Non-alcoholic fatty liver disease and its associated risk factors in Brazilian postmenopausal women.

OBJECTIVE: To evaluate the prevalence and risk factors of non-alcoholic fatty liver disease (NAFLD) in postmenopausal women. METHODS: A cross-sectional study was carried involving 188 women (age ≥ 45 years and amenorrhea ≥ 12 months) attending the outpatient unit in south-eastern Brazil. Exclusion criteria were liver disease (hepatitis B and C, cholestatic disease, liver insufficiency), use of drugs that affect liver metabolism; alcoholics; AIDS or cancer history; and morbid obesity. NAFLD was diagnosed by abdominal ultrasound. Clinical, anthropometric (body mass index, waist circumference) and biochemical variables were measured. RESULTS: Of the 188 women, 73 (38.8%) had NAFLD. Blood pressure, waist circumference, body mass index, LDL cholesterol, triglycerides and glucose were significantly higher in NAFLD patients when compared with women without NAFLD (control group) (p < 0.05). HOMA-IR values indicated insulin resistance only in the NAFLD group (6.1 ± 4.6 vs. 2.4 ± 1.4 in control group, p < 0.05). Metabolic syndrome was detected in 93.1% of the women affected by NAFLD, and 46.1% of the control group (p < 0.05). In multivariate analysis, adjusted for age and weight, the variables considered at risk for the development of NAFLD, were: high waist circumference (odds ratio (OR) 1.07, 95% confidence interval (CI) 1.01-1.13), insulin resistance (OR 3.81, 95% CI 2.01-7.13), and presence of metabolic syndrome (OR 8.68, 95% CI 3.3-24.1). CONCLUSION: NAFLD showed a high prevalence among postmenopausal women. The presence of metabolic syndrome, abdominal obesity and IR were indicators of risk for the development of NAFLD.

Validation of fingernail fluoride concentration as a predictor of risk for dental fluorosis.

The aim of this study was to validate the use of fingernail fluoride concentrations at ages 2-7 years as predictors of the risk for developing dental fluorosis in the permanent dentition. Fifty-six children of both genders (10-15 years of age) had their incisors and premolars examined for dental fluorosis using the Thylstrup-Fejerskov index. Fingernail fluoride concentrations were obtained from previous studies when children were 2-7 years of age. Data were analyzed by unpaired t test, ANOVA, and Fisher's exact test when the fingernail fluoride concentrations were dichotomized (≤ 2 or >2 µg/g). Children with dental fluorosis had significantly higher fingernail fluoride concentrations than those without the condition, and the concentrations tended to increase with the severity of fluorosis (r(2) = 0.47, p < 0.0001). Using a fingernail fluoride concentration of 2 µg/g at ages 2-7 years as a threshold, this biomarker had high sensitivity (0.84) and moderate specificity (0.53) as a predictor for dental fluorosis. The high positive predictive value indicates that fingernail fluoride concentrations should be useful in public health research, since it has the potential to identify around 80% of children at risk of developing dental fluorosis.

Biomarkers of fluoride in children exposed to different sources of systemic fluoride.

There has been no comparison between fluoride concentrations in urine and nails of children exposed to different sources of systemic fluoride. The aim of this study was to compare the relationship between fluoride intake with urinary fluoride excretion and fluoride concentrations in fingernails and toenails of children receiving fluoride from artificially fluoridated water (0.6-0.8 mg F/L, n = 25), naturally fluoridated water (0.6-0.9 mg F/L, n = 21), fluoridated salt (180-200 mg F/Kg, n = 26), and fluoridated milk (0.25 mg F, n = 25). A control population was included (no systemic fluoride, n = 24). Fluoride intake from diet and dentifrice, urinary fluoride excretion, and fluoride concentrations in fingernails/toenails were evaluated. Fluoride was analyzed with an ion-selective electrode. Urinary fluoride excretion in the control community was significantly lower when compared with that in the fluoridated cities, except for the naturally fluoridated community. However, the same pattern was not as evident for nails. Both urinary fluoride output and fluoride concentrations in fingernails/toenails were significantly correlated to total fluoride intake. However, the correlation coefficients for fluoride intake and urinary fluoride output were lower (r = 0.28, p < 0.01) than those observed for fingernails/toenails (r = 0.36, p < 0.001), suggesting that nails might be slightly better indicators of fluoride intake at the individual level.

Dietary fluoride intake by children receiving different sources of systemic fluoride.

There has been no comparison of fluoride (F) intake by pre-school children receiving more traditional sources of systemic F. The aim of this study was to estimate the dietary F intake by children receiving F from artificially fluoridated water (AFW-Brazil, 0.6-0.8 mg F/L), naturally fluoridated water (NFW-Brazil, 0.6-0.9 mg F/L), fluoridated salt (FS-Peru, 180-200 mg F/Kg), and fluoridated milk (FM-Peru, 0.25 mg F). Children (n=21-26) aged 4-6 yrs old participated in each community. A non-fluoridated community (NoF) was evaluated as the control population. Dietary F intake was monitored by the "duplicate plate" method, with different constituents (water, other beverages, and solids). F was analyzed with an ion-selective electrode. Data were tested by Kruskall-Wallis and Dunn's tests (p<0.05). Mean (+/- SD) F intake (mg/Kg b.w./day) was 0.04+/-0.01(b), 0.06+/-0.02(a,b), 0.05+/-0.02(a,b), 0.06+/-0.01(a), and 0.01+/-0.00(c) for AFW/NFW/FS/FM/NoF, respectively. The main dietary contributors for AFW/NFW and FS/FM/NoF were water and solids, respectively. The results indicate that the dietary F intake must be considered before a systemic method of fluoridation is implemented.

Limnological and ecotoxicological studies in the cascade of reservoirs in the Tietê river (São Paulo, Brazil)

O presente trabalho visou avaliar a qualidade de amostras de água e sedimento dos reservatórios em cascata do rio Tietê (SP) através de análises limnológicas e ecotoxicológicas. Foram realizadas coletas de água e sedimento em dois períodos (fevereiro e julho de 2000) e em 15 estações de amostragem. Foram realizados bioensaios de toxicidade aguda para Daphnia similis, de toxicidade crônica para Ceriodaphnia dubia e para larvas pós-eclodidas de Danio rerio. Análises de nutrientes totais, material em suspensão total e cádmio, cromo, cobre e zinco foram realizadas para as amostras de água e análises de matéria orgânica, granulometria e metais biodisponíveis (cádmio, cromo, cobre e zinco) para o sedimento. Os resultados obtidos para as variáveis limnológicas, revelaram diferenças na qualidade da água, com elevado aporte de nutrientes e metais pelos rios Tietê e Piracicaba, além da incorporação, da sedimentação e da redução de materiais no reservatório de Barra Bonita, promovendo a melhoria da qualidade da água nos demais reservatórios. Os bioensaios revelaram toxicidade aguda para Daphnia similis somente nos reservatórios localizados à jusante da barragem de Barra Bonita, porém os bioensaios de toxicidade crônica com Ceriodaphnia dubia e com Danio rerio revelaram toxicidade decrescendo em magnitude de Barra Bonita à Três Irmãos, evidenciando um gradiente de degradação ambiental nos reservatórios.

Limnological and ecotoxicological studies in the cascade of reservoirs in the Tietê River (São Paulo, Brazil).

An evaluation was made of the quality of samples of water and sediment collected from a series of reservoirs in the Tietê River (SP), based on limnological and ecotoxicological analyses. The samples were collected during two periods (Feb and Jul 2000) from 15 sampling stations. Acute toxicity bioassays were performed using the test organism Daphnia similis, while chronic bioassays were carried out with Ceriodaphnia dubia and Danio rerio larvae. The water samples were analyzed for total nutrients, total suspended matter and total cadmium, chromium, copper and zinc concentrations, while the sediment samples were examined for organic matter, granulometry and potentially bioavailable metals (cadmium, chromium, copper and zinc). The results obtained for the limnological variable, revealed differences in the water quality, with high contribution of nutrients and metals for Tietê and Piracicaba rivers, besides the incorporation and sedimentation, consequently causing a reduction of materials in Barra Bonita reservoir, thus promoting the improvement of the water quality in the other reservoirs. The toxicity bioassays revealed acute toxicity for Daphnia similis only in the reservoirs located below Barra Bonita dam. On the other hand, chronic toxicity for Ceriodaphnia dubia and acute for Danio rerio showed a different pattern, decreasing in magnitude from Barra Bonita to Três Irmãos, demonstrating an environmental degradation gradient in the reservoirs.