Healthy Adolescents Research Articles

Self-compassion and cognitive reappraisal restore female adolescents’ body satisfaction and appreciation after appearance-related rumination

Rumination regarding appearance is a major cause of body dissatisfaction among adolescents. Body ‎image concerns in this age group may lead to ‎considerable psychological distress. Studies suggest that adaptive emotion regulation strategies such as cognitive reappraisal and self-compassion can counteract the harmful consequences of rumination. The goal of the current study was to assess if and to what extent cognitive reappraisal and self-compassion can improve female adolescents’ body satisfaction and appreciation after engaging in appearance-related rumination. ‎Using an experimental design, 142 healthy female adolescents underwent an appearance-related rumination induction. ‎Following this, participants were randomly allocated to one of three experimental conditions requiring to implement either self-compassion, cognitive reappraisal, or rumination using a writing task. State body dissatisfaction ‎and appreciation were assessed at baseline, post-appearance rumination, and post-‎writing tasks. Appearance-related rumination increased state body dissatisfaction and reduced body appreciation in all groups. Importantly, state body dissatisfaction and appreciation fully restored to their baseline levels after implementing self-compassion and cognitive reappraisal, but not rumination. The findings provide empirical evidence regarding the negative consequences of appearance-related rumination among adolescents and demonstrate how adaptive emotion regulation strategies can assist in coping efficiently with appearance-related rumination.

Ventral striatal-cingulate resting-state functional connectivity in healthy adolescents relates to later depression symptoms in adulthood

BackgroundDepression is a significant public health concern. Identifying biopsychosocial risk factors for depression is important for developing targeted prevention. Studies have demonstrated that blunted striatal activation during reward processing is a risk factor for depression; however, few have prospectively examined whether adolescent reward-related resting-state functional connectivity (rsFC) predicts depression symptoms in adulthood and how this relates to known risk factors (e.g., childhood trauma). MethodsAt baseline, 66 adolescents (mean age = 14.7, SD = 1.4, 68 % female) underwent rsFC magnetic resonance imaging and completed the Children's Depression Inventory (CDI). At follow-up (mean time between adolescent scan and adult follow-up = 10.1 years, SD = 1.6, mean adult age = 24.8 years, SD = 1.7), participants completed the Childhood Trauma Questionnaire (CTQ) and Beck Depression Inventory– Second Edition (BDI-2). Average rsFC was calculated between nodes in mesocorticolimbic reward circuitry: ventral striatum (VS), rostral anterior cingulate cortex (rACC), medial orbitofrontal cortex, and ventral tegmental area. Linear regressions assessed associations between rsFC, BDI-2, and CTQ, controlling for adolescent CDI, sex assigned at birth, and scan age (Bonferroni corrected). ResultsGreater childhood trauma was associated with higher adulthood depression symptoms. Stronger VS-rACC rsFC during adolescence was associated with greater depression symptoms in adulthood and greater childhood trauma. LimitationsThe small sample size, limited depression severity, and seed-based approach are limitations. ConclusionsThe associations between adolescent striatal-cingulate rsFC and childhood trauma and adult depression symptoms suggest this connectivity may be an early neurobiological risk factor for depression and that early life experience plays an important role. Increased VS-rACC connectivity may represent an over-regulatory response on the striatum, commonly reported in depression, and warrants further investigation.

Human adolescent brain similarity development is different for paralimbic versus neocortical zones

Adolescent development of human brain structural and functional networks is increasingly recognized as fundamental to emergence of typical and atypical adult cognitive and emotional proodal magnetic resonance imaging (MRI) data collected from N [Formula: see text] 300 healthy adolescents (51%; female; 14 to 26 y) each scanned repeatedly in an accelerated longitudinal design, to provide an analyzable dataset of 469 structural scans and 448 functional MRI scans. We estimated the morphometric similarity between each possible pair of 358 cortical areas on a feature vector comprising six macro- and microstructural MRI metrics, resulting in a morphometric similarity network (MSN) for each scan. Over the course of adolescence, we found that morphometric similarity increased in paralimbic cortical areas, e.g., insula and cingulate cortex, but generally decreased in neocortical areas, and these results were replicated in an independent developmental MRI cohort (N [Formula: see text] 304). Increasing hubness of paralimbic nodes in MSNs was associated with increased strength of coupling between their morphometric similarity and functional connectivity. Decreasing hubness of neocortical nodes in MSNs was associated with reduced strength of structure-function coupling and increasingly diverse functional connections in the corresponding fMRI networks. Neocortical areas became more structurally differentiated and more functionally integrative in a metabolically expensive process linked to cortical thinning and myelination, whereas paralimbic areas specialized for affective and interoceptive functions became less differentiated, as hypothetically predicted by a developmental transition from periallocortical to proisocortical organization of the cortex. Cytoarchitectonically distinct zones of the human cortex undergo distinct neurodevelopmental programs during typical adolescence.

The mediating role of ability to delay gratification in the relationship between emotional abuse and dieting behavior in healthy adolescents: Considering body mass index as a covariate

ObjectivesIn the present study we investigated the relationship between interpersonal childhood trauma, ability to delay gratification (DG), and disordered eating attitudes among adolescents. MethodsData were collected from 145 adolescents aged 12 to 17 through an online survey distributed to parents and legal guardians. The sociodemographic data form, Childhood Trauma Questionnaire (CTQ), Eating Attitudes Test-26 (EAT-26), and Delaying Gratification Inventory were filled out by adolescents in the study. ResultsSociodemographic data revealed a mean age of 15.07 ± 1.64 years, with 62.8% females (n = 91). Correlation analyses revealed associations between body mass index (BMI), interpersonal childhood trauma experiences (measured by CTQ), and disordered eating attitudes (measured by EAT-26). Notably, emotional abuse correlated negatively with ability to DG and positively with dieting behavior. Mediation analysis showed that ability to DG partially mediated the relationship between emotional abuse and dieting behavior, even after controlling for BMI percentiles. ConclusionsThese findings suggest that emotional abuse may influence disordered eating attitudes especially dieting behavior through its impact on ability to DG. Further research is warranted to validate these findings and explore intervention strategies for adolescents affected by interpersonal childhood trauma and disordered eating attitudes.

Efficacy, immunogenicity and safety of CoronaVac® in children and adolescents aged 6 months to 17 years: a multicenter, randomized, double-blind, placebo-controlled phase III clinical trial

Safe and effective vaccines against COVID-19 for children and adolescents are needed. This international multicenter, randomized, double-blind, placebo-controlled, phase III clinical trial assessed the efficacy, immunogenicity, and safety of CoronaVac® in children and adolescents (NCT04992260). The study was carried out in Chile, South Africa, Malaysia, and the Philippines. The enrollment ran from September 10, 2021 to March 25, 2022. For efficacy assessment, the median follow-up duration from 14 days after the second dose was 169 days. A total of 11,349 subjects were enrolled. Two 3-μg injections of CoronaVac® or placebo were given 28 days apart. The primary endpoint was the efficacy of the CoronaVac®. The secondary endpoints were the immunogenicity and safety. The vaccine efficacy was 21.02% (95% CI: 1.65, 36.67). The level of neutralizing antibody in the vaccine group was significantly higher than that in the placebo group (GMT: 390.80 vs. 62.20, P <0.0001). Most adverse reactions were mild or moderate. All the severe adverse events were determined to be unrelated to the investigational products. In conclusion, in the Omicron-dominate period, a two-dose schedule of 3 μg CoronaVac® was found to be safe and immunogenic, and showed potential against symptomatic COVID-19 in healthy children and adolescents.

Does it need an app? – Differences between app-guided breathing and natural relaxation in adolescents after acute stress

A key component of stress management and biofeedback training is the use of relaxation exercises, such as slow/deep breathing (6 breaths/minute) in heart coherence exercises (HCEs). Breathing exercises are also increasingly being integrated into smartphones as part of health apps, though their effectiveness in adolescents after acute stress has rarely been validated scientifically. The aim of the current study was to investigate the effectiveness of an app-guided HCE (n = 36) after an acute stress situation (Trier Social Stress Test) compared with natural relaxation (n = 37), among healthy adolescents (aged 11–17 years). Endocrine, autonomic, and psychological stress parameters (cortisol, alpha-amylase, heart rate, heart rate variability, mood) were examined in 73 adolescents (46 female, 27 male; Mage = 13.86, SDage = 1.87). Significant group differences were found in heart rate variability, with higher values in the low frequency band and low-to-high frequency ratio for the HCE condition, possibly indicating improved physiological functions through the stimulation of vagal tone and baroreflex. The use of a general breathing technique (natural and app-guided) also resulted in stronger relaxation reactions in cortisol when controlling for the previous stronger stress reactivity. On the other hand, app-guided slow breathing without a long training may be experienced as more uncomfortable during relaxation. The integration of breathing exercises in health apps for adolescents appears to be useful, offering a helpful and low-threshold coping/relaxation strategy during acute stress situations. Further studies should examine the benefits of app-guided breathing exercises in both psychiatric samples and the general population across a wide age range.

Pediatric reference values for myocardial contraction fraction and global function index of the left ventricle: A cardiovascular magnetic resonance study

BackgroundCardiovascular magnetic resonance (CMR) derived global function index (GFI) and myocardial contraction fraction (MCF) were identified as useful imaging markers to assess left ventricular (LV) cardiac performance and can provide prognostic information for several cardiac diseases. As pediatric reference values are lacking, the aim of this retrospective study was to establish these values. Methods154 CMR examinations of healthy children and adolescents (4–18 years) were included. LV end-diastolic, end-systolic and stroke volumes, ejection fraction (LVEF) and myocardial mass were measured using short axis stacks. Results were used to calculate LVGFI and LVMCF. Statistically, the Lambda-Mu-Sigma (LMS)-method was applied to create percentile curves and tables. ResultsThe mean age (standard deviation) of the subjects was 13.8 (2.8) years, 102 were male (66%). Mean LVGFI was 46.3 (6.0)% and mean LVMCF was 110.6 (19.9) %. Both, LVGFI and LVMCF decreased significantly with age (LVGFI: r = −0.30, p < 0.001; LVMCF: −0.30, p < 0.001). There was no statistical difference between girls and boys (p all >0.05). Strong correlations between LVGFI and LVMCF (r = 0.78, p < 0.001) as well as between LVGFI and LVEF (r = 0.80, p < 0.001) were documented whereas the correlation of LVMCF and LVEF was weaker (r = 0.32, p < 0.001). Univariable and multivariable regression analysis demonstrated that LVGFI was strongly associated with age whereas LVMCF was associated with weight. Percentile curves and tables were created accordingly. ConclusionWe provide pediatric CMR reference values for the new cardiac functional markers LVGFI and LVMCF. These may improve the interpretation of clinical CMR studies and can be used for future research studies.

Impact of Idiopathic Scoliosis on the Cardiopulmonary Capacity of Adolescents.

Chest deformities in children with scoliosis may result in cardiopulmonary disorders, lowering cardiopulmonary capacity levels. However, results regarding the dependence of cardiopulmonary capacity on the severity level of scoliosis remain controversial. We aimed to use dynamic cardiopulmonary exercise testing (CPET) to investigate exercise capacity in reference to spinal deformity in patients with mild or moderate idiopathic scoliosis by means of multivariate analyses. Methods: We included 92 children and adolescents aged 10-17 years with mild and moderate idiopathic scoliosis and 94 healthy peers. The study consisted of three parts: (1) medical record analyses; (2) anthropometric measurements; and (3) CPET. Results: Our results revealed that the mean VO2peak and VO2peak/kg values of the participants with scoliosis were 0.27 L/min and 0.37 mL/min/kg lower than their healthy peers, respectively, regardless of age and gender. Furthermore, the occurrence of scoliosis correlates with a mean decrease in minute ventilation volume by 10.10 L/min, tidal volume by 0.11 L, breathing frequency by 3.78 bpm, and breathing reserve by 14.34%, regardless of the age and gender of the participants. Children and adolescents with mild-to-moderate scoliosis during CPET exhibit a lower ventilation capacity and lower VO2 max than healthy adolescents matched in age but their cardiorespiratory fitness parameters do not depend on the Cobb angle value and the angle rotation of the primary spinal curvature. Conclusions: Physical therapy and activity should be recommended to prevent cardiorespiratory failure in later life in patients with scoliosis. This study may also provide CPET reference values for healthy children and adolescents with scoliosis.

Optimalisasi Pelaksanaan Program Pelayanan Kesehatan Peduli Remaja (PKPR) Di Sekolah Menenggah Atas

Adolescent Care Health Services (PKPR) is one of the health service programs aimed at adolescents in high schools, to realize “healthy adolescents”. The purpose of this study was to optimize the implementation of the Adolescent Care Health Services Program (PKPR) in senior high schools. The implementation method is carried out by conducting a location survey, looking for problems related to PKPR and finding solutions to these problems. The result of youth empowerment is the development of an “optimization of health services” activity plan. This community service activity was attended by all high school students, teachers responsible for student health services, and PKPR health cadres at school. By providing information about optimizing PKPR health services in high schools and conducting health training for students. It is expected that related parties will be more serious and active in implementing the PKPR program by supervising and monitoring and evaluating the PKPR program regularly and continuously and can allocate special funds to support all activities in the PKPR program.

Serological response after COVID-19 infection compared to vaccination against COVID-19 in children with autoimmune rheumatic diseases

BackgroundPaediatric patients with autoimmune rheumatic diseases (pARD) have a dysregulated immune system, so infections present a major threat to them. To prevent severe COVID-19 infections we aimed to vaccinate them as soon as possible. Studies have shown that the BNT162b2 vaccine is safe, effective, and immunogenic, however, in a short observation period, only.MethodsThe main objective was to compare the serological response between three groups of pARD: after SARS-CoV-2 infection, after vaccination against COVID-19 with two doses of the BNT162b2 vaccine, and after experiencing both events. Data on demographics, diagnosis, therapy, and serology (anti-SARS-CoV-2 IgG/IgA) were collected from March 2020 to April 2022. For statistical analysis ANOVA, Mann-Whitney U test, Chi-square test and Fisher’s exact test were applied. To compare adverse events (AE) after vaccination we included a control group of healthy adolescents.ResultsWe collected data from 115 pARD; from 92 after infection and 47 after vaccination. Twenty-four were included in both groups. Serological data were available for 47 pARD after infection, 25 after vaccination, and 21 after both events. Serological response was better after vaccination and after both events compared to after infection only. No effect of medication on the antibody levels was noted. The safety profile of the vaccine was good. Systemic AE after the first dose of the vaccine were more common in healthy adolescents compared to pARD. In the observation period of 41.3 weeks, 60% of vaccinated pARD did not experience a symptomatic COVID-19 infection.ConclusionsIgG and IgA anti-SARS-CoV-2 levels were higher after vaccination and after both events compared to after infection only. Six months after vaccination we observed an increase in antibody levels, suggesting that pARD had been exposed to SARS-CoV-2 but remained asymptomatic.Trial registrationThe study was approved by the Medical Ethics Committee of the Republic of Slovenia (document number: 0120–485/2021/6).

Factors and level of physical performance of schoolchildren aged 13–14 years

There is an insufficiency of data on the characteristics of physical performance of schoolchildren in the critical period of ontogenesis associated with pubertal development.The aim of the study. To determine the factors and level of physical performance of schoolchildren aged 13–14 years, taking into account pubertal development.Methodology. The study involved healthy male adolescents aged 13–14 years (n = 165). Five stages of puberty were determined. To diagnose the level of physical performance, a complex of functional and ergometric tests and a battery of motor tests were used. The structure of performance was determined based on the factor analysis.Results and discussion. We determined the factors characterizing physical performance: aerobic capacity; absolute aerobic power; anaerobic alactic performance; anaerobic glycolytic performance; relative aerobic power. The identified factors are associated with zones of relative power. It has been established that during puberty, changes in indicators combined into different factors occur non-linearly and non-simultaneously. The results of the study show that subjects of the same age with stages II, III and IV of puberty differ in the level of key bioenergetic performance criteria. Transition to higher stages of puberty is accompanied with progressive dynamics of most indicators associated with factors of anaerobic performance, while indicators of aerobic power and capacity change in different directions, showing in some cases a tendency to temporarily decrease.Conclusion. It is advisable to use the results of the study when organizing various types of monitoring the functional state and regulation of aerobic and anaerobic physical activity in adolescents aged 13–14 years at different stages of puberty. The obtained materials can serve as a scientific basis for improving the physical education system in order to increase the functional capabilities of children’s bodies during the critical period of ontogenesis associated with pubertal development

Unilateral Heel-Raise Test: Estimating Normative Value and Reliability in Healthy Teenagers

Abstract Background: The unilateral heel-raise test (UHRT) is a manual muscle testing procedure used to evaluate the power and endurance of the plantar flexors, which are important muscles for human locomotion. UHRT is commonly used in clinical practice, and normative reference values for UHRT in both adults and the pediatric population can be found in the literature. However, there is a lack of normative values for UHRT specifically for teenagers. The objective of this research study was to determine the normative value of UHRT and establish intra-and inter-tester reliability in teenagers in age group 13–17 years old. Materials and Methods: A total of 315 healthy adolescents were recruited as a part of this research. The participants were instructed to stand on the dominant foot by keeping the opposite foot off the ground (by flexing the knee to 90°). UHRT was performed actively up to maximum repetitions until the development of fatigue. Observations were recorded and further analyzed. Results: The inter- and intra-reliability of UHRT were ICC(2,k) = 0.83 (0.77–0.88) and ICC(3,1) = 0.83 (0.76–0.88), respectively. The median value (25th and 75th interquartile range) obtained for UHRT was 21 (18, 24). The Bland-Altman limits of agreement were also satisfied. The standard error of measurement (SEM) was 0.41, and the minimal detectable change (MDC) for the test was estimated to be 2. Conclusions: This study determined the normative values for UHRT in healthy teenagers of the age group 13–17 years old. It provides a valuable benchmark for interpreting the results of UHRT in teenagers. The analyses revealed good inter- and intra-reliability and minimal error, suggesting that it can be used objectively in research and clinical evaluations.

Adolescent gut microbiome imbalance and its association with immune response in inflammatory bowel diseases and obesity

BackgroundRecently, there has been an increase in the number of studies focusing on the association between the gut microbiome and obesity or inflammatory diseases, especially in adults. However, there is a lack of studies investigating the association between gut microbiome and gastrointestinal (GI) diseases in adolescents.MethodWe obtained 16S rRNA-seq datasets for gut microbiome analysis from 202 adolescents, comprising ulcerative colitis (UC), Crohn’s disease (CD), obesity (Ob), and healthy controls (HC). We utilized Quantitative Insights Into Microbial Ecology (QIIME) and Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) to acquire Operational Taxonomic Units (OTUs). Subsequently, we analyzed Kyoto Encyclopedia of Genes and Genomes (KEGG) Orthology (KO) terms and pathway enrichment for the identified OTUs.ResultsIn this study, we investigated the difference between the gut microbiomes in adolescents with GI diseases and those in healthy adolescents using 202 samples of 16S rRNA sequencing data. The distribution of the six main gut microbiota (i.e., unclassified Dorea, unclassified Lachnospiraceae, unclassified Ruminococcus, Faecalibacterium prausnitzii, Prevotella copri, unclassified Sutterella) was different based on the status of obesity and inflammatory diseases. Dysbiosis was observed within Lachnospiraceae in adolescents with inflammatory diseases (i.e., UC and CD), and in adolescents with obesity within Prevotella and Sutterella. More specifically, our results showed that the relative abundance of Faecalibacterium prausnitzii and unclassified Lachnospiraceae was more than 10% and 8% higher, respectively, in the UC group compared to the CD, Ob, and HC groups. Additionally, the Ob group had over 20% and over 3% higher levels of Prevotella copri and unclassified Sutterella, respectively, compared to the UC, CD, and HC groups. Also, inspecting associations between the six specific microbiota and KO terms, we found that the six microbiota -relating KO terms were associated with NOD-like receptor signaling. These six taxa differences may affect the immune system and inflammatory response by affecting NOD-like receptor signaling in the host during critical adolescence.ConclusionIn this study, we discovered that dysbiosis of the microbial community had varying degrees of influence on the inflammatory and immune response pathways in adolescents with inflammatory diseases and obesity.

Physiological Impacts of Energy Drink Consumption: A Clinical Analysis in Adolescents.

Energy drink (ED) consumption among Israeli-Arab adolescents is widespread. This study aimed to investigate the acute glycemic and insulin effects of EDs in healthy adolescents. Seventy-one Israeli-Arab adolescents (56% girls, average age 16.04 ± 1.03 years) participated in a non-randomized, case-controlled, open-label study. Participants consumed ED (n = 36) or a volume- and carbohydrate-matched non-caffeinated soft drink (SD, n = 35), followed by a 2 h glucose tolerance test. Blood glucose was measured at baseline and 15, 30, 60, and 120 min post-consumption (T0, T15, T30, T60 and T120, respectively). Serum insulin concentration and caffeine relative intensity were determined 45 min post-consumption (T45). Blood glucose levels peaked significantly at T15 and remained significantly higher at T30 in the ED group compared to the SD group (p = 0.005, p = 0.017, respectively). Insulin concentrations were substantially higher at T45 in the ED group (t [64] = 2.794, p = 0.001). This pattern was especially prominent in heavy ED consumers. A positive correlation emerged between the amount of caffeine consumed (mg/kg), blood glucose levels at T15 and T30, and insulin concentration at T45. This study is the first to demonstrate the glycemic and insulin responses to ED consumption in adolescents, suggesting that regulatory measures limiting ED sales to adolescents could improve their health.

Serum Myostatin is Associated With Central-to-Peripheral Arterial Stiffness Gradient in Healthy Adolescents: The MACISTE Study.

Myostatin is a protein compound, structurally related to the transforming growth factor-beta protein, which plays a pivotal role in regulating muscle growth and extracellular matrix production. It exerts both profibrotic and antihypertrophic effects on vascular smooth muscle cells. Aim of the study was to explore the potential association between serum myostatin levels (sMSTN) and carotid-femoral pulse wave velocity (cf-PWV), carotid-radial pulse wave velocity (cr-PWV), and their ratio (PWVr), in a cohort of healthy adolescents. A cohort of 128 healthy subjects (mean age 17 ± 2 years, 59% male) was randomly selected from participants to the MACISTE (Metabolic And Cardiovascular Investigation at School, TErni) study. sMSTN was assessed utilizing an enzyme-linked immunosorbent assay. PWVs were measured in the supine position using high-fidelity applanation tonometry. The mean cf-PWV was 5.1 ± 0.9 m/s, cr-PWV was 6.9 ± 0.9 m/s, and PWVr was 0.75 ± 0.12. PWVr exhibited a linear increase across increasing quartiles of sMSTN (0.71 ± 0.1, 0.74 ± 0.1, 0.7 ± 0.1, 0.77 ± 0.1, P for trend = 0.03), whereas the association between sMSTN and each single component of PWVr (cf-PWV, cr-PWV) did not attain statistical significance. Quartiles of sMSTN displayed a positive trend with serum HDL-cholesterol (P = 0.01) and a negative one with LDL-cholesterol (P = 0.01). In a multivariate linear model, the association between PWVr and sMSTN was independent of SBP values, age, sex, heart rate, BMI, HDL-cholesterol, and HOMA Index. In healthy adolescents, sMSTN showed independent associations with PWVr, a measure of central-to-peripheral arterial stiffness gradient. sMSTN may exert differential effects on the structural and functional properties of the arterial wall.

Normal values of peripheral (brachial) blood pressure measured in 14062 Hungarian healthy children and adolescents with normal body mass index

Bevezetés: Korábban a gyermekek és serdülők vérnyomás-referenciaértékeire vonatkozó ajánlások adatbázisai a túlsúlyos/elhízott egyének adatait is tartalmazták. A vérnyomás és a túlsúly/elhízás közötti szoros összefüggés, valamint a túlsúly/elhízás előfordulási gyakoriságának az elmúlt évtizedekben világszerte tapasztalt emelkedése miatt a gyermekekre és serdülőkre vonatkozó vérnyomás-referenciaértékek meghatározásának módja felülvizsgálatra szorul. Célkitűzés: Célunk volt keresztmetszeti vizsgálatban meghatározni a 3–19 éves korú, normál testtömegű gyermekek és serdülők vérnyomásértékeit Magyarországon, valamint összehasonlítani a normál testtömegű gyermekek és serdülők vérnyomásértékeit a túlsúlyos/elhízott társaikéval. Módszer: 17 828 (9350 fiú) egyén esetében végeztünk antropológiai méréseket és oszcillometriás vérnyomásmérést. A normál testtömegű (n = 14 062, 7195 fiú), a túlsúlyos (n = 2527, 1427 fiú) és az elhízott (n = 1239, 728 fiú) csoportot a testtömegindex percentilisértékei alapján különítettük el. A vérnyomás-percentilisgörbéket és -értékeket LMS-módszerrel képeztük. Eredmények: Mind a systolés, mind a diastolés vérnyomás emelkedett az életkor előrehaladtával mindkét nemben, minden súlykategóriában. A normál testtömegű csoportban a medián testmagasságon mért systolés és diastolés vérnyomás 50. percentilisértéke 94/59 Hgmm-ről 124/68 Hgmm-re emelkedett a fiúkban, míg 94/59 Hgmm-ről 116/68 Hgmm-re a lányokban. A pubertás előtt a systolés vérnyomás nem különbözött szignifikánsan a nemek között, ezt követően fiúkban jelentősebben emelkedett. A diastolés vérnyomás tekintetében nem találtunk klinikailag releváns szignifikáns különbséget a nemek között. A vérnyomás-percentilisértékek a túlsúlyos és az elhízott páciensek csoportjában szignifikánsan magasabbak voltak a normál testtömegűekhez képest (p&lt;0,001). Következtetés: A közölt vérnyomás-normálértékek a jelenkori magyar gyermek- és serdülőpopulációra vonatkozó ismereteinket gyarapítják. Miután a túlsúlyos/elhízott gyermekek és serdülők vérnyomásértékei magasabbak, mint normál testtömegű társaiké, adataikat elkülönítve javasolt tanulmányozni. Orv Hetil. 2024; 165(28): 1086–1100.

Influence of Oral Contraceptives on Lipid Profile and Trajectories in Healthy Adolescents—Data From the EVA-Tyrol Study

PurposeOral contraception is one of the most popular contraceptive methods both in adults and adolescents. However, the effects of oral contraception on lipids in adolescents are not well studied. MethodsLipid profiles were measured and contraceptive use was assessed in 14- to 19-year-old female participants of the prospective population-based Early Vascular Ageing-Tyrol Study between 2015 and 2018, twice on average 22 months apart. ResultsFor this analysis, data from 828 young women with a median age of 17.0 years were available. Of them, 317 (38%) used oral contraceptives (OCs). OC users had a slightly higher systolic and diastolic blood pressure and larger changes over time and were more likely to use cigarettes than nonusers. Total cholesterol (179.6 vs. 162.4 mg/dL), low-density lipoprotein-cholesterol (106.4 vs. 94.6 mg/dL), and triglycerides (104.0 vs. 67.0 mg/dL) were significantly higher in OC users after multivariable adjustment in linear regression models. No difference in high-density lipoprotein-cholesterol between the two groups was found. In 558 females, follow-up data were available. Those who initiated OC use had on average 15.4 mg/dL higher low-density lipoprotein-cholesterol and 36.2 mg/dL higher triglyceride level changes between baseline and follow-up than never users. Duration of OC use did not show a significant association with lipid levels and changes. DiscussionWe showed an independent association between OC use and blood lipids as well as lipid trajectories over time in a large cohort of healthy adolescents. These changes are especially relevant to consider in adolescents with other risk factors for dyslipidemia or other cardiovascular risk factors.

Reference intervals and percentiles for soluble transferrin receptor and sTfR/log ferritin index in healthy children and adolescents.

Soluble transferrin receptor (sTfR) is a marker of both erythropoiesis and iron status and is considered useful for detecting iron deficiency, especially in inflammatory conditions, but reference intervals covering the entire pediatric age spectrum are lacking. We studied 1,064 (48.5 % female) healthy children of the entire pediatric age spectrum to determine reference values and percentiles for sTfR and the ratio of sTfR to log-ferritin (sTfR-F index) using a standard immunoturbidimetric assay. Soluble TfR levels were highly age-specific, with a peak in infancy and a decline in adulthood, whereas the sTfR-F index was a rather constant parameter. There were positive linear relationships for sTfR with hemoglobin (Hb) (p=0.008) and transferrin (females p<0.001; males p=0.003). Anegative association was observed between sTfR and ferritin in females (p<0.0001) and for transferrin saturation and mean corpuscular volume (MCV) in both sexes (both p<0.0001). We found a positive relationship between sTfR and body height, body mass index (BMI) and inflammatory markers (CrP p<0.0001; WBC p=0.0172), while sTfR-F index was not affected by inflammation. Soluble TfR values appear to reflect the activity of infant erythropoiesis and to be modulated by inflammation and iron deficiency even in a healthy cohort.

Inflammatory Hematological Ratios in Adolescents with Mental Disorders: A Scoping Review.

Inflammatory hematological ratios (IHRs), such as neutrophil to lymphocyte, monocyte to lymphocyte, and platelet to lymphocyte ratios, are associated with mental disorders, symptoms severity, and the disease phase. Evidence from the studies in adult patients has been summarized in systematic reviews and meta-analyses. The results of the studies in adolescents remain poorly systematized. To summarize the findings from the studies that investigated the relationship of IHRs with mental disorders in adolescent patients. This scoping review included studies of IHRs in patients aged 10-19 years with mental disorders (other than anorexia nervosa), published in English by December 31, 2023. The search for relevant papers was performed in MEDLINE. The studies were categorized into two groups: studies with external controls (healthy adolescents) and studies with internal controls (patients in different phases of mental disorder, with or without self-harm/suicidal behaviors). A total of 11 studies were included in the review (all cross-sectional ones). The results of these studies demonstrate that 1) adolescents with mental disorders (major depressive disorder, psychotic disorders, obsessive-compulsive disorder, attention deficit hyperactivity disorder, substance use disorders) have higher IHR values than individuals of the same age without corresponding disorders (5 studies); 2) IHR values are positively correlated with the severity of psychopathological symptoms (1 study); 3) higher IHR values are associated with the phase of the mental disorder - manic episode in bipolar disorder (1 study) and exacerbation of psychosis in psychotic disorders (1 study); and 4) higher IHR values are associated with self-harm/suicidal behaviors - suicide attempts (1 study) and non-suicidal self-injury (1 study). IHRs are associated with mental disorders in adolescents, and higher IHR values are associated with a more severe/acute clinical presentation (severity of symptoms, mania, acute psychosis, self-harm/suicidal behaviors). Further studies of higher methodological quality are needed to evaluate the diagnostic and prognostic value of IHRs as biomarkers of mental disorders in adolescence.

Sex- and age-specific reference intervals of 16 steroid metabolites quantified simultaneously by LC-MS/MS in sera from 2458 healthy subjects aged 0 to 77 years

BackgroundReference intervals covering the whole life span for all the metabolites in the steroid hormone biosynthesis quantified by sensitive and robust analytical methods are sparse or not existing. ObjectiveTo develop a state-of-the-art LC-MS/MS method for simultaneous quantification of multiple steroid metabolites and to establish detailed sex- and age-specific reference intervals for 16 steroid metabolites. Materials and methodAn isotope diluted LC-MS/MS method was developed for simultaneous quantitation of 16 steroid hormones. Serum samples from cross-sectional cohorts of healthy infants, children, adolescents, and adults aged 0.17 months to 77 years (n = 2458) were analysed. ResultsWith this novel, specific, and sensitive LC-MS/MS method, it was possible to quantify progesterone, 17-hydroxypregnenolone, 17-hydroxyprogesterone, dehydroepiandrosterone sulfate, androstenedione, testosterone, dihydrotestosterone, 11-deoxycorticosterone, corticosterone, 11-deoxycortisol, cortisol, and cortisone in ≥90 % of the samples, while estrone sulfate, aldosterone and dehydroepiandrosterone were quantified in 77 %, 75 % and 60 % of the samples, respectively. 21-deoxycortisol was only detectable in 2.5 % of samples from healthy subjects. Sex- and age-dependent fluctuations observed in minipuberty, puberty and adulthood including the menopausal transition were modelled. This enabled us to establish valid reference intervals from birth to late adult life for both males and females. ConclusionDetailed sex- and age-specific reference intervals of multiple, simultaneously quantified steroid metabolites by a novel and specific LC-MS/MS method provides a valuable tool for clinical practice and for future research.