Parental overweight/obesity,social factors,and child overweight/obesity at 7 years of age

Background: This study used gender‐based analyses to examine whether child overweight/obesity is related to parental overweight/obesity and sociodemographic factors, in a representative population‐based cohort of 7‐year‐old children. Methods: Data from the Québec Longitudinal Study of Child Development 1998–2010 was used. Children (n= 1336) were randomly selected from each public health region of Québec. The study was based on face‐to‐face interviews and a set of questionnaires addressed to mothers and fathers. Results: Compared to children with no overweight/obese parent, the adjusted odds ratio (OR) of being overweight/obese with two overweight/obese parents was 5 for boys (95% confidence interval [CI]: 2.31–10.85) and 5.87 for girls (95%CI: 2.63–13.12). Gender differences appeared when one parent was overweight/obese. For girls, having either an overweight/obese mother (OR, 3.10; 95%CI: 1.14–8.38) or father (OR, 3.64; 95%CI: 1.68–7.91) significantly increased the odds of being overweight/obese at 7 years. For boys, however, having only an overweight/obese father (OR, 2.05; 95%CI: 1.01–4.16) was related to overweight/obesity, but having only an overweight/obese mother was not related to overweight/obesity at 7 years for boys. In girls, but not in boys, having an immigrant mother also significantly related to overweight/obesity (OR, 2.71; 95%CI: 1.28–5.75) at 7 years, after controlling for other social factors. Conclusions: Gender differences in socialization may explain why at 7 years of age, girls' bodyweight is influenced by having even one overweight/obese parent (mother or father), while boys' bodyweight appears to be influenced only by father's overweight/obesity when only one parent is overweight/obese.     

Child–therapist alliance and clinical outcomes in cognitive behavioral therapy for child anxiety disorders

Background:  Few studies have examined the link between child–therapist alliance and outcome in manual-guided cognitive behavioral therapy (CBT) for children diagnosed with anxiety disorders. This study sought to clarify the nature and strength of this relation.
Methods:  The Therapy Process Observational Coding System for Child Psychotherapy – Alliance scale (TPOCS-A; McLeod, 2005 ) was used to assess the quality of the child–therapist alliance. Coders independently rated 123 CBT therapy sessions conducted with 34 children (aged 6–13 years) diagnosed with anxiety disorders. Parents reported on children's symptomatology at pre- mid-, and post-treatment.
Results:  A stronger child–therapist alliance early in treatment predicted greater improvement in parent-reported outcomes at mid-treatment but not post-treatment. However, improvement in the child–therapist alliance over the course of treatment predicted better post-treatment outcomes.
Conclusions:  The quality of the child–therapist alliance assessed early in treatment may be differentially associated with symptom reduction at mid- and post-treatment. Results underscore the importance of assessing the relation between alliance and outcome over the course of therapy to clarify the role the child–therapist alliance plays in child psychotherapy.     

Wheezing due to rhinovirus infection in infancy: Bronchial hyperresponsiveness at school age

Background: Characteristics related to decreased lung function and increased bronchial responsiveness after early childhood wheezing requiring hospitalization are not fully established.
Methods: Seventy-nine children with wheezing requiring hospitalization at age <2 years were prospectively followed up and re-investigated at age 5.6–8.8 years when the measurements of baseline lung function and bronchial responsiveness to exercise were performed.
Results: At early school age, 23% of children had decreased lung function, and 13% had increased bronchial responsiveness to exercise. Predictors of decreased lung function were maternal history of smoking during pregnancy (odds ratio [OR], 12.8; 95% confidence interval [CI]: 1.2–139.6), parental history of asthma (OR, 4.3; 95%CI: 1.1–17.1), and female gender (OR, 4.0; 95%CI: 1.2–13.7). Increased bronchial responsiveness was associated with rhinovirus infection-induced wheezing in infancy (OR, 6.5; 95%CI: 1.2–36.3), and early cat or dog exposure leading to sensitization (OR, 26.6; 95%CI: 1.3–525.2). Inhaled anti-inflammatory therapy was common in children with rhinovirus infection-induced wheezing in infancy ( n  = 13/19; P  = 0.001 vs children with other/no confirmed virus infection etiology for wheezing in infancy, n  = 16/60), which may have improved lung function and attenuated bronchial responsiveness in them.
Conclusions: After early childhood wheezing requiring hospitalization, one-fourth of children will have decreased lung function and one-eighth of children will show increased bronchial responsiveness at school age. Gender, heredity of asthma, and antenatal exposure to tobacco smoke are predictors of decreased lung function, whereas rhinovirus infection etiology of wheeze and early animal exposure leading to sensitization are associated with increased bronchial responsiveness later in childhood.     

Maternal obesity and initiation and duration of breastfeeding: data from the longitudinal study of Australian children

The aim of this paper is to investigate whether the lower rate of breastfeeding at 6 months by overweight and obese mothers is primarily due to these women giving up breastfeeding in the first week postpartum using a cross-sectional population survey. The sample is children from the infant cohort (about 12 months of age) of Wave 1 (2004) of the Longitudinal Study of Australian Children for whom breastfeeding and maternal information were available ( n  = 3075). Definitions used: normal-weight body mass index (BMI, kg/m²) 20 to <25, overweight BMI 25 to <30, obese BMI ≥30. Breastfeeding initiation was 95.1% for normal-weight women, 92.8% for overweight women and 87.1% for obese women. At 6 months, 64% of normal-weight women were breastfeeding, compared with 54% of overweight and 44% of obese women. On multivariate analysis, for women who initiated breastfeeding, overweight women had an odds ratio (OR) of 1.52 [95% confidence interval (CI) 1.02, 2.28] and obese women had an OR of 2.54 (95% CI 1.70, 3.79) of stopping breastfeeding by 1 week compared with normal-weight women (adjusted for maternal age, education, smoking, level of socio-economic disadvantage, caesarean birth, admission to special care nursery). For women who breastfed for at least 1 week, overweight women had an adjusted OR of 1.26 (1.04, 1.53) and obese women had an adjusted OR of 1.38 (1.10, 1.73) of ceasing to breastfeed before 6 months, compared with normal-weight women. In conclusion, among overweight/obese women who initiate breastfeeding, higher rates of cessation of breastfeeding in both the immediate postpartum period and in the first 6 months contribute to the shorter duration.     

Body mass index and thromboembolism in children with hematological malignancies

We evaluated the effects of body mass index (BMI) on the risk of thromboembolism (TE) in children (<18 years) with hematological malignancies during the period 1990-2009 (n = 359). Obesity was prevalent in 12% of patients: 6% versus 17% prior to and after the year 2000 (P = 0.02). Sixty-one (17%) patients developed TE; increasing BMI was associated with increased, but statistically insignificant risk of TE [adjusted odds ratios (OR): 0.75 (95%CI 0.32-1.77), 0.93 (95%CI 0.38-2.30), and 1.01(95%CI 0.42-2.41) for underweight, overweight, and obese group]. A large prospective study is needed to define the impact of BMI on the risk of TE in children.     

Prejudice against obesity among 10-year-olds: a nationwide population-based study

Aims:  Population-based research on children's possible prejudice against thin, obese and average body sizes is scarce. This study examined children's prejudice against various body sizes of both sexes. The effects of sex, body size, place of residence and socio-economic status (SES) on children's prejudice were also investigated.
Methods:  In 2005, a nationally representative sample of 10-year-old children (N = 1409) responded to a questionnaire measuring stereotypes and prejudice against thin, average-weight and obese silhouettes.
Results:  As estimated by odds ratios (ORs), children were more likely to report prejudice against obesity (OR = 53, 95% confidence interval [CI]: 42–67) and thinness (OR = 20, 95% CI: 16–26) than against average body weight. The risk of being prejudiced varied with child's sex and with sex and body size of the silhouette figure. No association was found between own body weight and prejudice against various body sizes. Children with high SES were more likely to be prejudiced against obesity compared with children with low SES (OR = 1.2, 95% CI: 1.1–1.4).
Conclusion:  This large, population-based study showed that Swedish 10-year-old children hold stereotypical attitudes and are prejudiced against not only peers with obesity but also those with thin body sizes. Interestingly, no association was found between own body weight and prejudice against various body sizes.     

Association between peer relationship problems and childhood overweight/obesity

Aims:  To assess the association between peer relationship problems and childhood overweight and obesity.
Methods:  Data on 4718 preschool children were obtained at the obligatory school entry health examination in Bavaria. Parentally reported peer relationship problems ('normal', 'borderline' or 'abnormal') were assessed from the Strengths and Difficulties Questionnaire. Overweight and obesity were defined according to age- and gender-specific BMI cut-off points. Multivariate logistic regression analysis was performed to control potential confounders.
Results:  The prevalence of overweight and obesity was higher among children with 'borderline' or 'abnormal' peer relationship problems compared to 'normal' children. The association of 'abnormal' peer relationship problems was still significant in the final logistic regression model for girls [odds ratio (OR) for overweight 2.0; 95% confidence interval (CI): 1.4–3.0; OR for obesity 2.6; 95% CI: 1.3–5.0]. Among boys the adjusted odds ratio were lower and no longer significant.
Conclusion:  The significantly increased prevalence of overweight and obesity among preschool children with peer relationship problems could not be explained by confounding. It seems evident that there is a relevant co-morbidity of peer relationship problems and obesity in pre-school children pointing to the need of interventions focusing on both physical as well as psychosocial health.     

Body mass index in Belgian schoolchildren and its relationship with sensitization and allergic symptoms

Results of studies of the influence of body mass index (BMI) on the allergic status are controversial. As a part of the Aalst Allergy Study, we assessed the prevalence of the different BMI categories (underweight, normal weight, overweight, and obesity) and a possible association between BMI and atopy in 1576 unselected Belgian schoolchildren, aged from 3.4 to 14.8 yr. BMI was used to determine weight status. Skin prick testing with the most common aeroallergens was performed. A parental questionnaire documented data on respiratory and allergic disorders, demographic characteristics and other potential risk factors for sensitization. Among the total children, 4.1% of the children were underweight, 14.5% were overweight, and 7.4% were obese. More girls than boys were overweight (p = 0.015). In the group of children older than 12 yr, we found more overweight (p = 0.03) and obese (p = 0.004) girls, and more obese boys (p = 0.004) than in the younger age groups. In contrast with reports in the literature, an increased prevalence of allergic sensitization in underweight girls only [adjusted odd ratio (OR_adj) = 2.9, 95% confidence interval (CI): 1.3–6.4] was documented. A strong association between obesity and exercise-induced respiratory symptoms was found in both boys (OR_adj = 14.5, 95% CI: 2.9–73.3) and girls (OR_adj = 4.9, 95% CI: 1.3–17.4). No correlations with allergic respiratory symptoms, eczema, or rhinoconjunctivitis could be documented.     

Weight status associations with physical activity intensity and physical self-perceptions in 10- to 11-year-old children

The study examined associations between children's weight status, physical activity intensity, and physical self-perceptions. Data were obtained from 409 children (224 girls) aged 10-11 years categorized as normal-weight or overweight/obese. Physical activity was assessed using accelerometry, and children completed the Physical Self-Perception Profile. After controlling for the effects of age, maturation, and socioeconomic status vigorous physical activity was significantly associated with normal-weight status among boys (OR = 1.13, p = .01) and girls (OR = 1.13, p = .03). Normal-weight status was significantly associated with perceived Physical Condition (Boys: OR = 5.05, p = .008; Girls: OR = 2.50, p = .08), and Body Attractiveness (Boys: OR = 4.44, p = .007; Girls: OR = 2.56, p = .02). Weight status of 10-11 year old children was significantly associated with time spent in vigorous physical activity and self-perceptions of Body Attractiveness and Physical Condition.     

Macronutrient intake, physical activity, serum lipids and increased body weight in primary schoolchildren in Istanbul

BACKGROUND: The aim of this cross-sectional study was to record the prevalence of underweight, overweight and obesity in primary school children living in Istanbul and to examine the relationship between increased body weight and certain cardiovascular disease (CVD) risk factors. METHODS: A total of 510 randomly selected children aged 12 and 13 years of age (257 boys, 253 girls) were examined. Information regarding anthropometrical indices, energy and macronutrient intake, physical activity, physical fitness and lipid profile were collected. Classification of children in overweight and obese subgroups was based on the cut-off points proposed by Cole et al. RESULTS: The prevalence of underweight, overweight and obesity was found to be 15.3%, 10.6% and 1.6%, respectively. Both overweight boys and girls were found to have lower physical fitness compared to their normal-weight counterparts, but no difference was observed for energy and macronutrient intake. Overweight boys were found to have higher total cholesterol (P < 0.001), low-density lipoprotein cholesterol (P < 0.01), triglycerides (P < 0.01) and total cholesterol/high-density lipoprotein cholesterol (HDL-C) ratio (P < 0.05) compared to their normal-weight counterparts, while overweight girls were found to have lower HDL-C (P < 0.05) compared to their normal-weight peers. CONCLUSIONS: Underweight and overweight coexisted in the current population. Increased body weight was accompanied by unfavorable lipid profiles and lower fitness levels. Consequently, there is an emergent need for early identification and understanding of behavioral and physiological variables related to obesity and CVD, so that appropriate interventions can be targeted to children who are at risk for adult onset of these diseases.     

Association between school children's overweight and maternal obesity and perception of their children's weight status

AIM: To determine the association between overweight children and a) other components of the mothers' metabolic syndrome, such as body mass index (BMI), waist circumference (WC), HDL-cholesterol, triglycerides, glucose, HOMA-IR, blood pressure (BP), and age; and b) the mothers' perception of their children's overweight. METHODS: Six hundred and twenty children (297 M) aged 9 +/- 2 years and their mothers aged 37.7 +/- 7 years were examined between April and August 2006. BMI, BP, fasting glucose and lipids and children's Tanner stage were determined. Questionnaires were filled in about the mothers' perceptions of their children's eating habits and of their children's shape. RESULTS: Ninety-five (17.4%) of the children were obese (> 95th percentile), 108 (15.3%) overweight (> 85th percentile) and 418 (67.3%) normal. One hundred and twelve (18%) of the mothers were obese and 183 (29.5%) overweight. Mean values for measures in mothers differed between normal vs overweight/obese children: z-BMI (-0.19 vs 0.42), triglycerides (84 vs 105 mg/dl), cholesterol (147 vs 157 mg/dl), glucose (78 vs 82 mg/dl) and insulin resistance (HOMA-IR 1.34 vs 1.72). There were significant differences in the proportion with distorted perception of shape (2.2% vs 47.5%) and eating habits (11.2% vs 37%) between mothers of normal versus overweight/ obese children. Logistic regression analysis using BMI > or = 85th percentile as the dependent variable showed that the mothers' perceptions of their children's shape (OR: 18.84; 95% CI: 5.0-69.6), eating habits (OR: 3.82; 95% CI: 1.5-9.5) and mothers' BMI (OR: 2.1; 95% CI: 1.3-3.4) were associated with children's overweight. CONCLUSIONS: There was an association between mothers' distorted perception of their children's shape and eating habits and mothers' obesity and their children's overweight. This observation provides clues for obesity prevention programs.     

Low and high birth weight as risk factors for obesity among 4 to 5-year-old Australian children: does gender matter?

Studies testing whether birth weight and childhood obesity differ by gender are lacking. We aimed to describe the relationship between birth weight and childhood overweight/obesity and investigate the influence that gender has on this relationship among 4 to 5-year-old children. We performed a secondary analysis of an Australian nationally representative cross-sectional study in 4 to 5-year-old children. The main outcome measure was child overweight and obesity. We found that low birth weight (LBW) was associated with lower risk of overweight/obesity among girls at 4–5 years before (OR 0.50, 95%CI 0.32, 0.77) and after adjusting for socio-demographic factors (OR 0.51 95% CI 0.33, 0.80) and ethnicity (OR 0.52, 95%CI 0.33, 0.81) but was not associated with child overweight/obesity among boys before or after adjustment. High birth weight (HBW) was associated with a higher risk of overweight/obesity among both girls (adjusted OR: 1.76, 95%CI 1.12, 2.78) and boys (adjusted OR: 2.42 95% CI 2.06, 2.86). Conclusion: There are gender differences in the association of birth weight with child overweight/obesity. HBW was associated with a higher risk of child overweight/obesity in boys and girls before and after adjustment for socio-demographic factors. However, LBW was associated with a lower risk of child overweight/obesity in girls but not in boys. These gender differences need to be considered when planning interventions to reduce child overweight/obesity.     

Outcomes and cardiac response of overweight prepubescent to the 6 minutes walk test

The six-minute walk test (6-MWT) has proved to be clinically relevant to assess the ability to perform daily activities. This study aimed at examining the performance and the heart rate (HR) response of overweight/obese children to the 6-MWT as compared their leaner pairs. Seventeen overweight children, aged 10.1±0.8 yrs, were matched to 34 normal-weight children according to age, height, and gender. All children underwent anthropometry and performed a 6-MWT. Heart rate (HR) and blood pressure (BP) were recorded at rest, during, and after the test. Overweight children walked the same distance (623±107 m) when compared to their normal-weight pairs (611±67 m) (P=0.881). Nonetheless, the work granted in the 6-MWT (i.e., 6 MWWk) was more important among overweight children (P<0.0001). Furthermore, only the 6 MWWk was correlated to the usual physical activity of children (r=-0.306 to -0.337, P<0.05). There was no difference in HR or its course during the test and in BP between overweight and normal-weight children. The 6-MWT elicits the HR of children at the same level and following an identical course regardless the weight status. Because of its relationships with the usual physical activity of children, the 6 MWWk needs to be considered as an important clinical outcome when the functional capacity of children is to be evaluated. There seems to be no contraindication to the 6-MWT among overweight/obese children free from any visible or declared orthopedic or musculoskeletal complications.     

Parental diabetes, pubertal stage, and extreme obesity are the main risk factors for prediabetes in children and adolescents: a simple risk score to identify children at risk for prediabetes

Objectives:  The current worldwide increase of prediabetes defined as impaired fasting glucose or impaired glucose tolerance and type 2 diabetes mellitus (T2DM) coincides the increase of obesity. However, it is unclear that which children have an increased risk and should be screened for prediabetes.
Methods:  We studied 437 overweight children and adolescents to identify risk factors for prediabetes. A risk score for prediabetes was calculated using logistic regression. This score was examined in a second, independent cohort of 567 overweight children and adolescents. History of T2DM in parents and grandparents, degree of overweight, age, pubertal stage, birth weight, hypertension, dyslipidemia, acanthosis nigricans, and abdominal obesity were considered as potential risk factors.
Results:  The frequency of prediabetes was 6% in sample 1 and 17% in sample 2. The strongest association was observed for history of parental diabetes with an adjusted odds ratio (aOR) of 9.5 [95% confidence interval (CI) 2.5–36.4] in sample 1 and 6.3 (95% CI 3.7–10.7) in sample 2, followed by pubertal stage with an aOR of 5.5 (95% CI 0.7–45.4) in sample 1 and 6.2 (95% CI 2.4–15.6) in sample 2, and by extreme obesity with an aOR of 5.0 (95% CI 1.7–15.3) in sample 1 and 3.3 (95% CI 2.0–5.4) in sample 2.
Conclusions:  The main risk factors for prediabetes were parental diabetes, pubertal stage, and extreme obesity. Screening for prediabetes seems meaningful in subjects with either a parental history of diabetes or a combination of extreme obesity and pubertal stage and detected nearly 90% of the overweight children and adolescents with prediabetes.     

Birthweight, breast-feeding, parental weight and prevalence of obesity in schoolchildren aged 10–12 years, in Greece; the Physical Activity, Nutrition and Allergies in Children Examined in Athens (PANACEA) study

Background: The purpose of the present study was to determine the prevalence of overweight and obesity in a sample of Greek children aged 10–12 years, and to evaluate these rates in relation to parental weight and birthweight.
Methods: During the 2005–2006 school period, 700 schoolchildren (323 boys, 377 girls) were randomly recruited from 18 schools, in Athens. Height and weight were measured and body mass index (BMI) was calculated. Cut-off points for BMI defining obesity and overweight for gender and age were calculated in accordance with international standards.
Results: Overall, 8.6% of boys and 9.0% of girls were obese, and 33.9% of boys and 22.1% of girls were overweight. Having an obese parent increased the odds of having an overweight or obese child (P < 0.01). Compared to non-breast-fed, boys who were breast-fed for >3 months had 70% lower likelihood of being overweight or obese (P < 0.01) and breast-fed girls had 80% lower odds (P < 0.01). Excessive birthweight (>3500 g) increased by 2.5-fold the likelihood of being overweight or obese only in girls (P < 0.05).
Conclusions: Parental weight, lack of breast-feeding and excess birthweight (in girls) were significant predictors of overweight or obesity in Greek children aged 10–12 years.     

Stunting, overweight and child development impairment go hand in hand as key problems of early infancy: Uruguayan case

Background

Stunting, overweight and child development impairment are key problems affecting early infancy and have short and long-term consequences on academic performance, social competence and adult health. The aim of this paper is to identify linkages and factors that may simultaneously contribute to these problems.

Study design

A cross sectional study.

Subjects

2,046 children under 5 years in Canelones, Uruguay.

Outcome measures

For simultaneous assessment of the relationship between stunting, overweight and child development impairment we used multiple logistic regression analyses. We included children, household, maternal and paternal variables as confounder factors. To give the strength of association we performed odds ratios (OR). A significant OR was defined as upper and lower 95% confidence limits not containing the value of one. Significance level was < 0.05.

Results

Low birthweight was a risk for stunting OR: 3.2 (1.8–5.6) and for reduced head circumference growth OR: 3.9 (1.9–8.0); infants with reduced head circumference had an increased chance of delayed psychomotor development OR: 2.4 (1.17–5.07) and of being stunted OR: 3.2 (1.7–6.3); stunted infants had almost three times risk of being overweight OR: 2.7 (1.8–4.1). Maternal stature < 160 cm, low BMI, low education and poverty were also predictor for stunting. Obese mother, maternal stature > 160 cm and maternal smoking increased chance of overweight. Some maternal behaviors, such as mother not used to singing songs and maternal smoking increased the likelihood of delaying psychomotor development.

Conclusions

The close linkages between stunting, being overweight and child development impairment suggest they should be targeted together: they coexist in the same infants and predict each other.     

Factors influencing parental decision to consult for children with upper respiratory tract infection

Aim:   This study aimed to determine which factors could influence (i) parents' decision to seek medical consultatin and (ii) their preference for either public or private medical service in children with upper respiratory tract infection.
Methods:   This cross-sectional study was conducted at the Gombak district, which is an urban area in Malaysia. We randomly selected parents of kindergarten children aged 4–5 years to participate in this questionnaire survey. The main outcome measures were predictors of early medical consultation and type of service utilisation (public versus private).
Results:   We achieved a response rate of 84.5% (n = 1033/1223). 64.1% sought early medical consultation and 70.9% preferred to consult a private doctor. Early consultation was predicated by the parent gender being male (OR 1.50; 95% CI 1.09, 2.05), non-Chinese (OR 1.75%; 95% CI 1.10, 2.79), and those who preferred child specialists (OR 2.02; 95% CI 1.27, 3.23). Lower income group (OR 4.28; 95% CI 2.30, 7.95) and not having a regular doctor (OR 4.99%; 95% CI 3.19, 7.80) were predictors of using the public health services.
Conclusions:   Parent's gender, ethnicity and income influenced their decision to seek early medical consultation for their children's respiratory illness while income and having a regular doctor could predict their choice of healthcare services.     

Do Parents Accurately Perceive Their Child's Weight Status?

IntroductionFew studies have evaluated the accuracy of parental perceptions of their child's weight status.MethodsA cross-sectional sample of children aged 5 to 12 years and their parents (n = 576 parent-child pairs) was enrolled from four schools. Child height and weight were measured. The parents classified their child on Likert scales ranging from “extremely overweight” to “extremely underweight.” Parental perceptions were compared with their child's weight status according to body mass index (BMI) age-gender percentiles. Fisher-Halton-Freeman tests, χ², and logistic regression were used to compare demographic factors between parents who inaccurately estimated and those who accurately estimated child weight status.ResultsMisclassification occurred 25% of the time (95% confidence interval: 21.4–28.5). All parents of children with a BMI greater than or equal to the 95th percentile classified their child in a category other than “extremely overweight,” and 75% of children with a BMI from the 85th to less than the 95th percentile were misclassified as “about right” or “underweight.” Boys were more likely to be misclassified than were girls (29% vs 21%, P = .03).ConclusionsThe majority of parents of obese and overweight children underestimate their child's weight status. Parents of boys are more likely to perceive their child's weight incorrectly.     

Association of Serum Alanine Aminotransferase Levels with Cardiometabolic Risk Factors in Normal-Weight and Overweight Children

Objective

This study aimed to determine the prevalence of increased alanine aminotransferase (ALT), defined by a gender-specific cutoff value, among normal weight and overweight children; and to assess the relationship of increasing ALT levels with cardiometabolic risk factors.

Methods

This cross-sectional study was conducted among school students, aged 6-18 years in Isfahan, Iran. Based on the body mass index (BMI) percentiles, a group of normal-weight was compared with a group of overweight and obese students. Gender differences were considered for increased levels of ALT, i.e. 19U/L and 30U/L for girls and boys respectively.

Findings

The study participants consisted of 1172 students (56.2% girls), with a mean (SD) age of 12.57 (3.3) years. Among overweight/obese students the mean triglycerides (TG) and diastolic blood pressure was significantly higher in those with increased ALT than in those with normal ALT levels. The logistic regression analysis showed that among overweight/obese boys, for each 1 unit increase in ALT, the odds ratio (OR) of TG, total cholesterol and systolic blood pressure increased significantly. After adjusting for age, these associations remained significant, and the OR of high density lipoprotein cholesterol (HDL-c) decreased significantly. In the model adjusting for age and BMI, the ORs of TG and HDL-c remained significant. After adjusting for age and waist circumference, HDL-c was the only parameter with significant OR. Among overweight/obese girls, in all models applied, the OR was significant for TG and total cholesterol. A significant independent association was documented for waist circumference and increase in ALT after adjustment for BMI.

Conclusion

This study documented significant relationship of increased ALT levels, defined by a gender-specific cutoff point, with cardiometabolic risk factors and hypertriglyceridemic-waist phenotype in Iranian children and adolescents.     

Comparison of risk factors for recurrent respiratory infections between urban and rural preschool children in Yiwu, China

Background

Many studies have shown an association between the risk of increased recurrent respiratory infections and socioeconomic and fostering factors, but often only a few risk factors have been studied. This study aimed to identify and compare such factors between urban and rural preschool children.

Methods

Case control studies were conducted in Yiwu urban and rural areas respectively in Zhejiang Province. A structured questionnaire was used to collect information on infl uencing factors such as socioeconomic factors, fostering factors, and housing conditions. The chisquare test was used to compare the distribution of some health related factors between urban and rural children. Risk factor analyses were also made in urban and rural children respectively. Univariate and multivariate analyses were made using the binary logistic regression.

Results

Multivariate analysis showed that maternal age (OR=0.94, 95%CI: 0.89?C0.99), asthma (OR=2.34, 95%CI: 1.22?C4.48), rickets (OR=5.03, 95%CI: 2.10?C12.05), snack (OR=1.62, 95%CI: 1.19?C2.20), traffi c mode (OR=1.38, 95%CI: 1.03?C1.86), living with patients with chronic respiratory system disease (OR=1.79, 95%CI: 1.02?C3.15), and indoor passive smoking (OR=1.46, 95%CI: 1.02?C2.10) were the influencing factors for recurrent respiratory infections in urban children. Rickets (OR=3.77, 95% CI: 1.13?C12.65) and passive smoking (OR=2.33, 95% CI: 1.17?C4.65) were the infl uencing factors for recurrent respiratory infections in rural children.

Conclusions

Public health measures against risk factors should be taken to prevent the occurrence of recurrent respiratory infections in urban and rural children respectively.