Seropositivity and history of hospitalisation for dengue in relation to anthropometric indices among Colombian children and adults.

The role of anthropometric status on dengue is uncertain. We investigated the relations between anthropometric characteristics (height, body mass index and waist circumference (WC)) and two dengue outcomes, seropositivity and hospitalisation, in a cross-sectional study of 2038 children (aged 2-15 years) and 408 adults (aged 18-72 years) from Bucaramanga, Colombia. Anthropometric variables were standardised by age and sex in children. Seropositivity was determined through immunoglobulin G antibodies; past hospitalisation for dengue was self-reported. We modelled the prevalence of each outcome by levels of anthropometric exposures using generalised estimating equations with restricted cubic splines. In children, dengue seropositivity was 60.8%; 9.9% of seropositive children reported prior hospitalisation for dengue. WC was positively associated with seropositivity in girls (90th vs. 10th percentile adjusted prevalence ratio (APR) = 1.19; 95% confidence interval (CI) 1.03-1.36). Among adults, dengue seropositivity was 95.1%; 8.1% of seropositive adults reported past hospitalisation. Height was inversely associated with seropositivity (APR = 0.90; 95% CI 0.83-0.99) and with hospitalisation history (APR = 0.19; 95% CI 0.04-0.79). WC was inversely associated with seropositivity (APR = 0.89; 95% CI 0.81-0.98). We conclude that anthropometry correlates with a history of dengue, but could not determine causation. Prospective studies are warranted to enhance causal inference on these questions.

Vitamin D serostatus and dengue fever progression to dengue hemorrhagic fever/dengue shock syndrome.

Vitamin D could modulate pathways leading to dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). We examined the associations of serum total 25-hydroxy vitamin D [25(OH)D] and vitamin D binding protein (VDBP) concentrations in patients with uncomplicated dengue fever (DF) with risk of progression to DHF/DSS. In a case-control study nested in a cohort of DF patients who were followed during the acute episode in Bucaramanga, Colombia, we compared 25(OH)D and VDBP at onset of fever between 110 cases who progressed to DHF/DSS and 235 DF controls who did not progress. 25(OH)D concentrations were also compared between the acute sample and a sample collected >1 year post-convalescence in a subgroup. Compared with 25(OH)D ⩾75 nmol/l, adjusted odds ratios (95% CI) for progression were 0·44 (0·22-0·88) and 0·13 (0·02-1·05) for 50 to 75 nmol/l (vitamin D insufficiency) and <50 nmol/l (vitamin D deficiency), respectively (P, trend = 0·003). Mean 25(OH)D concentrations were much lower post-convalescence compared with the acute episode, regardless of case status. Compared with controls, mean VDBP was non-significantly lower in cases. We conclude that low serum 25(OH)D concentrations in DF patients predict decreased odds of progression to DHF/DSS.

Age at menarche in relation to prenatal rainy season exposure and altitude of residence: results from a nationally representative survey in a tropical country.

Intrauterine exposure to the rainy season in the tropics may be accompanied by high rates of infection and nutritional deficiencies. It is unknown whether this exposure is related to the extrauterine timing of development. Our aim was to evaluate the relations of prenatal exposure to the rainy season and altitude of residence with age at menarche. The study included 15,370 girls 10 to <18 years old who participated in Colombia's 2010 National Nutrition Survey. Primary exposures included the number of days exposed to the rainy season during the 40 weeks preceding birth, and altitude of residence at the time of the survey. We estimated median menarcheal ages and hazard ratios with 95% confidence interval (CI) according to exposure categories using Kaplan-Meier cumulative probabilities and Cox proportional hazards models, respectively. All tests incorporated the complex survey design. Girls in the highest quintile of gestation days exposed to the rainy season had an earlier age at menarche compared with those in the lowest (adjusted hazard ratios (HR)=1.08; 95% CI 1.00-1.18, P-trend=0.03). Girls living at altitudes ⩾2000 m had a later age at menarche compared with those living <1000 m (adjusted HR=0.88; 95% CI 0.82-0.94, P-trend <0.001). The inverse association between gestation days during the rainy season and menarche was most apparent among girls living at altitudes ⩾2000 m (P, interaction=0.04). Gestation days exposed to the rainy season and altitude of residence were associated with the timing of sexual maturation among Colombian girls independent of socioeconomic status and ethnicity.

Effects of palm oil and dietary cholesterol on plasma lipoproteins: results from a dietary crossover trial in free-living subjects.

OBJECTIVE: To study the effects of palm oil (PO) and egg consumption (E) on plasma lipoproteins. DESIGN: Randomized crossover trial. SETTING: Free-living subjects. SUBJECTS: Twenty-eight healthy male students aged 20-34 y. INTERVENTIONS: Four typical Colombian diets (10 878 kJ/day; 57% energy in carbohydrates, 12% energy in proteins and 31% energy in fats) were consumed for 4 weeks. The HPOLC diet was high in PO (8.8% energy as palmitic acid, PA) and low in eggs (181.2 mg/kJ of dietary cholesterol, DC); the HPOHC diet was high in PO and high in eggs (866.1 mg/kJ of DC); the MPOMC diet was moderate in PO (6.3% energy as PA) and moderate in eggs (581.6 mg/kJ of DC); and the LOPOMC diet had no PO and was moderate in eggs (543.9 mg/kJ of DC). MAIN OUTCOME: Total (TC), low density (LDL-c), and high density lipoprotein cholesterol (HDL-c), and triacylglycerols (TAG) were measured on a pool of three fasting blood samples collected in consecutive days the last week of each diet. RESULTS: Comparison of the HPOHC and HPOLC diets showed increases in TC and LDL-c of 0.21 (P=0.01), and 0.16 mmol/l (P=0.05). Comparison of LOPOMC and MPOMC diets showed increases in TC and LDL-c of 0.39 (P<0.001), and 0.38 mmol/l (P<0.001), respectively. No significant changes in HDL-c or TAG were observed. CONCLUSIONS: Our findings suggest that non-extreme short-term changes in PO and DC consumption lead to significant elevations in plasma TC and LDL-c. SPONSORSHIP: CENIPALMA, Fundación Cardiovascular del Oriente Colombiano, Universidad Industrial de Santander.