Adiponectin and leptin trajectories in Mexican-American children from birth to 9 years of age.

OBJECTIVES: To address molecular mechanisms underlying obesity development, we examined patterns of critical metabolism-related hormones, adiponectin and leptin (adipokines), over childhood. SUBJECTS AND DESIGN: Plasma adiponectin and leptin were measured in 80 Mexican-American children at birth and again at 2, 5, and 9 years from the ongoing prospective cohort followed by the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS). We used a mixture modeling approach to identify patterns in adipokine trajectories from birth to 9 years. RESULTS: Leptin was positively related to child body size within all ages, however adiponectin had inverse and weaker associations with BMI at 2, 5, and 9 years. Correlations between adipokine levels over the 0-2, 2-5, and 5-9-year periods increased for both leptin (r = 0.06, 0.31 and 0.62) and adiponectin (r = 0.25, 0.41 and 0.46). Our mixture modeling approach identified three trajectory clusters for both leptin (1L [slowly-rising], 2L [rapidly-rising], and 3L [stable]) and adiponectin (1A [steep-dropping and rebounding], 2A [moderately-dropping], and 3A [stable]). While leptin groups were most separated over the 2-9-year period, adiponectin trajectories displayed greatest heterogeneity from birth to 2 years. Children in the rapidly-rising 2L group had highest BMI and waist circumference at 9 years. Further, children with greater birth weight had increased odds of belonging to this high risk group (OR = 1.21 95% CI 1.03, 1.43, compared to stable group 3L). Children whose mothers consumed more sugar-sweetened beverages during pregnancy were at risk of being in the steep-dropping 1A group (OR = 1.08, 95% CI 1.01, 1.17, compared to stable group 3A). CONCLUSION: Our results highlight developmental differences in leptin and adiponectin over the childhood period. Leptin closely reflects child body size however factors affecting adiponectin and long-term consequences of its changes over infancy need to be further explored.

Prenatal and postnatal bisphenol A exposure and body mass index in childhood in the CHAMACOS cohort.

BACKGROUND: Bisphenol A (BPA), a widely used endocrine-disrupting chemical, has been associated with increased body weight and fat deposition in rodents. OBJECTIVES: We examined whether prenatal and postnatal urinary BPA concentrations were associated with body mass index (BMI), waist circumference, percent body fat, and obesity in 9-year-old children (n = 311) in the CHAMACOS longitudinal cohort study. METHODS: BPA was measured in spot urine samples collected from mothers twice during pregnancy and from children at 5 and 9 years of age. RESULTS: Prenatal urinary BPA concentrations were associated with decreased BMI at 9 years of age in girls but not boys. Among girls, being in the highest tertile of prenatal BPA concentrations was associated with decreased BMI z-score (ß = -0.47, 95% CI: -0.87, -0.07) and percent body fat (ß = -4.36, 95% CI: -8.37, -0.34) and decreased odds of overweight/obesity [odds ratio (OR) = 0.37, 95% CI: 0.16, 0.91] compared with girls in the lowest tertile. These findings were strongest in prepubertal girls. Urinary BPA concentrations at 5 years of age were not associated with any anthropometric parameters at 5 or 9 years, but BPA concentrations at 9 years were positively associated with BMI, waist circumference, fat mass, and overweight/obesity at 9 years in boys and girls. CONCLUSIONS: Consistent with other cross-sectional studies, higher urinary BPA concentrations at 9 years of age were associated with increased adiposity at 9 years. However, increasing BPA concentrations in mothers during pregnancy were associated with decreased BMI, body fat, and overweight/obesity among their daughters at 9 years of age.

The use and abuse of multiple outcomes in randomized controlled depression trials.

OBJECTIVE: Multiple outcomes are commonly analyzed in randomized trials. Interpretation of the results of trials with many outcomes is not always straightforward. We characterize the prevalence and factors associated with multiple outcomes in reports of clinical trials of depression, methods used to account for these outcomes, and concordance between published analyses and original protocol specifications. METHODS: A PubMed search for randomized controlled depression trials that included multiple outcomes published between January 2007 and October 2008 in 6 medical journals. Original study protocols were reviewed where available. Parallel data collection by 2 abstractors was used to determine trial registration information, the number of outcomes, and analytical method. RESULTS: Of the 55 included trials, nearly half of the papers reported more than 1 primary outcome, while almost all (90.9%, n = 50) reported more than 2 combined primary or secondary outcomes. Relatively few of the studies (5.8%, n = 3) adjusted for multiple outcomes. While most studies had published protocols in clinical trial registries (76.4%, n = 42), many did not specify outcomes in the protocol (n = 11) and a number had discrepancies with the published report. CONCLUSIONS: Multiple outcomes are prevalent in randomized controlled depression trials and appropriate statistical analyses to account for these methods are rarely used. Not all studies filed protocols, and there were discrepancies between these protocols and published reports. These issues complicate interpretability of trial results, and in some cases may lead to spurious conclusions. Promulgation of guidelines to improve analysis and reporting of multiple outcomes is warranted.

The utility of the AUDIT in screening for drinking game involvement among female college students.

Drinking games (DG) facilitate heavy alcohol consumption in a short period and are associated with negative experiences. We examined the utility of Alcohol Use Disorders Identification Test (AUDIT) cut-off scores to identify DG involvement. Findings indicated an AUDIT score of at least 5 is needed to identify gamers among students at a women's college. Prevention implications are discussed.