Patterns of body fat deposition in youth and their relation to left ventricular markers of adverse cardiovascular prognosis.
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The patterns of body fat deposition in healthy youth and their relation to future development of cardiovascular disease remain incompletely understood. To further evaluate these patterns, we measured indirect indexes of central and general fat deposition in healthy adolescents (mean age 15.4+/-2.3 years) with family histories of hypertension. We examined the relation between these indexes and echocardiographic markers of adverse prognosis as well as the effect of gender and ethnicity. All 225 subjects (64% black and 48% female) had > or =1 biologic parent and 1 grandparent with hypertension. Skinfold thicknesses, waist-to-hip girth ratio, Quetelet index, Ponderal index, conicity, and Z score weight - Z score height were measured. Left ventricular (LV) mass, indexed LV mass, relative wall thickness (RWT), and midwall fractional shortening (MFS) were determined using echocardiography. In both black and white subjects, the adiposity indexes were significantly correlated with posterior wall thickness, total LV mass, and indexed LV mass (p <0.05 for all). Additionally, in black subjects, central adiposity was inversely related to MFS and directly related to RWT and septal thickness. General adiposity independently predicted indexed and nonindexed LV mass, whereas central adiposity predicted MFS and RWT. Compared with subjects with normal LV geometry, those with abnormal geometry were heavier and fatter based on every index of obesity (p <0.03 for all). Thus, indexes of fat deposition are significantly correlated with LV markers of adverse prognosis in healthy youth. (+info)
A radiographic comparison of apical root resorption after orthodontic treatment with a standard edgewise and a straight-wire edgewise technique.
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The purpose of this study was to compare the severity of apical root resorption occurring in patients treated with a standard edgewise and a straight-wire edgewise technique, and to assess the influence of known risk factors on root resorption incident to orthodontic treatment. The sample consisted of 80 patients with Angle Class II division 1 malocclusions, treated with extraction of at least two maxillary first premolars. Variables recorded for each patient included gender, age, ANB angle, overjet, overbite, trauma, habits, invagination, agenesis, tooth shedding, treatment duration, use of Class II elastics, body-build, general factors, impacted canines, and root form deviation. Forty patients were treated with a standard edgewise and 40 with a straight-wire edgewise technique, both with 0.018-inch slot brackets. Crown and root lengths of the maxillary incisors were measured on pre- and post-treatment periapical radiographs corrected for image distortion. Percentage of root shortening and root length loss in millimetres were then calculated. There was significantly more apical root resorption (P < 0.05) of both central incisors in the standard than in the straight-wire edgewise group. No significant difference was found for the lateral incisors. Root shortening of the lateral incisors was significantly associated with age, agenesis, duration of contraction period (distalization of incisors), and invagination, while root shortening of the central incisors was related to treatment group and trauma. (+info)
Shiver suppression using focal hand warming in unanesthetized normal subjects.
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BACKGROUND: A decrease of 1 or 2 degrees C in core temperature may provide protection against cerebral ischemia. However, during corporeal cooling of unanesthetized patients, the initiation of involuntary motor activity (shiver) prevents the reduction of core temperature. The authors' laboratory previously showed that focal facial warming suppressed whole-body shiver. The aim of the current study was to determine whether the use of hand warming alone could suppress shiver in unanesthetized subjects and hence potentiate core cooling. METHODS: Subjects (n = 8; healthy men) were positioned supine on a circulating water mattress (8-15 degrees C) with a convective-air coverlet (14 degrees C) extending from their necks to their feet. A dynamic protocol was used in which focal hand warming was used to suppress involuntary motor activity, enabling noninvasive cooling to decrease core temperatures. The following parameters were monitored: (1) heart rate; (2) blood pressure; (3) core temperature (rectal, tympanic); (4) cutaneous temperature and heat flux; (5) subjective shiver level (SSL scale 0-10) and thermal comfort index (scale 0-10); (6) metabolic data (n = 6); and (7) electromyograms. RESULTS: During cooling without hand warming, involuntary motor activity increased until it was widespread. After subjects reported whole-body shiver (SSL > or = 7), applied hand warming, in all cases, reduced shiver levels (SSL < o r= 3), decreased electromyographic root mean square amplitudes, and allowed core temperature to decrease from 37.0 +/- 0.2 to 35.9 +/- 0.5 degrees C (measured rectally). CONCLUSIONS: Focal hand warming seems to be valuable in minimizing or eliminating the need to suppress involuntary motor activity pharmacologically when it is desired to induce or maintain mild hypothermia; it may be used in conjunction with facial warming or in cases in which facial warming is contraindicated. (+info)
Early evidence of ethnic differences in cardiovascular risk: cross sectional comparison of British South Asian and white children.
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OBJECTIVES: To examine whether British South Asian children differ in insulin resistance, adiposity, and cardiovascular risk profile from white children. DESIGN: Cross sectional study. SETTING: Primary schools in 10 British towns. PARTICIPANTS: British children aged 8 to 11 years (227 South Asian and 3415 white); 73 South Asian and 1287 white children aged 10 and 11 years provided blood samples (half fasting, half after glucose load). MAIN OUTCOME MEASURES: Insulin concentrations, anthropometric measures, established cardiovascular risk factors. RESULTS: Mean ponderal index was lower in South Asian children than in white children (mean difference -0.43 kg/m(3), 95% confidence interval -0.13 kg/m(3) to -0.73 kg/m(3)). Mean waist circumferences and waist:hip ratios were similar. Mean insulin concentrations were higher in South Asian children (percentage difference was 53%, 14% to 106%, after fasting and 54%, 19% to 99%, after glucose load), though glucose concentrations were similar. Mean heart rate and triglyceride and fibrinogen concentrations were higher among South Asian children; serum total, low density lipoprotein, and high density lipoprotein cholesterol concentrations were similar in the two groups. Differences in insulin concentrations remained after adjustment for adiposity and other potential confounders. However, the relations between adiposity and insulin concentrations (particularly fasting insulin) were much stronger among South Asian children than among white children. CONCLUSIONS: The tendency to insulin resistance observed in British South Asian adults is apparent in children, in whom it may reflect an increased sensitivity to adiposity. Action to prevent non-insulin dependent diabetes in South Asian adults may need to begin during childhood. (+info)
Body mass index: a scientific evidence-based inquiry.
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OBJECTIVE: To objectively and critically assess body mass index and to propose alternatives for relating body weight and height that are evidence-based and that eliminate or reduce the limitations of the body mass index. METHODS: To analyze the relations involving weight and height, we used 2 databases as follows: 1) children and adolescents from Brazil, the United States, and Switzerland; and 2) 538 university students. We performed mathematical simulations with height data ranging from 115 to 190 cm and weight data ranging from 25 to 105 kg. We selected 3 methods to analyze the relation of weight and height as follows: body mass index - weight (kg)/height (m2); reciprocal of the ponderal index - height (cm)/weight 1/3 (kg); and ectomorphy. Using the normal range from 20 to 25 kg/m2 for the body mass index in the reference height of 170 cm, we identified the corresponding ranges of 41 to 44 cm/kg 1/3 for the reciprocal of the ponderal index, and of 1.45 to 3.60 for ectomorphy. RESULTS: The mathematical simulations showed a strong association among the 3 methods with an absolute concordance to a height of 170 cm, but with a tendency towards discrepancy in the normal ranges, which had already been observed for the heights of 165 and 175 cm. This made the direct convertibility between the indices unfeasible. The reciprocal of the ponderal index and ectomorphy with their cut points comprised a larger age range in children and adolescents and a wider and more central range in the university students, both for the reported (current) and desired weights. CONCLUSION: The reciprocal of the ponderal index and ectomorphy are stronger and are more mathematically logical than body mass index; in addition, they may be applied with the same cut points for normal from the age of 5 years on. (+info)
Human female attractiveness: waveform analysis of body shape.
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Two putative cues to female physical attractiveness are body mass index (BMI) and shape (particularly the waist-hip ratio or WHR). To determine the relative importance of these cues we asked 23 male and 23 female undergraduates to rate a set of 60 pictures of real women's bodies in front-view for attractiveness. In our set of images, the relative ranges of BMI and WHR favoured WHR. We based these ranges on a sample of 457 women. We did not limit the WHR range, although we kept the BMI range to 0.5 s.d. either side of the sample means. As a result, WHR averaged 1.65 s.d. either side of its sample mean. However, even with these advantages, WHR was less important than BMI as a predictor of attractiveness ratings for bodies. BMI is far more strongly correlated with ratings of attractiveness than WHR (BMI approximately 0.5, WHR approximately 0.2). To further explore the relative importance of BMI and WHR, we deliberately chose a subset of these images that demonstrated an inverse correlation of BMI and WHR (i.e. a group in which as images get heavier they also become more curvaceous). If WHR is the most important determinant of attractiveness, then the more curvaceous (but higher BMI) images should be judged most attractive. However, if BMI is a better predictor, then the opposite should be true. We found that the more curvaceous (but higher BMI) images were judged least attractive, thereby inverting the expected rating pattern. This strongly suggests that viewers' judgements were influenced more by BMI than WHR. Finally, it is possible that body shape is an important cue to attractiveness, but that simple ratios (such as WHR) are not adequately capturing it. Therefore, we treated the outline of the torso as a waveform and carried out a set of waveform analyses on it to allow us to quantify body shape and correlate it with attractiveness. The waveform analyses address the complexity of the whole torso shape, and reveal innate properties of the torso shape and not shape elements based on prior decisions about arbitrary physical features. Our analyses decompose the waveform into objective quantified elements whose importance in predicting attractiveness can then be tested. All of the components that were good descriptors of body shape were weakly correlated with attractiveness. Our results suggest that BMI is a stronger predictor of attractiveness than WHR. (+info)
Relation between sodium intake and blood pressure during sleep in young men.
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In the past, cross-sectional studies of small groups have not always shown a significant relation between habitual sodium intake and blood pressure (BP). This study examined the relation between 24-h urinary sodium excretion (Salt24, g/day) and BP during sleep in young subjects. The subjects were 132 medical students (93 males, 39 females) aged 21 to 26 years, with no renal disorder. Urine was collected for 24 h, and sodium (Na), chloride (Cl), and creatinine (Cr) excretion were measured. The 24-h urinary Cr excretion (Cr24) was compared with the Cr24 estimated from lean body mass as a guide to ensure accurate collection of 24-h urine. The natural logarithm [ln (Salt24/Cr24)] was taken as an index of sodium intake. On the same day, a portable multi-biomedical recorder (TM2425) was used to measure 24-h systolic BP (SBP)/diastolic BP (DBP). Daytime BP was calculated as the average of waking-time BP, and sleep BP was taken as statistical base BP (minimum BP) during nighttime sleep. No correlation was observed between ln (Salt24/Cr24) and daytime BP. The correlation coefficient with sleep SBP, on the other hand, was 0.34 (p<0.05) in the male group and 0.54 (p<0.01) in the male high-BP group (24-h BP>127/75 mmHg, n=28). No relation of this kind was observed in the female group. In conclusion, despite the small number of subjects, the present cross-sectional study revealed a significant positive correlation between sodium intake and sleep SBP in young men with high BP. (+info)
Developmental typology of trajectories to nighttime bladder control: epidemiologic application of longitudinal latent class analysis.
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The authors aimed to characterize developmental trajectories to nighttime continence by applying two latent class models-longitudinal latent class analysis (LLCA) and latent class growth analysis (LCGA)-to data on nighttime bed-wetting from a population-based birth cohort, the Medical Research Council 1946 National Survey of Health and Development cohort. Data on a binary outcome (wetting in the past month vs. not wetting) were available for children at six ages (4, 6, 8, 9, 11, and 15 years) assessed in 1950, 1952, 1954, 1955, 1957, and 1961. For 3,272 children with complete data (62.5% of the cohort), results of sequential model comparisons (T classes vs. T + 1 classes) and chi-square goodness-of-fit tests were evaluated using parametric bootstrapping. At least four trajectory classes (LLCA and LCGA) were identified. Associations between class membership and the prevalence of related measures were examined using a confirmatory latent class analysis approach. Inclusion of 1,483 children with partially incomplete data (n = 4,755; 90.9% of the cohort) enabled the authors to refine trajectories further: normal development (prevalence = 84.0%); delayed acquisition of bladder control ("transient" (8.7%) and "persistent" (1.8%)), capturing primary enuresis; chronic bed-wetting (2.6%), or experiencing night wetting until age 15 years; and a final trajectory (relapse = 2.9%) capturing secondary or onset enuresis. This empirically based, typologic approach to analysis of extensive longitudinal data in a general population sample provides an alternative perspective to that offered by traditional diagnostic criteria. (+info)