Brain 'master switch' controls reproduction, weight

Recent studies describe a genetic "switch" in the brain that is regulated by the hormone leptin and appears to link reproductive function and body weight. Scientists are closer to understanding the links between body weight and fertility after finding a genetic "master switch" that influences both.

Although the switch was characterized in the brains of mice, lead study author Marc Montminy from the Clayton Foundation Laboratories for Peptide Biology in La Jolla, San Diego, California, USA, noted that, "because this gene is crucial to the daisy chain of signals that run between body fat and the brain, it likely plays a pivotal role in how much we, as humans, eat and whether we have offspring."

Montminy and colleagues discovered the gene, known as TORC1, while studying appetite-regulating hormones such as leptin that carry information from fat tissues to the brain.

The investigators studied mice lacking TORC1 and found that these animals rapidly became obese after birth and were usually infertile.

Further study showed that TORC1 responds to leptin by up-regulating the Cocaine and Amphetamine Regulated Transcript gene (CART), which suppresses appetite, and turning on the KISS1 gene, which is essential for normal reproductive function.

In the absence of leptin, therefore, appetite is not adequately suppressed and reproductive functioning is abnormal, the researchers explain.

They conclude that, since TORC1 is kinase regulated, it should make a good target for therapeutic intervention to treat both obesity and infertility.

Source: Nature Medicine 2008

Low-birthweight babies predisposed to psychiatric disturbances

A Recent study examined the long-term effects of low-birthweight on psychiatric problems in socially disadvantaged children from Detroit and others from a middle-class suburb. Low-birthweight babies are more likely than those with a healthy birthweight to develop psychiatric disturbances during childhood and through high school, research reveals.

The findings add another disease to the list of conditions, including respiratory disease, cardiovascular disease, and irritable bowel syndrome, that low-birthweight individuals show a predisposition to.

For the study, Kipling Bohnert and Naomi Breslau (Michigan State University, East Lansing, USA) looked at the association between low birthweight and psychiatric problems among 413 children from a socially disadvantaged community in Detroit and 410 from a middle-class Detroit suburb.

Mothers and teachers both rated children's psychiatric disturbance at ages 6, 11, and 17 years.

Results showed that low-birthweight children had "modest excesses" of externalizing (odds ratio [OR] = 1.53) and internalizing disturbances (OR = 1.28), compared with normal birthweight children.

An increased incidence of attention problems was seen in low-birthweight individuals from the socially disadvantaged urban, but not the suburban, community, compared with their normal-birthweight counterparts, particularly for those with a very low birthweight, of 1,500 g or less.

Bohnert and Breslau note: "Attention problems at the start of schooling predict lower academic achievement later, controlling for key facts that contribute to academic test scores, which in turn predicts termination of schooling and curtailed educational attainment."

They suggest: "Early interventions to improve attention skills in urban low-birthweight children might yield better outcomes later."

Source: Arch Gen Psych 2008; 65: 1080-6

Advancing paternal age risks bipolar disorder

Babies whose fathers are older than 55 years of age face a significantly increased risk for bipolar disorder, an extensive study has shown.

Despite robust evidence supporting an association between increasing paternal age and severe mental disorders, including schizophrenia and autism spectrum disorder, the researchers believe no previous trials have looked at the association between paternal age and bipolar disorder.

They analyzed information on 13,428 patients with bipolar disorder and their parents by linking data from the Swedish Multigenerational Register and the Hospital Discharge Register.

Five healthy control individuals, matched for gender and year of birth to the case patients, were also studied.

Overall, 68 (0.5 percent) of the patients had fathers aged at least 55 years.

Analysis showed that, after adjusting for parity, maternal age, socioeconomic status, and family history of psychotic disorders, these offspring had a 37 percent increased risk for bipolar disorder (odds ratio [OR] = 1.37), compared with children whose fathers were aged 20-24 years when they were conceived.

The association between paternal age and bipolar disorder was much stronger for early-onset cases (OR = 2.63), Emma Frans (Karolinska Institutet, Stockholm, Sweden) and co-workers report.

Increasing maternal age also showed an association with the incidence of bipolar disorder, but the effect "was less pronounced," say the researchers.

"The results are consistent with the hypothesis that advancing paternal age increases the risk for de novo mutations in susceptibility genes for neurodevelopmental disorders," they conclude.

Source: Archives of General Psychiatry 2008; 65: 1034-40

Adolescents conceived with IVF psychosocially similar to those born naturally

Adolescents conceived through IVF show similar psychosocial development to adolescents conceived naturally and have comparable relationships with their parents, researchers report.

Hilde Colpin and G. Bossaert from the University of Leuven in Belgium previously compared psychosocial development at age 2 years in children born naturally and those born using IVF.

Most previous studies of this kind have found no statistically significant differences between children conceived through IVF and those conceived naturally, but these focused on young children, mostly less than 5 years of age.

For the current report, Colpin and Bossaert studied 24 of the families involved in the original research, each of which had a child conceived through IVF now aged 15 or 16 years.

The investigators assessed psychosocial development in these families and in 21 control families with children born through natural means.

The results of this assessment show that parents who used IVF to conceive and their children are not significantly different to families who did not use IVF in terms of parenting style, parenting-related stress, and behavioural problems in the child.

Behavioral problems also occurred at a similar frequency in children who knew they were conceived using IVF and those who did not, the team reports.

"As far as we know, this is the first psychosocial study following up IVF families into children's mid-adolescence and the first to investigate adjustment level by disclosure status in this age group," conclude the investigators.

Implants or Indians?

Selby quadruplets turn 5

Everyone in the seven-member Selby family gets to claim a day of the week. Having a "special day" means each girl -- quadruplets turning 5 today and 7-year-old big sister Brooke -- can pick breakfast, choose a movie and generally have a say in daily decisions. It's one way Brian and Bonnie Selby balance the competing needs in a family where "everything we do is five times over."

The river of laundry, diapers and formula unleashed by the quads after they were born six weeks premature on Aug. 25 in 2003 is a distant memory. Car seats and strollers also are gone, making it much simpler to get out.The biggest challenges now are tracking all the activities, from part-time preschool to ballet to swimming lessons, and tailoring parenting to the girls' evolving personalities.

"They're individuals," said Bonnie, 41. "They don't like to do the same things."

Sydney -- a tall brunette in contrast to her shorter, blond sisters -- is introverted and passionate. Amanda is a "sweet teddy bear" who loves to cuddle.

McKenna and Ryleigh looked enough alike that their parents finally decided on a DNA test to determine whether they're fraternal or identical. Turns out, they're identical.

Along with looks, the two share some personality traits. They're outgoing, strong-willed and free-spirited. But while Ryleigh is the princess, McKenna is more sporty.

The "quad squad" still shares a room, recently switching from toddler bed to bunk beds. To keep things fair, they switch every couple of months so each girl gets time in a coveted top spot.

The four girls also share a middle name -- Faith -- after Baby Faith, a fifth sister who died during the second trimester of Bonnie's pregnancy, the result of an exceptionally fruitful in-vitro fertilization.

Though multiple births are on the rise, quadruplets remain rare.

According to the federal Centers for Disease Control and Prevention there were 434 quadruplet births recorded in the United States in 2002, compared to 69 quintuplet births. There were 4 million U.S. births that year.

Mornings at the Selby house are a mad rush to get everyone fed and dressed and Brooke to nearby Superior Elementary, where she's in second grade. At night, even with "assembly line" showers, it takes an hour to get all the girls washed, dried, dressed in pajamas and hair detangled.

And, five years after their birth, the quads' baby books aren't done.

"I still haven't really started," Bonnie said. "The intentions are good, but the time isn't there."

Big sister Brooke is generally "gracious" about sharing her world with four younger sisters. To give her personal attention, she gets to go on "date nights" with dad, a 46-year-old corporate controller for a biotech firm.

Bonnie keeps their Rock Creek home ruthlessly organized.

A new mud room -- previously the laundry room -- keeps a multitude of shoes and coats out of the way. Plastic bins keep art supplies and toys contained. A drawer in the kitchen holds hair brushes and ties.

The basement was transformed into a fantasy playroom with the help of friends.

Walls are washed in pastel hues. A friend painted a tree on one wall, while Bonnie added hand-painted letters that spell out words like "dream" and "laugh." There's a "schoolroom," a homemade wood "stage" and a playhouse donated by a neighbor.

The Selbys said they've been blessed with both material donations and donated time.

A friend with older twin girls regularly leaves clothes on the doorstep. A stalwart volunteer from Rock Creek Church has continued her weekly visits since the girls were born, coming each Wednesday to make peanut butter sandwiches. Bonnie's mother, Minnie Byrd of Denver, remains their No. 1 helper.

The girls celebrated turning 5 with a weekend party at Chuck E. Cheese. They donned princess outfits, played games and indulged in the rare treat of soda.

Turning 5, McKenna said, is "to be older and do more fun stuff."

The family took their first real vacation, a weeklong trip to a ranch near Gunnison in June, since the quads were born. But their favorite activity of summer, hands-down, was a trip to Denver's Elitch Gardens amusement park. Coming in a close second was learning to ride two-wheel bikes and learning to swim.

Noted Ryleigh, "I'm learning to blow bubbles out my nose."

Asked what it's like to be a set of four, the girls are stumped. After all, they've never known another way.

Five years into living as a family of seven, their parents can't imagine a different reality, either.

"This is my life," Bonnie said. "You either fight it or learn to love it. I love it."

Septuplet joy for Egyptian couple

An Egyptian woman has given birth to seven babies in the northern city of Alexandria, doctors said. The mother, named as 27-year-old Ghazala Khamis, is said to be well and the septuplets - four boys and three girls - are reported to be stable. The babies are said to weigh between 1.45 and 2.8kg (3-6lb); the couple already have three girls.
They sought fertility treatment hoping to have a boy, and were said to be astonished at the multiple pregnancy. Since the introduction of in-vitro fertilisation (IVF) treatment 30 years ago, the number of multiple births has increased dramatically.
Health experts say septuplets are very rare, and it is even less common for all to survive. The seven were delivered by Caesarean section a month early, and all have been placed in incubators designed for premature babies. The woman's brother said that the Egyptian health minister had promised free milk and nappies for the babies for two years, to help the family cope.