The Oral Microbiome Profile of Water Polo Players Aged 16-20.

OBJECTIVES: Chlorine has a strong antibacterial property and is the disinfectant most frequently used in swimming pools. Therefore, the microbiota community in the oral cavity of those who practice water sports is assumed to be special due to their regular immersion in water. Adverse changes in the composition of oral cavity microbiota may have serious health consequences. We aimed to compare the oral microbiome between water polo players and non-athletes. We hypothesized that the oral cavity microbiota community differed between water polo players and non-athletes. MATERIALS AND METHODS: Altogether, 124 water polo players (62 males and 62 females, aged between 9 and 20 years) and 16 non-athlete youths (control group, eight males and eight females, aged between 16 and 20 years, mean age + SD = 17.1 + 1.4 years) who participated in body structure examinations voluntarily agreed to participate in the study. In a randomly selected subsample of water polo players (n: 29, aged between 16 and 20 years, mean age + SD = 17.3 + 1.0 years), saliva samples were also collected. Saliva samples were collected from all non-athlete youths (n: 16, aged between 16 and 20 years). The oral microbiome was determined from a saliva sample, and DNA was isolated using the QIAmp DNA Blood Mini Kit. The 16S rRNA gene amplicon sequencing method was used to analyze the microbiome community. PCR primers were trimmed from the sequence reads with Cutadapt. R library DADA2 was used to process reads in the abundance analysis. RESULTS: In general, Streptococcus, Veilonella, and Prevotella genera constituted more than 50% of the oral microbiome community in the two participant groups combined (n = 45). The oral microbial profile had significant sexual dimorphism and differed between water polo players and the non-athletes. Compared to females, males had a higher (p < 0.05) relative abundance of the Atopobium (medium effect size) and Pravotella_7 (very large effect size) genera and a lower (p < 0.05) relative abundance of the Fusobacterium (large effect size), Gemella (large effect size), and Streptococcus (large effect size) genera. Compared to non-athletes, water polo players had higher (p < 0.05, medium effect size) relative abundance of the genus Veillonella and lower (p < 0.05, large effect size) relative abundance of the genus Gemella. CONCLUSIONS: The results suggest that regular water training can unfavorably alter the composition of the oral microbial community.

Risk and protective factors for health behaviour in adolescence in Europe.

The purpose of the analysis was to identify the risk and protective factors for health behaviour in European adolescents from population health status and expenditure, mental health status, sexual life, social life and education indices and the existence of national strategies, programmes. National and international databases providing information on the presumed health behaviour predictors were used in the analysis. The existence of national health strategies, the level of health expenditure, the socioeconomic conditions, the level of education and literacy had significant influence on the health-risk behaviour of adolescents in the European societies. Six clusters of European countries were extracted by considering the health behaviour risks and health protection strategies. National health strategies combined with governmental support for health prevention and action plans have the most effective impact on the health-risk behaviour of adolescents.

A new monitoring system for nutritional status assessment in children at home.

Regular monitoring of children's nutritional status is essential to prevent micronutrient deficiencies, nutritional status abnormalities as stunting, wasting, overweight and obesity. Nutritional status assessment is usually performed by paediatricians by using anthropometry (body mass index, weight to height indices) and/or by body fat-mass measurement (bioimpedance analysis, dual-energy x-ray absorptiometry, computer tomography, etc.). Parents are also interested in but usually fail to evaluate their child's nutritional status. To help the sufficient collaboration between the physician and parents a new nutritional status monitoring method is developed for families. The new monitoring system was developed under a paediatrician's supervision by considering national and international recommendations, references as well as the anthropometric measurement possibilities at home. The model requires age, sex, body mass, height, waist circumference and hand circumference as predictor (input) variables of nutritional status, while (1) the centile values of the measured body dimensions, (2) body fat percentage and the centile of body fat percentage, (3) the nutritional status category (undernutrition, normal nutritional status, overfat/obese) can be predicted (outcome variables) by the new method. The predictive accuracy of the model for nutritional status category was 94.88% in boys and 98.66% in girls. The new model was developed for nutritional status assessment in school-aged children and will be incorporated in the healthy lifestyle module of 'Teenage Survival Guide' educational package to be developed by the Health Promotion and Education Research Team, Hungarian Academy of Sciences, Hungary. The new monitoring system could help the families to identify the early signs of malnutrition in children. Nutritional status assessment in children at home is suggested twice a year, and in case of suspicious nutritional status abnormality it is recommended to visit the general practitioner.

Urine flow acceleration in healthy children: A retrospective cohort study.

AIMS: To establish normal reference values of urine flow acceleration (Qacc ) in healthy children, as there is a lack of nomograms for normative reference values of Qacc by voided volumes in the pediatric population so far. Qacc might be an early indicator of autonomic neuropathy in children and adolescents. METHODS: Data were retrospectively collected from healthy children who underwent uroflowmetry between 1990 and 1992. Exclusion criteria were voided volume less than 20 ml, and postvoid residual more than 15%. Baseline characteristics and uroflowmetry parameters were collected from girls and boys aged between 6 and 18 years. Voided volume, voiding time, time to maximum flow rate, and maximum and average flow rates of urine were measured, and Qacc was calculated. Postvoid bladder diameter was measured by ultrasonography and converted to volume. RESULTS: Uroflowmetry parameters of 208 children (≤18 years old, 45.2% girls, mean age 9.68 ± 3.09 years) who performed 404 micturition were analyzed. Median voided volume, voiding time, time to Qmax , Qave , Qmax , Qacc , and postvoid residual volume were 130 [20-460] ml, 10 [3-56] s, 3 [1-14] s, 11.7 [2.5-36.6] ml/s, 20.5 [5-50] ml/s, 6 [0.81-25] ml/s2 , and 1.83 [0-38.62] ml, respectively. Qacc nomograms were given in centile forms for girls and boys separately, which show an inversely proportional correlation between voided volumes. CONCLUSIONS: These are the first nomograms for normative reference values of Qacc in the pediatric population (girls and boys separately) by voided volumes in centile forms. These may be useful to interpret abnormal Qacc values and diagnose lower urinary tract diseases over a wide range of voided volumes.

INvesTigating the Abnormality of detrusor ConTractility by uroflowmetry in diabetic children (INTACT Trial): protocol of a prospective, observational study.

INTRODUCTION: Bladder emptying abnormalities and cardiovascular autonomic dysfunction are manifestations of autonomic dysfunction in people with diabetes mellitus (DM), which are major causes of morbidity and mortality. Since they can reduce the quality of life, they are urgent to be addressed before resulting in complications. As uroflowmetry might determine autonomic neuropathy earlier than cardiovascular autonomic dysfunction symptoms occur, our aim is to detect early abnormalities in bladder muscle function in children with DM. We investigate the diagnostic accuracy of uroflowmetry. As a secondary aim, we compare the prevalence of uroflowmetry abnormalities to the appearance of measures of cardiovascular autonomic neuropathy. Finally, as an ancillary study, we examine the association of uroflowmetry with the appearance of peripheral neuropathy. These three aims, we feel, will put our results regarding uroflowmetry into an overall context of nerve disease early in the course of type 1 DM. To our knowledge, such an approach has heretofore not been performed. METHODS AND ANALYSIS: This will be a prospective, observational, single-centre clinical study. Patients with DM fulfilling the inclusion criteria and healthy controls will have uroflowmetry examination, cardiovascular autonomic dysfunction tests (heart rate response to deep breathing, to Valsalva manoeuvre, blood pressure and heart rate response to standing up, and to sustained handgrip) and nerve conduction test. The autonomic nervous system function will be examined by the reproducible and standardised cardiovascular reflex tests described by Ewing et al. During the examination, electrocardiogram (ECG) and blood pressure values will be recorded continuously. Heart rate response to deep inspiration will be executed to investigate the parasympathetic nervous system. Peripheral neuropathy will be evaluated by nerve conduction test. After a pilot period, when the first 50 diabetic and 50 healthy children will be assessed, sample size calculation will be carried out. The primary objective of this trial is to evaluate the diagnostic accuracy (sensitivity, specificity, positive and negative predictive value) of uroflowmetry. To do so, we compare uroflowmetry to the gold standard neuropathy tests, which are cardiovascular autonomic dysfunction tests (heart rate response to deep breathing, to Valsalva manoeuvre, blood pressure and heart rate response to standing up and to sustained handgrip). ETHICS AND DISSEMINATION: Ethics approval was obtained from the Scientific and Research Ethics Committee of the Heim Pál National Paediatric Institute in Budapest, Hungary (registration number KUT-37/2021). Results will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT05247840.

Effects of regular sport activities on stress level in sporting and non-sporting university students.

Background: Regular sport has favourable influence on the physical and mental state. Our aim was to analyse the relationship between regular sport activities, body parameters, cortisol level, perceived stress and the frequency of psychosomatic symptoms in male and female university students. Methods: Subjects were university students (N = 200). They were divided in sporting (more than 7 h week-1: 56 males (sm), 50 females (sf)) and non-sporting (less than 3 h week-1: 44 males (nsm) and 50 females (nsf)) groups. Body composition was estimated by Inbody720-analyser. Stress levels were measured by (1) free cortisol level in saliva measured by using IBL-ELISA kits and (2) questionnaires about psychosomatic symptoms and perceived stress scale. Results: There were significant subgroup' differences in body composition (fat%:sm:12.1 ± 6.0 vs. nsm:17.9 ± 6.8; sf:20.8 ± 5.5 vs. nsf:25.4 ± 5.7; muscle%:sm:50.3 ± 3.6 vs. nsm:47.6 ± 3.9; sf:43.8 ± 3.2 vs. nsf:41.7 ± 3.3), and in stress level (total scores:sm:21.0 ± 5.7 vs. nsm:23.3 ± 7.2; sf:25.5 ± 7.0 vs. nsf:28.0 ± 9.7). There were gender differences in the psychosomatic symptoms' frequency (total scores: sm: 14.6 ± 6.3 vs. sf: 20.4 ± 7.4; nsm: 14.9 ± 6.1 vs. nsf: 19.6 ± 8.2). The sporting students had larger muscle, smaller fat percentages, and lower level of stress. Basic level of salivary cortisol revealed significant relation with physical activity: sporting students had lower level of cortisol. This relation was reflected in higher percentage of students with low level of cortisol in the physically active subgroups (s/ns males: 29% vs. 15%; s/ns females: 18% vs. 5%) and in the higher percentage of female students with high level of cortisol in the non-sporting subgroup (27% vs. 11%). Conclusion: Regular sport activity is positively related with lower stress levels in university students.

Sport Activity Load and Skeletomuscular Robustness in Elite Youth Athletes.

In an earlier report, bone mineral reference values for young athletes were developed. This study addressed variations in bone mineral parameters of young athletes participating in sports with different mechanical loads. The bone mineral status of 1793 male and female athletes, 11 to 20 years of age, in several sports was measured with DEXA. Specific bone mineral parameters were converted to z-scores relative to age- and sex-specific reference values specified by the DEXA software. Z-score profiles and principal components analyses were used to identify body structural components in the young athletes and to evaluate the associations between the identified component and type of sport defined by mechanical load. A unique skeletomuscular robusticity of male wrestlers, pentathletes, and cyclists was noted: wrestlers had significantly more developed skeletomuscular robusticity and bone mineral density compared to the age-group average among elite athletes, while pentathletes and cyclists had lower bone mineral parameters than the age-group references among elite athletes. Among female athletes, bone mineral parameters of both the trunk and extremities of rhythmic gymnasts and pentathletes were significantly lower compared to the age-group means for elite athletes. The bone mineral development of elite young athletes varies with the impact forces associated with their respective sports. The skeletal development of cyclists, pentathletes, and rhythmic gymnasts should be monitored regularly as their bone development lags behind that of their athlete peers and the reference for the general population.

Body structural and cellular aging of women with low socioeconomic status in Hungary: A pilot study.

OBJECTIVES: The health status of an individual is determined not only by their genetic background but also by their physical environment, social environment and access and use of the health care system. The Roma are one of the largest ethnic minority groups in Hungary. The majority of the Roma population live in poor conditions in segregated settlements in Hungary, with most experiencing higher exposure to environmental health hazards. The main aim of this study was to examine the biological health and aging status of Roma women living in low socioeconomic conditions in Hungary. METHODS: Low SES Roma (n: 20) and high SES non-Roma women (n: 30) aged between 35 and 65 years were enrolled to the present analysis. Body mass components were estimated by body impedance analysis, bone structure was estimated by quantitative ultrasound technique. Cellular aging was assessed by X chromosome loss estimation. Data on health status, lifestyle and socioeconomic factors were collected by questionnaires. RESULTS: The results revealed that low SES women are prone to be more obese, have a higher amount of abdominal body fat, and have worse bone structure than the national reference values. A positive relationship was found between aging and the rate of X chromosome loss was detected only in women with low SES. Waist to hip ratio, existence of cardiovascular diseases and the number of gravidities were predictors of the rate of X chromosome loss in women. CONCLUSIONS: The results suggested that age-adjusted rate of X chromosome loss could be related to the socioeconomic status.

A proposal for the adjustment of bone mineral density for body dimensions in children.

Objectives: The precise age estimation is of high importance in bone mineral density (BMD) assessment in children, since the bone structure of a studied child is evaluated by using the age and gender dependent references. In addition, the biological age - the bone age in this case - estimation could help this bone structural evaluation process, since the developmental status of the skeletal system can significantly alter from the theoretical developmental status determined by chronological age in healthy, but early or late maturing children. The aims of the study were (1) to check whether volumetric BMD (vBMD) Z-scores estimated by considering chronological age and biological age differ significantly in children aged between 7-18 years, and (2) in the case of significant inaccuracy of Z-score estimation based on chronological age to construct new vBMD standards adjusted for body developmental status. Subjects and methods: Body structural and densitometry data of 476 healthy children aged between 7 and 18 years were used in the analysis. pQCT measurements were performed at the distal radius using Stratec XCT-2000 equipment (Stratec Inc, Germany). The centile curves of vBMD parameters were estimated by using lmsChartMaker Pro 2.3 software. Ulnar length age was used as biological age in the analysis. Results: The total and 'cortical + subcortical' vBMD changed by age in the studied age interval in both genders, while the trabecular vBMD showed significant change by age only in females. Our results confirmed that when the biological age of a child significantly differs from her/his chronological age, vBMD evaluation should be done by considering her/his biological age. Due to the increase in individual variability of rate and timing of pubertal developmental processes, the sensitivity of vBMD evaluation by considering body developmental status was the lowest in the age between 12 and 16 years in the boys and between 10 and 12 years in the girls. Therefore the suggested vBMD adjustments for biological ages are highly recommended to use at least in children with ages outside these age intervals. Conclusion: If the estimation of any biological age cannot be carried out, vBMD references adjusted for height or other body dimensions should be used in the bone health status estimation in children.

Physiological and Psychological Responses to a Maximal Swimming Exercise Test in Adolescent Elite Athletes.

BACKGROUND: Continuously rising performances in elite adolescent athletes requires increasing training loads. This training overload without professional monitoring, could lead to overtraining in these adolescents. METHODS: 31 elite adolescent athletes (boys: n = 19, 16 yrs; girls: n = 12, 15 yrs) participated in a field-test which contained a unified warm-up and a 200 m maximal freestyle swimming test. Saliva samples for testosterone (T) in boys, estradiol (E) in girls and cortisol (C) in both genders were collected pre-, post- and 30 min post-exercise. Lactate levels were obtained pre- and post-exercise. Brunel Mood Scale, Perceived Stress Scale and psychosomatic symptoms questionnaires were filled out post-exercise. RESULTS: Lactate levels differed between genders (boys: pre: 1.01 ± 0.26; post: 8.19 ± 3.24; girls: pre: 0.74 ± 0.23; post: 5.83 ± 2.48 mmol/L). C levels increased significantly in boys: pre- vs. post- (p = 0.009), pre- vs. 30 min post-exercise (p = 0.003). The T level (p = 0.0164) and T/C ratio (p = 0.0004) decreased after field test which draws attention to the possibility of overtraining. Maximal and resting heart rates did not differ between genders; however, heart rate recovery did (boys: 29.22 ± 7.4; girls: 40.58 ± 14.50 beats/min; p = 0.008). CONCLUSIONS: Our models can be used to explain the hormonal ratio changes (37.5-89.8%). Based on the results this method can induce hormonal response in elite adolescent athletes and can be used to notice irregularities with repeated measurements.

Bone Mineral Reference Values for Athletes 11 to 20 Years of Age.

OBJECTIVES: Training for sport is associated with the development of bone minerals, and the need for reference data based on athletes is often indicated. The purpose of this study was to develop a reference for bone mineral density (BMD) and content (BMC) specific for youth athletes of both sexes participating in several sports. Methods DEXA (dual energy X-ray absorptiometry) was used for total body measurements of bone minerals in 1385 athletes 11 to 20 years, 1019 males and 366 females. The athletes were training in several sports at Hungarian academies. Reference values for total bone mineral density and bone mineral content, and also BMD excluding the head (total body less head, TBLH) were developed using the LMS chartmaker pro version 2.3. RESULTS: The centile distributions for BMD and BMC of the athletes differed significantly from those of the age- and sex-specific references for the general population. The youth athletes had higher BMD and BMC than those of the reference for the general population. CONCLUSION: The potential utility of the DEXA reference for male and female youth athletes may assist in monitoring changes in the BMC and BMD associated with normal growth and maturation, and perhaps more importantly, may be useful in monitoring changes specific to different phases of sport-specific training protocols.

The body composition analysis as a complementary tool in the screening of bone structural abnormalities.

Purpose. The importance of early diagnosis, bone-healthy lifestyle and medication is required for remaining fracture free. Dual-energy X-ray absorptiometry and ultrasound densitometry are widely used to screen osteoporosis and other bone structural diseases. Bioelectrical impedance analysis (BIA) devices can also estimate bone mineral content (BMC), but it has not been recommended for diagnostic purposes. The aim was to analyse whether low levels of the body composition' components and low bone mineral content can predict bone structural risk. Methods. Healthy pre- (n: 235, 18-45 years) and postmenopausal women (n: 137, 46-78 years) were enrolled to the analysis. BMC (kg) was estimated by InBody 720 analyser. Bone structure was measured by ultrasound DTU-One osteometer. Broadband ultrasound attenuation (BUA, dB/MHz), which estimates structural characteristics of trabecular bone, was used to assess bone structure. Body mass components were estimated by Drinkwater-Ross method. Results. Age changes of BMC, absolute and relative bone mass, muscle mass and bone structural parameters were analysed in women. BMC (r = 0.43, p < 0.01), absolute muscle mass (r = 0.41, p < 0.01) and absolute bone mass (r = 0.37, p < 0.01) were highly correlated (Pearson correlation) with BUA in premenopausal women. In postmenopausal women weaker relationship was identified between BUA and its hypothetical predictive factors. Conclusion. BMC and other studied body mass components alone do not provide enough information to identify osteoporosis, but can complete and widen the screening methods for bone structural diseases. Bone mineral density of healthy premenopausal women with low BMC, low bone mass and/or low muscle mass values should be measured regularly.

[The prevalence of psychosomatic complaints among 8-17-year-old Hungarian children]. / Pszichoszomatikus tünetek elofordulási gyakorisága 8­17 éves magyar gyermekek körében.

INTRODUCTION: Subjective health complaints are common among children as well. Age, gender, health status, etc. can modify the prevalence, intensity, frequency and the dimensions of the psychosomatic complaints. AIM: The main purposes were to analyse the frequency pattern of psychosomatic complaints in children as well as to study the influence of physical status and lifestyle factors on psychosomatic status. METHOD: The subjects of the present analysis represented a random sample of the Hungarian National Growth Study (n = 13 331; 8-17-year-old). The three clusters of the health complaints were somatic, psychological and sleeping disorders. The psychosomatic status of 8-17-year-old children was analysed by dividing them into subgroups of experiencing the subjective health complaints often (weekly or more often), on an average level or rarely. Frequency distributions were examined for each subjective health complaint. Multinomial logistic regression analysis was applied to reveal the relationship between the frequency pattern of psychosomatic complaints and the hypothesized predictive factors. RESULTS: The prevalence of the psychosomatic complaints increased by age, and girls reported more symptoms than boys. Subjective health status, nutritional status, body image, academic achievement, stature, body mass and socioeconomic status influenced the frequency pattern of psychosomatic complaints in girls, while physical activity, self-esteem, socioeconomic status and subjective health status in boys. CONCLUSIONS: Age, gender, socioeconomic status and psychosocial status can affect the frequency pattern of the psychosomatic complaints. Orv Hetil. 2019; 160(12): 464-472.

The association of psychosomatic health with physical status and lifestyle factors in adolescence.

The main purposes were to analyse the age pattern of experiencing psycho-somatic complaints in children; to study the influence of physical status and lifestyle factors on psycho-somatic status. The sample (n: 13,331, aged 7-18) represented a subsample of the 2nd Hungarian National Representative Growth Study. Subjects were divided into underweight, normal, preobese and obese subgroups. A standard symptom list was used to assess the experience of psycho-somatic complaints. Children rated their current health status in terms of excellent, good, fair and poor. Subjects were divided into physical activity subgroups. The prevalence of the psycho-somatic complaints increased with age, girls reported more symptoms than boys. Irritability and waking up tired were the most frequent symptoms. Subjective health status, nutritional status, body image, academic achievement, stature, body mass and socioeconomic status influenced the pattern of psycho-somatic complaints in girls, while physical activity, self-esteem, socioeconomic status and subjective health status in boys.

Reference data for ultrasound bone characteristics in Hungarian children aged 7-19 years.

Backround: Osteoporosis is a common disease and physical activity (PA) has a favourable influence on bone status. AIM: To establish normative data for calcaneal quantitative ultrasound (QUS) bone characteristics in children and to analyse the relationships between PA, anthropometric and bone parameters. SUBJECTS AND METHODS: Hungarian children aged 7-19 (n = 2674; 1325 girls, 1349 boys) provided PA, anthropometric and bone data. QUS parameters were registered with Sonost3000 densitometer (speed of sound: SOS, m/s; broadband ultrasound attenuation: BUA, dB/MHz; bone quantity index (BQI = αSOS + ßBUA). Reference centiles of QUS parameters were constructed by LMS method. Multivariate linear regression models were used to analyse the relationships. RESULTS: QUS bone parameters increased with age. There were no gender differences, except in 11- and 19-year-old children, where boys showed higher values. SOS (1497.15 ± 15.72 vs 1494.05 ± 14.81 m/s) and BQI (65.31 ± 16.71 vs 62.26 ± 15.78) were higher in athletic children. The regression model revealed significant relations between SOS and age, relative muscle mass and PA; BUA correlated with gender, morphological age, BMI, relative muscle mass and PA. CONCLUSIONS: Changes in the bone parameters among 7-19-year-old Hungarian children depended on age, anthropometric dimensions and the level of PA. The normative data could be used for monitoring QUS bone parameters in children, leading to more effective interventions for healthy bones.

The relationship between reproductive and biochemical ageing at the time of the menopausal transition.

The biochemical ageing status of women in the menopausal transition was studied using quantitative analysis of age- and autophagy-related gene activities (CDC42 and MAP1LC3 genes were selected as target genes). Free estradiol and progesterone levels in saliva were estimated. General linear models were used to determine the relationship between lifestyle, health status, socioeconomic factors and CDC42 and MAP1LC3 gene expression levels. Gene expression analysis revealed (1) an increasing expression of CDC42 gene after 45years in women, (2) expression level of CDC42 gene associated with menopausal status, (3) while endocrine status was found to associate with the expression of both of the studied age-related genes, (4) the "never used hormonal contraceptives" and "obese nutritional status" were the strongest factors for increased level of age-related gene expressions, and (5) changes in gene expression levels by ageing should be studied by considering not only chronological, but also biological ages. Gene expression profile of ageing has mostly been studied in model systems or human blood samples, but rarely in human saliva samples. The concordance of results between the present and former gene expression analyses, and the simplicity of saliva sample collection emphasizes the importance of saliva tissue samples in gene expression analyses especially in epidemiological surveys.

A comparison of skeletal maturity assessed by radiological and ultrasonic methods.

OBJECTIVES: The estimation of skeletal maturity is a useful tool in pediatric practice to determine the degree of delay or advancement in growth disorders and the effectiveness of treatment in conditions that influence linear growth. Skeletal maturity of children is commonly assessed using either Greulich-Pyle (GP) or Tanner-Whitehouse methods (TW2 and TW3). However, a less invasive ultrasonic method, that does not use ionizing radiation, has been suggested for use in epidemiological studies of skeletal maturity. The main purpose of the present study was to determine the accuracy of an ultrasonic method based on the GP maturity indicators compared to the standard GP radiographic method. METHODS: Skeletal maturity of 1502 healthy children, aged from 6 to 18 years, was estimated by quantitative ultrasound and compared to GP bone ages estimated from left hand and wrist radiographs of a subsample of 47 randomly selected participants. RESULTS: The ultrasonic bone age estimation demonstrated very strong correlations with all the radiological age estimations. The correlation coefficients ranged between 0.895 and 0.958, and the strongest correlation of ultrasonic skeletal maturity estimation was found with the Tanner-Whitehouse RUS method. The ultrasonic bone age estimation is suggested for use between the chronological ages of 8.5-16.0 years in boys and 7.5-15.0 years in girls. CONCLUSIONS: The ultrasonic bone age estimation is suggested for use in epidemiological surveys since the sensitivity for screening for not normal bone development is appropriate, at least within the 8-15 years age interval.

Body fatness and endogenous sex hormones in the menopausal transition.

BACKGROUND: Age at the final menstrual period is of clinical and public health interest because the age at which natural menopause occurs may be a marker of ageing and health, and in general the menopausal transition increases the risk of many diseases, e.g. redistribution in the pattern of adiposity during the menopausal transition may increase risk of metabolic disease. The purpose of this research was to study the relationship between the menopausal status and body fatness. SUBJECTS AND METHODS: A random sample of 1932 Hungarian women was studied. Body composition was estimated by body impedance analysis. In a subsample free estradiol and progesterone levels in saliva were quantified. RESULTS: Body fat mass increased until the late 50s and then had a decrease through senescence. Premenopausal women who were much older than the median age at menopause had a higher amount of fat than their postmenopausal age-peers, while postmenopausal women, whose menopause occurred much earlier than the median age at menopause, had less fat than their premenopausal age-peers. The body fat mass in premenopausal women with low levels of sex hormones was always below the age-median value of the menopausal status subgroups, while the body fat mass of postmenopausal women with high levels of sex hormone levels was above the age-median values. CONCLUSIONS: The analysis of body fatness in the menopausal transition revealed that (1) the rate of reproductive ageing and the body fat pattern were significantly related, and (2) body fat mass of women with unexpected levels of sex hormones was related more to their hormonal levels than to their menopausal status or their age. Thus future epidemiological screenings of women exposed to higher levels of menopause-related health risks should be expanded beyond the estimation of menopausal status based only on menstrual history to include sex hormone level assessment, as well as body composition analysis.

SECULAR GROWTH AND MATURATION CHANGES IN HUNGARY IN RELATION TO SOCIOECONOMIC AND DEMOGRAPHIC CHANGES.

This paper analyses the secular changes in the body development patterns of Hungarian children between the 1910s and the beginning of the 2000s in relation to socioeconomic and demographic changes in the country. Individual growth data of children were available from two national growth studies (1983-86, 2003-06), while sample-size weighted means of children's body dimensions were collected through regional studies between the 1920s and 1970s. Gross domestic product, Gini index, life expectancy at birth and under-5 mortality rate were used to assess the changes in economic status, income inequalities of the society and the population's general health status, respectively. Secular changes in food consumption habits were also examined. The positive Hungarian secular changes in socioeconomic status were associated with a continuous increase in children's body dimensions. The negative socioeconomic changes reflected only in wartime and post-war periods of children's growth, and the considerable socioeconomic changes at the beginning of the 1990s did not appear to influence the positive trend in children's growth. The positive secular trend in stature and body mass did not level off at the beginning of the 2000s: the socioeconomic conditions that support optimal growth and maturation could improve in Hungary.

THE BIOLOGICAL STATUS OF CHILDREN LIVING IN DISADVANTAGED REGIONS OF HUNGARY.

The aim of this study was to find out whether differences exist in the physical development, nutritional status and psychosomatic status of children living in deprived regions of Hungary compared with the Hungarian national reference values. The Hungarian government's decree No. 24/2003 created a complex indicator of social and economic conditions by which the country's regions were graded into deprived and non-deprived regions. This study examined 3128 children (aged 3-18 years) living in the deprived regions and their biological status was compared with the national reference values (2nd Hungarian National Growth Study). Children's body development was assessed via some absolute body dimensions. Nutritional status was estimated by BMI with children being divided into 'underweight', 'normal', 'overweight' and 'obese' categories. For children aged 7-18 years a standard symptoms list was used to characterize psychosomatic status. The subjects were asked to rate their health status as excellent, good, fair or poor. The body development of children living in these deprived regions was significantly retarded compared with the national references in the age groups 7-9 years and 14-17 years for boys and in the age groups 4-6 and 14-17 for girls. The prevalence of underweight was significantly higher in children and adolescents living in deprived regions (boys: 4.8%; girls: 5.9%) than the national references (boys: 2.9%; girls: 4.0%), while the prevalence of overweight and obese children did not differ between deprived regions (boys: 20.2%; girls: 19.8%) and the national references (boys: 21.5%; girls: 19.1%). Children and adolescents living in the deprived regions rated their health status worse, and experienced more psychosomatic complaints (abdominal discomfort and fear), than the national references. Although the majority of body dimensions of children in deprived regions were close to the 50th centile of the Hungarian national references, a sizeable minority (31%) were 0.20SD or more away from the median value, which has implications as to how social, medical and public welfare policy can be shaped.