The compliance with vaccination recommendations in adolescence has not been well documented in Greece. The aims of the present study were to estimate the vaccination coverage in a sample of adolescents and to identify risk factors associated with incomplete immunization. Α total of 1,005 adolescents aged 11 to 19 years who were outpatient visitors at an Adolescent Health Unit were included in this study. Participation required parental presence and consent and presentation of the official Child Health Booklet, from which immunizations were transcribed. The highest coverage rates were observed for childhood immunizations: poliomyelitis and hepatitis B (both 96%), measles/mumps/rubella (MMR; 93.1%), and meningitidis C (MenC; 83.4%). By contrast, lower rates were shown for the booster dose of tetanus/diphtheria/pertussis (39.6%), for hepatitis A (HAV; 59.1%), for the varicella vaccine (13.8% among adolescents without disease history), and among girls for the human papillomavirus vaccine (11.9%). We found a significant association between age and series completion for MMR, MenC, and HAV, with lower uptake among older adolescents . Overall, 22.7% of study participants were fully vaccinated according to criteria employed. In particular, non-urban residents, non-nationals, and females had lower likelihood of being fully vaccinated. In conclusion, our findings suggest suboptimal vaccination coverage among our sample's adolescents, mandating that every effort should be made to increase uptake, particularly among the geographically dispersed and the culturally diverse and female adolescents.

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This study aims to globally assess the network of insulin resistance (IR)-related factors in a sample of overweight and obese Greek youths.A total of 185 subjects were examined, and IR was quantified by homeostasis model assessment (HOMA-IR). Multivariate hierarchical approach was performed, and five distinct levels were recognized, namely, immutable demographic features and early life parameters, current anthropometric measures, IR, unfavorable clinical conditions, and social parameters. Two analyses were performed based on HOMA-IR cut-off values (3.16 and, as an alternative, 3.99).Obesity was associated with IR (adjusted OR=3.19, 95% CI: 1.12–9.09). IR steadily predicted low HDL (adjusted OR=5.75, 95% CI: 1.58–20.87), hypertriglyceridemia (adjusted OR=10.28, 95% CI: 1.18–89.55), and systolic hypertension. At the alternative analysis, IR was also associated with older age, older age at menarche, hyperuricemia, and low school grades.Emerging on the grounds of obesity, IR confers risks for dyslipidemia and hypertension at a relatively early age. Along with weight loss, interventions targeted at IR are required to prevent cardiometabolic risk in adolescence.

Adipokines are a superfamily of cell signaling proteins produced by the adipose tissue. This study’s purpose was to reveal the association of adipokines (leptin, adiponectin), hs-CRP, and IL-6 with well-known cardiovascular risk factors (lipid profile, diabetes control, obesity, physical activity) in children and adolescents with T1D. This cross-sectional study included 80 participants (36 boys) with T1D, aged (mean ± SD) 14.8 ± 3.4 years. Body Mass Index (BMI), metabolic profile, and level of physical activity were assessed (using pedometers) for evaluation of their effect on serum leptin, adiponectin, IL-6, and hs-CRP. Leptin levels were associated with BMI (beta = 0.184, p < 0.001), waist to hip ratio (beta = −2.017, p = 0.022), Low Density Lipoprotein-C (LDL-C) (beta = 0.021, p = 0.005), and fat mass (beta = 14.07, p < 0.001). Adiponectin was correlated with waist to height ratio (beta = 0.048, p = 0.006), ΒΜΙ (beta = −0.056, p = 0.005), and muscle mass (beta = −0.013, p = 0.020). Interestingly, hs-CRP was associated with weight (beta = 0.035, p < 0.001), ΒΜI (beta = 0.186, p < 0.001), fat mass (beta = 5.2859, p = 0.004), and muscle mass (beta = 0.027, p = 0.008). Multiple regression analysis of muscle mass unveiled associations with log hs-CRP (beta = −1.237, p = 0.014) and inverse IL−6 (beta = 18.57, p = 0.01). Finally, multiple regression models of fat mass unveiled associations with physical activity (7-day-total-step-count) (beta = −3.90 × 10−7, p = 0.027), Inverse IL-6 (beta = −0.1572, p = 0.009), and squared leptin (beta = 0.0077, p = 0.03). This study reports a positive association of leptin with LDL-C, BMI, fat mass, and hip circumference and a negative association of adiponectin with BMI and muscle mass. Finally, hs-CRP was associated with HbA1c, fat mass, and BMI. We propose that leptin, adiponectin, and hs-CRP could be used as prognostic indicators of cardiovascular risk in children with T1D.

The health effects of eating disorders (EDs) in adolescence have been widely studied, but their impact on present adolescent psychosocial adjustment and development have been overseen. This study aimed to investigate the association between EDs and career aspirations in middle adolescence. The participants were 147 adolescents diagnosed with EDs. Participants reported on their future career aspirations, and these were coded according to the International Standard Classification of Education of 1997. Of the participants, 83 adolescents were followed up longitudinally, and their aspirations were reassessed and compared for stability across the two assessments. Moreover, participants' career aspirations were compared to those of healthy (non-ED) best-friend controls. Health-related and social-behavioral science careers were chosen significantly more by adolescents with an ED as compared to their non-ED counterparts. For adolescents with an ED, career choices were consistent across reassessments. These findings suggest that adolescents with an ED gravitate toward careers associated with their pathology, namely, both facets of their mind-body pathology. This finding may indicate restricted identity development for adolescents with an ED. Suggestions for treatments protocols to include identity exploration are discussed.

. Severe diabetic ketoacidosis (DKA), rarely, may be associated with elevated troponin and proBNP levels in adults with a history of diabetes. However, few cases have reported this association in children with severe and complicated DKA. We describe a case of severe DKA (pH: 6.89, HCO3: 6.5) in a 14-yr-old female adolescent in which the symptoms of DKA were presented days before the diagnosis. The patient was under the effect of acidosis (Kussmaul respiration) for 12 h before admission to our hospital, where she was admitted in a critical clinical condition. After successful treatment with DKA with intensive intravenous fluid and regular insulin, the patient presented with abnormal cardiac rhythm, disturbance of interventricular septum motility, a mild decrease in left ventricular systolic function, negative T waves in leads III and aVF, and a marked increase in troponin and brain natriuretic peptide (NT-proBNP) levels. All abnormal findings completely resolved within 8 days after the initiation of DKA treatment. The phenomenon in our case was transient, and the patient had a good long-term outcome. However, it represents a challenge for clinicians; therefore, emphasis should be given to cardiac monitoring during the course of severe and prolonged DKA in children and adolescents.

Exercise has a direct positive effect on glycemic control by promoting insulin secretion from β-pancreatic islet-cells and by increasing skeletal muscle glucose uptake. The reduction in daily insulin needs and the optimization of glycemic control improves the patient’s quality of life, self-esteem, mental wellness, as well as diabetes-related mobility and mortality. The aim of this study was to investigate the effect of physical activity in children and adolescents with type-1 diabetes (T1D) on diabetic control, cardiovascular, and biochemical profiles; hs-CRP; IL6; leptin; and adiponectin levels of the population under study. This is a prospective cross-sectional study that involved 80 participants (36 boys and 44 girls) with T1D, who were aged 6–21 years and who attended the Diabetes and Metabolism Clinic of the 2nd Pediatric Department, University of Athens, “P & A Kyriakou” Children’s Hospital of Athens. Twenty (25%) children were above the 75th percentile regarding total levels of physical activity, while 40 (50%) and 20 (25%) were between the 25th and 75th percentile, as well as below the 25th percentile, respectively. In the group with an intermediate level of exercise, physical activity was negatively associated with the participant’s family situation (traditional, single parent, grandparent, with others, or by himself/herself) (p = 0.013), ferritin (p = 0.031), lipoprotein(a) [Lp(a)] (p = 0.016), and squared leptin levels (p = 0.040). Whereas in the groups with extreme vs. no exercise there was a negative association with the number of daily glucose measurements (p = 0.047). However, in the group with non-vigorous exercise, physical activity was positively associated with high density lipoprotein-c (HDL-c) levels (p = 0.048). The findings of this study are indicative of the beneficial role of exercise on children and adolescents with T1D, which is achieved by primarily improving their cardiometabolic profile through the amelioration of lipid profile [HDL-c, Lp(a)] and leptin levels, as well as by reducing chronic systemic inflammatory response (ferritin) and ultimately decreasing the overall diabetes morbidity.

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