RESUMO
OBJECTIVE: To prospectively evaluate the relationship between household income, children's cortisol, and body mass index (BMI) trajectories over a 3-year period in early childhood. STUDY DESIGN: Household income, child hair cortisol levels, and BMI were measured at baseline, 12-, 24-, and 36-month follow-up visits in the Now Everybody Together for Amazing and Healthful Kids (NET-Works) Study (n = 534, children ages 2-4 years, and household income <$65 000/year at baseline). Relationships were examined between very low household income (<$25 000/year) at baseline, income status over time (remained <$25 000/year or had increasing income), cortisol accumulation from hair samples, and BMI percent of the 95th percentile (BMIp95) trajectories using adjusted linear growth curve modeling. Households with baseline income between $25 000 and $65 000/year were the reference group for all analyses. RESULTS: Children from very low-income households at baseline had annual changes in BMIp95 that were higher (P < .001) than children from reference group households (0.40 vs -0.62 percentage units/year). Annual increases in BMIp95 were also greater among children from households that remained very low income (P < .01, .34 percentage units/year) and among those with increasing income (P = .01, .51 percentage units/year) compared with the reference group (-0.61 percentage units/year). Children from households that remained very low income had higher hair cortisol accumulations (0.22 pg/mg, P = .02) than reference group children, whereas hair cortisol concentrations of children from households with increasing income (0.03 pg/mg) did not differ significantly from the reference group. Cortisol was not related to BMIp95. CONCLUSIONS: The economic circumstances of families may impact children's BMI trajectories and their developing stress systems, but these processes may be independent of one another.
Assuntos
Hidrocortisona , Obesidade Infantil , Criança , Pré-Escolar , Humanos , Hidrocortisona/análise , Estudos Prospectivos , Estudos Longitudinais , Obesidade , Índice de Massa Corporal , Renda , Obesidade Infantil/epidemiologiaRESUMO
BACKGROUND: The cholinergic system has an important role in mood regulation. Cholinesterase inhibitor pesticides (e.g. organophosphates) appear to increase depression and anxiety symptoms in the few existing animal and human studies. Human studies have not described such associations using biomarkers of exposure and studies among children are needed. METHODS: We studied 529 adolescents (ages 11-17y) in agricultural communities in the Ecuadorian Andes (ESPINA study). Acetylcholinesterase (AChE) activity was measured in a finger-stick sample. Anxiety and depression symptoms were assessed using the CDI-2 and MASC-2 (greater scores reflect greater internalizing symptoms). Models adjusted for age, gender, hemoglobin, income among others. RESULTS: The median age was 14.38y and 51% were female. The mean (SD) of the following parameters were: AChE 3.7 U/mL (0.55), depression T-score 53.0 (9.4) and anxiety T-score: 57.6 (9.8). Lower AChE activity (reflecting greater cholinesterase inhibitor exposure) was associated with higher depression symptoms (difference per SD decrease of AChE [ß [95% CI:]]: 1.09 [0.02, 2.16]), was stronger among girls (ßâ¯=â¯1.61) than boys (ßâ¯=â¯0.69), and among younger (<14.38y, ßâ¯=â¯1.61) vs. older children (ßâ¯=â¯0.57). The associations were strongest among girls <14.38y (ßâ¯=â¯3.30 [0.54, 6.05], OR for elevated symptoms per SD decrease in AChEâ¯=â¯2.58 [1.26, 5.27]). No associations were observed with anxiety scores. Analyses of AChE change between 2008 and 2016 concurred with these findings. DISCUSSION: We observed associations between a biomarker of pesticide exposure and children's depression symptoms. Lower AChE activity may create risk for depression in teenagers, particularly among girls during early adolescence.
Assuntos
Acetilcolinesterase/sangue , Ansiedade/enzimologia , Inibidores da Colinesterase , Depressão/enzimologia , Exposição Ambiental , Praguicidas , Adolescente , Biomarcadores/sangue , Criança , Equador , Feminino , Horticultura , Humanos , MasculinoRESUMO
OBJECTIVE: To evaluate cardiovascular and metabolic function in youths adopted internationally from orphanages/institutions (postinstitutionalized) who were height-stunted at adoption. STUDY DESIGN: A total of 30 postinstitutionalized youths (age, 9-18 years; body mass index [BMI] percentile, 7.2-90.4) who were height-stunted at adoption were compared with age- and BMI percentile-matched youths (n = 90). Measurements included total body fat and visceral adipose tissue (dual radiograph absorptiometry), arterial stiffness (augmentation index and pulse wave velocity), cardiac autonomic function (heart rate variability), blood pressure, and fasting lipid, glucose, and insulin levels. Linear regression analyses were computed controlling for parent education, age, trunk tissue fat, height-for-age, sex, and race. RESULTS: Compared with controls of the same age, sex, and BMI, the postinstitutionalized children had higher systolic blood pressure (P = .018), augmentation index (P= .033), total cholesterol (P= .047), low-density lipoprotein cholesterol (P= .03), triglycerides (P= .048), insulin (P= .005), and HOMA-IR (P= .01) values. The postinstitutionalized children had a lower low-frequency to high-frequency ratio (P = .008), indicating lower sympathetic tone, as well as a lower total lean mass (P = .016), a lower gynoid lean mass (P = .039), and a higher proportion of trunk tissue fat (P = .017). The postinstitutionalized and control children did not differ in any other body composition measures. CONCLUSIONS: Early life stress, as represented by height-stunted growth in institutional care, may be associated with early pathways to cardiovascular and metabolic risk in youths even after moving into well-resourced homes early in life and in the absence of increased adiposity. These findings suggest that postinstitutionalized youths with a history of height stunting may need to be closely monitored for emergent cardiometabolic risk factors.
Assuntos
Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Transtornos do Crescimento/complicações , Síndrome Metabólica/etiologia , Adolescente , Estatura/fisiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Criança , Estudos Transversais , Feminino , Seguimentos , Transtornos do Crescimento/diagnóstico , Humanos , Hipercolesterolemia/diagnóstico , Hipercolesterolemia/epidemiologia , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Incidência , Estudos Longitudinais , Masculino , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Orfanatos , Valores de Referência , Medição de Risco , Estresse Fisiológico , Estresse Psicológico , Fatores de Tempo , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Organophosphate exposures can affect children's neurodevelopment, possibly due to neurotoxicity induced by acetylcholinesterase (AChE) inhibition, and may affect boys more than girls. We tested the hypothesis that lower AChE activity is associated with lower neurobehavioral development among children living in Ecuadorian floricultural communities. METHODS: In 2008, we examined 307 children (age: 4-9 years; 52% male) and quantified AChE activity and neurodevelopment in 5 domains: attention/executive functioning, language, memory/learning, visuospatial processing, and sensorimotor (NEPSY-II test). Associations were adjusted for demographic and socioeconomic characteristics and height-for-age, flower worker cohabitation, and hemoglobin concentration. RESULTS: Mean ± standard deviation AChE activity was 3.14 ± 0.49 U/mL (similar for both genders). The range of scores among neurodevelopment subtests was 5.9 to 10.7 U (standard deviation: 2.6-4.9 U). Girls had a greater mean attention/executive functioning domain score than boys. In boys only, there were increased odds ratios of low (<9th percentile) neurodevelopment among those in the lowest tertile versus the highest tertile of AChE activity (odds ratios: total neurodevelopment: 5.14 [95% confidence interval (CI): 0.84 to 31.48]; attention/executive functioning domain: 4.55 [95% CI: 1.19 to 17.38], memory/learning domain: 6.03 [95% CI: 1.17 to 31.05]) after adjustment for socioeconomic and demographic factors, height-for-age, and hemoglobin. Within these domains, attention, inhibition and long-term memory subtests were most affected. CONCLUSIONS: Low AChE activity was associated with deficits in neurodevelopment, particularly in attention, inhibition, and memory in boys but not in girls. These critical cognitive skills affect learning and academic performance. Added precautions regarding secondary occupational pesticide exposure would be prudent.
Assuntos
Acetilcolinesterase/sangue , Desenvolvimento Infantil/efeitos dos fármacos , Inibidores da Colinesterase/toxicidade , Exposição Ambiental/efeitos adversos , Inseticidas/toxicidade , Organofosfatos/toxicidade , Agricultura , Atenção/efeitos dos fármacos , Atenção/fisiologia , Biomarcadores/sangue , Criança , Desenvolvimento Infantil/fisiologia , Pré-Escolar , Estudos Transversais , Equador , Feminino , Flores , Inquéritos Epidemiológicos , Humanos , Inibição Psicológica , Modelos Lineares , Masculino , Memória/efeitos dos fármacos , Memória/fisiologia , Testes Neuropsicológicos , Fatores SexuaisRESUMO
BACKGROUND: Children of workers exposed to pesticides are at risk of secondary pesticide exposure. We evaluated the potential for lower acetylcholinesterase activity in children cohabiting with fresh-cut flower plantation workers, which would be expected from organophosphate and carbamate insecticide exposure. Parental home surveys were performed and acetylcholinesterase activity was measured in 277 children aged 4-9 years in the Secondary Exposure to Pesticides among Infants, Children and Adolescents (ESPINA) study. Participants lived in a rural county in Ecuador with substantial flower plantation activity. RESULTS: Mean acetylcholinesterase activity was 3.14 U/ml, standard deviation (SD) of 0.49. It was lower by 0.09 U/ml (95% confidence interval (CI) -0.19, -0.001) in children of flower workers (57% of participants) than non-flower workers' children, after adjustment for gender, age, height-for-age, hemoglobin concentration, income, pesticide use within household lot, pesticide use by contiguous neighbors, examination date and residence distance to nearest flower plantation. Using a 4 level polychotomous acetylcholinesterase activity dependent variable, flower worker cohabitation (vs. not) had odds ratio 3.39 (95% CI 1.19, 9.64) for being <15th percentile compared to the highest tertile. Children cohabitating for ≥5 years (vs. never) had OR of 4.11 (95% CI: 1.17, 14.38) of AChE activity within <15th percentile compared to the highest tertile. CONCLUSIONS: Cohabitation with a flower worker was related to lower acetylcholinesterase activity in children. This supports the hypothesis that the amount of take-home pesticides from flower workers suffices to decrease acetylcholinesterase activity, with lower activity associated with longer exposure.
Assuntos
Acetilcolinesterase/sangue , Exposição Ambiental , Inseticidas/efeitos adversos , Exposição Ocupacional , Carbamatos/efeitos adversos , Criança , Pré-Escolar , Equador , Feminino , Flores , Humanos , Masculino , Razão de Chances , Organofosfatos/efeitos adversos , Fatores de TempoRESUMO
Correlational studies have shown associations between social class and salivary cortisol suggestive of a causal link between childhood poverty and activity of the stress-sensitive hypothalamic-pituitary-adrenocortical (HPA) system. Using a quasi-experimental design, we evaluated the associations between a family's participation in a large-scale, conditional cash transfer program in Mexico (Oportunidades, formerly Progresa) during the child's early years of life and children's salivary cortisol (baseline and responsivity). We also examined whether maternal depressive symptoms moderated the effect of program participation. Low-income households (income <20th percentile nationally) from rural Mexico were enrolled in a large-scale poverty-alleviation program between 1998 and 1999. A comparison group of households from demographically similar communities was recruited in 2003. Following 3.5 years of participation in the Oportunidades program, three saliva samples were obtained from children aged 2-6 years from intervention and comparison households (n=1197). Maternal depressive symptoms were obtained using the Center for Epidemiologic Studies-Depression Scale (CES-D). Results were that children who had been in the Oportunidades program had lower salivary cortisol levels when compared with those who had not participated in the program, while controlling for a wide range of individual-, household- and community-level variables. Reactivity patterns of salivary cortisol did not differ between intervention and comparison children. Maternal depression moderated the association between Oportunidades program participation and baseline salivary cortisol in children. Specifically, there was a large and significant Oportunidades program effect of lowering cortisol in children of mothers with high depressive symptoms but not in children of mothers with low depressive symptomatology. These findings provide the strongest evidence to date that the economic circumstances of a family can influence a child's developing stress system and provide a mechanism through which poverty early in life could alter life-course risk for physical and mental health disorders.
Assuntos
Participação da Comunidade , Hidrocortisona/análise , Pobreza/prevenção & controle , Saliva , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Entrevistas como Assunto , Masculino , México , Pobreza/psicologia , População Rural , Estresse Psicológico/fisiopatologiaRESUMO
Children (N = 324 boys, 315 girls) between the ages of 2.5 and 6 (mean age = 3.63) were identified in a house to house survey in low-income areas (income <20th percentile nationally) of urban Mexico. The Center for Epidemiologic Studies-Depression Scale was administered to mothers of all children. Salivary cortisol samples were taken in children as a measure of hypothalamic-pituitary-adrenocortical (HPA) system activity at time of arrival (baseline, Time 0), 25 min after arrival (Time 1), and 50 min after arrival (Time 2). Between Time 0 and Time 1, children were administered several cognitive tests. Results of hierarchical linear modeling analyses revealed that higher levels of maternal depressive symptoms were associated with lower baseline cortisol levels in their children (p < .05), while controlling for age, gender, and time since awakening. Higher levels of maternal depressive symptoms were associated with less of an increase in salivary cortisol to the arrival of the experimenters and subsequent cognitive testing (p < .05). All results were moderated by gender, with enhanced cortisol response in girls and no response in boys. These results suggest that among very low-income families, high maternal depressive symptoms are associated with hypoactivity of the HPA system in children, particularly boys.
Assuntos
Nível de Alerta/fisiologia , Filho de Pais com Deficiência/psicologia , Transtorno Depressivo/psicologia , Hidrocortisona/sangue , Mães/psicologia , Desenvolvimento da Personalidade , Pobreza/psicologia , População Urbana , Pré-Escolar , Transtorno Depressivo/sangue , Feminino , Inquéritos Epidemiológicos , Humanos , Sistema Hipotálamo-Hipofisário/fisiopatologia , Testes de Linguagem , Masculino , Comportamento Materno , México , Testes Neuropsicológicos , Apego ao Objeto , Determinação da Personalidade , Sistema Hipófise-Suprarrenal/fisiopatologia , Fatores de Risco , Saliva/química , Fatores SexuaisRESUMO
OBJECTIVES: To conduct the first population-based surveillance in the United States of parents who adopted children from countries outside of the United States. METHODS: A 556-item survey was mailed to 2,977 parents who finalized an international adoption in Minnesota between January 1990 and December 1998; 1,834 (62%) parents returned a survey. RESULTS: Eighty-eight percent of the parents reported transracial adoptions (97% of the parents were white); 57% of the adopted children were Asian; 60% were female; and on average, the children were 18 months-old at the time of placement. Only 15% of the parents reported household annual incomes less than $50,000 and 71% reported they had college educations. Sixty-one percent traveled to their child's country of birth prior to the adoption. Almost three-quarters involved their children in experiences related to their birth countries and 98% would recommend international adoption. Three-quarters of the parents believe that parental leave was an issue for them as they adopted. CONCLUSIONS: This is the first population-based survey of U.S. parents who have adopted internationally. The adoptive parents were socioeconomically different than birth parents in Minnesota and their families are most likely to be transracial. Because international adoption has become more prevalent, it is important to understand the strengths and needs of families that are created through this unique form of migration.