prospective assessment
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Abstract Background Underlying pathophysiological mechanisms drive excessive clustering of cardiometabolic risk factors, causing metabolic syndrome (MetS). However, MetS status may transform as adolescents transition to young adulthood. This study evaluated the latent clustering structure and its stability for MetS during adolescence and investigated the determinants for MetS transformation over 2 years of follow-up. Methods A community-based representative adolescent cohort (n=1516) was evaluated for MetS using four diagnostic criteria and followed for 2.2 years to identify new-onset MetS. Factor analysis and polytomous logistic regression were separately applied to investigate the latent clustering structure for MetS and the relationship between changes in metabolic risk factors and transformations in MetS status. Results The clustering pattern of cardiometabolic parameters was comparable at baseline and follow-up surveys; both comprised a fat‒blood pressure‒glucose three-factor structure (total variance explained: 68.8% and 69.7%, respectively). Among adolescents who were MetS-negative at baseline, 3.2%‒4.4% had incident MetS after 2 years. Among adolescents who were MetS-positive at baseline, 52.0%‒61.9% experienced MetS remission, and 38.1%‒48.0% experienced MetS persistence. Increased systolic blood pressure (SBP) was associated with a higher risk of MetS incidence, and decreased SBP, triglycerides, and glucose levels were associated with MetS remission. Compared with adolescents with a normal metabolic status at baseline, those having an initial abnormal status in the five MetS components all had greater risks for persistent metabolic abnormality 2 years later, with abdominal obesity and increased triglycerides rendering a 15.0- and 5.7-fold risk, respectively. Conclusions The structure of cardiometabolic parameter clustering for MetS is stable during adolescence. Changes in metabolic risk factors affect typological transformation of adolescent MetS. Abnormal MetS components have a high probability of persisting. Early identification of each abnormal component and attendant intervention are vital in adolescents to minimize the future risk of cardiometabolic disorders.

Background: The focus of this review was to assess changes in youth mental health, psychological wellbeing, or substance use, as well as changes or disruptions to the delivery of mental health or substance use services for young people during the COVID-19 pandemic. Method: We conducted a rapid review of the literature on our outcomes of interest among youth (age <=25) in the context of the COVID-19 pandemic. Primary studies and systematic reviews on change were eligible for inclusion. Searches were conducted in PubMed and Embase in May 2021, and two reviewers screened studies for inclusion. We report results using a narrative synthesis.Results: We included 156 primary publications. A variety of methods were used to assess change, including prospective assessment of longitudinal cohorts, retrospective recall by participants in cross-sectional and qualitative studies, and comparison of peri-pandemic data to pre-pandemic normative values. Publications regarding mental health (n = 121) and psychological wellbeing (n = 26) generally indicated poor outcomes during the pandemic period. Publications on substance use (n = 41) revealed overall declines or unchanged patterns of use, though certain groups reported increased or problematic use. Studies of service delivery (n = 11) indicated a generally positive reception for helplines and telehealth, although some youth experienced difficulties accessing mental health services. Conclusions: The evidence indicates negative impacts of the COVID-19 pandemic on young people’s mental health, although declines in alcohol and nicotine use were also found. Services will need to continue to adapt as the pandemic progresses, particularly to support disadvantaged youth who lack access to telehealth resources.

BACKGROUND: Obesity is currently considered as one of the most significant social chronic diseases. It has been proven that obese pregnant women are more likely than women with normal body weight to experience complications of pregnancy and labor. The most frequent complications of labor in obese women are weakness and discoordination, which are probably associated with a decrease in the sensitivity of the myometrium to oxytocin, due to suppression of oxytocin receptor expression. AIM: The aim of this study was to explore the clinical features of labor and morphological aspects of the myometrium receptor apparatus in obese women. MATERIALS AND METHODS: We performed a prospective assessment of labor activity in women with obesity, with a combination of obesity and gestational diabetes mellitus and in healthy women. We also conducted a morphological study of myometrium biopsies obtained during cesarean section. RESULTS: Obese patients are more likely to experience various complications of pregnancy and labor, which is the reason for the higher frequency of operative delivery. Patients with obesity showed lower expression of oxytocin receptors in the lower segment of the uterus, which, apparently, is the cause of abnormal contractility of the myometrium during labor and the lack of effect from drug correction of this condition. CONCLUSIONS: The presence of obesity in women before pregnancy contributes to frequent complications of pregnancy and labor, abnormal uterine contractility related to the decreased oxytocin receptor expression, and a high incidence of surgical delivery.