Dysfunction In Adolescents Research Articles

Relationship of Circulating Mirnas With Insulin Resistance and Metabolic Dysfunction in Adolescents

Abstract Objectives To evaluate the relationship of plasma expression of miR-122, -375, -139, 15-a and -let7c with insulin resistance and factors related to metabolic syndrome (MetS) in adolescents. Methods Data from 188 adolescents aged 12–19 years participating in a cross-sectional population-based study were analyzed, all non-smokers, without acute inflammatory diseases and cancer, and without the use of medication that would interfere in the outcome. The quantification of circulating miRNA was performed by RT-PCR, using the Fluidigm chip technique. The miRNA expression was compared among adolescents grouped by the absence (n = 94) or presence of insulin resistance (n = 94)—categorized according to with the HOMA-IR index -, and the absence (n = 92) or presence of 1 (n = 59), 2 (n = 23), 3 (n = 10) or 4 (n = 4) factors related to MetS. The comparison of means was performed using the Mann-Whitney test for two samples or Kruskal-Wallis followed by Dunn's post-test to compare three or more samples. Results Insulin resistance was identified in 50% of the individuals (HOMA-IR > 2.7). In adolescents with insulin resistance, the plasma expression of miR-122 was higher in comparison to normoglycemic individuals and was positively associated with fasting insulinemia (r = 0.157; P = 0.031), HOMA-IR index (r = 0.160; P = 0.028) and plasma hepcidin (r = 0.209; P = 0.005) levels. When evaluating the expression according to the number of factors related to MetS, the expression of miR-let7c, -139 and -15a increased according to the increase of the factors related to MetS. The opposite effect was observed in relation to miR-375. Individuals with 3 or more factors differed from groups whith 1 or 2 factores for plasma miR-375, -139, 15-a and -let7c expression. MiR-375 showed a negative association with body weight (r = −0.169; P = 0.019), while miR-139 was associated with systolic (r = 0.153; P = 0.055) and diastolic (r = 0.193; P = 0.016) blood pressure. Plasma miR-15a expression had a positive correlation with diastolic blood pressure (r = 0.198; P = 0.0064). MiR-let7c showed a positive correlation plasma TG (r = 0.156; P = 0.029). Conclusions Plasma miR 122 expression was related to insulin resistance, while plasma miR 375, 139, 15 a and let7c expressions were associated with MetS in adolescents. Funding Sources From Sao Paulo Research Foundation and National Council for Scientific and Technological Development

P648 Physical and mental health during COVID-19 quarantine in adolescents with chronic immunocompromised conditions and inflammatory bowel disease

BackgroundSocial connection is a fundamental part of the psychosocial development in adolescence; therefore quarantine has a potentially negative impact in the physical and mental health.Therefore, the objective of this study was to evaluate physical and mental health indicators in adolescents with preexisting chronic immunocompromised conditions, including inflammatory bowel disease(IBD) compare to healthy adolescents during COVID-19 quarantine.MethodsA cross-sectional study included 355 adolescents with chronic conditions(IBD, n=44) and 111 healthy adolescents. An online self-rated survey was used to investigate socio-demographic features, healthcare routine and the quarantine impact on physical and mental health. Validated self-reported version of Strengths and Difficulties Questionnaire(SDQ) evaluated psychosocial functioning.ResultsNo differences were observed between adolescents with preexisting chronic immunocompromised conditions versus healthy adolescents during quarantine of COVID-19 pandemic for age, sex and ethnicity, as well as for household conditions and schooling(p>0.05). The frequencies of psychosocial functioning abnormalities according to total difficulties SDQ score were high and similar in patients and controls(30% vs. 31%, p=0.775). Logistic regression analysis showed that being female(OR=1.965, 95%CI=1.091–3.541,p=0.024), fear of underlying disease activity/complication(OR=1.009, 95%CI=1.001–1.018, p=0.030) were associated with severe psychosocial dysfunction in adolescents with chronic conditions, whereas school homework(OR=0.449, 95%CI=0.206–0.981,p=0.045), physical activity (OR=0.990, 95%CI=0.981–0.999,p=0.030) and sleep quality(OR=0.986, 95%CI=0.975–0.998,p=0.017) were protective factors. Further analysis showed similar median age, fear (disease activity/complication, immunosuppressive use, and COVID-19), physical activity, sleep difficulties, and total difficulties SDQ score in IBD adolescents versus with chronic conditions (p>0.05). The frequencies of psychosocial functioning abnormalities according to total difficulties score of SDQ were high and similar in IBD adolescents vs. chronic condition(37% vs. 29%, p=0.329), as well sleep difficulties(34% vs. 32%, p=0.797).ConclusionBeing female, fear of underlying disease activity/complication and household members working outside of home were relevant issues for adolescents with preexisting chronic conditions. We also demonstrated that adolescents with IBD during COVID-19 quarantine had high risk of adverse health indicators, particularly psychosocial functioning and sleep difficulties. This study reinforces the need to establish mental health strategies for teens with chronic conditions, particularly during pandemic periods.

Self-reported symptoms of temporomandibular pain and jaw dysfunction in adolescents are associated with exposure to violence.

Temporomandibular disorders (TMDs) are multifactorial, and high levels of stress seem to increase symptoms. The association with exposure to violence has not been explored in adolescent populations. To examine the association of self-reported symptoms of temporomandibular pain and jaw dysfunction with child physical abuse, intimate partner violence, forced sexual intercourse, and bullying victimisation. An epidemiological, cross-sectional, school-based study was conducted in Olinda, northeast Brazil. The sample comprised 2,431 adolescents aged 14-19years. TMD-related symptoms and exposure to violence were assessed with questions from the 3Q/TMD screener and queries on exposure to different forms of violence. Multilevel logistic regressions were conducted to evaluate how 3Q screen-positive responses are associated with self-reported exposure to violence. Self-reported TMD-related symptoms had a prevalence of 40.5%. Significantly more females than males screened positive to all 3Q/TMD questions (p<.001). Adolescents experiencing intimate partner violence (p=.012) and bullying (p<.001) had significantly higher odds of 3Q positive responses than those who reported no exposure to violence. Significant associations of TMD-related symptoms with forced sexual intercourse (p=.014) and with bullying (p=.007) were observed. Adolescents with self-reported symptoms of temporomandibular pain and jaw dysfunction were significantly more often exposed to some type of violence. The number of adolescents reporting TMD-related symptoms increased in a dose-response manner with the number of violence forms the individual had experienced.

Cardiometabolic risk factors and early indicators of vascular dysfunction: a cross-sectional cohort study in South African adolescents

ObjectivesPrevalence of child and adolescents’ overweight and obesity in low- and middle-income countries has increased dramatically. Simultaneously, the incidence of pre-hypertension/hypertension is also increasing in children, which, in turn, predisposes...

Association between Urinary Phthalate Metabolites and Markers of Endothelial Dysfunction in Adolescents and Young Adults

Endothelial function is crucial in the pathogenesis of circulatory and cardiovascular toxicity; epidemiologic research investigating the association between phthalate exposure and endothelial dysfunction remains limited. We examined the associations between exposures to specific phthalates (di-2-ethylhexyl phthalate, DEHP; di-n-butyl phthalate, DnBP) and circulating endothelial and platelet microparticles (EMPs and PMPs) in adolescents and young adults. Of the 697 participants recruited, anthropometric measurements and health-related behaviors relevant to cardiovascular risks were collected and assessed. Urine and serum were collected and analyzed with liquid chromatography-tandem mass spectrometry (LC-MS/MS) and flow cytometry. Multiple linear regression indicated that increases in urinary concentrations of ΣDEHP and MnBP (mono-n-butyl phthalate), across quartiles, were positively associated with serum EMPs level (p for trend <0.001 and <0.001; β = 0.798 and 0.007; standard error = 0.189 and 0.001, respectively). Moreover, female and overweight subjects had higher MnBP, and males were more vulnerable to DnBP exposure compared to females. In conclusion, our results demonstrate a dose-response relationship between exposures to phthalates (ΣDEHP and MnBP) and microparticle formation (EMPs and PMPs) in adolescents and young adults. The findings indicate that exposures to phthalates of both low and high-molecular weight are positively associated with microparticle production, and might contribute to endothelial dysfunction; such damage might manifest in the form of atherosclerotic-related vascular diseases. Future in vivo and in vitro studies are warranted to elucidate whether a causal relationship exists between phthalate exposure and EMPs and PMPs.

Altered functional network connectivity and working memory dysfunction in adolescents with epilepsy.

Adolescents with epilepsy are at risk for deficits in working memory, which could lead to learning difficulties and poor academic outcomes. We used task-based functional magnetic resonance imaging (fMRI) to examine potential disruption in working memory function in adolescents with epilepsy as compared to healthy controls. We recruited 29 adolescents (13-17years) with non-lesional epilepsy and 20 healthy controls. All participants performed an N-back fMRI task and neuropsychological testing. A general linear model approach was used to create group activation maps of N-back fMRI for epilepsy and control groups and both groups combined (p < 0.05 corrected for multiple comparisons). Functionally defined regions of interest (ROIs) were identified based on clusters of combined group activation (z > 5). Subsets of these functional ROIs corresponding to cingulo-opercular and fronto-parietal networks were selected and differences in functional connectivity between the epilepsy and control groups were assessed. Adolescents with epilepsy had significantly poorer working memory scores compared to controls. For the N-back fMRI task, there were no significant differences in group activation. Functional connectivity was significantly reduced between the left frontal operculum and anterior cingulate gyrus (cingulo-opercular network) in adolescents with epilepsy compared to controls. This study demonstrates working memory deficits and an altered pattern of connectivity in brain networks supporting working memory in adolescents with epilepsy. Working memory performance was worse in adolescents with epilepsy; though scores were not directly correlated with reduced connectivity. These results suggest the neural substrates of working memory in adolescents with epilepsy may differ from those in typically-developing adolescents, and require further investigation to understand the reasons for poorer working memory performance.

Characteristics of effective online interventions: implications for adolescents with personality disorder during a global pandemic.

In recent years, the necessity of providing online interventions for adolescents, as an alternative to face-to-face interventions, has become apparent due to several barriers some adolescents face in accessing treatment. This need has become more critical with the coronavirus disease 2019 (COVID-19) global pandemic impacting the delivery of psychotherapy and limiting accessibility of face-to-face therapy. Whilst it has been established that face-to-face psychotherapy for adolescents with personality disorder can be effective in reducing the impact these complex mental illnesses have on functioning, online interventions for adolescents are rare, and to our knowledge there are no empirically validated online interventions for personality disorder. The development of novel online interventions are therefore necessary. To inform the development of online interventions for adolescents with personality disorder or symptoms of emerging personality disorder, a two-phase rapid review was conducted. Phase one consisted of a search and examination of existing online mental health programs for adolescents with symptoms of personality disorder, to understand how to best use online platforms. Phase two consisted of a rapid review of empirical literature examining online interventions for adolescents experiencing symptoms of personality disorder to identify characteristics that promote efficacy. There were no online programs specific to personality disorder in adolescence. However, 32 online mental health programs and 41 published empirical studies were included for analysis. Common intervention characteristics included timeframes of one to two months, regular confidential therapist contact, simple interactive online components and modules, and the inclusion of homework or workbook activities to practice new skills. There is an urgent need for online interventions targeting personality dysfunction in adolescence. Several characteristics of effective online interventions for adolescents were identified. These characteristics can help inform the development and implementation of novel online treatments to prevent and reduce the burden and impact of personality disorder, or symptoms of emerging personality disorder, in adolescents. This has implications for the COVID-19 pandemic when access to effective online interventions has become more urgent.

Oral and cutaneous manifestations of covid-19 in pediatric patients

ABSTRACT COVID-19 began in December 2019 in Wuhan City, China, and on March 11, 2020 it was classified by the World Health Organization as a pandemic. It is an asymptomatic infection that can progress to severe respiratory conditions. In adults, it is more prevalent, but is also observed in children, with the occurrence of extra respiratory symptoms, such as oral and cutaneous manifestations. This literature review aims to report the oral and cutaneous manifestations of COVID-19 in pediatric patients. The bibliographic search strategy was carried out in the PubMed, SciELO and Bireme databases on August 1, 2020, using MeSH Terms “COVID-19”; “Child”; “Oral Manifestations”; “Skin Manifestations”; “Ageusia”; “Dysgeusia” and corresponding Decs, and also manual search, without language restriction. The stages of search, screening, selection, evaluation of studies and data extraction were performed by four independent reviewers. Nine studies that met the eligibility criteria were identified. The most cited oral and cutaneous manifestations were, respectively, taste dysfunction in adolescents and erythematous eruption in extremities and trunk. Health professionals should be aware of these manifestations, however, this is a recent theme in the literature, and more careful studies with greater strength of evidence still need to be performed.

Factors Predictive of Behavioural and Emotional Dysfunction in Adolescents in a Secure Children\u2019s Home

The aim of the present study was to investigate what factors are predictive of behavioural and emotional dysfunction in adolescence. A sample of 60 young people accommodated under a welfare or youth custody service order in a UK secure children’s home between 2016 and 2018 was used. Data regarding young people’s Adverse Childhood Experiences (ACE’s) history, scores on standard assessments and factors thought to indicate behavioural and emotional dysfunction were collected from file information. Correlations and regression models were used to analyse the data. Analyses found that young people in this setting had been exposed to more ACEs than the general population. Furthermore, signs of behavioural and emotional dysfunction as a result of exposure to ACE’s appeared to be present from early adolescence. It was found that exposure to verbal and sexual abuse were the greatest predictors of involvement in risk incidents. The young person’s substance misuse habits were the best predictor of the length of stay in the secure children’s home. These findings may have policy implications and highlight the need for early interventions with young people exposed to ACE’s.

Clinical - neurological and vegetative dysfunctions in adolescents with metabolic syndrome.

Clinical - neurological and vegetative dysfunctions in adolescents with metabolic syndrome.

Aberrant posterior superior temporal sulcus functional connectivity and executive dysfunction in adolescents with internet gaming disorder.

Background and aimsThe clinical significance of Internet gaming disorder (IGD) is spreading worldwide, but its underlying neural mechanism still remains unclear. Moreover, the prevalence of IGD seems to be the highest in adolescents whose brains are in development. This study investigated the functional connectivity between large-scale intrinsic networks including default mode network, executive control network, and salience network. We hypothesized that adolescents with IGD would demonstrate different functional connectivity patterns among large-scale intrinsic networks, implying neurodevelopmental alterations, which might be associated with executive dysfunction.MethodsThis study included 17 male adolescents with Internet gaming disorder, and 18 age-matched male adolescents as healthy controls. Functional connectivity was examined using seed-to-voxel analysis and seed-to-seed analysis, with the nodes of large-scale intrinsic networks used as region of interests. Group independent component analysis was performed to investigate spatially independent network.ResultsWe identified aberrant functional connectivity of salience network and default mode network with the left posterior superior temporal sulcus (pSTS) in adolescents with IGD. Furthermore, functional connectivity between salience network and pSTS correlated with proneness to Internet addiction and self-reported cognitive problems. Independent component analysis revealed that pSTS was involved in social brain network.Discussion and conclusionsThe results imply that aberrant functional connectivity of social brain network with default mode network and salience network was identified in IGD that may be associated with executive dysfunction. Our results suggest that inordinate social stimuli during excessive online gaming leads to altered connections among large-scale networks during neurodevelopment of adolescents.

Caudate nuclei volume alterations and cognition and mood dysfunctions in adolescents with single ventricle heart disease.

Adolescents with single ventricle heart disease (SVHD) exhibit mood and cognitive deficits, which may result from injury to the basal ganglia structures, including the caudate nuclei. However, the integrity of the caudate in SVHD adolescents is unclear. Our aim was to examine the global and regional caudate volumes, and evaluate the relationships between caudate volumes and cognitive and mood scores in SVHD and healthy adolescents. We acquired two high-resolution T1-weighted images from 23 SVHD and 37 controls using a 3.0-Tesla MRI scanner, as well as assessed mood (Patient Health Questionnaire-9 [PHQ-9]; Beck Anxiety Inventory [BAI]) and cognition (Montreal Cognitive Assessment [MoCA]; Wide Range Assessment of Memory and Learning-2; General Memory Index [GMI]) functions. Both left and right caudate nuclei were outlined, which were then used to calculate and compare volumes between groups using ANCOVA (covariates: age, gender, and head-size), as well as perform 3D surface morphometry. Partial correlations (covariates: age, gender, and head-size) were used to examine associations between caudate volumes, cognition, and mood scores in SVHD and controls. SVHD subjects showed significantly higher PHQ-9 and BAI scores, indicating more depressive and anxiety symptoms, as well as reduced GMI scores, suggesting impaired cognition, compared to controls. SVHD patients showed significantly reduced caudate volumes (left, 3,198.8±490.1 vs. 3,605.0±480.4mm3 , p<0.004; right, 3,162.1±475.4 vs. 3,504.8±465.9mm3 , p<0.011) over controls, and changes were localized in the rostral, mid-dorsolateral, and caudal areas. Significant negative correlations emerged between caudate volumes with PHQ-9 and BAI scores and positive correlations with GMI and MoCA scores in SVHD and controls. SVHD adolescents show significantly reduced caudate volumes, especially in sites that have projections to regulate mood and cognition, which may result from developmental and/or hypoxia-/ischemia-induced processes.

The association between metabolic components and markers of inflammatory and endothelial dysfunction in adolescents, based on the Ewha Birth and Growth Cohort Study.

We assessed the association between metabolic health and markers of inflammation and of endothelial dysfunction using data from the Ewha Birth and Growth Cohort Study. The data of 195 subjects aged 13–15 years were analyzed. To assess metabolic syndrome, continuous metabolic syndrome (cMets) scores were calculated. We measured the levels of high-sensitivity C-reactive protein (hs-CRP), intercellular adhesion molecule 1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1) as markers of inflammation and endothelial dysfunction. An increase of one SD in the cMets score resulted in a 1.25-fold (95% CI 1.10–1.42) increase in the risk of acute inflammatory status and a 1.26-fold (95% CI 1.11–1.43) increase in the risk of endothelial dysfunction as defined by ICAM-1, while VCAM-1 showed a meaningless trend. Of the metabolic components, body mass index (BMI) was positively associated with elevated hs-CRP levels and high-density lipoprotein cholesterol (HDL-c) levels were negatively associated with elevated ICAM-1 levels. Additionally, a mediation analysis showed that a high BMI was directly related to elevated hs-CRP levels and indirectly related to elevated ICAM-1 levels via HDL-c. Our findings show that poor metabolic health was related to an unfavorable inflammatory status and endothelial dysfunction in adolescents.

MON-109 Modulator of Gut Barrier, Zonulin Was Associated with Waist to Height Ratio in Adolescents

Background: Zonulin is the endogenous protein known to control the permeability of intestinal tight junction reversibly. Zonulin is actively engaged in intestinal innate immunity and is over-expressed in autoimmune diseases where tight junction of intestine plays a pivotal role, such as celiac disease, malabsorption disorder, and type 1 diabetes. Waist-Height ratio was well known as one of indices of obesity and also Waist-Hip ratio was known of abdominal obesity. We investigated that the associations among Waist-Height, Waist-Height ratio, and the level of Zonulin by assessing obesity-related biomarkers, such as liver enzymes, lipid profiles, and insulin resistance, in a population of adolescents. Methods: The study included 198 adolescents aged 12-18 years; 92 were overweight/obese and 106 were of normal-weight. We assessed anthropometric and laboratory measures, including body mass index (BMI), BMI z-score, Waist-Height, Waist-Hip ratio, blood pressure, liver enzyme levels, lipid profiles, and insulin sensitivity. Serum Zonulin levels were measured using an enzyme-linked immunosorbent assay. Results: The mean age of the participants was 15.2±2.5 years. Circulating serum Zonulin levels were significantly increased in overweight/obese participants compared with those in normal-weight participants (P=0.042). Zonulin levels were significantly and positively associated with BMI, BMI z-score, alanine aminotransferase levels, triglyceride, fasting insulin, and insulin resistance as indicated by the homeostasis model assessment of insulin resistance (HOMA-IR) (all P<0.05). In multivariate linear regression analysis, alanine aminotransferase (P<0.0001), triglyceride (P<0.0001), and HOMA-IR (P=0.001) contributed independently to circulating Zonulin levels after controlling for the effect of BMI z-score. Zonulin levels were more strongly associated with Waist-Hip ratio rather than Waist-Height ratio. Conclusions: Zonulin was associated with indices of obesity. Waist-Hip ratio was more strongly associated with levels of Zonulin. The positive correlation between these parameters suggests putative pathophysiological mechanism linking Zonulin to metabolic dysfunction in adolescents.

Brain Reward System Dysfunction in Adolescence: Current, Cumulative, and Developmental Periods of Depression.

Reward system dysfunction is a well-known correlate and predictor of depression in adults and adolescents, with depressed individuals showing blunted (hyporeactive) striatal response to monetary rewards. Furthermore, studies of remitted depression suggest network-wide hyporeactivity of striatal (caudate, putamen, nucleus accumbens) and cortical (insula, anterior cingulate cortex [ACC]) regions even in the absence of current symptoms. Thus, it remains unclear which patterns of hyporeactivity represent a trait-like indicator of depression and which represent a current depressed state. The authors examined the relationships between regions of a cortico-striatal circuit supporting reward processing and both current depression and cumulative depression history. Using a functional MRI monetary reward task, the authors measured brain response to monetary gains and losses in a longitudinal sample of adolescents (N=131) who had been annually assessed for psychiatric symptoms since ages 3-5 years. Current depression severity was associated with hyporeactivity exclusively in the nucleus accumbens in response to the anticipation of a reward, while cumulative depression severity was associated with blunted response to anticipation across a cortico-striatal circuit (striatum, ACC, insula). Follow-up analyses investigating the effects of depression on reward processing at different developmental stages revealed a similar pattern: recent depression severity during adolescence was associated with more focal hyporeactivity in the nucleus accumbens, while depression severity during early childhood (i.e., preschool) was associated with more global hyporeactivity across the cortico-striatal circuit. The study findings indicate important distinctions between disruptions in reward system neural circuitry associated with a history of depression (particularly early-onset depression) and current depression. These results have implications for understanding the etiology and treatment of reward processing deficits in depression.

Higher Hepcidin Levels Associate with Visceral Fat and Cardiometabolic Risk in Obese Adolescents

Background: Hepcidin is a hormone that regulates iron flow in plasma, its production is induced by an iron overload and by inflammation. Some studies conducted in children and adolescents report an iron deficiency secondary to obesity-related to elevated levels of hepcidin. Although it is know hepcidin rises when IL6 increases, the relationship between hepcidin, dyslipidemia, IR, visceral adiposity index (VAI) and endothelial dysfunction in adolescents with obesity is unclear. Aims: We set out to explore the difference of hepcidin, iron metabolism markers and IL-6 between obese and no obese adolescents, and identify associations of with inflammation, dyslipidemia, insulin resistance, and endothelial dysfunction. Methods: Cross-sectional study of 29 obese adolescents and 30 controls subjects (normal BMI) from Guanajuato, Mexico. Anthropometric measurements and blood pressure were conducted using standard methods, VAI was calculated. Iron metabolism markers (hepcidin, transferrin, ferritin, soluble transferrin receptor -sTFR) were assayed by ELISA, as well as IL-6. Lipid profile and insulin were measured by standard auto-analyzer methods. We calculated HOMA index. sdLDL was analyzed by gradient electrophoresis using the Lipoprint LDL method from Quantimetrix. Flow-mediated vasodilation (FMD) and arterial stiffness were measured by ultrasound. The Ethical Committee of the University of Guanajuato approved this study and informed consent was obtained from the participant adolescents and their parents. Results: The obesity group showed significantly higher levels of hepcidin 14070.8 ± 7113.5 vs 8419.1 ± 4826.8c; IL-6 2.0 (1.0-4.9) vs 0.9 (0.5-1.3)c and ferritin 94.4 ± 82.4 vs 55.1 ± 39.6a. No significant difference was found for transferrin, sTFR and sTFR index. Obese adolescents showed significantly lower HDL-C (58.2 ± 9.6 vs 63.6 ± 5.0a mg/dl and higher levels of TG 139.3 ± 64.2 vs 83.2 ± 42.9c; mg/dl, sdLDL% 3.78 ± 4 vs 1.85 ±2.7a; HOMA (3.34 (2.4-5.5) vs 1.8 (1.2-2.2)d; VAI 1.6 ± 0.8 vs 0.9 ± 0.5c. FMD was significantly lower in obese adolescents 20.64 ± 7.1 vs 27.7 ± 9.3b. Hepcidin correlated positively with VAI r=0.29a; IL-6 r=0.35b; TG r=0.38b; sdLDL3% r=0.31a; HOMA r=0.29a; SBP r=0.36b; arterial stiffness r=0.29a; and negatively with FMD r=-0.29a. IL-6 correlated positively with VAI r=0.30 a and HOMA r=0.36 b ap<0.05; bp<0.01, cp<0.001; dp<0.0001 Conclusions: Adolescents with obesity show higher hepcidin levels that are associated with cardiometabolic risk markers such as IR, VAI, atherogenic dyslipidemia and endothelial dysfunction, while IL-6 was only associated with IR, and VAI. This suggests that hepcidin is a valuable marker of inflammation regardless of changes in iron metabolism and total body iron (TBI) as demonstrated by unchanged sTFR and TBI as sTFR/ferritin index. Long term effects of higher hepcidin levels on iron status should be explored.

Peripheral biomarkers of mitochondrial dysfunction in adolescents with bipolar disorder

BackgroundMitochondrial dysfunction has been implicated in the pathophysiology of bipolar disorder (BD). Impediment of mitochondrial oxidative phosphorylation results in a shift toward anaerobic respiration and lactate production. Elevated CNS lactate levels in adults with BD inform the need to evaluate lactate in peripheral samples and early in the course of BD. Furthermore, there exists a recent surge of investigations looking at circulating cell-free mitochondrial DNA (ccf-mtDNA) as a potential biomarker as they are released from cells under physiological stress, apoptosis, or bioenergetic compromise. ObjectivesTo compare lactate and ccf-mtDNA, two different ways in assessing the mitochondrial health and function, in adolescents with BD versus healthy control adolescents (HC). MethodsOne-hundred and five adolescents (n = 64 BD, n = 41 HC) were included. Serum lactate level was measured using a commercially available colorimetric kit. Serum ccf-mtDNA concentration was measured using quantitative polymerase chain reaction from ccfDNA purified by commercially available spin columns. Diagnosis and mood symptoms were evaluated using semi-structured interviews. ResultsThere is an increase in serum lactate level of adolescents with BD (1.319 ± 0.444 nmol/uL) versus HC (1.168 ± 0.353 nmol/uL; p = 0.043), but not ccf-mtDNA. Among BD adolescents, depression symptoms were negatively correlated with ccf-mtDNA levels (ρ = −0.289; p = 0.038) but loses significance when corrected for multiple comparison. Lactate was positively correlated with ccf-mtDNA in the overall sample (ρ = 0.201; p = 0.043). When examined by diagnosis, this association remained in BD (ρ = 0.273; p = 0.032), but not HC. ConclusionThese preliminary results indicate that elevated lactate is observed even among adolescents early in their course of BD, that the association between lactate and ccf-mtDNA appears to be specific to BD, and that ccf-mtDNA is potentially associated with depression symptoms in adolescent BD. In addition, the effect of psychotropic medications used in the treatment of BD on peripheral lactate and ccf-mtDNA requires further investigation.

Functional connectivity of specific brain networks related to social and communication dysfunction in adolescents with attention-deficit hyperactivity disorder

BackgroundAdolescents with attention-deficit hyperactivity disorder (ADHD) may have impaired social cognition and communication. However, the functioning of the brain networks involved in the social cognition and communication impairment in ADHD patients remains unclear. MethodsIn total, 18 adolescents with ADHD and 16 age- and sex-matched typically developing adolescents (controls)—all of whom underwent a brain magnetic resonance imaging examination—were enrolled. Their parents filled out Swanson, Nolan, and Pelham IV (SNAP-IV) and Social Responsiveness Scale (SRS) questionnaires. Functional connectivity analyses based on the default mode network, frontoparietal network, and cinguloopercular network were performed. ResultsCompared with controls, adolescents with ADHD exhibited higher total and subscale scores on SNAP-IV and SRS. Higher SNAP-IV and SRS scores were associated with higher functional connectivity between the default mode network (ventromedial prefrontal cortex) and cinguloopercular network (anterior insula) and between the FPN (dorsolateral and prefrontal cortex) and cinguloopercular network, but with lower functional connectivity between the default mode network (posterior cingulate cortex) and frontoparietal network (inferior parietal lobule) and between the default mode network (precuneus) and cinguloopercular network (temporoparietal junction). DiscussionSocial cognition and communication impairment and ADHD may commonly share the aberrant functional connectivity in the default mode network, frontoparietal network, and cinguloopercular network.

Психологические и психосоматические факторы риска суицидального поведения подростков

The article presents an overview of modern foreign studies, which aim to study the psychological, somatic and psychosomatic risks of suicidal behavior of adolescents, and, as an empirical illustration, results of the study of psychological and psychosomatic correlates of adolescent depression and suicidality. A rather extensive list of risk factors for suicide, described in foreign literature, was reduced to four classes: somatic (psychosomatic), intrapsychological, socio-psychological, behavioral. It has been shown that the greatest association with suicidal intentions and attempts belongs to depressive states, however, this association, in most cases, is mediated by other predictors of the risk of a suicide. The results of the empirical study described the main psychosomatic dysfunctions in adolescents’ suicides, usually accompanied by asthenic states.

Early Detection of Renal Dysfunction in Adolescents Aged 10-13 Years Born with very Low Birth Weight

Objective: Very low birth weight (VLBW), defined as less than 1500 gr, is an established risk factor for kidney disease in adulthood. To assess that, we examined whether VLBW manifests signs of renal dysfunction at as early as age 10 years, as reflected by elevated blood pressure, proteinuria and reduced glomerular filtration rate (GFR). Methods: 103 children aged 10-13 years and born with VLBW underwent consecutive blood pressure measurements, spot urine analysis, and weight and height measurements. Prevalence rates of hypertension, pre-hypertension and proteinuria were calculated. Characteristics were compared between children with normal and abnormal renal function, to identify risk factors for renal dysfunction. Results: The prevalence of systolic hypertension was 15.8% (95% CI 8.69% - 22.91%) of systolic pre-hypertension 6.9% (95% CI1.96% - 11.84%), and of proteinuria 15.7% (95% CI 8.64% - 22.76%) of the study population. Hypertension was associated with a significantly diminished mean birth weight compared to the remainder of the cohort (939.3gr vs 1111gr, P=0.024). Proteinuria and microalbuminuria were associated with lower mean current body weights: 27.2kg vs 36.7kg P=0.015 and 31.3 kg vs 36.8kg; P=0.023; and with increased mean estimated GFR (126.1 vs 108.3 mL/min per 1.73 m2; P = 0.0059). Conclusions: In a cohort of children aged 10-13 years, who were born preterm with VLBW, disturbed kidney function presented in considerably higher proportions than in general populations of this age. The findings merit considering initiation of routine screening during early adolescence, for hypertension, proteinuria and GFR in this risk group.