ABSTRACT
BACKGROUND: Obesity protects against bone loss, but it increases the risk of fragility fractures. AIM: To determine if bone mineral density (BMD) and the prevalence of fractures are different in postmenopausal Maya-Mestizo women grouped according to their body mass index (BMI). SUBJECTS AND METHODS: We studied 600 postmenopausal Maya-Mestizo women. A structured questionnaire for risk factors was applied. Body mass index was determined. BMD was assessed at the lumbar spine and total hip by dual-energy X-ray absorptiometry. History of low trauma fracture was determined from medical records. ANOVA was used to compare mean BMD between women with different BMI. To compare the frequency of fractures according to BMI group, we used χ2 test. RESULTS: According to WHO classification of BMI, 16.3% of women had normal BMI, 35.3% were overweight, and 48.4% had obesity. We found that women with obesity had a higher BMD versus women with normal BMI or overweight in all the anatomical sites analysed. The prevalence of history of fractures was 18.2%. We did not find differences between the women of different BMI; the wrist was the most frequent skeletal site of the fracture. CONCLUSION: Obesity in postmenopausal Maya-Mestizo women is not a risk factor for developing fragility fractures.
Subject(s)
Bone Density , Osteoporosis, Postmenopausal , Absorptiometry, Photon , Body Mass Index , Female , Humans , Lumbar Vertebrae , Osteoporosis, Postmenopausal/epidemiology , PostmenopauseABSTRACT
BACKGROUND: Osteoporosis is characterized by low bone mineral density (BMD), which is determined by an interaction of genetic, metabolic and environmental factors. AIM: To analyse the association between two polymorphisms of VDR as well as their haplotypes with BMD in post-menopausal Maya-Mestizo women. SUBJECTS AND METHODS: This study comprised 600 post-menopausal Maya-Mestizo women. A structured questionnaire for risk factors was applied and BMD was assessed at the lumbar spine (LS) and total hip (TH) by dual-energy X-ray absorptiometry. DNA was extracted from blood leukocytes. Two single-nucleotide polymorphisms of VDR (rs731236 and rs2228570) were studied using real-time PCR allelic discrimination for genotyping. Differences between the means of the BMDs according to the genotype were analysed with covariance. Haplotype analysis was conducted. RESULTS: TT genotype of rs731236 of VDR had higher BMD at total hip and femoral neck (FN), and one haplotype formed by the two polymorphisms was associated with only TH-BMD variations. This difference was statistically significant after adjustment for confounders. The genotype of rs2228570 of VDR analysis showed no significant differences with BMD variations. CONCLUSION: The results showed that the TT genotype of rs731236 of VDR and one haplotype formed by rs731236 and rs2228570 polymorphisms were associated with higher BMD at TH and FN.
Subject(s)
Bone Density/genetics , Femur Neck/physiology , Hip/physiology , Lumbar Vertebrae/physiology , Osteoporosis, Postmenopausal/genetics , Receptors, Calcitriol/genetics , Absorptiometry, Photon , Female , Gene Frequency , Genetic Association Studies , Humans , Mexico/epidemiology , Middle Aged , Osteoporosis, Postmenopausal/epidemiology , Polymorphism, Single Nucleotide , Real-Time Polymerase Chain Reaction , Surveys and QuestionnairesABSTRACT
The importance of Zinc (Zn) as a necessary oligoclement for human nutrition begins in the first three decades of life. At the moment, the role that Zn plays in the infantile nutrition is very well-known, acquiring a special connotation in children with proteic-energetics malnutrition (PEM). In this study the daily ingestion and the serum measuremets of Zn were determined in 64 undernourished children (light, mild and severe) and in 25 eutrophic children with ages between 1 to 5 years, belonging to families of the strata IV and V according to the Graffar scale corrected by age. The results of the serum values of Zn were for the light undernourished of 39.73 +/- 14.97 microg/dL (30.38 microg/dL-44.56 microg/dL), for the mild undernourished of 35.07 +/- 28.13 microg/dL (27.76 microg/dL-65.80 microg/dL) and for the severe undernourished of 15.48 +/- 10.44 microg/dL (5.57 microg/dL-28.56 microg/dL), which were diminished in relation with the control group, 76.71 +/- 33.29 microg/dL (45.75 microg/dL - 78.27 microg/dL) with p < 0.0001. Equally, there were significant differences (p < 0.001) among the group of severe undernourished with the light undernourished and normal subjects. In relation with the daily ingestion of Zn, a statistically significant difference was observed only (p < 0.001) in the severe undernourished, 1.87 +/- 0.54 mg/día (1.20 mg/día-2.87 mg/día) when comparing them with the light undernourished, 5.48 +/- 0.98 mg/día (3.50 mg/día-7.87 mg/día), the mild undernourished, 4.99 +/- 1.24 mg/día (4.10 mg/día-11.42 mg/día) ) and the normal subjects, 6.22 +/- 0.98 mg/día (4.8 mg/día-8.02 mg/día). There was a positive correlation between ingestion and seric values of Zn when the 3 undernourished groups were studied. These results allow to conclude that both the seric values of Zn and its ingestion show modifications in relation with the degree of nutritional deficiency.
Subject(s)
Protein-Energy Malnutrition/blood , Zinc/blood , Analysis of Variance , Child, Preschool , Female , Humans , Infant , Male , Prospective Studies , Spectrophotometry, Atomic , Venezuela , Zinc/deficiencyABSTRACT
La importancia del zinc (Zn) como oligoelemento necesario para la nutrición humana data de más de tres décadas. Actualmente el papel que desempeña el Zn en la nutrición infantil es bien conocido, adquiriendo especial connotación en los niños con desnutrición proteico-energética (DPE). En el presente estudio se determinaron las ingestas diarias y las concentraciones séricas de Zn en 64 niños desnutridos (leves, moderados y graves) y en 25 niños eutróficos en edades comprendidas entre 1 y 5 años, pertenecientes a familias de los estratos IV y V según Graffar modificado. Los resultados de las concentraciones séricas de Zn fueron en los desnutridos leves en 39,73 ± 14,97µg/dL (30,38 µg/dL-44.56 µg/dL), en los desnutridos moderados 35,07 ± 28,13 µg/dL (27,76 µg/dL-65,80 µg/dL) y en los desnutridos graves 15,48 ± 10,44 µg/dL (5,57 µg/dL-28,56 µg/dL), valores que estuvieron disminuidos en relación con el grupo control, 76,71 ± 33,29 µg/dL (45,75 µg/dL-78,27 µg/dL) con p < 0,0001. Igualmente se encontraron diferencias significativas (p < 0,001) entre el grupo de desnutridos graves y los desnutridos leves y moderados. En relación con la ingesta diaria de Zn sólo se observó diferencia estadísticamente significativa (p < 0,001) en los desnutridos graves, 1,87 ± 0,54 mg/día (1,20 mg/día-2,87 mg/día) al compararlos con los desnutridos leves, 5,48 ± 0,98 mg/día (3,50 mg/día-7,87 mg/día), los desnutridos moderados, 4,99 ±1,24 mg/día (4,10 mg/día-11,42 mg/día) y los eutróficos, 6,22 ± 0,98 mg/día (4,8 mg/día-8,02 mg/día). Se encontró una correlación positiva (r = 0,5146; p < 00,1) entre ingesta y concentración sérica de Zn cuando se estudiaron los 3 grupos de desnutridos. Estos resultados permiten concluir que tanto las concentraciones séricas de Zn como la ingesta se ven modificadas en relación con el grado de déficit nutricional
Subject(s)
Humans , Male , Female , Protein-Energy Malnutrition , Zinc , Nutritional Physiological Phenomena , Medicine , VenezuelaABSTRACT
Continuous medical education is the foundation for good medicine. One of the objectives of the National Academy of Medicine of Mexico is to achieve excellence in medicine, which requires solid academic preparation and appropriate strategies that enable it to reach the entire medical community. In 1994, the National Academy of Medicine established the National Program of Continuous Medical Education for the General Physician (PRONADAMEG), the sum of the efforts of the National Academy of Medicine of Mexico, the Schools and Faculties of Medicine and of medical colleges and societies in Mexico, which have enabled the program to reach the most distant sites our national territory. After 6 years of continuous activities and of updating teaching, PRONADAMEG achieved leadership and national recognition in continuous medical education and decided to regionalize the program, promoting a closer relationship among sites throughout the region and taking into account epidemiologic, ethnic and idiosyncratic characteristics. The project of regionalization of the PRONADAMEG in the area of health is the instrument of institutional support that permits application of the Program with greater participation, creativity, and agility.
