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1.
Cancer Res ; 2020 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-32156779

RESUMO

The recurring association of specific genetic lesions with particular types of cancer is a fascinating, and largely unexplained area of cancer biology. This is particularly true of clear cell renal cell carcinoma (ccRCC) where although key mutations such as loss of VHL is an almost ubiquitous finding, there remains a conspicuous lack of targetable genetic drivers. In this study, we have identified a previously unknown pro-tumorigenic role for the RUNX genes in this disease setting. Analysis of patient tumor biopsies together with loss of function studies in preclinical models established the importance of RUNX1 and RUNX2 in ccRCC. Patients with high RUNX1 (and RUNX2) expression exhibited significantly poorer clinical survival compared to patients with low expression. This was functionally relevant as deletion of RUNX1 in ccRCC cell lines reduced tumor cell growth and viability in vitro and in vivo. Transcriptional profiling of RUNX1-CRISPR-deleted cells revealed a gene signature dominated by extracellular matrix remodelling, notably affecting STMN3, SERPINH1, and EPHRIN signaling. Finally, RUNX1 deletion in a genetic mouse model of kidney cancer improved overall survival and reduced tumor cell proliferation. In summary, these data attest to the validity of targeting a RUNX1-transcriptional program in ccRCC.

2.
Oncogene ; 39(12): 2624-2637, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32005976

RESUMO

Epithelial to mesenchymal transition (EMT) is a dynamic process that drives cancer cell plasticity and is thought to play a major role in metastasis. Here we show, using MDA-MB-231 cells as a model, that the plasticity of at least some metastatic breast cancer cells is dependent on the transcriptional co-regulator CBFß. We demonstrate that CBFß is essential to maintain the mesenchymal phenotype of triple-negative breast cancer cells and that CBFß-depleted cells undergo a mesenchymal to epithelial transition (MET) and re-organise into acini-like structures, reminiscent of those formed by epithelial breast cells. We subsequently show, using an inducible CBFß system, that the MET can be reversed, thus demonstrating the plasticity of CBFß-mediated EMT. Moreover, the MET can be reversed by expression of the EMT transcription factor Slug whose expression is dependent on CBFß. Finally, we demonstrate that loss of CBFß inhibits the ability of metastatic breast cancer cells to invade bone cell cultures and suppresses their ability to form bone metastases in vivo. Together our findings demonstrate that CBFß can determine the plasticity of the metastatic cancer cell phenotype, suggesting that its regulation in different micro-environments may play a key role in the establishment of metastatic tumours.

3.
J Adolesc Health ; 66(2): 181-188, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31630924

RESUMO

PURPOSE: Disordered eating behaviors are prevalent among adolescents. Understanding how these behaviors link to body mass index (BMI) across different stages of development and over an extended period may provide insight for designing interventions around eating and weight. This study had two objectives: (1) to assess the distribution of disordered eating behaviors and develop a global score of disordered eating behaviors among adolescents and (2) to examine the association between the number of disordered eating behaviors in adolescence and BMI trajectory over 15 years. METHODS: Project Eating and Activity in Teens and Young Adults (EAT), a longitudinal study of weight-related health and behavior comprising four waves (EAT-I to EAT-IV), measured seven disordered eating behaviors (importance of weight and shape, frequent dieting, extreme unhealthy weight control behaviors, overeating, distress about overeating, loss of control while overeating, and frequency of overeating and loss of control) at baseline (N = 1,230, ages 11 to 18 years, 1998-1999). These behaviors were summed to create a disordered eating behavior score. BMI was self-reported at all four waves (up to age 27-33 years at EAT-IV). Repeated measures with random slope and intercept examined the association between disordered eating behaviors and BMI trajectories over 15 years. RESULTS: At baseline, 50.7% and 33.7% of females and males endorsed disordered eating behaviors. Throughout 15 years of follow-up, sociodemographic-adjusted BMI was higher among adolescents who engaged in disordered eating behaviors. The association remained significant after further adjustment for baseline BMI (p < .05). CONCLUSIONS: Among adolescents, regardless of the type of disordered eating behaviors, engagement in disordered eating behavior predicted higher BMI in a dose-response fashion.

4.
J Womens Health (Larchmt) ; 28(7): 951-960, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31184981

RESUMO

Background: International travel is increasingly popular, and women comprise half of all outbound travel from the United States (almost 46 million trips in 2017). The implications of international travel for women's reproductive health are not fully clear due to lack of data on travelers' contraceptive use. Methods: Women attending a U.S. university (n = 340) completed a cross-sectional survey in 2016-2017 about their sexual and reproductive health during recent international travel. Participants were 18-29 years old (mean: 21.1) and had a history of male sex partners. We calculated the prevalence of contraceptive lapse-nonadherence (e.g., missed pill) or having sex without contraception-by individual and travel-related characteristics and evaluated multivariable correlates of lapse using modified Poisson regression and prevalence ratios (PRs). Results: Prevalence of contraceptive lapse was 29% overall and especially high among pill users (50%). Multivariable correlates of lapse were the following: using the pill (PR 4.51, 95% confidence interval [CI] 2.57-7.94) compared to other or no contraception; trip duration of >30 days versus 1-7 days (PR 2.02, 95% CI 1.14-3.57); having trouble communicating with a male partner about contraception (PR 1.79, 95% CI 1.16-2.75); a high perceived impact of language barriers (PR 1.77, 95% CI 1.02-3.08); and perceiving local access to abortion as difficult (PR 1.67, 95% CI 1.22-2.27). There was a trend toward increased lapse prevalence among participants who had difficulty maintaining their contraceptive schedule while traveling across time zones (PR 1.38, 95% CI 1.00-1.91). Conclusions: During international travel, prevalence of contraceptive lapse varied by young women's chosen contraceptive method as well as travel-specific factors. Pretravel counseling by clinicians can help women anticipate contraceptive challenges and reduce the likelihood of unintended pregnancy.

5.
Arch Sex Behav ; 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31243616

RESUMO

International travel is popular worldwide, yet its implications for sexual and reproductive health are not fully understood. Few studies have examined the contextual factors that shape women's sexual and contraceptive behaviors-and thus, their risk of unintended pregnancy and sexually transmitted infections (STIs)-while traveling outside their home country. In this qualitative study, female university students with recent (n = 25) or upcoming (n = 19) travel outside the U.S. completed semi-structured interviews from October 2015 to March 2017. Transcripts were analyzed for themes related to contraceptive and sexual behaviors: (1) participants' pre-travel expectations of sex; (2) the circumstances surrounding sexual encounters with men while traveling; (3) negotiation about condom and contraception use with partners; and (4) factors affecting contraceptive adherence. Participants generally expected to be abstinent during travel, citing myriad rationales that included personal values, no perceived opportunities for sex, and the nature of the trip. Some travelers had unexpected sexual encounters, involving health-protecting behaviors and risk-taking (e.g., unprotected sex, substance use). New sexual partnerships were fueled by increased attention from men, situational disinhibition, and perceived heightened intimacy. International travel brought many contraceptive considerations (adequacy of supplies, access to refrigeration, time zone differences, etc.) as well as obstacles that triggered contraceptive lapses and discontinuation. Pill users described the most challenges, while travelers using intrauterine devices expressed appreciation for their maintenance-free contraception. This study suggests complex associations between international travel and young women's sexual and reproductive health. Some travelers were more vulnerable to situational risk factors, while others may have been more insulated. We identify potential intervention opportunities via clinical services, education, and policy to reduce young women's risk of adverse sexual and reproductive health outcomes while traveling abroad. We urge greater recognition of and conversations about contraceptive lapse and unintended pregnancy as potential health risks for female travelers of reproductive age, just as clinical guidelines acknowledge travel-associated STI.

6.
Int J Eat Disord ; 52(6): 659-668, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30939228

RESUMO

OBJECTIVE: Binge eating is prevalent across socioeconomic status (SES) groups, but it is unclear whether risk factors for binge eating vary by SES. This study examined the prevalence of several risk factors for binge eating by SES and SES as a potential moderator of these risk factors. METHOD: Participants included 2,179 individuals involved in Project EAT during early/middle adolescence (EAT-I) and 5 years later during late adolescence/emerging adulthood (EAT-II). Risk ratios were computed using modified Poisson regression of incident EAT-II binge eating on EAT-I risk factors among participants of high and low SES. Interactions between each risk factor and SES were tested. RESULTS: Among higher SES adolescents, overweight/obesity (RR = 3.2; 95% CI: 1.8, 5.7), body dissatisfaction (RR = 2.6; 95% confidence intervals (CI): 1.2, 5.5), dieting (RR = 4.0; 95% CI: 2.0, 8.2), and family weight-teasing (RR = 2.3; 95% CI: 1.3, 4.3) predicted increased risk for binge eating. Among adolescents from low-SES backgrounds, overweight/obesity (RR = 1.5; 95% CI: 0.9, 2.5), dieting (RR = 2.2; 95% CI: 1.2, 3.9), and food insecurity (RR = 1.4; 95% CI: 0.7, 2.7) predicted increased risk for binge eating. Moderator analyses revealed that overweight/obesity, body dissatisfaction, dieting, and family weight-teasing were stronger risk factors in the high-SES group than the low-SES group; interactions with food insecurity could not be examined given the low prevalence of food insecurity in the high-SES group. DISCUSSION: Risk factors for binge eating may vary by SES, suggesting the potential utility of modifying intervention and prevention methods based on SES. In particular, the role of food insecurity must be addressed.


Assuntos
Transtorno da Compulsão Alimentar/epidemiologia , Classe Social , Adolescente , Feminino , Humanos , Masculino , Fatores de Risco
7.
Int J Eat Disord ; 52(3): 304-308, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30636022

RESUMO

BACKGROUND: Problematic relationship to eating and food (PREF) captures a broad range of unhealthy eating behaviors. We previously reported that higher BMI is associated with PREF and graded by the number of PREF endorsed. In this study, we prospectively examined the association between PREF and metabolic syndrome and diabetes. METHOD: Eight PREF behaviors were assessed and summed to form the PREF score in 3800 black and white adults (age 27-41 years) in the Coronary Artery Risk Development in Young Adults Study. Diagnoses of incident metabolic syndrome and diabetes were made through 15 years of follow-up. Logistic regression estimated the association with metabolic syndrome. Proportional hazards regression estimated the association with diabetes. RESULTS: The odds ratio of metabolic syndrome was 1.25 per PREF point through 5 years of follow-up (95% CI: 1.17-1.34) and 1.17 per point from 5 to 10 years of follow-up (95% CI: 1.08-1.27). Hazard of diabetes was 1.20 per PREF point through 15 years of follow-up (95% CI: 1.12-1.28). Both associations attenuated after adjustment for BMI. DISCUSSION: Among participants with PREF, higher scores associate with metabolic syndrome and diabetes, with partial attenuation after adjustment for BMI. Early identification of PREF in middle-aged adults may reduce the burden of metabolic health outcomes.


Assuntos
Vasos Coronários/fisiopatologia , Diabetes Mellitus/etiologia , Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Síndrome Metabólica/etiologia , Adulto , Diabetes Mellitus/patologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Síndrome Metabólica/patologia , Fatores de Risco
8.
Transl Psychiatry ; 9(1): 16, 2019 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-30655501

RESUMO

Childhood psychosocial challenges (i.e., adversities, mental and substance use disorders, social challenges) may relate to the onset of obesity and extreme obesity. Identifying the types of psychosocial challenges most strongly associated with obesity could advance etiologic understanding and help target prevention efforts. Using a nationally representative sample of U.S. adults (N = 24,350), the present study evaluates relationships between childhood psychosocial challenges and development of obesity and extreme obesity. After mutually controlling, childhood poverty was a risk in men OR = 1.2 (1.0-1.4) and a significantly stronger one in women OR = 1.6 (1.4-1.8); maltreatment increased odds of obesity in both men and women OR = 1.3, 95% CI (1.1-1.4), and specifically increased odds of extreme obesity in women OR = 1.5 (1.3-1.9). Early childrearing (before age 18) was an independent risk factor in both men OR = 1.4 (1.0-1.9) and women OR = 1.3 (1.1-1.5); not finishing high school was the strongest childhood psychosocial challenge risk factor for extreme obesity in both men (OR = 1.6, 1.1-2.2) and women (OR = 2.0, 1.5-2.5). Psychiatric disorders (MDD, anxiety disorder, PTSD) before age 18 were not independently associated with adult obesity in men nor women, but substance use disorders (alcohol or drug) were inversely associated with adult obesity. Individuals who have experienced childhood adversities and social challenges are at increased risk for obesity. Previous findings also indicate that these individuals respond poorly to traditional weight management strategies. It is critical to identify the reasons for these elevated weight problems, and to develop interventions that are appropriately tailored to mitigate the obesity burden faced by this vulnerable population.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Obesidade/epidemiologia , Obesidade/psicologia , Adolescente , Adulto , Distribuição por Idade , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Distribuição por Sexo , Estados Unidos/epidemiologia , Adulto Jovem
9.
Perspect Sex Reprod Health ; 50(4): 173-180, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30118153

RESUMO

CONTEXT: International travel is common and may influence women's sexual and reproductive health through myriad pathways. Existing studies focus on travelers' risk of acquiring STDs, but not their pregnancy prevention behaviors. Further, it is unclear whether sexual and reproductive health outcomes observed for female travelers are associated with travel itself, because few studies compare travelers with nontravelers. METHODS: An online survey was conducted in 2016-2017 among females attending a U.S. university who reported a history of sex with men; the sample comprised 340 students who had traveled internationally in the past three months (travelers) and 170 who intended to travel in the next three months (pretravelers). Multivariable modified Poisson regression models assessed associations between travel status and two outcomes during travelers' recent trip or a period of similar duration for pretravelers: contraceptive lapse (incorrect or inconsistent use of any method) and new sexual partnership. RESULTS: Travelers and pretravelers reported similar levels of contraceptive lapse (29% and 32%, respectively) and new sexual partnerships (17% and 12%). Multivariable analysis confirmed that travelers were no more likely than pretravelers to have contraceptive lapses, but indicated that they were more likely to report a new male partner (relative risk, 1.7). Most participants (80%) had a regular source of sexual and reproductive health care; 42% of travelers had seen a health care provider in preparation for their trip. CONCLUSION: If the findings are corroborated by additional research, they may suggest a role for health care providers in students' pretravel period.


Assuntos
Comportamento Contraceptivo/psicologia , Cooperação do Paciente/psicologia , Comportamento Sexual/psicologia , Estudantes/psicologia , Viagem/psicologia , Adolescente , Adulto , Feminino , Humanos , Análise Multivariada , Distribuição de Poisson , Fatores de Risco , Parceiros Sexuais , Inquéritos e Questionários , Estados Unidos , Universidades , Adulto Jovem
10.
Ann Epidemiol ; 28(9): 590-596, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30153909

RESUMO

BACKGROUND: Child maltreatment is a major public health problem, but population-based surveillance and research is hindered by limitations of official child welfare data. The present study used a promising complementary data source, hospital discharge data, to investigate risk factors for infant injuries suggestive of maltreatment. METHODS: Discharge data from all hospital births to New York City residents from 1995 to 2004 were linked to birth certificates and to subsequent infant hospitalizations within 12 months after delivery. Probable maltreatment of infants was identified with 33 injury diagnosis codes highly correlated with maltreatment. Modified Poisson regression estimated the association of sociodemographic factors and pregnancy/birth characteristics with subsequent infant admission for probable maltreatment. RESULTS: Risk factors for maltreatment included neonatal intensive care unit stays of more than 11 days (adjusted risk ratio [aRR] = 1.8; 95% confidence interval [CI]: 1.1-2.8), preterm birth (aRR = 1.6; 95% CI: 1.2-2.1), maternal age less than 20 years (aRR = 1.5; 95% CI: 1.2-1.9), and public insurance (aRR = 1.5; 95% CI: 1.2-1.9). Factors associated with reduced maltreatment risk included mother born outside the United States (aRR = 0.7; 95% CI: 0.6-0.8) and female infant (aRR = 0.7; 95% CI: 0.6-0.9). CONCLUSIONS: Sociodemographic factors and challenges at birth (preterm, neonatal intensive care unit stays) are important risk factors for subsequent maltreatment-related hospitalization, with potential implications for prevention targeting.


Assuntos
Maus-Tratos Infantis/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Alta do Paciente , Vigilância da População/métodos , Adulto , Declaração de Nascimento , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Mães , Cidade de Nova Iorque , Gravidez , Fatores de Risco , Fatores Socioeconômicos , Ferimentos e Lesões
11.
Cell Death Dis ; 9(2): 19, 2018 01 16.
Artigo em Inglês | MEDLINE | ID: mdl-29339815

RESUMO

Analysis of publicly available genomic and gene expression data demonstrates that MCL1 expression is frequently elevated in breast cancer. Distinct from other pro-survival Bcl-2 family members, the short half-life of MCL-1 protein led us to investigate MCL-1 protein expression in a breast cancer tissue microarray and correlate this with clinical data. Here, we report associations between high MCL-1 and poor prognosis in specific subtypes of breast cancer including triple-negative breast cancer, an aggressive form that lacks targeted treatment options. Deletion of MCL-1 in the mammary epithelium of genetically engineered mice revealed an absolute requirement for MCL-1 in breast tumorigenesis. The clinical applicability of these findings was tested through a combination of approaches including knock-down or inhibition of MCL-1 to show triple-negative breast cancer cell line dependence on MCL-1 in vitro and in vivo. Our data demonstrate that high MCL-1 protein expression is associated with poor outcome in breast cancer and support the therapeutic targeting of MCL-1 in this disease.


Assuntos
Neoplasias da Mama/metabolismo , Terapia de Alvo Molecular , Proteína de Sequência 1 de Leucemia de Células Mieloides/metabolismo , Animais , Neoplasias da Mama/classificação , Neoplasias da Mama/patologia , Carcinogênese/patologia , Linhagem Celular Tumoral , Proliferação de Células , Sobrevivência Celular , Feminino , Humanos , Camundongos Endogâmicos BALB C , Camundongos Nus , Pessoa de Meia-Idade , Prognóstico , Resultado do Tratamento , Neoplasias de Mama Triplo Negativas/patologia , Ensaios Antitumorais Modelo de Xenoenxerto
12.
Int J Eat Disord ; 51(1): 10-17, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29215750

RESUMO

OBJECTIVE: Problematic eating behaviors and attitudes are of public health concern. Questionnaire-based assessment of these behaviors is important for large-scale research on eating behaviors. The questionnaire on eating and weight patterns-revised (QEWP-R) measures potential problematic behaviors and attitudes toward food (including anxieties, compensatory actions, overeating and loss of control, dieting, and shape concerns) that in aggregate may indicate diagnosable eating disorders. An important question regards the prevalence of these issues and their longitudinal associations with body mass index (BMI) in generally healthy middle aged adults. METHOD: Based on eight constructs measured on QEWP-R, we created a new problematic relationship to eating and food (PREF) scale by assigning a point for each construct endorsed. Analyses were conducted in 3,892 black and white men and women participating in the community-based Coronary Artery Risk Development in Young Adults (CARDIA) Study. The QEWP-R was administered in CARDIA year 10, when participants were aged 27-41 years. We used linear regression to model the relationship of individual constructs and the PREF scale to BMI over CARDIA follow-up. RESULTS: Fifty-five percent of participants had 1-5 points and 4% had 6-8 points on the PREF scale. Each separate construct was positively associated with BMI, except concern about weight and shape. Adjusting for age, race, sex, education, and study center, mean BMI at CARDIA year 10, the time of PREF assessment, was approximately 1.0-2.5 kg/m2 higher per PREF category. CONCLUSION: In middle age, problematic behaviors and attitudes toward food were common and associated with higher BMI.


Assuntos
Índice de Massa Corporal , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Cardiopatias/etiologia , Adulto , Feminino , Cardiopatias/patologia , Humanos , Masculino , Fatores de Risco , Inquéritos e Questionários , Fatores de Tempo
13.
Dev Psychopathol ; 30(4): 1447-1458, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29144209

RESUMO

Body dissatisfaction and depressive symptoms are commonly experienced during adolescence and increase the risk of adverse health outcomes, especially eating disorders. However, the dominant temporal associations between these two experiences (i.e., whether one is a risk factor for the other or the two are mutually reinforcing) has yet to be fully explored. We examined the associations between body dissatisfaction and depressive symptoms assessed at baseline and 5- and 10-year follow-up in younger (M age = 12.9 years at baseline, 56% female, n = 577) and older (M age = 15.9 years at baseline, 57% female, n = 1,325) adolescent cohorts assessed as part of Project Eating Among Teens and Young Adults. Associations between body dissatisfaction and depressive symptoms were examined using cross-lagged models. For females, the dominant directionality was for body dissatisfaction predicting later depressive symptoms. For males, the picture was more complex, with developmentally sensitive associations in which depressive symptoms predicted later body dissatisfaction in early adolescence and early adulthood, but the reverse association was dominant during middle adolescence. These findings suggest that interventions should be tailored to dynamic risk profiles that shift over adolescence and early adulthood, and that targeting body dissatisfaction at key periods during development may have downstream impacts on depressive symptoms.


Assuntos
Imagem Corporal/psicologia , Depressão/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Autoimagem , Adolescente , Índice de Massa Corporal , Criança , Emoções , Feminino , Humanos , Estudos Longitudinais , Masculino , Fatores de Risco , Adulto Jovem
14.
Soc Sci Med ; 188: 166-175, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28747248

RESUMO

OBJECTIVE: The current study investigated mediators between childhood/adolescent adversities (e.g., dating violence, maltreatment, homelessness, and parental death), low socioeconomic status (SES) during adolescence, and cardiovascular disease (CVD) risk in young adulthood. The purpose of these analyses was to understand whether SES during adolescence and childhood/adolescent adversities affect CVD risk through similar pathways, including maternal relationship quality, health behaviors, financial stress, medical/dental care, educational attainment, sleep problems, and depressive symptoms. METHODS: Using the National Longitudinal Study of Adolescent to Adult Health (N = 14,493), which has followed US adolescents (Wave 1; M = 15.9 years) through early adulthood (Wave 4; M = 28.9 years), associations were examined between childhood/adolescent adversity and SES to 30-year CVD risk in young adulthood. The outcome was a Framingham-based prediction model of CVD risk that included age, sex, body mass index, smoking, systolic blood pressure, diabetes, and antihypertensive medication use at Wave 4. Path analysis was used to examine paths through the adolescent maternal relationship to young adult mediators of CVD risk. RESULTS: Childhood/adolescent adversity significantly predicted greater adult CVD risk through the following pathways: maternal relationship, health behaviors, financial stress, lack of medical/dental care, and educational attainment; but not through depressive symptoms or sleep problems. Lower SES during adolescence significantly predicted greater adult CVD risk through the following pathways: health behaviors, financial stress, lack of medical/dental care, and educational attainment, but not maternal relationship, depressive symptoms, or sleep problems. CONCLUSIONS: Childhood/adolescent adversities and SES affected CVD risk in young adulthood through both similar and unique pathways that may inform interventions.


Assuntos
Doenças Cardiovasculares/etiologia , Nível de Saúde , Acontecimentos que Mudam a Vida , Classe Social , Adulto , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/psicologia , Grupos de Populações Continentais/estatística & dados numéricos , Depressão/epidemiologia , Depressão/etiologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Estudos Longitudinais , Masculino , Medição de Risco/métodos , Medição de Risco/normas , Fatores de Risco , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Inquéritos e Questionários , Estados Unidos/epidemiologia
15.
Ann Behav Med ; 51(6): 822-832, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28425019

RESUMO

BACKGROUND: Posttraumatic stress disorder (PTSD) is a risk factor for obesity, but the range of behaviors that contribute to this association are not known. PURPOSE: The purpose of this study was to examine associations between self-reported PTSD symptoms in 2007, with and without comorbid depression symptoms, and three problematic overeating behaviors in 2010, and to estimate the associations of PTSD-related overeating behaviors with obesity. METHODS: Cross-sectional and longitudinal analyses included 7438 male (n = 2478) and female (n = 4960) participants from the Growing Up Today Study (mean age 22-29 years in 2010). Three eating behavior outcomes were assessed: binge eating (eating a large amount of food in a short period of time with loss of control), top quartile of coping-motivated eating (from the Motivations to Eat scale), and top quartile of disinhibited eating (from the Three-Factor Eating Questionnaire). RESULTS: PTSD symptoms were associated with two- to threefold increases in binge eating and top-quartile coping-motivated eating; having ≥4 PTSD symptoms, relative to no PTSD symptoms, was associated with covariate-adjusted RRs of 2.7 (95% CI 2.1, 3.4) for binge eating, 2.1 (95% CI 1.9, 2.4) for the top quartile of coping-motivated eating, and 1.5 (95% CI 1.3, 1.7) for the top quartile of disinhibited eating. There was a trend toward PTSD symptoms in 2007 predicting new onset binge eating in 2010. Having depression symptoms comorbid with PTSD symptoms further increased risk of binge eating and coping-motivated eating. All eating behaviors were associated with obesity. CONCLUSION: Clinicians treating patients with PTSD should know of potential comorbid problematic eating behaviors that may contribute to obesity.


Assuntos
Adaptação Psicológica/fisiologia , Bulimia/fisiopatologia , Depressão/fisiopatologia , Comportamento Alimentar/fisiologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Obesidade/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Adulto , Bulimia/epidemiologia , Comorbidade , Estudos Transversais , Depressão/epidemiologia , Comportamento Alimentar/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Obesidade/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto Jovem
16.
Depress Anxiety ; 34(5): 391-400, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28380289

RESUMO

BACKGROUND: Studies in male combat veterans have suggested posttraumatic stress disorder (PTSD) is associated with shorter telomere length (TL). We examined the cross-sectional association of PTSD with TL in women exposed to traumas common in civilian life. METHODS: Data are from a substudy of the Nurses' Health Study II (N = 116). PTSD and subclinical PTSD were assessed in trauma-exposed women using diagnostic interviews. An array of health behaviors and conditions were assessed. DNA was extracted from peripheral blood leukocytes (collected 1996-1999). Telomere repeat copy number to single gene copy number (T/S) was determined by quantitative real-time PCR telomere assay. We used linear regression models to assess associations and examine whether a range of important health behaviors (e.g., cigarette smoking) and medical conditions (e.g., hypertension) previously associated with TL might explain a PTSD-TL association. We further examined whether type of trauma exposure (e.g., interpersonal violence) was associated with TL and whether trauma type might explain a PTSD-TL association. RESULTS: Relative to not having PTSD, women with a PTSD diagnosis had shorter log-transformed TL (ß = -.112, 95% confidence interval (CI) = -0.196, -0.028). Adjustment for health behaviors and medical conditions did not attenuate this association. Trauma type was not associated with TL and did not account for the association of PTSD with TL. CONCLUSIONS: Our results add to growing evidence that PTSD may be associated with more rapid cellular aging as measured by telomere erosion. Moreover, the association could not be explained by health behaviors and medical conditions assessed in this study, nor by type of trauma exposure.


Assuntos
Transtornos de Estresse Pós-Traumáticos/genética , Encurtamento do Telômero/genética , Adulto , Estudos Transversais , Feminino , Humanos , Leucócitos/metabolismo , Estudos Longitudinais , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros
17.
J Womens Health (Larchmt) ; 26(6): 677-682, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28075656

RESUMO

BACKGROUND: Intimate partner violence (IPV) and obesity are national public health problems that are potentially associated. We examined the association between IPV exposure and 5-year weight gain in young women. We also examined whether depressive mood conferred additional increases in weight gain. MATERIALS AND METHODS: Analyses were conducted among women in Project EAT, a longitudinal cohort study of weight-related health, which has collected data at three 5-year survey waves: "EAT I" (mean age 15 years), "EAT II" (mean age 19 years), and "EAT III" (mean age 25 years). Height and body weight were self-reported at each survey wave. IPV victimization and depressive mood were assessed on the EAT II survey. The study comprised women with data on IPV and body mass index (BMI) (N = 619). Linear regression analyses examined (1) 5-year (EAT II to EAT III) BMI change as a function of IPV exposure and (2) 5-year BMI change as a function of depressive mood at EAT II in women with and without IPV exposure. RESULTS: Almost 20% of the study sample reported IPV. Women exposed to both physical and sexual IPV at EAT II gained 1.1 kg/m2 (95% CI -0.2 to 2.4) more, over 5 years, than women unexposed to IPV, although this did not reach statistical significance. Among those with IPV exposure, depressive mood at EAT II was associated with an additional increase in BMI of 1.8 kg/m2 (95% CI 0.2-3.4) relative to no depressive mood. CONCLUSION: Survivors of IPV with depressive mood may have accelerated weight gain. Trauma-informed obesity prevention strategies may be warranted in this group.


Assuntos
Vítimas de Crime/psicologia , Depressão/etiologia , Violência por Parceiro Íntimo/psicologia , Parceiros Sexuais , Maus-Tratos Conjugais , Sobreviventes/psicologia , Ganho de Peso , Adolescente , Adulto , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Estudos Longitudinais , Minnesota , Autorrelato , Sobreviventes/estatística & dados numéricos , Adulto Jovem
18.
Vaccine ; 34(22): 2501-6, 2016 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-27020709

RESUMO

BACKGROUND: Human papillomavirus (HPV) vaccine uptake in the US is suboptimal; identifying risk factors associated with low vaccine uptake is critical to increase vaccination coverage. Some evidence suggests body mass index (BMI) is associated with low HPV vaccine uptake and increased risk of HPV infection in adults. BMI may therefore be an important factor in targeting HPV vaccine to US adolescents. METHODS: We investigated the relationship between BMI categories (underweight, normal weight, overweight and obese) and HPV vaccine uptake in 4109 adolescents (9-18 years old) using data from the 2009 to 2014 National Health and Nutrition Examination Survey (NHANES). We used modified Poisson regression to assess the relationship between BMI and receipt of at least one HPV vaccine, and BMI and completion of the vaccine three-dose series. We assessed the relationship between BMI and age at first HPV vaccination using linear regression. RESULTS: Receipt of at least one dose of HPV vaccine was low in both females (35%) and males (10%). High BMI was not associated with initiation of the HPV vaccine series, age at first HPV vaccination, or completion of the HPV vaccine three-dose course. CONCLUSIONS: We found no evidence that high BMI is associated with reduced initiation or completion of the HPV vaccination series, or age at initiation of the three-dose course among a general population sample of US adolescents. Our results suggest that efforts to increase HPV vaccine uptake need not consider targeting by weight status at this time.


Assuntos
Índice de Massa Corporal , Obesidade , Sobrepeso , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Vacinação/estatística & dados numéricos , Adolescente , Criança , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Inquéritos Nutricionais , Infecções por Papillomavirus/virologia , Vacinas contra Papillomavirus/efeitos adversos , Análise de Regressão , Fatores de Risco , Adulto Jovem
19.
Prev Med ; 87: 194-199, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-26970036

RESUMO

Reducing socioeconomic disparities in weight-related health is a public health priority. The purpose of this paper was to examine 10-year longitudinal patterns in overweight and weight-related behaviors from adolescence to young adulthood as a function of family-level socioeconomic status (SES) and educational attainment. Project EAT (Eating and Activity in Teens and Young Adults) followed a diverse sample of 2287 adolescents from 1999 to 2009. Mixed-effects regression tested longitudinal trends in overweight, fast food, breakfast skipping, physical inactivity, and screen use by family-level SES. The influence of subsequent educational attainment in young adulthood was examined. Results revealed that the prevalence of overweight increased significantly from adolescence to young adulthood with the greatest change seen in those from low SES (mean change=30.7%, 95% CI=25.6%-35.9%) as compared to high SES families (mean change=21.7%, 95% CI=18.2%-25.1%). Behavioral changes from adolescence to young adulthood also differed by SES background; the prevalence of frequent fast food intake (≥3times/week) increased most dramatically in those from low SES (mean change=6%, 95% CI=0.5%-11%) as compared to high SES families (mean change=-1.2%, 95% CI=-5.2%-2.9%). Overall trends suggest that a higher educational attainment mitigates the negative impacts of a low SES background. These findings suggest that continued effort is needed to ensure that public health strategies addressing obesity and related behaviors reach adolescents and young adults from low SES backgrounds and do not contribute to widening socioeconomic gaps in weight-related health.


Assuntos
Ingestão de Alimentos/fisiologia , Sobrepeso/epidemiologia , Classe Social , Ganho de Peso/fisiologia , Adolescente , Peso Corporal , Escolaridade , Feminino , Humanos , Estudos Longitudinais , Masculino , Minnesota/epidemiologia , Prevalência , Adulto Jovem
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