Changes in the phenylalanine ammonia lyase activity, total phenolic compounds, and flavonoids in Prosopis glandulosa treated with cadmium and copper.

The aim of the present work is to evaluate the changes on the phenylalanine ammonia lyase (PAL) activity, phenolic compounds accumulation and photochemical efficiency in leaves of P. glandulosa treated with Cd2+ (0.001 M) and Cu2+ (0.52 M) concentrations for 96 h under hydroponic conditions. The results showed that only leaves treated with copper had a decrease in photochemical efficiency and leaf epidermal polyphenols in P. glandulosa leaves after 96 h of exposure. On the other hand the reverse-phase HPLC analysis revealed higher levels of phenolic compound (gallic, vanillic and caffeic acids) and flavonoids (rutin and kaempferol-3-O-glucosides) in plant leaves from Cu and Cd-treatments with respect to control plants. Finally, highest increments in PAL activity was observed in extracts of leaves treated with Cu and Cd (about 205 and 284%), respectively, with respect to control plants after 96 h treatment. These suggest that activation of phenylpropanoid pathway represent a source of nonenzymatic antioxidants that protect at P. glandulosa against oxidative stress when exposed to cadmium and copper. Hence future studies are necessary to elucidate the participation of phenylpropanoid pathway in the reduction of metal toxicity in Prosopis species.

Anticoncepción en adolescentes mexicanos de escuelas del nivel medio superior: uso y necesidades insatisfechas / Contraception in Mexican adolescents in upper secondary schools: use and unmet needs

Resumen: Objetivo: Describir el comportamiento sexual y el uso de anticonceptivos en adolescentes escolarizados. Material y métodos: Encuesta representativa nacional en escuelas de educación media superior en México, realizada en 2014. Modelos logísticos identifican factores asociados al uso de anticonceptivos y a necesidades insatisfechas de anticoncepción (NIA). Resultados: Entre los hombres, no emplear anticonceptivos en la última relación sexual se asocia con la no utilización de éstos durante el debut sexual (RM=11.5; IC95% 5.6-23.4) y desconocer anticonceptivos efectivos (RM=2.4; IC95% 1.04-5.5). Entre las mujeres, no emplear anticonceptivos se asocia con el no uso de éstos durante el debut sexual (RM=4.5; IC95% 2.3-8.4) y la falta de autoeficacia en el uso/negociación del condón (RM=3.1; IC95% 1.18.2). Las NIA se asocian con baja autoeficacia respecto al uso/negociación del condón (RM=3.5; IC95% 1.3-9.4), no usar anticonceptivos en el debut sexual (RM=9.0; IC95% 2.5-32.4) y usar alcohol o drogas en relaciones sexuales (RM=3.0; IC95% 1.1-8.1). Conclusiones: Se requieren estrategias que garanticen el uso de anticonceptivos desde el debut sexual y que promuevan la autoeficacia y las prácticas seguras entre los adolescentes.

Abstrac: Objective: To describe sexual behavior and contraceptive use in adolescent students. Materials and methods: National representative survey in upper secondary schools in Mexico 2014. Logistic regressions identify the factors associated with contraceptive use and unmet needs for contraception (UNC). Results: For male adolescents, non-contraceptive use in the last sexual relation is associated with non-contraceptive use in the sexual debut (OR=11.5; IC95%:5.6,23.4) and not recognizing effective contraceptive methods (OR=2.4;IC95%:1.04,5.5). For female adolescents, non-contraceptive use is associated with non-contraceptive use in sexual debut (OR=4.5;IC95%:2.3,8.4) and low self-efficacy towards condom use and negotiation (OR=3.1; IC95%:1.1,8.2). UNC were associated with insecure attitudes towards condom use and negotiation (OR=3.5;IC95%:1.3,9.4), non-contraceptive use in sexual debut (OR=9.0;IC95%:2.5,32.4) and use of alcohol or drugs during sexual relations (OR=3.0;IC95%:1.1,8.1). Conclusions: Strategies to ensure contraceptive use from sexual debut onwards are required, promoting self-efficacy and safe sex practices among adolescents.

Child labor and severe functioning difficulties and disability in Mexican children and adolescents 5-17 years of age / Trabajo infantil y dificultades severas de funcionamiento y discapacidad en niños y adolescentes mexicanos de 5-17 años

Abstract: Objective: To describe the characteristics of Mexican children and adolescents 5-17 years with severe functioning difficulties and disability and explore their participation in child labor. Materials and methods: Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used logistic regression to explore the association between this condition and child labor. Results: While 11.2% of Mexicans 5-17 years-old has severe functioning difficulties or disability, 13.4% work. The functioning difficulty and disability domains with the highest prevalence are experiencing anxiety (5.4%) and depression (1.5%) daily. Children and adolescents with severe functioning difficulties and disability are 70% more likely to do child labor [OR=1.7, 95%CI:1.2,2.4]. Educational lag doubles the likelihood of doing child labor [OR=2.2, 95%CI:1.5,3.3]. Conclusions: Guaranteeing educational opportunities and respect for the rights of children with severe functioning difficulties and disability is essential to achieve development of their full potential.

Resumen: Objetivo: Describir la población mexicana de 5-17 años con problemas severos de funcionamiento y discapacidad y explorar su realización de trabajo infantil. Material y métodos: Basado en la Encuesta Nacional de Niños, Niñas y Mujeres 2015, se estimaron prevalencias de problemas de funcionamiento y discapacidad y se exploró la relación con el trabajo infantil en un modelo de regresión logística. Resultados: El 11.2% de los mexicanos de 5-17 años tiene dificultades severas de funcionamiento o discapacidad y 13.4% realiza trabajo infantil. Los ámbitos con la mayor prevalencia fueron ansiedad (5.4%) y depresión (1.5%) experimentadas diariamente. Niños y adolescentes con problemas severos de funcionamiento o discapacidad tienen 70% más posibilidades de realizar trabajo infantil [RM=1.7, IC95%:1.2,2.4]. El rezago educativo duplica las posibilidades de realizar trabajo infantil [RM=2.2, IC95%:1.5,3.3]. Conclusiones: Es imprescindible garantizar oportunidades educativas y respeto a los derechos de la población infantil con problemas de funcionamiento y discapacidad para lograr su desarrollo integral.

Prevalence of functioning difficulties and disability in Mexican adolescent women and their populational characteristics / Prevalencia de dificultades de funcionamiento y discapacidad en adolescentes mexicanas y sus características poblacionales

Abstract: Objective: Report prevalence of functioning difficulties and disabilities among Mexican adolescent women 15-17 years old and identify differences in characteristics of those with and without a functioning difficulty or disability Materials and methods: Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used chi square tests for independence and logistic regression to explore associations between this condition and various characteristics. Results: Of Mexican adolescent women 15-17 years old, 11.1% had a functioning difficulty or disability. The group of domains of functioning difficulty and disability with by far the highest prevalence was socio-emotional and behavioral functioning difficulties or disability with 8.6%. Being employed, rural residence and self-reported depression symptoms were associated with having functioning difficulties or disability. Conclusions: This survey constitutes an important initial step in collecting data on functioning difficulty and disability in Mexico although larger samples should be studied.

Resumen: Objetivo: Reportar la prevalencia de dificultades de funcionamiento y discapacidad entre mujeres adolescentes mexicanas de 15-17 años e identificar diferencias en características entre las que tienen tal condición y las que no. Material y métodos: Basado en la Encuesta Nacional de Niños, Niñas y Mujeres 2015, se estimaron prevalencias de problemas de funcionamiento y discapacidad y se exploró la relación con varias características con ji cuadrada y regresión logística. Resultados: El 11.1% de las mujeres adolescentes mexicanas de 15-17 años tuvieron dificultades de funcionamiento o discapacidad. El grupo de ámbitos de dificultades de funcionamiento y discapacidad con la mayor prevalencia fue socioemocional y comportamiento con 8.6%. Tener empleo, residencia rural y síntomas de depresión autoreportadas están asociadas con tener dificultades de funcionamiento y discapacidad. Conclusiones: Esta encuesta constituye un primer paso importante en la generación de datos sobre dificultades de funcionamiento y discapacidad en México, aunque se requiere estudiar el tema en muestras mayores.

Poly(lactic-co-glycolic acid) nanoparticles for sustained release of allyl isothiocyanate: characterization, in vitro release and biological activity.

The objective of this study is to establish the ability of entrap allyl isothiocyanate (AITC) into polymeric nanoparticles to extend its shelf life and enhance its antiproliferative properties. Natural compounds, such as AITC, have showed multi-targeting activity resulting in a wide-range spectrum of therapeutic properties in chronic and degenerative diseases, conversely with most current pharmaceutical drugs showing single targeting activity and often result in drug resistance after extended administration periods. Apparently, AITC-loaded poly(lactic-co-glycolic acid) nanoparticles (PLGA NPs) reduced AITC degradation and volatility and were able to extend AITC shelf life compared with free AITC (65% vs. 20% in 24 h, respectively). Cell viability and uptake of AITC-loaded nanoparticles were studied in vitro, showing that the protection and sustained release of AITC from polymeric NPs involved a larger toxicity of tumoral cells. These nanoparticles could be used as protective systems for enhancing a biological activity.

Educación sexual integral: cobertura, homogeneidad, integralidad y continuidad en escuelas de México / Comprehensive sexual education in Mexico: an analysis of coverage, comprehensiveness and continuity of contents in Mexican public and private schools

Resumen: Objetivo: Analizar la cobertura de la educación sexual integral (ESI) en México y describir su integralidad, homogeneidad y continuidad en cuanto a contenidos sobre salud sexual y reproductiva, autoeficacia, derechos y relaciones. Material y métodos: En una encuesta probabilística transversal con muestreo estratificado y por conglomerados, se aplicó un cuestionario sobre ESI a una muestra representativa a nivel nacional de 3 824 adolescentes de 45 escuelas de educación media superior públicas y privadas, en localidades urbanas y rurales. Resultados: El porcentaje de adolescentes que reportan recibir educación sexual integral varía dependiendo de los temas y nivel escolar. Los temas más frecuentes están relacionados con salud sexual y reproductiva; los menos tratados con derechos y relaciones. Los contenidos de educación sexual se trasmiten mayoritariamente durante la escuela secundaria. Conclusiones: Se requiere garantizar la integralidad, homogeneidad y continuidad de los contenidos de la ESI, asegurando que se imparta la totalidad de los temas planteados en recomendaciones nacionales e internacionales.

Abstract Objective: To analyze coverage of comprehensive sex education (CSE) in high schools in Mexico and describe whether it is comprehensive, homogeneous and has continuity based on student reports of exposure to topics in three dimensions: reproductive and sexual health, self-efficacy and rights and relations. Materials and methods: Within a probabilistic, cross-sectional survey with stratified, cluster sampling, a nationally representative sample of 3 824 adolescents attending 45 public and private high-schools in urban and rural areas completed questionnaires on CSE. Results: The proportion of adolescents reporting having received sex education from school personnel varies depending on topics and grade level. Topics most frequently covered are those related to sexual and reproductive health while rights and relations are least frequently dealt with. Most sex education topics are covered during junior high school and much less frequently in elementary or high school. Conclusions: CSE needs to be comprehensive and homogenous in terms of content, ensure inclusion of priority topics, meet national and international recommendations, ensure continuity and adapt contents to student age through all education levels.

Bases metodológicas y resultados de la implementación de la Encuesta Nacional de Niños, Niñas y Mujeres en México 2015 / Methodological bases and implementation results of Mexico's National Survey of Children and Women 2015

Resumen: Objetivo: Describir la metodología y los resultados del levantamiento de la Encuesta Nacional de Niños, Niñas y Mujeres en México (ENIM 2015). Material y métodos: La ENIM 2015 es una encuesta probabilística con muestreo polietápico, estratificado y por conglomerados, con representatividad regional, por estratos rural y urbano, y para la población indígena. Se aplicaron cuestionarios para obtener información sobre el hogar, mujeres de 15 a 49 años, niños y niñas menores de cinco años y niños y niñas y adolescentes de 5 a 17 años. Resultados: La tasa de respuesta en hogares y en mujeres fue de 94%; se obtuvo información de 10 760 hogares y 12 110 mujeres; para los niños y niñas y adolescentes y niños y niñas menores de cinco años, estos valores fueron de 98%, 11 607 y 8 066, respectivamente. Conclusión: El diseño probabilístico de la ENIM 2015 permite generar indicadores que se pueden desagregar en cinco regiones, para los estratos rural y urbano y para la población indígena, así como una línea base para 15 indicadores de los ODS.

Abstract: Objective: To describe the methodology and the implementation survey results from National Survey of Children and Women Mexico's (ENIM 2015). Materials and methods: The ENIM 2015 is a probability survey with multistage, stratified and cluster sample, with regional, rural and urban strata, and indigenous population representation.We applied questionnaires to get information from the household, women aged 15 to 49 years, children under five years and children and adolescents aged 5-17 years. Results: The response rate for households and women was 94%, obtaining information from 10 760 households and 12 110 women; while for children and adolescents and children under five years was 98%, 11 607 and 8 066, respectively. Conclusion: The ENIM 2015 probabilistic design allows generate indicators that can be stratified into five regions, rural and urban strata and from indigenous population, as well as a baseline for 15 indicators of the ODS.

Analysis of a suppressive subtractive hybridization library of Alternaria alternata resistant to 2-propenyl isothiocyanate

Background Isothiocyanates (ITCs) are natural products obtained from plants of the Brassicas family. They represent an environmentally friendly alternative for the control of phytopathogenic fungi. However, as it has been observed with synthetic fungicides, the possibility of inducing ITC-resistant strains is a major concern. It is, therefore, essential to understanding the molecular mechanisms of fungal resistance to ITCs. We analyzed a subtractive library containing 180 clones of an Alternaria alternata strain resistant to 2-propenyl ITC (2-pITC). After their sequencing, 141 expressed sequence tags (ESTs) were identified using the BlastX algorithm. The sequence assembly was carried out using CAP3 software; the functional annotation and metabolic pathways identification were performed using the Blast2GO program. Results The bioinformatics analysis revealed 124 reads with similarities to proteins involved in transcriptional control, defense and stress pathways, cell wall integrity maintenance, detoxification, organization and cytoskeleton destabilization; exocytosis, transport, DNA damage control, ribosome maintenance, and RNA processing. In addition, transcripts corresponding to enzymes as oxidoreductases, transferases, hydrolases, lyases, and ligases, were detected. Degradation pathways for styrene, aminobenzoate, and toluene were induced, as well as the biosynthesis of phenylpropanoid and several types of N-glycan. Conclusions The fungal response showed that natural compounds could induce tolerance/resistance mechanisms in organisms in the same manner as synthetic chemical products. The response of A. alternata to the toxicity of 2-pITC is a sophisticated phenomenon including the induction of signaling cascades targeting a broad set of cellular processes. Whole-transcriptome approaches are needed to elucidate completely the fungal response to 2-pITC.

Efecto antifúngico de extractos fenólicos y de carotenoides de chiltepín (Capsicum annum var. glabriusculum) en Alternaria alternata y Fusarium oxysporum / Antifungal effect of phenolic and carotenoids extracts from chiltepin (Capsicum annum var. glabriusculum) on Alternaria alternata and Fusarium oxysporum

En el presente estudio se evaluó el efecto de extractos fenólicos y de carotenoides procedentes de frutos de chiltepín sobre el crecimiento micelial y la germinación de conidios de Alternaria alternata y Fusarium oxysporum, 2 importantes hongos causantes de podredumbres en frutas y hortalizas. Los extractos fenólicos presentaron una inhibición en el crecimiento micelial de A. alternata del 38,46 %, y redujeron significativamente la germinación de conidios al quinto día después del tratamiento al 92 % en relación al control. No se observaron cambios significativos en el crecimiento micelial de F. oxysporum, pero sí se redujo significativamente al 85 % en relación al control, el número de conidios germinados a los 5 días de tratamiento. Los extractos de carotenoides mostraron una inhibición del 38,5 % en el crecimiento micelial y del 85,3 % en la germinación de conidios de A. alternata, 5 días después del tratamiento. Frente a F. oxysporum, dichos extractos presentaron menor inhibición del crecimiento micelial (20,3 %), mientras que hubo una mayor inhibición en la germinación de conidios (96 %). Los extractos fenólicos y de carotenoides de chiltepín pueden ser una alternativa promisoria de importancia agrícola como fungicidas naturales.

The effect of phenolic and carotenoid extracts from chiltepin fruits on mycelial growth and the inhibition of conidial germination of Alternaria alternata and Fusarium oxysporum were investigated in the present work. Phenolic extracts inhibited mycelial growth of A. alternata by 38.46%, and significantly reduced conidial germination on the fifth day after treatment to 92% in relation to control. No significant changes were observed in the inhibition of mycelial growth in Fusarium oxysporum; however, the number of germinated conidia was reduced, showing 85% inhibition five days after treatment in relation to control. Moreover, carotenoid extracts showed 38.5% inhibition of mycelial growth and 85.3% inhibition of conidial germination of A. alternata, five days after treatment. Carotenoid extracts showed less inhibition of mycelial growth (20.3%) in F. oxysporum, with respect to A. alternata; while there was greater inhibition of conidial germination (96%) on the fifth day after treatment. Phenolic and carotenoid extracts from chiltepin may be a promising alternative as a natural fungicide against fungi of agricultural importance.

Specimen self-collection and HPV DNA screening in a pilot study of 100,242 women.

Since cervical cancer remains common in Mexico despite an established cytology screening program, the Ministry of Health recently introduced pilot front-line HPV testing into the Mexican cervical cancer screening program (CCSP). Here, we present the key field performance metrics of this population-based study. High-risk HPV DNA (hrHPV) testing was conducted on self-collected vaginal specimens from 100,242 women aged 25-75 years residing in Morelos State. All hrHPV positive women and a random sample of 3.2% (n = 2,864) of hrHPV negative participants were referred for colposcopic examination. The main disease endpoint of interest was cervical intraepithelial neoplasia grade 2 or higher (CIN2+). We calculated relative risk, positive predictive value and negative predictive value adjusted for screening test verification bias. The overall prevalence of hrHPV was 10.8% (95% CI 10.6-11.0). Women positive for hrHPV had a relative risk of 15.7 for histologically detectable CIN2+. The adjusted positive predictive value of the hrHPV test was 2.4% (95% CI 2.1-2.7); whereas the adjusted negative predictive value was 99.8% (95% CI 99.8-99.9). These findings suggest that large-scale vaginal hrHPV testing in a middle-income country can identify women at greater risk of advanced cervical abnormalities in a programmatically meaningful way but care is warranted to ensure that disease not detectable at colposcopy is kept to a minimum. PASS shows areas that need improvement and sets the stage for wider use of hrHPV screening of self-collected vaginal specimens in Mexico.

Overcoming barriers to HPV vaccination: non-inferiority of antibody response to human papillomavirus 16/18 vaccine in adolescents vaccinated with a two-dose vs. a three-dose schedule at 21 months.

For middle and low-income countries, the cost of HPV vaccines remains challenging. We conducted an open-label nonrandomized clinical trial evaluating immune response to the HPV-16/18 AS04-adjuvanted vaccine administered on a standard (months (M) 0-1-6) versus extended schedule (M 0-6-60) at 7, 21, 60, 72 and 120 months post-vaccination. Participants were females recruited in Morelos, Mexico: 474 girls aged 9-10 years and 500 women aged 18-24 years receiving a standard schedule, and 1026 girls aged 9-10 years receiving an extended schedule (currently the girls in the extended schedule had received only the first 2 doses). This report presents the interim analysis results for non-inferiority between the regimes conducted with the current available data at 21 months after the first dose, with serum antibodies assessed by ELISA. A pre-stated margin of non-inferiority was defined by post-vaccination geometric mean titer (GMT) ratio (upper 95% confidence interval [CI]≤2.0) between the standard and the two-dose schedule in girls at month 21. Immune response to the vaccine was strongest in adolescent girls and in the 3-dose group. Statistical non-inferiority of the two-dose versus three-dose groups was demonstrated. At 21 months, comparing the adolescent 2-dose versus 3-dose groups, the GMT ratio and 95% CI were 1.66 (1.55-1.81) and 1.67 (1.51-1.86) for HPV16 and 18, respectively. The two-dose regimen was non-inferior when compared to the three-dose response in same-age girls and with women aged 18-24 years after 21 months of follow-up. The reduction in the number of doses from the current three-dose schedule may lower overall costs associated with the vaccination and increase accessibility and compliance with the recommended dosing of the HPV vaccine.

Cervical cancer screening in the US-Mexico border region: a binational analysis.

Cervical cancer mortality is high along the US-Mexico border. We describe the prevalence of a recent Papanicolaou screening test (Pap) among US and Mexican border women. We analyzed 2006 cross-sectional data from Mexico's National Survey of Health and Nutrition and the US Behavioral Risk Factor Surveillance System. Women aged 20-77 years in 44 US border counties (n = 1,724) and 80 Mexican border municipios (n = 1,454) were studied. We computed weighted proportions for a Pap within the past year by age, education, employment, marital status, health insurance, health status, risk behaviors, and ethnicity and adjusted prevalence ratios (APR) for the US, Mexico, and the region overall. Sixty-five percent (95 %CI 60.3-68.6) of US women and 32 % (95 %CI 28.7-35.2) of Mexican women had a recent Pap. US residence (APR = 2.01, 95 %CI 1.74-2.33), marriage (APR = 1.31, 95 %CI 1.17-1.47) and insurance (APR = 1.38, 95 %CI 1.22-1.56) were positively associated with a Pap test. Among US women, insurance and marriage were associated (APR = 1.21, 95 %CI 1.05-1.38 and 1.33, 95 %CI 1.10-1.61, respectively), and women aged 20-34 years were about 25 % more likely to have received a test than older women. Insurance and marriage were also positively associated with Pap testing among Mexican women (APR = 1.39, 95 %CI 1.17-1.64 and 1.50; 95 %CI 1.23-1.82, respectively), as were lower levels of education (≤8th grade or 9th-12th grade versus some college) (APR = 1.74; 95 %CI 1.21-2.52 and 1.60; 95 %CI 1.03-2.49, respectively). Marriage and insurance were associated with a recent Pap test on both sides of the border. Binational insurance coverage increases and/or cost reductions might bolster testing among unmarried and uninsured women, leading to earlier cervical cancer diagnosis and potentially lower mortality.

[Obesity in Mexico: epidemiology and health policies for its control and prevention]. / Obesidad en México: epidemiología y políticas desalud para su control y prevención.

Obesity is a major risk factor for developing type 2 diabetes, cardiovascular disease, hypertension, dyslipidemias, musculoskeletal diseases, and certain types of cancer. In Mexico the prevalence of overweight and obesity is 16.7% in preschool children, 26.2% in school children, and 30.9% in adolescents. For adults, the prevalence of overweight and obesity is 39.7 and 29.9%, respectively (ENSANUT 2006). Based on an analysis of the situation in Mexico, the need for a comprehensive, multisectoral, multilevel policy and an effective coordination policy have been clearly identified to achieve changes in eating patterns and physical activity to enable the prevention of chronic diseases and to reduce the prevalence of overweight and obesity The combination of strategies and actions of the Mexican National Agreement for Healthy Nutrition proposed by the federal government proposes among its aims for 2012: a reversal in the prevalence of overweight and obesity for children aged 2-5 years in comparison with ENSANUT to stop the increasing prevalence in this condition for school children and adolescents (aged 5-19 years), and to slow down the increasing prevalence of overweight and obesity in adults. This challenge will require important regulatory actions, efficient and adaptable implementation, and participation of all sectors of society.

Methodology for the analysis of type 2 diabetes, metabolic syndrome and cardiovascular disease risk indicators in the ENSANUT 2006 / Metodologia para el análisis de diabetes tipo 2, síndrome metabólico e indicadores de riesgo cerdiovascular en la ENSANUT 2006

OBJECTIVE: To describe: a) the methods used to quantify biochemical indicators of Type 2 Diabetes (T2D), and other cardiovascular risk indicators in the Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006) and b) compare the sub-sample with the non-selected participants in diverse socio-demographic, anthropometric and health characteristics. MATERIAL AND METHODS: A sub-sample of 6 021 fasting adult participants was randomly selected from the total fasting participants (n=39 425). We compared diverse socio-demographic, anthropometric and health parameters between this sub-sample and the rest of the participants. RESULTS: No differences were found in sociodemographics characteristics, except age, between the sub-sample and from the rest of the fasting adults. In addition no difference were found between prevalences of overweight and obesity, central obesity, and previously diagnosed high blood pressure, T2D or hypertrigliceridemia. CONCLUSIONS: The randomly selected sub-sample was not essentially different from the rest of the fasting subjects. Thus, no bias is expected in the interpretation of cardiovascular risk indicators derived from these data.

OBJETIVO: Describir: a) los métodos usados para definir Diabetes tipo 2 (T2D), y otros indicadores de riesgo cardiovascular en la submuestra de la Encuesta Nacional de Salud y Nutrición 2006 (ENSANUT 2006) y b) comparar en características sociodemográficas, antropométricas y otros determinantes de salud a los participantes de la submuestra con los no seleccionados. MATERIAL Y MÉTODOS: Una submuestra de 6 021 adultos fue seleccionada aleatoriamente de la totalidad de participantes en ayuno (n= 39 425). Se compararon parámetros sociodemográficos, antropométricos y de salud entre la submuestra y el resto de los participantes. RESULTADOS: No se encontraron diferencias en ninguna de las variables sociodemográficas, a excepción de la edad; ni en la prevalencia de sobrepeso, obesidad abdominal, diagnóstico previo de hipertensión, T2D, hipercolestrolemia e hipertrigliceridemia entre los adultos de la submuestra y los no seleccionados. CONCLUSIONES: La submuestra no fue estadísticamente diferente del resto de los sujetos no seleccionados. Por ello, no se espera un sesgo en la interpretación de los indicadores de riesgo cardiovascular derivados del análisis de estos datos.

Metabolic syndrome in Mexican adults: results from the National Health and Nutrition Survey 2006 / Síndrome metabólico en adultos mexicanos: resultados de la Encuesta Nacional de Salud y Nutrición 2006

OBJECTIVE: To examine the prevalence of metabolic syndrome (MS) and its associated risk factors in Mexican adults aged 20 years or older, using data derived from the National Health and Nutrition Survey 2006 (ENSANUT 2006). MATERIAL AND METHODS: The ENSANUT 2006 was conducted between October 2005 and May 2006. Questionnaires were administered to 45 446 adult subjects aged 20 years or older who were residents from urban and rural areas. Anthropometric and blood pressure measurements were obtained from all subjects and fasting blood specimens were provided by 30 percent of participants. We randomly selected a sub-sample of 6 613 from which laboratory measurements were carried out for glucose, insulin, triglycerides, total cholesterol and HDL-cholesterol. For this analysis, we included only results from eight or more hours of fasting samples (n=6 021). We used individual weighted factors in the statistical analysis and considered the survey's complex sampling design to obtain variances and confidence intervals. All analyses were done using SPSS 15.0. RESULTS: In accordance with definitions by the National Cholesterol Education Program Adult Treatment Panel III (ATP III), the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI), and the International Diabetes Federation (IDF), the prevalence of MS in Mexican adults aged 20 years or older was 36.8, 41.6 and 49.8 percent, respectively. Women were more affected than men due to the higher prevalence of central obesity among females. Prevalence of MS increased with age and was higher among populations living in metropolitan areas, in the west-central region, and those with lower education. DISCUSSION: Regardless of the MS definition, a large proportion of Mexican adults has the condition, so preventive measures are needed to decrease the prevalence of the MS components in this population. MS can predict type 2 diabetes and cardiovascular disease, two of the main causes ...

OBJETIVO: Describir la prevalencia de síndrome metabólico (SM) y los factores asociados en población mexicana de 20 años y más de edad a partir de datos de la Encuesta Nacional de Salud y Nutrición 2006 (ENSANUT 2006). MATERIAL Y MÉTODOS: La ENSANut 2006 se realizó entre octubre de 2005 y mayo de 2006. Se entrevistó a 45446 adultos de 20 años y más residentes de localidades rurales y urbanas. A todos ellos se les tomaron medidas antropométricas y de tensión arterial. Al 30 por ciento de los adultos entrevistados se les tomó una muestra de sangre, preferentemente en ayunas. Se seleccionó al azar una submuestra de 6613 individuos para la determinación de glucosa, insulina, triglicéridos, colesterol total y colesterol HDL. Para el análisis de laboratorio sólo se incluyeron las muestras obtenidas en ayuno de 8 horas o más (n=6021). Se utilizaron las definiciones de SM publicadas por el ATP III, modificada por la American Heart Association; National Heart, Lung and Blood Institute (AHA/NHLBI) y la International Diabetes Federation (IDF). Para el análisis estadístico se utilizaron los factores de expansión individuales y para el cálculo de las varianzas e intervalos de confianza se tomó en consideración el diseño complejo de la encuesta usando SPSS 15.0. RESULTADOS: La prevalencia nacional de SM en adultos de 20 años de edad y más, de acuerdo con el ATP III, AHA/NHLBI e IDF fue de 36.8, 41.6 y 49.8 por ciento, respectivamente. Con las tres definiciones, la prevalencia fue mayor en las mujeres que en los hombres, debido principalmente al mayor porcentaje de obesidad en las mujeres. La prevalencia de SM aumentó conforme a la edad y fue ligeramente mayor en la población residente de las áreas metropolitanas, en la región centro-occidente y con el menor nivel de escolaridad. DISCUSIÓN: Independientemente de la definición utilizada, una gran proporción de mexicanos presenta SM, el cual es considerado como predictor de diabetes tipo 2 y enfermedad ...

Prevalence and distribution of type 2 diabetes mellitus in Mexican adult population: a probabilistic survey / Prevalencia y distribuición de la diabetes mellitus tipo 2 en población adulta mexicana: una encuesta probabilística

OBJECTIVE: To describe the prevalence, distribution and degree of control of type 2 diabetes (T2D) in Mexican population. MATERIAL AND METHODS: Subjects were classified as previously diagnosed T2D (PD); or as "finding of the survey" (FS) (glucose >126 mg/dL). Hemoglobin A1c was measured in PD-subjects. RESULTS: The prevalence for PD-T2D was 7.34 percent (95 percentCI 6.3, 8.5) and for FS 7.07 percent (95 percentCI 6.1, 8.1), summing 14.42 percent; (7.3 million diabetics). 5.3 percent of PD-T2D were in good, 38.4 percent in poor and 56.2 percent very poor control. Older age (OR=0.96, 95 percentCI 0.94, 0.97), lower BMI (OR=0.95, 95 percentCI 0.91, 1.0), were protective for poor control. Affiliation to private services (OR=1.77, 95 percentCI 0.98, 3.13), larger T2D duration (OR=1.05, 95 percentCI 1.01, 1.08), and combining oral medication and insulin (OR=16.1, 95 percentCI 1.61, 161) were riskier. CONCLUSIONS: We found an alarming prevalence of T2D in Mexican population; the majority of PD diabetics are in poor control. Research on the latter is warranted.

OBJETIVO: Describir la prevalencia, distribución y grado de control de diabetes tipo 2 (DT2) en población mexicana. MATERIAL Y MÉTODOS: Los sujetos fueron clasificados como "previamente diagnosticados" (PD) o "hallazgos de la encuesta" (FS) (glucosa >126 mg/dL). La hemoglobina A1c se midió en DT2-PD. RESULTADOS: La prevalencia de DT2-PD fue 7.34 por ciento (IC95 por ciento 6.3, 8.5) y 7.07 por ciento.(IC95 por ciento 6.1, 8.1) para FS, sumando 14.42 por ciento (7.3 millones de diabéticos). Los DT2-PD tenían 5.3 por ciento control bueno, 38.4 por ciento, malo y 56.2 por ciento muy malo. Tener mayor edad (RM=0.96, IC95 por ciento 0.95, 0.97) o IMC más bajo (RM=0.95, IC95 por ciento 0.91, 1.0) fueron protectores contra mal control. Atenderse en servicios médicos privados (RM=1.77, IC95 por ciento 0.98, 3.13), larga duración de DT2 (RM=1.05, IC95 por ciento 1.01, 1.08) o recibir hipoglucemiantes más insulina (RM=16.1, IC95 por ciento 1.61, 161) fueron de riesgo. CONCLUSIONES: Existe una prevalencia alarmante de DT2 en la población mexicana, la mayoría de los PD-DT2 tenían mal control glicémico. Se necesita más investigación sobre este problema.

Early-onset type 2 diabetes in a Mexican survey: results from the National Health and Nutrition Survey 2006 / Diabetes tipo 2 de inicio temprano en una encuesta nacional: resultados de la Encuesta Nacional de Salud y Nutrición 2006

OBJECTIVE: To describe the characteristics of patients with type 2 diabetes diagnosed before age 40 (early-onset type 2 diabetes) identified in a nation-wide, population-based study. MATERIALS AND METHODS: The survey was done in Mexico during 2006. Medical history, anthropometric and biochemical measurements were obtained in every subject. RESULTS: Cases diagnosed before (n=181) and after age 40 (n=659) were included. Early-onset type 2 diabetes was present in 13.1 percent of the previously diagnosed, 30.3 percent of the cases identified during the survey and 21.5 percent of the whole population with diabetes. These individuals had a greater prevalence of obesity and hypertriglyceridemia compared to the cases diagnosed after age 40. CONCLUSIONS: Early-onset type 2 diabetes was present in 21.5 percent of patients with type 2 diabetes in Mexico. Close to 70 percent of them were obese or overweight and had the clinical profile of the metabolic syndrome.

OBJETIVO: Describir las características de los pacientes con diabetes diagnosticados antes de los 40 años en una encuesta representativa de la población mexicana. MATERIAL Y MÉTODOS: La encuesta fue realizada en México durante 2006. Se registró la historia médica, mediciones antropométricas y bioquímicas de los participantes. RESULTADOS: Se incluyeron casos diagnosticados antes (n=181) y después (n=659) de los 40 años. La diabetes tipo 2 de inicio temprano está presente en 13.1 por ciento de los casos previamente diagnosticados, 30.3 por ciento de los identificados durante la encuesta y en 21.5 por ciento de la población total con diabetes. En los casos diagnosticados antes de los 40 años hay una prevalencia mayor de obesidad e hipertrigliceridemia que en los diagnosticados después de los 40. CONCLUSIONES: La diabetes de aparición temprana está presente en 21.5 por ciento de los casos con diabetes en México. Setenta por ciento de ellos tenían un peso mayor al saludable y tenían el perfil clínico del síndrome metabólico.

Prevalence of dyslipidemias in the Mexican National Health and Nutrition Survey 2006 / Prevalencia de las dislipidemias en la Encuesta Nacional de Salud y Nutrición 2006

OBJECTIVE: To describe the prevalence of lipid abnormalities found in the Mexican National Health and Nutrition Survey 2006 (ENSANut 2006). MATERIAL AND METHODS: Information was obtained from 4 040 subjects aged 20 to 69 years, studied after a 9- to 12-hour fast. RESULTS: Median lipid concentrations were: cholesterol 198.5 mg/dl, triglycerides 139.6 mg/dl, HDL-cholesterol 39.0 mg/dl, non-HDL-cholesterol 159.5 mg/dl and LDL-cholesterol 131.5 mg/dl. The most frequent abnormality was HDL-cholesterol below 40 mg/dl with a prevalence of 60.5 percent (95 percentCI 58.2-62.8 percent). Hypercholesterolemia (> 200 mg/dl) had a frequency of abnormality of 43.6 percent (95 percentCI 41.4-46.0 percent). Only 8.6 percent of the hypercholesterolemic subjects knew their diagnosis. Hypertriglyceridemia (> 150 mg/dl) was observed in 31.5 percent (IC 95 percent 29.3-33.9 percent) of the population. CONLUSIONS: The ENSANUT 2006 data confirm that the prevalence of hypoalphalipoproteinemia and other forms of dyslipidemia in Mexican adults is very high.

OBJETIVO: Presentar la prevalencia de las dislipidemias observada en la Encuesta Nacional de Salud y Nutrición 2006 (ENSANUT 2006). MATERIAL Y MÉTODOS: Se incluyeron 4040 individuos con edad entre 20 y 69 años estudiados bajo un ayuno de 9 a 12 horas. RESULTADOS: Las concentraciones medias de los lípidos sanguíneos fueron colesterol 198.5 mg/dl, triglicéridos 139.6 mg/dl, colesterol HDL 39.0 mg/dl, colesterol noHDL 159.5 mg/dl y colesterol LDL 131.5 mg/dl. La anormalidad más común fue la hipoalfalipoproteinemia (colesterol HDL< 40 mg/dl); su prevalencia fue 60.5 por ciento (IC95 por ciento 58.2-62.8 por ciento). La hipercolesterolemia (colesterol > 200 mg/dl) fue la segunda anormalidad en frecuencia, con 43.6 por ciento (IC95 por ciento 41.4-46.0 por ciento). Sólo el 8.6 por ciento de los casos conocía su diagnóstico. La hipertrigliceridemia (> 150 mg/dl) fue observada en 31.5 por ciento (IC95 por ciento 29.3-33.9 por ciento) de la población en estudio. CONCLUSIONES: Los datos de la ENSANUT 2006 confirman que la prevalencia de hipoalfalipoproteinemia y otras formas de dislipidemia es muy alta en los adultos mexicanos.

Prevention of cardiovascular disease based on lipid lowering treatment: a challenge for the Mexican health system / Prevención de la enfermedad cardiovascular basada en tratamiento hipolipemiante: un reto para el sistema de salud de México

OBJECTIVE: To estimate the percentage of Mexican adults that may require lipid-lowering treatment according to National Cholesterol Education Program-III guidelines, using data from the National Health and Nutrition Survey 2006 (ENSANut 2006). MATERIAL AND METHODS: Information was obtained from 4 040 subjects aged 20 to 69 years, studied after a 9 to 12 hours fast. RESULTS: A cardiovascular risk equivalent was found in 13.8 percent and >2 risk factors were present in 31.5 percent of the population. LDL-C concentrations were above the treatment goal in 70 percent of the high-risk group and in 38.6 percent of subjects with >2 risk factors. Nearly 12 million Mexicans should be taught how to change their lifestyles and close to 8 million individuals require drug therapy to decrease their cardiovascular risk. CONCLUSIONS: Thirty percent of Mexican adults require some form of lipid-lowering treatment (lifestyle modifications in 36.25 percent, drug therapy in 24.19 percent).

OBJETIVO: Calcular el porcentaje de adultos que requiere tratamiento hipolipemiante de acuerdo con las recomendaciones del Programa Nacional de Educación en Colesterol-III, usando los datos de la Encuesta Nacional de Salud y Nutrición 2006. MATERIAL Y MÉTODOS: Se incluyeron 4040 individuos con edad entre 20 y 69 años estudiados bajo un ayuno de 9 a 12 horas. RESULTADOS: Un equivalente de enfermedad cardiovascular fue identificado en 13.8 por ciento de los participantes. El 31.5 por ciento de la población tenía >2 factores de riesgo cardiovascular. La concentración de colesterol LDL estuvo arriba de la meta terapéutica en 70 por ciento de los casos con alto riesgo cardiovascular y en el 38.6 por ciento de los sujetos con >2 factores de riesgo. Cerca de 12 millones de mexicanos deben modificar su estilo de vida para reducir su concentración de colesterol LDL. Casi 8 millones califican para recibir tratamiento farmacológico. CONCLUSIONES: Una tercera parte de los adultos requiere alguna forma de tratamiento hipolipemiante (cambios en el estilo de vida: 36.25 por ciento, medicamentos: 24.19 por ciento).

Trends for type 2 diabetes and other cardiovascular risk factors in Mexico from 1993-2006 / Tendencia en la prevalencia de diabetes tipo 2 y otros indicadores de riesgo cardiovascular en México entre 1993-2006

OBJECTIVE: To describe the trends in the prevalence of type 2 diabetes (T2D), and other cardiovascular risk factors in three national health surveys (1993, 2000 and 2006). MATERIALS AND METHODS: The databases of three surveys: ENEC 1993, ENSA 2000 and ENSANUT 2006 were gathered. Calculations of published data were reprocessed to do appropriate adjustments to assure comparability among surveys. RESULTS: From 1993 to 2006 the prevalence of type 2 diabetes (6.7-14.4 percent), metabolic syndrome (26.6-36.8 percent), hypertension (23.8-30.7 percent), hypercholesterolemia (27-43.6 percent), and high LDL-cholesterol (31.6-46 percent) increased rapidly. The prevalence of low HDL cholesterol was very high (60.5-63 percent) in all surveys and remained remarkably unchanged among surveys. CONCLUSIONS: This increasing trends for the prevalence of T2D and cardiovascular risk factors predicts larger increments in the near future for T2D and cardiovascular morbidity and mortality. Intensification of the preventive and remedy strategies is mandatory in order curve the foreseen dramatic increment in the disease burden.

OBJETIVO: Describir las tendencias en la prevalencia de diabetes tipo 2 (T2D), y otros factores de riesgo cardiovascular como las dislipidemias y la hipertensión en tres encuestas nacionales de salud (1993, 2000 y 2006). MATERIAL Y MÉTODOS: Las bases de datos de ENEC 1993, ENSA 2000 y ENSANUT 2006 fueron reprocesados para asegurar la comparabilidad entre las encuestas. RESULTADOS: Entre 1993 y 2006 la prevalencia de T2D (6.7-14.4 por ciento), síndrome metabólico (26.6-36.8 por ciento), hipertensión (23.8-30.7 por ciento), hipercolesterolemia (27-43.6 por ciento), y LDL-colesterol alto (31.6-46 por ciento) aumentaron rápidamente. La prevalencia de concentraciones bajas de HDL-colesterol fue muy alta (60.5-63 por ciento) en todas las encuestas, manteniéndose esencialmente sin cambios. CONCLUSIÓN: La tendencias crecientes en las prevalencias de T2D y factores de riesgo cardiovascular predicen que a corto plazo habrá importantes incrementos en la morbilidad y mortalidad asociada a la T2D y enfermedades cardiovasculares, por lo que deben intensificarse las estrategias para prevenir y reducir los incrementos dramáticos previstos en la carga de enfermedad.