This investigation extended prior work by determining if stress and body mass index (BMI) contributed independently to tumor necrosis factor-α (TNF-α) levels among prepubescent Latino children and if sex and family history of type 2 diabetes mellitus (T2DM) modified these relationships. Data were collected in South Florida from 112 nondiabetic school-aged Hispanic children, of whom 43.8% were obese (BMI ≥ 95th percentile) and 51.8% presented with a family history of T2DM. Stressful life events were assessed via parental report using a life events scale. Plasma TNF-α levels were determined with enzyme-linked immunosorbent assay. The relative contributions of stress and BMI with TNF-α levels and the potential interaction effects of sex and family history of T2DM were analyzed with multiple linear regression analyses. Stress and BMI each accounted for a significant proportion of the unique variance associated with TNF-α. The association between stress and TNF-α was not modified by sex or family history of T2DM. These findings implicate BMI and stress as independent determinants of TNF-α (an inflammatory cytokine and adipocytokine) among Latino children. Future investigations should examine the potential roles of exercise, nutritional status, age, and growth hormone in explicating the relationship between TNF-α production and psychosocial distress and risk for infection among obese children. Keywords TNF-α; Children; BMI; StressObesity has reached pandemic proportions worldwide. Recent data had indicated that obesity has doubled in developed and developing nations (Ogden, Flegal, Carroll, & Johnson, 2002). In the United States, 16% of children and teenagers between 6 and 19 years old (more than 9 million) have been determined as obese, defined as placing above the 95th reference percentiles of body mass index (BMI), adjusted for age and sex (Ogden et al., 2002), with a disproportionate representation of Latino and African American children (Goran, 2001). These numbers remain concerning in light of the associations that have been established between childhood overweight and obesity (as reflected by greater BMI), with increased childhood morbidity, including type 2 diabetes mellitus (T2DM) and insulin resistance syndrome, hypertension, dyslipidemia, left ventricular hypertrophy, atherosclerosis, proteinuria, Daniels et al., 2005). Although obesity has been recognized as one of the easiest medical conditions to recognize, it has remained one of the most difficult to treat, with an annual cost estimated at 100 billion dollars in the United States alone (Wang & Dietz, 2002). These significant costs, with regard to actual dollars as well as the significant noted physical and psychological burden, have provided the impetus to identify pathophysiological markers associated with childhood obesity.As an inflammatory cytokine, tumor necrosis factor-α (TNF-α) has been implicated in the pathogenesis of medical complications secondary to obesity, including insulin resistance and T2DM (Hotamisligil, 2000), coronary morbid...
The current study investigated the impact of a severe environmental stressor and the role that declining social integration played in mediating its effect on loneliness and immune status. Increased loneliness and decreased social support in the months following the stressor (storm) were significantly associated with increased HHV-6 antibody titers, reflecting poorer control over the virus. Poorer social integration mediated the relationship between loneliness and HHV-6, even after controlling for nonspecific polyclonal B-cell activation, disease status (CD3+CD4+ cell counts), living arrangements, acute social losses (bereavement), and potential disruptions in socialsupport resources. These findings suggest that specific elements of social support may explain the oft-noted negative effects of loneliness on the immune system, and generalized to a medically vulnerable population.Currently, HIV infection is perceived as a chronic, debilitating, life-threatening illness with inherent challenges to physical and psychological health. Persons with HIV frequently confront challenges related to feeling stigmatized by the general public, alienated from friends and family, and fearful of potential threats to their health and lives (Antoni et al
The intervention offered a promising strategy for reducing decline in physical function and potentially lowering total health care expenditures for high-risk Medicare beneficiaries, especially for those in rural areas. Future studies need to investigate whether the findings can be replicated in other types of rural areas through a refined intervention and better targeting of the study population.
Objective: To examine the relationships between TNF-a, obesity, and insulin resistance among prepubescent children. Design: Cross-sectional study. Setting and subjects: Data were collected from 112 nondiabetic Latino schoolchildren from public schools in three South Florida communities. Of the enrolled participants, 43.8% were obese (BMI 95th percentile) and 51.8% presented with a family history of type 2 diabetes mellitus (T2DM). With one exception, all demonstrated normal glucose tolerance. Interventions: Plasma TNF-a levels were determined with enzyme-linked immunosorbance assay (ELISA). Homeostasis model assessment (HOMA-IR) was calculated as an index of insulin resistance. Mean levels of TNF-a among obese vs nonobese children were compared with a one-way analysis of variance with two groups, and the association between TNF-a and HOMA-IR was assessed with a Pearson's correlation. Results: Higher circulating TNF-a levels were revealed among nonobese vs obese children. Nonobese girls demonstrated higher TNF-a levels than obese girls, whereas there were no significant differences for boys. There were no significant differences after stratifying for family history of T2DM. There was a modest relationship between increased TNF-a levels and decreased insulin resistance. Conclusions: The observed elevated circulating TNF-a concentrations among leaner participants may reflect an inflammatory process that has been associated with higher levels of physical fitness in both adults and prepubescent children. This effect may remain stronger for prepubescent girls, and the mechanism may be attenuated by the hormonal changes that occur with the onset of puberty.
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