Cardiometabolic risk factors associated with renal function in apparently healthy young students: a cross-sectional study

ABSTRACT Background: Cardiometabolic risk factors (CMRFs) appear decades before developing chronic kidney disease (CKD) in adulthood. Objective: The objective of the study was to identify the prevalence and association between CMRFs and kidney function in apparently healthy young adults (18-25 years old). Methods: We included 5531 freshman year students. Data collected on CMRFs included central obesity, high body mass index (hBMI >25), blood pressure, glycemia, lipids, uric acid (UA >6.8 mg/dL), and insulin. Glomerular filtration rate (GFR) was estimated by CKD-Epidemiology Collaboration formula. We used logistic regression and a log linear for odds ratio (OR) (95% confidence level) and probabilities. Results: The presence of any CMRF was observed in 78% (4312) of individuals; GFR ≥120/130 mL/min/1.73 m2sc was found in 33%, GFR <90 mL/min/1.73 m2sc in 3%, and proteinuria in 3%. Factors associated with high GFR were hBMI (OR 1.3 [1.14, 1.47]), UA (OR 0.2 [0.15, 0.26]), high-density lipoprotein (HDL) (OR 1.4 [1.2, 1.6]), and insulin resistance (OR 1.3 [1.05, 1.7]). CMRF associated with low GFR was UA (OR 1.8 [1.3, 2.6]), low-density lipoprotein cholesterol (OR 1.66 [1.05, 2.6]), and proteinuria (OR 3.4 [2.07, 5.7]). Proteinuria was associated with high UA (OR 1.59 [1.01, 2.5]) and hypercholesterolemia (OR 1.8 [1.03, 3.18]). The sole presence of hBMI+UA predicted low GFR with p = 0.6 and hBMI+UA+low HDL predicted proteinuria with p = 0.55. Conclusions: CMRFs were highly prevalent among this freshman student population and were associated with proteinuria and GFR abnormalities. Future studies should focus on public health programs to prevent or delay the development of CKD.

Prevalencia del síndrome metabólico y sus componentes en adolescentes de la Ciudad de Monterrey, Nuevo León / Metabolic syndrome prevalence in teenagers of Monterrey, Nuevo León

Objetivo: Determinar la prevalencia del síndrome metabólico (SM) y de sus componentes en adolescentes del área metropolitana de Monterrey, Nuevo León, México (AMM). Método: Se realizó un estudio transversal de población, que incluyó a 254 escolares con edades entre 10 a 19 años. Se investigó: características personales, mediciones antropométricas, glucosa, triglicéridos y colesterol-HDL. Para determinar si un sujeto padecía SM, se adaptó la definición recomendada por el Nacional Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII). Resultados: La prevalencia de SM fue de 9.4% (IC95%: 5.8 a 13.0), sin que se observaran diferencias significativas entre sexos. Los distintos componentes de SM tuvieron la siguiente prevalencia: hipertigliceridemia, 24.4%; obesidad abdominal, 20.1%; colesterol de alta densidad (HDL-c) bajo, 19.0%; niveles de glucosa elevados, 11.4 %, e hipertensión arterial: 9.1% diastólica y 5.9% sistólica. Los fenotipos de predicción de SM fueron índice de masa corporal (IMC) (OR = 4.93, IC95%: 2.26, 10.73), e interacción entre el IMC del adolescente y sus antecedentes familiares de obesidad (OR = 1.37, IC95%: 1.0, 1.87). Se observó que la diabetes tipo 2 familiar sólo tuvo un efecto marginal. Conclusiones: La prevalencia de SM en escolares del AMM es alta, situación que resulta alarmante si este riesgo se mantiene durante el desarrollo y hasta la vida adulta. La obesidad en familiares de primero y segundo grados, junto con IMC del adolescente, son factores de predicción importantes de SM.

Objective: To determine the prevalence of the metabolic syndrome (SM) and its components in teenagers from the metropolitan area of Monterrey Nuevo Leon, Mexico (AMM). Method: A transversal research involving 254 teenage students from 10 to 19 years old. To research investigated their personal characteristics, anthropometrics measures, glucose, triglycerides and cholesterol HDL. The SM definition was adapted from the one suggested by the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII). Results: The SM prevalence was 9.4 % (IC95%: 5.8 to 13.0), there was not a difference between the sexes. The prevalence among each SM component was: 24.4% for high triglycerides, 20.1% for abdominal obesity, 19.0% for cholesterol of lipoproteins of a high density (HDL-c) low, 11.4 % for high glucose and for high blood pressure (9.1% diastolic and 5.9% systolic). The prevalent SM phenotypes were corporal mass (IMC) (OR = 4.93, IC95%: 2.26, 10.73) and the IMC interaction of the teenager with a family history of obesity (OR = 1.37, IC95%: 1.0, 1.87). It was observed that those with a family history of diabetes type 2 only experienced a marginal effect. Conclusion: The SM prevalence in teenagers from AMM is high it was an alarming situation if it continues into adulthood. The existence of obesity in relatives of the first and second grade, altogether with teenager IMC are important prediction factors of SM.

Vitamin E modifies neither fructusamine nor HbA1c levels in poorly controlled diabetes

Objetivo. Investigar los efectos de la vitamina E sobre la glicación de las proteínas totales del suero (fructosamina), glicación de la hemoglobina (HbA1c), y niveles de glucemia, colesterol total, trigliceridos, LDLC, HDL-C, apolipoproteína A1 y apolipoproteína B. Material y métodos. Sesenta pacientes diabéticos con descontrol metabólico crónico fueron asignados al azar para recibir 1200 mg/día de vitamina E o cápsulas idénticas del placebo durante dos meses en un diseño doble ciego cruzado con un periodo de lavado de cuatro semanas entre cada régimen terapéutico. Resultados. Siete pacientes fueron excluídos del estudio por razones no relacionadas con los medicamentos. En los 53 pacientes restantes, los niveles de glucemia, fructosamina, HbA1c, colesterol total, HDL-C, LDL-C, apo A1 y apo B no mostraron variaciones significativas de la vitamina E en comparación con placebo. Conclusiones. No se observaron efectos significativos de la vitamina E en los niveles de los parámetros evaluados en paciente scon diabetes descontrolada