Bone mineral density and fractures in postmenopausal women of Maya-Mestizo ethnic origin with different body mass indexes.

BACKGROUND: Obesity protects against bone loss, but it increases the risk of fragility fractures. AIM: To determine if bone mineral density (BMD) and the prevalence of fractures are different in postmenopausal Maya-Mestizo women grouped according to their body mass index (BMI). SUBJECTS AND METHODS: We studied 600 postmenopausal Maya-Mestizo women. A structured questionnaire for risk factors was applied. Body mass index was determined. BMD was assessed at the lumbar spine and total hip by dual-energy X-ray absorptiometry. History of low trauma fracture was determined from medical records. ANOVA was used to compare mean BMD between women with different BMI. To compare the frequency of fractures according to BMI group, we used χ2 test. RESULTS: According to WHO classification of BMI, 16.3% of women had normal BMI, 35.3% were overweight, and 48.4% had obesity. We found that women with obesity had a higher BMD versus women with normal BMI or overweight in all the anatomical sites analysed. The prevalence of history of fractures was 18.2%. We did not find differences between the women of different BMI; the wrist was the most frequent skeletal site of the fracture. CONCLUSION: Obesity in postmenopausal Maya-Mestizo women is not a risk factor for developing fragility fractures.

Polymorphism of LRP5, but not of TNFRSF11B, is associated with a decrease in bone mineral density in postmenopausal Maya-Mestizo women.

OBJECTIVE: Osteoporosis is a complex disease characterized principally by low bone mineral density (BMD), which is determined by an interaction of genetic, metabolic, and environmental factors. The aim of this study was to analyze the possible association among one polymorphism of LRP5 and three polymorphisms of TNFRSF11B as well as their haplotypes with BMD variations in Maya-Mestizo postmenopausal women. METHODS: We studied 583 postmenopausal women of Maya-Mestizo ethnic origin. A structured questionnaire for risk factors was applied and BMD was measured in lumbar spine (LS), total hip (TH), and femoral neck (FN) by dual-energy X-ray absorptiometry. DNA was obtained from blood leukocytes. One single-nucleotide polymorphism of LRP5 (rs3736228, p.A1330V) and three of TNFRSF11B (rs4355801, rs2073618, and rs6993813) were studied using real-time PCR allelic discrimination for genotyping. Differences between the means of the BMDs according to the genotype were analyzed with covariance. Deviations from Hardy-Weinberg equilibrium were tested. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated by direct correlation r(2), and haplotype analysis of TNFRSF11B was conducted. RESULTS: The Val genotype of the rs3736228 (p.A1330V) of LRP5 was significantly associated with BMD variations at the LS, TH, and FN. None of the three polymorphisms of TNFRSF11B was associated with BMD variations. CONCLUSIONS: Our results show that p.A1330V was significantly associated with BMD variations at all three skeletal sites analyzed; the Val allele and the Val/Val genotype were those most frequently found in our population.

[Prevalence of bacterial vaginosis in a group of women at a family planning clinic]. / Prevalencia de vaginosis bacteriana en un grupo de mujeres de una clínica de planificación familiar.

OBJECTIVE: To determine the prevalence of bacterial vaginosis among family planning users and the relationship between clinical symptoms and gynecologic signs. MATERIAL AND METHODS: Four hundred and fifty women were studied: they answered a detailed structured questionnaire and had a vaginal secretion sampling to make the diagnose of bacterial vaginosis according to the Amsel et al criteria. RESULTS: 85 women were excluded because they were found to have either yeast or trichomonas. 144/450 women were found to have bacterial vaginosis (32%), while 221 women without evidence of this problem served as a comparison group. We found an increased number of sexual partners, and more abortions and premature rupture of membranes in women with bacterial vaginosis than women without the problem. More than 50% of patients with bacterial vaginosis were asymptomatic of disease complaints and the only sign with significance observed in bacterial vaginosis patients was a grey vaginal discharge. Use of IUD wasn't associated with bacterial vaginosis. CONCLUSIONS: The prevalence of bacterial vaginosis we found in a family planning clinic was similar to those that have been reported in developed countries whereas it seems to be higher than other national studies. We must emphasize the importance of an accurate diagnose and a suitable treatment to prevent subsequent complications.

Analysis of polymorphisms in interleukin-10, interleukin-6, and interleukin-1 receptor antagonist in Mexican-Mestizo women with pre-eclampsia.

Due to the fact that studies seeking associations of polymorphisms in regulatory regions of cytokine genes with pre-eclampsia (PE) have not always been consistent in different population analyses, the aim of this study was to investigate the possible association between rs1800896 of interleukin-10 (IL-10), rs1800795 of interleukin-6 (IL-6), and the variable number of tandem repeats (VNTR) in intron 2 of interleukin-1 receptor antagonist (IL-1Ra), as well as gene-gene interactions between these three polymorphisms with the presence of PE in Mexican-Mestizo women and one Amerindian population from México (Maya). A case-control study was performed where 411 pre-eclamptic cases and 613 controls were genotyped. For the rs1800896 of IL-10 and rs1800795 of IL-6, we used real-time polymerase chain reaction (PCR) allelic discrimination and for the VNTR of IL-1Ra, PCR. Allele frequency differences were assessed by Chi-squared test; logistic regression was used to test for associations; a gene-gene interaction was conducted. Genotypic and allelic distribution of the polymorphisms was similar in our population. The estimated of the gene-gene interaction between the polymorphisms did not differ significantly. However, we observed important differences in the distribution of the alleles and genotypes of the three polymorphisms analyzed between Mestiza-Mexicanas and Maya-Mestizo women. In conclusion, we did not find an association between polymorphisms in IL-10, IL-6, and IL-1Ra and PE in Mexican-Mestizo and Maya-Mestizo women. To our knowledge, this is the first time that these three polymorphisms were analyzed together with gene-gene interaction in women with PE.

[Chlamydia trachomatis infection in women using 2 family planning clinics]. / Infección por Chlamydia trachomatis en usuarias de dos clínicas de planificación familiar.

OBJECTIVE: To determine the prevalence of Chlamydia trachomatis in women attending two family planning clinics in Merida, Yucatan, Mexico. MATERIAL AND METHODS: From January to December 1998, a cross-sectional study was conducted in 1,100 sexually active women between 15 and 45 years of age. Study subjects had not received antibiotic therapy for at least one month prior to their visit to the clinic. Endocervical samples were taken for bacterial detection with the enzymatic Wellcozyme immunoassay method. Data were analyzed using the Epi-Info program. Statistical analysis was conducted using the chi-squared test and prevalence ratios. RESULTS: Seventy four women were positive to Chlamydia trachomatis (6.7%). Almost 50% of those women were asymptomatic. No statistically significant differences were found between the group with Chlamydia and the group without it who had vulvar-vaginal symptoms. Cervical changes were more frequent in infected women. More positive cases of Chlamydia infection were found in oral contraceptive users (8.3%) than among non users (5.4%). CONCLUSIONS: Study results confirm the high prevalence of asymptomatic infections and emphasize the importance of timely diagnosis to avoid infection sequelae. The English version of this paper is available at:http://www.insp.mx/salud/index.html.

Infección por Chlamydia trachomatis en usuarias de dos clínicas de planificación familiar / Chlamydia trachomatis infection in users of two family planning clinics

OBJETIVO: Determinar la prevalencia de infección por Chlamydia trachomatis en mujeres que acuden a dos clínicas de planificación familiar. MATERIAL Y MÉTODOS: Se llevó a cabo un estudio transversal en 1 100 mujeres sexualmente activas, aparentemente sanas, de Mérida, Yucatán, México, quienes acudieron a dos clínicas de planificación familiar en el periodo comprendido de enero a diciembre de 1998. Las mujeres incluidas en el estudio tuvieron entre 15 y 45 años de edad, y habían estado libres de tratamiento antibacteriano al menos durante el mes previo a su inclusión. Se obtuvieron muestras endocervicales y datos epidemiológicos. La detección de bacterias fue realizada por el método inmunoenzimático de marca Wellcozyme. Los datos fueron procesados en el programa EPI Info. Como métodos estadísticos se utilizaron la prueba de Z, ji cuadrada y como medida de asociación, la razón de prevalencias. RESULTADOS: Setenta y cuatro mujeres (6.7 por ciento) fueron positivas a infección por Chlamydia trachomatis. Cerca de 50 por ciento de las mujeres estuvo asintomática. No se encontró diferencia estadística entre la proporción de mujeres con y sin Chlamydia que tuvieron síntomas vulvovaginales; por el contrario, los cambios relacionados con cervicitis fueron más frecuentes en las pacientes infectadas. C trachomatis fue más frecuente en usuarias de anticonceptivos orales (8.3 por ciento) comparadas con mujeres que no tenían método anticonceptivo (5.4 por ciento). CONCLUSIONES: Los resultados de este estudio confirman la alta prevalencia de infecciones asintomáticas y pone énfasis en la importancia de un diagnóstico oportuno para evitar secuelas.

Efecto de dos tipos de DIU's sobre los niveles circulantes de hemoglobina, hierro sérico e índice de saturación de transferrina / Effect of two types of IUD's on circulating hoemoglobin serum iron and transferrin saturation index

Se determinaron los niveles de hemoglobina, hierro sérico e índice de saturación de transferrina antes de la inserción de dos tipos de dispositivos (Lippes y TCu 380A), a intervalos de tres meses durante un año, en mujeres de clase socioeconómica baja, y con niveles iniciales de hemoglobina inferiores a 11.0 g. de Hb./dl. Se encontró una disminución estadísticamente significativa de todos los valores hematológicos estudiados en las pacientes con ambos tipos de DIU's. Los resultados de este estudio indican que es necesario valorar cuidadosamente a las pacientes de clase socioeconómica baja que acuden a las clínicas de planificación familiar pidiendo inserción de dispositivos

Encuesta de síntomas del climaterio en áreas semirurales de Yucatán / Survey of climateric symptoms in semi-rural areas of Yucatan

Objetivo. Determinar los principales síntomas del climaterio en mujeres de dos áreas rurales de Yucatán. Material y Métodos. Estudio transversal de 202 mujeres de los pueblos de Seyé y Cuzamá. Se aplicó un cuestionario que permitió conocer algunos aspectos socioeconómicos y síntomas del climaterio en ellas. Resultados. Las manifestaciones más comunes fueron lumbalgia y cansancio en más de la mitad, y sudoración y bochornos en el 35 por ciento y 31 por ciento respectivamente. Conclusión. Nuestras observaciones fueron diferentes a las obtenidas en otro estudio efectuado en una población similar en que no encuentran los síntomas hormonales de bochorno y sudoración

Tamiz neonatal para hipotiroidismo congénito. Experiencia en el Laboratorio Regional del Sureste / Neonatal screening for congenital hypothyroidism. Experience in the Southeast Regional Laboratory

Introducción. Se presenta en este artículo los resultados del Programa para Prevención de Retraso Mental por Hipotiroidismo Congénito del Laboratorio Regional del Suereste. El objetivo del estudio fue mostrar la frecuencia de este problema en las muestras enviadas por los hospitales de Yucatán, Campeche, Quintana Roo, Chiapas, Tabasco y Oaxaca; asimismo, se describen algunos problemas y dificultades realcionados con éste. Material y métodos. Se estudiaron 58,154 muestras de sangre de niños en edades comprendidas desde el nacimiento hasta los 3 meses de edad, durante el período de enero de 1993 a diciembre de 1995. Resultados. Se detectó 20 casos de hipotiroidismo congénito, lo cual dio una incidencia de 1 caso en 2,907 recién nacidos tamizados. Conclusión. La incidencia fue menor a la reportada en estudios efectuados en México; asimismo, se identificaron algunos problemas relacionados con la toma de la muestras y los seguimientos de los casos sospechosos