Neck circumference cut-offs for overweight and obesity in a group of Mexican adolescents.

BACKGROUND/OBJECTIVES: Neck circumference (NC) has been used for screening overweight/obesity for its high correlation with age, weight, body mass index (BMI), and waist circumference (WC). Cut-offs should be population specific. The aim of the study was to obtain cut-offs of NC for overweight/obesity in Mexican adolescents and to correlate them with anthropometric indicators. SUBJECTS/METHODS: Weight, height, BMI, NC, WC, and mid-upper arm circumference (MUAC) of 465 12-14-year-old Mexican-mestizo students attending a public school in Mexico City were assessed. Using receiver operating characteristics analyses, neck cut-offs were obtained according to the WHO age and sex criteria for overweight/obesity. RESULTS: NC cut-offs with the highest sensitivity and specificity for males and females, respectively, were as follows: 30.0 and 29.3 cm for 12-year-olds; 31.9 and 30.4 cm for 13-year-olds; and, 33.5 and 30.7 cm for 14-year-old adolescents. Overweight/obesity was identified with NC cut-offs in 80% of males and 86% of females, and showed significant correlations (p < 0.01) in males and females with weight (r = 0.821 and r = 0.840, respectively), BMI (r = 0.649 and r = 0.819, respectively), WC (r = 0.710 and r = 0.813, respectively) and MUAC (r = 0.736 and r = 0.815, respectively). CONCLUSIONS: Neck circumference may be used as a first-stage screening tool or jointly with BMI to identify overweight/obesity in 12-14-year-old Mexican adolescents.

[Change in prevalence of physical and sports activities in a cohort of students]. / Cambio en la prevalencia de sedentarismo y actividad deportiva en una cohorte de estudiantes.

BACKGROUND: Sedentary lifestyle is one of the worldwide problems of Public Health. Given that, physical activity has both direct and indirect effects on the mortality and morbidity on non-communicable chronic diseases. The aim was to determine the change in prevalence of sedentary lifestyle in a cohort of students. METHODS: The Universidad Nacional Autónoma de México makes an Automated Medical Examination to students. In this evaluation, the sport, physical activity and other risk factors were analyzed in students admitted in 2010 to the Faculty of Medicine that were previously analyzed in 2007. RESULTS: A total of 593 students were studied. The mean age was 15.1 ± 1.4 years. The prevalence of physical inactivity increased from 38.3 to 39.9 %. When stratified by gender, women were more sedentary (p < 0.05). Sports activities decreased significantly in frequency and time. In the sedentary population, the prevalence of overweight increased in men and the obesity in women. Smoking increased 4.9 % and alcohol consumption in 36.7 % in both sexes. CONCLUSIONS: The prevalence of physical inactivity was higher compared to other countries. Smoking and alcohol consumption increased so it is necessary to follow up and implement programs of health promotion.

Introducción: la inactividad física tiene efectos directos e indirectos con la muerte por enfermedades crónicas no transmisibles y es un problema de salud pública. El objetivo de este trabajo fue conocer el cambio en la prevalencia de sedentarismo y actividad deportiva en una cohorte de estudiantes. Métodos: la Universidad Nacional Autónoma de México hace el Examen Médico Automatizado a sus alumnos. En este trabajo se analizó la actividad física y deportiva, así como algunos factores de riesgo en los estudiantes que ingresaron en 2010 a la Facultad de Medicina y contaran con información en 2007. Resultados: participaron 593 estudiantes. El promedio de edad inicial fue 15.1 ± 1.4 años. El sedentarismo incrementó de 38.3 a 39.9 %. Al estratificar por sexo, las mujeres resultaron ser más sedentarias (p < 0.05). Las actividades deportivas disminuyeron considerablemente en frecuencia y tiempo. En la población sedentaria, la prevalencia de sobrepeso incrementó en los hombres y la obesidad en las mujeres. Aumentó el tabaquismo 4.9 % y consumo de alcohol en 36.7 % en ambos sexos. Conclusiones: la prevalencia de sedentarismo resultó más alta en comparación con otros países. El tabaquismo y consumo de alcohol se incrementaron por lo que es necesario su seguimiento y realizar programas de promoción de la salud.

Cambio 2007-2010 de la prevalencia de factores de riesgo para enfermedades crónicas en estudiantes / 2007-2010 change the prevalence of risk factors for chronic disease in students

Resumen Introducción: Para diseñar estrategias de prevención, control y tratamiento de enfermedades crónicas no transmisibles en estudiantes es necesario conocer el comportamiento de éstas y los factores de riesgo a los que se exponen. Objetivo: Comparar los cambios en la prevalencia de riesgos de enfermedades crónicas en estudiantes de la Universidad Nacional Autónoma de México (UNAM) al pasar del bachillerato a la licenciatura. Material y métodos: Se comparó información de los años 2007 y 2010 de la encuesta de valoración integral de la salud que aplica la Dirección General de Servicios Médicos (DGSM) a los estudiantes sobre consumo de alcohol, tabaco, actividad física o deportiva, cambios somatométricos, y la presencia de hipertensión arterial (HA), diabetes mellitus (DM), cáncer, sobrepeso y obesidad en ellos y sus familiares directos. Resultados: Participaron 593 alumnos, de ellos 69.6% eran mujeres. El índice de masa corporal (IMC) cambio en 3 años de ٢٢.٣ a ٢٣.٤ (p < 0.001) en los hombres y de 22.1 a 22.8 (p < 0.001) en las mujeres. La frecuencia de presión arterial alta cambió de ١.٥٤ a 1.69%, el consumo de alcohol y tabaco se incrementó 32 y 7.6%, respectivamente. Los hombres resultaron más activos físicamente que las mujeres (p < 0.05); disminuyó la práctica de futbol en 21.7% y de corredores en 23%. En los familiares, la prevalencia de HA incrementó de 24.1 a 30.4%; obesidad de 27.6 a 31.3%, y DM tipo 2 de 12.8 a 16.2% con p < 0.01. El consumo de alcohol se incrementó de 11.4 a 13.3% y el tabaquismo de 24.5 a 24.9%. Conclusiones: El incremento de los factores de riesgo en los estudiantes y las enfermedades crónicas en sus familiares apuntalan hacia un perfil de mayor riesgo, por ello es importante promover conductas saludables y formar a los jóvenes como agentes de cambio, para que puedan influir en la reducción de daño en ellos y sus familiares.

Abstract Introduction: To design strategies of prevention, control and treatment of chronicnon transmissible diseases in students, it's necessary to know the behavior of these and the risk factors to which they are exposed. Objective: To compare the changes in the prevalence of risks of chronic diseases in students of the National Autonomous Universisty of Mexico (Universidad Autónoma de México [UNAM]) as they make their way from high school to college. Material and methods: Information from the survey of integral valorization of health that the General Board of Medical Services carried in 2007 and 2010 was compared. The information regarded alcohol and tobacco consumption, physical and sports activity, somatometric changes and the presence of high blood pressure, diabetes mellitus, cancer and overweight in the students and their direct family. Results: 593 students participated, 69.6 were women. The BMS changed in three years from 22.3 to 23.4 (P<0.001) in men and from 22.1 to 22.8 (P<0.001) in women. The frequency of high blood pressure changed from 1.54 to 1.69%, the alcohol and tobacco consumption was increased in three years, 32 and 7.6% respectively. Men resulted to be more physically active than women. (P<0.05); in three years the practice of soccer decreased in 21.7% and the practice of running 23%. In family members the prevalence of high blood pressure increased from 24.1 to 30.4%; obesity from 27.6 to 31.3% and diabetes mellitus type 2 from 12.8 to 16.2% with P<0.01. Alcohol consumption from 11.4 to 13.3% and tobacco consumption from 24.5 to 24.9%. Conclusions: The increase in risk factors in students and the chronic diseases in their family members indicate a higher risk profile. This is the reason why it is important to promote healthy conducts and to form the youth as agents of change so they can have influence in the reduction of damage in them and their family members.

[Activities after school time and obesity in children. Influence of family and neighborhood environment]. / Actividad extraescolar y obesidad en los niños. Influencia del ámbito familiar y del vecindario.

BACKGROUND: elementary school children spend little time at the school in Mexico. The aim was to investigate the activities after school time in children and to determine the presence of overweight and obesity. METHODS: one hundred and seventy two children of both sexes were included. They belonged to the first and second grade of an official primary school from a marginalized zone. Somatometry was obtained and the type of physical practice and motifs for no practice physical activity were investigated. Descriptive statistics were applied. RESULTS: the frequency of underweight was 12.1 %, overweight 19 %, and obesity 18.5 %. Sedentary activities like watching television and playing video games were the most common registered, whereas sports were the lowest physical activity practiced, especially in girls. The parents' lack of time, low family income, and the scarcity of safe spaces where children can play and practice physical activity or sports were the most related factors. CONCLUSIONS: poverty and insecurity of the neighborhoods influence the outside activities in after school time. The high frequency of underweight, overweight and obesity in school children were associated to the lack of physical activity.

Introducción: los niños de primaria en México permanecen poco tiempo en el ámbito escolar. El objetivo de este trabajo fue conocer las características somatométricas de los escolares y sus padres e investigar las actividades extraescolares que realizan y las que les gustaría realizar y la razón por la que no lo hacen. Métodos: participaron 172 niños de uno y otro sexo, de primer y segundo año de una escuela primaria oficial de una colonia marginada. Resultados: la frecuencia de bajo peso fue de 12.1 %; de sobrepeso, de 19 % y de obesidad, de 18.5 %. Las actividades sedentarias como ver la televisión y los videojuegos fueron las más altas y las deportivas las más bajas, principalmente en las niñas. La falta de tiempo de los padres, los bajos recursos económicos de la familia y la falta de espacios seguros donde los niños puedan jugar y realizar actividades físicas y deportivas fueron los factores más importantes. Conclusiones: la pobreza y la inseguridad del barrio determinan las actividades extraescolares. La alta frecuencia de bajo peso, el sobrepeso y la obesidad en los escolares se relacionaron con la falta de actividad física.

[Food consumption in and around the school]. / Consumo alimentario dentro y fuera de la escuela.

BACKGROUND: elementary school students usually stay in school 4.5 hours a day in Mexico. The main food consumption is outside school. The objective was to explore behaviors on food consumption beyond the school environment. METHODS: descriptive trial that included 173 children, both sexes, from public elementary school in Mexico City. Eating habits were obtained through questionnaire and anthropometric characteristics from physical measurement. RESULTS: participants reported to consume soft drinks and canned juices at high frequency and quantity (80 %) and low consumption of animal foods. They also eat industrialized dairy products with high caloric content and low in protein. Moreover, 30 % of children eat 4 or 5 times a day, whereas 10 % eat one or two times a day. These results were associated with the somatometric characteristics of the children, 37.6 % of whom presented as overweight or obese while 12 % were underweight. CONCLUSIONS: it is necessary that health education involves teachers, parents and children in programs for obesity prevention with the objective of increasing healthy behaviors.

Introducción: en México, los niños de primaria permanecen aproximadamente 4.5 horas en la escuela, por lo que fuera de ese espacio es donde consumen la mayor parte de sus alimentos. El objetivo de esta investigación fue explorar las conductas alimentarias más allá del entorno escolar que pudieran favorecer la obesidad. Métodos: estudio descriptivo de niños de una escuela primaria oficial en el Distrito Federal. Los hábitos alimentarios se conocieron por un cuestionario y las características antropométricas, por medición física. Resultados: los participantes indicaron consumir refrescos y jugos enlatados con alta frecuencia y en cantidades importantes (80 %), así como productos lácteos industrializados con alto valor calórico y bajo contenido de proteínas; ingerían pocos alimentos de origen animal; 30 % comía cuatro o cinco veces al día y 10 %, una o dos veces. Los resultados se asociaron con las características omatométricas de los niños, 37.6 % de los cuales presentó sobrepeso u obesidad y 12 %, bajo peso. Conclusiones: para la prevención de la obesidad son necesarios programas de educación que involucren a profesores, padres de familia y escolares, para obtener conductas saludables y preservar la salud.

[Obesity or overweight and metabolic syndrome in Mexico City teenagers]. / Exceso de peso y síndrome metabólico en adolescentes de la Ciudad de México.

UNLABELLED: aim: To know the metabolic syndrome and its components prevalence in Mexico City adolescents sample. DESIGN: A cross-sectional survey was conducted in 772 men and 1078 women, 12 to 16 years old, from 8 randomly selected public junior high schools in Mexico City. METHODS: Anthropometric variables, lipids, lipoproteins, Apo AI and B, glucose and insulin were determined. RESULTS: Prevalence of metabolic syndrome was 12.5%, 11.15% in men and 13.5% en women (p ns). The most frequently metabolic syndrome component found in México City adolescents was low HDL-C levels (38%), followed by hypertriglyceridemia (25.5%), hypertension (19.2%), central obesity (11.8%) and elevated fasting glucose (1.7). Except by the hypertriglyceridemia, higher in woman than in men, 28.2% vs. 21.6%, p < 0.001, the prevalence of metabolic syndrome components was similar between males and females. CONCLUSIONS: The high prevalence of biochemical and physiological factors of metabolic syndrome, associated with overweight and obesity in Mexico City adolescents, increases the risk of premature development of coronary atherosclerosis and diabetes mellitus in this population.

Exceso de peso y síndrome metabólico en adolescentes de la Ciudad de México / Obesity or overweight and metabolic syndrome in Mexico City teenagers

Objetivo: Conocer la prevalencia del síndrome metabólico y sus componentes en una muestra de adolescentes de la Ciudad de México. Diseño: Se efectuó un estudio transversal en 772 varones y 1,078 mujeres de 12 a 16 años edad, en ocho escuelas secundarias de la Ciudad de México seleccionadas al azar. Métodos: Se realizaron medidas antropométricas, lípidos y lipoproteínas, Apo-AI y B, glucosa e insulina. Resultados: La prevalencia del síndrome metabólico fue de 12.5%, 11.5% en los varones y 13.5% en las mujeres (p = ns). La concentración baja de colesterol en las HDL fue el componente del síndrome metabólico más frecuente (38%), seguido de triglicéridos elevados (25.5%), hipertensión arterial (19.2%), obesidad central (11.8%) y glucosa en ayuno elevada (1.7%). Excepto por la hipertrigliceridemia, 28.2% en las mujeres y 21.6% en los varones (p < 0.001), la prevalencia de los componentes del síndrome metabólico fue similar en ambos géneros. Conclusiones: La prevalencia elevada de componentes bioquímicos y fisiológicos del síndrome metabólico, asociada con el sobrepeso y la obesidad en los adolescentes de la Ciudad de México, incrementa el riesgo en este grupo de la población de desarrollar de manera prematura ateroesclerosis coronaria y diabetes mellitus.

Aim: To know the metabolic syndrome and its components prevalence in Mexico City adolescents sample. Design: A cross-sectional survey was conducted in 772 men and 1078 women, 12 to 16 years old, from 8 randomly selected public junior high schools in Mexico City. Methods: Anthropometric variables, lipids, lipoproteins, Apo AI and B, glucose and insulin were determined. Results: Prevalence of metabolic syndrome was 12.5%, 11.15% in men and 13.5% en women (p ns). The most frequently metabolic syndrome component found in México City adolescents was low HDL-C levels (38%), followed by hypertriglyceridemia (25.5%), hypertension (19.2%), central obesity (11.8%) and elevated fasting glucose (1.7). Except by the hypertriglyceridemia, higher in woman than in men, 28.2% vs. 21.6%, p < 0.001, the prevalence of metabolic syndrome components was similar between males and females. Conclusions: The high prevalence of biochemical and physiological factors of metabolic syndrome, associated with overweight and obesity in Mexico City adolescents, increases the risk of premature development of coronary atherosclerosis and diabetes mellitus in this population.

Blood pressure and associated cardiovascular risk factors in adolescents of Mexico City / Tensión arterial y su asociación con factores de riesgo cardiovascular en adolescentes de

OBJECTIVE: To determine the prevalence of high blood pressure and associated cardiovascular risk factors in Mexican adolescents. METHODS: A cross-sectional study was conducted in 770 male and 1076 female students (12 to 16 years old) from eight randomly selected high schools in Mexico City. Anthropometry, blood pressure and fasting lipids and lipoproteins were measured. RESULTS: Blood pressure levels were adjusted for age, gender, and height. The prevalence rates of hypertension (systolic blood pressure (SBP) and/or diastolic (DBP) > or =95th percentile), and pre-hypertension (SBP or DBP > or =90th but <95th percentile) were 10.6 and 10%, respectively. Compared to normotensive subjects, those with high blood pressure showed a significantly higher prevalence of obesity, overweight, and dyslipidemia. A stepwise multiple regression analysis showed that waist (18.3%), Tanner stage (4.7%), age (2.1%), gender (0.6%), and body mass index (BMI, 0.3%) accounted for 26% of the variance in SBP; whereas BMI (8.7%), age (4.8%), Tanner stage (1.7%), waist (0.4%), and gender (0.4%) accounted for 15.9% of the variance in DBP. CONCLUSIONS: These results reveal a high prevalence of high blood pressure in adolescents living in Mexico City. Prehypertensive and hypertensive subjects showed a higher prevalence of cardiovascular risk factors, suggesting that, as adults, these adolescents will be at a higher risk of developing cardiovascular disease.

Blood pressure and associated cardiovascular risk factors in adolescents of Mexico City.

OBJECTIVE: To determine the prevalence of high blood pressure and associated cardiovascular risk factors in Mexican adolescents. METHODS: A cross-sectional study was conducted in 770 male and 1076 female students (12 to 16 years old) from eight randomly selected high schools in Mexico City. Anthropometry, blood pressure and fasting lipids and lipoproteins were measured. RESULTS: Blood pressure levels were adjusted for age, gender, and height. The prevalence rates of hypertension (systolic blood pressure (SBP) and/or diastolic (DBP) > or =95th percentile), and pre-hypertension (SBP or DBP > or =90th but <95th percentile) were 10.6 and 10%, respectively. Compared to normotensive subjects, those with high blood pressure showed a significantly higher prevalence of obesity, overweight, and dyslipidemia. A stepwise multiple regression analysis showed that waist (18.3%), Tanner stage (4.7%), age (2.1%), gender (0.6%), and body mass index (BMI, 0.3%) accounted for 26% of the variance in SBP; whereas BMI (8.7%), age (4.8%), Tanner stage (1.7%), waist (0.4%), and gender (0.4%) accounted for 15.9% of the variance in DBP. CONCLUSIONS: These results reveal a high prevalence of high blood pressure in adolescents living in Mexico City. Prehypertensive and hypertensive subjects showed a higher prevalence of cardiovascular risk factors, suggesting that, as adults, these adolescents will be at a higher risk of developing cardiovascular disease.

[Tobacco smoking in urban and rural adolescents and its association with individual and familiar characteristics]. / Tabaquismo en adolescentes del medio urbano y rural. Caracteristicas individuales y familiares asociadas.

OBJECTIVE: The purpose was to estimate the prevalence of smoking in adolescents and its association with some individual and family characteristics in urban and rural areas. METHODS: An analytic cross-sectional study was carried out in 3161 junior high school students, of eight public and two private urban schools and three public rural schools. Some student behaviors on tobacco use, patterns of smoking and alcohol consumption in the family and socioeconomic status were measured. RESULTS: The prevalence of smoking increased with age. In private urban schools, women had a higher prevalence that males (27.6 % vs. 19.3 %). In rural area schools was higher in males (9.9 % vs. 3.5 %). Individual characteristics associated with smoking were: the curiosity to smoke (OR = 9.7, CI 95 % = 5.8-16.3), having experienced with smoking (OR = 26, CI 95% = 12-56.6) and alcohol consumption (OR = 2.9, CI 95 % = 2.1-3.9). The family characteristics that influence adolescent smoking were the presence of smoking habit in the father (OR = 1.5, CI 95% = 1.1-2) or in the brother or sister (OR = 2, CI 95 % = 1.3-3). The parents living together (OR = 0.6, CI 95 % = 0.4-0.9) was a protective factor. CONCLUSIONS: The exploratory behavior of the adolescent and the patterns of tobacco use and alcohol consumption in the family influenced the adoption of this habit.

Lipid and lipoprotein profiles and prevalence of dyslipidemia in Mexican adolescents.

The objective of the study was to determine the prevalence of different forms of dyslipidemia in an urban population of Mexican adolescents. A cross-sectional study was conducted in 1846 students from 8 randomly selected public junior high schools in Mexico City. Anthropometry, blood pressure, and 12-hour fasting lipids and lipoproteins were measured. We studied 770 male and 1076 female adolescents (13.2 +/- 1 years). The most prevalent dyslipidemia was low high-density lipoprotein cholesterol (HDL-C) (<35 mg/dL) either combined with other abnormalities (17.5% for male and 12.9% for female subjects, P < .001) or isolated (13.5% and 9.6% for male and female subjects, respectively, P < .001). Obese subjects showed the highest prevalence of low HDL-C (47.2% for male and 34.4% for female subjects) and of high total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) (19.4%, 27.8%, and 36.1%, respectively, for male subjects; 9.8%, 13.1%, and 24.6%, respectively, for female subjects). Multiple regression analysis showed that waist circumference was negatively associated with HDL-C and positively associated with LDL-C and TG levels, whereas Tanner stages were negatively associated but sex was positively associated with total cholesterol, LDL-C, and TG concentrations. As in Mexican adults, low HDL-C and high TG levels were the most prevalent dyslipidemias. Increased blood lipids over long periods suggest that, as adults, these adolescents will be facing a higher risk for atherosclerosis.

Prevalence and interrelations of cardiovascular risk factors in urban and rural Mexican adolescents.

PURPOSE: To examine the prevalence of coronary risk factors in Mexican adolescents, and their relations to school type, gender, and residence in urban and rural areas. METHODS: A cross-sectional survey was conducted in 3121 junior high school students, aged 12 to 16 years, attending urban schools (eight public, n = 1850, two private, n = 480) and three rural public (n = 791) schools. Weight, height, waist circumference, blood pressure, and fasting glucose and lipid-lipoprotein levels were measured. Tobacco smoking and physical activity were also ascertained. The prevalence rates of cardiovascular risk factors were determined by gender and school type. RESULTS: Obesity, overweight, high blood pressure, cigarette smoking, and physical inactivity were higher for urban than rural adolescents. The prevalence of the low HDL-C level was exceedingly high in adolescents of three school types (> 30%) but particularly in male rural students (48.9%). Compared with rural students, high LDL-cholesterol was twice as high in private schoolchildren. The prevalence of impaired fasting glucose was .35% in the whole population and much higher in obese males (1.6%) and obese females (2.4%). CONCLUSIONS: Our findings highlight an epidemic of coronary risk factors mainly in adolescents living in the urban area, suggesting the importance of environmental factors.

[Trends of 6 primary causes of mortality in Mexican children in 1971-2000. Epidemiologic transition in children]. / Tendencia de seis principales causas de mortalidad en niños mexicanos durante el periodo 1971-2000. La transición epidemiológica en los niños.

OBJECTIVE: To determine trends of six main causes of mortality in Mexican children < 15 years of age. TYPE OF STUDY: Observational, descriptive and retrospective. STUDY PERIOD: January 1, 1971 to December 31, 2000. Studied Population: Children < 15 years of age, Statistic Analysis: mortality rates were obtained due to perinatal causes, respiratory infections, intestinal infections, accidents, congenital malformations (CM), and cancer (CA). They were stratified according to age groups in < 1 year, 1 to 4 years, 5 to 14 years, and 1 to 14 years of age. Percentage differences were calculated between 1971 and 2000, as were respective trends. RESULTS: Global decrease in mortality was according to age group, 83.5% in 0 to 14-year-old, 71.3% in under one year old, 90.5 in 1 to 4-years-old, 79.2% in 5 to 14-year-old. The largest decrease in all groups was observed for infectious causes (> 90%), and increased CM between 120.1 to 160.5%, and CA between 28.0 to 56.4%. CONCLUSIONS: Mortality in Mexican children has decreased significantly. Infectious causes show the most important reduction, the CM and CA showing largest increase. Accidents, although they reveal some tendency to decrease, are first cause of death in the group 1 to 14 years of age. Present data indicate the need to continue programs to provide care for infections diseases, and to establish new programs that include care for accidents, CM, and CA in children.

Prevalence of high blood pressure and associated coronary risk factors in an adult population of Mexico city

Background. Several studies have addressed arterial hypertension prevalence in Mexico. However, few include an anlysis of other types of hypertension and their associated risk factors. The present work describes the prevalence of high blood pressure (HBP), isolated systolic hypertension (ISH) and diastolic hypertension (DH) and their association to certain risk factors of cardiovascular disease in an adult population of Mexico City. Methods. A cross-sectional study was performed on 825 subjects age between 20 and 90 years, selected by multistage cluster sampling. HBP was diagnosed by previous history if systolic blood pressure was =140 mmHg and/or diastolic blood pressure =90 mmHg. The measurements taken included body mass index, waist-to-hip ratio, systolic and diastolic blood pressure, levels of insulin, glucose, triglycerides, total cholesterol, high and low density hipoprotein cholesterol, and lipoprotein(a). Results. Prevalence adjusted by age for HBP was 19.4 percent, for ISH, 4.7 percent, and for DH, 4.1 percent. Age had an important influence on HBP and ISH with highly significant X²t. The profile of metabolic variables was modified according to sex and type of hypertension. Thus, in DH, metabolic variables were more affected than in other types of hypertension. Conclusions. Results in HBP prevalence in the present study were lower than in other surveys performed in Mexico. It must be noted, however, that much care should be taken to choose the strategy of subject selection, since results of the prevalence of a disease depend on it to a great extent. The ISH and DH and their association to risk factor must be studied thoroughly because they constitute different clinical entities

Maternal infertility and ultrasonography exposure during pregnanacy as associated risk factors of congenital heart disease

Introducción. Objetivo. Determinar la asociación entre la infertilidad materna y exposición a ultrasonografía (USG) con el desarrollo de cardiopatías congénitas. Material y métodos. Diseño de la investigaicón: estudio de casos y controles, tipo prolectivo. Sitio de estudio: Hospital de Pediatría del Centro Médico Nacional Siglo XXI. Pacientes: se estudiaron 142 casos y 171 controles, los casos fueron incidentes y prevalentes, los controles se obtuvieron del mismo hospital de donde se obtuvieron los casos. Como instrumento de medición se aplicó un cuestionario precodificado, con las diferentes variables de estudio. Se calculó la razón de momios (RM), así como los intervalos de confianza al 95 por ciento (IC 95 por ciento), y se controlaron las variables de confusión utilizando regresión logística no condicionada. Resultados. Se encontró que el antecedente de infertilidad tuvo una RM de 4.38 (IC 95 por ciento = 0.81-43.71), la exposición de USG de 1.53 (IC 95 por ciento = 0.92-2.54), la cual aumentó cuando se realizó durante el primer trimestre del embarazo (RM=2.08; IC 95 por ciento = 0.89-4.98) y la tendencia, según trimestre de exposición, fue estadísticamente significativa (P=0.03). El antecedente de amenaza de aborto tuvo una RM 2.22 (IC 95 por ciento = 1.03-5.0). La RM ajustada para la infertilidad materna fue de 4.10 (IC 95 por ciento =0.81-20.6) y para USG de 1.47 (IC 95 por ciento = 0.90-2.38). Conclusiones. La infertilidad materna, la exposición a USG durante el embarazo y la amenaza de aborto se asocian al desarrollo de cardiopatías congénitas en niños

Factores de riesgo para el desarrollo de tumores de células germinales en niños / Risk factors for germinal cell tumor development in children

Determinar los factores de riesgo para el desarrollo de tumor de células germinales (TCG) en hijos residentes del Distrito Federal (DF). Estudio observacional, prolectivo, de casos y controles, en niños menores de 15 años, derechohabientes del Instituto Mexicano del Seguro Social y residentes en el DF. La población de estudio se seleccionó del primero de enero de 1990 al 31 de diciembre de 1994. A los padres de los pacientes se les aplicó un cuestionario de 230 preguntas, precodificado y validado con anterioridad mediante un estudio piloto. Para el análisis se obtuvieron las frecuencias simples de las diferentes variables y como medida de asociación se calculó la razón de momios (OR) y el intervalo de confianza al 95 por ciento (IC95 por ciento). Se obtuvieron 21 casos y 105 controles. Como factores de riesgo significativos se encontró a la concepción en invierno (OR= 7.6, IC95 por ciento 1.5-39.3=0.007); la menor escolaridad de los padres (OR= 2.9m IC95 por ciento 1.1-7.5; P=0.026); la exposición en el padre a polvos y electricidad antes del embarazo (OR-26, IC95 por ciento 2.28-1291.86; P=0.0007), durante(OR=8.58, IC95 por ciento 0.89-106.5; P=0.05) y después del embarazo (OR=9.66, IC95 por ciento 0.99- 1202; P=0.027). Se observó con un efecto protector a los cuadro infecciosos de repetición en la primera infancia. Se incluye que el mayor riesgo con la concepción en invierno apoya una teoría infecciosa en el desarrollo de TCG; también se resalta la importancia de la menor educación y la exposición a agentes físicos en el padre así como el hallazgo de los factores de protección

Lipoprotein(a) and cardiovascular risk in adult Mexicans

De 1991 a 1992 se realizó un estudio epidemiológico transversal en una muestra aleatoria de la población adulta de la ciuda de México en la que se analizaron los factores de riesgo de enfermedad arterial coronaria (EAC). La concentración plasmática de lipoproteína(A) (Lp(a)) se midió por ELISA en 404 hombres y 311 mujeres de 20 a 90 años de edad. La mediana de Lp(a) fue de 6.9 mg/dL y la prevalencia de valores elevados (> 30 mg/dL) de 14 por ciento. El nivel de Lp(a) correlacionó positivamente con el de colesterol total (rs = 0.16) y con el colesterol de lipoproteína de baja densidad (C-LDL) (rs = 0.21), y en forma negativa con la insulina (rs = 0.13). La insulina y el C-LDL fueron las variables que mejoro explicaron las concentraciones de Lp(a) en la población. La distribución de Lp(a) en la ciudad de México es similar a la descrita para otras poblaciones y nuestros resultados sugieren, aunque sin alcanzar significancia estadística, que las cifras elevadas de Lp(a) pudieran estar asociadas con la EAC en nuestra población

High Blood pressure and cardiovascular risk factors in an adult population of Mexico City: characteristics of the studies population

The present report is a description of the characteristics of a studied population and of the methodology used in a study performed to investigate high blood pressure prevalence and cardiovascular risk factors among the adult population of Mexico City. A cross-sectional study was conducted from January 1991 to March 1992. Random samplings of multiple stages was used and 825 adult subjects were studied in Mexico City. The following measurements were registered: blood pressure, body mass index (BMI), waist-hip ratio (WHR), total cholesterol (TC), triglycerides (TG), high density lipoproteins (HDL-C) and low density lipoproteins (LDL-C), lipoprotein(a) (Lp(a)), glucose and insulin. Personal and family history of cardiovascular illness were investigated, as well as exposure to some risk factor such as smoking, alcohol consumption and sedentarism. The response rate was 86.6 percent. The prevalence of high blood pressure was 21.1 percent, and of non-insulin dependent diabetes mellitus was 8.7 percent. Frequency of dyslipidemia in the studied sample was 24.4 percent for high TG, 23.6 percent for low HDL-C, 23.6 percent for high LDL-C, 14.9 percent for Lp(a) excess (lp(a) > or = 30 mg/dl; overweight and obesity were more prevalent among women. The diversity of living conditions among the population of Mexico City was included in the sampling strategy design, not only to register the high blood pressure (HBP) frequency in each stratum but to identify other cardiovascular risk factors which could be decisive in the development of HBP. Regarding the features of the studied population, BMI did not reveal differences among men, but their TG levels were higher and HDL levels lower than those of other populations. In women, the results obtained for BMI, WHR, lipids and lipoproteins were also higher compared with the mean reported for other populations

Factores de riesgo y exposición al plomo en niños escolares / Risk factors and lead exposition in childrens

En este trabajo se hace una revisión bibliográfica para delimitar los ámbitos epidemiológicos de la contaminación ambiental con respecto al plomo. Se parte del concepto de que el ambiente corresponde a un complejo macrosistema abierto; es por esta razón que para estudiarlo, o intervenir en él, es preciso abordarlo en forma fragmentada, dividiéndolo en sus partes: el aire, el suelo y los alimentos. Los compuestos de plomo en estos ámbitos epidemiológicos constituyen "Factores de riesgo" para el hombre, en la medida en que ejercen un efecto negativo para su salud; de aquí la importancia que tiene el eventual contacto de una persona con un compuesto de plomo, y del lapso en que se establece la exposición.