RESUMO
La historia familiar (HF) de Enfermedades Crónicas no Transmisibles (ECNT), aumentaría el riesgo de síndrome metabólico (SM). En Chile, el SM afecta al 27% de niños con sobrepeso, y la hiperglicemia de ayuno (HA) es el trastorno menos prevalente (4.0%). El objetivo fue estudiar la prevalencia del SM y de los factores de riesgo cardiovascular (FRCV) en niños con sobrepeso e HF de ECNT analizando su asociación con el número de parientes afectados y con la historia parental (HP). En 183 niños con IMC ≥p85 de 11,8 ± 1,8 años (86 varones) e HF (padres y/o abuelos) de ECNT, se evaluó el z IMC (CDC / NCHS), el perímetro de cintura, la presión arterial, la glicemia, la insulina, los triglicéridos y el colesterol-HDL. El SM y los FRCV fueron diagnosticados por el criterio de Cook y la insulinoresistencia (IR) por el HOMA-IR. Se utilizaron Chi², ANOVA, t Student y Willcoxon. La HF de DM2, hipertensión arterial y dislipidemia fue de 81,4 %, 88,0 % y 71,6 % respectivamente. La prevalencia del SM fue de 46,5%, asociándose a la magnitud del sobrepeso y a la HP de ECNT. La prevalencia de hipertrigliceridemia y de hiperglicemia de ayuno fueron de 54,6% y 31,4% respectivamente. No hubo asociación entre el número de parientes con HF y el perfil cardiovascular y metabólico del niño. Se concluye, que la HF de ECNT, se asocia a una mayor prevalencia del SM, de dislipidemia y de hiperglicemia de ayuno que la observada en población general de niños con sobrepeso.
Metabolic syndrome prevalence in Chilean children and adolescent with family history of chronic noncommunicable diseases. . Family history (FH+) of non transmisible chronic diseases (NTCD) increase MetS risk. In Chile, the MetS affects 27% of overweight children, and fasting hyperglycemia is very low prevalent (4,0%). The objective was to study the prevalence of MetS and the cardiovascular risk factors (CVRF) in overweight children with a family background of NTCD and analyze its association with the number of relatives witth NTCD and with parental history (PH). In 183 overweight children (BMI ≥p85) mean age 11,8 ± 1,8 (86 males) with a FH+ (parental or grandparental) of NTCD, were assessed the BMI z (CDC / NCHS), waist circumference, blood arterial pressure, fasting Glucose and Insulin (RIA), triglycerides, HDL chol. The MetS and the CVRF were diagnosed using the Cook phenotype and the insulin resistance (IR) through the HOMA-IR. Chi², ANOVA, t Student and Willcoxon test were performed. The frequency of FH+ of DM2, hypertension and dyslipidemia were 81,4 %, 88,0 % and 71,6 % respectively. The MeTS prevalence was 46,5 % associated to overweight magnitude an parental history of NTCD. The prevalence of hypertriglyceridemia was 54,6%, while fasting hyperglycemia affected 31,4% of the sample. There was no association between number of relatives with NTCD and CV risk profile. We conclude that in overweight children with FH+ of NTCD, the prevalence of MetS, dyslipidemia and fasting hyperglycemia are significantly higher, than those observed in the general population of obese children.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Doenças Cardiovasculares/genética , Hipoglicemia/epidemiologia , Síndrome Metabólica/epidemiologia , Glicemia/análise , Doença Crônica , Chile/epidemiologia , Colesterol/sangue , Complicações do Diabetes , Suscetibilidade a Doenças , Dislipidemias/epidemiologia , Família , Resistência à Insulina/fisiologia , Anamnese , Sobrepeso/complicações , Prevalência , Fatores de RiscoRESUMO
AIM: To measure the glucose and insulin responses of a standard dry pasta and a dry pasta enriched with egg in their long and short presentation. MATERIAL AND METHODS: The glycemic index (GI) and the insulin index (II) were determined in a randomized, cross over protocol in 10 healthy volunteers between 26 and 58 years of age. Each subject underwent ten tests: six with the standard meal (bread) and four with the study pastas. Every study pasta was evaluated 10 times. Blood glucose and insulin levels were measured in the fasted state and over the 180 min following commencement of consumption of the foods. The Area Under the Curve (AUC) was calculated for the values above baseline for the 3-hour period following the meal. GI and II were calculated as the ratio of glucose and insulin Auks for a given test meal and the AUCs for the standard meal. RESULTS: Both type of pasta in their long and short presentation had lower GI than the standard meal (long pasta A: 47.8+/-54.4 percent, pasta B: 58.6+/-95.4 percent; short pasta A:71.4+/-32.8, pasta B: 79.9+/-47.6 percent percent p<.001). The II was lower with the two type of large pasta compare to the standard meal and to the two type of short pasta (p<.005). CONCLUSIONS: This study has shown that dry pasta with or without addition of egg put in the mass, is low Gl food. Long dry pasta has lower insulin response.
Introducción: Las pastas secas (industrializadas) se caracterizan por ser manufacturadas a base de harina dura de trigo y otros cereales, llamado semolina, a diferencia del pan que se prepara con harina fina, lo que supone que la respuesta insulinémica y glicémica debiera ser menor que la del pan. Objetivo: Medir la respuesta glicémica e insulinsulinémica de una pasta seca estándar y una pasta seca enriquecida con huevo, de presentación larga (espagueti) y corta (corbata). Material y Métodos: El índice glicémico (IG) e índice insulinémico (II) se determinaron en 10 sujetos sanos entre 26 y 58 años de edad. En forma aleatoria a cada sujeto se le midió la glicemia e insulina en ayuno y después de ingerir en forma isoglucídica alimento estándar (pan marraqueta) o los 2 tipos de pasta en presentación larga o corta a los 15,45,60,90,120,150 y 180 minutos. Posteriormente se calculó el área bajo la curva (ABC) de glucosa e insulina en cada sujeto. Los IG e II fueron calculados como la razón entre el ABC para un alimento de prueba dado y el ABC del alimento estándar (considerado el 100 por ciento). RESULTADOS : Ambos tipos de pasta en presentación larga y corta presentaron menor IG que el alimento estándar (marraqueta) ( pasta larga A: 47,8+/-54,4, pasta larga B: 58,6+/-95,4 por ciento; pasta corta A:71,4+/-32,8 por ciento, pasta corta B: 79,9+/-4,.6 por ciento p<001). El II de los dos tipos de pasta larga fue menor que el alimento estándar y los mismos tipos de pasta, pero cortas (p<.005). El II de las pastas cortas no se diferenció del alimento estándar. Conclusión: Este estudio demostró que las pastas secas con o sin adición de huevo tienen una menor respuesta glicémica que el alimento estándar, por lo tanto, se pueden clasificar como alimento de bajo IG. Además las pastas de presentación larga tienen una menor respuesta insulinémica.
Assuntos
Humanos , Masculino , Feminino , Adulto , Índice Glicêmico , Massas Alimentícias , Doenças Cardiovasculares , Diabetes Mellitus , Intolerância à Glucose , Estresse OxidativoRESUMO
Nutritional status of vitamin D has regained importance in the last few years because its deficiency is highly prevalent, and because, apart from its well known effects on bone metabolism, this vitamin participates in cellular proliferation and differentiation and muscle strength and balance, among other effects. The active molecule is 1,25(OH)2D, but serum concentration of total 25 OH vitamin D (i.e. including ergocalciferol or vitamin D2 plus chole calciferol or vitamin D3) is the preferred indicator of vitamin D status. Recent evidences suggest the need to increase dietary recommendations in adults up to 1,000 IU/day. However, in deficiency states it is often necessary to supplement with pharmaceutical preparations, which contain higher doses of this vitamin since the amounts previously employed were not able to return levels to normal. In the present article we present the entire list of vitamin D preparations commercially available in Chile. The difficulty of choosing the most adequate product for an individual patient becomes clear, because there are only few formulations containing more than 800IU and, in addition they are usually combined with calcium, biphosphonates or multiple minerals and other vitamins.
El estado nutricional de vitamina D ha cobrado importancia en los últimos a±os debido a que su deficiencia es altamente prevalente, y además por sus conocidos efectos en el metabolismo óseo, participa en la diferenciación y proliferación celular, función muscular y equilibrio, entre otros. La molécula activa es la 1,25(OH)2D, pero se recomienda medir niveles séricos de 25 OH vitamina D total (es decir la suma de ergocalciferol o vitamina D2 y colecalciferol o vitamina D3), como reflejo del status de vitamina D. La evidencia actual sugiere la necesidad de elevar las recomendaciones para la ingesta dietaria en adultos, hasta cifras cercanas a 1.000 Ul/día. Sin embargo en casos de deficiencia puede ser necesario utilizar suplementos farmacéuticos conteniendo dosis superiores de esta vitamina, por cuanto aquellas utilizadas en el pasado no lograban corregir el déficit. En este artículo se presenta un listado de los preparados comerciales que contienen vitamina D disponibles en Chile. Al analizarlo se pone de mamfiesto la dificultad que representa elegir el preparado más adecuado para corregir la deficiencia en un paciente individual, debido a que son pocas las preparaciones que contienen más de 800 UI, además de que habitualmente se encuentra en asociación con calcio, bifosfonatos o múltiples otros minerales y vitaminas.
Assuntos
Humanos , Colecalciferol/administração & dosagem , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/dietoterapia , Deficiência de Vitamina D/tratamento farmacológico , Ergocalciferóis/administração & dosagem , Chile , Colecalciferol/análise , Suplementos Nutricionais , Ergocalciferóis/análise , Hidroxicolecalciferóis/análiseRESUMO
BACKGROUND: In Chile between 1986 and 1998, the prevalence of obesity has increased from 4.6% to 24% in prepuberal and from 2.3% to 17% in puberal children. AIM: To assess the prevalence of metabolic syndrome (MS) in a sample of obese and overweight Chilean children. PATIENTS AND METHODS: Descriptive study in 489 children (273 females), aged from 6 to 16 years, consulting in an obesity program. Body mass index, Tanner puberal development, waist circumference, blood pressure, fasting blood glucose, insulin and lipid levels were measured. Insulin sensitivity was calculated using the mathematical models QUICKI and HOMA. MS was diagnosed when three or more of the following criteria were met: a waist circumference over percentile 90, a blood pressure over percentile 90, serum triglycerides over 110 mg/dl, HDL cholesterol of less than 40 mg/dl or a fasting blood glucose level over 100 mg/dl. RESULTS: MS was present in 4% of children with overweight and 30% of obese children. No differences in prevalence were observed for sex or puberal development. The most prevalent cardiovascular risk factors were abdominal obesity, present in 76% of the sample and high triclycerides levels in 39%. The less prevalent risk factor was a fasting blood glucose over 100 mg/dl in 3.7%. The risk for MS increased ten fold in children with severe obesity, compared with those with overweight. Those with abdominal obesity had a 17 times higher risk of MS. Basal insulin sensitivity was significantly associated with the number of cardiovascular risk factors and the presence of MS. CONCLUSIONS: In this sample of children, fat distribution and the severity of obesity were strong determinants of MS. Waist circumference had a higher impact on MS than body mass index.
Assuntos
Resistência à Insulina , Síndrome Metabólica/epidemiologia , Estado Nutricional/fisiologia , Obesidade/epidemiologia , Gordura Abdominal , Adolescente , Glicemia , Distribuição da Gordura Corporal , Índice de Massa Corporal , Criança , Chile/epidemiologia , Métodos Epidemiológicos , Feminino , Homeostase , Humanos , Masculino , Ambulatório Hospitalar , Fenótipo , Relação Cintura-QuadrilRESUMO
Background: In Chile between 1986 and 1998, the prevalence of obesity has increased from 4.6 percent to 24 percent in prepuberal and from 2.3 percent to 17 percent in puberal children. Aim: To assess the prevalence of metabolic syndrome (MS) in a sample of obese and overweight Chilean children. Patients and methods: Descriptive study in 489 children (273 females), aged from 6 to 16 years, consulting in an obesity program. Body mass index, Tanner puberal development, waist circumference, blood pressure, fasting blood glucose, insulin and lipid levels were measured. Insulin sensitivity was calculated using the mathematical models QUICKI and HOMA. MS was diagnosed when three or more of the following criteria were met: a waist circumference over percentile 90, a blood pressure over percentile 90, serum triglycerides over 110 mg/dl, HDL cholesterol of less than 40 mg/dl or a fasting blood glucose level over 100 mg/dl. Results: MS was present in 4 percent of children with overweight and 30 percent of obese children. No differences in prevalence were observed for sex or puberal development. The most prevalent cardiovascular risk factors were abdominal obesity, present in 76 percent of the sample and high triclycerides levels in 39 percent. The less prevalent risk factor was a fasting blood glucose over 100 mg/dl in 3.7 percent. The risk for MS increased ten fold in children with severe obesity, compared with those with overweight. Those with abdominal obesity had a 17 times higher risk of MS. Basal insulin sensitivity was significantly associated with the number of cardiovascular risk factors and the presence of MS. Conclusions: In this sample of children, fat distribution and the severity of obesity were strong determinants of MS. Waist circumference had a higher impact on MS than body mass index.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Resistência à Insulina , Síndrome Metabólica/epidemiologia , Estado Nutricional/fisiologia , Obesidade/epidemiologia , Gordura Abdominal , Glicemia , Distribuição da Gordura Corporal , Índice de Massa Corporal , Chile/epidemiologia , Métodos Epidemiológicos , Homeostase , Ambulatório Hospitalar , Fenótipo , Relação Cintura-QuadrilRESUMO
Backgrounds: There is a high prevalence of obesity and hyperinsulinism among Chilean prepuberal children. Aim: To evaluate insulin sensitivity (IS) using fasting insulin, the Homeostasis Model Assessment (HOMA) and quantitative insulin-sensitivity check index (QUICKI) in Chilean children. Material and Methods: Body mass index (BMI), total body fat percentage ( percentTBF) using the sum of 4 skin folds, abdominal obesity determined through waist circumference (WC), pubertal maturation using five Tanner stages, fasting glucose (Glu) and insulin (Ins), were measured in 354 children aged 6 to 15 years (173 males). IS was evaluated using HOMA and QUICKI. Results: IS was strongly associated with percentTBF and WC. Ins, HOMA and QUICKI were significantly correlated with BMI (r =0.412; 0.405 y -0.442, respectively), percentTBF (r =0.370; 0.367 y -0.394, respectively), and WC (r =0.452; 0.446 y -0.481, respectively). Ins and HOMA increased and QUICKI decreased significantly (p <0.0001) with age. Children in a similar Tanner stage did not have differences in Ins, HOMA and QUICKI. No differences in Ins, HOMA and QUICKI were observed between children in Tanner stages 1 and 2. However, children in Tanner stages 1 and 2, had significantly lower Ins and HOMA and higher QUICKI than those in Tanner 3 to 5 stages. The highest Ins quartile for Tanner stages 1 and 2 was 10.0 æUI/dl; for Tanner stages 3 to five, the figure was 15.6 æUI/dl. Conclusions: These results confirm the relationship of IS with BMI, percentTBF, WC and pubertal maturation. IS decreases significantly and fasting Ins levels increase approximately 50 percent with puberty. This fact must be considered for the diagnosis of hyperinsulinism and insulin resistance in children.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Glicemia/análise , Resistência à Insulina , Insulina/sangue , Estado Nutricional , Obesidade/sangue , Puberdade/sangue , Índice de Massa Corporal , Teste de Tolerância a Glucose , Homeostase , Valores de Referência , Fatores de RiscoRESUMO
Background:Infantile obesity is associated with metabolic disturbances (hiperinsulinism, impaired glucose, dislypidemia) that determine a higher risk of type 2 diabetes, high blood pressure and atherosclerotic vascular disease in adulthood. Insulin resistance is a central mechanism of complications of obesity and is associated to body fat mass. Aim: To investigate insulin sensitivity and its association with anthropometric and metabolic variables in obese children. Patients and methods: We studied 314 children aged 6 to 15 years. Of these, 235 had a body mass index (BMI) over the 95 percentile for age and sex (classified as obese) and 79 had a normal body mass index; 161 were pre-pubescent and 153 were pubescent. Weight, height, percentage of total body fat (% TBF) using the sum of 4 skinfolds, blood pressure (BP), waist circumference (WC), basal glucose (Glu) and insulin (Ins) were measured. Insulin sensitivity (IS) was calculated with the homeostasis model assessment (HOMA) and QUICKI index. Serum lipids, postprandial Glu and Ins were measured only in obese children. Results: BMI, WC and % TBF had an inverse and significant correlation with basal IS (p <0.001). Obese children had higher BP, basal Ins, and HOMA and a lower QUICKI index, compared to normal weight children. A low basal IS was present in 58% of obese children. Obese children with low IS had higher WC, % TBF, triglycerides, total/HDL-cholesterol ratio, basal and 2-h post glucose Gli and Ins and lower HDL-cholesterol than obese children with normal IS. In prepubescent children, the risk of a low IS was 2.43 times higher with a TBF over 33%. In pubescent children, it was 2.92 times higher with a TBF over 37%. Conclusions: Low IS in prepubescent and pubescent obese children is associated with central obesity and a higher cardiovascular risk.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Resistência à Insulina , Síndrome Metabólica/diagnóstico , Obesidade/complicações , Glicemia , Pressão Sanguínea , Estudos Transversais , Síndrome Metabólica/metabolismo , Estado Nutricional , Obesidade/metabolismo , Puberdade , Fatores de Risco , Fatores SexuaisRESUMO
Se evaluó la prevalencia de bocio por palpación de la glándula tiroidea en 1296 escolares de educación básica de una zona con alta ingesta de yodo (Calama) y se comparó con la de otra zona de ingesta normal de yodo (Punta Arenas). En una sub muestra del 10 por ciento de los escolares se midió la excreción de yodo urinaria y los niveles de hormonas tiroídeas en sangre. En ambas localidades se seleccionaron aleatoriamente del comercio 148 muestras de sal para consumo humano en las que se determinó la concentración de yodo. Se encontró una prevalencia de bocio de 11,1 por ciento (10,0 por ciento en varones y 12,5 por ciento en mujeres) mayoritariamente bocio grado Ia (7,2por ciento), sin diferencias por zona (11,6 por ciento en Calama y 10,6 por ciento en Punta Arenas). La concentración de yodo en la sal de consumo humano en ambas localidades fue adecuada a la exigencia actual del Reglamento Sanitario de los Alimentos (RSA) (33,3 µgI/g sal en Calama, 34,0 en Punta Arenas). La excreción de yodo en la orina fue significativamente más alta en Calama (460 ± 190 µgI/L)que en Punta Arenas (273 ± 155). No se detectaron diferencias en los niveles de T4 y TSH (Calama 7.1 ± 1.5 y 3.3 ± 1.8 y Punta Arenas 7.2 ± 1.1 y 2.9 ± 1.2 respectivamente) en tanto que las valores de T3 en ambas localidades mostraron diferencias significativas (103.9 ± 33.1 y 145.0 ± 26.0 respectivamente, p<0.001) . Se observó sólo una tendencia al aumento de la prevalencia de bocio, con persistencia de valores elevados de yoduria en Calama, lo que sugiere una fuente de yodo extra en esta localidad, cuya procedencia desconocemos y es necesario investigar.
Goiter prevalence determined by palpation of thyroid gland was evaluated in 1296 primary school age children from an area of high iodine intake (Calama) and compared with an area of normal iodine intake (Punta Arenas). Urinary iodine excretion and plasmatic thyroid hormones were measured in 10 percent of school children. In both areas 148 samples of salt for human consumption were randomly selected to measure iodine concentration. A goiter prevalence of 11,1 percent (10,0 percent in males and 12,5 percent in females) mainly goiter grade Ia (7,2 percent), without differences per area (11,6 percent in Calama and 10,6 percent in Punta Arenas) was found. Iodine concentration in salt for human consumption at both areas was adequated according the present Food Sanitary Regulation (FSR) in Chile (33,3 (gI/g salt in Calama, and 34,0 in Punta Arenas). Urinary iodine excretion was significantly higher in Calama (460 ( 190 (g I/L) than in Punta Arenas (273 ( 155 (g I/L). No differences were detected in T4 and TSH plasma levels (Calama 7.1 ( 1.5 and 3.3 (1.8; and Punta Arenas 7.2 ( 1.1 and 2.9 ( 1.2 respectively), while T3 plasma levels were significantly higher in Punta Arenas (103.9 ( 33.1 y 145.0 ( 26.0 respectivamente, p<0.001) . Only a tendency to a higher goiter prevalence with persistent and significantly higher urinary iodine excretion in children at Calama was observed, suggesting an extra source of iodine in this area, with an unkown origen that must be investigated.
Assuntos
Humanos , Criança , Bócio/epidemiologia , Iodo , Deficiência de Iodo , Estudantes , Glândula Tireoide , Chile , Cloreto de Sódio/normas , Micronutrientes , Prevalência , Hormônios Tireóideos , Iodo/urina , Iodo/sangueRESUMO
BACKGROUND: Energy restriction (ER) extends life span in animals, by decreasing oxidative stress. AIM: To compare adiposity, metabolic variables and DNA oxidative damage, among adults, reporting a constant body weight (weight maintainers), versus those reporting a progressive increase (weight gainers). SUBJECTS AND METHODS: Clinical history, dietary recall, anthropometric measures, abdominal CT scan and fasting blood samples (to measure lipoproteins, glucose and insulin), were obtained in 44 males. These subjects were classified as weight maintainers if they had a change in weight of 3 kg or less in the last 10 years, or weight gainers, if they had a weight increment of more than 6 kg, in the same lapse. Oxidative damage was assessed by 8-hydroxydeoxyguanosine (8-OHdG), in DNA extracted from circulating lymphocytes, in 5 weight maintainers, 8 weight gainers and 5 healthy elders. RESULTS: Energy Intake was 18% higher in weight gainers (p <0.01). Adiposity and central fat were higher among weight gainers (p <0.01). Abdominal fat correlated with serum lipoproteins, glucose and insulin sensitivity, assessed by the Homeostasis Model Assessment (HOMA). 8-OHdG levels did not differ between groups. CONCLUSIONS: The analysis of weight change based on the clinical history correlates with actual body composition, thus it may be a reliable indicator of long term energy Intake. This method could be comparable to weight clamp models employed in animals to study aging.
Assuntos
Adulto , Animais , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Animais , Composição Corporal , Peso Corporal , Restrição Calórica , Tecido Adiposo/metabolismo , Dano ao DNA , Doenças Cardiovasculares/etiologia , Estresse Oxidativo , Fatores de Risco , Aumento de PesoRESUMO
La insuficiencia hepática (IH) crónica altera la mineralización ósea (MO) de acuerdo a la etiología de la IH, debido a los problemas nutricionales agregados y por el tratamiento post transplante con inmunosupresores y glucocorticoides. El objetivo del presente estudio fue conocer la mineralización ósea en niños con insuficiencia hepática secundaria a atresia de vías biliares y la dinámica ósea. La mineralización ósea se determinó en columna lumbar (L2-L4) mediante un densitómetro Lunar radiológico y la dinámica ósea a través la medición de osteocalcina en el suero y piridinolinas en la orina. El rango de edad de los pacientes estudiados fue de 7 meses a 14 a¤os. El porcentaje de adecuación del IMC fue de 102.1 ( 6.7 y el puntaje z de talla/edad fue de -0.53(1.06. La densidad mineral ósea (DMO) en L2-L4 z =-2.48 (1.23, la osteocalcina sérica de 44.1(13.9 8/8 casos disminuidos, la excreción de calcio urinaria 3.8 (3.3 aumentada en 5/8 casos y D-piridinolinas urinarias 39.9 (25.0, en todos los casos por sobre los valores de población sana. Se concluye que los pacientes con IH, previo al trasplante presentan precozmente un déficit de DMO, con un recambio óseo con menores índices de formación y mayores de resorción. Esta situación es susceptible de ir deteriorándose aun mas con el uso de corticoides después del transplante, lo que deberá prevenirse con mediadas nutricionales, aumento de la actividad física y un adecuado manejo de su tratamiento farmacológico.
Assuntos
Humanos , Masculino , Pré-Escolar , Criança , Adolescente , Feminino , Lactente , Doenças Ósseas Metabólicas , Glucocorticoides/efeitos adversos , Insuficiência Hepática/complicações , Insuficiência Hepática/etiologia , Atresia Biliar , Densidade Óssea , Chile , Transplante de FígadoRESUMO
Objetivo: Evaluar los niveles plasmáticos de vitamina D y la ingesta de calcio en pacientes celíacos. Material y Método: 25 pacientes celíacos (20 mujeres y 5 hombres, de 5 a 15 años de edad) con una buena adhesión al régimen libre de gluten de al menos los dos últimos años. La ingesta de calcio se evaluó mediante tres encuestas de recordatorio de 24 horas. La 25 OH vitamina D se determinó mediante RIA (INCSTAR). Resultados: Un 80 por ciento de los pacientes presentó una ingesta de calcio insuficiente de acuerdo al consenso del NIH; en los menores de 10 años la ingesta promedio fue de 866 ( 423 y en los mayores de 11 años 605 ( 237 mg/día. Se encontró déficit de vitamina D (<37.5 nmol/L ó 15 ng/mL) en 5 de los casos (20 por ciento), de los cuales 4 corresponden a muestras tomadas en invierno y una en verano. En dos casos el déficit fue severo <20 nmoles/L (<8 ng/ml). Conclusión: En pacientes celíacos evaluados la hipovitaminosis D y la ingesta insuficiente de calcio fueron situaciones frecuentes, lo que puede producir el déficit de masa ósea detectado en estos pacientes y facilitar el desarrollo futuro de osteoporosis y diabetes. Se recomienda evaluar los niveles de vitamina D y la ingesta de calcio como parte del control de estos pacientes y en caso necesario efectuar una suplementación con calcio y vitamina D.
Assuntos
Humanos , Masculino , Adolescente , Feminino , Criança , Cálcio da Dieta , Doença Celíaca , Vitamina D/sangue , Densidade Óssea , Inquéritos Nutricionais , Osteoporose/prevenção & controle , Fatores de RiscoRESUMO
Background: In Chile, the recommendation for salt iodination was reduced from 100 to 40 ppm, after detecting high urinary iodine excretion in school age children. Aim: To assess iodine nutrition in school age children after the modification of salt iodination. Subjects and methods: Iodine nutrition was studied in 3712 school age Chilean children of primary level in 4 areas (Calama, Santiago, Temuco and Punta Arenas) through palpation of thyroid gland, urinary iodine excretion and iodine concentration in salt for human consumption of the surveyed areas. Results: A 6.4% goiter prevalence was found (5,9% in boys and 6,8% in girls). Grade Ia goiter was more common (5.0%), without detecting differences between areas (7.3% in Calama, 5.9% in Santiago, 5.9 in Temuco and 6.7 in Punta Arenas). Iodine concentration in salt for human consumption of the areas was adequate according to the recent modification of Chilean legislation (25.4 mgI/g salt in Calama, 36.2 in Santiago, 27.7 in Temuco and 33.4 in Punta Arenas). Urinary iodine excretion was very high according to recommendation in boys and girls (2838 and 2852 mgI/g salt in Calama, 700 and 837 in Santiago, 1318 and 1438 in Temuco, 407 and 312 in Punta Arenas). Conclusions: Endemic goiter is not longer a problem in Chile. Salt iodination is in agreement with present legislation. However, urinary iodine excretion increased in Calama and Temuco, did not change in Santiago and decreased only in Punta Arenas in spite of the changes in the legislation. It is necessary to investigate the causes of the high urinary iodine excretions detected in school age children, and it is very important to have a continuous surveillance of iodine nutrition in Chile (Rev Méd Chile 2003; 131: 1390-8).
Assuntos
Humanos , Masculino , Feminino , Criança , Dieta , Bócio Endêmico/epidemiologia , Iodo , Cloreto de Sódio na Dieta , Chile/epidemiologia , Iodo/urina , Prevalência , Cloreto de Sódio na Dieta/análiseRESUMO
La obesidad infantil se asocia a una alta prevalencia de trastornos metabólicos (TM) que preceden a la Diabetes Mellitus tipo 2 y a la cardiopatía isquémica. Detectarlos y corregirlos tempranamente permitiría disminuir la morbimortalidad por estas enfermedades. La dislipidemia y la resistencia insulínica se relacionan con la cantidad de grasa corporal total (GCT), describiéndose un mayor riesgo biológico cuando es igual o mayor al 30 por ciento. Para calificar el sobrepeso en el menor de 18 años la OMS recomienda el Indice de Masa Corporal (IMC). Los referentes más utilizados son los del CDC-NCHS (USA) que califica como obesidad al IMC _> p95 y el del International Obesity Task Force (IOTF), cuya calificación de obesidad se basa en los IMC calculados regresivamente a partir de una población que a los 18 ańos tenía un IMC 30; ambos estándares se apoyan en un criterio estadístico. El propósito de este estudio fue comparar la sensibilidad de los puntos de cortes que califican obesidad de estos 2 estándares y del 30 por ciento GCT, para pesquizar los trastornos metabólicos asociados a la obesidad, con el objeto de aportar antecedentes que permitan realizar un diagnóstico más biológico que estadístico. En 259 niños con sobrepeso de ambos sexos entre 5 y 17 años, se midió el colesterol total (CT), el colesterol LDL (Col-LDL), la insulinemia basal (Ins bas ) y 2 horas post sobrecarga de glucosa (Ins 2 hrs). Se calificó el exceso de peso utilizando los estándares CDC/NCHS e IOTF y el por ciento GCT. Por tablas de contingencia simple, Chi2 y Odds Ratio (OR) R se evaluó la validez, la sensibilidad y la especificidad para pesquisar los trastornos metabólicos de estos tres criterios. Hubo un 25 por ciento de hiper CT, un 24,2 por ciento de hipercol- LDL, un 20,5 por ciento de hiper Ins b y 39,5 por ciento de hiper Ins 2h. La prevalencia de obesidad y/o sobrepeso se asoció significativamente (p < 0.000) al criterio utilizado para calificarlos. No se encontró asociación entre la calidad del exceso ponderal y el riesgo de dislipidemia, ni hipersinsulinismo post sobrecarga al utilizar los estandares CDC-NCHS e IOTF. En los obesos el riesgo de hipersinsulinismo basal fue 4.8 y 4.5 veces mayor respectivamente. El punto de corte _> 30 por ciento GCT mostró la mayor sensibilidad y validez estadística para la pesquiza del hiperinsulinismo tanto basal como postsobrecarga de glucosa.
Assuntos
Humanos , Masculino , Adolescente , Feminino , Pré-Escolar , Criança , Índice de Massa Corporal , Doenças Metabólicas/complicações , Doenças Metabólicas/epidemiologia , Hiperlipidemias , Resistência à Insulina , Obesidade/diagnóstico , Obesidade/etiologia , Sensibilidade e Especificidade , Chile , Fatores de RiscoRESUMO
La masa ósea máxima (MOM) del adulto joven constituye el capital de reserva para prevenir trastornos de la mineralización ósea (MO) en la vida de adulto mayor. Nos interesó conocer si adultos jóvenes chilenos, sanos y que reunieran todos los factores favorecedores de una adecuada MO, tenían una MOM similar a los valores de referencia de los densitómetros LUNAR, que se usan para determinar la adecuación de la MO. Se estudiaron 23 jóvenes cuyas edades fluctuaron entre 27 y 29 años (12 varones y 11 mujeres), a los cuales se les determinó la densidad mineral ósea (DMO) en cuerpo entero, columna y caderas con un densitómetro LUNAR-DEXA. No se encontraron diferencias significativas entre los valores determinados en estos adultos jóvenes chilenos con los valores de referencia de la LUNAR. Estos resultados indicarían que los valores de MOM de la LUNAR pueden usarse como meta a obtener especialmente en programas de prevención de osteoporosis.
Assuntos
Humanos , Masculino , Adulto , Feminino , Densidade Óssea , Calcificação Fisiológica , Osteoporose/prevenção & controle , Densitometria , Padrões de ReferênciaRESUMO
Se describe la evolución de la nutrición de yodo en el escolar chileno perteneciente a 4 zonas censorias del país, destacando la excesiva excreción urinaria de yodo a pesar que el Reglamento Sanitario de los Alimentos disminuyó el año 2000 la concentración de yodo en la sal de 100 ppm a un rango de 20 a 60 ppm. Nos interesó profundizar porque no disminuyeron las yodurias en los escolares. Para ello se midió el contenido de yodo en el pan, por tener un alto consumo en Chile (en promedio 250 g por día). En diferentes tipos de pan se determinó la concentración de yodo que fue alrededor de 0.5 ug/g, valor 10 veces mas alta que las concentraciones en Inglaterra y España. Sin embargo se estimó que el consumo de pan en Chile aportaría alrededor de 130 ug I/día, lo que no explicaría totalmente las altas cifras de excreción de yodo actuales. De importancia es continuar indagando las causas de este alto consumo para evitar sus posibles complicaciones
Assuntos
Humanos , Criança , Pão , Iodo , Nutrição do Lactente , Análise de Alimentos , Iodo , Micronutrientes , Tireoidite AutoimuneRESUMO
Background: Obesity is the most prevalent nutritional disease in people of less than 20 years old. Aim: To report biological, familial and metabolic characteristics in obese children. Patients and methods: A retrospective review of 187 children seen at obesity clinics and that had a complete metabolic study. Results: Ninety five prepuberal and 92 puberal children, aged 8.7ñ2.2 and 12.6ñ2.2 years old respectively, were studied. Body mass index was over 4 standard deviations in 48.4 per cent of prepuberal children and in 39.1 per cent of puberal children. Paternal obesity was twice more prevalent (30.2 per cent) than in the general population. The daily caloric intake and basal metabolic rate (BMR) were within the normal range; nevertheless there was a positive caloric balance due to minimal physical activity. The mean daily fat intake was normal (26.4ñ8.5 and 25.3ñ9.1 per cent of total calories in prepuberal and puberal children respectively). The daily fiber intake was under 70 per cent of recommendation. The total cholesterol was over 200 mg/dl in 26.6 and 23.9 per cent of prepuberal and puberal children. LDL cholesterol was over 130 mg/dl in 27.3 and 26.6 per cent and triacylglycerol was over 150 mg/dl in 16.9 and 25 per cent of prepuberal and puberal children respectively. Basal serum insulin was over 20 uIU/ml in 27.7 and 42.2 per cent of prepuberal and puberal children, respectively. Post glucose serum insulin was over 60 uIU/ml in 40 and 63 per cent of prepuberal and puberal children, respectively. Conclusions: Infantile and juvenile obesity is a chronic disease with a high incidence of metabolic alterations
Assuntos
Humanos , Masculino , Adolescente , Feminino , Pré-Escolar , Obesidade , Transtornos da Nutrição Infantil/complicações , Peso ao Nascer , Colesterol , Puberdade , Diabetes Mellitus Tipo 2 , Hipercolesterolemia , Hiperinsulinismo , Índice de Massa Corporal , Ingestão de Alimentos , Metabolismo EnergéticoRESUMO
Es una muestra de 10.000 escolares de Antofagasta, Viña, Valparaíso, Temuco, Valdivia y de la Región Metropolitana, se encontraron 104 niñas que habían presentado su menarquia dentro del mes que se efectuó la encuesta. El nivel socieconómico (NSE) se determinó por la escala de Graffar, las adecuaciones del peso y talla de acuerdo a las tablas OMS, las áreas magray grasa braquial (AMB Y AGB) por la fórmula de frisancho, el porcentaje degrasa corporal por la fórmulade Durnin y la relación de segmentos corporales por silla de segmentos corporales. No se encontró diferencias en estas determinaciones de acuerdo al NSE. Se encontró un menor peso y un mayor porcentaje talla/edad en las niñas con menarquia más temprana. Se encontró diferencias en la edad de menarquia y en el porcentaje de la talla/edad en las diferentes áreas geográficas analizadas. Estos resultados muestran la relación de área grasa con la edad de menarquia y la edad de maduración puberal con la talla final. Se detectaron variaciones de estas determinaciones por región