[Modifiable risk factors in adolescents with obesity]. / Factores de riesgo modificables en adolescentes con obesidad.

Background: Adolescence is a stage of growth with changes whose result is adulthood. Obesity increases the risk of chronic diseases; therefore, it is important to identify modifiable risk factors to prevent obesity in adolescents. Objective: To iIdentify modifiable risk factors for obesity in adolescents from a Family Medicine Unit in the city of Puebla. Material and methods: Case-control study. The Graffar scale, the World Health Organization percentile tables, the Krece Plus test and the Short Diet Quality Screener (sDQS) were applied. Chi squared, odds ratios (OR) with 95% confidence intervals (95% CI), and Pearson's phi with Cramer's V were used. Results: 348 adolescents participated, divided into 2 groups. In the group of adolescents with obesity, exclusive breastfeeding was present in 44.8%, 60.9% had at least one obese parent, 66.7% had an inadequate diet, and 63.8% had a bad lifestyle. On the other hand, the group of adolescents without obesity presented exclusive breastfeeding in 88.5%, 75.3% did not have parents with obesity, 66.1% presented an adequate diet in some aspects and 52.3% had a fair to good lifestyle. Conclusion: The absence of exclusive breastfeeding in the first 6 months of life, parental obesity, poor physical activity, and inadequate diets were associated with the presence of obesity in adolescents.

Introducción: la adolescencia es una etapa del crecimiento con cambios cuyo resultado es la adultez. La obesidad aumenta el riesgo de enfermedades crónicas; por ello, es importante identificar los factores de riesgo modificables para prevenirla en adolescentes. Objetivo: identificar los factores de riesgo modificables para obesidad en adolescentes de una unidad de medicina familiar en la ciudad de Puebla. Material y métodos: estudio de casos y controles. Se aplicó la escala de Graffar, las tablas percentilares de la Organización Mundial de la Salud, el test Krece Plus y el cuestionario breve de calidad de la dieta (sDQS). Se empleó chi cuadrada, razones de momios (RM) con intervalos de confianza del 95% (IC 95%) y el coeficiente phi de Pearson con V de Cramer. Resultados: participaron 348 adolescentes divididos en dos grupos. En el grupo de adolescentes con obesidad, la lactancia materna exclusiva estuvo presente en 44.8%, el 60.9% contaban con al menos un padre con obesidad, el 66.7% presentó dieta inadecuada y el 63.8% presentaba un mal estilo de vida. Por su parte, el grupo de adolescentes sin obesidad presentó lactancia materna exclusiva en el 88.5%, el 75.3% no contaba con padres con obesidad, el 66.1% presentó dieta adecuada en algunos aspectos y el 52.3% contó con un estilo de vida de regular a bueno. Conclusión: la ausencia de lactancia materna exclusiva los primeros seis meses de vida, la obesidad parental, la mala actividad física y las dietas inadecuadas se asociaron con la presencia de obesidad en adolescentes.

Functional gastrointestinal disorders in women with systemic lupus erythematosus: A case-control study.

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease with multisystemic involvement. Gastrointestinal (GI) manifestations are frequent but functional gastrointestinal disorders (FGIDs) have scarcely been studied in SLE. To determine the prevalence of FGIDs and their potential risk factors in SLE female patients vs controls. METHODS: Systemic lupus erythematosus patients meeting the American College of Rheumatology (ACR) criteria and controls completed the Rome III questionnaire for FGIDs and a structured interview to assess sociodemographic, clinical, and treatment variables after excluding organic GI diseases. Logistic regression was used to determine risk factors (ie, alcohol drinking, medications) for FGIDs. KEY RESULTS: Responders included 113 SLE patients and 122 age-matched controls. The presence of at least one FGIDs was higher in SLE (73.4%) vs controls (54.1%), P = .003. The most frequent FGIDs in SLE patients were nausea and vomiting disorders (NVD), belching disorders, globus, anorectal pain, functional heartburn (FH), and functional bloating (FB). After adjustment for confounding variables, SLE was associated with NVD (OR: 7.1, 95% CI: 2.7-19.1) globus (3.5, 1.3-9.3), anorectal pain (3.4, 1.4-8.4), and FH (2.5, 1.5-4.4). The simultaneous presence of >1 FGID was more common in SLE patients than controls (69.8% vs 31.8%). Glucocorticoids (5.2, 1.3-19.9) and non-steroidal anti-inflammatory drugs (NSAIDs; 3.0, 1.1-8.0) were associated with any FGID in SLE patients while alcohol drinking with gallbladder/sphincter of Oddi disorders 7.4 (1.1-47.3). CONCLUSIONS AND INFERENCES: Functional gastrointestinal disorders are more frequent in SLE patients compared with controls. Medication that may alter gastrointestinal homeostasis, such as glucocorticoids and NSAIDs, are potential risk factors for FGIDs in SLE.