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    A feasibility study investigating the risk of prediabetes among children in New Zealand
    (Springer Nature Limited, 2025-08-26) Tupai-Firestone R; Cheng S; Corbin M; Lerwill N; Pulu T; Latu L; Dunn H; Pulu V; Firestone J; Fuge K; Tapu-Ta’ala S; Gokhale P; Matheson A; Read D; Borman B; Henry A; Krebs J; Samoa R; Kingi TK; Aitaoto N
    Prediabetes is a non-communicable disease (NCD) that is common in New Zealand (NZ), and it can lead to poor health. The aim of this study was to identify whether there is an increased risk of developing prediabetes among 11–13-year-olds, outside an organised screening programme. Consenting school aged children and their parents completed a series of screening questionnaires including dietary patterns, anthropometrics and socio-economic characteristics. Adapted Australasian Paediatric Endocrinology Guidelines (APEG) criterion was used to identify children at risk of developing prediabetes or have new onset prediabetes. Of the 276 participants, significant differences between Pacific, Māori and non- Māori non-Pacific children were evident among those who: were obese (BMI > 95th percentile); lived in overcrowded homes and in deprived areas. In our study, a large proportion of children (35%) were at risk of developing prediabetes. From our dietary analyses, we identified two distinct dietary patterns from among the children: (1) a diverse diet that included a wide range of foods, but was particularly high in sweet and savoury snacks, takeaway foods, and sugary drinks; and (2) a predominantly vegetarian diet rich in legumes. The study prevalence of prediabetes risk is indicative of childhood lifestyles, and we recommend early screening and better resourcing for promotion of healthy nutrition as preventative measures.
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    Case-Control Study of Congenital Anomalies: Study Methods and Nonresponse Bias Assessment.
    (Wiley Periodicals LLC, 2025-02-20) Eng A; Mannetje AT; Ellison-Loschmann L; Borman B; Cheng S; Lawlor DA; Douwes J; Pearce N
    BACKGROUND: To describe the methods of a congenital anomalies case-control study conducted in New Zealand, discuss the encountered methodological difficulties, and evaluate the potential for nonresponse bias. METHODS: The potential cases (n = 2710) were New Zealand live births in 2007-2009 randomly selected from the New Zealand Congenital Anomalies Registry. The potential controls (n = 2989) included live births identified from the Maternity and Newborn Information System, frequency matched to cases by the child's year of birth and sex. Mothers were invited to complete an interview covering demographic, lifestyle, and environmental factors. Response probabilities for case and control mothers were evaluated in relation to maternal age, deprivation, occupation, and ethnicity, available from the Electoral Roll, and inverse probability weights (IPWs) for participation were calculated. Odds ratios (ORs) for key demographic and selected risk factors were estimated through unconditional logistic regression, with and without IPW. RESULTS: A total of 652 (24%) of case mothers and 505 (17%) of control mothers completed the interview. Younger and more deprived mothers were underrepresented among the participants, particularly for controls, resulting in inflated ORs of associations with congenital anomalies for younger age, Māori ethnicity, deprivation, and risk factors under study, such as blue-collar occupations and smoking, indicative of nonresponse bias. Nonresponse bias was minimized through IPW, resulting in ORs and exposure prevalence estimates similar to those based on the prerecruitment sample. CONCLUSIONS: Attaining high participation rates was difficult in this study that was conducted in new mothers, particularly for the controls. The resulting nonresponse bias was minimized through IPW.
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    Pesticide exposure in New Zealand school-aged children: Urinary concentrations of biomarkers and assessment of determinants
    (Elsevier Ltd, 2022-05) Li Y; Wang X; Feary McKenzie J; 't Mannetje A; Cheng S; He C; Leathem J; Pearce N; Sunyer J; Eskenazi B; Yeh R; Aylward LL; Donovan G; Mueller JF; Douwes J
    This study aimed to assess pesticide exposure and its determinants in children aged 5-14 years. Urine samples (n = 953) were collected from 501 participating children living in urban areas (participant n = 300), rural areas but not on a farm (n = 76), and living on a farm (n = 125). The majority provided two samples, one in the high and one in the low spraying season. Information on diet, lifestyle, and demographic factors was collected by questionnaire. Urine was analysed for 20 pesticide biomarkers by GC-MS/MS and LC-MS/MS. Nine analytes were detected in > 80% of samples, including six organophosphate insecticide metabolites (DMP, DMTP, DEP, DETP, TCPy, PNP), two pyrethroid insecticide metabolites (3-PBA, trans-DCCA), and one herbicide (2,4-D). The highest concentration was measured for TCPy (median 13 μg/g creatinine), a metabolite of chlorpyrifos and triclopyr, followed by DMP (11 μg/g) and DMTP (3.7 μg/g). Urine metabolite levels were generally similar or low compared to those reported for other countries, while relatively high for TCPy and pyrethroid metabolites. Living on a farm was associated with higher TCPy levels during the high spray season. Living in rural areas, dog ownership and in-home pest control were associated with higher levels of pyrethroid metabolites. Urinary concentrations of several pesticide metabolites were higher during the low spraying season, possibly due to consumption of imported fruits and vegetables. Organic fruit consumption was not associated with lower urine concentrations, but consumption of organic food other than fruit or vegetables was associated with lower concentrations of TCPy in the high spray season. In conclusion, compared to other countries such as the U.S., New Zealand children had relatively high exposures to chlorpyrifos/triclopyr and pyrethroids. Factors associated with exposure included age, season, area of residence, diet, in-home pest control, and pets.