RESUMEN
BACKGROUND: Understanding the self-rated health of industrially disabled individuals is an important variable that significantly affects their quality of life, satisfaction, and return to work after an industrial accident. Since the health of people with industrial disabilities is affected by various environments and variables, interventions and policies that are suitable for their characteristics are needed. OBJECTIVES: This study aimed to identify changes in self-rated health among industrially disabled individuals, distinguish between different latent classes, and verify predictive factors for each latent class. METHODS: Four time-point datasets from the 2018-2021 panel study of Korean workers' compensation insurance were used. Using the latent growth curve model, an overall trajectory of self-rated health of industrially disabled individuals was confirmed, and the number and characteristics of different trajectories were identified using the latent class growth model. Multinomial logistic regression analysis was used to identify the predictive factors for each class. RESULTS: Four classes of self-rated health trajectories were identified: low-decreasing (21.7%), moderate-increasing (15.7%), high-decreasing (56.1%), and low-stable (6.5%) classes. A multinomial logistic regression analysis revealed that significant determinants (age, capacity, type of industrial accident, grade of disability, mental activity, outdoor activity, and social relationships) were different for each latent class. Capacity level affected all potential class classifications. CONCLUSIONS: To improve the self-rated health of industrially disabled individuals, it is necessary to develop an appropriate strategy that considers the characteristics of the latent class.
RESUMEN
This cross-country four-year longitudinal study investigated the development of processing speed throughout primary school education. The analyses were conducted on data accumulated from 441 pupils in grades from 1 to 4 (aged 6.42 to 11.85 years) in Kyrgyzstan and Russia. Mixed effects growth modeling was applied to estimate average and individual growth trajectories for processing speed in two cross-country samples. Latent class growth modeling was conducted to describe various types of growth trajectories for processing speed and to compare the distribution of the types within the analyzed samples. According to the results, processing speed significantly increases across primary school years. The trajectory is described by nonlinear changes with most dynamic growth between grades 1 and 2, which slows down until grade 4. No significant cross-country differences were found in the initial score of processing speed or developmental changes in processing speed across primary school years. The development of processing speed is described by a model including three quadratic growth types but this minimally differs. It is concluded that in both samples, the development of processing speed may be characterized by homogeneity, with the most intensive growth from grade 1 to grade 2 and subsequent linear improvement until grade 4.
RESUMEN
Background: We aimed to investigate the latent smoking classes in men and their association with health-related quality of life (HRQoL) of themselves, their wives and offspring. Methods: Using Tehran Lipid and Glucose Study (TLGS), 1781 men with marital stability and 8-18-year-old offspring were followed for 15 years (1999-2014). Latent class growth modeling (LCGM) was used to identify men's smoking patterns in 1139 men with at least three non-missing measurements of cigarettes per day (CPD); they had 1908 children (8-18 years at baseline). HRQoL and its physical and mental component summaries (PCS and MCS) was measured at the last follow-up using the SF-12v2 questionnaire. The associations of men's smoking classes with HRQoL of the family members were examined using generalized linear model. Results: LCGM revealed four trajectories for men's smoking patterns; non/rare smokers, decreasing light, persistent moderate smokers, and persistent heavy smokers. Persistent smoking men, regardless of the amount of smoking (light or heavy), had lower scores in general health (ß= -7.80 for moderate and ß= -10.71 for heavy class) but not overall PCS. Al three trajectories of smoker men had poorer overall MCS than non/rare smokers. Living with persistent heavy smoker men was associated with decreased overall MCS in women (ß= -4.20), in particular role emotional (ß= -8.82) and mental health (ß= -9.42). No significant association was detected between fathers' smoking patterns and offspring HRQoL in young adulthood. Conclusion: Our results show men's heavy and persistent smoking worsens their own and their spouses' HRQoL, mainly in mental health dimensions.
RESUMEN
BACKGROUND: This study identified differences between individuals with and without depression regarding demographic and socioeconomic variables, health behavior, health status, health care utilization, and self-rated health (SRH) to identify the depressed group's SRH trajectories. METHODS: Data of individuals with (n = 589) and without (n = 6856) depression aged ≥20 from the 2013-2017 Korean Health Panel were analyzed. A chi-square test and t-tests examined differences in demographic and socioeconomic variables, health behaviors, health status, health care utilization, and the mean of SRH. Latent Growth Curve and Latent Class Growth Modeling identified SRH development trajectories and the most suitable latent classes explaining the trajectories, respectively. Multinomial logistic regression determined the predicting factors that classified latent classes. RESULTS: The depressed group had a lower mean SRH than the non-depressed group among most variables. Three latent classes were identified, each showing different SRH trajectories. Body-mass index and pain/discomfort were predicting factors for the "poor" classes compared with the "moderate-stable" class; older age, less national health insurance, less physical activity, more pain/discomfort, and more hospitalization were predictors for the "poor-stable" class. The depressed group's mean SRH was "poor." LIMITATIONS: Latent Class Growth Modeling in individuals with depression was based on experimental data; however, it needed to review other sample data to identify similar types of latent classes to those suggested in the current study. CONCLUSIONS: Predictors of the "poor-stable" class that were identified in this study can contribute to the formulation of intervention plans for the health and welfare of individuals with depression.
Asunto(s)
Depresión , Vida Independiente , Humanos , Depresión/epidemiología , Estado de Salud , Conductas Relacionadas con la Salud , DolorRESUMEN
Introduction: The progression of complications of type 2 diabetes (T2D) is unique to each patient and can be depicted through individual temporal trajectories. Latent growth modeling approaches (latent growth mixture models [LGMM] or latent class growth analysis [LCGA]) can be used to classify similar individual trajectories in a priori non-observed groups (latent groups), sharing common characteristics. Although increasingly used in the field of T2D, many questions remain regarding the utilization of these methods. Objective: To review the literature of longitudinal studies using latent growth modeling approaches to study T2D. Methods: MEDLINE (Ovid), EMBASE, CINAHL and Wb of Science were searched through August 25th, 2021. Data was collected on the type of latent growth modeling approaches (LGMM or LCGA), characteristics of studies and quality of reporting using the GRoLTS-Checklist and presented as frequencies. Results: From the 4,694 citations screened, a total of 38 studies were included. The studies were published beetween 2011 and 2021 and the length of follow-up ranged from 8 weeks to 14 years. Six studies used LGMM, while 32 studies used LCGA. The fields of research varied from clinical research, psychological science, healthcare utilization research and drug usage/pharmaco-epidemiology. Data sources included primary data (clinical trials, prospective/retrospective cohorts, surveys), or secondary data (health records/registries, medico-administrative). Fifty percent of studies evaluated trajectory groups as exposures for a subsequent clinical outcome, while 24% used predictive models of group membership and 5% used both. Regarding the quality of reporting, trajectory groups were adequately presented, however many studies failed to report important decisions made for the trajectory group identification. Conclusion: Although LCGA were preferred, the contexts of utilization were diverse and unrelated to the type of methods. We recommend future authors to clearly report the decisions made regarding trajectory groups identification.
RESUMEN
BACKGROUND: The depressive symptom trajectories of COPD individuals and its' predictors remain to be established. Therefore, this study aimed to explore the trajectories of depressive symptoms and predictors thereof in COPD patients. METHODS: A total of 1286 individuals over 45 years of age with self-reported COPD were assessed. Depressive symptoms were evaluated using the Center for Epidemiological Studies Depression Scale short form, with depressive symptom trajectories being identified via latent class growth analysis. The predictors of depressive symptom trajectories were then identified through multinomial logistic regression. RESULTS: Finally, three depressive symptom trajectories were identified: "steadily high", "consistently moderate", and "consistently low". Old age, longer night-time sleep duration, and high BMI were found to be associated with individuals being classified under the "consistently moderate" trajectory. Moreover, participants exhibiting more than two chronic conditions were more likely to be classified under the "consistently moderate" trajectory. Higher education and lower hand grip strength were important predictors of individuals classified in the "steadily high" trajectory. CONCLUSIONS: To conclude, three depressive symptom trajectories were identified in self-reported COPD individuals. To ensure timely intervention aimed at preventing the worsening of depressive symptom progression among COPD individuals, health-care workers should regular analyze depressive symptoms and provide appropriate interventions when possible.
Asunto(s)
Depresión , Enfermedad Pulmonar Obstructiva Crónica , Depresión/epidemiología , Fuerza de la Mano , Humanos , Modelos Logísticos , Estudios Longitudinales , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , AutoinformeRESUMEN
OBJECTIVES: Social isolation has objective and subjective dimensions. Few studies have simultaneously examined trajectories of both dimensions. We integrated multiple indicators of both dimensions to identify social isolation trajectory patterns and investigated how different patterns were related to adults' physical, mental, cognitive, and self-rated health. METHODS: We used latent class growth modeling to examine social isolation trajectory patterns, based on data from the 2008-2016 waves of the Health and Retirement Study (N = 6457). Mixed-effect linear models were used to examine how trajectory patterns were associated with functional limitations, depressive symptoms, memory deficits, and self-rated health over the 8-year study period. RESULTS: Four social isolation trajectory patterns were identified: severe isolation (15.4%), moderate isolation (37.6%), some objective and rare subjective isolation (35.4%), and rare objective and low subjective isolation (11.6%). Social isolation trajectory patterns showed a gradient in all health domains. The rare objective and low subjective isolation group had the best health (i.e., the fewest functional limitations, depressive symptoms, and memory deficits and the best self-rated health); the some objective and rare subjective isolation group had the next best health; the moderate isolation group had the second worst health; and the severe isolation group had the worst health. CONCLUSIONS: The prevalence and stability of severe and moderate social isolation suggest it may be necessary to address social isolation at the national level. The most favorable health outcomes associated with the rare objective and low subjective isolation group supports interventions to strengthen social networks and engagement midlife and later-life.
Asunto(s)
Jubilación , Aislamiento Social , Humanos , Trastornos de la Memoria , Aislamiento Social/psicologíaRESUMEN
Individual differences in temperament have been well-described, but individual differences in temperament trajectories require elaboration. Specifically, it is unknown if subgroups of infants display different developmental patterns and if these patterns relate to later behavioral problems. The aims were to identify distinct developmental patterns in broad dimensions of temperament among typically developing infants, to determine whether these developmental patterns differ by sex, to evaluate how developmental patterns within each dimension of temperament relate to developmental patterns within other dimensions of temperament, and to determine whether developmental patterns of infant temperament are associated with internalizing and externalizing behavior at 2 years of age. Data from the longitudinal Alberta Pregnancy Outcomes and Nutrition study (n = 1,819) were used to model latent class trajectories of parent-reported infant temperament at 3, 6, and 12 months. Four to five unique latent trajectories were identified within each temperament dimension. Sex was not associated with trajectory groups. Developmental coordination was observed between trajectories of negative emotionality and regulatory capacity, and between regulatory capacity and positive affect, but not between positive affect and negative emotionality. Negative emotionality and regulatory capacity predicted internalizing and externalizing behavior. Patterns of development in infant temperament, and not just intensity of temperament, contribute toward later problem behavior.
Asunto(s)
Análisis de Clases Latentes , Problema de Conducta , Psicología Infantil , Temperamento , Alberta , Femenino , Humanos , Individualidad , Lactante , Conducta del Lactante , Estudios Longitudinales , EmbarazoRESUMEN
AIM: The association between adult height and follow-up cognition requires an update in China. We aimed to examine the association between baseline height and follow-up cognitive trajectories in Chinese subjects from the China Health and Retirement Longitudinal Study (CHARLS). METHODS: A total of 6508 adults aged 45 years or older from the CHARLS were included for analysis. Latent class growth modeling was used to determine cognitive trajectories of 2011, 2013 and 2015. Multivariable linear regression and logistic regression models were used to examine the association between baseline adult height and cognitive performance and trajectories, respectively. RESULTS: At baseline, an increment of 1 SD (8.3 cm) of height was associated with a higher global cognitive score (ß = 0.492, 95% CI, 0.348-0.636), verbal episodic memory (ß = 0.155, 95% CI, 0.086-0.224) and mental status (ß = 0.337, 95% CI, 0.225-0.449). These associations were still observed even when stratified by sex. Prospectively, for females, the third quartile of height level (i.e., 155 to 158 cm) was associated with a better global cognitive function trajectory (OR = 1.627, P = 0.001, P for trend = 0.009) and mental status trajectory (OR = 1.456, P = 0.012, P for trend = 0.047); and the tallest height level (i.e., 159 cm or taller) was related to a better verbal episodic memory trajectory (OR = 1.574, P = 0.017). For males, no associations were observed. CONCLUSION: Increased stature might be associated with better cognitive trajectories for subjects in China. Geriatr Gerontol Int 2021; 21: 732-740.
Asunto(s)
Memoria Episódica , Jubilación , China/epidemiología , Cognición , Femenino , Humanos , Estudios Longitudinales , MasculinoRESUMEN
BACKGROUND AND OBJECTIVES: Studies on the development and treatment of anxiety disorders mostly focus on the comparison of predefined groups. An alternative approach is to use data-driven latent class growth analyses (LCGA) to determine differentiation between groups based on particular mechanistic factors. This study validated the use of LCGA on responses in a compact fear conditioning task and whether specific characteristics are associated with maladaptive fear learning trajectories. METHODS: Healthy subjects (N = 300) completed a fear conditioning task that included uninstructed and instructed acquisition and extinction phases. Subjective fearfulness and US expectancy were used as outcome measures. Latent classes in the responses to the CS+ (coupled with a scream) and the CS- (control stimulus) were determined based on trajectories across the experimental phases. State and trait anxiety were measured during testing, and return of fear and intrusions were measured one and six weeks later. RESULTS: Fear learning trajectories of poor extinction in responding to the CS+ and generalization of fear to the CS- were associated with higher state and trait anxiety. Individuals belonging to these trajectories reported more intrusions, fear and had higher US expectancy ratings after 1 week. LIMITATIONS: Only 56% of participants completed the six weeks follow-up measures. CONCLUSION: Fear learning trajectories are associated with individual characteristics, return of fear and intrusions. Next, this task will be implemented in clinical practice to assess its predictive power for the extent to which patients benefit from exposure treatments.
Asunto(s)
Condicionamiento Clásico , Extinción Psicológica , Ansiedad , Miedo , Voluntarios Sanos , HumanosRESUMEN
PURPOSE: Total knee arthroplasty (TKA) is usually effective, although not all patients have satisfactory outcomes. This assumes distinct recovery patterns might exist. Little attention has been paid to determine which patients have worse outcomes. This study attempts to distinguish specific recovery patterns using the Oxford knee score (OKS) during the first postoperative year. The secondary aim was to explore predictors of less favourable recovery patterns. METHODS: Analysis of patients in the Dutch Arthroplasty Register (LROI) with unilateral primary TKA. Data collected up to one year postoperative was used. To identify subgroups of patients based on OKS, latent class growth modeling (LCGM) was used. Moreover, multivariable multinomial logistic regression analysis was used to explore predictors of class membership. RESULTS: 809 Patients completed three OKS during the first year postoperative and were included. LCGM identified 3 groups of patients; 'high risers' (most improvement during first 6-months, good 12-month scores 77%), 'gradual progressors' (continuous improvement during the first year 13%) and 'non responders' (initial improvement and subsequent deterioration to baseline score 10%). Predictors of least favourable class membership (OR, 95%CI) are EQ-5D items: VAS health score (0.83, 0.73-0.95), selfcare (2.22, 1.09-4.54) and anxiety/depression (2.45, 1.33-4.52). CONCLUSION: Three recovery patterns after TKA were distinguished; 'high risers', 'gradual progressors' and 'non responders'. Worse score on EQ-5D items VAS health, selfcare, and anxiety/depression were correlated with the least favourable 'non responders' recovery pattern.
Asunto(s)
Artroplastia de Reemplazo de Rodilla , Osteoartritis de la Rodilla/cirugía , Anciano , Ansiedad , Artroplastia de Reemplazo de Rodilla/efectos adversos , Depresión , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Osteoartritis de la Rodilla/psicología , Complicaciones Posoperatorias , Sistema de Registros , Análisis de Regresión , Autocuidado , Resultado del TratamientoRESUMEN
Considering the high burden of micronutrient deficiencies in Bangladeshi children, this analysis aimed to identify the factors associated with micronutrient deficiencies and association of plasma micronutrient concentration trajectories from 7 to 24 months with the concentrations at 60 months of age. Plasma samples were collected at 7, 15, 24, and 60 months of age, and hemoglobin, ferritin, zinc, and retinol concentrations of 155, 153, 154, and 155 children were measured, respectively. A generalized estimating equation was used to identify the factors associated with micronutrient deficiencies, while latent class growth modeling identified the trajectories of plasma micronutrients from 7 to 24 months and its association with the concentrations of micronutrients at 60 months was examined using multiple linear regression modeling. Early (AOR = 2.21, p < 0.05) and late convalescence (AOR = 1.65, p < 0.05) stage of an infection, low ferritin (AOR = 3.04, p < 0.05), and low retinol (AOR = 2.07, p < 0.05) were associated with increased anemia prevalence. Wasting at enrollment was associated with zinc deficiency (AOR = 1.8, p < 0.05) and birth weight was associated with ferritin deficiency (AOR = 0.58, p < 0.05). Treatment of drinking water was found protective against vitamin A deficiency (AOR = 0.57, p < 0.05). Higher trajectories for ferritin and retinol during 7-24 months were positively associated with plasma ferritin (ß = 13.72, p < 0.05) and plasma retinol (ß = 3.99, p < 0.05) at 60 months.
Asunto(s)
Anemia Ferropénica , Trastornos de la Nutrición del Niño , Deficiencia de Vitamina A , Zinc/deficiencia , Adulto , Bangladesh , Preescolar , Femenino , Ferritinas/sangre , Humanos , Lactante , Masculino , Vitamina A/sangre , Adulto Joven , Zinc/sangreRESUMEN
We identified distinct trajectories of temporal changes in employment status and investigated their association with self-rated health, perceived stress, and sleep. Data pertaining to 1228 respondents (age: 17-31 years) were extracted from the Korea Youth Panel (YP2007) survey (3rd-9th wave) datasets. Participants were either paid employees (permanent or precarious) or currently unemployed but seeking a job at baseline. Latent class growth analyses were employed to extract different classes based on the annual change in employment status (permanent/precarious/unemployed). Logistic regression analyses were performed using extracted classes as predictor variables and health-related variables at the final time-point as outcome variables. Five trajectories of employment status change were identified: stability sustained; gradually deteriorated; swiftly alleviated; gradually alleviated; instability sustained. Compared with the stability sustained group, the gradually deteriorated and gradually alleviated groups showed higher odds of perceived stress. The gradually deteriorated, instability sustained, and gradually alleviated groups showed significantly higher odds of shorter sleep than the stabilized group. We highlight the adverse health effects of prolonged unstable employment and the need for interventions to mitigate these effects.
Asunto(s)
Empleo/estadística & datos numéricos , Sueño , Estrés Psicológico , Adolescente , Adulto , Femenino , Estado de Salud , Humanos , Masculino , República de Corea , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: Health At Every Size® (HAES®) interventions have been increasingly recognized as a sustainable strategy in obesity management. Nevertheless, heterogeneity among obese individuals leads to challenges as it translates in mixed responses to treatment. In this context, our objective was to identify trajectories of responses to a non-diet intervention for adult overweight/obese women to highlight profiles of responders. METHOD: Based on data from a multicentric quasi-experimental study, a latent class growth modeling (LCGM) was performed. Two hundred and ten women with high body mass index (BMIâ¯≥â¯25, MBMIâ¯=â¯36.53) who followed a non-diet intervention offered in Health and Social Services Centres completed questionnaires at Tâ¯=â¯0, 4 and 16 months. Outcomes used in the LCGM were intuitive eating and body esteem, two central components in HAES® interventions. Types of responders were then profiled on sociodemographic, weight, lifestyle, psychological and eating variables. RESULTS: The LCGM revealed a 4-trajectory model (pâ¯<â¯.001), comprising non-responders (14.67%), moderate improvement with low maintenance responders (49.89%), moderate improvement with high maintenance responders (29.28%) and high functioning partial responders (6.56%). Analysis of variances showed significant differences between all types of responders with medium to large effect sizes on depressive symptoms, self-esteem and disinhibited eating (pâ¯<â¯.001; η2â¯=â¯.23, 0.30 and 0.16 respectively). Fewer differences were found on sociodemographic, lifestyle, health and weight variables. Overall, non-responders (14.67%) had a distinctive profile compared to the other groups by consistently expressing poorer psychological functioning, less adapted eating behaviors and reaching more frequently the clinical cutoff for severe depression (pâ¯=â¯.001). CONCLUSIONS: Findings strongly support the relevance of considering psychological characteristics to move towards personalized healthcare in obesity management.
Asunto(s)
Manejo de la Obesidad/métodos , Obesidad/terapia , Adulto , Índice de Masa Corporal , Peso Corporal , Conducta Alimentaria/psicología , Femenino , Humanos , Análisis de Clases Latentes , Estilo de Vida , Masculino , Persona de Mediana Edad , Obesidad/fisiopatología , Obesidad/psicología , Autoimagen , Encuestas y Cuestionarios , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Few studies use longitudinal designs to assess patterns of body mass index (BMI) change from adolescence to adulthood or incorporate severe obesity as a unique subgroup. OBJECTIVE: To examine patterns of BMI trajectories from adolescence to adulthood and identify demographic characteristics associated with each BMI trajectory pattern. DESIGN: Height, weight, and demographic characteristics were drawn from Waves I to V of the nationally representative school-based sample of the National Longitudinal Study of Adolescent to Adult Health (Add Health) conducted from 1994 to 2018 (data collection is ongoing). PARTICIPANTS/SETTING: Participants included 3,315 (55.5% female) subjects responding to in-home interviews across all five Waves of Add Health. MAIN OUTCOME MEASURES: BMI at each wave modeled over time. STATISTICAL ANALYSES: Latent class growth modeling and logistic regression analysis using population sample weights. RESULTS: Five classes of weight patterns best fit the sample. Twenty-nine percent of the sample had an always healthy BMI (class 1) and 34.9% changed from healthy weight to overweight (class 2). Moving from healthy weight to obese comprised 21.8% of the sample (class 3). BMI patterns increasing from overweight to obese (class 4) and from obese to severely obese (class 5) comprised 7.6% and 7.1% of the sample, respectively. Weight change was similar for males and females with some racial or ethnic minority participants more likely to be severely obese in adulthood. CONCLUSIONS: Results emphasize the importance of tracking weight longitudinally and point to a nationally representative trend of increasing BMI during the transition to adulthood. There was no substantive decreasing trend identified in the sample. Findings highlight the need for effective early and ongoing intervention and prevention strategies and can aid in identification of vulnerable youth who are at the highest risk for moving to problematic weight categories.
Asunto(s)
Índice de Masa Corporal , Peso Corporal , Análisis de Clases Latentes , Adolescente , Adulto , Estatura , Etnicidad , Femenino , Estado de Salud , Humanos , Estudios Longitudinales , Masculino , Obesidad/epidemiología , Sobrepeso/epidemiología , Factores de Riesgo , Adulto JovenRESUMEN
BACKGROUND: Although prenatal cocaine exposure (PCE) has been linked with greater externalizing behavior, no studies have investigated heterogeneity of developmental trajectories in children with PCE to date. The present study aimed to: (1) identify developmental trajectories of externalizing problems in childhood by using a person-oriented analytic approach; (2) examine whether trajectories differ by PCE and other environmental and biological correlates; and (3) investigate how trajectories were associated with adolescent substance use and sexual behavior. METHODS: Adolescents (N = 386; 197 PCE, 187 non-cocaine exposed (NCE)), primarily African-American and of low socioeconomic status, were prospectively enrolled in a longitudinal study at birth. Externalizing problems were assessed with the Child Behavior Checklist (CBCL) at ages 4, 6, 9, 10, 11, and 12. Substance (tobacco, alcohol, marijuana) use, via self-report and biologic assays, and early (before age 15) sexual intercourse were assessed at age 15. RESULTS: Latent class growth modeling indicated four distinctive developmental trajectories of externalizing behavior from ages 4 to 12: low-decreasing group (32%); moderate-decreasing group (32%); accelerated risk group (14%); and elevated-chronic group (22%). PCE and maternal psychological distress interactively differentiated developmental trajectories of externalizing behavior, which were related to subsequent adolescent substance use and early sexual behavior differently across gender. CONCLUSIONS: The two high-risk trajectories (accelerated risk and elevated-chronic groups), comprising 36% of the sample, identified in the present study may reflect multi-causality of early substance use and perhaps greater risk for transition to substance use disorders later in development.
Asunto(s)
Conducta del Adolescente/psicología , Trastornos de la Conducta Infantil/psicología , Cocaína/efectos adversos , Efectos Tardíos de la Exposición Prenatal/psicología , Conducta Sexual/psicología , Trastornos Relacionados con Sustancias/psicología , Adolescente , Adulto , Niño , Trastornos de la Conducta Infantil/diagnóstico , Trastornos de la Conducta Infantil/epidemiología , Preescolar , Femenino , Humanos , Estudios Longitudinales , Masculino , Embarazo , Efectos Tardíos de la Exposición Prenatal/diagnóstico , Efectos Tardíos de la Exposición Prenatal/epidemiología , Factores de Riesgo , Autoinforme , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
OBJECTIVE: To identify distinct longitudinal patterns of body mass index (BMI) z score in type 1 diabetes from childhood to young adulthood and secondly to determine sex differences as well as associated clinical covariates. STUDY DESIGN: A total of 5665 patients with type 1 diabetes (51% male) with follow-up from 8 to 20 years of age from the multicenter diabetes prospective registry DPV were studied (baseline diabetes duration ≥1 years, BMI z score aggregated per year of life). Latent class growth modeling (SAS: PROC TRAJ) was applied to analyze BMI z score over time. RESULTS: Six distinct BMI z score trajectories were identified (group 1: 7% of patients, group 2: 22%, group 3: 20%, group 4: 16%, group 5: 25%, and group 6: 10%). Group 1, 2, 5, and 6 had an almost stable BMI z score, either in the low, near-normal, high stable, or chronic overweight range. Group 3 (60% girls) increased their BMI during puberty, whereas group 4 (65% boys) had a BMI decrease. Similar patterns were observed for girls only, whereas boys followed nearly stable trajectories without fluctuation over time. Between the near-normal and the other groups, significant differences (P < .05) in sex ratio, migration background, mental health, height z score, glycated hemoglobin A1c, diabetes treatment, dyslipidemia, hypertension, and smoking were observed. CONCLUSIONS: In youth with type 1 diabetes, a great heterogeneity of BMI z score trajectories exists that highlight the importance of personalized sex-specific intervention programs for subjects at risk for unfavorable BMI development.
Asunto(s)
Índice de Masa Corporal , Diabetes Mellitus Tipo 1/epidemiología , Adolescente , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Estatura , Niño , Dislipidemias/epidemiología , Europa (Continente)/epidemiología , Trastornos de Alimentación y de la Ingestión de Alimentos/epidemiología , Femenino , Hemoglobina Glucada/análisis , Humanos , Hipertensión/epidemiología , Hipoglucemiantes/uso terapéutico , Insulina Detemir/uso terapéutico , Masculino , Pubertad , Sistema de Registros , Factores Sexuales , Migrantes/estadística & datos numéricos , Adulto JovenRESUMEN
AIMS: To inform research on the etiology and prevention of substance use among rural African American youth by (a) identifying developmental trajectory classes of cannabis use and heavy drinking across adolescence and young adulthood and (b) examining associations between trajectory class membership and multi-level assessments of risk factors. DESIGN: A prospective study spanning 9 years with assessments of cannabis use and heavy drinking, the catecholamines epinephrine and norepinephrine, perceived stress and psychosocial risk factors. SETTING: Rural communities in the southeastern United States. PARTICIPANTS: African American youth (n = 518). MEASUREMENTS: Participants were assessed for cannabis use and heavy drinking at seven assessments beginning at 16 years of age and continuing to 25 years of age. At age 19, participants provided overnight urine voids that were assayed for catecholamines, a biological marker of life stress resulting from sympathetic nervous system activation. At ages 16 and 19, participants provided information on malleable psychosocial risk factors. FINDINGS: Latent class growth models revealed three distinct trajectory classes for cannabis use and for heavy drinking. Higher levels of circulating stress hormones and perceived stress were associated with classes reporting greater substance use over time (all Ps < 0.05). A composite of selected risk factors discriminated class membership (all Ps < 0.05). Trajectory classes characterized by rapid usage increases in early adulthood exhibited the greatest increase in deviant peer affiliations between ages 16 and 19 years. CONCLUSIONS: Rural African American youth's cannabis use and heavy drinking across adolescence and young adulthood demonstrate distinct developmental courses; a small number of risk factors and measures of biological and perceived stress differentiate class membership prognostically. Variability over time in these measures, specifically an increase in deviant peer affiliation, may help to account for steep increases in young adulthood.
Asunto(s)
Consumo Excesivo de Bebidas Alcohólicas/epidemiología , Negro o Afroamericano/estadística & datos numéricos , Uso de la Marihuana/epidemiología , Estrés Psicológico/epidemiología , Consumo de Alcohol en Menores/estadística & datos numéricos , Rendimiento Académico/psicología , Rendimiento Académico/estadística & datos numéricos , Adolescente , Adulto , Negro o Afroamericano/psicología , Consumo Excesivo de Bebidas Alcohólicas/psicología , Epinefrina/orina , Femenino , Amigos , Humanos , Análisis de Clases Latentes , Masculino , Uso de la Marihuana/psicología , Norepinefrina/orina , Relaciones Padres-Hijo , Estudios Prospectivos , Racismo/psicología , Racismo/estadística & datos numéricos , Factores de Riesgo , Población Rural , Sudeste de Estados Unidos/epidemiología , Estrés Psicológico/psicología , Estrés Psicológico/orina , Consumo de Alcohol en Menores/psicología , Adulto JovenRESUMEN
It remains unclear if the developmental trajectories of a specific inflammatory biomarker during the acute phase of ST-elevation myocardial infarction (STEMI) provide outcome prediction. By applying latent class growth modeling (LCGM), we identified three distinctive trajectories of CD14++CD16+ monocytes using serial flow cytometry assays from day 1 to day 7 of symptom onset in 96 de novo STEMI patients underwent primary percutaneous coronary intervention. Membership in the high-hump-shaped trajectory (16.8%) independently predicted adverse cardiovascular outcomes during a median follow-up of 2.5 years. Moreover, inclusion of CD14++CD16+ monocyte trajectories significantly improved area under the curve (AUC) when added to left ventricular ejection fraction-based prediction model (ΔAUC = 0.093, P = 0.013). Therefore, CD14++CD16+ monocyte trajectories during STEMI hospitalization are a novel risk factor for post-STEMI adverse outcomes. These results provide the first proof-of-principle evidence in support of the risk stratification role of LCGM-based longitudinal modeling of specific inflammatory markers during acute STEMI.
Asunto(s)
Hospitalización , Mediadores de Inflamación/inmunología , Monocitos/inmunología , Infarto del Miocardio con Elevación del ST/inmunología , Anciano , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Proteínas Ligadas a GPI/sangre , Proteínas Ligadas a GPI/inmunología , Humanos , Mediadores de Inflamación/sangre , Receptores de Lipopolisacáridos/sangre , Receptores de Lipopolisacáridos/inmunología , Masculino , Persona de Mediana Edad , Monocitos/metabolismo , Intervención Coronaria Percutánea , Receptores de IgG/sangre , Receptores de IgG/inmunología , Factores de Riesgo , Infarto del Miocardio con Elevación del ST/sangre , Infarto del Miocardio con Elevación del ST/diagnóstico , Infarto del Miocardio con Elevación del ST/cirugía , Factores de Tiempo , Resultado del TratamientoRESUMEN
Determining lifelong physical activity (PA) trajectories and their determinants is essential to promote a physically active lifestyle throughout the life-course. We aimed to identify PA trajectories from childhood to midlife and their determinants in a longitudinal population-based cohort. This study is a part of the Cardiovascular Risk in Young Finns Study. From 1980, a population-based cohort (N = 3596; 1764 boys/1832 girls, age 3-18 years) has been followed up for 31 years. PA indices were formed based on self-reported data (between age 9-49 years) on frequency, duration, and intensity of leisure (during childhood) or high-intensity (at later age) PA and on sports club participation/competitions. PA trajectories were analyzed using group-based trajectory modeling. Childhood (age 12 years), young adulthood (age 24 years), and early midlife (age 37 years) determinants were analyzed. Five PA trajectories were identified: persistently active (6.6%), decreasingly active (13.9%), increasingly active (13.5%), persistently low active (51.4%, reference group), persistently inactive (14.6%). In childhood, rural residential area (OR 0.45, 95% CI 0.21-0.96) and high academic performance (OR 2.18; 95% CI 1.58-3.00) associated with persistently active group. In early midlife, smoking (OR 1.66; 95% CI 1.07-2.58) associated with persistently inactive group, regular alcohol drinking (OR 2.91; 95% CI 1.12-7.55) with persistently active group and having children (OR 2.07; 95% CI 1.27-3.38) with decreasingly active group. High adulthood education associated with both decreasingly (OR 1.87; 95% CI 1.05-3.35) and increasingly (OR 2.09; 95% CI 1.19-3.68) active groups. We identified five PA trajectories from childhood into midlife. Most prominent determinants were academic achievement, education, having children and health habits (i.e. smoking/alcohol use).