• Spanish celiac youth have folate intakes below 80% Dietary Reference Values (DRV). • Under 3% of commercial gluten-free (GF) products include added folic acid. • Fortifying with 60 μg folic acid/100 g GF foods meet DRV without exceeding safe limits. Celiac disease (CD) is an autoimmune enteropathy triggered by dietary gluten, affecting 1% of the global population. The only currently available treatment is the gluten-free (GF) diet, which is often associated with nutritional imbalances and deficiencies in both macronutrients and micronutrients, particularly folate. This study aimed first to assess the folate intake of children and adolescents with CD (n = 68) compared to healthy controls (n = 65) using three 24-hour dietary recalls and a food frequency questionnaire. Secondly, to evaluate the vitamin composition of cereal-based GF products available in the Spanish market, using a previously developed GF food database (GLUTENFREE-2019). And finally, simulate two scenarios of GF product fortification with folic acid (low (60 μg/100 g) and high (280 μg/100 g) as a strategy to prevent folate deficiency in children and adolescents with CD. Dietary assessments showed that folate intake among CD patients was significantly lower than that of controls ( p = 0.006) and fell below 80 % of the Dietary Reference Values (DRV), suggesting a higher risk of folate deficiency within youngsters with CD. The analysis of 629 GF products revealed that only ten were fortified with folic acid. The fortification model at a concentration of 60 μg/100 g proved to be adequate to cover DRV of children and adolescents with CD without exceeding tolerable upper intake levels. In conclusion, possible folate deficiencies in the young population with CD could be reduced by fortification of commercially available GF products.

Hip osteoarthritis (HOA) is the most common hip joint disorder, accounting for approximately 27.9% of all cases of osteoarthritis (OA), often leading to total hip replacement (THR). In the last decades, femoroacetabular impingement (FAI) has been addressed as a significant etiological factor in the development of early-onset HOA, especially in young adults with non-dysplastic hips. FAI has been found to cause damage to all joint tissues, cartilage, labrum, and subchondral bone, thus underlining the importance of an early diagnosis and intervention to prevent progression to end-stage disease. This review aims to provide a comprehensive overview of the biochemical, morphological, and cellular alterations occurring in hip joint tissues in the presence of FAI. Understanding the early pathological changes is of crucial importance as they often precede radiographic signs of disease and may serve as valuable biomarkers for early detection and management of FAI and peri-arthritic conditions to delay or prevent the need for THR in younger populations.

Cardiovascular Disease and Sudden Cardiac Arrest in Young Individuals: An Evolving Challenge.

The choice of segmentation method for HR-pQCT scans influences accuracy of bone microarchitecture measurements. Smaller or under-mineralized bone can present challenges in accurate extraction of bone structure using global thresholding methods, as local variations in intensity are not considered and finer structural details are not detected. This is especially important in small hand bones, where bone structure is finer, or younger populations, where bone tissue may be under mineralized. This study compared accuracy of global thresholding methods using Gaussian and Laplace-Hamming filters, and an adaptive local thresholding (AT) method in HR-pQCT scans of carpal bones. Eight ex vivo human cadaveric forearms (n = 64 carpal bones) were analyzed. Three specimens (n = 24 carpal bones, 2 female, mean age: 82.7 ± 4.6yr) were used for AT parameter optimization, and 5 specimens (n = 40 carpal bones, 3 female, mean age: 82.0 ± 6.4yr) were used to compare trabecular microarchitecture accuracy and spatial agreement relative to micro-CT (μCT, 20μm isotropic resolution). Micro-CT images were segmented using a Gaussian filter and Otsu's method, and HR-pQCT images were segmented using Gaussian filtering and global thresholding, Laplace-Hamming filtering and global thresholding, and the AT method. Trabecular thickness (Tb.Th), separation (Tb.Sp), and bone volume fraction (Tb.BV/TV) accuracy were evaluated, and spatial agreement was assessed using Dice similarity coefficients (DSC), 95th percentile Hausdorff distances (HD95), and average symmetric surface distances (ASSD). The AT method yielded the smallest absolute and relative errors, and lowest bias across all trabecular parameters. Compared to the Gaussian and fixed threshold method, AT reduced mean absolute error by 36% for Tb.Th, 14% for Tb.Sp, and 15% for Tb.BV/TV, and achieved the highest spatial agreement with μCT (DSC = 0.84, HD95 = 0.061mm, and ASSD = 0.018mm). These findings extend prior HR-pQCT segmentation validation studies to carpal bones and demonstrate that AT outperforms the standard and Laplace-Hamming methods.

• The influence of vehicle labels on EV preferences was tested. • Different framings should be applied to communicate with different populations. • Appropriate communication can increase the probability of EV choice by over 20%. • Younger populations are more sensitive to GHG information presentation. One of the factors significantly contributing to EV preferences is how greenhouse gas (GHG) information is presented. This study aimed to identify the best GHG information presentation to communicate with different populations. Therefore, seven new framings for GHG information presentation were tested based on theories such as psychological distancing. The performance of these framings was compared with the GHG information presentation applied to current vehicle labels in Canada. A survey of over 2000 participants was administered. The optimal label for communicating with different populations was identified, and the influence of different framings on EV preference probability was calculated. The results confirmed the importance of GHG information presentation on EV preference/choice. Further, it was postulated that different framings should be applied to communicate with various populations. Some of the framings developed in this study could increase the EV preference probability by over 20% (e.g., disaster-based framing for residents of Alberta).

The overlap in signs and symptoms of CGH with other forms of headaches greatly complicates the process of an appropriate diagnosis, resulting in inaccurate diagnoses in approximately 50% of CGH cases. To identify and categorise the diagnostic criteria employed for CGH in randomised controlled trials published from 1997 to 2023 and to descriptively examine the outcome measures and physical examination methods employed, with reference to different age group applications. The literature search for this systematised review was conducted from six different electronic databases using a specific search strategy and citation tracking. In total, 498 articles were screened by two reviewers based on preset inclusion and exclusion criteria using the PICO format, and disagreements were resolved by consensus; 59 RCTs were included in the review. Data were extracted on study characteristics, diagnostic criteria, outcome measures, and assessment methods. Due to methodological and clinical heterogeneity, a narrative qualitative synthesis was performed. Fifty-nine RCTs involving 3454 participants were included. The mean age of participants ranged from 11.6±2.3years in paediatric samples to 54.5±7.9years in older adults. Cervicogenic Headache International Study Group (CHISG/Sjaastad) criteria were most commonly used (49%), followed by International Headache Society (IHS) criteria (39%) and International Classification of Headache Disorders, 2nd edition (ICHD-2) criteria (3%). The commonly employed outcome measures included pain intensity (VAS/NPRS), headache frequency and duration, cervical range of motion, and disability indices (e.g.,NDI). Subgroup analysis revealed a lack of standardised diagnostic criteria in paediatric and adolescent studies. The included studies identified inconsistency in diagnostic criteria and outcome measures, particularly in younger populations. Despite the availability of established frameworks, their variable applications in the studies limit their comparability and clinical translation. This review highlights the urgent need for standardised diagnostic criteria for specific age and outcome coresets to strengthen future CGH research and clinical practice.

Male germ cell tumors, of which testicular is the most common, are rare but generally highly curable malignancies. Cure rates in the metastatic setting are among the highest for any solid tumor, although outcomes in the poor-risk subgroup remain suboptimal. Although most men are cured, risk prognostication tools have identified poor-risk patients with inferior outcomes leading to significant mortality in this predominantly young patient population. To optimize survival in this group, proper therapy selection throughout the treatment course of poor-risk patients is vital to maximize survival opportunities. Established first-line therapies are available requiring expertise in their selection and toxicity management. Surgical evaluation remains vital for poor-risk patients to address unique disease characteristics seen in this population including multifocal residual disease, extensive mediastinal disease, and brain metastases. Salvage systemic therapies have been developed with several options of conventional and high-dose chemotherapy, requiring expertise in patient selection and treatment delivery. This review discusses the treatment landscape of poor-risk patients, systemic therapy selection, surgical evaluation of patients, treatment of brain metastases, and contemporary management strategies of pertinent clinical scenarios highlighting the multidisciplinary approach needed to optimize cure rates in this group.

Young adults aged 18 to 24 face increased risk for acquiring sexually transmitted infections (STIs) and reduced access to healthcare as they transition into adulthood and assume responsibility for their health. Furthermore, racial, ethnic, gender, and sexual minority young adults are at an increased risk for STIs and are less likely to have health insurance. This study evaluates the demographics of young adults undergoing STI and human immunodeficiency virus (HIV) testing at a sexual health clinic, and the impact of healthcare access and insurance status on the likelihood of STI diagnosis and treatment. Data were collected between January 1, 2021, and December 31, 2023, for all patients aged 18 to 24 presenting to a community-based clinic for youth ages 13 to 24 offering free STI and HIV testing and other low-cost sexual health services. Data analysis included test results for gonorrhea, chlamydia, syphilis, and HIV. Demographics of patients testing positive for STIs were similar to those seen nationally in the United States for this age group, apart from syphilis; however, overall infection rates were higher. Those who receive healthcare outside of the clinic were less likely to test positive for gonorrhea and chlamydia. Patients who visited the clinic before were less likely to test positive for chlamydia, while those who had not been seen before were more likely to test positive. Access to care, either at our clinic or elsewhere, may be associated with better screening or proactive preventative care, which could reduce the likelihood of testing positive for STIs in young adult populations.

Deconstructing the cortisol awakening response (CAR): Post-peak decline predicts health vulnerability in healthy females.

Understanding key product characteristics of oral nicotine pouches (ONPs), an emerging nicotine product category, is essential to developing evidence-based regulations that address ONP use among young populations. This experimental trial assessed the effects of variations in nicotine concentration and pH in NPs on two behavioral outcomes of regulatory interest: sensory attributes and appeal. We conducted an in-person, double-blind, within-subject randomized experiment involving standardized self-administration of 4 commercially available NPs (drawn from a pool of 20 ZYN and on! products) varying in nicotine strength (high: 6-8 mg vs. low: 3-4mg) and pH (high: 8.5-9.3 vs. low: 7.6-8.0). Experimental conditions were not mutually exclusive (i.e., NP with a high pH could either have high or low nicotine concentration, or vice versa), and NPs were randomly assigned without replacement to ensure participants did not receive the same product more than once in each condition. Los Angeles metropolitan area in California, United States (U.S.). Seventy-three young adults (21-35 years, mean[standard deviation] = 23.7[3.1] years; 87.7% males, 49.3% White) who currently use NPs were recruited between October 2024 and July 2025. Participant rated ONP appeal and sensory attributes (sweetness, smoothness, bitterness, harshness) on 0 ('not at all') to 100 ('extremely') scales. Repeated-measures random-intercept models assessed the effects of nicotine concentration and pH on the appeal and sensory attributes. In the sample, high (vs. low) nicotine strength produced statistically significant lower ratings of appeal (b = -8.75, 95% confidence interval [CI] = -15.41, -2.08) and smoothness (b = -7.72, 95% CI = -14.01, -1.44) and higher harshness ratings (b = 7.21, 95% CI = 1.07, 13.36). No statistically significant linear effects of pH on appeal and sensory attributes were observed. Quadratic analyses revealed non-linear associations whereby ONP appeal and sweetness declined at both tails of the pH distribution (inverted U-shape). Statistically significant interactions between nicotine concentration and quadratic pH were observed for appeal and bitterness with stronger quadratic pH effects in high (vs. low) ONPs. In addition, statistically significant pH-sex interactions showed stronger quadratic effects in females (vs. males) for appeal and bitterness. In this double-blind randomized experiment among young adult oral nicotine pouch (NP) users in the United States, exposure to NPs with [1] higher vs. lower nicotine concentrations produced lower appeal and smoothness and greater harshness; [2] varying pH produced non-linear effects, such that appeal and palatability rose at moderate pH levels and then declined at high pH levels, particularly for high-nicotine NPs and among females.

This review aims to assess the current state of bone and soft tissue sarcomas (STS) management in the adolescent and young adult population (AYA) with a focus on Ewing sarcoma (EWS), osteosarcoma (OS), rhabdomyosarcoma (RMS), and non-rhabdomyosarcoma soft tissue sarcoma (NRSTS). There has been a significant growth in novel agents available for bone sarcomas in the AYA population; trials continue to study the efficacy of these agents. The future of STS will likely include more single histology and targeted biologic studies. Joint pediatric and adult sarcoma clinical trials are feasible. AYAs continue to represent an underserved patient population in medical oncology. Collaboration between pediatric and adult practices may increase patient enrollment and enable single histology and biology specific studies. Trials for EWS, OS, RMS, and NRSTS should include both pediatric and adult patients whenever possible.

Spondylolysis is a common cause of low back pain, especially in the young athletic population. It involves a defect, either unilateral or bilateral, of the pars interarticularis. Numerous techniques have been developed for the surgical treatment of spondylolysis, each with its own strengths and weaknesses. This article aims to describe a modified minimally invasive technique using cortical bone trajectory screws with a U-rod to stabilize the lumbar spondylolysis. Adult patients who presented between July 2020 and August 2024 with low back pain due to spondylolysis were included in this study. Imaging studies of the lumbar spine were performed to confirm the spondylolysis. All patients were confirmed to be treated conservatively for at least 12 months prior to surgical intervention. A 2.5 cm midline incision was made at the level of the spondylolysis. Under fluoroscopic guidance, two screws were inserted into the level of the spondylolysis in the cortical bone trajectory, and the screws were connected with a U-shaped bent rod. Four adult patients (one male, three females) were included. The mean age was 38.5 ± 16.1 years. Average intraoperative blood loss was 6 ± 3 mL. Mean postoperative hospital stay was 3 ± 0.5 days. Both postoperative visual analog scale (VAS) and Oswestry disability index (ODI) scores showed significant improvement. Lumbar spine CT scans performed 1-year post-operation confirmed fusion of the pars defect in seven of the eight defects. We described a modified minimally invasive technique for the treatment of spondylolysis. This approach offers the advantage of being minimally invasive, leading to less blood loss, short hospital stays, and fast recovery. It also requires less technical expertise than traditional pars screw placement and utilizes readily available instrumentations. Patients reported improved pain scores, and imaging confirmed successful fusion of the pars defect.

Cold spells and PM2.5 pollution frequently cooccur, intensifying health and economic impacts. However, the spatiotemporal trends and disparities of these compound events remain unclear. In this study, we defined a compound event as a day on which both a cold spell and a PM2.5 pollution event occurred and assessed its spatiotemporal characteristics and disparities at the grid scale. Our findings indicated an increase in global compound exposure, accompanied by significant regional disparities. From 2000 to 2023, 86% of Europeans experienced at least one compound event per year, 20 times the population more than in North America. More than 70% of countries with rising event days and population exposure were located in Asia and Africa. Total exposure increased from 64.5 to 91.3 million person-days, with the highest levels observed in high-income countries, where young adults, males, and urban populations were most affected. Our research provides a new perspective on understanding the inequities in compound exposure, particularly with respect to economic and regional disparities.

Real-world evidence for the use of nirmatrelvir/ritonavir in routine clinical practice remains limited in the Kingdom of Saudi Arabia (KSA). This study aimed to describe the demographic and clinical characteristics, treatment patterns, and healthcare resource utilization (HCRU) of adult patients with coronavirus disease 2019 (COVID-19) prescribed nirmatrelvir/ritonavir in the KSA. This was a multicenter, retrospective observational cohort study, including adult patients with COVID-19 who were prescribed nirmatrelvir/ritonavir between April 2022 and June 2024. Data were collected through an electronic case report form from patients' electronic medical records and included patient demographics, clinical characteristics, vaccination history, prescribing characteristics, and HCRU. Data were collected from the index date, defined as the date of nirmatrelvir/ritonavir prescription, up to 30days post-index. Descriptive analyses were conducted to summarize patient and clinical characteristics, treatment patterns, and HCRU. Logistic regression models were used to assess associations between patient characteristics and COVID-19-related hospitalization at the index date. A total of 248 patients were included. The mean age was 49.9years, 59.7% of patients were women, and 90.3% had at least one comorbidity. At the index date, 48.4% of patients were hospitalized, with 60.0% of hospitalizations related to COVID-19. Within 30days post-index, 9.3% of patients had a documented hospitalization, of which 8.7% were COVID-19-related. In multivariable analysis, patients aged 50-64years had a lower likelihood of COVID-19-related hospitalization at the index date compared with those aged 18-30years (odds ratio 0.33; 95% confidence interval [CI] 0.11-0.99). This study revealed a relatively young adult patient population with a high rate of hospitalization at the time of nirmatrelvir/ritonavir initiation. Older age (50-64years) was associated with a lower likelihood of COVID-19-related hospitalization at the index date. Further research is needed to better characterize the real-world use of nirmatrelvir/ritonavir and to investigate its potential benefit among hospitalized patients. ClinicalTrials.gov identifier NCT06016556.

Seeking oral contraceptives information from pharmacists among female adolescents and young adults.

Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, highlighting the need for improved risk prediction and prevention strategies. Polygenic Risk Scores (PRS), derived from genome-wide association studies (GWAS), offer a novel approach to estimating an individual's genetic predisposition to conditions such as coronary artery disease (CAD), atrial fibrillation (AF), and heart failure (HF). PRS can improve early risk stratification, particularly among individuals with high genetic susceptibility who may not yet present traditional risk factors. Evidence suggests that PRS enhances risk prediction in younger populations and may inform targeted prevention efforts. However, several limitations constrain their clinical utility. These include limited predictive power relative to conventional risk models, a lack of diverse population representation in GWAS, and challenges in incorporating PRS into routine clinical workflows. While PRS holds promise for advancing personalized cardiovascular care, its clinical implementation requires overcoming key limitations. Increasing diversity in genetic research and integrating PRS with established clinical risk tools are critical steps toward realizing their full potential in CVD prevention and management.

BackgroundNeck pain poses a significant and growing public health challenge, with rising prevalence among younger populations and negative impacts on both quality of life and socioeconomic costs. Clinical manifestations are diverse, including restricted movement, muscle spasms, headaches, and upper limb numbness. Although drug therapy is widely used, its long-term use is limited by adverse effects. Traditional Chinese medicine (TCM) exercises offer a promising alternative, but high-quality evidence directly comparing their efficacy and safety to oral medications is currently lacking.ObjectiveThis study aims to compare the efficacy and safety of TCM exercises and oral medication in treating neck pain.MethodsWe will identify relevant randomized controlled trials (RCTs) through a systematic search of multiple databases (including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure [CNKI], Chinese Biomedical Literature Database [CBM], VIP, and Wanfang) from inception through September 2025. Only RCTs directly comparing TCM exercise to oral medication will be included. Study quality will be assessed using the Cochrane RoB2 tool, and the overall evidence will be graded via the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. For heterogeneity, the I² statistic and Cochran Q test will be applied. A fixed-effect model will be adopted if I²<50% and P≥.10; otherwise, subgroup analysis will be performed. Should heterogeneity persist, sensitivity analysis or a random-effects model will be employed, leading to a reduction in the GRADE rating.ResultsThis is a study protocol; therefore, no results are available at this stage. The systematic review is scheduled to commence in August 2025, with the literature search from August to September 2025, study screening from September to December 2025, data extraction and analysis from January to May 2026, and manuscript submission by June 2026.ConclusionsThis protocol outlines a systematic review and meta-analysis designed to compare the efficacy and safety of TCM exercises versus oral medications for neck pain. The completed review aims to synthesize the available evidence and clarify whether TCM exercises offer a comparable or superior alternative to pharmacotherapy. By systematically evaluating direct head-to-head RCTs, this study seeks to provide evidence-based insights to inform clinical decision-making. Potential limitations of the forthcoming review may include heterogeneity in exercise protocols, challenges in blinding, and a possible limited number or geographic concentration of available trials, which could affect the generalizability of the findings. These limitations will be considered when interpreting the results.

The World Health Organization identifies 21 neglected tropical diseases (NTDs) affecting millions globally. While their population burden is well recognised, less is known about the long-term trends in severe NTD-related morbidity requiring hospitalization. We analysed national trends and geographic patterns of hospitalizations attributed to NTDs in Ecuador between 2000 and 2024. We analysed hospital discharge data from Ecuador's national registry over a 25-year period. Age-standardized hospitalization rates were estimated, and temporal trends were assessed using Joinpoint regression for the 5 most frequent NTDs. Standardized morbidity ratios (SMRs) were estimated for these NTDs for census years (2001, 2010 and 2022) to explore relative changes in hospitalization rates over time and by geography. A total of 179,439 hospital discharges were attributed to NTDs, representing 0.7% of all hospitalizations. The five most frequent NTDs accounted for 97.1% of hospitalizations: dengue and chikungunya (62.4%), snakebite envenoming (20.1%), soil-transmitted helminthiases (8.7%), taeniasis and cysticercosis (3.9%), and scabies and other ectoparasitoses (2.0%). Only 0.4% of hospitalizations resulted in death. Hospitalizations were more frequent in males (54%) and younger populations (median 19 years, Q1 9 - Q3 37). Overall hospitalizations rates increased over time, driven primarily by arboviral infections, while non-arboviral NTDs showed declining trends: snakebite (from 2014, annual percent change -7.81%, 95% CI -11.27, -5.69, P = 0.006), soil-transmitted helminths (from 2000, -5.62%, 95% CI -6.56, -4.68, P < 0.001), and taeniasis and cysticercosis (from 2003, -10.42%, 95% CI -14.50, -9.68, P = 0.002). Relative morbidity caused by NTDs was consistently greater in Coastal and Amazon provinces, with dynamic shifts over time across regions, although taeniasis and cysticercosis morbidity remained greatest in southern Andean Provinces. Over 25 years in Ecuador, hospitalizations attributed to several non-arboviral NTDs declined, while arboviral infections increasingly contributed to severe NTD-related morbidity. These findings reflect trends in the most severe clinical manifestations requiring inpatient care and highlight persistent geographic inequalities, particularly in the Amazon region. Strengthening surveillance, prevention, and equitable access to timely diagnosis and care will be essential to reduce severe NTD morbidity and support progress towards national and global NTD elimination and control targets.

Rationale:Rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) are distinct inflammatory rheumatic diseases with different clinical, serological, and genetic profiles. RA is typically characterized by symmetric peripheral polyarthritis and autoantibody positivity, particularly anti-cyclic citrullinated peptide (anti-CCP), whereas axSpA primarily involves the axial skeleton and sacroiliac joints and is often associated with human leukocyte antigen-B27 (HLA-B27). The coexistence of seropositive RA and axSpA is uncommon and presents diagnostic and therapeutic challenges, particularly when axial symptoms are under-recognized in young patients. This case highlights a rare overlap phenotype and emphasizes the role of advanced imaging and individualized management.Patient concerns:An 18-year-old Saudi woman presented with inflammatory peripheral joint pain, associated with chronic axial symptoms suggestive of sacroiliac involvement.Diagnoses:Laboratory investigations revealed markedly elevated anti-cyclic citrullinated peptide (anti-CCP) antibodies (373 U/mL), supporting the diagnosis of seropositive RA based on the 2010 American College of Rheumatology/European Alliance of Associations for Rheumatology criteria. Magnetic resonance imaging of the sacroiliac joints demonstrated bilateral sacroiliitis with active inflammatory changes, fulfilling the Assessment of SpondyloArthritis International Society (ASAS) criteria for axial spondyloarthritis, despite negative HLA-B27 and absence of other typical spondyloarthritis features.Interventions:The patient was initially managed with methotrexate (15 mg/wk) and low-dose prednisone (5 mg/d). Due to persistent axial symptoms, treatment was escalated to adalimumab following appropriate screening and counseling.Outcomes:At 3-month follow-up, the patient demonstrated significant clinical improvement (>70%) in both peripheral and axial symptoms, with normalization of inflammatory markers C-reactive protein (CRP) and erythrocyte sedimentation rate.Lessons:This case underscores the importance of considering overlapping rheumatologic conditions in patients with atypical presentations. Magnetic resonance imaging plays a critical role in detecting axial involvement, particularly in HLA-B27–negative patients. Early recognition of such overlap syndromes is essential to guide appropriate targeted therapy and improve long-term outcomes, especially in young populations.

BACKGROUND In our search to unravel the pathophysiological mechanisms underlying the development of insulin resistance (IR) in the young population, we evaluated the waist-to-height ratio (WtHR) in 39 participants, setting 0.5 as the cut-off value. A high WtHR has been associated with metabolic alterations and increased risk of developing IR. AIM To explore the relationship between WtHR and IR in young individuals with endoplasmic reticulum (ER) stress molecular mechanisms. METHODS This was a cross-sectional study conducted at the Faculty of Medicine of the Autonomous University of Baja California (Mexico). A total of 39 young participants (18-25 years old, both sexes) were recruited from the general community. All measurements and sample analyses were performed in a single study visit per participant. According to their WtHR, 0.5 is used as the threshold to define high or low WtHR. The degree of IR was estimated using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index. Additionally, we analyzed ER stress markers in platelets, including SERCA protein expression and phosphorylation levels of PERK and JNK. Data were analyzed using one-way ANOVA followed by Dunn’s post-hoc test. RESULTS Young individuals with high WtHR showed greater body weight, body mass index, and visceral fat area percentage; additionally, high-density lipoprotein cholesterol (HDL-C) levels were lower, and the triglyceride/HDL-C ratio was higher (P &lt; 0.05). Fasting insulin was higher in the high-WtHR group (18.76 ± 2.35 µU/mL vs 13.54 ± 1.5 µU/mL; P &lt; 0.05), resulting in elevated HOMA-IR (4.34 ± 0.54 vs 2.90 ± 0.3; P &lt; 0.05). Moreover, platelets from participants with high WtHR exhibited elevated SERCA protein expression (297.3 ± 39.4 vs 98.8 ± 14.9; P &lt; 0.0002) and increased PERK phosphorylation (532.0 ± 98.9 vs 127.8 ± 29.6; P &lt; 0.001), indicating activation of the unfolded protein response. These platelets also showed greater JNK phosphorylation than those from individuals with low WtHR (604.9 ± 216.3 vs 126.7 ± 25; P &lt; 0.04), confirming JNK activation, a negative regulator of the insulin signaling pathway. CONCLUSION High-WtHR in young people is associated with IR and ER stress, driven by JNK activation in platelets, suggesting molecular alterations in early metabolic dysfunction.