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Resumen Introducción: Varios estudios han demostrado en poblaciones indígenas alta prevalencia de obesidad, diabetes mellitus, hipertensión arterial, proteinuria y enfermedad renal crónica. Objetivo: Detectar factores de riesgo cardiovascular y renal, hipertensión arterial, sobrepeso y obesidad, obesidad central, diabetes y proteinuria, y evaluar nivel educativo, situación laboral, nivel socioeconómico y cobertura de salud en sujetos de la etnia wichi, habitantes de "El Impenetrable" chaqueño. Material y métodos: Se realizó un estudio descriptivo observacional, de corte transversal, con muestra aleatoria de sujetos mayores de 18 años. La encuesta semiestructurada, y traducida a lengua wichi, incluyó: edad, sexo, sedentarismo, tabaquismo, nivel educativo, situación laboral, cobertura de salud y nivel socioeconómico. Se midió peso, talla, circunferencia de cintura, presión arterial sistólica y diastólica, glucemia y proteinuria. Se calculó el índice de masa corporal. Resultados: Se evaluaron 156 personas (el 58,3% varones, edad 34 ± 12 años). El índice de masa corporal fue de 27,9 ± 5,3, sin diferencia entre sexos. Presentó hipertensión arterial el 10,8%, sobrepeso el 34,0%, obesidad el 30,9%, obesidad central el 40,1% (mayor en mujeres, p= 0,03), tabaquismo el 17,4%, sedentarismo el 83,3%, y proteinuria el 14,5%. Se registró un único caso de diabetes. Solo 6,4% refirió trabajar, el 49,3% no había finalizado estudios primarios, el 61,7% calificó como marginal en el nivel socioeconómico, y solo el 3,8% tenía cobertura de salud. Conclusión: Este grupo poblacional evidencia un alto grado de vulnerabilidad alimentaria, educativa, laboral, social y sanitaria, reflejado en la alta prevalencia de factores de riesgo cardiovascular y renal (en particular exceso de peso y obesidad central), en el bajo nivel educativo, laboral y socioeconómico, y en la falta de cobertura de salud.
Abstract Introduction: Several studies have shown a high prevalence of obesity, diabetes mellitus, hypertension, proteinuria and chronic kidney disease in indigenous populations. Aim: To detect cardiovascular and renal risk factors, hypertension, overweight and obesity, truncal obesity, diabetes and proteinuria, and to evaluate educational level, employment situation, socioeconomic level and health care coverage in subjects from the Wichi ethnic group who inhabit in "El Impenetrable" in Chaco. Methods: An observational, descriptive, cross-sectional study was carried out, with a random sample of subjects over 18 years of age. The semi-structured survey, translated into the Wichi language, included: age, sex, sedentary lifestyle, smoking habit, educational level, employment situation, health care coverage and socioeconomic level. Weight, height, waist circumference, systolic and diastolic blood pressure, blood glucose and proteinuria were measured. Body mass index was calculated. Results: 156 people were evaluated (58.3% men; age: 34 ± 12 years). The body mass index was 27.9 ± 5.3, with no difference between the sexes. Hypertension was present in 10.8% of individuals; overweight in 34.0%; obesity in 30.9%; truncal obesity in 40.1% (higher in women, p = 0.03); smoking habit in 17.4%; sedentary lifestyle in 83.3%, and proteinuria in 14.5%. A single case of diabetes was registered. Only 6.4% reported having a job, 49.3% had not completed primary studies, 61.7% qualified as marginal in terms of socioeconomic status, and only 3.8% had health care coverage. Conclusion: This population group shows a high degree of food, educational, occupational, social and health vulnerability, reflected in the high prevalence of cardiovascular and renal risk factors (particularly excess weight and truncal obesity), in the low educational, employment and socioeconomic levels, and in the lack of health coverage.
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INTRODUCTION: Little information is available regarding the evaluation of renal volume in healthy Latin-American children of different ages. The objective of this work was to establish a predictive model of renal size (volume and length) and develop a web-based calculator. MATERIALS AND METHODS: A selective and representative sample was obtained randomly from the database of healthy children living in Resistencia city, Chaco, Argentina: a) the National Health Program for children under 6 years old; b) school children until 18 years old (primary and middle education). Renal dimensions were obtained by ultrasonography via a single experienced operator at the indicated site (schools or primary health care centers). Renal volume was calculated using Dinkel's formula. A multiple linear regression model was applied using potential predictors. The final model was implemented in a free web-based application. RESULTS: Random selection was made from the database to include 882 subjects with ages between 0.03 and 230.63 months. The data was divided into two sets (one for training and the other for model testing). The training set (423) included 212 (50%) females. Significant predictors included age, height, current weight and birth weight, and the interaction between age and present weight. Using the test dataset, both renal volume and length root mean square errors were 5.06 cm3 and 0.59 cm. CONCLUSION: The prediction model was accurate and allowed for the development a freely-available web app: Renal size prediction (https://porbm28.shinyapps.io/RenalVolume/). Once the models are validated by additional studies, the app could be a useful tool to predict renal volume and length in pediatric clinical practice.
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Rim/anatomia & histologia , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Rim/diagnóstico por imagem , Modelos Lineares , Masculino , Tamanho do Órgão , UltrassonografiaRESUMO
INTRODUCCIÓN: Se carece de datos sobre situación nutricional y factores de riesgo cardiovascular y renal en pediatría en la provincia del Chaco, una de las más pobres y con mayor población pediátrica de Argentina. OBJETIVO: Determinar la prevalencia de factores de riesgo nutricionales (bajo peso/talla, baja talla/edad, bajo peso y sobrepeso), factores de riesgo perinatales (edad materna y edad gestacional al nacimiento), cardiovasculares y renales (sobrepeso, hipertensión arterial y proteinuria), correlacionados con el peso al nacer, en población de un mes a 18 años del conglomerado urbano del Gran Resistencia, provincia del Chaco. MATERIAL Y MÉTODOS: Se realizó un estudio descriptivo observacional de corte transversal. Los participantes se seleccionaron por muestreo probabilístico por conglomerados según peso de la población en cada estrato, de escuelas para niños de 6 a 18 años y de centros de salud para menores de 6.RESULTADOS: Se estudiaron 850 niños. La prevalencia de factores de riesgo fue: 24% alto riesgo por edad materna; 21% nacidos pre-término; 7,2% bajo peso al nacer; 9,1% baja talla/edad; 4,2% bajo peso/talla; 11,8% alto peso/talla; 6,3% bajo peso/edad; 2,4% proteinuria; y 6,8% hipertensión arterial. En menores de 6 años con bajo peso al nacer comparados con nacidos con peso normal, la odd ratio para presentar bajo peso/talla fue de 6,15, y para bajo peso/edad de 5,02; para nacidos con alto peso comparados con nacidos con peso normal, la odd ratio para sobrepeso fue 3,07. CONCLUSIONES: La población pediátrica estudiada presenta una situación de alto riesgo nutricional que correlaciona con el peso al nacer. La prevalencia de proteinuria e hipertensión arterial no se asociaron al peso al nacer
INTRODUCTION: There is a lack of data on nutritional status and cardiovascular and renal risk factors in pediatrics in the province of Chaco, one of the poorest provinces and with the largest pediatric population in Argentina. OBJECTIVE: To determine the prevalence of these risk factors: nutritional (low weight/height, low height/age, low weight and overweight); perinatal (maternal age and gestational age at birth), as well as cardiovascular and renal (overweight, hypertension and proteinuria), correlated with birth weight, in population from one month old to 18 years old in the urban agglomeration of Gran Resistencia, province of Chaco. MATERIAL AND METHODS: An observational descriptive cross-sectional study was conducted. Participants were selected by probabilistic sampling through agglomerations according to population weight in each strata, taken from schools for 6-18 year-old children and from health centers for children under 6. RESULTS: A total of 850 children were studied. The prevalence of risk factors was: 24% with high risk for maternal age, 21% with preterm birth, 7.2% with low birth weight, 9.1% with low height/age, 4.2% with low weight/height, 11.8% with high weight/height, 6.3% with low weight/age, 2.4% with proteinuria and 6.8% with high blood pressure. In children under 6 years of age with low birth weight, compared to those with normal birth weight, the odd ratio for low weight/height was 6.15, and for low weight/age it was 5.02; for those born with a high weight compared to those born with normal weight, the odd ratio for overweight was 3.07. CONCLUSIONS: the pediatric population which was studied presents a situation of high nutritional risk that correlates with birth weight. The prevalence of proteinuria and high blood pressure were not associated with birth weight
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Humanos , Criança , Proteinúria , Peso ao Nascer , Estado Nutricional , Pediatria , Argentina , Doenças Cardiovasculares , Fatores de Risco , HipertensãoRESUMO
La provincia del Chaco, Argentina, posee una población de 1.055.259 habitantes, siendo una de las que tiene mayor población pediátrica y aborigen del país. El objetivo del presente estudio es conocer las cifras de presión arterial (PA) y estado nutricional (EN) en población pediátrica del Chaco y describir las diferencias encontradas entre la población caucásica (CP) y aborígenes de la etnia Toba (AT) en menores de 10 años. Estudio con una muestra no aleatoria, de 678 niños de 1-17 años realizado en sus casas. Se utilizaron las tablas elaboradas por la OMS 2007 para determinar el EN. La PA se tomó adaptando la técnica descrita en el IV Reporte de PA en niños y adolescentes. Según la edad y la etnia, los niños participantes se dividieron en 4 grupos: grupo I , 90 (13,3%) AT menores a 10 años; grupo II , 52 (7,7%) de CP del mismo rango de edad; grupo III , 190 (28%) CP de 11-13 años y grupo IV , 346 (51%) CP de 14-17 años. El riesgo de sobrepeso y el sobrepeso se encontraron entre el 24-46% de los niños. Presentaron bajo peso el 2,7% (IC 95% 1,6-4,2). Se detectaron cifras tensionales mayores o iguales al percentil 95 en el 42% de los del grupo I, 30% del grupo II , 21% del grupo III , 16% del grupo IV (p < 0,05). La frecuencia de sobrepeso hallada es superior a la de estudios realizados en Canadá y Buenos Aires y menor a la de Estados Unidos. Los AT presentaron mayor frecuencia de peso normal y menor estatura
Chaco Province, Argentina, has a population of 1,055,259 inhabitants, and has one of the largest pediatric and indigenous populations in the country. The aim of this study was to determine the blood pressure (BP) and nutritional status (NS) in the pediatric population in Chaco Province and to describe the differences between the Caucasian population (CP), and a group of Toba aborigines (AT) less than 10 years old. This study was conducted on a non-random sample of 678 children of 1-17 years who did not attend medical appointments. The tables developed by WHO 2007 were used to determine NS. BP was taken by adapting the technique described in the Fourth BP Report. Depending on age and ethnicity, the participating children were divided into four groups. In Group I, 90 (13.3%) AT under 10 years, group II, 52 (7.7%) of CP of the same age range, group III, 190 (28%) CP 11-13 years, and in group IV, 346 (51%) CP 4-17 years. There was a risk of overweight and overweight, in between 24% and 46% of children, and underweight in 2.7% (95% CI; 1.6 to 4.2). Blood pressure above or equal to the 95 percentile was detected in 42% of Group I, 30% of Group II, 20% of group III, and 16% of group IV (p < .05). The prevalence of overweight is higher than that that found in other studies from Canada and Buenos Aires, Argentina, and lower than in the United States. The AT had a higher frequency of normal weight and shorter stature
