Body mass index (BMI) of drug-naïve psychotic adolescents based on a population of adolescent psychiatric inpatients.

OBJECTIVE: To investigate the connection between overweight and first-episode schizophrenia spectrum as well as non-schizophrenia spectrum psychiatric disorders in adolescent male and female drug-naïve psychiatric inpatients, whose illness was early onset. METHOD: Three hundred twenty-three adolescents with no past or present psychiatric medication, 12-17 years of age, admitted to the psychiatric inpatient care (Oulu University Hospital, Northern Finland) between April 2001 and March 2006. DSM-IV diagnoses were based on the "Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime" (K-SADS-PL). An adolescent was defined as overweight if his or her BMI was greater than or equal to the 85th percentile. RESULTS: Overweight values were highest in drug-naïve adolescent boys with first-episode schizophrenia spectrum (RR: 2.5, 95%CI: 1.08-4.29) and non-schizophrenia spectrum (RR: 2.80, 95%CI: 2.20-3.45) disorders. The RR in girls with non-schizophrenia spectrum disorders was 1.73 (95%CI: 1.31-2.23), but in those with first-episode schizophrenia spectrum disorders RR did not differ from general population. CONCLUSIONS: In our study sample of first-episode schizophrenia spectrum drug-naïve adolescents, overweight was shown to be prevalent in all diagnostic groups other than first-episode schizophrenia spectrum psychotic girls. To the best of our knowledge, this is the first study in which overweight was analyzed and verified among drug-naïve adolescent boys, suffering from first-episode schizophrenia spectrum disorder. To what extent our results are applicable to other regions and study groups, remains to be seen.

Gestational diabetes identifies women at risk for permanent type 1 and type 2 diabetes in fertile age: predictive role of autoantibodies.

OBJECTIVE: Our aim was to evaluate the predictive value of gestational diabetes mellitus (GDM), diabetes-associated autoantibodies, and other factors for development of clinical diabetes later in life. RESEARCH DESIGN AND METHODS: In this case-control study the presence of autoantibodies was studied in 435 women with GDM and in healthy matched control subjects. The need for exogenous insulin during GDM was recorded. In the GDM group, the mean follow-up period was 5.7 years and in the control group 6.1 years. RESULTS: Among the subjects with GDM, 20 (4.6%) developed type 1 diabetes and 23 (5.3%) developed type 2 diabetes, whereas none of the control subjects became diabetic. Two-thirds of those who developed type 1 diabetes tested positive initially for islet cell antibodies (ICAs), whereas 56% of them had autoantibodies to GAD (GADAs) and 38% to the protein tyrosine phosphatase-related IA-2 molecule. Only 2 of the 23 women who presented later with type 2 diabetes tested positive for autoantibodies. According to multivariate analysis, initial age < or =30 years, the need for insulin treatment for GDM, and antibody positivity for ICAs and GADAs were associated with increased risk for clinical type 1 diabetes. CONCLUSIONS: Pregnancy seems to identify women who are at risk of developing diabetes later in life. About 10% of Finnish women with GDM will develop diabetes over the next 6 years; nearly half of them develop type 1 diabetes and the other half type 2 diabetes. Age < or =30 years, the need for insulin treatment during pregnancy, and positivity for ICAs and GADAs confer a high risk of subsequent progression to type 1 diabetes in women affected by GDM.