-1、瘦素、脂联素水平等,判断三组间指标差异及网膜素-1与其他指标相关性。采用Logistics回归判断有无脂肪肝与其他指标的关系,采用ROC曲线评估腰围、体重指数(BMI)、网膜素-1水平对儿童脂肪肝诊断标准有无价值。结果 血清网膜素-1在肥胖伴脂肪肝患儿中水平较另两组水平低(P<0.05)。矫正年龄及腰围后网膜素-1与有无合并脂肪肝、瘦素/脂联素(LAR)、低密度脂蛋白胆固醇(LDL-C)为负相关,与脂联素呈正相关(P<0.05)。Logistics回归分析发现BMI、胰岛素抵抗指数(HOMA-IR)为脂肪肝的危险因素,网膜素-1为脂肪肝的保护因素。腰围、BMI、血清网膜素-1水平对儿童脂肪肝诊断有一定价值。结论 血清网膜素-1水平与儿童中心性肥胖、脂代谢紊乱及脂肪肝密切相关,在儿童脂肪肝的发病中有保护作用。     

矢车菊素-3-葡萄糖苷对肥胖大鼠低度炎症反应及胰岛素敏感性的影响

目的 观察矢车菊素-3-葡萄糖苷(cyanidin-3-glucoside, C3G)对肥胖大鼠血清炎症因子(TNF-α、IL-6和MCP-1)及胰岛素敏感性的影响。方法 3周龄雄性SD大鼠30只, 随机分为对照组(n=8)和高脂饮食组(n=22), 分别予以普通饲料及高脂饲料喂养5周。肥胖造模成功的17只大鼠再随机分为肥胖组(n=8)和C3G组(n=9)。C3G组予C3G 100 mg/(kg·d)灌胃, 其余组予等量生理盐水灌胃。实验结束时准确称量大鼠体重及内脏脂肪质量, 全自动生化分析仪测定空腹血糖(fasting glucose, FPG), 放免法测血清胰岛素(fasting insulin, FINS), ELISA测血清脂联素及TNF-α、IL-6、MCP-1水平, 并计算内脏脂肪比和胰岛素敏感指数(insulin sensitivity index, IAI)。结果 肥胖组和C3G组大鼠体重、内脏脂肪比和血清TNF-α、IL-6、MCP-1水平明显高于对照组(P均<0.05), 而C3G组上述指标明显低于肥胖组(P均<0.05)。肥胖组和C3G组血清脂联素水平及IAI明显低于对照组(P均<0.05), 而C3G组上述指标明显高于肥胖组上述指标。结论 C3G能明显增加肥胖大鼠的胰岛素敏感性, 其可能与增加血清脂联素水平及降低血清炎症因子(TNF-α、IL-6、MCP-1)水平有关。     

高原医学地理环境与高尿酸血症的关系及其研究进展

目的对比高原地区与平原地区健康体检人群空腹血糖水平差异,以进一步探讨血糖的影响因素。方法回顾性从我院2014年至2017年健康体检数据中,随机选取389例青海果洛藏族自治州与548例上海金山区健康体检人群作为研究对象,采集研究对象的性别、年龄、民族、空腹血糖、腰围、体质指数、空腹胰岛素等相关数据进行对比分析,运用Logistic回归分析空腹血糖升高的相关因素。结果与平原地区比较,高原地区空腹血糖明显偏低,而腰围(85.25 vs 89.98)、BMI(25.48 vs 26.98)、空腹胰岛素水平(51.72 vs 62.82)、血尿酸明显偏高(344.75 vs 403.48)。回归分析筛选出四个相关因素：高原、年龄、腰围、空腹胰岛素。结论高海拔地区人群较平原地区空腹血糖明显偏低。高原、年龄、腰围、空腹胰岛素水平均是空腹血糖影响因素。体质指数与空腹血糖升高无明显相关性。     

初断乳大鼠锌补充对成年高脂诱导肥胖后胰岛素的影响

目的 探讨初断乳大鼠锌补充对成年期高脂饮食下胰岛素水平的影响,为阐明生命早期适量补锌预防成年后胰岛素抵抗的机制提供重要依据。方法 初断乳雄性SD大鼠85只随机分为基础饲料组和高、中、低锌补充组。锌补充4周后各组均以基础饲料喂养1周,于第5周末检测大鼠血糖、胰岛素水平并计算胰岛素抵抗指数。随后将基础饲料组大鼠随机分为肥胖组和正常对照组,肥胖诱导组及3个锌补充组均喂以高脂饲料。高脂干预8周后处死所有大鼠并检测上述指标。结果 大鼠成年高脂干预后,1)3个锌补充组分别较肥胖诱导组体重明显降低(P＜0.05),高脂饲料喂养后锌补充组体重正常,而肥胖诱导组发生肥胖;2)3个锌补充组分别较肥胖诱导组血糖、胰岛素明显降低(P＜0.05),而胰岛素抵抗指数明显升高(P＜0.05),高脂饲料喂养后锌补充组胰岛素水平正常,而肥胖诱导组产生胰岛素抵抗。结论 生命早期适量补锌可持续发挥作用,在一定程度上维持成年后高脂膳食下血糖和胰岛素处于正常水平,预防胰岛素抵抗发生。     

Body-composition measurements as predictors of glucose and insulin abnormalities in HIV-positive men

BACKGROUND: Fat redistribution and metabolic abnormalities are seen increasingly in HIV-positive patients. However, the degree to which abnormalities in fat distribution predict glucose and insulin concentrations in these patients remains unknown. OBJECTIVE: We determined how well measurements of fat distribution derived from anthropometry, dual-energy X-ray absorptiometry, and computed tomography predicted hyperinsulinemia in HIV-positive men. DESIGN: Body-composition data were analyzed in 41 HIV-positive men (21 with fat redistribution and 20 without) and 20 HIV-negative control subjects matched for age and body mass index (BMI). Multivariate modeling was performed to determine the effects of body composition on fasting insulin and insulin area under the curve (AUC) during standard glucose tolerance testing. RESULTS: WHR was superior to other body-composition measures in predicting fasting hyperinsulinemia and was a strong predictor of insulin AUC in HIV-positive men. Fasting insulin increased by 77.4 pmol/L for each 0.1-unit change in WHR (95% CI: 18.6, 136.1; P = 0.011), overall r(2) = 0.415 in a model also including age, BMI, and protease inhibitor use. Measures of intraabdominal and subcutaneous fat did not predict fasting hyperinsulinemia but were independent predictors of insulin AUC in multivariate modeling. The ratio of visceral to subcutaneous abdominal fat predicted the largest degree of variance in insulin AUC. CONCLUSIONS: Fat redistribution contributes to hyperinsulinemia in HIV-positive men, independent of BMI and protease inhibitor use. WHR is an integrated index of body-composition changes and strongly predicts both fasting hyperinsulinemia and insulin AUC in HIV-positive men.     

Childhood and family influences on body mass index in early adulthood: findings from the Ontario Child Health Study

ABSTRACT: BACKGROUND: Overweight and obesity are steadily increasing worldwide with the greatest prevalence occurring in high-income countries. Many factors influence body mass index (BMI); however multiple influences assessed in families and individuals are rarely studied together in a prospective design. Our objective was to model the impact of multiple influences at the child (low birth weight, history of maltreatment, a history of childhood mental and physical conditions, and school difficulties) and family level (parental income and education, parental mental and physical health, and family functioning) on BMI in early adulthood. METHODS: We used data from the Ontario Child Health Study, a prospective, population-based study of 3,294 children (ages 4--16 years) enrolled in 1983 and followed up in 2001 (N = 1,928; ages 21--35 years). Using multilevel models, we tested the association between family and child-level variables and adult BMI after controlling for sociodemographic variables and health status in early adulthood. RESULTS: At the child level, presence of psychiatric disorder and school difficulties were related to higher BMI in early adulthood. At the family level, receipt of social assistance was associated with higher BMI, whereas family functioning, having immigrant parents and higher levels of parental education were associated with lower BMI. We found that gender moderated the effect of two risk factors on BMI: receipt of social assistance and presence of a medical condition in childhood. In females, but not in males, the presence of these risk factors was associated with higher BMI in early adulthood. CONCLUSION: Overall, these findings indicate that childhood risk factors associated with higher BMI in early adulthood are multi-faceted and long-lasting. These findings highlight the need for preventive interventions to be implemented at the family level in childhood.     

Stability of adiposity phenotypes from childhood and adolescence into young adulthood with contribution of parental measures.

OBJECTIVE: The stability of several indicators of body composition and adipose tissue distribution over 12 years was quantified. RESEARCH METHODS AND PROCEDURES: The participants were 77 boys and 76 girls who were evaluated along with their parents at baseline as children and adolescents (8 to 18 years of age) and remeasured as young adults 12 years later. Indicators of body composition included the body mass index, fat mass, fat free mass, percentage of body fat, sum of six skinfolds (SF6), and the first principal component of six age-adjusted skinfold residuals. Relative adipose tissue distribution was represented by the second principal component of skinfold residuals and a trunk-to-extremity skinfold ratio, adjusted for SF6. RESULTS: Partial interage correlations, controlling for initial age and length of follow-up, were 0.65 and 0.59 for the body mass index, 0.59 and 0.64 for fat mass, 0.65 and 0.57 for fat free mass, 0.50 and 0.57 for percentage of body fat, 0.66 and 0.44 for SF6, 0.64 and 0.42 for the first principal component of six age-adjusted skinfold residuals, 0.19 and 0.31 for the second principal component of skinfold residuals, and 0.41 and 0.47 for trunk-to-extremity skinfold ratio, adjusted for SF6, in men and women, respectively. Multiple regression analyses indicated that the significant partial R(2) values of parental measurements on the prediction of their offspring in young adulthood ranged from 2% to 9%. DISCUSSION: The results indicate moderately high stability of indicators of body composition and somewhat lower stability of measures of adipose tissue distribution. Overall, parental measures offer less predictive value than do measures of childhood and adolescent body composition and adipose tissue distribution.     

补体C5a及肿瘤坏死因子α与肥胖儿童胰岛素抵抗的相关性分析

目的 通过观察儿童肥胖伴或不伴胰岛素抵抗临床指标及炎症因子的变化, 探讨补体C5a及TNF-α与胰岛素抵抗的相关性。方法 收集2014年9月-2016年9月在西安交通大学第二附属医院小儿内分泌门诊就诊的7~14岁未成年人, 分为肥胖伴胰岛素抵抗组(n=60), 肥胖不伴胰岛素抵抗组(n=46)和正常对照组(n=40)。测量体格数据、血脂、血糖、胰岛素、TNF-α和补体C5a, 并分析临床指标与胰岛素抵抗指数HOMA-IR相关性。结果 BMI及腰围在肥胖两组均高于正常对照组(P<0.001);胰岛素抵抗组高于非胰岛素抵抗组(P<0.001)。甘油三酯、空腹血糖、胰岛素在胰岛素抵抗组高于无胰岛素抵抗组, HDL-C在胰岛素抵抗组低于无胰岛素抵抗组(P<0.001), 而总胆固醇在三组间差异无统计学意义(P>0.05);肥胖组TNF-α、C5a均高于正常对照组(P<0.001), TNF-α在肥胖两组间差异无统计学意义(P=0.456)。C5a在肥胖伴胰岛素抵抗组高于肥胖不伴胰岛素抵抗组(P=0.034)。多元线性回归显示BMI(β=0.413)、腰围(β=0.234)、空腹血糖(β=0.268)、TNF-α(β=0.318)和C5a(β=0.400)与胰岛素抵抗显著正相关(P<0.05或<0.01)。结论 炎性指标TNF-α、C5a与胰岛素抵抗指数密切相关。BMI、甘油三酯、空腹血糖、TNF-α和C5a是胰岛素抵抗的独立危险因素。     

If you are good you can have a cookie: How memories of childhood food rules link to adult eating behaviors

OBJECTIVE: The aim of this study was to determine whether memories of parental rules about food during childhood are linked to adult eating behaviors. METHOD: An adult community sample (N=122) (56% female, 44% male) with a mean age of 44.6 years completed self-report measures of weight and dieting history, current eating patterns, and recollection of different types of rules about food from their parents. Three types of food rules were assessed: (a) rules which restrict intake of certain foods, (b) rules which encourage food intake, and (c) rules where food is used to reward or punish behavior. RESULTS: Binge eating and dietary restraint in adulthood are significantly related to participants' recollection of their parents using food to control their behavior in childhood. These results held true regardless of body mass index (BMI), ethnicity, age, or childhood weight status. DISCUSSION: This study suggests that some childhood food rules may have a long-lasting impact on eating behaviors. Further research on the impact of using food to reward and punish children's behavior is needed to inform recommendations to parents regarding the use of food for behavioral control.     

Coping with stressful events: influence of parental alcoholism and race in a community sample of women

The study explores the role of race and differences in coping among 290 white women and black women with and without alcoholic parents, addressing two questions: (1) Does coping vary by parental alcoholism or race? and (2) How is coping in adulthood affected by childhood stressors and resources and by adulthood resources? Standardized self-administered questionnaires (Coping Responses Inventory and the Children of Alcoholics Screening Test) measuring approach and avoidant coping methods were used. Collateral information was obtained from siblings who completed questionnaires focused on parental drinking, parental psychiatric history, and key childhood events. Women with alcoholic parents and black women more often reported avoidant coping. Women with negative childhood family environments and a lack of adolescent social support more often reported avoidant coping responses. Self-esteem was associated with a higher score on active cognitive coping and a lower score on avoidant coping. Findings of greater use of avoidant coping by women with alcoholic parents contrast with other studies showing no differences in coping, or very small group differences. The fact that all women in this sample lived with two parents in childhood may be one explanation.     

结合家长参与的康复训练对功能性构音障碍的疗效分析

目的 分析家长参与的康复训练对功能性障碍患儿构音清晰度的疗效,为临床综合性治疗提供科学依据。 方法 选取2018年9月—2020年1月在株洲市中心医院康复治疗科治疗的67例功能性构音障碍患儿为研究对象,按随机数字表法随机分为家长参与组33例和常规组34例。两组均予以常规构音训练,家长参与组在常规组的基础上增加家长参与整个治疗过程、每周1次家长培训和每日微信打卡作业,共治疗12周。比较两组治疗前后采用构音清晰度评估和疗效评定。 结果 治疗12周后,两组构音清晰度均较治疗前明显提高(t＝22.38、25.50,P＜0.01),且家长参与组治疗后构音清晰度高于常规组,差异有统计学意义(t=5.10,P＜0.01);家长参与组每周平均家中练习天数与总有效率均显著高于常规组(t=16.08、χ²=19.90 ,P＜0.01)。 结论 结合家长参与的康复训练对功能性构音障碍患儿疗效明显。     

山东省某农村小学生情感忽视的调查研究

目的 研究农村小学生情感忽视的发生率及其影响因素,为制定预防儿童情感忽视措施提供参考。方法 2014年对山东省某农村地区5所学校一至六年级的989名小学生家长进行匿名自填式问卷调查,了解儿童情感忽视的发生情况,并采用Logistic回归方程分析家长对子女情感忽视的影响因素。结果 被调查家长对儿童情感忽视的总发生率为56.9%,男、女儿童情感忽视率分别为54.8%和 59.3%,差异无统计学意义(χ²=2.020,P=0.155)。多因素Logistic回归分析结果显示,高年级(OR=1.912)、儿童学习成绩差(OR=1.852)、非独生子女(OR=1.445)、家长学历低(OR=1.527)、家庭经济状况差(OR=1.576)、父母社会支持程度一般/较少(OR=2.161)是儿童情感忽视的危险因素。结论 所调查农村地区的儿童情感忽视发生率较高,应重视农村地区家长对儿童的情感忽视问题,开展预防儿童情感忽视的父母教育活动,提高父母的育儿技能。     

Socioeconomic differences in cardiometabolic factors: social causation or health-related selection? Evidence from the Whitehall II Cohort Study, 1991-2004

In this study, the health-related selection hypothesis (that health predicts social mobility) and the social causation hypothesis (that socioeconomic status influences health) were tested in relation to cardiometabolic factors. The authors screened 8,312 United Kingdom men and women 3 times over 10 years between 1991 and 2004 for waist circumference, body mass index, systolic and diastolic blood pressure, fasting glucose, fasting insulin, serum lipids, C-reactive protein, and interleukin-6; identified participants with the metabolic syndrome; and measured childhood health retrospectively. Health-related selection was examined in 2 ways: 1) childhood health problems as predictors of adult occupational position and 2) adult cardiometabolic factors as predictors of subsequent promotion at work. Social causation was assessed using adult occupational position as a predictor of subsequent change in cardiometabolic factors. Hospitalization during childhood and lower birth weight were associated with lower occupational position (both P's ≤ 0.002). Cardiometabolic factors in adulthood did not consistently predict promotion. In contrast, lower adult occupational position predicted adverse changes in several cardiometabolic factors (waist circumference, body mass index, fasting glucose, and fasting insulin) and an increased risk of new-onset metabolic syndrome (all P's ≤ 0.008). These findings suggest that health-related selection operates at younger ages and that social causation contributes to socioeconomic differences in cardiometabolic health in midlife.     

Serum insulin and ECG abnormalities suggesting coronary heart disease in the populations of Mauritius and Nauru: Cross-sectional and longitudinal associations

Cross-sectional associations between insulin and ECG abnormalities suggestive of ‘possible’ and ‘probable’ coronary heart disease (CHD) in the populations of Nauru (n = 568) and Mauritius (n = 3280) have been examined in both non-diabetic and diabetic subjects. Additionally, the longitudinal relationship between baseline insulin and incident ECG abnormalities has been explored in non-diabetic Nauruans (n = 177) over 5 years. Age-adjusted mean 2-hour serum insulin was generally higher in subjects with ECG abnormalities than those with a normal ECG, but the difference was significant only for non-diabetic Mauritian men (p < 0.01). There was no clear association between prevalence of ECG abnormalities and quintiles of fasting or 2-hr insulin in Mauritians, and in non-diabetic Nauruans there was a non-significant positive association between prevalence of ECG abnormalities and tertiles of 2-hr insulin. Logistic regression analyses showed a slight positive association between 2-hr insulin and ECG abnormalities in non-diabetic Mauritians (p = 0.06 in males, p = 0.09 in females), and non-diabetic male Nauruans (p = 0.054) independent of possible confounders. Fasting insulin was not associated in any group. In longitudinal analyses in Nauruans there were no significant differences in mean baseline fasting or 2-hr serum insulin between subjects who maintained a normal ECG and those who developed abnormalities consistent with ‘possible CHD’ (there were no changes suggestive of ‘probable CHD’). The incidence of ECG changes suggesting ‘possible CHD’ was slightly higher in the upper tertile of baseline fasting insulin in both sexes and 2-hr insulin in females, but when other factors were accounted for, multiple logistic regression analyses did not support this finding. Data from the populations of Mauritius and Nauru do not support a major role for serum insulin in ECG abnormalities suggestive of CHD.     

Adolescent alcohol and drug abuse and health

Purpose: To examine the relationship of adolescent alcohol and drug use over a 5-year period to cumulative health problems in late adolescence and young adulthood.

Methods: We prospectively examined self-reported health problems in a sample of adolescents, some of whom received treatment for substance use disorders and had consistently poor substance use outcomes (n = 38), some of whom received treatment for substance use disorders and had positive substance use outcomes (n = 30), and a low alcohol and drug use community comparison group (n = 48). Data regarding health-related problems of these adolescents (mean, 15.9 years; 83% Caucasian; 56.5% female) were collected at 2, 4, and 6 years following initial assessments.

Results: Alcohol and/or drug involvement severe enough to warrant treatment during adolescence was associated with more cumulative health problems and severe health problems for girls and more cumulative health problems for boys. Protracted and continuous abuse of alcohol and drugs was associated with more cumulative and severe health problems for girls and more severe health problems for boys.

Conclusions: These results suggest that significant health problems and concerns are related to both brief and protracted alcohol and drug abuse during adolescence. Health problems will likely become even more evident as early-onset, chronic substance abusers continue to age.