LRG1 Associates with Iron Deficiency Anemia Markers in Adolescents.

Leucine-rich α-2 glycoprotein1 (LRG1) has been shown to be associated with several health conditions; however, its association with iron deficiency anemia, especially in children, has not been previously explored. In this study, we investigated the association between LRG1 and several iron deficiency anemia markers, including hemoglobin (Hb), albumin, red cell distribution width (RDW), iron, ferritin, and Hb transferrin saturation. A total of 431 participants were included in this analysis aged between 11 and 14 years. Higher LRG1 levels were observed in children diagnosed with anemia [31.1 (24.6, 43.2) µg/mL] compared to non-anemic children [29.2 (22.7-35.95) µg/mL]. Statistically significant differences of LRG1 level across the three groups (tertiles) of Hb, iron, transferrin saturation, albumin, RDW, ferritin, and WBC were observed. Strong negative correlations were observed between LRG1 and Hb (Spearman's rho = -0.11, p = 0.021), albumin (Spearman's rho = -0.24, p < 0.001), iron (Spearman's rho = -0.25, p < 0.001), and Hb transferrin saturation (Spearman's rho = -0.24, p < 0.001), whereas circulating LRG1 levels were positively associated with RDW (Spearman's rho = 0.21, p < 0.001). In conclusion, our findings demonstrate for the first time the strong association between iron deficiency anemia markers and LRG1 in otherwise healthy school-aged children. However, further studies are needed to corroborate those results and to look for similar associations in other population subgroups.

Sex and obesity status modify the association between vitamin D and eczema among adolescents.

BACKGROUND: Epidemiologic studies have reported inconsistent associations between vitamin D and eczema. This study sought to assess whether sex and obesity status could modify the association between vitamin D and eczema. METHODS: A cross-sectional study enrolled 763 adolescents in Kuwait. 25-hydroxyvitamin D (25(OH)D) was measured in venous blood. Current eczema was defined according to clinical history and characteristic morphology and distribution. RESULTS: In sex-stratified analysis, decreased 25(OH)D levels were associated with increased current eczema prevalence among males (adjusted odds ratio (aOR)tertile 1 vs. tertile 3: 2.14, 95% confidence intervals (CI): 1.07-4.56), but not among females (aORtertile 1 vs. tertile 3: 1.08, 95% CI: 0.71-1.66). Further stratification by obesity status showed that lower 25(OH)D levels were associated with increased current eczema prevalence among overweight/obese males (per 10-unit decrease in 25(OH)D levels: aOR: 1.70, 95% CI: 1.17-2.46). Such an association was weaker and statistically non-significant among overweight/obese females (per 10-unit decrease in 25(OH)D levels: aOR: 1.26, 95% CI: 0.93-1.70). CONCLUSIONS: Sex and obesity status modified the association between vitamin D levels and eczema, with an inverse association observed among overweight/obese males, but not among overweight/obese females. These results suggest that preventive and clinical management strategies could vary by sex and obesity status. IMPACT: The current study showed that sex and obesity modify the association between vitamin D and eczema among adolescents. An inverse association between vitamin D and eczema was observed among overweight/obese males, but this association was not as pronounced among overweight/obese females. Vitamin D was not associated with eczema among underweight/normal weight males and females. The identification of effect modification by sex and obesity status add to the current scientific knowledge and further highlight the complexity of the association between vitamin D and eczema. These results may promote a more individualized approach to the future prevention and clinical management of eczema.

Serum cotinine as a predictor of lipid-related indices in Turkish immigrants with type 2 diabetes: A clinic-based cross-sectional study.

Background: Turkish immigrants form the largest ethnic minority group in the Netherlands and show a higher prevalence of (i) cardiovascular disease (CVD), (ii) cigarette smoking, and (iii) type 2 diabetes (T2D) as compared to the native Dutch. This study examines the association of CVD risk factors: serum cotinine, as an indicator of cigarette smoke, and lipid-related indices among first-generation (foreign-born) Turkish immigrants with T2D living in deprived neighbourhoods in the Netherlands. Methods: A total of 110 participants, physician-diagnosed with T2D, aged 30 years and older, were recruited by convenience sampling from the Schilderswijk neighbourhood of The Hague in a clinic-based cross-sectional design. Serum cotinine (independent variable) was measured with a solid-phase competitive chemiluminescent immunoassay. Serum lipids/lipoproteins (dependent variables) were determined by enzymatic assays and included: total cholesterol (CHOL), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and triglycerides (TG). The Castelli Risk Index-I (CRI-I), and Atherogenic Coefficient (AC) were calculated using standardised formulas and assessed as dependent variables in multiple linear regression (MLR) models. Log-transformation of HDL-c, TG, CRI-I, and AC values were performed to account for the extreme right skewness of the data. Statistical analyses included descriptive characteristics and MLR models were adjusted for all major confounders of cotinine and lipids. Results: The sample size had a mean age of 52.5 years [standard deviation (SD) = 9.21]. The geometric mean of serum cotinine level was 236.63 ng/mL [confidence interval (CI) = 175.89 ± 318.36]. The MLR models indicated that high serum cotinine levels (≥10 ng/mL) was positively associated with HDL-c (P = 0.04), CRI-I (P = 0.03), and AC (P = 0.03) in the age, gender, WC, diabetes medications, and statins-adjusted models (n = 32). Conclusion: This study indicated that lipid ratios of HDL-c, CRI-I and AC are dependent determinants of serum cotinine and higher serum cotinine levels (≥10 ng/mL) are associated with worse HDL-c, CRI-I and AC values in participants with T2D. Clinical comprehension of these biochemical indicators (lipids/lipoproteins) and symptomatic results (CVD risk) in individuals with T2D will aid in the intervention (smoking) approach for this vulnerable cohort (Turkish immigrants). Therapy that is targetted to modify this behavioural risk factor may improve cardiovascular health outcomes and prevent comorbidities in Turkish immigrants with T2D living in deprived neighbourhoods in the Netherlands. In the meantime, this report contributes to a growing body of information and provides essential guidance to researchers and clinicians.

Microalbuminuria and Hypertension among Immigrants with Type 2 Diabetes: A Community-Based Cross-Sectional Study.

PURPOSE: This study examined the association of microalbuminuria (MAU), as determined by albumin-to-creatinine ratio (ACR), with hypertension (HTN) among Turkish immigrants with type 2 diabetes (T2D) living in deprived neighborhoods of The Hague, Netherlands. METHODS: A total of 110 participants, physician-diagnosed with T2D, aged ≥ 30 years were recruited from multiple sources from The Hague, Netherlands in a cross-sectional design. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using automated office blood pressure equipment. Urine albumin was measured by immunoturbidimetric assay. Urine creatinine was determined using the Jaffe method. MAU was defined as ACR ≥ 3.5 mg/mmol for females and/or ACR ≥ 2.5 mg/mmol for males. RESULTS: MAU was present in 21% of Turkish immigrants with T2D. Adjusted logistic regression analysis indicated that the odds of having MAU were 6.6 times higher in hypertensive than those that were normotensive (p = 0.007; 95% confidence interval [CI]: 1.19, 36.4). CONCLUSION: These findings suggest that HTN and MAU may be assessed as a standard of care for T2D management for this population. Prospective studies of diabetes outcomes are recommended to further verify these findings.

Increased LRG1 Levels in Overweight and Obese Adolescents and Its Association with Obesity Markers, Including Leptin, Chemerin, and High Sensitivity C-Reactive Protein.

Leucine-rich α-2 glycoprotein1 (LRG1) is a member of the leucine-rich repeat (LRR) family that is implicated in multiple diseases, including cancer, aging, and heart failure, as well as diabetes and obesity. LRG1 plays a key role in diet-induced hepatosteatosis and insulin resistance by mediating the crosstalk between adipocytes and hepatocytes. LRG1 also promotes hepatosteatosis by upregulating de novo lipogenesis in the liver and suppressing fatty acid ß-oxidation. In this study, we investigated the association of LRG1 with obesity markers, including leptin and other adipokines in adolescents (11−14 years; n = 425). BMI-for-age classification based on WHO growth charts was used to define obesity. Plasma LRG1 was measured by ELISA, while other markers were measured by multiplexing assay. Median (IQR) of LRG1 levels was higher in obese (30 (25, 38) µg/mL) and overweight (30 (24, 39) µg/mL) adolescents, compared to normal-weight participants (27 (22, 35) µg/mL). The highest tertile of LRG1 had an OR [95% CI] of 2.55 [1.44, 4.53] for obesity. LRG1 was positively correlated to plasma levels of high sensitivity c-reactive protein (HsCRP) (ρ = 0.2), leptin (ρ = 0.2), and chemerin (ρ = 0.24) with p < 0.001. Additionally, it was positively associated with plasma level of IL6 (ρ = 0.17) and IL10 (ρ = 0.14) but not TNF-α. In conclusion, LRG1 levels are increased in obese adolescents and are associated with increased levels of adipogenic markers. These results suggest the usefulness of LRG1 as an early biomarker for obesity and its related pathologies in adolescents.

Vitamin D level in relation to depression symptoms during adolescence.

BACKGROUND: This study aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D) and depression symptoms among adolescents in Kuwait, a country with a high prevalence of vitamin D deficiency. METHODS: A school based cross-sectional study was conducted on randomly selected 704 adolescents in middle schools. Data on depression symptoms were collected using the Children's Depression Inventory (CDI). Data on covariates were collected from the parents by self-administered questionnaire and from adolescents by face-to-face interview. Blood samples were analyzed in an accredited laboratory; and 25(OH)D was measured using liquid chromatography-tandem mass spectrometry. RESULTS: Of 704 adolescents, 94 (13.35%; 95%CI:10.35-17.06%) had depression symptom (a score of 19 or more on the CDI). There was no significant difference in the median CDI score between different vitamin D status (p = 0.366). There was also no significant correlation between serum 25(OH)D concentration and CDI score (Spearman's rank correlation = 0.01; p = 0.825).There was no significant association between 25(OH)D and depression symptoms whether 25(OH)D was fitted as a continuous variable (crude odds ratio (OR) 0 .99 [95%CI: 0.98, 1.01], p = 0.458 and adjusted OR 1.01 [95%CI: 0.99, 1.02], p = 0.233), categorical variable as per acceptable cut-of points (crude analysis p = 0.376 and adjusted analysis p = 0.736), or categorical variable as quartiles (crude analysis p = 0.760 and adjusted analysis p = 0.549). CONCLUSION: Vitamin D status does not seem to be associated with depression symptoms among adolescents in our setting. Nevertheless, it is important to have sufficient vitamin D levels during adolescence for several other health benefits.

Is age of menarche directly related to vitamin D levels?

INTRODUCTION: Very few studies have examined the direct link between age of menarche and vitamin D level and controversial results have been reported. This study aimed to investigate the association between vitamin D and age of menarche in a group of adolescent girls in an area with plenty of sunshine. METHODS: At baseline, data were collected on 722 middle schoolgirls that were randomly selected by probability proportional to size sampling method. Of this group, 598 were followed including 173 who had their menarche during the follow-up. Serum 25-hydroxyvitamin D (25OHD) was measured at baseline using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Data on potential confounders were collected at baseline from the parents using self-administered questionnaire and from schoolgirls through face-to-face interview. Multiple linear regression and time-to-event analysis were used to investigate the association between 25OHD concentration and age of menarche. RESULTS: The mean (SD) age of the study group was 12.51 (0.91) years while the main (SD) age of menarche was 11.82 (1.04) years. The prevalence of vitamin D deficiency (<50 nmol/L) among schoolgirls was 91.69%. We found no evidence for the association between 25OHD levels and age of menarche before (ß, .00, 95% confidence interval (CI) [-0.01, 0.01]; p = .808) or after (ß, .00, 95% CI [-0.01, 0.01]; p = .765) adjusting for potential confounders. We also found no evidence for association between 25OHD status and age of menarche before (p = .424) or after (p = .356) adjusting for potential confounders. Time-to-event analysis showed no association between 25OHD level or status and age of menarche (p = .850). CONCLUSION: In Middle Eastern setting, where vitamin D deficiency is common despite plenty of sunshine, vitamin D is not a major determinant of the age at menarche. Regardless of the link between vitamin D and age of menarche, there are several other health benefits of having adequate vitamin D level during childhood and adolescence.

Plasma 25-hydroxyvitamin D is positively associated with folate and vitamin B12 levels in adolescents.

Vitamin D affects the absorption of folate in vitro, and perhaps of vitamin B12 (B12). However, epidemiological studies on the association of vitamin D with folate and B12 are inconclusive. We hypothesized a positive association of plasma 25-hydroxyvitamin D [25(OH)D] with folate and B12 levels in adolescents. This hypothesis was tested in a cross-sectional study of healthy adolescents (11-16 years old; n = 1416), selected from public middle schools from across Kuwait, using stratified multistage cluster random sampling. Plasma 25(OH)D was measured by LC-MS/MS. Serum B12 and total folate in hemolyzed whole blood were analyzed with commercial kits; RBC and plasma folate were calculated from total folate. Data on potential confounders were collected from the parents and adolescents. In a univariable model, 25(OH)D as a continuous variable was positively associated with each of total, RBC, and plasma folate (P < .001). After adjusting for potential confounders, this association remained significant with total folate (ß = 2.0, P < .001) and red blood cell folate (ß = 1.8, P < .001), but not with plasma folate (ß = 0.2, P = .34). A similar pattern of association was evident when 25(OH)D was fitted as categorical variable. Correlation between B12 and 25(OH)D was weak but significant (ρ = 0.1, P < .001). 25(OH)D was positively associated with B12 in both univariable and multivariable models (P < .001) when fitted as a categorical variable only. Simultaneous quantile regression confirmed these results. We conclude that plasma 25(OH)D is positively associated with folate and B12 levels in adolescents. Properly designed large-scale randomized controlled trials are warranted to investigate the causal role of vitamin D in folate and B12 absorption.

The routine chemiluminescence assay for plasma 25-hydroxyvitamin D analysis does not overestimate the prevalence of vitamin D deficiency in adolescents.

Vitamin D deficiency (VDD) is a global public health problem. Inaccurate methods for measuring plasma 25-hydroxyvitamin D (25[OH]D) may have contributed to the reported high prevalence of VDD. We hypothesized that the most commonly used assay for vitamin D status, chemiluminescence immunoassay (CLIA), underestimates 25(OH)D levels and thus overestimates VDD. Using both liquid chromatography-tandem mass spectrometry and CLIA for plasma 25(OH)D, we evaluated the prevalence of VDD in adolescents (11-16 years-old; n = 410) by both methods in a cross-sectional study. Subjects were selected from public middle schools from all the 6 Governorates of Kuwait using stratified multistage cluster random sampling. Cohen κ agreement, linear regression, and Bland-Altman plots were used to evaluate the classification of VDD by the 2 methods. VDD (25[OH]D < 50 nmol/L) was 85.9% with CLIA and 81.2% with liquid chromatography-tandem mass spectrometry. There was a good agreement between the 2 methods in classifying the study subjects as deficient, insufficient, or sufficient (κ = 85.1%, P < .001). The between-assay bias was very small with a mean percentage difference < 1% from the mean value of the 25(OH)D as assessed by the 2 methods. These data did not support our hypothesis, and we conclude that the routine methods used for plasma 25(OH)D levels have no or little impact on evaluating VDD as a public health problem or in clinical management.

Correlation of circulating ANGPTL5 levels with obesity, high sensitivity C-reactive protein and oxidized low-density lipoprotein in adolescents.

Angiopoietin-like proteins (ANGPTL) is a family of eight members known to play an important role in metabolic diseases. Of these, ANGPTL5 is suggested to regulate triglyceride metabolism and is increased in obesity and diabetes. However, its role in metabolic diseases in adolescents is not well-studied. In this study, we tested the hypothesis of a positive association between plasma ANGPTL5, and obesity, high sensitivity C-reactive protein (HsCRP) and oxidized low-density lipoprotein (Ox-LDL) in adolescents. Adolescents (N = 431; age 11-14 years) were randomly selected from middle schools in Kuwait. Obesity was classified by the BMI-for-age based on the WHO growth charts. Plasma ANGPTL5, HsCRP, and Ox-LDL were measured using ELISA. The prevalence of overweight and obesity was 20.65% and 33.18%, respectively. Mean (SD) plasma ANGPTL5 levels were significantly higher in obese, compared with overweight and normal-weight adolescents (23.05 (8.79) vs 18.39 (7.08) ng/mL, and 18.26 (6.95) ng/ml, respectively). ANGPTL5 was positively associated with both HsCRP (ρ=0.27, p < 0.001) and Ox-LDL (ρ = 0.24, p < 0.001). In Conclusion, ANGPTL5 levels are elevated in obese adolescents and are associated with cardiovascular disease risk factors, HsCRP and Ox-LDL. The use of ANGPTL5 as a powerful diagnostic and prognostic tool in obesity and metabolic diseases needs to be further evaluated.

Season of birth and sugary beverages are predictors of Raven's Standard Progressive Matrices Scores in adolescents.

To investigate factors associated with cognitive functioning in healthy adolescents, a school-based cross-sectional study was conducted on 1370 adolescents aged 11-16 years that were randomly selected from all governorates of Kuwait. Raven's Standard Progressive Matrices (SPM), a non-verbal test of intelligence, was used to measure cognitive functioning of the study participants. Data on predictors of cognitive functioning were collected from parents and adolescents. Weight and height of the participants were measured in a standardized manner and blood samples were tested in an accredited laboratory under strict measures of quality control. In multivariable linear regression analysis, factors that showed significant association with the SPM score were gender (p = 0.002), season of birth (p = 0.009), place of residence (p < 0.001), father's (p < 0.001) and mother's (p = 0.025) educational level, type of housing (p < 0.001), passive smoking at home (p = 0.031), sleeping hours during weekends (p = 0.017), students' educational level (p < 0.001) and the frequency of consumption of sugary drinks (p < 0.001). The link between cognitive functioning and season of birth seems to be robust in various geographical locations including the Middle East. The association between sugary drinks and cognitive functioning highlights the importance of diet independently of obesity and support efforts to reduce consumption of sugary drinks among children.

Anemia and its associated factors among Adolescents in Kuwait.

We estimated the prevalence of anemia among school children and investigated factors associated with this problem in Kuwait. A cross-sectional study was conducted on 1415 adolescents randomly selected from middle schools in Kuwait. Hemoglobin, iron, ferritin, folate and vitamin B12, in addition to many other laboratory indicators, were measured in a venous blood sample. Data on risk factors for anemia were collected from parents and adolescents. Multiple logistic regression was used to investigate factors associated with anemia. The prevalence of anemia was 8.06% (95% CI: 6.69-9.60%), which was significantly higher among females compared to males (10.96% vs. 5.04%; p < 0.001). Mean (SD) Hb level was 133.7 (9.89) g/L and 130.00 (10.48) g/L among males and females, respectively (p < 0.001). The prevalence of mild, moderate and severe anemia was 5.94%, 1.91% and 0.21%, respectively. Gender, age, iron concentration and ferritin were associated with anemia in multivariable analysis. These data indicate that anemia among school children in Kuwait is of mild public health significance. Further reduction in anemia in school girls should focus on correcting iron deficiency. Surveillance systems for anemia may consider using a cut-off point that is specific for the method of blood sampling and the method of Hb measurement.

Vitamin D levels in relation to low back pain during adolescence.

This study aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D) level and low back pain (LBP) among adolescents while adjusting for potential confounders pertinent to this age group including the weight of school bags, BMI and physical activity. A cross-sectional study was conducted on 760 randomly selected adolescents in middle schools. Data on LBP and the risk factors for LBP were collected from parents by a self-administered questionnaire and from adolescents by face-to-face interview. Blood samples were tested in an accredited laboratory; and 25(OH)D was measured using liquid chromatography-tandem MS. The lifetime prevalence and the 6-month prevalence of LBP were 32·28 (95 % CI 28·97, 35·73) % and 21·26 (95 % CI 18·40, 24·33) %, respectively. There was no difference in the geometric mean of 25(OH)D between those with and without LBP in the past 6 months (28·50 nmol/l and 30·82 nmol/l, respectively; P = 0·122). There was no association between 25(OH)D and LBP in the univariable or multivariable analysis whether 25(OH)D fitted as a continuous or as a categorical variable. We found no association between vitamin D level and LBP in adolescents in an area with high prevalence of vitamin D deficiency. Although it is important to have sufficient vitamin D levels during adolescence for several other health benefits, we concluded that vitamin D is not a major determinant for LBP among adolescents in our setting.

Trends in Fast-food Consumption among Kuwaiti Youth.

BACKGROUND: We assessed fast-food consumption including frequency, type, and reasons among college students from the Kuwait University, and whether there were any key sex differences. METHODS: A cross-sectional survey was conducted from January-March 2016 with 421 students (297 women, mean age = 20.99 ± 3.14 years). Students completed self-administered fast-food questionnaires and weight and height measurements were obtained. RESULTS: Most (81.4%) consumed fast food more than twice per week and more men than women were overweight or obese (54.8% vs. 38.7%, respectively; P = 0.002); however, there were no differences in the fast-food frequency per body mass index or sex. Taste was the most reported motivator to consume fast food (46.7%) and women were significantly more likely to value taste as compared to men (49.8% vs. 38.9%, respectively; P = 0.005). CONCLUSIONS: Fast food is a key part of college students' diet in Kuwait; therefore, students should be educated on the negative effects of frequent fast-food consumption. University health promotional activities should include nutrition education on healthier fast-food options and how to prepare easy-to-cook meals at home.

Plasma 25-Hydroxy Vitamin D is not Associated with Acne Vulgaris.

Few studies have investigated the association between Acne vulgaris (AV) and vitamin D level. In this study we aimed to investigate the association between 25-hydroxyvitamin D (25-OH-VitD) level and AV in a country with plenty of sunshine. A cross-sectional study was conducted on 714 adolescents who were randomly selected from public schools using multistage cluster random sampling with probability proportional to size. 25-OH-VitD levels were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The Global Acne Grading System (GAGS) was used to assess the severity of AV. Data on potential confounders were collected from the parents through a self-administered questionnaire, and from the adolescents using a face-to-face interview. Of 714 participants, 351 (41.16%) were males. The mean (standard deviation (SD)) age was 12.28 (0.81) years. AV was observed in 479 (67.1%) adolescents. There was no significant association between 25-OH-VitD level and clinically assessed AV before or after adjusting for potential confounders. This was consistent whether 25-OH-VitD was fitted as a continuous variable or categorized using acceptable cutoff points or tertiles. In this study vitamin D status was not associated with AV, therefore our data do not support vitamin D supplementation either to treat or to prevent AV.

Plasma 25-Hydroxy Vitamin D Is Not Associated with Either Cognitive Function or Academic Performance in Adolescents.

Several observational studies have reported an association between low levels of vitamin D (VD) and poor cognition in adults, but there is a paucity of data on such an association in adolescents. We investigated the association between VD and cognitive function or academic achievement among 1370 adolescents, who were selected from public middle schools in Kuwait, using stratified multistage cluster random sampling with probability proportional to size. Plasma 25-hydroxy VD (25-OH-D) was measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). An age-adjusted standard score (ASC), calculated from Raven's Standard Progressive Matrices test, was used to evaluate cognitive function; academic achievements were extracted from the schools' records. Data on various covariates were collected from the parents through a self-administered questionnaire and from the adolescents using face-to-face interviews. 25-OH-D was weakly correlated positively with ASC (ρ = 0.06; p = 0.04). Univariable linear regression analysis showed an association between 25-OH-D categories and ASC after adjusting for gender, but adjusting for parental education was sufficient to explain this association. Multivariable analysis showed no association between 25-OH-D and ASC after adjusting for potential confounders whether 25-OH-D was fitted as a continuous variable (p = 0.73), a variable that is categorized by acceptable cutoff points (p = 0.48), or categorized into quartiles (p = 0.88). Similarly, 25-OH-D was not associated with academic performance. We conclude that 25-OH-D is associated with neither cognitive function nor academic performance in adolescents.

Vitamin D status among adolescents in Kuwait: a cross-sectional study.

OBJECTIVES: In Kuwait, as in many Arab states in the Gulf region, there are limited data on the prevalence of vitamin D deficiency among healthy adolescents. This study aimed to estimate the prevalence of vitamin D deficiency in a nationally representative sample of adolescents and investigate factors associated with vitamin D status. METHODS: A cross-sectional study was conducted on 1416 adolescents aged 11-16 years, who were randomly selected from middle schools in all governorates of Kuwait. Data were collected from parents through self-administered questionnaire and from adolescents through face-to-face interview. Vitamin D was measured using liquid chromatography-tandem mass spectrometry. Logistic regression was used to investigate the independent factors associated with vitamin D status. RESULTS: The prevalence of vitamin D deficiency was 81.21% (95% CI 71.61% to 90.81%), while severe deficiency was 39.48%. Only 3.60% of adolescents were vitamin D-sufficient. The prevalence of vitamin D deficiency was significantly higher among girls compared with boys (91.69% vs 70.32%; p<0.001). There was a significant inverse correlation between vitamin D and parathyroid hormone (Spearman correlation=-0.35; p<0.001). In the final model, gender, age, governorate, parental education, body mass index, vitamin D supplement and the number of times adolescents walk to schools per week were all significantly related to vitamin D deficiency. CONCLUSION: High prevalence of vitamin D deficiency was noted among adolescents in Kuwait despite the abundant sunshine, which may reflect strong sun avoidance behaviour. Adequate outdoor daytime activities should be encouraged especially for girls. We call for locally tailored guidelines for vitamin D supplement in which girls should have a higher dose compared with boys.

Do mothers affect daughter's behaviors? Diet, physical activity, and sedentary behaviors in Kuwaiti mother-daughter dyads.

The objective of the study was to evaluate 169 Kuwaiti mother-daughter dyads and their associations with health behaviors for eating healthy, engaging in physical activity, daughters perceived body weight, time spent with computer/video, and time viewing television. Female students aged 10-14 years were selected from private and public schools in the State of Kuwait. Results demonstrated that daughters exhibited similar behaviors to their mothers in their perceived eating behavior, physical activity, computer/video game use, and TV screen time. Future research is essential to determine the role of mothers in effective health behavior intervention strategies for female Kuwaiti adolescents.

Corrigendum to "Perceived Body Image, Eating Behavior, and Sedentary Activities and Body Mass Index Categories in Kuwaiti Female Adolescents".

[This corrects the article DOI: 10.1155/2016/1092819.].

Perceived Body Image, Eating Behavior, and Sedentary Activities and Body Mass Index Categories in Kuwaiti Female Adolescents.

Background. The State of Kuwait has a growing obesity epidemic in both genders and all age groups; however, obesity rates in the young seem to be rising. Methods. We conducted a cross-sectional survey in 169 Kuwaiti female adolescents attending both private and public schools spanning the six governorates in the State of Kuwait in order to explore female adolescents' self-image, body dissatisfaction, type of school (private versus public), TV viewing, and computer games and their relationship to body mass index. Results. Approximately half the students classified as obese perceived their body image to lie in the normal range. Females in the obese category were the most dissatisfied with their body image, followed by those in the overweight category. Eating behavior, level of physical activity, school type, television viewing, computer/video usage, and desired BMI were not significantly associated with level of obesity. Conclusion. This study was one of the few studies to assess adolescent females' body image dissatisfaction in relation to obesity in the State of Kuwait. The results suggest that including body image dissatisfaction awareness into obesity prevention programs would be of value.