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PubMed1998

The importance of serum IgE for level and longitudinal change in airways hyperresponsiveness in COPD.

BACKGROUND: Airways hyperresponsiveness (AHR) is an important feature of patients with chronic obstructive pulmonary disease (COPD). Little is known about factors that modulate AHR in COPD. OBJECTIVE: To study these factors, we performed a long-term, double-blind, parallel intervention study in 58 male, non-allergic patients with COPD. METHODS: During a period of 2 years, patients were treated with inhaled budesonide (1600 microg/day), inhaled budesonide (1600 microg/day) plus oral prednisolone (5 mg/day), or placebo. PC20 histamine was measured at 4-monthly intervals. The influence of treatment, smoking, age, level of lung function, initial serum IgE level and peripheral blood eosinophils on level and longitudinal change of PC20 histamine was analysed. RESULTS: During follow-up, PC20 decreased in our group, and this decrease was not influenced by treatment. PC20 tended to decrease faster in current smokers than in ex-smokers. PC20 was significantly associated with pre-challenge FEV1 at each time point. Level nor decline of PC20 were significantly related to age. A higher initial serum IgE level was independently associated with a lower PC20. Moreover, a higher initial serum IgE level was associated with a slower annual decline of PC20, regardless of treatment, pre-challenge FEV1, and other modulating factors. No significant associations were found between initial blood eosinophils and level or decline of PC20. CONCLUSION: We conclude that AHR increases over time in non-allergic patients with COPD. Treatment with an inhaled corticosteroid alone or in combination with oral prednisolone does not change this increase. Our study suggests an important role for IgE in the course of the disease, since a higher initial serum IgE level predicts a more favourable course with regard to annual decline of PC20 histamine.

Aged↗
PubMed1989

Longitudinal changes in pulmonary function following bone marrow transplantation.

We prospectively followed a well characterized cohort of patients post-bone marrow transplantation for changes in pulmonary function. Thirty-four recipients without respiratory symptoms were available for follow up with a mean of two years. Spirometry and other measures of lung volume were well preserved following bone marrow transplantation. A progressive 11.9 percent decline in percent predicted diffusing capacity per year occurred. Age, cigarette smoking, type of cytoreductive therapy, type of GVHD prophylaxis, and the occurrence of AGVHD did not affect longitudinal changes in pulmonary function. Patients receiving transplants for CML developed a highly significant fall in diffusing capacity. Asymptomatic patients with CGVHD developed evidence of progressive obstructive ventilatory impairment. This suggests a subclinical spectrum of patients who may progress to the development of bronchiolitis obliterans and respiratory failure post-bone marrow transplantation.

Adult↗
PubMed2001

Cardiovascular recovery from stress predicts longitudinal changes in blood pressure.

Cardiovascular reactivity and recovery were examined as predictors of blood pressure changes over 3 years. Blood pressure and heart rate readings were obtained from 73 men and women aged 18-20 years during cold pressor, mental arithmetic, tourniquet ischemia, cycle exercise and step exercise tasks. Regression analyses indicated that after adjustment for initial blood pressure, initial age, initial body-mass index, sex, parental history of hypertension, and length of follow-up, heightened heart rate reactivity to mental arithmetic was associated with increased follow-up systolic blood pressure (DeltaR(2)=0.04, P<0.05). Systolic blood pressure recovery from cold pressor and tourniquet ischemia were also positively related to follow-up systolic blood pressure (DeltaR(2)=0.04 and 0.04, respectively, P<0.05) and remained so even after adjustment for the corresponding cardiovascular reactivity measures. These findings suggest that cardiovascular reactivity and recovery measures are modest predictors of longitudinal changes in blood pressure.

Adolescent↗
PubMed2003

Predictors of longitudinal change in sleep-disordered breathing in a nonclinic population.

STUDY OBJECTIVES: To quantify and identify the determinants of the 5-year change in the respiratory disturbance index (RDI). DESIGN: Longitudinal cohort study (Cleveland Family Study). Multivariate analyses were used to quantify baseline RDI and RDI change. SETTING: Community-based study. PARTICIPANTS: 486 cohort members (62% from families of probands with sleep-disordered breathing [SDB])--mean age 31.6 +/- 17.9 (SD) years, 60% female, 21% Black ethnicity--who underwent 2 assessments over 5.3 +/- 0.9 (SD) years. INTERVENTIONS: NA. MEASUREMENTS: The RDI was measured twice over approximately 5 years with in-home monitoring. Symptoms and medical histories were obtained from standardized questionnaires, and weight, height, and blood pressure were measured. RESULTS: The prevalence of SDB (defined by a RDI > or = 15), increased from 13.7% to 23.4% (P < 0.01) in men and from 8.3% to 11.4% (P = 0.13) in females. Baseline and follow-up mean RDIs were 6.0 +/- 10.0 and 8.6 +/- 14.3; both were higher in older individuals, in men, and in those with a higher body mass index. Median 5-year change in RDI varied nonlinearly with age (-0.1, 1.1, 2.3, and 0.9, for those < 18, 19-40, 41-54, and > or = 55 years, respectively) and obesity (2.8 vs -0.1, for the top versus lowest body mass index quartile). The effects of changing weight and aging varied in population subgroups. At any given age and weight, the RDI increased less in women. CONCLUSIONS: Longitudinal change in the RDI varies nonuniformly with age, sex, and weight. Older heavier men may experience the highest rate of increase in RDI over time and, thus, may benefit most from prospective monitoring.

Adult↗
PubMed1987

Correlative analysis of longitudinal changes in bronchoalveolar lavage, 67gallium scanning, serum angiotensin-converting enzyme activity, chest X-ray, and pulmonary function tests in pulmonary sarcoidosis.

Despite the relatively high cost and complicated procedures, Gallium-67 (67Ga) scanning and bronchoalveolar lavage (BAL) are increasingly advocated as more sensitive indicators of disease activity in sarcoidosis than chest X-ray and serum angiotensin-converting enzyme activity (SACE). To evaluate the clinical usefulness of 67Ga scanning and BAL, we followed 31 patients with pulmonary sarcoidosis, using these four parameters, at 9- to 24-month intervals over periods of 9 to 48 months. We obtained 68 complete evaluations. Close correlations were observed among chest X-ray, 67Ga scanning, SACE, and the percentage of lymphocytes in BAL fluid (p less than 0.1 to 0.001). Longitudinal changes were also well correlated in these four parameters (p less than 0.001) and paralleled the changes in vital capacity (p less than 0.01 to 0.001). However, we were unable to predict the patients' outcome from the initial evaluation of these four parameters. These results suggest that, in terms of their usefulness for estimating disease activity, the differences among these four indicators are negligible. We therefore conclude that chest X-ray and SACE sufficiently reflect disease activity and that, at present, routine evaluation by 67Ga scanning and BAL are not necessarily indicated in the long-term management of pulmonary sarcoidosis.

Adult↗
PubMed1997

Longitudinal changes in the skeletal pattern of deciduous anterior crossbite.

Some patients who have an anterior crossbite in the deciduous dentition lose the crossbite during the transitional stage to permanent anterior teeth without orthodontic and/or orthopedic treatment. We observed 220 anterior crossbite patients at regular intervals and identified three groups of patients: in group N (n = 16) the crossbite corrected when the central incisors erupted; in group R1 (n = 16) the crossbite was within [formula: see text] and remained unchanged following the eruption of the permanent central incisors; in group R2 (n = 12) the crossbite extended over [formula: see text] and remained following the eruption of the permanent central incisors. The purpose of this study was to determine whether any differences existed among the above three groups at the initial examination, or if differences arose during eruption of the teeth. The findings indicate that the mandibular position in group N was more posterior than in groups R1 and R2, and the lengths of Pog'-Go and Gn-Cd in group N were smaller. Tooth axis of the lower incisors in groups R1 and R2 showed lingual tipping, and the maxilla in group R2 was underdeveloped. The findings of the longitudinal changes indicated that the maxillary length in group N increased and mandibular forward growth was suppressed. The initial maxillary position in groups R1 and R2 remained much the same until the permanent central incisors erupted.

Cephalometry↗
PubMed2001

Peritoneal transport status correlates with morbidity but not longitudinal change of nutritional status of continuous ambulatory peritoneal dialysis patients: a 2-year prospective study.

Cross-sectional studies show that peritoneal transport status is associated with nutritional status and clinical outcome of continuous ambulatory peritoneal dialysis (CAPD) patients. High transporters often are assumed to have progressive malnutrition as a result of fluid overload and nutrient loss in dialysis effluent. There are few prospective data to confirm this assumption, however. We studied 235 unselected CAPD patients to examine this possibility. There were 58 new cases and 177 prevalent cases. A standard peritoneal equilibration test was performed at enrollment. All patients were followed for 2 years. Dialysis adequacy and nutritional assessment, including serum albumin, protein nitrogen appearance, and lean body mass, were performed at 0, 12, and 24 months. Clinical outcome included hospitalization, actuarial patient survival, and technique survival. The mean age was 51.6 +/- 12.4 years. The mean 4-hour dialysate-to-plasma ratio of creatinine was 0.57 +/- 0.12 for all cases (0.60 +/- 0.12 for new cases). Patients were classified into three groups: high/high-average (H/HA) (63 cases), low-average (LA) (105 cases), and low (L) (67 cases) transporters. Baseline demographic data and total Kt/V were similar in all transport groups. There were weak correlations between 4-hour dialysate-to-plasma ratio of creatinine and baseline serum albumin (r = -0.249, P: < 0.001), protein nitrogen appearance (r = -0.190, P: < 0.01), and percentage of lean body mass (r = -0.194, P: < 0.01). The H/HA group was a specific but not a sensitive predictor of poor baseline nutritional status. There was no significant change in any nutritional indices after 2 years in new cases and prevalent cases, regardless of transport status. The differences in nutritional indices between groups remained unchanged during the study period. There was a significant difference in hospitalization rate among peritoneal transport groups (median 12 versus 7 versus 3 days per year for H/HA, LA, and L groups, Kruskal-Wallis test, P: < 0.05). The difference remained similar when new cases and prevalent cases were analyzed separately. The L group had slightly better 2-year patient survival than the H/HA group (90.2% versus 83.3%), but the result was not statistically significant. We conclude that peritoneal transport status is not associated with longitudinal change of nutritional parameters, although transport status is associated with short-term patient morbidity. Further study is needed to identify the mechanisms of poor clinical outcome in high peritoneal transporters.

Biological Transport↗
PubMed2001

Longitudinal changes in pulmonary function and respiratory symptoms in cotton textile workers. A 15-yr follow-up study.

To evaluate the chronic effects of exposure to cotton dust, a 15-yr follow-up study in cotton textile workers was performed in Shanghai, China from 1981 to 1996. Testing occurred four times during the 15-yr period. The achieved follow-up rates were 76-88% of the original 447 cotton textile workers, and 70-85% of the original 472 silk textile workers (as a control group). Identical questionnaires, equipment, and methods were used throughout the study. The prevalence of byssinosis increased over time in cotton workers, with 15.3% at the last survey versus 7.6% at the baseline, whereas no byssinosis was found in silk workers. More workers in the cotton group consistently reported symptoms than in the silk group, although symptom reporting varied considerably from survey to survey. Cotton workers had small, but significantly greater, adjusted annual declines in FEV(1) and FVC than did the silk workers. Years worked in cotton mills, high level of exposure to endotoxin, and across-shift drops in FEV(1) were found to be significant determinants for longitudinal change in FEV(1), after controlling for appropriate confounders. Furthermore, there were statistically significant associations between excessive loss of FEV(1) and byssinosis, chest tightness at work, and chronic bronchitis in cotton workers. Workers who consistently (three or four of the surveys) reported byssinosis or chest tightness at work had a significantly greater 15-yr loss of FEV(1). We conclude that long-term exposure to cotton dust is associated with chronic or permanent obstructive impairments. Consistent reporting of respiratory symptoms, including byssinosis and chest tightness at work, is of value to predict the magnitude and severity of chronic impairments in textile workers.

Adult↗
PubMed2000

Age-related decreases in the prevalence of myopia: longitudinal change or cohort effect?

PURPOSE: The prevalence of myopia shows a decline with age in cross-sectional studies. This pattern may represent an increase in the prevalence of myopia in younger generations, possibly through increased exposure to near work, or an intrinsic age-related decline in myopia prevalence. Data were analyzed from published studies to determine which of these two alternatives better explains the data: a cohort effect of changing prevalence by decade or a longitudinal effect of changing prevalence as a function of age. METHODS: Prevalence data were taken from three studies conducted in the late 1980s and compared with those obtained indirectly from a national survey conducted in the early 1970s. The prevalence of myopia was then plotted as a function of age and year of birth. RESULTS: The pattern of change in the prevalence of myopia as a function of age was consistent across all studies when data were scaled relative to the prevalence of myopia at age-range midpoints from 44.5 to 49.5 years. The pattern of change was not consistent as a function of year of birth. When the data were scaled relative to the prevalence of myopia among those with years of birth from 1940 to 1942 and plotted by year of birth, results from the early 1970s were offset from those of later studies by approximately 18 years. CONCLUSIONS: The decline in the prevalence of myopia in older adults between the early 1970s and the late 1980s can be better explained by age than by year of birth. The prevalence of myopia appears to decrease because of an intrinsic age-related decrease in the amount of an individual's myopia rather than because of a cohort effect of increasing prevalence over time. The hypothesis that increasing environmental exposures to near work in recent decades have changed the prevalence of myopia is not supported by this analysis.

Adolescent↗
PubMed2003

Longitudinal changes in children's speech and voice physiology after cochlear implantation.

OBJECTIVES: The purposes of this investigation were 1) to describe speech/voice physiological characteristics of prelingually deafened children before and after cochlear implantation and determine whether they fall into a range that would be considered deviant, 2) to determine whether selected deviant articulatory and phonatory behaviors of children with cochlear implants persist despite long-term cochlear implant use and continued participation in aural rehabilitation services, and 3) to determine whether further development of deviant articulatory and phonatory behaviors occurs postimplantation. DESIGN: Seven prelingually deafened children who received cochlear implants after 5 yr of age were followed from shortly before implantation until 5 to 6 yr postimplantation. These children received their early education in a Total Communication environment and used the Nucleus 22-electrode cochlear implant. All of them initially used the MPEAK speech processing strategy, and five of them eventually upgraded to the SPEAK speech processing strategy. Speech/voice physiological measurements that were obtained periodically from the children included intraoral air pressure (P(o)), nasal and phonatory air flow, voice onset time (VOT), and fundamental frequency (F(o)). Data from the deaf children were compared with a database from 56 children with normal hearing to determine when the deaf children exhibited "deviant" speech/voice behaviors. Speech/voice behaviors were considered "deviant" if they never occurred for children with normal hearing or were associated with z-scores that were outside the range of +/-2.0. RESULTS: The deaf children showed a wide range of deviant speech and voice behaviors both pre- and post-cochlear implant. The most frequently occurring atypical behaviors were use of negative P(o), high P(o) for [b, m], long and short VOT for [p], and high F(o). Some deviant behaviors improved post-cochlear implant. However, deviant behaviors often persisted for several years post-cochlear implant. There was considerable evidence of further development of deviant behaviors post-cochlear implant. All of the deaf children demonstrated deviancy on at least two of our measures at the last data collection interval (5 to 6 yr post-cochlear implant). CONCLUSIONS: Children who received cochlear implants after 5 yr of age and who were educated in a Total Communication setting showed persistence and further development of deviant speech/voice behaviors for several years post-cochlear implant. Although our findings cannot be generalized to other populations of children with cochlear implants (i.e., those who were implanted earlier, those educated in auditory-oral programs), it seems wisest at the present time not to assume that children's deviant speech/voice behaviors will remit spontaneously with continued cochlear implant use. Our data provide an important comparative database for future investigations of pediatric cochlear implant users who have had shorter periods of auditory deprivation and who have received cochlear implants with more current technological features. Longitudinal Changes in Children's Speech and Voice Physiology after Cochlear Implantation

Child↗
PubMed2004

Longitudinal changes in lower urinary tract symptoms among a cohort of black American men: the Flint Men's Health Study.

OBJECTIVES: To examine the progression of lower urinary tract symptoms in a longitudinal population-based cohort of black men. Population-based studies of prostatism and longitudinal data regarding changes in lower urinary tract symptom severity have largely focused on white men, with little attention directed toward black men. METHODS: In 1996, a probability sample of 369 black men, aged 40 to 79 years, residing in Genesee County, Michigan, and without a prior history of prostate cancer/surgery participated in a prostate cancer screening protocol that included completing the American Urological Association Symptom Index (AUASI). Four years after baseline, 175 of the 369 men agreed to participate in the follow-up protocol. Of the 175 men, 149 had not reported undergoing treatment for benign prostatic hyperplasia and had complete symptom data. These men were included in this study. Differences between baseline and follow-up AUASI scores were examined. RESULTS: The mean and standard deviation AUASI scores at baseline and follow-up were 7.1 (6.4) and 7.0 (6.8), respectively. Although overall no statistically significant change was found in the mean AUASI during the 4 years of follow-up (-0.11; SD 6.2; P = 0.7), the average change in the symptom score and the variability in the change increased with patient age at baseline from a mean of -0.42 (SD 5.0) among men in their 40s to 2.1 (SD 6.6) among men in their 70s. Of the 91 men (61.1%) who reported mild to no symptoms (AUASI score 7 or less) at baseline, 24 (26.4%) reported moderate to severe symptoms (AUASI score 8 or more) at follow-up. This progression of symptom severity was observed across all ages. CONCLUSIONS: In this population-based study of longitudinal changes in urinary symptoms in black men, we found a substantial percentage of men demonstrated a measurable progression in urinary symptom severity over time. Additional studies are needed to examine critically any racial differences in lower urinary tract symptom progression.

Adult↗
PubMed2001

Hormone replacement therapy and longitudinal changes in blood pressure in postmenopausal women.

BACKGROUND: The incidence of hypertension in postmenopausal women exceeds that in age-matched men. Longitudinal studies relating hormone replacement therapy (HRT) to blood pressure changes are sparse. OBJECTIVE: To investigate the association between HRT and longitudinal changes in blood pressure in postmenopausal women. DESIGN: Longitudinal observational study. SETTING: Community-dwelling volunteers. PATIENTS: 226 healthy, normotensive postmenopausal women from the Baltimore Longitudinal Study of Aging with a mean (+/-SD) age of 64 +/- 10 years were followed for 5.7 +/- 5.3 years. Seventy-seven women used both estrogen and progestin, and 149 used neither. MEASUREMENTS: Lifestyle variables, blood pressure, and traditional cardiovascular risk factors were measured at baseline and approximately every 2 years thereafter. RESULTS: Systolic blood pressure at baseline was similar in HRT users and nonusers (133.9 +/- 16.0 mm Hg vs. 132.4 +/- 14.8 mm Hg). Over time, average systolic blood pressure increased less in HRT users than nonusers, independent of other cardiovascular risk factors, physical activity, and alcohol use. For example, HRT users who were 55 years of age at their first Baltimore Longitudinal Study of Aging visit experienced a 7.6-mm Hg average increase in systolic blood pressure over 10 years; in contrast, the average increase in nonusers was 18.7 mm Hg. The lesser increase in systolic blood pressure in HRT users was more evident at older age. Diastolic blood pressure, which did not change statistically over time in either group, was not associated with HRT. CONCLUSION: Postmenopausal women taking HRT have a smaller increase in systolic blood pressure over time than those not taking HRT. This difference is intensified at older ages.

Age Factors↗
PubMed1984

Risk factors associated with longitudinal change in pulmonary function.

In a longitudinal study of pulmonary function, we investigated the relationship between loss of forced expiration over time and a series of potential risk factors, as well as 4 other measures of pulmonary function at initial visit. Data on 1,912 adults tested twice, with an average of 4.7 yr between visits, were used. Of the potential risk factors examined, only age and smoking were consistently associated with increased loss of forced expiratory function in both men and women. Statistically significant differences among ABO blood types and among Pi types were also seen in women, although the direction of these differences was unexpected in that non-Z Pi variant phenotypes showed less decline in pulmonary function than did the most common Pi M phenotypes. Similar patterns of differences were seen in men, although these were not statistically significant. Of 4 initial-visit pulmonary function measures examined, only closing capacity at initial visit was consistently associated with subsequent loss of forced expiratory volume in one second (delta FEV1) in both men and women. The final predictive model for delta FEV1 accounted for a modest proportion of the total variation seen in this sample, however, limiting its potential use for predicting decline in pulmonary function over a 5-yr span in individual subjects.

ABO Blood-Group System↗
PubMed2006

Longitudinal changes in dietary patterns during adult life.

Despite the growing interest in dietary patterns, there have been few longitudinal investigations. The objective of the present study was to extend an earlier method of dietary pattern assessment to longitudinal binary data and to assess changes in patterns over time and in relation to socio-demographic covariates. A prospective national cohort of 1265 participants completed a 5 d food diary at three time-points during their adult life (at age 36 years in 1982, 43 years in 1989 and 53 years in 1999). Factor analysis identified three dietary patterns for women (fruit, vegetables and dairy; ethnic foods and alcohol; meat, potatoes and sweet foods) and two patterns in men (ethnic foods and alcohol; mixed). Trends in dietary pattern scores were calculated using random effects models. Marked changes were found in scores for all patterns between 1989 and 1999, with only the meat, potatoes and sweet foods pattern in women recording a decline. In a multiple variable model that included the three time-points, socio-demographic variables and BMI time-dependent covariates, both non-manual social class and higher education level were also strongly associated with the consumption of more items from the ethnic foods and alcohol pattern and the mixed pattern for men (P < 0.0001) and the fruit, vegetables and dairy pattern and the ethnic foods and alcohol pattern for women (P < 0.01). In conclusion, longitudinal changes in dietary patterns and across socio-economic groups can assist with targeting public health initiatives by identifying stages during adult life when interventions to improve diet would be most beneficial to health.

Adult↗
PubMed2003

Biomarkers of aging in women and the rate of longitudinal changes.

The purposes of this study were (1) to estimate biological age score (BAS) in Japanese healthy women based on the 4-7 years longitudinal data for physiological, hematological and biochemical examinations and (2) to examine the rate of aging changes in adult women based on the estimated BAS. The samples consisted of cross-sectional (n=981) and longitudinal (n=110) groups. Out of 31 variables examined, five variables (forced expiratory volume in 1.0 s, systolic blood pressure, mean corpuscular hemoglobin, glucose, albumin/globulin ratio) that met the following criteria: 1) significant cross-sectional correlation with age; 2) significant longitudinal change in the same direction as the cross-sectional correlation; and (3) assessment of redundancy, were selected as candidate biomarkers of aging. This variable set was then submitted into a principal component analysis, and the first principal component obtained from this analysis was used as an equation for assessing one's BAS. Individual BAS showed a high longitudinal stability of age-related changes, suggesting high predictive validity of our newly developed aging measurement equation. However, changes in the aging rate based on the estimated BAS were not constant. The mean slopes of the regression lines of BAS for the three age groups (age<45, 45</=age<65 yrs, 65</=age) were 0.095, 0.065, 0.138, respectively. One-way analysis of variance detected a significant difference (F=5.14, p<0.01) among the three age groups. These results suggest that the rate of aging in adult women is relatively slower until 65 years of age, but after 65, the rate of aging shows a rapid increase. We concluded that the longitudinal method used for selection of variables to compute the BAS was useful and theoretically valid compared to those obtained from cross-sectional data analysis.

Adaptation, Physiological↗
PubMed2006

Longitudinal change in food habits between adolescence (11-12 years) and adulthood (32-33 years): the ASH30 Study.

BACKGROUND: Links between diet in childhood and the prevention of disease in adulthood have been established. This longitudinal dietary survey provided quantitative evidence of dietary change from adolescence to adulthood, in Northumberland, England. OBJECTIVE: To report longitudinal dietary change in 198 respondents between the ages of 12 and 33 years, to explore dietary 'tracking' between the same time points and to describe the effects of gender, socio-economic status and location on dietary change. METHODS: A longitudinal study recorded dietary change from adolescence to adulthood. Two 3-day food diaries were collected in 1980 and 2000 from the same 198 respondents. Foods consumed were assigned to the five categories in the Balance of Good Health (BGH). Demographic and socio-economic information were obtained in 1980 and 2000. RESULTS: Intakes of foods containing fat and/ or sugar and milk and dairy foods decreased (p < 0.01 and p < 0.031, respectively), while intakes of fruits and vegetables increased (p < 0.01). Intakes of bread, other cereals and potatoes (p = 0.002, r = +0.219); fruits and vegetables (p < 0.01, r = +0.256) and meat, fish and alternatives (p = 0.026, r = +0.158) 'tracked' from adolescence to adulthood. Men had increased intake from meat, fish and alternatives and decreased milk and dairy foods more than female respondents (p = 0.003 and p = 0.019). Respondents who had moved away from Northumberland had a greater increase in intake of fruits and vegetables compared with those who remained in the local (p = 0.010). Individuals who had moved to a lower socio-economic group had increased their intake of bread, other cereals and potatoes (p = 0.040). CONCLUSION: Food intake changed considerably in a direction more in the line with current dietary recommendations. Food intake in adolescence was a significant, but not strong, predictor of intake in adulthood. Dietary change is influenced by variables including gender, location and socio-economic status.

Adult↗
PubMed2004

Longitudinal changes in bone metabolism and bone mineral content in children with celiac disease during consumption of a gluten-free diet.

BACKGROUND: A gluten-free diet (GFD) rapidly corrects the bone mineral deficit of children with untreated celiac disease. The mechanisms underlying such changes are still poorly understood. OBJECTIVE: In a longitudinal study, we monitored changes in bone metabolism during consumption of a GFD. DESIGN: We studied 22 white patients with celiac disease (11 girls) aged 10.5 +/- 1.0 y at the time of diagnosis. We compared bone metabolism and bone mass values in these patients with those in 428 healthy white children aged 11.3 +/- 0.2 y. Bone-specific alkaline phosphatase (a bone formation index) and N-terminal telopeptide of type I collagen (NTx; a bone resorption marker) were measured at the time of diagnosis and after 2, 6, and 12 mo of the GFD. Bone mineral content was measured at the lumbar spine and for the whole skeleton. RESULTS: The bone mineral content of patients was significantly lower than that of control subjects at the time of diagnosis but not after 1 y of the GFD. Serum bone-specific alkaline phosphatase concentrations of patients were significantly lower than those of control subjects at the time of diagnosis (P = 0.0064) and increased gradually and significantly during the GFD (ANOVA F = 4.71; P = 0.024). Conversely, patients with untreated disease had significantly higher urinary concentrations of NTx than did healthy control subjects (P < 0.0001). Urinary concentrations of NTx were not significantly affected by treatment (P = 0.37). CONCLUSIONS: The rate of bone metabolism is altered in children with untreated celiac disease, and these alterations may be the cause of osteopathy. Remarkable changes occur after the initiation of a GFD, and they result in a more balanced equilibrium.

Alkaline Phosphatase↗
PubMed2006

Longitudinal changes in ultrasound measurements: a parallel study in subjects with genetic disorders and healthy controls.

Disturbances in skeletal status in subjects with genetic disorder may increase their fracture risk. The aim of the study was longitudinal observation of phalangeal speed of sound changes across the bone over a period of 2 y in 24 patients (14 boys and 10 girls, mean age 9.63 +/- 1.8 y.) and 24 age-matched healthy controls (14 boys and 10 girls, mean age 9.65 +/- 1.71 y.). Weight and height did not differ between patients and controls at baseline and follow-up. Patients with the following disorders were evaluated: 7 with Down syndrome, 6 nonspecific mental retardations of unknown etiology, 5 Martin-Bell syndrome and 6 with other diseases. In patients and controls, no factors potentially influencing bone metabolism (except for genetic disorder) were present. Bone status was assessed by quantitative ultrasound at hand phalanges using DBM Sonic 1200 (IGEA, Carpi, Italy), which measures amplitude-dependent speed of sound (Ad-SoS [m/s]). At baseline, Ad-SoS and Z-score were significantly lower in patients than in controls (1892 +/- 51 m/s versus 1936 +/- 43 m/s, p < 0.01 and -1.47 +/- 1.43 versus -0.14 +/- 1.04, p < 0.001, respectively. In follow-up, Ad-SoS and Z-score increased significantly in patients (1892 +/- 51 m/s to 1934 +/- 48 m/s, p < 0.0001 and -1.47 +/- 1.43 to -0.76 +/- 1.00, p < 0.01, respectively) and in controls (1936 +/- 43 m/s to 1976 +/- 60 m/s and -0.14 +/- 1.04 to 0.31 +/- 1.08, p < 0.05, respectively). Follow-up Ad-SoS and Z-Score were significantly lower in patients (p < 0.01). Longitudinal changes in Ad-SoS, Z-score weight did not differ between patients and control, and height increased more in controls (13.2 +/- 2.8 cm versus 11.4 +/- 5.9 cm, p < 0.05)+). In patients, Ad-SoS increased by 42 m/s (2.22%), and in controls increased by 40 m/s (2.07%). Difference in Ad-SoS between patients and controls was 44 m/s at baseline and 42 m/s at follow-up. Using the value of the least significant change (LSC = 20.5 m/s), in 16 patients (67%) and in 18 controls (75%) Ad-SoS showed an increase greater than the LSC, in one control (4%) a decrease greater than the LSC and in rest of subjects studied remained unchanged (33% patients and 19% controls) over a period of observation. In conclusion, despite comparable improvement in measured ultrasound parameter in patients and controls observed over a study duration, the difference between them remained stable.

Bone Density↗