growth trajectories

增长轨迹
  • 文章类型: Journal Article
    在他的职业生涯中,JohnSchulenberg挑战我们将青少年发展理解为远端和近端经历以及关键过渡的融合。听从这个电话,我们研究了慢性儿童同伴受害是否通过早期出现的抑郁生长轨迹预测青少年的抑郁症状,继续受害到青春期,以及中学过渡时的压力放大。从636名青年(338名女孩;法师=7.96岁,66.7%白色,21.7%黑色,其他11.6%)在2-9年级。潜在增长曲线分析显示,七年级,慢性儿童同伴受害仅通过与青春期同伴受害的间接关联与抑郁症状相关,强调相互关联的历史和持续的人际压力源如何影响青少年精神病理学。
    Throughout his career, John Schulenberg challenged us to understand adolescent development as the confluence of distal and proximal experiences along with critical transitions. Heeding this call, we examined whether chronic childhood peer victimization predicted adolescents\' depressive symptoms via early-emerging depression growth trajectories, continued victimization into adolescence, and stress-amplification at the middle school transition. Self-reported depressive symptoms and teacher-reported and self-reported peer victimization were obtained from 636 youth (338 girls; Mage = 7.96 years, 66.7% White, 21.7% Black, 11.6% other) in the 2nd-9th grades. Latent growth curve analyses revealed that, by 7th grade, chronic childhood peer victimization was associated with depressive symptoms only through an indirect association with peer victimization in adolescence, underscoring how interrelated historical and ongoing interpersonal stressors contribute to adolescent psychopathology.
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  • 文章类型: Journal Article
    背景:婴儿期体重指数(BMI)较高的平均值和快速增加与随后的肥胖有关,并且可能受到暴露于内分泌干扰化学物质如酚的影响。
    目的:在2010-2014年进行的前瞻性美国队列中,我们调查了199名婴儿环境苯酚暴露与BMI之间的关系。
    方法:我们在6-8岁和12周时测量了7种尿酚,并在出生至36周时的12次研究访视时评估了BMIz评分。我们使用平均差异(β[95%置信区间(CI)])和使用相对风险比(RR[95%CI])与BMIz评分轨迹检查了平均早期婴儿期酚类物质与BMIz评分水平的个体和联合关联。
    结果:二苯甲酮-3,对羟基苯甲酸甲酯和对羟基苯甲酸丙酯,和所有酚类共同与较高的平均BMIz评分呈正相关(0.07[-0.05,0.18],0.10[-0.08,0.27],0.08[-0.09,0.25],0.17[-0.08,0.43],分别)。相对于稳定轨迹,二苯甲酮-3,2,4-二氯苯酚,2,5-二氯苯酚,和所有酚类共同与快速增加轨迹的风险呈正相关(1.46[0.89,2.39],1.33[0.88,2.01],1.66[1.03,2.68],1.41[0.71,2.84],分别)。
    结论:早期苯酚暴露与婴儿期BMIz评分的平均值较高且快速增加有关,信号潜在的长期心脏代谢暴露的后果。
    BACKGROUND: Higher mean and rapid increases in body mass index (BMI) during infancy are associated with subsequent obesity and may be influenced by exposure to endocrine-disrupting chemicals such as phenols.
    OBJECTIVE: In a prospective US-based cohort conducted 2010-2014, we investigated associations between environmental phenol exposures and BMI in 199 infants.
    METHODS: We measured seven urinary phenols at ages 6-8 and 12 weeks and assessed BMI z-score at up to 12 study visits between birth and 36 weeks. We examined individual and joint associations of averaged early infancy phenols with level of BMI z-score using mean differences (β [95% confidence intervals (CI)]) and with BMI z-score trajectories using relative risk ratios (RR [95% CI]).
    RESULTS: Benzophenone-3, methyl and propyl paraben, and all phenols jointly were positively associated with higher mean BMI z-score (0.07 [-0.05, 0.18], 0.10 [-0.08, 0.27], 0.08 [-0.09, 0.25], 0.17 [-0.08, 0.43], respectively). Relative to a Stable trajectory, benzophenone-3, 2,4-dichlorophenol, 2,5-dichlorophenol, and all phenols jointly were positively associated with risk of a Rapid Increase trajectory (1.46 [0.89, 2.39], 1.33 [0.88, 2.01], 1.66 [1.03, 2.68], 1.41 [0.71, 2.84], respectively).
    CONCLUSIONS: Early phenol exposure was associated with a higher mean and rapid increase in BMI z-score across infancy, signaling potential long-term cardiometabolic consequences of exposure.
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  • 文章类型: Journal Article
    关于低收入/中等收入国家儿童成长轨迹的最新趋势的证据有限。我们调查了2000年后在两个不同时间段出生的巴西儿童的身高和体重指数(BMI)的年龄轨迹如何变化。
    我们使用了一个基于人口的队列(“1亿巴西人队列”的一部分),该队列是由三个巴西行政数据库的链接创建的:联邦政府的Cadastro乌尼科,国家活产系统和国家营养和食品监测系统。我们纳入了2001年至2014年出生的5,750,214名3至<10岁儿童的纵向数据(20,209,133观察)。我们应用具有随机效应的分数多项式模型来估计儿童的平均身高和BMI轨迹。
    与2001-2007年出生的孩子相比,2008-2014年出生的孩子平均较高,男孩的z评分为0.15,女孩的z评分为0.12。他们的高度轨迹向上移动,男女大约1厘米。BMI水平几乎没有增加,z分数为0.06(男孩)和0.04(女孩)。平均BMI轨迹也变化不大。然而,超重/肥胖的患病率在队列之间增加,例如,从26.8%到30%的男孩和23.9%-26.6%的女孩年龄在5和<10岁之间。
    巴西儿童在短时间内平均身高增加1厘米,表明母婴健康有所改善,特别是那些来自低收入家庭由于新的健康和福利政策在巴西。虽然平均BMI变化不大,儿童超重/肥胖的患病率略有上升,且仍然很高.
    这项工作得到了国家科学技术发展委员会的支持-CNPq;国家卫生研究所(NIHR)大奥蒙德街医院生物医学研究中心;Tecnologia,MiniériodaSaúde-Decit/SECTICS/MS.该研究还利用了卫生数据和知识整合中心(CIDACS)的资源,它得到了比尔和梅林达·盖茨基金会的资助,威康信托基金,卫生部卫生监测秘书处和巴伊亚州科学技术秘书处(SECTI-BA)。
    UNASSIGNED: There is limited evidence on recent trends in childhood growth trajectories in Low-/middle-income countries. We investigated how age-trajectories for height and Body Mass Index (BMI) have changed among Brazilian children born in two different time periods after 2000.
    UNASSIGNED: We used a population-based cohort (part of the \"Cohort of 100-Million Brazilians\") created by the linkage of three Brazilian administrative databases: the Cadastro Único of the Federal Government, the National System of Live Births and the National Nutritional and Food Surveillance System. We included longitudinal data on 5,750,214 children who were 3 to <10 years of age and born between 2001 and 2014 (20,209,133 observations). We applied fractional polynomial models with random-effects to estimate mean height and BMI trajectories for children.
    UNASSIGNED: Compared to children born in 2001-2007, the cohort born in 2008-2014 were on average taller, by a z-score of 0.15 in boys and 0.12 in girls. Their height trajectories shifted upwards, by approximately 1 cm in both sexes. Levels of BMI increased little, by a z-score of 0.06 (boys) and 0.04 (girls). Mean BMI trajectories also changed little. However, the prevalence of overweight/obesity increased between cohorts, e.g., from 26.8% to 30% in boys and 23.9%-26.6% in girls aged between 5 and <10 years.
    UNASSIGNED: An increase of 1 cm in mean height of Brazilian children during a short period indicates the improvement in maternal and child health, especially those from low-income families due to the new health and welfare policies in Brazil. Although mean BMI changed little, the prevalence of child overweight/obesity slightly increased and remained high.
    UNASSIGNED: This work was supported by National Council for Scientific and Technological Development - CNPq; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES; National Institute for Health Research (NIHR) Great Ormond Street Hospital Biomedical Research Centre; Society for the Study of Human Biology; Fundação de Amparo à Pesquisa do Estado de Minas Gerais - FAPEMIG; Departamento de Ciência e Tecnologia da Secretaria de Ciência, Tecnologia, Inovação e Complexo da Saúde do Ministério da Saúde - Decit/SECTICS/MS. The study also used resources from the Centre for Data and Knowledge Integration for Health (CIDACS), which receives funding from the Bill & Melinda Gates Foundation, the Wellcome Trust, the Health Surveillance Secretariat of the Ministry of Health and the Secretariat of Science and Technology of the State of Bahia (SECTI-BA).
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  • 文章类型: Randomized Controlled Trial
    背景:人乳包含被天然磷脂膜包裹的大脂肪球,而婴儿配方奶粉含有少量,蛋白质涂层的脂滴。先前的实验研究表明,在婴儿配方奶粉(IMF)中模仿人乳脂滴的结构会改变脂质代谢,并对以后的代谢健康产生持久的有益影响。
    目的:为了评估一项随机随访(FU)研究,对照试验是否具有大的概念IMF,富含乳制品脂质的乳磷脂涂层脂滴有益地影响长期体重指数(BMI,以kg/m2为单位)的轨迹和学龄期的血压。
    方法:完全配方喂养的婴儿被随机分配到概念IMF(n=115)或对照IMF,前4个月含有植物油的小脂滴(n=108)。一组88名母乳喂养的婴儿作为参考。FU期间,人体测量在1、3、4和5岁时收集,和血压只有在最后一次访问。
    结果:与对照组相比,概念组儿童在FU期间的平均BMI值一直较低,在1岁时差异最大(平均值差异-0.71kg/m2,95%置信区间(CI):-1.13,-0.29;P=0.001);平均值接近母乳喂养组(P>0.05)。相反,在FU1~5岁期间,对照组的平均BMI值高于母乳喂养组(平均值差异分别为0.59~0.96kg/m2;P<0.02).五岁时,与对照组相比,概念组的平均舒张压和动脉压降低;-4.3mmHg(95%CI:-7.3,-1.3;P=0.005)和-3.7mmHg(95%CI:-6.5,-0.9;P=0.01),分别。
    结论:创新的IMF的早期喂养,富含乳制品脂质的乳磷脂涂层脂滴导致BMI轨迹更接近母乳喂养的婴儿,并在学龄期降低血压。该试验在荷兰试验登记处注册为NTR3683和NTR5538。
    BACKGROUND: Human milk comprises large fat globules enveloped by a native phospholipid membrane, whereas infant formulas contain small, protein-coated lipid droplets. Previous experimental studies indicated that mimicking the architecture of human milk lipid droplets in infant milk formula (IMF) alters lipid metabolism with lasting beneficial impact on later metabolic health.
    OBJECTIVE: To evaluate in a follow-up (FU) study of a randomized, controlled trial whether a Concept IMF with large, milk phospholipid-coated lipid droplets enriched with dairy lipids beneficially impacts long-term body mass index (BMI in kg/m2) trajectories and blood pressure at school age.
    METHODS: Fully formula-fed infants were randomly assigned to Concept IMF (n = 115) or Control IMF with conventional, small lipid droplets containing vegetable oils (n = 108) for the first 4 mo of age. A group of 88 breastfed infants served as a reference. During FU, anthropometrics were collected at 1, 3, 4, and 5 y of age, and blood pressure only at the last visit.
    RESULTS: Compared to Control, Concept group children had consistently lower mean BMI values during FU, with the most marked difference at 1 y of age (difference in means -0.71 kg/m2, 95% confidence interval (CI): -1.13, -0.29; P = 0.001); mean values were close to the breastfed group (P > 0.05). Contrary, the mean BMI values of the Control group were higher compared with the breastfed group during FU from 1 to 5 y of age (differences in means from 0.59 to 0.96 kg/m2, respectively; P < 0.02). At 5 y of age, the Concept group had a lower mean diastolic and arterial blood pressure compared with the Control group; -4.3mm Hg (95% CI: -7.3, -1.3; P = 0.005) and -3.7 mm Hg (95% CI: -6.5, -0.9; P = 0.01), respectively.
    CONCLUSIONS: Early life feeding of an innovative IMF with large, milk phospholipid-coated lipid droplets enriched with dairy lipids results in a BMI trajectory closer to breastfed infants and a lower blood pressure at school age. This trial was registered at the Dutch Trial Register as NTR3683 and NTR5538.
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  • 文章类型: Systematic Review
    目的:使用兴奋剂产品治疗注意力缺陷/多动障碍(ADHD)已被证明是安全有效的;但是,人们仍然担心它们对增长轨迹可能产生的不利影响。我们对来自生态有效数据库和注册表的现有文献进行了系统回顾,以评估有关兴奋剂对自然样本生长轨迹影响的知识体系。方法:使用PubMed和PsycINFO,我们从来自自然人群研究的综合数据集中,搜索了2023年2月8日之前发表的文章,这些文章关注儿科ADHD中与兴奋剂治疗相关的生长结果.结果:在最初确定的1070篇文章中,12符合所有纳入标准。样本量从157到163,820名青年不等。检查身高的10篇文章中有7篇发现,与慢性兴奋剂治疗相关的身高显着下降,在2项研究中,随着时间的推移而恢复正常。三篇文章发现兴奋剂治疗与身高之间没有显着关联。在兴奋剂治疗的累积持续时间和剂量与成人身高之间没有明确的关联。所有检查体重的文章和检查体重指数(BMI)的八篇文章中的六篇发现,最初的显着下降趋于正常化,然后随着时间的推移而增加。延长使用兴奋剂药物的持续时间主要与体重和BMI的显着降低有关。兴奋剂剂量对体重和BMI的影响大多较弱,临床上不明显。大多数研究发现兴奋剂治疗开始时的年龄与身高变化之间没有显着关联,体重,或BMI。大多数研究没有发现与生长参数相关的显著性别效应。结论:对生态信息样本的审查表明,兴奋剂治疗对生长轨迹的影响主要是小而短暂的。对于大多数从儿童到青春期和成年期接受兴奋剂治疗的ADHD年轻人来说,这些影响似乎在临床上微不足道。
    Objective: Attention-deficit/hyperactivity disorder (ADHD) treatment with stimulant products has been shown to be safe and effective; however, there are remaining concerns about their possible adverse effects on growth trajectories. We conducted a systematic review of the extant literature derived from ecologically valid databases and registries to assess the body of knowledge about the effects of stimulants on growth trajectories in naturalistic samples. Methods: Using PubMed and PsycINFO, we searched for articles published before February 8, 2023 that focused on growth findings associated with stimulant treatment in pediatric ADHD from comprehensive datasets derived from naturalistic population studies. Results: Of the 1070 articles initially identified, 12 met all inclusion criteria. Sample sizes ranged from 157 to 163,820 youths. Seven of 10 articles examining height found significant decreases in height associated with chronic stimulant treatment that normalized over time in 2 studies. Three articles found no significant association between stimulant treatment and height. No clear associations were identified between cumulative duration and dose of stimulant treatment and adult height. All articles examining weight and six of eight articles examining body mass index (BMI) found significant initial decreases that tended to normalize then increase over time. Longer duration of stimulant medication use was predominantly associated with significant weight and BMI reductions. The effects of stimulant dose on weight and BMI were mostly weak and clinically insignificant. Most studies found no significant association between age at start of stimulant treatment and change in height, weight, or BMI. Most studies did not find significant sex effects in relation to growth parameters. Conclusions: This review of ecologically informative samples revealed that the effects of stimulant treatment on growth trajectories are mainly small and transient. These effects seem to be clinically insignificant for most youth with ADHD who receive stimulant treatment from childhood onto adolescence and adulthood.
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  • 文章类型: Journal Article
    这项研究的目的是在一个很大的宏观队列中检查怀孕期间母体脂质分布与后代生长轨迹之间的关联。这是ROLO出生队列的二次分析(n=293),发生在国立妇产医院,都柏林,爱尔兰。婴儿大多是宏观的,55%的人出生体重>4公斤。产妇平均年龄为32.4岁(SD3.9岁),平均BMI为26.1kg/m2(SD4.4kg/m2),出生儿童中48%为男性.总胆固醇,高密度脂蛋白胆固醇(HDL-胆固醇),从妊娠14周和28周的母亲的空腹血液样本中测量低密度脂蛋白胆固醇(LDL-胆固醇)和甘油三酸酯。还检查了从妊娠早期到妊娠晚期母体脂质水平的变化。在妊娠20周和34周测量后代腹围和体重,出生,6个月,产后2年和5年。线性样条多级模型检查了母体血脂谱与后代生长之间的关联。我们发现了一些微弱的,母体血脂与后代生长轨迹之间存在显着关联。重大发现接近零,提供有限的证据。例如,孕妇甘油三酯的1mmol/L增加与从20到34周妊娠的婴儿体重增长更快有关(0.01kg/周,95%CI-0.02,-0.001)和2至5年的腹围较慢(0.01厘米/周,95%CI-0.02,-0.001)。这些发现没有提供临床上有意义的效果的证据。结论:这些发现提出了有关针对孕妇血脂状况的干预措施在有巨大儿风险的妊娠中的有效性的疑问。需要对这一主题进行新的研究。已知的:•早期妊娠期间的母体脂肪积累可以通过提供脂质储备来潜在地支持妊娠晚期的胎儿生长,所述脂质储备被分解并穿过胎盘屏障转移至婴儿。•有有限的研究探索母亲的血脂对婴儿和儿童健康的影响使用生长轨迹跨越产前到产后生活。新增内容:•孕妇血脂谱与怀孕至5岁的后代体重和腹围的生长轨迹无关。由于重要的发现接近零,为有临床意义的关系提供了有限的证据。•这项工作的优势包括使用从产前到产后的婴儿生长轨迹,并纳入从妊娠早期到妊娠晚期的母体脂质水平变化的分析,以及它们与从妊娠20周到5岁的后代生长轨迹的关联。
    The purpose of this study is to examine associations between maternal lipid profiles in pregnancy and offspring growth trajectories in a largely macrosomic cohort. This is a secondary analysis of the ROLO birth cohort (n = 293), which took place in the National Maternity Hospital, Dublin, Ireland. Infants were mostly macrosomic, with 55% having a birthweight > 4 kg. Maternal mean age was 32.4 years (SD 3.9 years), mean BMI was 26.1 kg/m2 (SD 4.4 kg/m2) and 48% of children born were males. Total cholesterol, high density lipoprotein cholesterol (HDL-cholesterol), low density lipoprotein cholesterol (LDL-cholesterol) and triglycerides were measured from fasting blood samples of mothers at 14 and 28 week gestation. The change in maternal lipid levels from early to late pregnancy was also examined. Offspring abdominal circumference and weight were measured at 20- and 34-week gestation, birth, 6 months, 2 years and 5 years postnatal. Linear spline multilevel models examined associations between maternal blood lipid profiles and offspring growth. We found some weak, significant associations between maternal blood lipids and trajectories of offspring growth. Significant findings were close to the null, providing limited evidence. For instance, 1 mmol/L increase in maternal triglycerides was associated with faster infant weight growth from 20- to 34-week gestation (0.01 kg/week, 95% CI - 0.02, - 0.001) and slower abdominal circumference from 2 to 5 years (0.01 cm/week, 95% CI - 0.02, - 0.001). These findings do not provide evidence of a clinically meaningful effect.    Conclusion: These findings raise questions about the efficacy of interventions targeting maternal blood lipid profiles in pregnancies at risk of macrosomia. New studies on this topic are needed. What is Known: • Maternal fat accumulation during early pregnancy may potentially support fetal growth in the third trimester by providing a reserve of lipids that are broken down and transferred to the infant across the placental barrier. • There are limited studies exploring the impact of maternal lipid profiles on infant and child health using growth trajectories spanning prenatal to postnatal life. What is New: • Maternal blood lipid profiles were not associated with offspring growth trajectories of weight and abdominal circumference during pregnancy up to 5 years of age in a largely macrosomic cohort, as significant findings were close to the null, providing limited evidence for a clinically meaningful relationship. • Strengths of this work include the use of infant growth trajectories that span prenatal to postnatal life and inclusion of analyses of the change of maternal lipid levels from early to late pregnancy and their associations with offspring growth trajectories from 20-week gestation to 5 years of age.
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  • 文章类型: Journal Article
    目的:研究妊娠期糖尿病(GDM)二甲双胍或胰岛素治疗与0-60个月子代生长轨迹之间的关系。
    方法:参与者来自出生在布拉德福德出生队列研究。使用协变量调整的多级线性样条模型(4条样条:0-1.6、1.6-6、6-17和17-60个月),我们比较了体重,高度,和BMIz得分轨迹:(1)暴露于二甲双胍(OGDM-二甲双胍)的76个后代和暴露于胰岛素(OGDM-胰岛素)的420个后代;(2)OGDM-二甲双胍和未暴露于GDM(No-GDM)的9,171个后代;(3)OGDM-胰岛素和No-GDM。
    结果:(1)OGDM-二甲双胍在0-60个月时具有与OGDM-胰岛素相当的生长轨迹。(2)OGDM-二甲双胍的平均出生体重z评分低于非GDM。OGDM-二甲双胍在17-60个月和60个月时的身高z评分变化更快(0.13(95CI0.026,0.24)),与无GDM的平均BMIz评分相当。(3)OGDM-胰岛素的平均出生体重和身高z评分低于No-GDM。OGDM-胰岛素在1.6-6个月和60个月的体重(0.32(0.021,0.62))和身高(0.50(0.087,0.91))变化更快,与无GDM的平均BMIz评分相当。
    结论:与胰岛素治疗相比,GDM二甲双胍治疗与后代生长轨迹的差异无关。在60个月时,二甲双胍和胰岛素暴露的后代的BMIz评分与No-GDM相当。
    To investigate the associations between gestational diabetes mellitus (GDM) metformin or insulin treatment and offspring growth trajectories from 0 to 60 months.
    Participants were from the Born in Bradford birth cohort study. Using covariate-adjusted multilevel linear spline models (4 splines: 0-1.6, 1.6-6, 6-17 and 17-60 months), we compared weight, height and body mass index (BMI) z-score trajectories of: (1) 76 offspring exposed to metformin (OGDM-Metformin) and 420 offspring exposed to insulin (OGDM-Insulin); (2) OGDM-Metformin and 9171 offspring not exposed to GDM (No-GDM); (3) OGDM-Insulin and No-GDM.
    (1) OGDM-Metformin had comparable growth trajectories to OGDM-Insulin from 0 to 60 months. (2) OGDM-Metformin had a lower mean birthweight z-score than No-GDM. OGDM-Metformin had faster changes in height z-score (0.13 [95% CI 0.026, 0.24]) from 17 to 60 months and by 60 months, had comparable mean BMI z-score to No-GDM. (3) OGDM-insulin had lower mean birthweight and height z-scores than No-GDM. OGDM-Insulin had faster changes in weight (0.32 [0.021, 0.62]) and height (0.50 [0.087, 0.91]) from 1.6 to 6 months and by 60 months, had comparable mean BMI z-score to No-GDM.
    GDM metformin treatment was not associated with differences in offspring growth trajectories compared to insulin treatment. Both metformin and insulin-exposed offspring had comparable BMI z-score to No-GDM by 60 months.
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  • 文章类型: Randomized Controlled Trial
    背景:焦虑与酒精使用障碍(AUD)的病程和预后有关;然而,目前尚不清楚AUD治疗如何影响焦虑和饮酒的联合轨迹.我们使用来自酒精依赖的联合药物疗法和行为干预(COMBINE)研究的数据,以检查AUD治疗期间和之后的AUD患者的亚临床焦虑症状与酒精使用之间的纵向关系。
    方法:使用五波COMBINE研究数据的单变量和平行过程生长模型,对865名随机接受药物治疗(n=429)或药物加心理治疗(n=436)的成年人进行分析。每周饮酒量和每周平均焦虑症状在基线测量,中期治疗,治疗结束,和三个随访期。
    结果:在治疗中期和一段时间内发现焦虑症状和饮酒呈显著正相关。时间关联显示,随着时间的推移,较高的治疗中期焦虑预示着饮酒的减少。基线焦虑和饮酒预测治疗中期焦虑和饮酒。只有基线焦虑预测饮酒会随着时间的推移而增加。组差异显示,治疗中期饮酒可预测药物组的焦虑随着时间的推移而减少。
    结论:研究结果表明,亚临床焦虑对AUD治疗后一年内饮酒的影响。基线焦虑症状可能会影响治疗过程中的饮酒行为。研究结果表明,即使对于患有共病焦虑症的个体,也有必要在AUD治疗中更多地关注负面影响。
    Anxiety is implicated in the course and prognosis of alcohol use disorder (AUD); however, it is unclear how current AUD treatments affect the joint trajectories of anxiety and alcohol use. We used data from the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) study to examine the longitudinal relationship between subclinical anxiety symptoms and alcohol use during and following AUD treatment in adults with AUD and no comorbid anxiety disorders.
    Univariate and parallel process growth models using five waves of COMBINE study data were analyzed from 865 adults randomized to medication (n = 429) or medication plus psychotherapy (n = 436). Weekly drinking quantity and average weekly anxiety symptoms were measured at baseline, mid-treatment, end-of-treatment, and three follow-up periods.
    Significant positive associations of anxiety symptoms and drinking were found at mid-treatment and over time. Temporal associations revealed that higher mid-treatment anxiety predicted decreases in drinking over time. Baseline anxiety and drinking predicted mid-treatment anxiety and drinking. Only baseline anxiety predicted increases in drinking over time. Group differences revealed mid-treatment drinking predicted decreases in anxiety over time in the medication group.
    Findings demonstrate the influence of subclinical anxiety on alcohol use during and up to one year after AUD treatment. Baseline anxiety symptoms may influence drinking behavior over the course of treatment. Findings suggest that greater attention to negative affect in AUD treatment is warranted even for those individuals who do have a comorbid anxiety disorder.
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  • 文章类型: Journal Article
    背景:在囊性纤维化(CF)中,较高的生长百分位数与更有利的肺功能相关,促使建立CF基金会(CFF)营养指南。
    目的:为了描述CF中的幼儿成长轨迹,以确定生长轨迹是否与六岁时的肺功能差异有关,并确定轨迹组之间不同的因素。
    方法:使用美国CFF患者登记处对2000-2011年被诊断为CF的儿童进行回顾性队列研究。六岁之前的年化生长参数包括在基于组的轨迹建模中,以识别独特的早期生命生长轨迹。使用线性回归比较了6岁时的FEV1预测百分比(FEV1pp)。使用多项逻辑回归确定与组成员资格相关的因素。
    结果:6,809名儿童符合纳入标准。确定了六个离散的生长轨迹,包括三个以生长参数>第50百分位数开始的组,称为:“总是很高”,“逐渐下降”,“快速下降”,三个以生长参数<50%开始,称为:“快速立管”,“逐渐上升”,“总是低”。6岁时的FEV1pp是“始终高”轨迹中最高的。始终低轨迹比始终高轨迹低近10%。性,种族,新生儿筛查和胰腺功能与轨迹类成员相关.
    结论:在CF中确定了不同的早期生命生长轨迹。符合CFF营养指南建议的轨迹与6岁时较高的FEV1pp相关。CF护理团队应继续与家庭合作,鼓励干预措施,以支持最佳生长,以改善CF的肺功能。
    Higher growth percentiles are associated with more favorable lung function in cystic fibrosis (CF), prompting the creation of CF Foundation (CFF) nutritional guidelines.
    To describe early childhood growth trajectories within CF, to determine if growth trajectories are associated with differences in lung function at age six, and to identify factors that differ between trajectory groups.
    Retrospective cohort study of children diagnosed with CF and born 2000-2011 using the US CFF Patient Registry. Annualized growth parameters prior to age six were included in group-based trajectory modeling to identify unique early life growth trajectories. FEV1 percent predicted (FEV1pp) at age six was compared between trajectory groups using linear regression. Factors associated with group membership were identified using multinomial logistic regression.
    6,809 children met inclusion criteria. Six discrete growth trajectories were identified, including three groups that began with growth parameters >50th percentile, termed: \"always high\", \"gradual decliner\", \"rapid decliner\", and three which began with growth parameters <50th percentile, termed: \"rapid riser\", \"gradual riser\", \"always low\". FEV1pp at age six was highest for the Always High trajectory. The Always Low trajectory was nearly 10% lower than the Always High trajectory. Sex, ethnicity, newborn screening and pancreatic function were associated with trajectory class membership.
    Distinct early life growth trajectories were identified within CF. Trajectories that met CFF nutritional guideline recommendations were associated with higher FEV1pp at age six. CF care teams should continue to partner with families to encourage interventions to support optimal growth to improve lung function in CF.
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  • 文章类型: Journal Article
    目标:膳食微量营养素铁的摄入量,已知叶酸和维生素B12会影响血红蛋白。低母体血红蛋白(母体贫血)与胎儿和婴儿的低出生体重和其他不良健康结果有关。我们的主要目的是探索母亲膳食微量营养素摄入量之间的关系,孕妇全血计数(FBC)参数和胎儿腹围(AC)和估计胎儿体重(EFW)的生长轨迹。其次,我们旨在评估母亲膳食微量营养素摄入量之间的关系,母体血红蛋白值和胎盘重量和出生体重。
    方法:纳入ROLO研究的母子对(n=759)纳入分析。从怀孕每个三个月完成的食物日记中计算出母亲的饮食微量营养素摄入量。在妊娠13周和28周收集FBC样本。在妊娠20周和34周记录胎儿超声测量结果。使用潜在类别轨迹混合模型估计AC和EFW的生长轨迹。
    结果:所有三个月的饮食中铁和叶酸的摄入量不足。孕妇平均血红蛋白水平在妊娠13周和28周时充足。膳食铁,叶酸和维生素B12的摄入与胎儿生长轨迹无关,胎盘重量或出生体重。妊娠28周时母体血红蛋白浓度较低与胎儿生长速度较快、胎盘重量和出生体重较大有关。
    结论:妊娠28周时母体血红蛋白与加速的胎儿和胎盘生长之间的负相关可能是由于胎儿在较快的生长轨迹上消耗了更多的母体铁和血红蛋白,此外还有胎盘对低氧状态的生化反应。
    Dietary micronutrient intakes of iron, folate and vitamin B12 are known to influence hemoglobin. Low maternal hemoglobin (maternal anemia) has been linked to low birthweight and other adverse health outcomes in the fetus and infant. Our primary aim was to explore relationships between maternal dietary micronutrient intakes, maternal full blood count (FBC) parameters and fetal abdominal circumference (AC) and estimated fetal weight (EFW) growth trajectories. Secondarily, we aimed to assess relationships between maternal dietary micronutrient intakes, maternal hemoglobin values and placental weight and birthweight.
    Mother-child pairs (n = 759) recruited for the ROLO study were included in this analysis. Maternal dietary micronutrient intakes were calculated from food diaries completed during each trimester of pregnancy. FBC samples were collected at 13- and 28-weeks\' gestation. Fetal ultrasound measurements were recorded at 20- and 34-weeks\' gestation. Growth trajectories for AC and EFW were estimated using latent class trajectory mixture models.
    Dietary intakes of iron and folate were deficient for all trimesters. Mean maternal hemoglobin levels were replete at 13- and 28-weeks\' gestation. Dietary iron, folate and vitamin B12 intakes showed no associations with fetal growth trajectories, placental weight or birthweight. Lower maternal hemoglobin concentrations at 28 weeks\' gestation were associated with faster rates of fetal growth and larger placental weights and birthweights.
    The negative association between maternal hemoglobin at 28 weeks\' gestation and accelerated fetal and placental growth may be due to greater consumption of maternal iron and hemoglobin by fetuses\' on faster growth trajectories in addition to placental biochemical responses to lower oxygen states.
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