Status of folate in healthy children in Almeria.

The objective of this study is to establish reference values for folic acid in a healthy population of children aged 4-11 years and to examine related epidemiological, dietary and analytical factors. A cross-sectional study of 658 healthy children aged 4-11 years was made. Epidemiological, socioeconomic and dietary variables were analysed, the BMI Z-score was obtained, levels of serum folate and serum vitamin B12 were determined and haematological, iron status and erythropoietic activity parameters were examined. The study data were analysed by non-parametric tests and linear multiple regression. The mean folate value was 8.6 ± 4.6 ng/mL (95% reference interval: 2.8-20 ng/mL). A level < 3 ng/mL (5th percentile) was considered as folate deficiency (4.6% of subjects). No child reported symptoms related to this deficiency. Folate values were significantly lower with age (p < 0.01), low NSE and low parental educational level (p: 0.0001). No relationship was found between folates and the analytical variables. According to multivariate linear regression, the variables significantly associated with serum folate were age, socioeconomic level and vitamin B12.Conclusions: Serum folate levels in healthy school children are described. Age, socioeconomic level and serum vitamin B12 are factors associated with folate status. Specific cut-off values for a paediatric population should be defined. What is Known: • Folic acid is an essential micronutrient for optimal growth and development; its deficit is associated with adverse health effects. • The studies on their status and deficit are not comparable due to a lack of agreement on appropriate indicators and reference values. What is New: • This study reports the levels of serum folate in a large population of healthy schoolchildren, with strict inclusion criteria in a developed country and identifies the associated sociodemographic, dietary and analytical (vitamin B12, iron parameters and erythropoietic activity) factors, avoiding potential confusion.

Relationship between Obesity and Iron Deficiency in Healthy Adolescents.

The relationship between overweight/obesity (excess of weight [EW]) and iron deficiency (ID) is not well defined. Objective: To analyze the relationship between EW and ID in healthy adolescents, assessing the contribution of new diagnostic measures of iron status and erythropoietic activity. Method: A cross-sectional study was made of 405 healthy adolescents, 12-16 years of age. A total of 289 were normal weight (NW) and 116 were otherwise healthy EW. Epidemiological, socioeconomic, diet, BMI Z-score, CRP (C-reactive protein), hematological, iron status, and erythropoietic activity parameters were measured. Statistical tests were Student's, analysis of variance (ANOVA), Chi-square, Pearson's correlation, and odds ratio. Results: ID prevalence in the EW group was 22.6% vs. 29.5% in the NW group (p: 0.3). Greater body weight was associated with lower reticulocyte hemoglobin content (CHr) (NW: 31.3 ± 1.7 pg vs. OW: 30.2 ± 1.7 pg, p: 0.007) and greater CRP (NW: 0.1 ± 0.2 mg/dL vs. OW: 0.2 ± 0.18 mg/dL, p < 0.001), leukocytes (NW: 6.69 ± 1.57 × 103/L vs. OW: 7.43 ± 1.63 × 103/L, p < 0.02), platelets (NW: 265.6 ± 58.9 × 103/L vs. OW: 291.8 ± 54.4 × 103/L, p < 0.002), ferritin (NW: 32.1 ± 17.9 ng/mL vs. OW: 42.8 ± 20.3 ng/mL, p: 0.01), serum transferrin receptor (sTfR) (NW: 1.39 ± 0.4 mg/L vs. OW: 1.73 ± 0.45 mg/L, p: 0.008), sTfR-F index (sTfR/log Ferritin) (NW: 1.06 ± 0.7 vs. OW: 1.33 ± 0.85, p: 0.036) and reticulocyte count (NW: 54.2 ± 18 × 103/L vs. OW: 65.4 ± 24.2 × 103/L, p: 0.003). A positive correlation was observed between the BMI Z-score and CRP, ferritin, sTfR, leukocytes, platelets, and reticulocyte count, and a negative one between the BMI Z-score and CHr and medium corpuscular volume. Conclusions: The prevalence of ID in otherwise healthy EW adolescents was no higher than in NW. The effect of obesity on iron status was low. The findings reveal the concomitant low-grade inflammation, and probably the effect of adiposity on erythropoietic activity. Specific cutoff values for ID in adolescents with OW need to be defined.

Análisis de la determinación de niveles de tiopurínicos en pacientes pediátricos con enfermedad inflamatoria intestinal / Laboratory determination of thiopurine levels in paediatric patients with inflammatory bowel disease

INTRODUCCIÓN Y OBJETIVOS: Las tiopurinas son fármacos muy empleados para el mantenimiento de la remisión en pacientes con enfermedad inflamatoria intestinal. Se conocen cuáles son los niveles plasmáticos óptimos, y existe controversia acerca de si reducen la necesidad de otros fármacos o son coste-efectivos. El objetivo de nuestro estudio fue describir el uso del tratamiento optimizado con tiopurínicos en pacientes pediátricos con enfermedad inflamatoria intestinal seguidos en nuestra unidad desde la implementación de la determinación de niveles de fármaco. MATERIAL Y MÉTODOS: Estudio descriptivo retrospectivo en el que se analizaron valores en plasma mediante cromatografía líquida de 6-tioguanina (6-TGN), 6-metilmercaptopurina (6-MMP) y sus cocientes, así como estado clínico y variables analíticas y demográficas de pacientes con enfermedad inflamatoria intestinal en seguimiento en nuestra unidad. RESULTADOS: Se incluyeron 72 pacientes y se realizaron 140 determinaciones de metabolitos. En el 61,5% de las determinaciones los niveles de 6-TGN se encontraban por debajo del rango terapéutico (en 7 casos debido a falta de adherencia terapéutica), y en el 7,4% de las de 6-MMP estaban en rango de toxicidad. Tras la determinación de 77 muestras se tomó alguna actitud derivada, procediéndose a la modificación de dosis, al cambio de formulación o a la suspensión del fármaco. Únicamente 9 pacientes escalaron a fármaco biológico (13,4% del total que estaban en monoterapia). No se encontró relación entre la actividad de la enfermedad y los niveles de tiopurínicos. CONCLUSIONES: En nuestra experiencia la monitorización de niveles de tiopurinas ayudó a modificar la dosis de fármaco que recibía el paciente, adecuando sus niveles terapéuticos y evitando potencialmente la adición de nuevos fármacos

INTRODUCTION AND OBJECTIVES: Thiopurines are drugs widely used in patients for the maintenance of remission in inflammatory bowel disease. The optimal plasma levels are known, but there is controversy about whether the need for other drugs is reduced or is cost-effective. The aim of this study is to describe the use of the optimised treatment with thiopurines in paediatric patients with inflammatory bowel disease followed up in this Unit since the introduction of determining the drug levels. MATERIAL AND METHODS: A descriptive retrospective study was conducted in which the plasma values of 6-thioguanine (6-TGN), 6-methyl-mercapto-purine (6-MMP), and their ratios were analysed using liquid chromatography. Other variables were collected, such as clinical status, analytical and demographic variables of patients with inflammatory bowel disease followed up in this Unit. RESULTS: A total of 72 patients were included, and 149 determinations of metabolites were performed. The 6-TGN levels were found to below the therapeutic range in 61.5% of patients (in 7 cases due to lack of adherence to therapy), and 6-MMP was in the toxicity range in 7.4%. After the determination of 77 specimens, some action was taken, such as modifying the dose, change of formula, or withdrawing the drug. Only 9 patients were scaled to a biological drug (13.4% of the total on single therapy). No association was found between the activity of the disease and the thiopurine levels. CONCLUSIONS: In our experience, the monitoring of thiopurine levels helped to modify the drug dose that the patient received, adjusting their therapeutic levels, and potentially avoiding the addition of new drugs

[Laboratory determination of thiopurine levels in paediatric patients with inflammatory bowel disease]. / Análisis de la determinación de niveles de tiopurínicos en pacientes pediátricos con enfermedad inflamatoria intestinal.

INTRODUCTION AND OBJECTIVES: Thiopurines are drugs widely used in patients for the maintenance of remission in inflammatory bowel disease. The optimal plasma levels are known, but there is controversy about whether the need for other drugs is reduced or is cost-effective. The aim of this study is to describe the use of the optimised treatment with thiopurines in paediatric patients with inflammatory bowel disease followed up in this Unit since the introduction of determining the drug levels. MATERIAL AND METHODS: A descriptive retrospective study was conducted in which the plasma values of 6-thioguanine (6-TGN), 6-methyl-mercapto-purine (6-MMP), and their ratios were analysed using liquid chromatography. Other variables were collected, such as clinical status, analytical and demographic variables of patients with inflammatory bowel disease followed up in this Unit. RESULTS: A total of 72 patients were included, and 149 determinations of metabolites were performed. The 6-TGN levels were found to below the therapeutic range in 61.5% of patients (in 7 cases due to lack of adherence to therapy), and 6-MMP was in the toxicity range in 7.4%. After the determination of 77 specimens, some action was taken, such as modifying the dose, change of formula, or withdrawing the drug. Only 9 patients were scaled to a biological drug (13.4% of the total on single therapy). No association was found between the activity of the disease and the thiopurine levels. CONCLUSIONS: In our experience, the monitoring of thiopurine levels helped to modify the drug dose that the patient received, adjusting their therapeutic levels, and potentially avoiding the addition of new drugs.

Aflatoxins Contamination in Maize Products from Rural Communities in San Luis Potosi, Mexico.

BACKGROUND: Aflatoxins are a group of mycotoxins that have been associated with hepatic damage and cancer. Aflatoxins B1 and B2 are secondary metabolites produced by fungi Aspergillus. These toxins can be found in a variety of commodities, especially in maize, and have been studied around the world due to their effects in human health. The Latin American population is especially exposed to aflatoxins given that maize products can be found in traditional diets all over the continent. Interestingly, in Mexico, chronic hepatic diseases and cirrhosis are leading causes of death in adult population. METHODS: In order to observe the effect of physical variables like temperature and humidity, this study was conducted collecting samples in four different seasons, in two communities in the State of San Luis Potosi, in Mexico. The content of aflatoxins in tortillas was measured using immunoaffinity columns prior to HPLC-FLD analysis. FINDINGS: Results showed that 18% of samples exceeded the Mexican limits for AFB1; whereas, 26% of the samples exceeded the limits of the European Union for AFB1. The AFB1 was detected in 80% of samples in one site and higher concentrations were found in samples collected during fall and winter seasons. CONCLUSIONS: Lack of control in storing practices is the principal cause for the contamination of maize. Considering that maize products are part of the staple diet of Mexican population, our results show that AFB1 detection has to be declared a public health priority. Detection and prevention of aflatoxins through a surveillance program, may avoid chronic health effects.

Reference values of serum transferrin receptor (sTfR) and sTfR/log ferritin index in healthy children.

ABSTARCT The aims of this study were to determine appropriate reference ranges for serum transferrin receptor (sTfR) and sTfR/log ferritin (sTfR-F index) in healthy children and their relationship with iron parameters, erythropoiesis, and other conditions presented by the subject. A total of 902 children with normal iron status, aged 1-11 years, were included in a cross-sectional study. A physical examination was conducted and z-score of body mass index (zBMI) obtained. Complete blood count, iron biomarkers, erythropoietin, C-reactive protein, sTfR, and sTfR/log ferritin were determined. Linear multiple regression was applied to identify the factors that determined sTfR and sTfR-F index variability. Mean values for sTfR and sTfR-F index were 1.22 ± 0.28 mg/L (95% confidence interval [CI]: 1.2-1.23) and 0.87 ± 0.25 (95% CI: 0.85-0.88). The reference intervals (2.5th to 97.5th percentiles [P2.5-P97.5]) were 0.78-1.9 mg/L and 0.49-1.46, respectively. sTfR and sTfR-F values decreased with age (P <.03 and P <.0001, respectively). No changes were observed with sex. Changes in sTfR and sTfR-F index were consistent with ferritin and erythropoietin variations. Iron biomarkers, erythropoietin, and zBMI predicted 19% and 18.1% of the sTfR and sTfR-F index variability. The results provide reference ranges for sTfR and sTfR-F index in healthy children for clinical use in the assessment of body iron status. Both biomarkers are predicted by iron parameters, erythropoietin, and zBMI.

PREVALENCE OF METABOLIC SYNDROME AMONG ADOLESCENTS IN A CITY IN THE MEDITERRANEAN AREA: COMPARISON OF TWO DEFINITIONS.

BACKGROUND AND OBJECTIVE: there are few studies on the prevalence of metabolic syndrome (MetS) in European adolescent populations, and some have reported a higher prevalence in the Mediterranean basin area. Our objective was to examine the prevalence of MetS in adolescents in a Mediterranean city of Spain, comparing two different definitions of MetS and the associated risk factors. METHODS AND RESULTS: a cross-sectional population-based study was conducted among 379 adolescents aged 12-16.9 years, selected using a random sampling method. Anthropometric measurements and fasting blood samples were obtained. The definitions of MetS used were that of the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATPIII) and that of the International Diabetes Federation (IDF). Kappa coefficient was used to measure the agreement between definitions and a multivariate logistic regression model to determine the associated risk factors. RESULTS: the prevalence of MetS was 5.7% (95%CI 3.33-8.07) according to the NCEP-ATPIII definition and 3.8% (95%CI 1.85-5.75) according to the IDF definition. No differences between the sexes or by age groups were found. The agreement between the two definitions was very good (kappa 0.815), especially in the obese subsample, but was lower in normal weight adolescents (kappa 0.497). Insulin resistance and obesity were associated with both definitions. CONCLUSIONS: the prevalence of MetS in our adolescent population is higher than the European media. Although the overall agreement between both definitions was very good, the prevalence was higher using the NCEP-ATPIII criteria. Independently of the definition used, obesity and insulin resistance were risk factors for MetS.

Introducción y objetivos: existen escasos estudios acerca de la prevalencia de síndrome metabólico (MetS) en la población general adolescente en Europa. Algunos resultados muestran mayor prevalencia en adolescentes del área mediterránea. Nuestro objetivo fue estudiar la prevalencia de MetS en la población general adolescente de una ciudad del área mediterránea en España, comparando dos definiciones de MetS y los factores de riesgo asociados. Material y métodos: estudio epidemiológico observacional sobre una muestra de base poblacional, elegida de forma aleatoria, representativa de los adolescentes de 12 a 16,9 años escolarizados en la ciudad de Almería. Se recogieron variables antropométricas y analíticas. Se compararon dos definiciones de SM para población adolescente: National Cholesterol Education Program (NECP- ATPIII) e International Diabetes Federation (IDF). Estadística: coeficiente kappa para analizar la concordancia entre definiciones y regresión logística múltiple para el estudio de factores de riesgo asociados. Resultados: la prevalencia de MetS fue 5,7% (95%IC 3,33-8,07) con la definición NECP-ATPIII y 3,8% (95%IC 1,85-5,75) con los criterios IDF. No se encontraron diferencias entre sexos ni entre grupos de edad. La concordancia entre ambas definiciones fue muy buena a nivel global (kappa 0,815) y especialmente en el grupo de obesos, pero empeoró entre adolescentes con normopeso (kappa 0,497). Los factores asociados a ambas definiciones fueron obesidad y resistencia insulínica. Conclusiones: nuestros resultados muestran una prevalencia de MetS en adolescentes mayor a la media europea. Aunque la concordancia entre definiciones fue muy buena a nivel global, la prevalencia fue mayor con la definición NECP-ATPIII. Obesidad y resistencia insulínica fueron los factores de riesgo asociados.

Prevalence of metabolic syndrome among adolescents in a city in the Mediterranean area: comparison of two definitions / Prevalencia de síndrome metabólico en la población general adolescente de una ciudad del área mediterránea: comparación de dos definiciones

Background and objective: there are few studies on the prevalence of metabolic syndrome (MetS) in European adolescent populations, and some have reported a higher prevalence in the Mediterranean basin area. Our objective was to examine the prevalence of MetS in adolescents in a Mediterranean city of Spain, comparing two different definitions of MetS and the associated risk factors. Methods and results: a cross-sectional population-based study was conducted among 379 adolescents aged 12-16.9 years, selected using a random sampling method. Anthropometric measurements and fasting blood samples were obtained. The definitions of MetS used were that of the National Cholesterol Education Program’s Adult Treatment Panel III (NCEP-ATPIII) and that of the International Diabetes Federation (IDF). Kappa coefficient was used to measure the agreement between definitions and a multivariate logistic regression model to determine the associated risk factors. Results: the prevalence of MetS was 5.7% (95%CI 3.33-8.07) according to the NCEP-ATPIII definition and 3.8% (95%CI 1.85-5.75) according to the IDF definition. No differences between the sexes or by age groups were found. The agreement between the two definitions was very good (kappa 0.815), especially in the obese subsample, but was lower in normal weight adolescents (kappa 0.497). Insulin resistance and obesity were associated with both definitions. Conclusions: the prevalence of MetS in our adolescent population is higher than the European media. Although the overall agreement between both definitions was very good, the prevalence was higher using the NCEP-ATPIII criteria. Independently of the definition used, obesity and insulin resistance were risk factors for MetS (AU)

Introducción y objetivos: existen escasos estudios acerca de la prevalencia de síndrome metabólico (MetS) en la población general adolescente en Europa. Algunos resultados muestran mayor prevalencia en adolescentes del área mediterránea. Nuestro objetivo fue estudiar la prevalencia de MetS en la población general adolescente de una ciudad del área mediterránea en España, comparando dos definiciones de MetS y los factores de riesgo asociados. Material y métodos: estudio epidemiológico observacional sobre una muestra de base poblacional, elegida de forma aleatoria, representativa de los adolescentes de 12 a 16,9 años escolarizados en la ciudad de Almería. Se recogieron variables antropométricas y analíticas. Se compararon dos definiciones de SM para población adolescente: National Cholesterol Education Program (NECP-ATPIII) e International Diabetes Federation (IDF). Estadística: coeficiente kappa para analizar la concordancia entre definiciones y regresión logística múltiple para el estudio de factores de riesgo asociados. Resultados: la prevalencia de MetS fue 5,7% (95%IC 3,33-8,07) con la definición NECP-ATPIII y 3,8% (95%IC 1,85-5,75) con los criterios IDF. No se encontraron diferencias entre sexos ni entre grupos de edad. La concordancia entre ambas definiciones fue muy buena a nivel global (kappa 0,815) y especialmente en el grupo de obesos, pero empeoró entre adolescentes con normopeso (kappa 0,497). Los factores asociados a ambas definiciones fueron obesidad y resistencia insulínica. Conclusiones: nuestros resultados muestran una prevalencia de MetS en adolescentes mayor a la media europea. Aunque la concordancia entre definiciones fue muy buena a nivel global, la prevalencia fue mayor con la definición NECP-ATPIII. Obesidad y resistencia insulínica fueron los factores de riesgo asociados (AU)

[Associated factors to insulin values in a population-based study in adolescents]. / Factores asociados a insulinemia en población general adolescente.

OBJECTIVES: To identify factors that correlate with insulin values and to examine its independent associations among adolescents. METHODS: A cross-sectional population-based study was conducted among adolescents aged 12-16,9 years old. A multi-stage stratified cluster random sampling method was employed. Anthropometric measurements and nutritional survey were performed, and fasting blood samples for insulin were obtained. STATISTICS: Multiple lineal regression. RESULTS: 379 adolescents were included. Mean age was 14.08 ± 1.30 years. Factors associated with higher fasting insulin levels were puberty [ß 4.55 (95% IC 0.42-8.69)], abdominal obesity [ß 6.11 (95% IC 3.93-8.29)] and to be born small for gestational age (SGA) [ß 7.45 (95% IC 2.47-12.44)]. It was observed a negative association between the regular intake of olive oil at home and insulin values [ß -4.14 (95% IC -7.31- -0.98)]. CONCLUSIONS: Abdominal obesity and SGA were factors associated with higher fasting insulin values. In contrast, the regular intake of olive oil at home was an independent protective factor.

Objetivo: Analizar los factores asociados con insulinemia en ayunas en población general adolescente. Métodos: Estudio epidemiológico observacional sobre una muestra poblacional de adolescentes (12-16,9 años) seleccionados mediante muestreo probabilístico polietápico. Se realizaron examen físico, antropometría, encuesta nutricional y se determinó insulinemia en ayunas. Estadística: regresión lineal múltiple. Resultados: Se incluyeron 379 adolescentes con edad media 14,08 ± 1,30 años. Se relacionaron con mayores cifras de insulinemia el desarrollo puberal [??4,55 (95% IC 0,42-8,69)], obesidad abdominal [??6,11(95% IC 3,93- 8,29)] y el antecedente de bajo peso para la edad gestacional (BPEG) [??7,45 (95% IC 2,47-12,44)]. El consumo habitual de aceite de oliva en domicilio mostró una relación inversa con las cifras de insulinemia [??-4,14 (95% IC -7,31- -0,98)]. Conclusión: Los factores de riesgo asociados a mayores cifras de insulinemia en ayunas fueron la obesidad abdominal y el antecedente de BPEG. El consumo habitual de aceite de oliva en domicilio fue un factor protector.

Factores asociados a insulinemia en población general adolescente / Associated factors to insulin values in a population-based study in adolescents

Objetivo: Analizar los factores asociados con insulinemia en ayunas en población general adolescente. Métodos: Estudio epidemiológico observacional sobre una muestra poblacional de adolescentes (12-16,9 años) seleccionados mediante muestreo probabilístico polietápico. Se realizaron examen físico, antropometría, encuesta nutricional y se determinó insulinemia en ayunas. Estadística: regresión lineal múltiple. Resultados: Se incluyeron 379 adolescentes con edad media 14,08 ± 1,30 años. Se relacionaron con mayores cifras de insulinemia el desarrollo puberal [β 4,55 (95% IC 0,42-8,69)], obesidad abdominal [β 6,11(95% IC 3,938,29)] y el antecedente de bajo peso para la edad gestacional (BPEG) [β 7,45 (95% IC 2,47-12,44)]. El consumo habitual de aceite de oliva en domicilio mostró una relación inversa con las cifras de insulinemia [β -4,14 (95% IC -7,31- -0,98)]. Conclusión: Los factores de riesgo asociados a mayores cifras de insulinemia en ayunas fueron la obesidad abdominal y el antecedente de BPEG. El consumo habitual de aceite de oliva en domicilio fue un factor protector (AU)

Objectives: To identify factors that correlate with insulin values and to examine its independent associations among adolescents. Methods: A cross-sectional population-based study was conducted among adolescents aged 12-16,9 years old. A multi-stage stratified cluster random sampling method was employed. Anthropometric measurements and nutritional survey were performed, and fasting blood samples for insulin were obtained. Statistics: Multiple lineal regression. Results: 379 adolescents were included. Mean age was 14.08 ± 1.30 years. Factors associated with higher fasting insulin levels were puberty [β 4.55 (95% IC 0.42-8.69)], abdominal obesity [β 6.11 (95% IC 3.93-8.29)] and to be born small for gestational age (SGA) [β 7.45 (95% IC 2.47-12.44)]. It was observed a negative association between the regular intake of olive oil at home and insulin values [β -4.14 (95% IC -7.31- -0.98)]. Conclusions: Abdominal obesity and SGA were factors associated with higher fasting insulin values. In contrast, the regular intake of olive oil at home was an independent protective factor (AU)

Prevalencia de sobrepeso y obesidad en niños y adolescentes de 2 a 16 años / Prevalence of overweight and obesity in children and adolescents aged 2-16 years

Objetivos Calcular la prevalencia de obesidad y sobrepeso en niños y adolescentes de nuestra ciudad e investigar los factores asociados. Sujetos y métodos Estudio transversal de 1.317 niños y adolescentes de 2 a 16 años. Mediante muestreo probabilístico polietápico se seleccionaron 3 grupos: 411 de 12 a 16, 504 de 6 a 12 y 402 de 2 a 6 años. Se les calculó el índice de masa corporal y se definió obesidad y sobrepeso según la International Obesity Task Force. Se realizó un cuestionario de consumo de alimentos y de características clínicas y sociodemográficas. Los resultados se expresan como porcentajes (intervalos de confianza al 95%). Mediante regresión logística múltiple se estudió la asociación entre exceso de peso (obesidad y sobrepeso) y las distintas variables, calculando la odds ratio (OR) ajustada. Resultados El 9,5% (8,0-11,0) de los niños y adolescentes de 2 a 16 años son obesos y 22,4% (23,3-24,6) tienen sobrepeso. En el grupo de 12 a 16 años, el 8,5% (5,9-11,2) son obesos y el 20,5% (16,7-24,3) tienen sobrepeso, en el grupo de 6 a 12 años el 11,6% (8,9-14,3) y el 31,0% (27,0-35,0) y en el de 2 a 6 años el 8,0% (5,4-10,6) y el 13,6% (10,3-16,9), respectivamente. Se asocian con el exceso de peso la edad (OR 1,21; p<0,001), la obesidad materna (OR 10,99; p = 0,008), el peso al nacer mayor de 4kg (OR 2,91; p = 0,002) y la lactancia artificial exclusiva (OR 1,82; p = 0,005).Conclusión La obesidad y el sobrepeso infantil y juvenil son problemas extraordinariamente prevalentes en nuestra ciudad (AU)

Objectives To estimate the prevalence of obesity and overweight in children and adolescents in our city and to investigate the associated factors. Subjects and methods A cross-sectional study of 1317 children and adolescents aged 2-16 years. Multistage probability sampling was used to select three groups of subjects: 411 aged 12 to 16 years, 504 aged 6 to 12 years, and 402 aged 2 to 6 years. Body mass index was calculated, and obesity and overweight were diagnosed using the threshold levels of the International Obesity Task Force for children and adolescents. Parents were asked about eating habits, health, social, and demographic aspects. Results are given as percentages (95% confidence interval). The relationship between obesity and overweight and the different variables was studied using multiple logistic regression. The adjusted odds ratio (OR) was calculated. Results Among children and adolescentes aged 2-16 years, 9.5% (8.0%-11.0%) were obese and 22.4% (23.3%-24.6%) were overweight. Of subjects aged 12-16 years, 8.5% (5.9%-11.2%) were obese and 20.5% (16.7%-24.3%) were overweight. In the groups aged 6-12 years and 2-6 years, rates of obesity and overweight were 11.6% (8.9% -14.3%) and 31.0% (27.0-35.0) and 8.0% (5.4%-10.6%) and 13.6% (10.3%-16.9%) respectively. Obesity or overweight was associated to age (OR 1.21; P <0.001), maternal obesity (OR 10.99; P= 0.008), a birthweight higher than 4kg (OR 2.91; p 0.002), and formula feeding (OR 1.82; P= 0.005).Conclusion Obesity and overweight in children and adolescents are highly prevalent problems in our city (AU)

Prevalence of overweight and obesity in children and adolescents aged 2-16 years.

OBJECTIVES: To estimate the prevalence of obesity and overweight in children and adolescents in our city and to investigate the associated factors. SUBJECTS AND METHODS: A cross-sectional study of 1317 children and adolescents aged 2-16 years. Multistage probability sampling was used to select three groups of subjects: 411 aged 12 to 16 years, 504 aged 6 to 12 years, and 402 aged 2 to 6 years. Body mass index was calculated, and obesity and overweight were diagnosed using the threshold levels of the International Obesity Task Force for children and adolescents. Parents were asked about eating habits, health, social, and demographic aspects. Results are given as percentages (95% confidence interval). The relationship between obesity and overweight and the different variables was studied using multiple logistic regression. The adjusted odds ratio (OR) was calculated. RESULTS: Among children and adolescents aged 2-16 years, 9.5% (8.0%-11.0%) were obese and 22.4% (23.3%-24.6%) were overweight. Of subjects aged 12-16 years, 8.5% (5.9%-11.2%) were obese and 20.5% (16.7%-24.3%) were overweight. In the groups aged 6-12 years and 2-6 years, rates of obesity and overweight were 11.6% (8.9% -14.3%) and 31.0% (27.0-35.0) and 8.0% (5.4%-10.6%) and 13.6% (10.3%-16.9%) respectively. Obesity or overweight was associated to age (OR 1.21; P<0.001), maternal obesity (OR 10.99; P= 0.008), a birthweight higher than 4kg (OR 2.91; p 0.002), and formula feeding (OR 1.82; P= 0.005). CONCLUSION: Obesity and overweight in children and adolescents are highly prevalent problems in our city.

Effect of fluoride exposure on different immune parameters in humans.

CONTEXT: T regulatory (Treg) cells play an important role in the modulation of the immune response, and are implicated in the pathogenesis of autoimmune diseases. Many people is exposed to fluoride (F), mainly through drinking water. OBJECTIVE: The aim of this work was to assess the possible effect of F exposure on different immune parameters, mainly Treg cells. MATERIALS AND METHODS: We studied 61 subjects from a community of the state of Durango, Mexico, where the population is exposed to F levels over 2.0 ppm in drinking water. Peripheral blood mononuclear cells (PBMC) were isolated and the level and function of Treg cells was analyzed by flow cytometry and cell proliferation assays. In addition, we detected the presence of apoptotic cells, the expression of TLR/CD14, and the in vitro synthesis of TNF-α by monocytes. RESULTS: We found a negative correlation between urinary F and percentage of CD4(+)CD25(+) Treg cells (r = -0.55, P < 0.001). Accordingly, a defective function of these cells was detected in 30% of individuals exposed to F. In contrast, a positive association between levels of CD4(+)TGF-ß(+) or CD4(+)IL-10(+) Treg lymphocytes and F urine concentrations was detected. In addition, a negative correlation was detected between the F urinary levels and the proportion of apoptotic cells, in PBMC or T cells or monocytes (P < 0.05 in all cases). Finally, no apparent association between F exposure and TLR4/CD14 expression or the synthesis of TNF-α was detected. CONCLUSION: Our data suggest that F exposure exerts a complex and relevant effect on Treg cells in humans.

Pattern of expression of apoptosis and inflammatory genes in humans exposed to arsenic and/or fluoride.

We have assessed whether the combined exposure to arsenic (As) and fluoride (F) exerts a different effect than the exposure to As alone on the pattern of expression of apoptosis and inflammatory genes by immune cells. RNA was extracted from peripheral blood mononuclear cells from twenty individuals exposed or not to As or F or both. Then, cDNA was isolated, and the expression of 180 genes related to apoptosis and inflammation was tested by a cDNA array test. We found significant differences in the expression of 9 apoptosis and 15 inflammation genes in the three exposed groups compared to non-exposed individuals. In addition, subjects exposed to As or F or both showed different patterns of expression of at least 19 genes. Our data indicate that the combined exposure to As and F has a different effect on gene expression than the exposure to As or F alone.

Environmental health assessment of deltamethrin in a malarious area of Mexico: environmental persistence, toxicokinetics, and genotoxicity in exposed children.

We reported previously that children are exposed to deltamethrin in malarious areas. In the present work we explored the levels of this insecticide in soil samples and also obtained relevant toxicokinetic data of deltamethrin in exposed children. Results show that, after spraying, indoor levels of deltamethrin in soil samples were higher than outdoor levels. The mean half-life estimated with these data was 15.5 days for outdoor samples and 15.4 days for indoor samples. Children's exposure to deltamethrin was assessed using as biomarkers the urinary concentrations of the metabolites 3-phenoxybenzoic acid (3-PBA) and cis-3-(2,2-dibromovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid (Br2CA). The mean level of both biomarkers reached a peak within the first 24 hr postexposure; 6 months after the initial exposure, urinary levels of 3-PBA and Br2CA were found at levels observed before exposure. Approximately 91% of the total 3-PBA or Br2CA was excreted during the first 3 days after exposure. Therefore, we estimated a half-life for this period, the values for 3-PBA and Br2CA being almost identical (13.5 vs. 14.5 hr). Finally, considering reports about the genotoxicity of deltamethrin, we assessed DNA damage in children before and 24 hr after indoor spraying of deltamethrin; we found no differences in the comet assay end points. In conclusion, we observed exposure to deltamethrin in children, but we did not find any relationship between soil concentrations of deltamethrin and urinary levels of the metabolites. At least for genotoxicity, the exposed children appeared not to be at risk.