Sexual behavior, depressive feelings, and suicidality among Estonian school children aged 13 to 15 years.

BACKGROUND: The present paper is based on a WHO Collaborative Cross-National Study "Health Behavior in School-Aged Children (HBSC)." AIMS: It aimed at describing and analyzing how the sexual behaviors of 13- to 15-year-old Estonian school children were associated with self-reported depressive feelings and suicidality. Distinctive behavioral traits in relation to age of first sexual intercourse were also investigated. METHODS: Self-reported questionnaires from school children (n = 3,055) were analyzed. RESULTS: In total, 15.2% of school children reported being nonvirgin. Among 13-year-olds, 2.9% of girls and 6.8% of boys were nonvirgins. Approximately 25% of the 15-year-old girls and boys were nonvirgins. The likelihood of depressive feelings and suicidal ideation increased significantly in both genders with loss of virginity. Boys who had lost their virginity at 13 years or younger were 4.2 times more likely to have suicidal thoughts; comparable girls were 7.8 times more likely to have suicidal thoughts. Compared to virgins, youths who had lost their virginity reported poor self-assessed health and more risk behaviors in themselves and their peers. CONCLUSION: Experiences of sexual intercourse increased the odds ratios for depressive feelings and suicidality. The earlier sexual intercourse was initiated, the greater were the odds of lower mental well-being. Risk behaviors emerged as a complex phenomenon requiring complex prevention.

Determinants of risk factors of atherosclerosis in the postinfarction period: the Tallinn MI study.

Environmental as well as genetic factors are involved in the pathogenesis of myocardial infarction. The disease is a frequent cause of mortality in the middle-aged male population of Estonia. The high prevalence of premature myocardial infarction (PMI) in this country is not fully understood. The association of atherogenic and thrombogenetic risk factors with lifestyle was evaluated in men who had suffered myocardial infarction at 55 years of age (n = 71) and in randomly selected corresponding controls (n = 85). Serum routine lipids, apolipoprotein (apo)A-I, apoB, apoE polymorphism, lipoprotein(a) and fibrinogen levels were determined. Behavioural risk factors, indices of obesity, blood pressure and pedigree data were registered. In 80.6 % of PMI subjects some type of hyperlipidaemia was observed (European Atherosclerosis Society Classification) and lipid-lowering drugs were taken by 13.9 % of patients. In PMI patients the most common positive determinants of atherogenic lipoprotein indices were waist-to-hip ratio and physical inactivity, and in controls, waist-to-hip ratio and apoE phenotype. The odds ratio (OR) of PMI was 8.9-fold greater in the highest tertile of apoB/apoA-I distribution compared with the lowest tertile. The OR of PMI in the highest tertile of fibrinogen distribution versus the lowest tertile was 6.2 (95 % CI 2.46-15.44), and OR of PMI in the highest Lp(a) tertile versus the lowest was 3.1 (95 % CI 1.31-7.40). Thus, atherogenic dyslipidaemia was the most serious cardiovascular risk factor among PMI patients. From two thrombogenesis-related markers, the levels of fibrinogen and Lp(a), the first one was more strongly associated with PMI status.

Serum lipid and apolipoprotein profiles in newborns and six-year-old children: the Tallinn Young Family Study.

Seventy children aged 6 years (34 boys, 36 girls) were studied for cardiovascular risk factors. Among the children 40 had also been investigated at birth. The aim of the study was to determine changes in serum lipoprotein parameters from birth up to preschool age and to assess the role of some relevant factors that might affect the process. An obvious association was found between serum apolipoprotein (apo) B levels, the apoB/apoA-I ratio and lipoprotein(a) (Lp(a)) levels at birth and at 6 years of age (r = 0.43; p<0.05, r = 0.73; p<0.0001 and r = 0.81; p<0.0001, respectively). Thirty percent of children who were in the top quartile by apoB or total cholesterol levels and 66.7% of those in this quartile by apoB/apoA-I ratio at birth remained in the top quartiles also in the follow-up study. The significantly higher apoB/apoA-I ratio in newborns and the apoB/apoA-I and apoB values in the 6-year-old children were observed in the carrier apoE4 isoform as compared to E3 homozygotes. A significant influence of apoE polymorphism on serum apoB/apoA-I ratio and apoB level in preschool children was confirmed by ANOVA one-way analysis of variance. In a multiple regression analysis from all the studied factors, the independent determinants of apoB level in preschool age were apoE phenotype, gestational age and Apgar score in the first minute of life. Thus, tracking of serum Lp(a), apoB, apoB/apoA-I ratio and total cholesterol levels from birth up to 6 years of age was demonstrated. The association between apoE polymorphism and serum lipoprotein parameters became more obvious after the first 6 years of life.

Lipoprotein parameters in relation to other risk factors of atherosclerosis in adults and newborns: Tallinn Young Family Study.

A cohort of young families from Tallinn was studied for coronary risk factors. In sera from 239 adults and cord blood from 138 of their newborns, TC, HDL-C, LDL-C, TG, Lp(a) and apo-B levels were determined, and body mass index (BMI) and lifestyle factors were registered. In newborns, characteristics of maturity were assessed by Dubowitz and Apgar scores after birth. The aim of the study was to investigate the risk factors for atherosclerosis in young families and to reveal the main determinants of atherogenic lipoprotein parameters in adults and newborns. Using the criteria of the International Lipid Information Bureau, it was found that 24.4% of the men and 9.8% of the women were hypercholesterolemic, 31.5% of the men and 9.6% of the women had low HDL-C, TG levels were elevated accordingly in 5.3% and 1.2% of subjects. The independent determinants of TG level in males were BMI and age, and for LDL-C and apo-B levels--BMI, age and nationality. Female neonates had higher TC, HDL-C and apo-B levels than male neonates, the differences seeming to be associated with the different physiological requirements of male and female fetuses. Newborns' HDL-C levels were correlated positively with their TCs (r=0.72; p<0.001), LDL-C (r=0.47; p<0.001) and apo B (r=0.23; p<0.05). A negative linear correlation was found between neonates' TC levels and the Dubowitz maturity score (r=-0.22; p=0.038). Serum Lp(a) levels did not differ significantly between males and females, either in adults or in newborns. The independent determinants of neonates' serum Lp(a) concentrations were parents' serum levels of Lp(a) and nationality.

Lipoprotein(a), apolipoprotein A-I and B serum levels in young families from Tallinn, Estonia. Relationships with other cardiovascular risk factors and nationality.

Serum lipid, lipoprotein(a) (Lp(a)), apolipoprotein (apo) A-I and B concentrations were studied in young families of Tallinn: 157 husbands, 81 wives and 149 newborns participated in the study; 48% of subjects were Estonians, 39% Russians and 13% other nationalities. As previous studies among middle-aged men and school children of Estonia revealed clear national differences in serum lipoprotein profiles, our special interest was to study lipoprotein parameters in relation to ethnic origin. Body mass index (BMI), blood pressure (BP) and smoking habits were determined. In newborns, maturity by physical and neurological criteria and Apgar score after birth were assessed. At the age of 18-30 years, Estonian men had significantly higher serum total cholesterol, LDL cholesterol, triglyceride and Lp(a) levels than did Russian men. Estonian newborns had higher serum triglyceride concentration than Russian ones. Among women no national differences were recorded in the measured parameters. Lp(a) levels were not statistically correlated with age, BMI, BP or current smoking. Negative associations were revealed between Lp(a) and serum level of apo A-I (in men) or triglycerides (in newborns). Lp(a) concentrations correlated positively with LDL cholesterol (in women) and apo B (in newborns). Lp(a) levels of newborns were not associated with birthweight or health status, but correlated strongly with the sum of parental and fathers' Lp(a) concentrations, demonstrating that a genetic factor(s) is involved in the values of plasma Lp(a) levels.

[Effects of prophylactic vitamin administration to Tallin's schoolchildren on their health and physical development]. / Vliianie profilakticheskoi vitaminizatsii shkol'nikov Tallinna na ikh zdorov'e i fizicheskoe razvitie.

Data are presented on the influence of prophylactic vitamin administration to schoolchildren in two schools on their health. The morbidity rate significantly decreased, the levels of lysozyme in the saliva, hemoglobin in the blood and total protein in the blood serum rose in the children who received multivitamin "Undevitum" during 5-7 months, as compared to those who were not given the vitamins. Vitamin administration did not influence the physical development of schoolchildren.