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PubMed2005

Standardized quantification of circulating peripheral tumor cells from lung and breast cancer.

Detection and quantitation of circulating tumor cells from solid epithelial tumors could become a valuable tool for therapy monitoring if the procedure can be standardized. In the present work we assessed the influence of pre-analytical handling, storage and white blood cell isolation on analysis of a population of spiked tumor cell-line cells and intrinsically present epithelial cells in the peripheral blood of breast and lung cancer patients and the sensitivity of their detection. Sucrose density separation did not enrich epithelial cells, and even depleted them, leading to a gross underestimation of their numbers (3/13 positive, between 2.9 and 50 cells/mL) in comparison to red blood cell lysis (13/13 positive, between 77,200 and 800 cells/mL). Short-term storage of whole blood samples for up to 7 days had little influence on the number of epithelial cells recovered. The effectiveness of magnetic bead enrichment was dependent on the number of relevant cells and the volume used for enrichment. Red blood cell lysis and fluorochrome-labeled antibody staining in a no-wash procedure with subsequent laser scanning cytometry allowed the detection of circulating epithelial cells in 92% of breast and lung cancer patients. Two examples of how this method can be applied for the longitudinal analysis in individual patients are shown, with an increase in numbers preceding relapse and a decrease paralleling tumor reduction. The proposed simple and easy method allows close monitoring, which may help in real-time analysis of the response of solid tumors, especially their systemic component, to therapy and hopefully will contribute to more individually tailored therapy.

Adolescent↗
PubMed1991

Use of polymerase chain reactions to monitor minimal residual disease in acute lymphoblastic leukemia patients.

T-cell receptor (TCR) delta gene rearrangements are observed in more than 80% of acute lymphoblastic leukemia (ALL) patients. Moreover, a preferential usage of specific genetic elements has been shown in different ALL subtypes: V delta 1 DJ delta 1 rearrangements predominate in T-ALL, while most B-precursor ALLs show a recombination of V delta 2 to D delta 3. Recently we have proposed a strategy for the detection of minimal residual disease (MRD) based on the isolation of clonospecific probes following the in vitro amplification of V delta 1 DJ delta 1 junctions by polymerase chain reaction (PCR) and now have adapted this method to the preparation of specific V delta 2 D delta 3 fragments. In the present study, clonospecific probes were generated from 11 T-ALL and 16 cALL patients (21 children, 6 adults). The sensitivity of these 27 probes in detecting residual leukemia cells varied between 10(-4) to 10(-6) as determined by semiquantitative evaluation of dilution experiments. PCR analysis of 55 bone marrow (BM) and peripheral blood (PB) samples obtained from the 27 patients during complete clinical remission showed the following results: (1) Evidence for MRD was obtained in the BM of all patients (eight of eight) investigated 2 to 6 months after remission induction and also in 6 of 11 cases on maintenance therapy 7 to 19 months after diagnosis. (2) In contrast, all patients but one (10 of 11) analyzed 6 to 41 months after the termination of treatment lacked apparent evidence for leukemia DNA; the exception was a girl exhibiting 10(-4) to 10(-5) residual cells in her PB 5.5 years after diagnosis. (3) Longitudinal analysis in nine patients disclosed marked individual differences in the intervals between achievement of clinical remission and complete eradication of the leukemia cell clone. (4) Differences in the duration of MRD were not associated with distinct clinical-hematologic features. (5) Detection of residual disease by PCR proceeded clinical relapse in two cases.

Blotting, Southern↗
PubMed2004

Respiratory symptoms and lung function of coke oven workers: a lung function surveillance system from 1990-2000.

This study investigated the association of exposure to coke oven emissions with respiratory symptoms and with lung function. Data for respiratory symptoms and lung function were repeatedly collected from 764 male coke oven workers between 1990 and 2000. The data were analyzed cross-sectionally and longitudinally. Working in "Operation" increased the risk for cough (odds ratio [OR] = 2.37), phlegm (OR = 2.55), and shortness of breath (OR = 1.52). Cross-sectionally, each year of working in Operation was associated with a reduction in FEV1 of approximately 10 mL (P = 0.006) and in FVC of around 21 mL (P = 0.0001). From longitudinal analysis, each year of working in Operation was associated with an extra annual decline in FEV1 of 1.5 mL (P = 0.0012) and in FVC of around 1.8 mL (P = 0.0017). Exposure to coke oven emissions increased the risk for respiratory symptoms and adversely affected lung function.

Adult↗
PubMed1994

Comparison of tests for glycated haemoglobin and fasting and two hour plasma glucose concentrations as diagnostic methods for diabetes.

OBJECTIVE: To compare the ability of tests measuring two hour plasma glucose, fasting plasma glucose, and glycated haemoglobin concentrations in predicting the specific microvascular complications of non-insulin dependent diabetes mellitus. DESIGN: Cross sectional and longitudinal analysis of the relation between complications and concomitant results of the three tests. SETTING: Gila River Indian Community, Arizona. SUBJECTS: Pima Indians (cross sectional, n = 960), aged 25 years or above who were not receiving insulin or oral hypoglycaemic treatment at the baseline examination. MAIN OUTCOME MEASURES: Development of retinopathy and nephropathy. RESULTS: Cross sectionally, frequency distributions of logarithms of the three sets of results were bimodal, with the prevalence of retinopathy and nephropathy being, respectively, 12.0-26.7 and 3.9-4.2 times as high above as below cut off points which minimised overlap (two hour plasma glucose concentration 12.6 mmol/l; fasting plasma glucose concentration 9.3 mmol/l; glycated haemoglobin (HbA1c) concentration 7.8%). Longitudinally, each of the three measures of glycaemia significantly predicted the development of retinopathy (P < 0.0001) and nephropathy (P < 0.05). Receiver operating characteristic curves showed that two hour plasma glucose concentration was superior to fasting plasma glucose concentration (P < 0.05) for prevalent cases of retinopathy, but otherwise no variable had a significant advantage for detecting incident or prevalent cases of either complication. CONCLUSIONS: These findings suggest that determination of glycated haemoglobin or fasting plasma glucose concentrations alone may be acceptable alternatives to measuring glucose concentration two hours after challenge with 75 g glucose for the diagnosis of diabetes.

Adult↗
PubMed2005

Major depression predicts an increase in long-term body weight variability in young adults.

OBJECTIVE: To test the hypothesis that major depression predicts an increase in long-term body weight variability (BWV). RESEARCH METHODS AND PROCEDURES: This was a prospective community-based single-age cohort study of young adults (N = 591) followed between the ages of 19 and 40. Following initial screening, information was derived from six subsequent semistructured diagnostic interviews conducted by mental health professionals. Major depression was diagnosed on the basis of DSM criteria. BWV was defined as the root mean square error of a regression line fitted to each individual's BMI values over time. Multiple regression analysis was used to test the association between major depression and BWV while controlling for potentially confounding variables including antidepressant treatment, eating disorder symptoms, and physical activity. We used random effects models to determine the temporal relationship between repeated measures of major depression and body weight change. RESULTS: A highly significant positive association between major depression and BWV was found, whereas major depression was not associated with BMI level or BMI trend. Depression severity showed a dose-response-type relationship with the magnitude of BWV. After controlling for potentially confounding variables including antidepressant use, eating disorder symptoms, smoking, and physical activity, major depression remained a significant predictor of BWV (beta= 0.13, p < 0.001). Longitudinal analysis revealed a unidirectional association between major depression and a later increase in body weight change rate irrespective of antidepressant medication. DISCUSSION: Results from this study implicate depression as an important risk factor for increased BWV. Given increasing evidence for a link between major depression and both diabetes and cardiovascular disease, current results encourage further research on depression, BWV, and negative health outcomes.

Adult↗
PubMed2003

Lipoproteins in the DCCT/EDIC cohort: associations with diabetic nephropathy.

BACKGROUND: Lipoproteins may contribute to diabetic nephropathy. Nuclear magnetic resonance (NMR) can quantify subclasses and mean particle size of very low density lipoprotein (VLDL), low density lipoprotein (LDL), and high density lipoprotein (HDL), and LDL particle concentration. The relationship between detailed lipoprotein analyses and diabetic nephropathy is of interest. METHODS: In a cross-sectional study, lipoproteins from 428 women and 540 men from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) cohort were characterized by conventional lipid enzymology, NMR, apolipoprotein levels, and LDL oxidizibility. Linear regression was performed for each lipoprotein parameter versus log albumin excretion rate (AER), with and without covariates for age, diabetes duration, HbA1c, hypertension, body mass index, waist-hip ratio, and DCCT treatment group. Significance was taken at P < 0.05. RESULTS: By multivariate analysis, conventional profile, total triglycerides, total- and LDL cholesterol, but not HDL cholesterol, were associated with AER. NMR-determined large, medium, and small VLDL were associated with AER in both genders (except large VLDL in women), and intermediate density lipoprotein (IDL) was associated with AER (men only). LDL particle concentration and ApoB were positively associated with AER (in men and in the total cohort), and there was a borderline inverse association between LDL diameter and AER in men. Small HDL was positively associated with AER and a borderline negative association was found for large HDL. No associations were found with ApoA1, Lp(a), or LDL oxidizibility. CONCLUSION: Potentially atherogenic lipoprotein profiles are associated with renal dysfunction in type 1 diabetes and further details are gained from NMR analysis. Longitudinal studies are needed to determine if dyslipoproteinemia can predict patients at risk of nephropathy, or if lipoprotein-related interventions retard nephropathy.

Adolescent↗
PubMed1996

Elevated serum level of soluble HLA class I antigens in patients with systemic lupus erythematosus.

OBJECTIVE: To examine the clinical significance of serum soluble HLA class I antigens (sHLA class I) in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). METHODS: Serum levels of sHLA class I were measured by enzyme-linked immunosorbent assay, using a monoclonal antibody against monomorphic determinant of HLA class I (W6/32) and an enzyme-labeled polyclonal antibody to human beta 2-microglobulin. RESULTS: The serum sHLA class I concentration was 1.85 +/- 1.15 micrograms/ml (mean +/- SD) in 27 patients with SLE (P < 0.0001 versus normal controls, P = 0.0001 versus RA), 0.61 +/- 0.34 micrograms/ml in 16 patients with RA (P = 0.02 versus normal controls), and 0.41 +/= 0.20 micrograms/ml in normal controls. The HLA class I levels were significantly correlated with the SLE Disease Activity Index (r = 0.62, P = 0.0004) and with a reduction of CH50 levels (r = -0.60, P = 0.0007). A longitudinal analysis of patients with SLE indicated that serum sHLA class I levels fluctuated in conjunction with other disease activity markers. CONCLUSION: Serum sHLA class I may be useful as a disease activity marker of SLE. The mechanism of secretion and the physiologic role of sHLA class I require further study.

Adolescent↗
PubMed2000

Bronchiolitis obliterans syndrome after lung transplantation and health-related quality of life.

The present study was undertaken to assess the relationship between health-related quality of life (HRQOL) and bronchiolitis obliterans syndrome (BOS), as both represent important parameters of outcome after lung transplantation. HRQOL was measured both cross-sectionally and longitudinally by standardized patient self-administered questionnaires, including the Nottingham Health Profile, the State-trait Anxiety Inventory, the Zung Self-Rating Depression Scale, and the Index of Well-Being. Data were collected at 4 and 7 mo, and every 6 mo afterwards for as long as 49 mo post-transplantation. The number of patients who completed the questionnaires varied from 72 at 4 mo, to 27 at 49 mo after transplantation. Cross-sectionally, the patients with BOS reported persistently statistically significantly more restrictions on the dimensions energy and physical mobility of the Nottingham Health Profile compared with patients without BOS. Other domains, i.e., pain, sleep, social interaction, and emotional reactions, were not affected. Additionally, patients with BOS reported statistically significantly more depressive symptoms and anxiety 1 and 2 yr after transplantation. Results from the longitudinal analysis support these findings, although no change in depressive symptoms could be found after onset of BOS. This study suggests that all lung transplant recipients improve in HRQOL. The development of BOS, however, is associated with a significantly reduced HRQOL.

Activities of Daily Living↗
PubMed1987

Courses of development in mentally retarded persons.

A total of 80 subjects, 47 of them men and 33 women, with an average age of 25 and an average IQ of 53, were studied using a wide range of psychological methods from 1966 to 1971. In addition data from the subjects' childhood was collected, including IQ, achievement at elementary school and certain social variables. Thirteen years later a follow-up study was carried out. All eighty subjects were traced and the attained social adjustment was analysed from a broad angle, combining quantitative and qualitative methods in the collection of data. In a proceeding longitudinal analysis the intention is to identify, describe and explain fundamental courses or processes of development, focusing both continuity and change over time. The results show that prediction is comparatively feasible as regards cognitive abilities and especially verbal and numerical skills, but considerably more difficult when it comes to more complex abilities. As regards changes and their causes only preliminary results are reported.

Activities of Daily Living↗
PubMed1997

Epidemiology of pollution-induced airway disease: urban/rural differences in East and West Germany.

The prevalence of asthma and allergic disorders was assessed in 9-11 year-old children in Leipzig and Halle in East Germany, as well as in Munich, West Germany. Both East German cities are heavily polluted due to private burning of coal and industrial emissions, while Munich has low smoke emissions but heavy road traffic. All fourth grade pupils in Munich were compared with those in Leipzig and Halle. Non-specific airway disease (bronchitis), cough, and autumn/winter nasal symptoms were most prevalent in Leipzig and Halle. Hay fever and skin test reactivity to aeroallergens were higher in West Germany compared with East Germany. Furthermore, the prevalence of asthma was also higher in the West German study area. Increased skin prick test reactivity in the West explained the increased prevalence of asthma. Longitudinal analysis showed increased respiratory symptoms on days with high mean levels of sulphur dioxide and oxides of nitrogen, as well as on days with a high peak level of 10 mu respirable particles (PM10) in East Germany. The effects of these pollutants were additive. Exposure to heavy road traffic in Munich was related to decreased pulmonary function and non-specific airway symptoms, but not to allergic sensitization and asthma.

Air Pollutants↗
PubMed1994

Short-term kinetics of the humoral anti-C1q response in SLE using the ELISPOT method: fast decline in production in response to steroids.

Twenty four systemic lupus erythaematosus patients and 17 patients with other diagnoses were investigated regarding the presence of cells producing C1q reactive antibodies in peripheral blood mononuclear cells using the ELISPOT technique. These results were then compared with parallel serum levels of C1q reactive antibodies. Current production of anti-C1q was almost entirely confined to the systemic lupus erythaematosus group. Longitudinal analysis of anti-C1q ELISPOT positive patients showed rapid changes in the number of anti-C1q producing cells, but only slowly changing serum levels of the corresponding antibodies in response to glucocorticoids. In one systemic lupus erythaematosus patient prednisolone treatment had a selective effect on this autoantibody production, as the production of anti-C1q spot forming cells rapidly dropped to zero, at the same time as the number of total spot-forming cells showed only less change. In another patient, self-limiting connective tissue disease was associated with temporal occurrence of IgM anti-C1q. We believe, from these data, that the ELISPOT method for determination of current antibody production may be of particular value in longitudinal evaluation of disease course and therapeutic effects in systemic lupus erythaematosus and other rheumatic diseases.

Adult↗
PubMed2006

Self-esteem in adolescent females.

PURPOSE: Self-esteem is a major "predictor" of satisfaction with life. This longitudinal study examined mean and individual changes in self-esteem, and how self-esteem is affected by race and body mass. METHODS: Girls were recruited at ages 9 and 10 years, and followed to age 22 years. The Harter Self-Perception Profile was administered every other year, analyzing scores from the Global Self-Worth Scale, by age or developmental phase: ages 9-12 (I), 13-16 (II), and 17-22 (III). Regression modeling included main effects and interactions between age/phase, race, and body mass index (BMI). RESULTS: Self-worth was greater in black than white women, and greater with lower BMI in both races. In the model with age ("traditional model") (with race and BMI), significant variables included BMI (inverse relationship) and the interactions between age and race, race and BMI, and the triple interaction between age, race, and BMI. In the model with phase ("transitional model") (with race and BMI), BMI, and the interactions between BMI and race, and race and phase, were significant. For example, self-worth was generally lower in Phase II (middle adolescence) for white women. Self-esteem tracked significantly (correlation 0.22, p < .001). An individual's self-worth during any given phase of adolescence was correlated significantly with the other two phases. CONCLUSIONS: In this longitudinal analysis of self-esteem in adolescent girls, race and BMI are important predictors of self-esteem. Self-esteem is consistent across the phases of adolescence, and comparable with other personality traits. As noted by others, lower levels of self-esteem may increase the vulnerability of adolescents to risky behaviors.

Adolescent↗
PubMed2003

Risk-adjusted sequential probability ratio tests and longitudinal surveillance methods.

Regardless of the exact method employed, the application of statistical process controL SPRTs, or related longitudinal analysis methods can significantly improve the ability to monitor clinical processes and outcomes. Incorporation and adaptation of risk-adjustment and rare events into these methods represent important contributions to their use in health care. Fostering greater and more widespread use of these methods, however, remains a significant challenge. Hopefully studies such as those by Spiegelhalter et al. will lead to more awareness of their value for contributing to a safer health care system.

Humans↗
PubMed2005

Results of a multisite randomized trial of supported employment interventions for individuals with severe mental illness.

CONTEXT: National probability surveys indicate that most individuals with schizophrenia and other severe mental illnesses are not employed. This multisite study tested the effectiveness of supported employment (SE) models combining clinical and vocational rehabilitation services to establish competitive employment. METHODS: We randomly assigned 1273 outpatients with severe mental illness from 7 states in the United States to an experimental SE program or to a comparison or a services-as-usual condition, with follow-up for 24 months. Participants were interviewed semiannually, paid employment was tracked weekly, and vocational and clinical services were measured monthly. Mixed-effects random regression analysis was used to predict the likelihood of competitive employment, working 40 or more hours in a given month, and monthly earnings. RESULTS: Cumulative results during 24 months show that experimental group participants (359/648 [55%]) were more likely than those in the comparison programs (210/625 [34%]) to achieve competitive employment (chi(2) = 61.17; P<.001). Similarly, patients in experimental group programs (330/648 [51%]) were more likely than those in comparison programs (245/625 [39%]) to work 40 or more hours in a given month (chi(2) = 17.66; P<.001). Finally, participants in experimental group programs had significantly higher monthly earnings than those in the comparison programs (mean, US 122 dollars/mo [n=639] vs US 99 dollars/mo [n=622]); t(1259) = -2.04; P<.05). In the multivariate longitudinal analysis, experimental condition subjects were more likely than comparison group subjects to be competitively employed, work 40 or more hours in a given month, and have higher earnings, despite controlling for demographic, clinical, work history, disability beneficiary status, and study site confounders. Moreover, the advantage of experimental over comparison group participants increased during the 24-month study period. CONCLUSION: The SE models tailored by integrating clinical and vocational services were more effective than services as usual or unenhanced services.

Adult↗
PubMed1993

Different linkage of depression to hypercortisolism early versus late after stroke. A 3-year longitudinal study.

BACKGROUND AND PURPOSE: Using the dexamethasone suppression test, we studied the suppressibility of the cortisol axis and its clinical determinants at various time points after stroke. A major aim was to examine the dexamethasone test as a diagnostic tool for the diagnosis of major depression in stroke patients. METHODS: The dexamethasone suppression test, major depression, functional ability, and disorientation were assessed in a cohort of 70 patients with acute stroke and after 3 months (n = 63) and 3 years (n = 43). RESULTS: Early after stroke, 24% of the patients were nonsuppressors, with about the same proportion at 3 months (22%) and 3 years (21%). None of the controls (17 healthy elderly volunteers) were nonsuppressors. High cortisol levels early after stroke were significantly associated with functional impairment (r = 0.35; p = 0.003) and disorientation (r = 0.27; p = 0.03). Three years after stroke, high postdexamethasone cortisol levels were significantly associated with major depression (r = 0.57; p < 0.001). The sensitivity of the dexamethasone test was 70% and the specificity 97%. In a longitudinal analysis of the long-term survivors (n = 42), postdexamethasone cortisol values at 3 months predicted major depression at 3 years. CONCLUSIONS: Hypercortisolism is associated with major depression late (3 years) but not early (0-3 months) after stroke. Patients with hypercortisolism 3 months after stroke are at risk of major depression later in the course and warrant careful follow-up from a psychiatric viewpoint.

Aged↗
PubMed2004

["Healthy cities"--requirements and performance. Questionnaire results and a suggestion on quality monitoring (healthy-cities-barometer)].

PURPOSE: The overall goal of the WHO Healthy Cities Project was to translate some key points of the Ottawa Charter for Health Promotion (1986) into reality such as public health policies, creating health-promoting environments, strengthening community action through active public participation (empowerment of communities) and equity in health at the local level. These should be anchored within the local political administrative system (PAS), which means health should be on the agenda of policymakers in all sectors. To figure out how far this has been attained after almost 15 years of "healthy cities" policy in Germany was the focal point of the first questioning of local project coordinators. METHODS: A written questionnaire containing 128 items has been developed in collaboration with the Healthy Cities Network-Coordinator. The questionnaire consists of 78 standardised questions and some (23) open-ended questions for more specific qualitative information. Also included are 27 ten-point rating scales to evaluate the coordinators' view of some aspects of their healthy cities work and to assess its progress. Based on 30 questions of the questionnaire we generated six quality indices, summarised to a quality index for a monitoring model. 47 (90 %) project-coordinators from a list of 52 took part in the first German Healthy Cities survey in the spring 2002. RESULTS: Selected results of the network questioning concerning the local "healthy cities" offices, work priorities and methods demonstrate differences between East and West Germany and general weakpoints of the "healthy cities" projects. Data analysis based on six quality dimensions of the "Healthy Cities" work, Programme Equipment and Commitment (Structure), Concept Quality and Integration within the Network (Process), Self-reported Success and Integration within the City/Municipality (Outcome), revealed some weak points of the " Healthy Cities" work as follows: Basing on the six quality dimensions we present a monitoring model (Healthy-Cities Barometer) which can also be used for strategic controlling (benchmarking) within the German Healthy Cities Network. Based on the data we identified 13 Cities at an A-level (excellent), 22 Cities at a B-level (satisfactory) and 12 Cities at a C-level (INADEQUATE). CONCLUSION: The "Healthy-Cities Barometer" provides a surveillance instrument which - if constantly used over several years - could offer data for a longitudinal analysis of the Healthy Cities' development. With its help the Healthy Cities Network-Coordinator could gain more information for a better performance and a continuous quality improvement process of the local Healthy Cities projects.

Germany↗
PubMed2001

Long-term medical conditions and major depression in a Canadian population study at waves 1 and 2.

BACKGROUND: Cross-sectional studies have reported that certain long-term medical conditions are associated with major depression. Here, these associations are explored using a longitudinal analysis. METHODS: Data from the first (1994/95) and second (1996/97) waves of the Canadian National Population Health Survey (NPHS) were utilized. The first wave of the NPHS utilized a probability sample of 17626 members of the Canadian population. Members of this cohort were recontacted by Statistics Canada 2 years later. The Composite International Diagnostic Interview Short Form for Major Depression was used to identify episodes of major depression in both waves of the survey. Subjects free of major depression in the year preceding the 1994/95 survey were selected for inclusion in this analysis. The incidence of new-onset episodes in subjects with and without reported long-term medical conditions was compared. RESULTS: Individuals suffering from one or more long-term medical conditions were found to be at increased risk of major depression. Migraine headaches, sinusitis and back problems were the conditions most strongly associated with major depression. Having a long-term medical condition approximately doubled the risk of major depression in this analysis. LIMITATIONS: The most important limitation of this study was its reliance on self report data about medical conditions. CONCLUSIONS: A large proportion of the general population in Canada suffers from long-term medical conditions. These individuals are at increased risk of major depression. This study suggests an important role for long-term medical conditions in the etiology of major depression.

Adolescent↗
PubMed1998

The Singapore Youth Coronary Risk and Physical Activity Study.

The purpose of this study was to examine coronary risk factors and physical activity patterns of primary and secondary school children in Singapore. Children 6-18 yr (730 boys, 849 girls) were evaluated for anthropometry, percent body fat, resting blood pressure, fasting plasma lipids and lipoproteins and glucose. A physical activity and leisure pursuits self-reported survey was used to group children into five categories ranging from "inactive" to "vigorous" activity. The self-reported questionnaire also recorded individual responses to exercise behaviors, leisure activities, and participation in organized games and sports. Body weight, body mass index (BMI; kg x m[-2]), and percent body fat were compared by age and gender. The blood analysis showed no significant differences in boys' and girls' plasma lipid and lipoprotein concentrations. Physical activity was significantly correlated with total cholesterol (rs = -0.13, P = 0.018) and triglycerides (rs = -0.18, P = 0.001) for boys and between physical activity with body fat (rs = -0.22, P = 0.0001) and BMI (rs = -0.16, P = 0.01) for girls. Height, weight, BMI, percent body fat, and blood pressure were greater for each age to 14 yr, after which there was less recorded body fat for boys. Girls' body fat remained about the same after 14 yr. Comparing by gender and age, significant differences were found between physical activity groups and total cholesterol and body fat. Although few children were at risk for heart disease, this study provides baseline coronary risk and physical activity data for further longitudinal analysis in this population.

Adolescent↗