Iodine nutrition and thyroid function assessment in childbearing age women from Queretaro, Mexico.

OBJECTIVE: To assess iodine nutrition and thyroid function in Mexican childbearing age women. METHODS: 101 childbearing age women (21.7 ± 3.5 years) randomly selected from the university student population participated in this cross-sectional study. TSH, thyroid hormones, anti-thyroid antibodies, thyroid volume, iodine intake, and urinary iodine concentration (UIC) were assessed. The knowledge about the importance of iodine in nutrition was also evaluated by using questionnaires. RESULTS: TSH median (interquartile range) value was 1.9 (1.4-2.5) mIU/L, while FT4 median value was 9.0 (8.3- 9.6) µg/dL. The median FT3 and total rT3 values were 3.3 pg/mL and 40.1 ng/dL, respectively. The prevalence of subclinical hypothyroidism (serum TSH >4.5 mIU/L) and of positive anti-thyroid antibodies were 2.9% and <5.9%, respectively. Median thyroid volume was 5.6 mL and none of the subjects were diagnosed with goiter. Median urinary iodine concentration was 146 (104-180) µg/L. As for the knowledge of iodine nutrition, only 37.6% considered that a pregnant woman needs more dietary iodine than a non pregnant woman, while 43.6% recognized that the lack of iodine can cause mental retardation in children. CONCLUSIONS: Prevalence of thyroid test function abnormalities was low in this population and the median UIC indicates adequate iodine intake. We also found a poor knowledge about the importance iodine nutrition in the studied population.

Iodine nutrition and thyroid function assessment in child bearing age women from Queretaro, Mexico / Estado nutricio en yodo y función tiroidea en mujeres en edad reproductiva de Querétaro, México

Objective: To assess iodine nutrition and thyroid function in Mexican childbearing age women. Methods: 101 childbearing age women (21.7 ± 3.5 years) randomly selected from the university student population participated in this cross-sectional study. TSH, thyroid hormones, anti-thyroid antibodies, thyroid volume, iodine intake, and urinary iodine concentration (UIC) were assessed. The knowledge about the importance of iodine innutrition was also evaluated by using questionnaires. Results: TSH median (interquartile range) value was1.9 (1.4-2.5) mIU/L, while FT4 median value was 9.0 (8.3-9.6) μg/dL. The median FT3 and total rT3 values were 3.3pg/mL and 40.1 ng/dL, respectively. The prevalence of subclinical hypothyroidism (serum TSH >4.5 mIU/L) and of positive anti-thyroid antibodies were 2.9% and <5.9%,respectively. Median thyroid volume was 5.6 mL and none of the subjects were diagnosed with goiter. Median urinary iodine concentration was 146 (104-180) μg/L. As for the knowledge of iodine nutrition, only 37.6% considered that a pregnant woman needs more dietary iodine than a non pregnant woman, while 43.6% recognized that the lack of iodine can cause mental retardation in children. Conclusions: Prevalence of thyroid test function abnormalities was low in this population and the median UIC indicates adequate iodine intake. We also found a poor knowledge about the importance iodine nutrition in the studied population (AU)

Objetivo: Evaluar el estado nutricional en yodo y la función tiroidea en mujeres mexicanas en edad reproductiva. Métodos: 101 mujeres universitarias en edad reproductiva(21,7 ± 3,5 años) fueron seleccionadas al azar para participar en este estudio transversal. Se evaluaron los niveles séricos de tirotropina, hormonas tiroideas, anticuerpos anti-tiroideos, volumen tiroideo, consumo de yodo y yoduria. También se evaluó el conocimiento sobre la importancia del yodo en la nutrición. Resultados: La mediana (rango intercuartilar) de tirotropina fue de 1,9 (1,4-2,5) mIU/L, mientras que para T4libre fue de 9,0 (8,3-9,6) μg/dL. Los valores de la mediana de T3 libre y T3 reversa fueron de 3,3 pg/mL y 40,1 ng/dL, respectivamente. La prevalencia de hipotiroidismo subclínico fue 2,9% (tirotropina sérica >4,5 mUI/L). La prevalencia de anticuerpos antitiroideos positivos fue <5,9%.La mediana del volumen tiroideo fue de 5,6 mL y no se diagnosticaron mujeres con bocio. La mediana (rangointercuartilar) de la yoduria fue de 146 (104-180) μg/L. En cuanto al conocimiento de la importancia del yodo en la nutrición, el 37,6% consideró que las mujeres gestantes requieren más yodo en la dieta que las no gestantes, mientras que el 43,6% reconoció que la deficiencia de yodo puede causar retraso mental en los infantes. Conclusiones: Se encontró una baja prevalencia de alteraciones en las pruebas de función tiroidea, mientras que la mediana de la yoduria indicó un adecuado consumo de yodo. También se encontró un conocimiento bajo acerca de la importancia del yodo en la nutrición (AU)

[Pepsinogen and gastrin in the noninvasive diagnosis of gastric atrophy. A case-control study in Peruvian population]. / Pepsinógeno y gastrina en el diagnóstico no invasivo de la atrofia gástrica. Un estudio caso-control en población Peruana.

INTRODUCTION: Detection of gastric atrophy could be used for early diagnosis of gastric cancer in Perú. It was determined the pepsinogens I and II (PGI, PGII) and Gastrin-17 (G17) serum levels, and the PGI/PGII ratio as a non-invasive diagnostic test for gastric atrophy in Peruvian patiens. METHODS: Dyspeptic adults undergoing endoscopy and gastric biopsies were studied.For each case with atrophy two controls without atrophy were selected. Differences were evaluated and ROC curves constructed. A serologic profile was produced combining PGI and PGI/PGII ratio. Sensitivity and specificity were calculated. RESULTS: 22 cases and 44 controls were included. Areas under ROC curves were 0.599, 0.546 and 0.534 for PGI, PGII and PGI/PGII ratio, respectively. None of these allowed for discrimination between cases and controls. The serological profile did not reach appropriate sensitivity and specificity. DISCUSSION: This first study of pepsinogen, gastrin and atrophy in Peru showed none of these tests to be useful. Their potential impact in early detection and prevention of prevalent cancer justify further investigation. Recruiting more patients, excluding those previously treated for Helicobacter pylori, and processing independently the antrum and corpus biopsies, could reveal findings not seen in present study.

Pepsinógeno y gastrina en el diagnóstico no invasivo de la atrofia gástrica: un estudio caso-control en población peruana / Pepsinogen and gastrin in non-invasive diagnosis of gastric atrophy: a case-control study in peruvian population

INTRODUCCIÓN: La detección de atrofia gástrica podría ser utilizada en el diagnóstico precoz de cáncer gástrico en Perú. Se evaluó la determinación de niveles séricos de pepsinógenos I y II (PGI, PGII), gastrina-17 (G17), y la relación PGI/PGII como posible prueba de diagnóstico no invasivo de atrofia en pacientes peruanos. MATERIAL Y MÉTODOS: Se estudiaron adultos con dispepsia sometidos a endoscopía con biopsia gástrica, considerando dos controles sin atrofia por cada caso con atrofia. Se evaluaron las diferencias y se confeccionaron curvas ROC, así como el perfil serológico combinando PGI y PGI/PGII. Se calculó su sensibilidad y especificidad. RESULTADOS: Se analizaron 22 casos y 44 controles. El área bajo la curva ROC fue 0.599, 0.546 y 0.534 para PGI, PGII, y PGI/PGII respectivamente. Ninguna prueba discriminó entre casos y controles. El perfil serológico no alcanzó sensibilidad y especificidad adecuadas. DISCUSIÓN: Este primer estudio de pepsinógeno, gastrina y atrofia en Perú, no mostró utilidad de estos métodos. El impacto potencial en la detección y prevención de una neoplasia prevalente justifica mayor investigación. Incluir más pacientes, excluir a los tratados previamente contra Helicobacter pylori, y procesar separadamente las biopsias de antro y cuerpo, podrían revelar asociaciones no vistas en este estudio.

INTRODUCTION: Detection of gastric atrophy could be used for early diagnosis of gastric cancer in Perú. It was determined the pepsinogens I and II (PGI, PGII) and Gastrin-17 (G17) serum levels, and the PGI/PGII ratio as a non-invasive diagnostic test for gastric atrophy in Peruvian patiens. METHODS: Dyspeptic adults undergoing endoscopy and gastric biopsies were studied. For each case with atrophy two controls without atrophy were selected. Differences were evaluated and ROC curves constructed. A serologic profile was produced combining PGI and PGI/PGII ratio. Sensitivity and specificity were calculated. RESULTS: 22 cases and 44 controls were included. Areas under ROC curves were 0.599, 0.546 and 0.534 for PGI, PGII and PGI/PGII ratio, respectively. None of these allowed for discrimination between cases and controls. The serological profile did not reach appropriate sensitivity and specificity. DISCUSSION: This first study of pepsinogen, gastrin and atrophy in Peru showed none of these tests to be useful. Their potential impact in early detection and prevention of prevalent cancer justify further investigation. Recruiting more patients, excluding those previously treated for Helicobacter pylori, and processing independently the antrum and corpus biopsies, could reveal findings not seen in present study.

Assessment of vitamin A status with the relative-dose-response test in Peruvian children recovering from pneumonia.

BACKGROUND: The relative-dose-response (RDR) test is used to identify subjects with marginal liver vitamin A stores, but its use has not been evaluated during episodes of infection. OBJECTIVE: The objective was to assess, with the RDR test, the vitamin A status of children recovering from pneumonia. DESIGN: As part of a double-blind, placebo-controlled clinical trial of high-dose vitamin A supplements among children hospitalized with pneumonia in Lima, Peru, we examined the association of treatment group, nutritional status, severity of disease, and induction of the acute phase response [on the basis of serum C-reactive protein (CRP)] on serum retinol and the RDR test. RESULTS: Serum retinol was low at admission and increased significantly in both the vitamin A and placebo groups during recovery. Serum CRP had a significant, inverse association with retinol at both admission and discharge. Serum retinol and CRP concentrations never differed significantly between the treatment groups. Among subjects with CRP > or =10 mg/L, 21% in the vitamin A group and 20% in the placebo groups (P = 0.83) had a positive RDR test result. Among subjects with CRP <10 mg/L, 56% in the placebo group but only 6% in the vitamin A group had positive RDR test results (P = 0.002). CONCLUSION: The RDR test was useful in assessing the vitamin A status of children recovering from pneumonia when CRP concentrations were <10 mg/L but not when CRP concentrations were higher.

Evolución de la inmunidad pasiva y respuesta a la vacunación contra el sarampión / Follow up of the pasive immunity and response to antimesles vaccination

Treinta y cuatro niños recién nacidos fueron seguidos hasta los 10 meses de edad. Evaluaciones clínicas y antropométricas se llevaron a cabo al nacimiento y a los 3,6 y 9 meses. Una pequeña muestra de sangre fue obtenida durante estas evaluaciones con la finalidad de tederminar el título de las inmunoglobulinas G (igG) anti-sarampión usando la técnica de ELISA modificada en nuestro laboratorio. A los 9 meses de edad todos los niños fueron vacunados contra contra sarampión y el título de igG anti-sarampión fue determinado nuevamente a los 10 meses de edad. El estado nutricional de acuerdo a las medidas antropométricas (usando los standards de crecimiento del NCHS) estuvieron generalmente dentro del rango normal para todos los niños durante el estudio. Treinta y tres niños seroconvirtieron despúes de la vacunación contra el sarampión y un niño presentó valores de seroconversión dudosos. La relación Hijo/Madre de igG antisarampión al nacimiento fue de 1.40 para todos los niños, siendo 1.70 para los varones y 1.15 para las mujeres. Se encontró que la pérdida de anticuerpos anti-sarampión fue en función de los títulos iniciales (al nacimiento), de modo que a la edad de 9 meses, los tres grupos de niños (con títulos inicales bajo, intermedio y alto) presentaron títulos promedio idénticos. Se propone la hipótesis de que el estado nutricional o el incremento en la frecuencia de la exposición de los niños al agente infecciosossería el responsable de la pérdida temprana de los anticuerpos anti-sarampión provenientes de la madre