Physical activity (PA) is an important part of lifestyle management for adolescents with Type 1 diabetes (T1D). Opportunities for PA were reduced by COVID-19 restrictions. Therefore, the purpose of ...this cross-sectional study was to compare PA among adolescents with and without T1D during the first New Zealand (NZ) COVID-19 lockdown. PA levels of adolescents aged 11-18 years with T1D (
= 33) and healthy controls (
= 34) were assessed through self-reported and parent proxy-reported questionnaires. Overall, PA levels during lockdown were below recommended levels. PA levels did not differ between T1D and control participants (
= 0.212) nor between genders (
= 0.149). Younger adolescents tended to be more active than older adolescents (
= 0.079). PA level was negatively associated with BMI z-score (
= -0.29,
= 0.026) but was not associated with socioeconomic status (SES) or T1D-related parameters. In the T1D group, higher HbA1c was associated with lower school decile (
= -0.58,
< 0.001) and higher BMI z-score (
= 0.68,
< 0.001). Overall, young people were insufficiently active during lockdown, and some sub-groups were more affected than others by the restrictions. Pandemics are likely to be part of our future, and further studies are needed to understand their impact on the health and wellbeing of adolescents.
Background
Adolescents with type 1 diabetes (T1D) experience higher rates of psychological disorders compared with their healthy peers. As poor psychological health has been associated with ...suboptimal glycaemic control and more frequent complications, there is an urgent need to develop more ‘clinically usable’ interventions. Digital mental health interventions offer unique advantages compared with in‐person interventions; however, what adolescents with T1D want in terms of content and functionality is poorly understood. Accordingly, the current study conducted focus groups to examine the views of adolescents with T1D regarding digital mental health interventions.
Methods
Four focus groups were conducted, including 16 adolescents with T1D, ranging from 13 to 17 years in age (69% female). Transcripts were analysed using directed content analysis to examine (1) ‘what adolescents dislike about existing digital mental health interventions?’ and (2) ‘what adolescents want in future digital mental health interventions?’.
Results
Findings provide a preliminary understanding of what adolescents dislike and also the type of content and functional features, which may be important to include in digital mental health programs for this population, such as a peer support feature (reported by 16 of 16), emotion and diabetes check‐in feature (11 of 16) and diabetes‐relevant content (12 of 16).
Conclusions
Early data suggest that digital mental health interventions should include a significant peer support element, diabetes‐relevant content and examples, and check‐in on their mental health and diabetes self‐management regularly, while avoiding fixed responses or modules and non‐age‐appropriate content. Based on these findings, a digital intervention is currently being developed.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Abstract
Context
Age of pubertal onset has been decreasing in many countries but there have been no data on pubertal development in Chinese children over the last decade.
Objective
The primary ...objective of the study was to evaluate the current status of sexual maturation in Chinese children and adolescents. Secondary objectives were to examine socioeconomic, lifestyle, and auxological associations with pubertal onset.
Methods
In this national, cross-sectional, community-based health survey, a multistage, stratified cluster random sampling method was used to select a nationally representative sample, consisting of 231 575 children and adolescents (123 232 boys and 108 343 girls) between 2017 and 2019. Growth parameters and pubertal staging were assessed by physical examination.
Results
Compared to 10 years previously, the median age of Tanner 2 breast development and menarche were similar at 9.65 years and 12.39 years respectively. However, male puberty occurred earlier with a median age of testicular volume ≥4 mL of 10.65 years. Pubertal onset did occur earlier at the extremes, with 3.3% of the girls with breast development at 6.5-6.99 years old, increasing to 5.8% by 7.5-7.99 years old. Early pubertal onset was also noted in boys, with a testicular volume ≥ 4 mL noted in 1.5% at 7.5-7.99 years, increasing to 3.5% at 8.5-8.99 years old. Obesity and overweight increased risk of developing earlier puberty relative to normal weight in both boys and girls.
Conclusion
Over the past decade, pubertal development is occurring earlier in Chinese children. While the cause is multifactorial, overweight and obesity are associated with earlier puberty onset. The currently used normative pubertal data of precocious puberty may not be applicable to diagnose precocious puberty.
Maternal age at childbirth continues to increase worldwide. We aimed to assess whether increasing maternal age is associated with changes in childhood height, body composition, and metabolism.
277 ...healthy pre-pubertal children, born 37-41 weeks gestation were studied. Assessments included: height and weight corrected for parental measurements, DEXA-derived body composition, fasting lipids, glucose, insulin, and hormonal profiles. Subjects were separated according to maternal age at childbirth: <30, 30-35, and >35 years.
Our cohort consisted of 126 girls and 151 boys, aged 7.4 ± 2.2 years (range 3-10); maternal age at childbirth was 33.3 ± 4.7 years (range 19-44). Children of mothers aged >35 and 30-35 years at childbirth were taller than children of mothers aged <30 years by 0.26 (p = 0.002) and 0.23 (p = 0.042) SDS, respectively. There was a reduction in childhood BMISDS with increasing maternal age at childbirth, and children of mothers aged >35 years at childbirth were 0.61 SDS slimmer than those of mothers <30 years (p = 0.049). Children of mothers aged 30-35 (p = 0.022) and >35 (p = 0.036) years at childbirth had abdominal adiposity reduced by 10% and 13%, respectively, compared to those in the <30 group. Children of mothers aged 30-35 years at childbirth displayed a 19% increase in IGF-I concentrations compared to offspring in <30 group (p = 0.042). Conversely, IGF-II concentrations were lower among the children born to mothers aged 30-35 (6.5%; p = 0.004) and >35 (8.1%; p = 0.005) compared to those of mothers aged <30 years. Girls of mothers aged 30-35 years at childbirth also displayed improved HOMA-IR insulin sensitivity (p = 0.010) compared to girls born to mothers aged <30 years.
Increasing maternal age at childbirth is associated with a more favourable phenotype (taller stature and reduced abdominal fat) in their children, as well as improved insulin sensitivity in girls.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Objective
To evaluate the impact of a liquid chromatography‐tandem mass spectrometry (LCMSMS) second‐tier test on newborn screening for congenital adrenal hyperplasia due to 21‐hydroxylase deficiency ...(CAH) in New Zealand.
Design
In a prospective study, a LCMSMS method to measure 17‐hydroxyprogesterone (17OHP) was adapted to measure four additional steroids. Steroid concentrations were collected on all second‐tier CAH screening tests while protocols remained unchanged. Steroid ratio parameters with recommended or published screening cuts‐offs were evaluated for their impact on newborn screening performance.
Measurements
Precision, accuracy, linearity and recovery of the second‐tier LCMSMS method were evaluated. Second‐tier specimens were divided in 3 groups; newborn screening bloodspots from neonates with confirmed CAH (n = 7) and 2 groups specimens from neonates with a birthweight (BW) ≤1500 g (n = 795) and with a BW > 1500 g (n = 806) with a negative newborn screening test. Six protocols using four steroid ratio parameters were evaluated. The sensitivity, specificity, false positive rate and positive predictive value of screening was calculated for each protocol.
Results
The LCMSMS method was sufficiently accurate and precise to be used as a second‐tier test for CAH. Screening sensitivity remained at 100% for each protocol apart from (17OHP + androstenedione)/cortisol when the highest cut‐off of 3.75 was applied. The false positive rate was significantly improved when (17OHP + androstenedione)/cortisol and (17OHP + 21‐deoxycortisol)/cortisol were evaluated with cut‐offs of 2.5 and 1.5 respectively (P < .01) and both with a positive predictive value of 64%.
Conclusions
A second‐tier LCMSMS newborn screening test for CAH offers significant improvements to screening specificity without any other changes to screening protocols.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Aims to evaluate the incidence of type 1 diabetes mellitus in children,15 years of age in the Auckland region (New Zealand) over 20 years (1990–2009). Performs a retrospective review of all patients ...from an unselected complete regional cohort. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aim
To assess participation with a structured transition programme for adolescents with diabetes.
Methods
Data from a regional cohort aged less than 16 years of age with type 1 (T1) and type 2 ...diabetes (T2D) in Auckland, New Zealand (2006–2016). Participation was defined as opting into a structured transition programme.
Results
Five hundrend and twelve adolescents who were to be transferred to adult care (476 type 1 (T1D) and 36 type 2 (T2D)), overall participation rate of 83%, 86% (408/476) with T1D compared to 47% (17/36) with T2D. Within the cohort of T1D, participation rates for Māori and Pacific were lower (74% and 77%, respectively) than New Zealand Europeans (88%, p = 0.020 and p = 0.039, respectively). Lower socio‐economic status was associated with reduced participation (77%) compared to higher socio‐economic status (90%, p = 0.002).
Of the 476 T1D who participated, 408 (96%) subsequently attended at least one adult service clinic (“capture”). 42% attended an adult clinic within the planned 3 months, 87% at 6 months and retention in adult clinics over 5 years of follow‐up was 78%. By contrast, the 68 young people with T1D who did not participate in the structured transition had a capture rate of 78% (p < 0.001) and retention of 63% (p = 0.036).
Conclusions
In adolescents with diabetes, a formal transition from a paediatric service was associated with high rates of adult capture and subsequent retention in adult care over a 5‐year follow‐up period. Low socio‐economic status, Māori or Pacific ethnicity and T2D were associated with reduced participation in the structured transition programme.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
An adverse prenatal environment may induce long-term metabolic consequences, in particular obesity, hyperleptinemia, insulin resistance, and type 2 diabetes. Although the mechanisms are unclear, this ...“programming” has generally been considered an irreversible change in developmental trajectory. Adult offspring of rats subjected to undernutrition (UN) during pregnancy develop obesity, hyperinsulinemia, and hyperleptinemia, especially in the presence of a high-fat diet. Using this model of maternal UN, we have recently shown that neonatal leptin treatment in females reverses the postnatal sequelae induced by developmental programming. To examine possible gender-related effects of neonatal leptin treatment, the present study investigated the effect of neonatal leptin treatment on the metabolic phenotype of adult male offspring. Leptin treatment (recombinant rat leptin, 2.5 μg/g·d, sc) from postnatal d 3–13 resulted in a transient slowing of neonatal weight gain, particularly in programmed offspring. Neonatal leptin treatment of male offspring from normally nourished mothers caused an increase in diet-induced weight gain and related metabolic sequelae, including hyperinsulinemia and increased total body adiposity compared with saline-treated controls. This occurred without an increase in caloric intake. These effects were specific to offspring of normal pregnancies and were not observed in offspring of mothers after UN during pregnancy. In the latter, neonatal leptin treatment conferred protection against the development of the programmed phenotype, particularly in those fed the chow diet postnatally. These data further reinforce the importance of leptin in determining long-term energy homeostasis, and suggest that leptin’s effects are modulated by gender and both prenatal and postnatal nutritional status.
Objective. Hysterosalpingography (HSG) with oil-soluble contrast medium (OSCM) improves pregnancy rates in women with idiopathic infertility. However, OSCM has high iodine content and slow clearance ...resulting in potential iodine excess. If pregnancy occurs, this could impact fetal thyroid gland development and function. We aim to determine the effect of a preconceptional OSCM HSG on the thyroid function of the neonate. Design and Patients. This was a retrospective analysis of newborn TSH data for a cohort of neonates conceived within six months of an OSCM HSG in the Auckland region, New Zealand, from the years 2000 to 2019. Thyroid-stimulating hormone (TSH) levels of these newborns were obtained from newborn screening, which is routinely performed for all children at 48–72 hours of life. The primary outcome was the incidence of permanent or transient congenital hypothyroidism in this cohort. Results. Of 146 babies included, all had normal TSH levels with values ranging from 1 to 7 mIU/L on the whole blood analysis of a capillary heel sample using the Perkin–Elmer AutoDelfia assay. Conception during the first 3 cycles following an OSCM HSG was 76%; however, TSH levels in this group were not higher than those conceived in later cycles. Conclusion. Preconceptional OSCM HSG did not increase the risk of congenital hypothyroidism in the New Zealand scenario.
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FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UL, UM, UPUK
Genomewide Association Studies of Stroke Ikram, M. Arfan; Seshadri, Sudha; Bis, Joshua C ...
New England journal of medicine/The New England journal of medicine,
04/2009, Volume:
360, Issue:
17
Journal Article
Peer reviewed
Open access
A genomewide association study indicates that a locus on chromosome 12 confers susceptibility (with a hazard ratio of approximately 1.3) to ischemic stroke. This locus is close to
NINJ2,
which ...encodes a cell adhesion molecule that shows increased expression on glia in response to nerve injury. A second gene near this locus influences blood pressure and hypertension.
A genomewide association study indicates that a locus on chromosome 12 confers susceptibility (with a hazard ratio of approximately 1.3) to ischemic stroke. This locus is close to
NINJ2,
which encodes a cell adhesion molecule that shows increased expression on glia in response to nerve injury.
Stroke is the leading neurologic cause of death and disability.
1
Twin and familial aggregation studies suggest that the risk of stroke has a substantial genetic component,
2
–
4
but the genes underlying this risk in the general population remain undetermined. Studies of candidate genes or studies that use classical linkage approaches have yielded inconsistent findings.
5
Genomewide association studies have uncovered previously unsuspected common variants underlying the risk of complex diseases such as diabetes
6
and coronary disease.
7
,
8
Two previous genomewide association studies of stroke were limited by a case–control design that is more susceptible to survival and selection biases than the . . .
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