RESUMEN
OBJECTIVE: We sought to define plasma homocysteine reference values in healthy individuals in the Canary Islands and to determine its relations to folate and vitamin B12 intakes and concentrations. DESIGN: Cross-sectional study. SETTING: Population-based representative sample of 557 participants, aged 18-65 years, from the Canary Islands Nutrition Survey (ENCA). SUBJECTS: All participants completed two 24-h dietary recalls and a general questionnaire collecting socio-demographic and health-related lifestyle information. INTERVENTIONS: Plasma homocysteine and serum vitamin B12 levels were measured by immunoassay, whereas folate levels through an automated ionic capturing method. RESULTS: Median plasma homocysteine was 11.9 micromol/l, higher in men (13.1 micromol/l) than in women (10.9 micromol/l) (P<0.001) and positively associated with age in both sexes (P<0.001). The prevalence of hyperhomocysteinaemia (> or = 15 micromol/l), 21.4%, was also greater in men (32.2%) than in women (13.4%). There were significant negative correlations between plasma homocysteine and serum (r=-0.32, P<0.001) and erythrocyte (r=-0.26, P<0.001) folate, as well as serum vitamin B12 (r=-0.28, P<0.001) concentrations. When divided in quartiles of vitamin intakes or concentrations, men with the lowest vitamin B12 and folate serum values had significantly higher plasma homocysteine concentrations than those in the other three quartiles. In women, hyperhomocysteinaemia was higher in the lowest quartiles of folate intake and serum and erythrocyte folate concentrations. CONCLUSIONS: These data provide further evidence that hyperhomocysteinaemia is a sensitive marker of inadequate folate and vitamin B12 status, allowing for the identification of those with greatest need for nutritional interventions.
Asunto(s)
Dieta , Ácido Fólico/administración & dosificación , Homocisteína/sangre , Hiperhomocisteinemia/epidemiología , Vitamina B 12/administración & dosificación , Adolescente , Adulto , Factores de Edad , Anciano , Biomarcadores , Estudios Transversales , Eritrocitos/química , Femenino , Ácido Fólico/metabolismo , Humanos , Hiperhomocisteinemia/sangre , Estilo de Vida , Masculino , Recuerdo Mental , Persona de Mediana Edad , Encuestas Nutricionales , Prevalencia , Valores de Referencia , Factores Sexuales , España/epidemiología , Encuestas y Cuestionarios , Vitamina B 12/metabolismoRESUMEN
OBJECTIVE: To analyze the prevalence of infection, the frequency of HCV genotypes and the epidemiology characteristics among the patients in hemodialysis treatment in one 25 years old hospital hemodialysis center and one 15 years old secondary unit by a transversal cross-section study in 1998. PATIENTS AND METHODS: 171 hemodialyzed-patients were studied. Patients sera were analyzed by the presence of HCV antibodies anti-VHC by a enzymoimmunoassay (Abbott Cientifica) and the presence of antibodies was confirmed by a line immunoassay (Inno-LIA HCV AbIII) and by the presence of VHC-RNA by reverse transcriptase PCR (Cobas Amplicor HCV). Genotypes were determinate by reverse hybridization (Inno-LIA HCV III). RESULTS: Fifty (29.2%) of the patients were HCV antibody positive. Forty-five (26.3%) were HCV-RNA positive, all of them with antibodies positive. The distribution of genotypes was: 1b, 34 (75.5%); 4f, 4 (8.9%); 1a, 3 (6.7%); 1, 3 (6.7%) and 1 case could not be typed (2.2%). In 14 patients (28.0%), seroconversions were documented Twenty-one patients (42.0%) were diagnosed when the routine tests were available and 15 patients (30.0%) were diagnosed pre-dialysis. The multivariate analysis showed that the risk of HCV infection was greater for patients who had been more 8 years on dialysis (OR: 6.22; 95% CI: 1.24-31.07). CONCLUSIONS: Data presented indicate that the prevalence of HCV infections in our hemodialysis units and the number of seroconversions were high and the HCV subtype 1b was more frequent; because of this, the screening by both serological and molecular methods is necessary, at least twice a year, to identify all the infected patients. Besides, we think that is necessary to increase the control of the completion of the Universal Precautions.
Asunto(s)
Unidades de Hemodiálisis en Hospital/estadística & datos numéricos , Anticuerpos contra la Hepatitis C/sangre , Hepatitis C/epidemiología , Estudios Transversales , Femenino , Genotipo , Hepacivirus/genética , Hepacivirus/inmunología , Humanos , Masculino , ARN Viral/análisis , Análisis de Regresión , Estudios Seroepidemiológicos , España/epidemiologíaRESUMEN
El carcinoma hepatocelular (CHC) es el más frecuente de los cánceres primitivos de hígado y desde su descubrimiento, la alfa fetoproteína (AFP) ha sido el marcador de elección para su diagnóstico y seguimiento. En base a obtener información valiosa sobre la rentabilidad diagnóstica del marcador, en cuanto a sus niveles y circunstancias de comorbilidad, se realizó un estudio de tipo retrospectivo en el área de referencia del Hospital Nuestra Señora del Pino de Las Palmas de Gran Canaria. Para ello se utilizaron los datos del laboratorio, exportados en un fichero en código ASCII, e implementados con datos demográficos y clínicos obtenidos del fichero maestro de pacientes del Hospital.Se realizaron 346 determinaciones a 159 pacientes. De ellos, 11 presentaban CHC (6 asociados con cirrosis y 4 con hepatitis), 75 cirrosis hepática (4 asociados con hepatitis), 64 presentaban otros procesos tumorales, 2 cáncer secundario de hígado y 7 otros diagnósticos. El 45 por ciento de los casos de CHC tenían niveles de AFP > 50 ng/ml y el 36.5 por ciento AFP > 500 ng/ml, frente al 5.2 por ciento y 1.3 por ciento respectivamente para los casos de cirrosis hepática. La utilización de bases de datos relacionales constituye un método eficaz, rápido y rentable en términos económicos para obtener información sobre problemas clínicos seleccionados. Abreviaturas: CHC, carcinoma hepatocelular; AFP, alfa fetoproteína; VHB, virus de la hepatitis B; VHC, virus de la hepatitis C; CH, cirrosis hepática; CEA, antígeno carcinoembrionario. (AU)