Health behaviors and mental health among adolescents: A comparison based on BMI using the 2021 Korea Youth Risk Behavior Survey.

Background: Obesity and underweight can have adverse effects on adolescents. However, previous obesity management program conducted in Korea for adolescents with obesity showed low effectiveness, and there are few studies on underweight Korean adolescents. Objective: This study aims to analyze differences in the health behaviors and mental health of adolescents based on their body mass index (BMI). Methods: Data from the 2021 Korea Youth Risk Behavior Survey were examined. The health behaviors and mental health of 53,445 adolescents were analyzed according to BMI using SAS version 9.4 with the Rao-Scott χ2 test and logistic regression analysis. Results: Regarding the difference in health behaviors according to BMI, a higher proportion of participants who are drinking alcohol and are exposed to secondhand smoke were in the underweight group than in the obesity group. The rate of obesity among those engaged in physical activity was higher than that among those involved in non-physical activity. In addition, the obesity group used smartphones more than the underweight group, while the quality of sleep was better among the underweight group than the obesity group. Conclusion: While the health behaviors and mental health of adolescents according to BMI are similar to those of previous studies, there are also distinct aspects. Consequently, further exploration of health behaviors and mental health based on BMI is crucial for developing and implementing targeted nursing intervention programs for adolescents with different weights.

Clinical Application of Factor VIII:C to VWF:Ag Ratio for the Screening of Haemophilia A Carriers.

Analyses of factor VIII procoagulant activity (FVIII:C) and the FVIII:C to VWF:Ag ratio (FVIII:C/VWF:Ag ratio) have been investigated as screening bioassays to detect haemophilia carriers. This study aimed to determine the validity of the FVIII:C/VWF:Ag ratio and FVIII:C analyses as screening tests. We reviewed the medical records of 137 genetically confirmed, proband haemophilia A patients and 179 of their familial females who had undergone carrier testing. The collected data included the severity and mutation type of F8 gene from probands and age, ABO blood type, FVIII:C, VWF:Ag, and the result of targeted gene analysis in females. We diagnosed 110 females as carriers, and their FVIII:C and FVIII:C/VWF:Ag ratio were lower than those in 69 non-carriers (FVIII:C: 59.3 IU/dL vs. 106.1 IU/dL, p = 0.000; FVIII:C/VWF:Ag ratio: 0.62 vs. 1.08, p = 0.000). In receiver operating characteristic analysis, the areas under the curve (AUC) of the FVIII:C/VWF:Ag ratio and FVIII:C were 0.936 and 0.876, respectively. The cut-off value of FVIII:C/VWF:Ag ratio (0.81) at the maximum Youden J index provided a sensitivity of 82.8% and specificity of 96.6%. The cut-off value of FVIII:C (83.8 IU/dL) showed a sensitivity of 81.8% and specificity of 79.7%. Considering the AUC, the FVIII:C/VWF:Ag ratio is a good screening test to detect haemophilia A carriers, as evidenced by its specificity of 96.6%; however, it may also induce false-negative results.

Eating disorders between male and female adolescents with type 1 diabetes mellitus in Korea.

Background: Diabetes mellitus and its prevalence are rising dramatically in Korea and throughout the world, not only in adults but in adolescents. Objective: This study aimed to identify the sex-specific factors that influence eating disorders in adolescents with type 1 diabetes. Methods: A secondary analysis of a descriptive survey was employed. Raw data from 136 adolescents aged 13 to 18 years who were diagnosed with type 1 diabetes were obtained in the original study using the Diabetes Eating Problem Survey-Revised (DEPS-R), Rosenberg Self-Esteem Scale (RSES), and Beck Depression Inventory-II (BDI-II). The data were analyzed using the independent t-test and multiple regression analysis. Results: The female and male participants with eating disorders scored 21.67 ± 11.70 and 13.15 ± 8.03 points, respectively. Among the adolescents with type 1 diabetes, the factors related to eating disorders in female participants were body image satisfaction (ß = 0.48, p <0.001) and depression (ß = 0.22, p = 0.043), accounting for 33.4% of the variance. While the factors related to eating disorders in the male participants were BMI (ß = 0.33, p = 0.006) and depression (ß = 0.28, p = 0.017), accounting for 17.4% of the variance. Conclusion: Sex-specific factors should be considered to induce healthy eating behavior in adolescents with type 1 diabetes and reduce eating disorders. Moreover, it is necessary for female adolescents to perceive their body type accurately, and male adolescents need exercise and nutrition education to lower their body mass index. Collaborations between medical practitioners, changes in the medical environment, and social interests are necessary. Since depression is the common factor associated with eating disorders in female and male adolescents with type 1 diabetes, a periodic depression screening test and intervention program that can lower depression should be developed. At the government level, it is necessary to strengthen economic support for cost interventions.

[Predictors of Eating Disorders in Adolescents with Type 1 Diabetes]. / 1형 당뇨병 ì²­ì†Œë „ì˜ ì„­ì‹ìž¥ì• ì˜ˆì¸¡ìš”ì¸.

PURPOSE: The purpose of this study was to identify predictors of eating disorders in adolescents with type 1 diabetes, with the goal of providing data in support of nursing interventions to improve their health. METHODS: A total of 136 adolescents aged 13-18 years with type 1 diabetes completed the Diabetes Eating Problem Survey-Revised, Rosenberg Self-Esteem Scale, and the Beck Depression Inventory-II, using structured self-reported questionnaires. The collected data were analyzed using the t-test, x 2 test, and binominal logistic regression with SPSS version 23.0 for Windows. RESULTS: The prevalence of eating disorders in adolescents with type 1 diabetes was 39%. Four significant predictors of eating disorders were identified; absence of body satisfaction (odds ratio [OR]=3.87, 95% confidence interval [CI]=1.55~9.65), depression (OR=2.87, 95% CI=1.13~7.28), female gender (OR=2.67, 95% CI=1.09~6.54), and glycosylated hemoglobin type A1c levels (OR=1.47, 95% CI=1.10~1.97). CONCLUSION: In order to prevent eating disorders among adolescents with type 1 diabetes, programs for managing adolescents' depression and improving their body satisfaction should be developed. Futhermore, more attention should be directed towards programs aiming to prevent eating disorders in female adolescents.

Suppression of Inflammatory cytokine production by ar-Turmerone isolated from Curcuma phaeocaulis.

Rhizomes of Curcuma phaeocaulis Valeton (Zingiberaceae) have traditionally been used for controlling inflammatory conditions. Numerous studies have aimed to isolate and characterize the bioactive constituents of C. phaeocaulis. It has been reported that its anti-inflammatory properties are a result of cyclooxygenase-2 inhibition; however, its effect on the T-cell function remains to be elucidated. In this study, four known sesquiterpenoids, viz., ar-turmerone (TM), germacrone (GM), (+)-(4S,5S)-germacrone-4,5-epoxide (GE), and curzerenone (CZ), were isolated from C. phaeocaulis rhizomes and evaluated for their effects on the CD4(+) T-cell function. While GM, GE, and CZ had no effect on the activation of splenic T cells or CD4(+) T cells, TM suppressed the interferon (IFN)-γ production, without affecting the interleukin (IL)-4 expression. TM also decreased the expression of IL-2 in CD4(+) T cells, but did not change their cell-division rates upon stimulation. These results suggest that TM, a major constituent of C. phaeocaulis rhizomes selectively exerts potent anti-inflammatory effects via suppression of the inflammatory cytokines IFN-γ and IL-2.

Lysine 313 of T-box is crucial for modulation of protein stability, DNA binding, and threonine phosphorylation of T-bet.

A T-box-containing protein expressed in T cells (T-bet) is a key transcription factor involved in the regulation of Th cell differentiation. Although T-bet-deficient CD4(+) T cells fail to produce IFN-γ and typically differentiate into Th2 cells in vitro, ectopic overexpression of T-bet elevates IFN-γ and suppresses production of IL-2 and Th2 cytokines through different mechanisms. Despite the importance of the T-bet protein level, the regulatory mechanisms that control T-bet protein stability are largely unknown. In this study, we found that T-bet underwent proteasomal degradation via ubiquitination at Lys-313. Despite its robust accumulation following lysine mutation, T-bet(K313R) failed to increase IFN-γ production because of diminished DNA binding activity, as demonstrated in the crystal structure of T-bet-DNA complex. Strikingly, T-bet(K313R) entirely lost the ability to suppress IL-2 production and Th2 cell development; this was due to loss of its interaction with NFAT1. We further identified that the T-bet(K313R) reduced the phosphorylation of T-bet at Thr-302, and that threonine phosphorylation was essential for T-bet interaction with NFAT1 and suppression of NFAT1 activity. Retroviral transduction of T-bet(T302A) into T-bet-deficient cells restored IFN-γ levels compared with those induced by wild-type T-bet, but this mutant failed to inhibit IL-2 and Th2 cytokine production. Collectively, these data show that Lys-313 in the T-box domain is essential for controlling T-bet protein stability via ubiquitin-dependent degradation, T-bet binding to the IFN-γ promoter, and for the interaction with and suppression of NFAT1. Thus, multiple posttranslational modifications of T-bet are involved in fine-tuning cytokine production during Th cell development.