Changes in Athletic Performance in Children Attending a Secondary School with a Physical Activity Profile.

The longitudinal and multidisciplinary research project Malmö Youth Sport Study measured the sports results achieved by two cohorts of pupils using a variable named ACHIEVE, dividing the pupils into three categories (an elite group competing at the national or international level, a group competing at the district level, and a third group either not competing at all or below district level). This was assessed three and six years after baseline at age 13. An additional hypothetical measure, based on information from the athletes' trainers, predicted the category the pupils were expected to belong to after twelve years (age 25). Social variables related to the ACHIEVE variable are sex, socio-economic position of the parents, ethnicity, completed secondary sports school, sports capital, and quartile of birth. After three years, 28% of the pupils belonged to the elite group and after six years, 26%. Thirty-two and 48%, respectively, had abandoned their elite efforts. The elite group remained fairly stable over time but fewer girls than boys advanced to the elite group. The pupils at the school have a homogenous middle-class background. We found little evidence that socio-economic factors affected ACHIEVE. Nearly all parents had been engaged in sports, either competing or as coaches. On admission to the school, there was a pronounced relative age effect (RAE). This remained after three years as the age was significantly different between the three groups but was reduced after six years. According to the prognosis made by the coaches, the elite group would be considerably smaller when the subjects reached the age of 25. The RAE was again significant in the prognosis. A further follow-up when the subjects are 25 years old will reveal not only what proportion of subjects are actively competing, but also if they are engaged in recreational sports, to what extent the RAE is present, and how accurately coaches can predict success.

Physical activity spectrum discriminant analysis-A method to compare detailed patterns between groups.

Investigating physical activity (PA) patterns as a detailed intensity spectrum instead of crude intensity categories have improved the ability to analyze the relationship between measured PA and health variables. The aim of this methodological study was to introduce and investigate the utility of using detailed PA intensity spectrum compared to crude PA intensity categories for comparison of PA between groups and between repeated measures. The study sample consisted of two groups of children, where one group was scheduled for extended physical education (PE) by daily classes while the other group followed usual PE schedule. Accelerometer data was processed into traditional crude PA intensity categories and into detailed PA intensity spectrum. Multivariate partial least squares regression for discriminant analysis (PLS-DA) was applied for PA intensity spectrum group comparison and compared to traditional univariate statistical analysis. Repeated measures were investigated using independent PLS-DA as well as multilevel PLS-DA for paired analysis. While traditional analysis of crude PA intensity categories was unable to find any group differences, multivariate analysis of the PA intensity spectrum identified statistically significant differences. By the extension of multilevel PLS-DA for paired comparison, a clear difference in the PA intensity spectrum was demonstrated between repeated measures. In conclusion, analysis of detailed PA intensity spectrum demonstrates utility for comparing detailed PA data between groups and between repeated measures in interventional and observational research.

Lung function is associated with tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) levels in school-aged children.

BACKGROUND: Tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) is a cytokine with inflammatory and apoptotic properties. A complex relationship exists between TRAIL and the lung where both elevated TRAIL and TRAIL deficiency are associated with lung impairment. In neonatal mice, TRAIL is thought to translate respiratory infections into chronic lung disease but the association between TRAIL and lung function in childhood has not been assessed. AIM: To assess the cross-sectional relationship between TRAIL levels and lung function in school-aged children. METHODS: The study cohort consisted of 170 school-aged children attending four schools in Malmö, Sweden. Lung volumes, impulse oscillometry (IOS) and serum TRAIL were measured for all children. Linear regression was used to assess changes in lung function per 1-SD increase in TRAIL. General linear models were used to assess mean lung function by tertiles (T) of TRAIL. RESULTS: Mean age was 9.9 years (±0.6). A 1-SD increase in TRAIL was associated with lower values of FEV1 and FEV1/VC (change in FEV1 (L) and FEV1/VC ratio: -0.047, p-value 0.002, and -0.011, p-value 0.020, respectively) and higher values of lung resistance (change in R5 and R20 (kPa/(L/s)): 0.035, p-value <0.001 and 0.027, p-value 0.004, respectively). These associations remained significant after excluding children with pre-existing lung disease. Higher TRAIL levels were associated with more negative values for X5 in general linear models (Mean X5 (kPa/(L/s)) in T1 (low TRAIL): -0.193 vs T3 (high TRAIL): -0.216, p-value 0.026). CONCLUSIONS: High TRAIL levels are significantly associated with markers of pulmonary airflow obstruction in school-aged children.

Automated Bone Scan Index as an Imaging Biomarker to Predict Overall Survival in the Zometa European Study/SPCG11.

BACKGROUND: Owing to the large variation in treatment response among patients with high-risk prostate cancer, it would be of value to use objective tools to monitor the status of bone metastases during clinical trials. Automated Bone Scan Index (aBSI) based on artificial intelligence has been proposed as an imaging biomarker for the quantification of skeletal metastases from bone scintigraphy. OBJECTIVE: To investigate how an increase in aBSI during treatment may predict clinical outcome in a randomised controlled clinical trial including patients with high-risk prostate cancer. DESIGN, SETTING, AND PARTICIPANTS: We retrospectively selected all patients from the Zometa European Study (ZEUS)/SPCG11 study with image data of sufficient quality to allow for aBSI assessment at baseline and at 48-mo follow-up. Data on aBSI were obtained using EXINIboneBSI software, blinded for clinical data and randomisation of zoledronic acid treatment. Data on age, overall survival (OS), and prostate-specific antigen (PSA) at baseline and upon follow-up were available from the study database. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Association between clinical parameters and aBSI increase during treatment was evaluated using Cox proportional-hazards regression models, Kaplan-Meier estimates, and log-rank test. Discrimination between prognostic variables was assessed using the concordance index (C-index). RESULTS AND LIMITATIONS: In this cohort, 176 patients with bone metastases and a change in aBSI from baseline to follow-up of ≤0.3 had a significantly longer median survival time than patients with an aBSI change of >0.3 (p<0.0001). The increase in aBSI was significantly associated with OS (p<0.01 and C-index=0.65), while age and PSA change were not. CONCLUSIONS: The aBSI used as an objective imaging biomarker predicted outcome in prostate cancer patients in the ZEUS/SPCG11 study. An analysis of the change in aBSI from baseline to 48-mo follow-up represents a valuable tool for prognostication and monitoring of prostate cancer patients with bone metastases. PATIENT SUMMARY: The increase in the burden of skeletal metastases, as measured by the automated Bone Scan Index (aBSI), during treatment was associated with overall survival in patients from the Zometa European Study/SPCG11 study. The aBSI may be a useful tool also in monitoring prostate cancer patients with newly developed bone metastases.

Relative Age Effect of Sport Academy Adolescents, a Physiological Evaluation.

The relationship between birth quarter distribution and physiological characteristics related to athletic skills, in adolescent sport academy students has not been fully investigated. In a cross-sectional study, we recruited 86 boys and 52 girls aged 12-14 years during their first term at a sport academy school. We measured body size, cardiac size, pulmonary function, body composition, lower body power, cardiorespiratory fitness parameters, and running endurance by standard methods and analyzed these estimates in relation to birth quarter by ANOVA. Birth quarter distribution in our cohort was compared with birth quarter distribution in the same ages in the whole of Sweden and analyzed by logistic regression. The academy had an overrepresentation of students born in the first quartile of the year compared to those born in the last quartile (odds ratio 2.3 (95% CI: 1.1-4.7)). When comparing the physiological characteristics between birth quarters, uniformity is prominent since out of 26 performed physiological and anthropometric tests only four showed statistically significant group differences. We thus believe that the selection process to the sport academy favours athletes with higher chronological age, i.e., a so-called relative age effect is present.

A Longitudinal Analysis of the Relationships of Physical Activity and Body Fat With Nerve Growth Factor and Brain-Derived Neural Factor in Children.

BACKGROUND: Nerve growth factor (NGF) and brain-derived neural factor (BDNF) are important for brain function and detectable in the blood. This study explored the longitudinal associations of physical activity and body fat with serum NGF and BDNF in children. METHODS: Two waves of measurements were performed 2 years apart in 8- to 11-year-old children, including physical activity using the ActiGraph model 7164, body composition by dual-energy X-ray absorptiometry, and serum NGF and BDNF determined by multiplex immunoassay. The first wave included 248 children. Full information maximum likelihood estimation with robust standard errors was applied in structural equation modeling. RESULTS: Vigorous physical activity showed a direct positive longitudinal relationship with NGF (standardized coefficient ß = 0.30, P = .01) but not with BDNF (ß = 0.04, P = .84). At the same time, body fat percentage was positively related to both NGF (ß = 0.59, P < .001) and BDNF (ß = 0.17, P = .04). There was an indication of an indirect relationship of vigorous physical activity with NGF (product of unstandardized coefficient ß = -0.18, P = .02) and BDNF (ß = -0.07, P = .05) through the negative relationship with body fat percentage (ß = -0.36, P < .001). CONCLUSIONS: Vigorous physical activity is directly related to serum NGF and indirectly through the level of body fat. The relationships with serum BDNF are more complex.

School-based study found that physical activity and aerobic fitness predicted increases in total body fat and abdominal fat at a mean age of 9.8 years.

AIM: We assessed whether baseline measurements of physical activity, aerobic fitness, body fat and abdominal fat were predictors of changes in body fat measurements over a two-year period. METHODS: The study comprised of 204 children aged 9.8 ± 0.6 years with a normal body mass distribution, who recruited from four schools in middle-class areas of Malmö, Sweden, from 2001 to 2004. Peak oxygen uptake and physical activity were measured at baseline. Body fat was measured by dual-energy X-ray absorptiometry at baseline and two years later. RESULTS: Physical activity, aerobic fitness and total body fat or abdominal fat were predictors of change in total body fat or abdominal fat over a period of two years. Changes in the percentage of body fat were not related to any of the baseline measurements. CONCLUSION: Our two-year follow-up of children with a mean age of 9.8 years at baseline showed that physical activity, aerobic fitness and body fat or abdominal fat predicted changes in total body fat or abdominal fat, but not the percentage of body fat.

Galectin-3 levels relate in children to total body fat, abdominal fat, body fat distribution, and cardiac size.

Galectin-3 has recently been proposed as a novel biomarker for cardiovascular disease in adults. The purpose of this investigation was to assess relationships between galectin-3 levels and total body fat, abdominal fat, body fat distribution, aerobic fitness, blood pressure, left ventricular mass, left atrial size, and increase in body fat over a 2-year period in a population-based sample of children. Our study included 170 children aged 8-11 years. Total fat mass and abdominal fat were measured by dual-energy x-ray absorptiometry (DXA). Body fat distribution was expressed as abdominal fat/total fat mass. Maximal oxygen uptake was assessed by indirect calorimetry during a maximal exercise test and scaled to body mass. Systolic and diastolic blood pressure and pulse pressure were measured. Left atrial size, left ventricular mass, and relative wall thickness were measured by echocardiography. Frozen serum samples were analyzed for galectin-3 by the Proximity Extension Assay technique. A follow-up DXA scan was performed in 152 children 2 years after the baseline exam. Partial correlations, with adjustment for sex and age, between galectin-3 versus body fat measurements indicated weak to moderate relationships. Moreover, left atrial size, left ventricular mass, and relative wall thickness and pulse pressure were also correlated with galectin-3. Neither systolic blood pressure nor maximal oxygen uptake was correlated with galectin-3. There was also a correlation between galectin-3 and increase in total body fat over 2 years, while no such correlations were found for the other fat measurements. CONCLUSION: More body fat and abdominal fat, more abdominal body fat distribution, more left ventricular mass, and increased left atrial size were all associated with higher levels of galectin-3. Increase in total body fat over 2 years was also associated with higher levels of galectin-3. What is Known: • Galectin-3 has been linked to obesity and been proposed to be a novel biomarker for cardiovascular disease in adults. • Information on this subject in children is very scarce. What is New: • The present study demonstrates a relationship between galectin-3 levels and total body fat, abdominal fat, body fat distribution, cardiac size and geometry, and increase in total body fat over 2 years in young children.

Cognitive abnormalities and cerebral perfusion defects in a community-dwelling cohort of elderly men with MMSE within the normal range.

OBJECTIVES: Mini Mental State Examination's (MMSE's) sensitivity in its upper level is questioned, hence we investigated cognitive abnormalities and defects in regional cerebral blood flow (rCBF) in elderly with MMSE scores ≥24. METHODS: One hundred and four men at age 81 with MMSE scores ≥24 (mean 28.4 ± 1.7), no dementia or stroke, were examined with neuropsychological test battery, and their rCBF was estimated using 99mTc-HMPAO SPECT. RESULTS: MMSE was very sparsely correlated with rCBF. Instead, visuo-spatial tests were correlated with rCBF in parietal and occipital lobe, verbal tests with rCBF in frontal and temporal-parietal lobes, and most of all between Digit Symbol and all rCBF regions, especially in subcortical gray and white matter. In a cluster of low achievers, test of Synonyms, followed by Digit Symbol and Benton test, had highest discriminatory importance. Low achievers had generalized rCBF changes especially in subcortical areas. Only lower scores on two MMSE items, figure drawing and calculation, could discriminate the clusters. CONCLUSION: A substantial number of octogenarian men with MMSE ≥ 24p have widespread rCBF changes corresponding to a decreased speeded performance and verbal capacity.

Cystatin B, cathepsin L and D related to surrogate markers for cardiovascular disease in children.

OBJECTIVE: This study investigated potential associations between novel biomarkers for cardiovascular disease and other surrogate markers for health. METHODS: Community sample of 170 (92 boys and 78 girls) children aged 8-11 years. Total fat mass (TBF) and abdominal fat (AFM) were measured by Dual-energy x-ray absorptiometry (DXA). Total body fat was also expressed as percentage of total body mass (BF%), and body fat distribution was calculated as AFM/TBF. Maximal oxygen uptake (VO2PEAK), systolic and diastolic blood pressure (SBP and DBP) and pulse pressure (PP) were measured. Echocardiography was performed. Left atrial size (LA) and left ventricular mass (LVM) were measured. A follow-up DXA scan was available in 152 children (84 boys and 68 girls). Frozen serum samples were analyzed for cystatin B, cathepsin L and cathepsin D. RESULTS: Partial correlations between cystatin B versus lnTBF, lnBF%, lnAFM, AFM/TBF, VO2PEAK and PP were; r = 0.38, 0.36, 0.38, 0.29, -0.25 and 0.25, P = 0.001 or less for all. Weaker predominantly non-significant correlations were found for cathepsin L, whereas cathepsin D was not related to any surrogate markers for health. No significant correlations were found between biomarkers and change in body fat over 2 years. CONCLUSION: Findings from this community-based cohort of young children show that surrogate markers for cardiovascular disease such as total fat mass, percent body fat, abdominal fat, body fat distribution, maximal oxygen uptake and pulse pressure were all associated with cystatin B. This was not found for cathepsin L or cathepsin D.

Total body fat, abdominal fat, body fat distribution and surrogate markers for health related to adipocyte fatty acid-binding protein (FABP4) in children.

BACKGROUND: The aim of the study was to assess possible relationships between adipocyte fatty acid-binding protein (FABP4) and total body fat (TBF), abdominal fat, body fat distribution, aerobic fitness, blood pressure, cardiac dimensions and the increase in body fat over 2 years in a community sample of children. METHODS: A cross-sectional study was used in a community sample of 170 (92 boys and 78 girls) children aged 8-11 years. TBF and abdominal fat (AFM) were measured by dual-energy X-ray absorptiometry (DXA). TBF was also expressed as percentage of total body mass (BF%), and body fat distribution was calculated as AFM/TBF. Maximal oxygen uptake (VO2PEAK) was assessed by indirect calorimetry during a maximal exercise test and scaled to body mass. Systolic and diastolic blood pressure (SBP and DBP) and pulse pressure (PP) were measured. Echocardiography was performed. Left atrial (LA) size was measured, and left ventricular mass (LVM) was calculated. A follow-up DXA scan was available in 152 children (84 boys and 68 girls). Frozen serum samples were analyzed for FABP4. RESULTS: Partial correlations, with adjustment for sex, between FABP4 vs. ln TBF, ln BF%, ln AFM, AFM/TBF and VO2PEAK were (r=0.69, 0.68, 0.69, 0.49 and -0.39, p<0.05 for all). Moreover, SBP, PP, LVM and LA were also weakly correlated with FABP4 (r=0.23, 0.22, 0.28 and 0.21, p<0.05 for all). Correlations between FABP4 vs. increase in TBF and AFM over 2 years were 0.29 and 0.26, p<0.05, for both. (Increase in percent body fat or change in fat distribution were not correlated.) Conclusions: Findings from this community-based cohort of young children show that increased body fat and abdominal fat, more abdominal body fat distribution, low fitness, more LVM and increased LA, increased SBP and PP were all associated with increased levels of FABP4. Increase in TBF and abdominal fat over 2 years were also associated with increased levels of FABP4.

Correlation between physical activity, aerobic fitness and body fat against autonomic function profile in children.

AIM: To evaluate correlations between physical activity, VO2PEAK and body fat versus autonomic function in children. METHODS: Children (n = 98) between 10 and 12 years underwent a maximal exercise test (VO2PEAK) and dual-energy X-ray absorptiometry measured body fat. General physical activity, moderate to vigorous physical activity and vigorous physical activity were assessed by accelerometers. Deep breath test with E/I-ratio calculation and a head-up tilt test were performed. The sum of z-scores represented an index score for autonomic function profile and included E/I-ratio plus difference in blood pressure and heart rate between supine and tilted position. Correlation analyses were performed between physical activity parameters, body fat and VO2PEAK versus autonomic function profile. RESULTS: No significant correlations were found between autonomic function profile and physical activity or body fat (p > 0.05). VO2PEAK was correlated with autonomic function profile in boys (r = 0.30, p < 0.05), but not in girls (r = 0.04, NS). One girl and eight boys terminated head-up tilt test prematurely due to intolerance. Minutes of vigorous physical activity per day was lower in these boys compared with those (n = 48) who completed the head-up tilt test (5.1 ± 3.3 vs. 10.4 ± 6.6, p < 0.05). CONCLUSION: Physical activity or body fat was not associated with autonomic function profile. VO2PEAK correlated to autonomic function profile in boys.

Clinical value of wireless pH-monitoring of gastro-esophageal reflux in children before and after proton pump inhibitors.

BACKGROUND: Wireless pH-monitoring is an accurate method for diagnosing adults with gastroesophageal reflux disease (GERD). The aim of this study was to evaluate the use of the Bravo capsule on children investigated for GERD in terms of safety, tolerability and feasibility before and after administration of proton pump inhibitors. METHODS: A Bravo capsule was inserted during upper endoscopy under general anaesthesia or deep sedation with propofol. 48-hour pH-metry was performed in 106 children (50 males, 56 females) at the median age of 11 years (range 17 months-18 years). On the second day of investigation, proton pump inhibitor (PPI) was given at a mean dose of 1.6 mg/kg (SD ±0.6 mg). The definition of GERD was set to a reflux index (RI) of ≥5% and DeMeester score (DMS) ≥14.7. RESULTS: Application of the capsule was successful in 103 of the 106 children (97.2%) and interpretable in 99 of these 103 (96.1%). 49 of the children with interpretable results (49.5%) had GERD according to RI, while 51 (56.7%) had GERD according to DMS. After PPI was given on day 2, RI decreased from a median of 4.9% (range 0.3-63.4%) to 2.2% (0-58.0%), while DMS decreased from a median of 17.6 (range 2.2-207.6) to 8.2 (0.3-178.6), respectively (p < 0.0001). No severe adverse events were reported. CONCLUSION: Wireless pH-metry is a safe and tolerable method when investigating children for GERD. PPI given on the second day of assessment provides additional information on response to treatment suggesting that pH-metry preferably should be extended to 48 hours.

New routine for nuclear medicine technologists to determine when to add SPECT/CT to a whole-body bone scan.

UNLABELLED: Bone scintigraphy is usually obtained as a whole-body scan producing 2 images: an anterior view and a posterior view. Sometimes abnormal findings in the spine are difficult to distinguish on whole-body bone scans. SPECT/CT may be performed to localize and interpret a lesion correctly and to help differentiate between benign and metastatic lesions. The assessment of whether SPECT/CT is needed is usually made by a physician. The aim of this study was to evaluate our new routine for nuclear medicine technologists to determine when to add SPECT/CT to whole-body bone scintigraphy. METHODS: A 3-part educational course was developed for the nuclear medicine technologists. The first part was to learn criteria for when SPECT/CT should be added to a whole-body bone scan. The second part was to review a selection of training whole-body bone scans illustrating the criteria. The third part was to pass a test of whether whole-body bone scans should be supplemented by SPECT/CT. RESULTS: The nuclear medicine technologists and the physicians agreed that SPECT/CT was required in 63 cases and not required in 27 cases. The resulting percentage agreement was 90%, and the κ value was 0.77. There was disagreement in 10 cases. In 6 of these cases only the nuclear medicine technologists wanted to add SPECT/CT, and in 4 of these cases only the physicians wanted to add SPECT/CT. CONCLUSION: After participating in the training course developed in this project, the nuclear medicine technologists were able to decide whether a SPECT/CT study is needed. An implication of this result is that the effectiveness of the nuclear medicine department should be improved after our new routine is implemented. The successful outcome of this project may stimulate departments to take on similar quality-improvement projects in the future.

Posterior laryngitis: a disease with different aetiologies affecting health-related quality of life: a prospective case-control study.

BACKGROUND: Laryngo-pharyngeal reflux (LPR) is assumed to be the most common cause of posterior laryngitis (PL). Since LPR is found in healthy subjects, and PL patients are not improved by acid-reducing therapy, other aetiologies to PL must be considered. The aims of this study in PL were to investigate the prevalence of acid reflux in the proximal oesophagus and functional gastrointestinal symptoms, to analyse motilin levels in plasma, and to assess health-related quality of life (HRQOL) before and after treatment. METHODS: Forty-six patients (26 women), with verified PL, median age 55 (IQR 41-68) years, were referred to oesophago-gastro-duodenoscopy and 24-h pH monitoring. Plasma motilin was analysed. The 36-item Short-Form questionnaire was completed at inclusion and at follow-up after 43±14 months, when also the Visual Analogue Scale for Irritable Bowel Syndrome was completed. Values were compared to controls. Treatment and relief of symptoms were noted from medical records. RESULTS: Thirty-four percent had proximal acid reflux and 40% showed signs of distal reflux. Ninety-four percent received acid-reducing treatment, with total relief of symptoms in 17%. Patients with reflux symptoms had lower plasma motilin levels compared to patients without reflux symptoms (p = 0.021). The HRQOL was impaired at inclusion, but improved over time. Patients, especially men, had more functional gastrointestinal symptoms than controls. CONCLUSIONS: This study indicates that a minority of patients with PL has LPR and is cured by acid-reducing therapy. Disturbed plasma motilin levels and presence of functional gastrointestinal symptoms are found in PL. The impaired HRQOL improves over time.

Tracking of physical activity with accelerometers over a 2-year time period.

BACKGROUND: Limited data exist of tracking and changes in accelerometer-measured physical activity in children. METHODS: Physical activity was assessed by accelerometers for 4 days in 167 children (boys, n = 90; girls n = 77) age 9.8 ± 0.6 years. Follow-up measurement was made 2.0 ± 0.1 yrs later (range 1.9-2.1 yrs). General physical activity (GPA) was defined as mean count/minute. Minutes of inactivity; light, moderate, and vigorous physical activity (LMVPA); moderate and vigorous physical activity (MVPA); and vigorous physical activity (VPA) per day were calculated both as absolute values and as percentage of total registration time. RESULTS: Spearman rank order correlation indicated low tracking of MVPA and VPA in girls (r = .25-0.33, P < .05), and low-moderate tracking of GPA, inactivity, LMVPA, MVPA and VPA in boys (r = .23-0.40, P < .05). Time in inactivity increased at follow-up by 5%-14%. Most of the assessed physical activity variables were decreased at follow-up by 6% to 30%. CONCLUSIONS: Physical activity tracks at a low-moderate degree from age 10-12 years, which confirm previous investigations that have used self-report assessments. The low-moderate tracking of physical activity variables indicate that those who were most active initially remained most active. Increasing inactive behavior was observed and that several other physical activity variables were decreased at follow-up.

Evaluation of image reconstruction methods for (123)I-MIBG-SPECT: a rank-order study.

BACKGROUND: There is an opportunity to improve the image quality and lesion detectability in single photon emission computed tomography (SPECT) by choosing an appropriate reconstruction method and optimal parameters for the reconstruction. PURPOSE: To optimize the use of the Flash 3D reconstruction algorithm in terms of equivalent iteration (EI) number (number of subsets times the number of iterations) and to compare with two recently developed reconstruction algorithms ReSPECT and orthogonal polynomial expansion on disc (OPED) for application on (123)I-metaiodobenzylguanidine (MIBG)-SPECT. MATERIAL AND METHODS: Eleven adult patients underwent SPECT 4 h and 14 patients 24 h after injection of approximately 200 MBq (123)I-MIBG using a Siemens Symbia T6 SPECT/CT. Images were reconstructed from raw data using the Flash 3D algorithm at eight different EI numbers. The images were ranked by three experienced nuclear medicine physicians according to their overall impression of the image quality. The obtained optimal images were then compared in one further visual comparison with images reconstructed using the ReSPECT and OPED algorithms. RESULTS: The optimal EI number for Flash 3D was determined to be 32 for acquisition 4 h and 24 h after injection. The average rank order (best first) for the different reconstructions for acquisition after 4 h was: Flash 3D(32) > ReSPECT > Flash 3D(64) > OPED, and after 24 h: Flash 3D(16) > ReSPECT > Flash 3D(32) > OPED. A fair level of inter-observer agreement concerning optimal EI number and reconstruction algorithm was obtained, which may be explained by the different individual preferences of what is appropriate image quality. CONCLUSION: Using Siemens Symbia T6 SPECT/CT and specified acquisition parameters, Flash 3D(32) (4 h) and Flash 3D(16) (24 h), followed by ReSPECT, were assessed to be the preferable reconstruction algorithms in visual assessment of (123)I-MIBG images.

Body fat, abdominal fat and body fat distribution related to cardiovascular risk factors in prepubertal children.

AIM: We analysed whether total body fat (TBF), abdominal fat and body fat distribution are associated with higher composite risk factor scores for cardiovascular disease (CVD) in young children. METHODS: Cross-sectional study of 238 children aged 8-11 years. TBF and abdominal fat mass (AFM) were measured by Dual-Energy X-Ray Absorptiometry. TBF was expressed as a percentage of body weight (BF%). Body fat distribution was calculated as AFM/TBF. Maximal oxygen uptake (VO(2PEAK) ), systolic and diastolic blood pressure (SBP, DBP), and resting heart rate (RHR) were measured. Mean arterial pressure (MAP) and pulse pressure (PP) were calculated. Left atrial diameter (LA) was measured, and left ventricular mass (LVM) and relative wall thickness (RWT) were calculated. Z-scores were calculated. Sum of z-scores for SBP, DBP, MAP, PP, RHR, LVM, LA, RWT and -VO(2PEAK) was calculated in boys and girls, separately, and used as composite risk factor score. RESULTS: Pearson correlations between ln BF%, ln AFM and AFM/TBF versus composite risk factor score for boys were r = 0.56, r = 0.59 and r = 0.48, all p < 0.001, and for girls r = 0.45, r = 0.50 and r = 0.48, all p < 0.001. CONCLUSION: Total body fat, abdominal fat and body fat distribution were all associated with higher composite risk factor scores for CVD in young children.

Body fat, abdominal fat, and body fat distribution is related to left atrial diameter in young children.

In adults, the size of the left atria (LA) has important prognostic information. In obese adults, adolescents and children enlargement of LA have been observed. This has not been investigated on a population-based level in young children. We therefore assessed if total body fat mass (TBF), abdominal fat, and body fat distribution were related to LA diameter. Cross-sectional study of 244 children (boys = 137 and girls n = 107) aged 8-11 years, recruited from an urban population-based cohort. Dual-energy X-ray absorptiometry (DXA) measured total lean body mass, TBF, and abdominal fat mass (AFM). Body fat was also calculated as a percentage of body mass (BF%). Body fat distribution (AFM/TBF) was calculated. Echocardiography was performed with two-dimensional guided M-mode. LA diameter was measured and left ventricular mass (LVM) was calculated. Systolic blood pressure and diastolic blood pressure were measured and maturity assessed according to Tanner. There were significant (P < 0.05) univariate correlations for all children between TBF (r = 0.40), BF% (r = 0.32), AFM (r = 0.41), and AFM/TBF (r = 0.41) vs. LA diameter. Multiple regression analyses with the inclusion of possible confounders such as lean body mass, blood pressure, gender, age, and Tanner stage revealed that TBF, AFM, and AFM/TBF were all independently related to LA diameter. Differences in the different body fat measurements explained 6-9% of the variance in LA size. These results demonstrated that both total body fat, AFM, and body fat distribution are already at a young age negatively and independently associated to LA diameter.

Aerobic fitness related to cardiovascular risk factors in young children.

Low aerobic fitness (maximum oxygen uptake (VO(2 PEAK))) is predictive for poor health in adults. In a cross-sectional study, we assessed if VO(2 PEAK) is related to a composite risk factor score for cardiovascular disease (CVD) in 243 children (136 boys and 107 girls) aged 8 to 11 years. VO(2 PEAK) was assessed by indirect calorimetry during a maximal exercise test and scaled by body mass (milliliters per minute per kilogram). Total body fat mass (TBF) and abdominal fat mass (AFM) were measured by Dual-energy X-ray absorptiometry. Total body fat was expressed as a percentage of total body mass (BF%) and body fat distribution as AFM/TBF. Systolic and diastolic blood pressure (SDP and DBP) and resting heart rate (RHR) were measured. The mean artery pressure (MAP) and pulse pressure (PP) were calculated. Echocardiography, 2D-guided M-mode, was performed. Left atrial diameter (LA) was measured and left ventricular mass (LVM) and relative wall thickness (RWT) were calculated. Z scores (value for the individual - mean value for group)/SD were calculated by sex. The sum of z scores for DBP, SDP, PP, MAP, RHR, LVM, LA, RWT, BF%, AFM and AFM/TBF were calculated in boys and girls, separately, and used as composite risk factor score for CVD. Pearson correlation revealed significant associations between VO(2 PEAK) and composite risk factor score in both boys (r = -0.48 P < 0.05) and in girls (r = -0.42, P < 0.05). One-way ANOVA analysis indicated significant differences in composite risk factor score between the different quartiles of VO(2 PEAK) (P < 0.001); thus, higher VO(2 PEAK) was associated with lower composite risk factor score for CVD. In conclusion, low VO(2 PEAK) is associated with an elevated composite risk factor score for CVD in both young boys and girls.