Population-based Sample Of Adolescents Research Articles

Distribution and determinants of glycosylated hemoglobin in adolescents - Results from a nationwide population-based survey in Germany.

The role of glycosylated hemoglobin (HbA1c) in youth is largely unclear. The aims of this study are to investigate the distribution and potential determinants of HbA1c among a population-based sample of adolescents. The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) Wave 2 includes a nationwide representative sample of 0-17-year-old participants. For this evaluation, data from a randomly selected subgroup aged 14-17 years and without diagnosed diabetes was included (n = 857). Percentile-based HbA1c values (measured at laboratory in whole blood samples by high performance liquid chromatography) were calculated to examine HbA1c distribution. Multivariable linear regression analyses were performed to investigate factors (age, sex, parental socioeconomic status, body mass index (BMI), birth weight, smoking, alcohol consumption, healthy food diversity, sport activity, oral contraceptive use) associated with HbA1c. The mean HbA1c level was 5.2% (minimum: 3.9%, P10: 4.8%, P50: 5.1%, P90: 5.5%, maximum: 6.7%). Overall, 2.8% of adolescents had an HbA1c value in the prediabetic range (5.7-6.4%) and 0.1% had an undiagnosed diabetes (≥6.5%). Multivariable regression analysis showed an inverse association of age with HbA1c (17 vs. 14 years: ß: -1.18; 95% CI -2.05, -0.31). Higher HbA1c values were observed for higher BMI-standard deviation scores (SDS) (ß: 0.24; 95% CI -0.04, 0.52) and smoking (ß: 0.73; 95% CI -0.12, 1.57), but these tendencies were non-significant. In sex-stratified analysis, smoking and birth weight were significantly associated with HbA1c in boys. Among adolescents without diagnosed diabetes in Germany, HbA1c values ranged from 3.9% to 6.7%. To ensure health in adulthood, the influence of determinants on HbA1c levels in younger age should be further investigated.

No association between methylphenidate use and psychotic experiences in a population-based sample of adolescents at risk of emotional and behavioral problems.

No association between methylphenidate use and psychotic experiences in a population-based sample of adolescents at risk of emotional and behavioral problems.

Is There any Difference Between DSM-5 performance-only Specifier and Social Anxiety Disorder? Results from the Young-HUNT3 Study

With the publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, APA, 2013), the diagnostic criteria for social anxiety disorder (SAD) changed; the generalized SAD specifier was removed, and a performance-only specifier was introduced. Despite growing awareness and understanding of the DSM-5 performance-only type specifier, information about its key aspects is lacking. Exploring a large, population-based adolescent sample (N = 8,216), we identified three SAD classes: full spectrum SAD, subclinical SAD, and the performance-only specifier. The three groups were compared across a broad range of parameters. The results indicate that adolescents with the performance-only specifier differed significantly from both the full spectrum and subclinical groups on most clinical indexes. By contrast, the subclinical and full spectrum groups differed less from each other on most parameters. Thus, there were specific aspects of the performance-only specifier group that differentiate this condition from subclinical and clinical SAD in our sample of adolescents. These data indicate that the specifier in the new version of the DSM may be valid in adolescents, and that policymakers and clinicians should not disregard adolescents who show subclinical SAD levels with performance-related challenges. Furthermore, researchers and clinicians should consider the extent to which adolescents with the SAD performance-only specifier may need a different treatment approach.

Dating violence victimization disparities across sexual orientation of a population-based sample of adolescents: An adverse childhood experiences perspective.

Dating violence victimization disparities across sexual orientation of a population-based sample of adolescents: An adverse childhood experiences perspective.

Dimensions of Early Adversity and Sexual Behavior in a US Population-Based Adolescent Sample

PurposeEarly life adversity (ELA) is associated with sexual risk, but ELA dimensions—and potential mechanisms—have been less examined. We evaluated associations between threat and deprivation—two key ELA dimensions—and sexual behaviors in adolescents. Secondary analyses investigated age at menarche as a mechanism linking ELA with sexual outcomes in girls. We predicted associations between threat and sexual behaviors, with younger age at menarche as a pathway. MethodsData were from the National Comorbidity Survey, Adolescent Supplement. Adolescents and caregivers reported on youths' ELA experiences, which were categorized as threat- or deprivation-related. Adolescents reported if they engaged in sex (N = 9,937) and on specific sexual risk indicators, including age at first sex, number of past-year sexual partners, and condom use consistency (“always” vs. “not always” used). Girls reported age at menarche. ResultsThreat (odds ratio [OR] = 1.76 [95% confidence interval [CI], 1.62–1.92]) and deprivation (OR = 1.51 [95% CI, 1.24–1.83]) were each linked with engagement in sex, ps<.05. Threat-related experiences were associated with multiple sexual risk markers, even when accounting for deprivation: earlier age at first sex (b = −0.20 [95% CI, −0.27 to 0.13]), greater number of partners (b = 0.17 [95% CI, 0.10–0.25]), and inconsistent condom use (OR = 0.72 [95% CI, 0.64–0.80]), ps <.001. Deprivation was not associated with sexual risk when adjusting for threat. We observed no significant indirect effects through age at menarche. DiscussionAlthough threat and deprivation were related to engagement in sexual activity, threat-related experiences were uniquely associated with sexual risk. Screening for threat-related ELA may identify adolescents at-risk for poor sexual health.

A Mixed-Methods Approach to Refining and Measuring the Construct of Positive Risk-Taking in Adolescence.

Adolescence is a peak period for risk-taking, but research has largely overlooked positive manifestations of adolescent risk-taking due to ambiguity regarding operationalization and measurement of positive risk-taking. We address this limitation using a mixed-methods approach. We elicited free responses from contemporary college students (N=74, Mage =20.1 years) describing a time they took a risk. Qualitative analysis informed the construction of a self-report positive risk-taking scale, which was administered to a population-based sample of adolescents (N=1,249, Mage =16 years) for quantitative validation and examination of associations with normative and impulsive personality. Sensation seeking predicted negative and positive risk-taking, whereas extraversion and openness were predominantly related to positive risk-taking. Results provide promising evidence for a valid measure of adolescents' engagement in positive risks.

The associationsof dietary habits with health, well-being, and behavior in adolescents: A cluster analysis.

Dietary habits may be associated with adolescents' health and behavior. However, previous findings are inconsistent and often unadjusted for sociodemographic confounders. The aim of this study was to investigate (1) whether dietary habits (consumption of fruits, vegetables, sweets, soft drinks, breakfast, and family meals) cluster among adolescents and (2) how these clusters associate with a range of health, well-being, and behavior outcomes in a large population-based sample of adolescents. The study included adolescents (n= 7529; n= 3891 [51.7%] girls; mean [standard deviation] age = 14.9[2.1] years) from the 2018 Luxembourg Health Behaviour in School-aged Children study. We used cluster analysis to define clusters of dietary habits (consumption of fruits, vegetables, sweets, soft drinks, breakfast, and family meals) and logistic regression analyses to assess the cross-sectional associations of the clusters with health, well-being and behavior, adjusted for age, gender, family affluence, and migration background. Cluster analysis yielded five clusters of dietary habits: (1) healthy, (2) family meal and breakfast skippers, (3) sugar consumption, (4) unbalanced diet, and (5) unhealthy. The healthy cluster was associated with better health and positive mental health and behavior, whereas the less healthy clusters were associated with worse health, mental health problems, and risk behavior. Findings suggest that healthy dietary habits associate with positive health and behavior, whereas unhealthy dietary habits associate with health problems and risk behavior during adolescence. More research is needed to investigate the underlying mechanisms. Interventions should include dietary habits as a component of lifestyle modification to improve adolescents' health, well-being, and behavior.

Measurement Invariance and Application of an Alcohol-Related Consequence Scale for American Indian Adolescents.

American Indian (AI) adolescents experience disproportionate alcohol-related consequences. The present study evaluated the psychometric properties and application of the American Drug and Alcohol Survey (ADAS™) alcohol-related consequence scale for AI adolescents through a secondary analysis of a large population-based sample of adolescents living on or near AI reservations. We found support for the ADAS alcohol-related consequence scale as a one-factor model, invariant discretely across race, sex assigned at birth, and age, and with good internal consistency. Evidence for construct validity was found through significant positive correlations between frequency of past 12 months of drinking, frequency of past 12 months of intoxication, and lifetime alcohol-related consequences. AI adolescents were significantly more likely to report more alcohol-related consequences than their non-Hispanic White peers. Race significantly interacted with frequency of drinking in predicting alcohol-related consequences such that these associations were stronger for AI adolescents. However, race did not significantly interact with frequency of intoxication in predicting alcohol-related consequences. Results from this study demonstrate the utility of the ADAS alcohol-related consequence scale for use across demographic groups with little risk of measurement bias.

Carotid Intima-Media Thickness Percentiles in Adolescence and Young Adulthood and Their Association With Obesity and Hypertensive Blood Pressure in a Population Cohort.

This study aimed to derive carotid intima media thickness (CIMT) percentiles from a population-based sample of adolescents and young adults using improved technology, standardization and quality control, and to investigate the association of CIMT with hypertensive blood pressure (BP) and obesity. Four thousand seven hundred nine 14- to 28-year-old participants of the German KiGGS cohort 11-year follow-up, which was based on a nationwide population sample, had B-mode ultrasound CIMT measurement with semi-automated edge-detection and automatic ECG-gated real-time quality control. CIMT percentiles were estimated from far wall CIMT during 2 to 6 heart cycles using the GAMLSS statistical model. Hypertensive BP, overweight, obesity, and a risk score from added Z scores of triglycerides, total/HDL (high-density lipoprotein)-cholesterol ratio, and glycated hemoglobin were based on standardized measurements at baseline and follow-up. CIMT differed by sex at all ages, furthermore by age and height in a nonlinear fashion. Percentiles were estimated simultaneously by age and height. Hypertensive BP and obesity were associated cross-sectionally and longitudinally with a higher risk of CIMT ≥75th percentile in log-binomial regression models adjusted for age, sex, height, current smoking, and cardiovascular risk score. For CIMT ≥90th percentile, the relative risk effect estimates were consistently >1 but often had large confidence intervals including 1, largest adjusted relative risk 3.37 (95% CI, 1.41-8.04) for the combination of hypertensive BP and obesity at follow-up. Based on state-of-the-art measurements and statistical techniques, these population-based CIMT percentiles by sex, age and height add unbiased evidence for the association of subclinical atherosclerosis with hypertensive BP and obesity in the young.

Antisocial behavior is associated with reduced frontoparietal activity to loss in a population-based sample of adolescents.

Adolescent antisocial behavior (AB) is a public health concern due to the high financial and social costs of AB on victims and perpetrators. Neural systems involved in reward and loss processing are thought to contribute to AB. However, investigations into these processes are limited: few have considered anticipatory and consummatory components of reward, response to loss, nor whether associations with AB may vary by level of callous-unemotional (CU) traits. A population-based community sample of 128 predominantly low-income youth (mean age = 15.9 years; 42% male) completed a monetary incentive delay task during fMRI. A multi-informant, multi-method latent variable approach was used to test associations between AB and neural response to reward and loss anticipation and outcome and whether CU traits moderated these associations. AB was not associated with neural response to reward but was associated with reduced frontoparietal activity during loss outcomes. This association was moderated by CU traits such that individuals with higher levels of AB and CU traits had the largest reductions in frontoparietal activity. Co-occurring AB and CU traits were also associated with increased precuneus response during loss anticipation. Findings indicate that AB is associated with reduced activity in brain regions involved in cognitive control, attention, and behavior modification during negative outcomes. Moreover, these reductions are most pronounced in youth with co-occurring CU traits. These findings have implications for understanding why adolescents involved in AB continue these behaviors despite severe negative consequences (e.g. incarceration).

The relationship between commercial sexual exploitation of children (CSEC) and childhood sexual abuse (CSA) among boys and girls in Haiti

To test the hypothesis that childhood sexual abuse (CSA) is a risk factor for commercial sexual exploitation of children (CSEC), we analysed data from the Haiti Violence Against Children Survey (VACS), a population-based sample of adolescents and young adults ages 13–24 (1459 males and 1457 females). Twenty-one percent of males and 25% of females reported CSA; 6% of males and 4% of females reported CSEC. The adjusted odds ratios (AORs) for CSEC based on exposure to CSA were 5.6 (95% confidence interval/CI: 3.1–10.2) for males and 5.9 (CI: 2.6–13.0) for females. For each year earlier that males first experienced CSA, the odds of CSEC increased 60% (AOR 1.6, CI 1.2–2.0). In this first nationally-representative study of lifetime CSEC, both boys and girls victimised by CSA in Haiti were more likely to have also experienced CSEC than other youth, with children who experienced CSA at younger ages at the greatest risk.

Vaping Disparities at the Intersection of Gender Identity and Race/Ethnicity in a Population-Based Sample of Adolescents.

Transgender adolescents use vape products (eg, e-cigarettes) at higher rates than cisgender adolescents. Little is known about how these disparities differ from the intersectional perspective of both gender identity and race/ethnicity. We examined disparities in past 30-day vaping frequency at the intersection of gender identity and race/ethnicity among adolescents participating in two pooled waves of the population-based California Healthy Kids Survey (N = 953 445; 2017-2019). Generalized linear mixed models included gender identity-by-race/ethnicity interactions and adjusted for potential confounders. Stratified models quantified relationships between gender identity and vaping within race/ethnicity strata and between race/ethnicity and vaping within gender identity strata. Transgender adolescents of color were more likely to report a higher frequency of vaping than cisgender white adolescents. In models stratified by race/ethnicity, transgender adolescents evidenced greater odds of more frequent vaping than cisgender adolescents of the same race/ethnicity; disparities were greatest between transgender and cisgender Black adolescents (adjusted odds ratio [AOR]: 6.05, 95% CI: 4.76-7.68) and smallest between transgender and cisgender white adolescents (AOR: 1.20, 95% CI: 1.06-1.35). In models stratified by gender identity, disparities were greatest between transgender Black and transgender white adolescents (AOR: 2.85, 95% CI: 2.20-3.70) and smallest between transgender multiracial and transgender white adolescents (AOR: 1.28, 95% CI: 1.05-1.58). Similar, though less consistent, patterns emerged for adolescents of color unsure of their gender identity relative to cisgender white adolescents. Transgender adolescents of color may be especially vulnerable to vaping disparities. Future research should identify and intervene on causal mechanisms undergirding disparities. Research finds that transgender adolescents use vape products at higher rates than their cisgender peers, however, little is known about how patterns of adolescent vaping may differ by both gender identity and race/ethnicity, information needed to inform culturally tailored prevention and control initiatives to decrease adolescent vaping disparities. Our analysis of data from a population-based adolescent health survey finds evidence of magnified disparities in vaping frequency among transgender adolescents of color.

Adolescent Experiences of Violence Victimizations Among Minors Who Exchange Sex/Experience Minor Sex Trafficking.

This work investigates the associations between experiences of domestic minor sex trafficking and adolescent interpersonal violence victimizations, including intimate partner violence (IPV) and community violence. Abuse and violence in childhood are commonly proposed as risk factors for domestic minor sex trafficking. However, less is known about how interpersonal violence victimizations in adolescence connect to domestic minor sex trafficking experiences. The poly-victimization framework provides a means to understand domestic minor sex trafficking as a type of violence amid a web of additional interconnected violence victimizations. Efforts to better understand the interpersonal violence experienced by survivors of domestic minor sex trafficking are valuable in contextualizing trafficking experiences for adolescents. Data from The National Longitudinal Study of Adolescent to Adult Health, a population-based sample of adolescents in the United States (n = 12,605) were used to examine experiences of domestic minor sex trafficking for minor respondents, as measured through questions about exchanging sex for money or drugs. A multivariable logistic regression model was used to estimate the associations between domestic minor sex trafficking and IPV or community violence, while controlling for demographic variables and adolescent risk behaviors. Minors who experience community violence had significantly greater odds of having exchanged sex (aOR: 1.86; 95% CI: 1.32 -2.64). However, IPV was not significantly associated with minors’ experiences of sex exchange (aOR: 1.14; 95% CI: 0.85 -1.54). Alcohol or drug use (aOR: 1.87; 95% CI: 1.32 -2.65) and having run away (aOR: 2.04; 95% CI: 1.53 -2.72) were also significantly associated with minor sex exchange. As experiences of domestic minor sex trafficking were significantly associated with community violence victimizations, prevention and intervention efforts targeting youth at high risk for or survivors of domestic minor sex trafficking should consider how community violence victimizations impact these adolescent populations, and programming/messaging should be adjusted to account for these additional violence victimizations.

Lack of Associations Between C-Reactive Protein and Mood and Anxiety Symptoms in Adolescents.

Introduction: Increased peripheral inflammation has been consistently documented in both adult and pediatric depression. However, elevated levels of C-reactive protein (CRP), a nonspecific biomarker for inflammation, have been primarily reported in adults; whether CRP plays a similar role in adolescent depression has not been conclusively established. In our prior work, we identified relationships between CRP and reward neurocircuitry in adolescents with psychiatric symptoms (N = 64) but not with depressive symptoms. Extending this work, we sought to examine CRP across the full range of mood and anxiety symptom severity in a larger, clinically diverse cohort of psychotropic medication-free adolescents and healthy controls (HCs). Methods: Subjects were adolescents (N = 127, age: 15.17 ± 2.19 years, 78 female) with psychiatric symptoms (n = 96, including previous cohort of 64) and HC (n = 31). All completed a semi-structured psychiatric evaluation and dimensional assessments for depression, anxiety, anhedonia, and suicidality. Group-comparison and correlation analyses utilized nonparametric statistics controlled for body mass index, sex, and age at pFWE < 0.05. Results: No group differences were identified in CRP levels between the clinical cohort and HCs. In addition, correlations between CRP and clinical symptomatology were not significant in either the whole sample or the psychiatric group. Conclusions: We found that, unlike in adults, CRP was not associated with depressive symptoms. This suggests that inflammation in pediatric depression is more narrowly delimited at the onset of psychiatric symptoms and may only become systemic with chronicity.

Adolescents with functional somatic syndromes: Symptom profiles, illness perception, illness worry and attachment orientation

ObjectiveTo describe patterns of somatic symptoms, illness perception, illness worries and attachment in adolescents with functional somatic syndromes (FSS) in comparison with a population-based sample of adolescents. MethodsSelf-reported and clinical data were collected from two studies: 1) Adolescents aged 15-19 with multiple FSS of at least 1 year's duration (n = 91) from the trial AHEAD (Acceptance and Commitment Therapy for Health in Adolescents). 2) A sex-matched population-based sample of adolescents (n = 1573) derived from the 16-17-year follow-up of the Copenhagen Child Cohort 2000 (CCC2000), including a subgroup with high somatic symptom-load (n = 155). ResultsSymptom patterns were similar across groups, but somatic symptoms were approximately 2-3-fold more common in AHEAD compared to CCC2000, with the exception of neurological symptoms, i.e. ‘moving pain’, ‘unpleasant numbness or tingling sensation’ and ‘feeling of paresis’ which were 6.5-9.0 times higher in AHEAD. Adolescents from AHEAD reported considerably more negative illness perception and illness worry compared to both the CCC2000 sample and the high symptom subgroup. Levels of attachment avoidance and anxiety, respectively, were similar in AHEAD as compared with CCC2000 but lower compared to the high symptom subgroup of CCC2000. ConclusionSimilar symptom profiles in AHEAD and CCC2000 support the concept of a general (i.e. not syndrome-specific) factor for symptom development in FSS. Functional neurological symptoms may be useful indicators of clinical impairment. A high degree of negative illness perception and illness worry in youth may lead to healthcare seeking and should have a specific focus in assessment and treatment of youth with FSS.

Associations of saliva cortisol and hair cortisol with generalized anxiety, social anxiety, and major depressive disorder: An epidemiological cohort study in adolescents and young adults

ObjectivesMost of the observed associations of generalized anxiety disorder (GAD), social anxiety disorder (SAD) and major depressive disorder (MDD) with cortisol concentrations came from clinical and adult study samples, with inconsistent findings, partly due to method variance. We examined cross-sectional and longitudinal associations between GAD, SAD and MDD with saliva and hair cortisol as well as hair cortisol change in a population-based sample of adolescents and young adults, considering relevant co-factors. DesignEpidemiological cohort study in Dresden, Germany. Data of 1050 individuals (mean age: 17.2 years) assessed at baseline (11/2015–12/2016) and of 605 individuals assessed at 1-year follow-up (FU1) are used. MethodsMultivariable regression models were implemented to assess cross-sectional and longitudinal associations of DSM-5 defined 12-month diagnoses of GAD, SAD, and MDD, with short-term (saliva cortisol: cortisol awakening response (CAR) and area under the curve (AUC) as total cortisol) and long-term (hair cortisol) cortisol indices. Multivariable models were adjusted for age or “tanner” stage, waist circumference, tobacco and alcohol consumption, physical inactivity, and hair cortisol dependent confounder. Sex-specific analyses were additionally conducted. ResultsCross-sectional analyses revealed positive associations between SAD and baseline saliva cortisol in multivariable models (CAR: β-coefficient: 0.12; 95% CI: 0.01; 0.23) but could not be confirmed after adjusting for “tanner” stage or comorbid depression. Cross-sectional analyses concerning GAD and MDD in the full baseline sample yielded no significant associations. Sex-specific linear models revealed a significant inverse cross-sectional association between MDD (β-coefficient: − 2.21; 95% CI: − 3.64; − 0.79) as well as SAD (β-coefficient: − 2.21; 95% CI: − 4.03; − 0.38) with baseline hair cortisol in males, but not in females. In longitudinal analyses, no significant associations were found in the fully adjusted model, except for a positive association between hair cortisol change between baseline and FU1 and FU1-SAD (OR: 1.07; 95% CI: 1.02; 1.12). ConclusionsResults confirmed sex-specificity and the role of pubertal development in the association between cortisol with SAD and MDD, while no association emerged regarding cortisol and GAD. Future research in adolescents focusing on the role of cortisol in the pathogenesis of anxiety and depressive disorders would benefit from considering factors like sex-specificity and puberty development as well as comorbidity.

Exposure to perfluoroalkyl substances (PFAS) and dyslipidemia, hypertension and obesity in adolescents. The Fit Futures study

BackgroundPrevalence of obesity, hypertension and dyslipidemia has been increasing in children and adolescents worldwide. Exposure to environmental pollutants may contribute to this development. Our aim was to study associations between perfluoroalkyl substances (PFAS) and dyslipidemia, hypertension and obesity in a population-based sample of adolescents. MethodsSerum PFAS concentrations were measured in 940 adolescents, mean age 16.4 (SD 1.3) years, from the cross-sectional Fit Futures study by the UHPLC-MS/MS method. The following endpoints were used: hypertension (systolic blood pressure over 130 mmHg and/or diastolic blood pressure over 80 mmHg); obesity (body mass index over 2 z-score, WHO charts for adolescents); dyslipidemia (total cholesterol ≥ 5.17 mmol/L, and/or LDL-cholesterol ≥ 3.36 mmol/l, and/or apolipoprotein B ≥ 1.10 g/L). ResultsPerfluorooctane sulfonate (PFOS), perfluorononanoate (PFNA), perfluorodecanoate (PFDA) and perfluoroundecanoate (PFUnDA) serum concentrations were positively associated with apolipoprotein B, total- and LDL cholesterol. The highest vs. lowest quartiles of total PFAS (∑PFAS), PFNA and PFDA concentrations were positively associated with the risk of dyslipidemia: OR 2.24 (95% CI 1.10–4.54), OR 2.30 (95% CI 1.16–4.57) and 2.36 (95% CI 1.08–5.16), respectively. The highest vs. lowest quartiles of ∑PFAS, perfluorohexane sulfonate (PFHxS), PFOS, perfluorooctanoate (PFOA) concentrations were positively associated with the risk of hypertension: OR 1.91 (95% CI 1.12–3.26), OR 2.06 (95% CI 1.16–3.65), 1.86 (95% CI 1.08–3.19) and 2.08 (95% CI 1.17–3.69) respectively. PFHxS and perfluoroheptane sulfonate (PFHpS) concentrations were positively associated with obesity. ConclusionsThis cross-sectional study showed a possible link between several PFAS and dyslipidemia, hypertension and obesity in Norwegian adolescents.

Sex steroid hormones, leptin, and high-sensitivity C-reactive protein levels in adolescents.

The association of sex hormones with C-reactive protein (CRP) levels has been reported. However, this association remains unexplored in children in whom important anthropometric and hormonal changes are taking place. To analyze the association between high-sensitivity CRP (hs-CRP) and testosterone, estradiol and sex hormone-binding globulin (SHBG) levels in a population-based sample of adolescents, and to evaluate the influence of leptin levels on this association. The sample population of this cross-sectional study was comprised of 338 male and 385 female adolescents, aged 12-16years. Information on anthropometric variables, hormone, leptin, and hs-CRP levels was available. In male adolescents in our study, higher age is significantly associated with higher testosterone levels and with lower leptin and SHBG concentrations across the range of age studied. No significant changes in leptin and SHBG levels by age are observed in females. In males, leptin correlates negatively with testosterone levels (-0.263, p<0.001), showing a stronger correlation after adjusting by body mass index (BMI) (-0.424, p<0.001). A significant correlation between hs-CRP and testosterone levels is observed in males after adjusting by BMI, but the correlation disappears after adjusting by leptin. No association between testosterone and hs-CRP was observed in females. The negative association between hs-CRP levels and SHBG remains significant after adjusting by leptin in both sexes but disappears in males after adjusting by BMI. The negative association between hs-CRP and testosterone concentrations observed in 12- to 16-year-old males seems to be related to leptin levels which are closely negatively related to testosterone levels in males independently of BMI.

Association Between Anaemia and Dental Caries in Brazilian Adolescents.

Purpose: The present study analysed the association between anaemia and dental caries in adolescents on the basis of predisposing factors and presence of severely decayed teeth.<br /> Materials and Methods: This observational study included a complex probabilistic sample of adolescents (17-18 years old) enrolled at public schools in São Luís, Brazil (n = 363). Two hypothesis models were tested: (1) anaemia and dental caries are associated given that they share predisposing factors, such as socioeconomic and high sugar consumption, and (2) the presence of severely decayed teeth may increase the susceptibility of patients to anaemia. In the first model, the association between anaemia and the history of dental caries (the outcome number of affected teeth) was analysed by Poisson regression. In the second model, the association between the presence of severely decayed teeth with pulp exposure/necrosis and the outcome anaemia was analysed by logistic regression. Bivariate and multivariate analyses after adjusting for socioeconomic factors and sugar consumption were performed, considering 5% of statistical significance level and using STATA 115.0.<br /> Results: Anaemia was associated with a higher number of affected teeth with a history of dental caries in bivariate (means ratio [MR]: 1.30; 95% confidence intervals [CI95%]: 1.10-1.52; p = 0.001) and multivariate (MR: 1.18; CI95%: 1.01-1.39; p = 0.046) analyses. Severely decayed teeth with pulp exposure/necrosis were associated with anaemia in bivariate (odds ratios [OR]: 5.75; CI95%: 1.97-16.8; p = 0.001)] and multivariate (OR 5.51; CI95%: 1.71-17.74; p = 0.004) analyses.<br /> Conclusion: This study suggests that anaemia and dental caries are associated in a population-based sample of adolescents and that predisposing factors and severely decayed teeth seem to be involved in this association..

Neural mechanisms of reward and loss processing in a low-income sample of at-risk adolescents.

Adolescence is a time of engagement in risky, reward-driven behaviors, with concurrent developmental changes within reward-related neural systems. As previous research has recruited mostly higher socioeconomic, European and European American participants, therefore limiting generalizability to the US population, especially for populations of color or low-income populations. The current study provided one of the first opportunities to examine the neural correlates of reward and loss functioning in a population-based sample of adolescents at increased risk for poverty-related adversities. The study investigated neural reward and loss processing and whether age, pubertal status and the social constructs of gender and race predicted individual differences in reward- and loss-related brain function. One hundred and twenty-eight primarily low-income adolescents (mean age: 15.9 years, 75% African American) from urban environments completed a modified monetary incentive delay task during functional magnetic resonance imaging (fMRI). Consistent with the previous research, reward and loss anticipation recruited similar motivational circuitry including striatal, insular, thalamic and supplementary motor areas. Race and gender were not associated with reward- or loss-related neural reactivity. Age and pubertal development were associated with differences in neural reactivity to reward and loss, suggesting that older and more mature adolescents had increased activity in sensory and motivational circuits, but decreased activity in regions responsible for error detection and behavior modification.