Birthweight,Childhood Body Mass Index,Height and Growth,and Risk of Polycystic Ovary Syndrome

IntroductionAdult obesity is linked with polycystic ovary syndrome (PCOS), but the importance of body size at ages before PCOS is diagnosed is unknown.ObjectiveTo investigate associations between a woman''s own birthweight, childhood body mass index (BMI), height and growth patterns in relation to her risk of PCOS.MethodsWe included 65,665 girls from the Copenhagen School Health Records Register, born in the period 1960–1996, with information on birthweight and measured weight and height at the ages of 7–13 years. Overweight was defined using International Obesity Task Force (IOTF) criteria. From the Danish National Patient Register, 606 women aged 15–50 years were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by Cox regression analysis.ResultsBirthweight was not associated with PCOS. At the age of 7–13 years, girls with overweight had a higher risk of developing PCOS than girls without overweight; HR 2.83 (95% CI 2.34–3.42) at age 7 years and 2.99 (95% CI 2.38–3.76) at age 13 years. Furthermore, girls with overweight at both 7 and 13 years had a higher risk of developing PCOS than girls without overweight or overweight at only one age. Height was positively associated with PCOS risk at all ages. Girls who were persistently tall or changed from tall to average height had a higher risk of developing PCOS than girls with average height growth.ConclusionOverweight and tall stature in childhood are positively associated with PCOS risk, but birthweight is not.     

Individualizing recall intervals in child dental care

Abstract Individualizing and extending recall intervals for children have been recommended in Norway to target resources efficiently. Recall intervals were changed for children aged 3–18 years in Drammen from 1991. Clinical time spent by dentists and dental hygienists, dental health status and length of recall intervals were registered from 1990 to 1993. For the child population, the mean recall interval changed from 12.5 to 13.7 months and the annual time spent per child was reduced by 14% from 1990–91 to 1992–93. Adjusted for the decline in number of new decayed teeth, the reduction in time spent was 11%. Children with intervals of 17 to 20 months had fewer new decayed teeth and their care required less personnel time than other children. For children with new decayed teeth, time spent for dental care was not associated with recall interval, while for children without new decayed teeth, longer recall intervals were associated with shorter time for dental care. The variation in number of decayed teeth and time spent for dental care was substantial at all intervals. Individualizing and extending recall intervals to some extent targeted resources at children with more dental disease. However, in the short run, inequality in dental health persisted. Limited extension of recall intervals did not interrupt the long-term trend toward better dental health in the children and substantial resources were saved in the dental services.     

Urodynamic biofeedback training for children with bladder-sphincter dyscoordination during voiding

Neurologically normal children with recurrent urinary tract infections (UTIs), night- and daytime wetting, and urge and painful voiding may have staccato voiding due to pelvic floor contractions. The immediate effect of non-invasive urodynamic biofeedback (BF) therapy was assessed using a historical follow-up study in 31 children aged 5–15 years suffering from urodynamically proven overactive urethra during voiding. A long-term follow-up study was performed to investigate whether improvement was maintained. Twenty-four children (77.5%) benefited from the treatment. Of these 16 (51.5%) were cured, while 8 (26%) had a pronounced reduction in their symptoms. Although the flow was normalized in 17 (55%) and nearly normalized in 7 (22.5%), there was no significant correlation between subjective and objective criteria of improvement. Similarly, no relationship was found between the initial urodynamic characteristics and the treatment outcome. During a mean follow-up time of 4 years (range: 1–7.5 years) two of the initially cured patients relapsed. They were recured with a refresher course. Three had had a single or a few episodes of cystitis in the course of several years. Of the patients with pronounced reduction in their symptoms, three relapsed. A refresher course was attempted in two patients; one was successful. It can thus be concluded that BF is an effective way of treating this disturbance and the beneficial effect is to a wide degree maintained.     

Dental caries in schoolchildren in some Danish communities with and without school dental service

ABSTRACT The purpose of the investigation was to compare the caries prevalence (DMF-T) among 762 7th grade children, of whom one-hall had received regular school dental care throughout their school attendance and the other half had never received school dental care. The children were grouped according to social status in order to see if there was any difference in the caries prevalence between the social groups. The caries prevalence in children both with and without school dental service was high, 9.5 DMF-T and 10.5 DMF-T. The prevalence of untreated caries and secondary caries was lowest in the group with school dental service.     

Comparison of vitamin D metabolism in early healthy and late osteoporotic postmenopausal women

Summary We studied 20 healthy premenopausal women aged 36.5±4.0 years (mean±1 SD), 123 healthy postmenopausal women aged 50.0±2.4 years, and 103 postmenopausal women aged 65.1±5.6 years with symptomatic osteoporosis (forearm and spinal fracture). Serum levels of vitamin D metabolites [25(OH)D, 24,25(OH)₂D₃, and 1,25(OH)₂D] were compared with (1) bone mass in the forearm (single photon absorptiometry) and in the spine (dual photon absorptiometry); (2) biochemical indices of bone formation (serum alkaline phosphatase, plasma bone Gla protien), and bone resorption (fasting urinary hydroxyproline); and (3) other biochemical estimates of calcium metabolism (serum calcium, serum phosphate, 24-hour urinary calcium, intestinal absorption of calcium). The present study revealed no difference in any of the vitamin D metabolites between the premenopausal women, the healthy postmenopausal women and the osteoporotic women as a group. The concentrations of 1,25(OH)₂D and 25(OH)D were significantly lower in patients with spinal fracture than in those with forearm fracture. In the early postmenopausal women, serum 1,25(OH)₂D was related to forearm bone mass (r=−0.20;P<0.05), intestinal calcium absorption (r=0.18;P<0.05), and 24-hour urinary calcium (r=0.21;P<0.05); serum 25(OH)D was related to spinal bone mass (r=0.23;P<0.01). In the osteoporotic women, serum vitamin D metabolites were not related to bone mass, but 1,25(OH)₂D was related to bone Gla protein (r=0.33;P<0.001), serum phosphate (r=−0.27;P<0.01), and 24-hour urinary calcium (r=0.43;P<0.001). The present study demonstrates that in a population that is apparently not deficient in vitamin D, a disturbance of the vitamin D metabolism is not likely to play a pathogenetic role in early postmenopausal bone loss. Patients with spinal fractures have low levels of vitamin D metabolites, which may aggravate their osteoporosis.     

Glycemic and insulinemic responses as determinants of appetite in humans

BACKGROUND: The importance of the postprandial glycemic and insulinemic responses for appetite and energy intake (EI) is controversial. OBJECTIVE: The aim of the study was to test the hypothesis that postprandial appetite sensations and subsequent EI are determined by postprandial glycemic and insulinemic responses after the intake of a range of breakfast meals. DESIGN: The study was a randomized, crossover meal test including 28 healthy young men, each of whom tested 10 of 14 breakfast meals. Each meal contained 50 g carbohydrate with various glycemic index and energy and macronutrient contents. Blood samples were taken, and appetite sensations were measured 3 h after the meals. Subsequently, EI at lunch (EI(lunch)) was recorded. RESULTS: The glycemic response was unrelated to appetite sensations, whereas the insulinemic response was positively associated with postprandial fullness (R2 = 0.33, P < 0.05). In contrast, the insulinemic response was unrelated to the subsequent EI(lunch), whereas the glycemic response was positively associated with EI(lunch) (R2 = 0.33, P < 0.05). Although no significant difference in EI(lunch) was observed between different breakfast conditions, a low breakfast EI was associated with a high EI(lunch) (R2 = 0.60, P < 0.001). CONCLUSIONS: The current study does not support the contention that the postprandial glycemic response has an important effect on short-term appetite sensations, but a low-glycemic index meal may reduce subsequent EI. In contrast, postprandial insulin seems to affect short-term appetite sensations.