Association between genetic and socioenvironmental risk for schizophrenia during upbringing in a UK longitudinal cohort.

BACKGROUND: Associations of socioenvironmental features like urbanicity and neighborhood deprivation with psychosis are well-established. An enduring question, however, is whether these associations are causal. Genetic confounding could occur due to downward mobility of individuals at high genetic risk for psychiatric problems into disadvantaged environments. METHODS: We examined correlations of five indices of genetic risk [polygenic risk scores (PRS) for schizophrenia and depression, maternal psychotic symptoms, family psychiatric history, and zygosity-based latent genetic risk] with multiple area-, neighborhood-, and family-level risks during upbringing. Data were from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally-representative cohort of 2232 British twins born in 1994-1995 and followed to age 18 (93% retention). Socioenvironmental risks included urbanicity, air pollution, neighborhood deprivation, neighborhood crime, neighborhood disorder, social cohesion, residential mobility, family poverty, and a cumulative environmental risk scale. At age 18, participants were privately interviewed about psychotic experiences. RESULTS: Higher genetic risk on all indices was associated with riskier environments during upbringing. For example, participants with higher schizophrenia PRS (OR = 1.19, 95% CI = 1.06-1.33), depression PRS (OR = 1.20, 95% CI = 1.08-1.34), family history (OR = 1.25, 95% CI = 1.11-1.40), and latent genetic risk (OR = 1.21, 95% CI = 1.07-1.38) had accumulated more socioenvironmental risks for schizophrenia by age 18. However, associations between socioenvironmental risks and psychotic experiences mostly remained significant after covariate adjustment for genetic risk. CONCLUSION: Genetic risk is correlated with socioenvironmental risk for schizophrenia during upbringing, but the associations between socioenvironmental risk and adolescent psychotic experiences appear, at present, to exist above and beyond this gene-environment correlation.

Childhood body mass index and endothelial dysfunction evaluated by peripheral arterial tonometry in early midlife.

BACKGROUND/OBJECTIVES: Endothelial dysfunction predicts mortality but it is unknown whether childhood obesity predicts adult endothelial dysfunction. The aim of this study was to determine whether anthropometric indices of body fat in childhood, adolescence and early midlife are associated with endothelial dysfunction in early midlife. SUBJECTS/METHODS: Participants belonged to a representative birth cohort of 1037 individuals born in Dunedin, New Zealand in 1972 and 1973 and followed to age 38 years, with 95% retention (the Dunedin Multidisciplinary Health and Development Study). We assessed anthropometric indices of obesity at ages 3, 5, 7, 9, 11, 13, 15, 18, 21, 26, 32 and 38 years. We tested associations between endothelial function assessed by peripheral arterial tonometry (PAT) at age 38 and; age 38 cardiovascular risk factors; age 3 body mass index (BMI); and four BMI trajectory groups from childhood to early midlife. RESULTS: Early midlife endothelial dysfunction was associated with BMI, large waist circumference, low high-density lipoprotein cholesterol, low cardiorespiratory fitness and increased high-sensitivity C-reactive protein. After adjustment for sex and childhood socioeconomic status, 3-year-olds with BMI 1 s.d. above the mean had Framingham-reactive hyperemia index (F-RHI) ratios that were 0.10 below those with normal BMI (ß=-0.10, 95% confidence interval (CI) -0.17 to -0.03, P=0.007) at age 38. Cohort members in the 'overweight', 'obese' and 'morbidly obese' trajectories had F-RHI ratios that were 0.08 (ß=-0.08, 95% CI -0.14 to -0.03, P=0.003), 0.13 (ß=-0.13, 95% CI -0.21 to -0.06, P<0.001) and 0.17 (ß=-0.17, 95% CI -0.33 to -0.01, P=0.033), respectively, below age-peers in the 'normal' trajectory. CONCLUSIONS: Childhood BMI and the trajectories of BMI from childhood to early midlife predict endothelial dysfunction evaluated by PAT in early midlife.

Leptin deficiency in maltreated children.

Consistent with findings from experimental research in nonhuman primates exposed to early-life stress, children exposed to maltreatment are at high risk of detrimental physical health conditions, such as obesity and systemic inflammation. Because leptin is a key molecule involved in the regulation of both energy balance and immunity, we investigated abnormalities in leptin physiology among maltreated children. We measured leptin, body mass index and C-reactive protein in 170 12-year-old children members of the Environmental-Risk Longitudinal Twin Study, for whom we had prospectively-collected information on maltreatment exposure. We found that maltreated children exhibited blunted elevation in leptin levels in relation to increasing levels of physiological stimuli, adiposity and inflammation, compared with a group of non-maltreated children matched for gender, zygosity and socioeconomic status. These findings were also independent of key potential artifacts and confounders, such as time of day at sample collection, history of food insecurity, pubertal maturation and depressive symptoms. Furthermore, using birth weight as a proxy measure for leptin, we found that physiological abnormalities were presumably not present at birth in children who went on to be maltreated but only emerged over the course of childhood, after maltreatment exposure. Leptin deficiency may contribute to onset, persistence and progression of physical health problems in maltreated children.

Evaluation of a school-based influenza surveillance system.

Previous studies have suggested using school-based surveillance to monitor epidemic influenza-like illness in a community. Since the late 1970s, no studies have sought to evaluate this public health measure. The Boulder County Health Department developed, piloted, and implemented a school-based surveillance system beginning with the 1988-89 school year. After five seasons of surveillance, the school-based system was evaluated for sensitivity by comparing the epidemic curves from the school-based system with those of a preexisting communicable disease sentinel surveillance system. Additional attributes evaluated included acceptability, simplicity, timeliness, and overall usefulness. Comparisons of the overall epidemic patterns suggest a close correlation between the two measures for the influenza seasons 1988-89 through 1992-93. The school-based system closely followed the general rise, peak, and fall of epidemic influenza-like illness as measured by the preexisting sentinel system. Three of five epidemic peaks matched on the week of occurrence between the two surveillance systems; for the remaining seasons, 1989-90 and 1991-92, the school-based system peaked 1 week earlier than the sentinel system. The use of school-based surveillance has several positive attributes which suggests schools are an ideal setting for detecting influenza outbreaks, including the epidemiology of influenza which has shown children play an important role in the acquisition and spread of influenza-like illness. Student populations were accessible and easily monitored by absenteeism rates that required no diagnosis or invasive testing. All 44 schools within the school district readily participated in the surveillance of influenza. Only minimal time and resources were needed for the system's maintenance. The school-based surveillance system allowed the local health department to track influenza-like illness activity and provide timely and important information concerning outbreaks to schools, public health officials, health care providers,and the public.

The epidemiology of school-related injuries: new perspectives.

Among school-aged children, unintentional injuries are the leading cause of morbidity and mortality. We began this prospective study in a sample of nine schools within the Boulder Valley School District (Colorado) during the 1988-1989 school year in an effort to explore the etiology of school-related injuries and to provide information relevant to their prevention. During the study period, 509 injuries were reported among a population of 5,518 students, yielding an incidence of 9.22 per 100 students. Boys were nearly one and one-half times more likely to have sustained a school-related injury than girls (risk ratio (RR) = 1.41; 95% confidence intervals [CIs] 1.18, 1.68). We found a significant difference among injury rates by school level (P less than .001). Middle/junior high students had the highest rate, followed closely by elementary students and distantly by high school students. Sports activities accounted for the largest percentage of school injuries (53%), and the percentage of sports-related injuries increased with increasing grade level. Analysis of injury rates by school location revealed that high school students were most frequently injured in the gym (1.52 per 100), middle/junior high students on the athletic field (4.26 per 100), and elementary students on the playground (6.12 per 100). Using injury location as the focal point, we examined relationships among the variables sport/activity, body site, and nature of injury. We found that a large percentage of injuries sustained on the athletic field or in the gym were similar and affected similar body sites, whereas playground injuries differed in their nature and in body site affected.(ABSTRACT TRUNCATED AT 250 WORDS)