RESUMO
Os problemas emocionais e comportamentais infantis têm sido alvo de crescente investigação devido a sua alta estabilidade e por precederem os transtornos psicopatológicos na vida adulta. Esse estudo objetivou investigar o papel mediador do vínculo de apego na relação entre práticas parentais e problemas externalizantes (agressividade/delinquência) e internalizantes (retraimento social/ansiedade/depres-são). Um total de 289 crianças (M = 10,5 anos, DP = 0,77) responderam à Security Scale e 181 mães responderam ao Child Rearing Practices ReportQ e, também, ao ChildBehavior Checklist. Os resultados revelaram o papel mediador do vínculo de apego materno nosproblemas externalizantes, mas não nos internalizantes, e salientam a importância de se considerar aqualidade do apego nas relações entre práticas parentais e problemas emocionais e comportamentaisna infância(AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Apego ao Objeto , Poder Familiar/psicologiaRESUMO
The role of various physical and lifestyle factors in determining axial bone mineral density (BMD) at the lumbar segment of the spine, as measured by dual-photon absorptiometry, and peripheral BMD at the distal third of the radius, as measured by single-photon absorptiometry, was assessed in 299 healthy white children of both sexes, aged 6 to 18 years. The BMD measurements were correlated with age, height, weight, body mass index, and pubertal status. Peripheral and axial BMD were highly correlated with age, height, weight, and pubertal stage, and more weakly with body mass index. Approximately 76% of the observed changes in peripheral BMD were accounted for by age, height, weight, and pubertal stage, with weight being the single strongest predictor. Up to 80% of the variation in axial BMD was explained by weight and pubertal stage, with pubertal stage being the strongest single predictor. After adjustment for weight, the effect of puberty on axial BMD in both sexes was greatest between middle and late puberty. These data indicate that a large amount of the observed changes on BMD is accounted for by standard measures of growth and development, which are largely genetically determined. Peripheral BMD rose steadily with age. Axial BMD increased steadily before puberty, followed by accelerated increases during puberty, beginning at 10 years of age in girls and 13 years of age in boys. A significant positive effect of dietary calcium intake on peripheral BMD and of physical activity on axial BMD indicated a potentially important impact of physical activity and calcium intake on peak bone mass.
Assuntos
Densidade Óssea , Puberdade/fisiologia , Adolescente , Antropometria , Densidade Óssea/fisiologia , Cálcio da Dieta , Criança , Feminino , Humanos , Vértebras Lombares , Masculino , Rádio (Anatomia) , Valores de ReferênciaRESUMO
To determine whether the insulin resistance in patients with Turner syndrome, which may be exaggerated by treatment with human growth hormone, leads to excessive insulin secretion, we applied the hyperglycemic glucose-clamp technique to produce a standard hyperglycemic stimulus (6.9 mmol/L, or 125 mg/dl, greater than fasting plasma glucose level for 120 minutes) in seven patients with Turner syndrome and in seven healthy children. These studies were repeated in the patients after 6 to 12 months of therapy with growth hormone. Fasting plasma levels of insulin were comparable in control subjects and patients before therapy but increased significantly in the patients after 6 to 12 months of treatment with growth hormone. Despite identical glucose increments in the two groups during the glucose-clamp procedure, both first- and second-phase insulin responses were significantly greater in the patients than in the control subjects. Moreover, the hyperinsulinemic responses to glucose were markedly exaggerated in the patients after their treatment with growth hormone, reaching values (first phase 474 +/- 100 pmol and second phase 826 +/- 100 pmol; p less than 0.02 vs pretreatment values) that were almost threefold greater than those in control subjects (p less than 0.001). Nevertheless, the rate of insulin-stimulated glucose metabolism during the last 60 minutes of the clamp procedure was similar in all three groups of studies. Glycosylated hemoglobin, total cholesterol level, and blood pressure remained normal in patients after therapy with growth hormone. We conclude that glucose-stimulated insulin response is increased in patients with Turner syndrome and that these alterations are further exaggerated by treatment with growth hormone. These hyperinsulinemic responses appear to compensate for reductions in insulin sensitivity.