الملخص
ABSTRACT Objective: To evaluate the expression of UCP1, UCP2, and UCP3 mRNA and encoded proteins in epicardial and mediastinal adipose tissues in patients with coronary artery disease (CAD). Subjects and methods: We studied 60 patients with CAD and 106 patients undergoing valve replacement surgery (controls). Expression levels of UCP1, UCP2, and UCP3 mRNA and encoded proteins were measured by quantitative real-time PCR and Western blot analysis, respectively. Results: We found increased UCP1, UCP2, and UCP3 mRNA levels in the epicardial adipose tissue in the CAD versus the control group, and higher UCP1 and UCP3 mRNA expression in the epicardial compared with the mediastinal tissue in the CAD group. There was also increased expression of UCP1 protein in the epicardial tissue and UCP2 protein in the mediastinum tissue in patients with CAD. Finally, UCP1 expression was associated with levels of fasting plasma glucose, and UCP3 expression was associated with levels of high-density lipoprotein cholesterol and low-density cholesterol in the epicardial tissue. Conclusions: Our study supports the hypothesis that higher mRNA expression by UCP genes in the epicardial adipose tissue could be a protective mechanism against the production of reactive oxygen species and may guard the myocardium against damage. Thus, UCP levels are essential to maintain the adaptive phase of cardiac injury in the presence of metabolic disorders.
الملخص
Objetivo: identificar o risco de desenvolvimento de diabetes tipo 2 em enfermeiras e sua relação com as alterações metabólicas. Método: estudo transversal, com 155 enfermeiras. As variáveis investigadas foram: sociodemográficas, índice de massa corporal, a circunferência da cintura, índice cintura-quadril, perfil lipídico, a glicemia basal e a curva oral de tolerância à glicose. Para a coleta de dados utilizou-se o Finnish Diabetes Risk Score. Resultados: Das 155 (100%) enfermeiras, a média de idade foi de 44 anos e 85% apresentavam sobrepeso ou obesidade; 52% tinham história familiar de diabetes e 21%, hiperglicemia ocasional. Em relação ao risco, 59% foram identificados com risco moderado e muito alto de diabetes tipo 2. A glicose, a insulina, a hemoglobina glicosilada A1c e a resistência à insulina aumentaram paralelamente ao aumento do risco de diabetes tipo 2, embora os lipídios não tenham aumentado. 27% das participantes apresentaram glicemia em jejum alterada, 15%, intolerância à glicose e 5%, diabetes tipo 2. Conclusão: houve uma elevada taxa de detecção de risco de diabetes tipo 2 (59%) e a pontuação de risco alto e muito alto foi associado com níveis elevados de hemoglobina glicosilada A1c, glicose, insulina e resistência à insulina, mas não com lipídios.
Objective: to detect the risk of development of type 2 diabetes in nurses and its relationship with metabolic alterations. Method: cross-sectional study, with 155 nurses. The variables investigated were: sociodemographic, body mass index, waist circumference, waist-hip index, lipid profile, basal glycemia and oral glucose tolerance curve. The Finnish Diabetes Risk Score was used to collect data. Results: 155 nurses were included, with an average age of 44 years and 85% were overweight or obese. 52% had a family history of diabetes and 21% had occasional hyperglycemia. With respect to the risk, 59% were identified with moderate and very high risk for type 2 diabetes. Glucose, insulin, glycosylated hemoglobin A1c and insulin resistance increased in parallel to the increased risk for type 2 diabetes, although lipids did not increase. 27% of the sample had impaired fasting glycemia. 15% had glucose intolerance and 5% had type 2 diabetes. Conclusion: there was a high detection rate of people at risk for type 2 diabetes (59%) and the high and very high risk score was associated with high levels of glycosylated hemoglobin A1c, glucose, insulin and insulin resistance, but not with lipids.
Objetivo: identificar el riesgo de desarrollo de diabetes tipo 2 en enfermeras y su relación con alteraciones metabólicas. Método: estudio transversal, con 155 enfermeras. Las variables investigadas fueron: sociodemográficas, el índice de masa corporal, circunferencia de cintura, índice cintura-cadera, perfil de lípidos, glucemia basal y curva de tolerancia oral a la glucosa. Para la recolección de datos se utilizó el Finnish Diabetes Risk Score. Resultados: De las 155 enfermeras, la edad promedio fue 44 años y 85% tenía sobrepeso u obesidad. El 52% tenía antecedentes familiares de diabetes de primera línea, el 21% hiperglucemia ocasional. Con relación al riesgo, se identificaron 59% con riesgo de diabetes tipo 2 moderado y muy alto. Glucosa, insulina, hemoglobina glucosa A1c y la resistencia a la insulina incrementaron paralelos al aumento del riesgo de diabetes tipo 2, aunque los lípidos no. El 27% de las enfermeras presentó glucemia basal alterada. El 15% tuvo intolerancia a la glucosa y 5% diabetes tipo 2. Conclusión: la detección de riesgo de diabetes tipo 2 fue elevada (59%) y el puntaje de riesgo alto y muy alto se relacionó con valores mayores de hemoglobina glucosa A1c, glucosa, insulina y resistencia a la insulina pero no con lípidos.
الموضوعات
Humans , Male , Female , Adult , Middle Aged , Aged , Prediabetic State/complications , Prediabetic State/prevention & control , Body Mass Index , Diabetes Mellitus, Type 2/ethnology , Diabetes Mellitus, Type 2/prevention & control , Overweight/complications , Hyperglycemia/diagnosis , Obesity/complications , Socioeconomic Factors , Insulin Resistance , Cross-Sectional Studies , Surveys and Questionnaires , Mexicoالملخص
La lactancia materna exclusiva (LME) representa beneficios para la madre y bebé. Sin embargo, México no logra las cifras esperadas, debido a que influyen factores de la madre y su entorno. El objetivo del estudio fue analizar las principales barreras y facilitadores para la práctica de LME en un grupo de madres de la Ciudad de México. Se realizó un estudio transversal analítico en una Universidad. Participaron 500 madres trabajadoras y sus conocidas, de 19 a 45 años, clínicamente sanas, que su último hijo tuviera 6-24 meses de edad. Respondieron encuestas sobre principales barreras y facilitadores para LME y su autopercepción de la lactancia. Se compararon frecuencias de principales barreras y facilitadores de LME y se realizaron modelos de regresión logística con la no práctica de LME como variable dependiente. Los principales facilitadores fueron: buen acomodo del bebé (54%, n=270), paciencia-perseverancia (46%, n=230). Las variables asociadas a no practicar LME fueron: autopercepción negativa de LME (RM:7,48; IC95%:3,78-14,98), ser principal proveedora de ingreso (RM:2,42; IC95%:1,25-4,68) ser madre soltera (RM:1,92; IC95%:1,13-3,25), sentir que no sale leche (RM:2,31; IC 95%:1,27-4,20) y falta de información (RM:1,91; IC95%:1,01-2,98). Existe necesidad de contar con programas de educación pre y posnatal sobre la LME, así como de la extracción y conservación de leche oportuna en todos los grupos de madres, pero enespecial a aquellas que trabajan fuera del hogar(AU)
Exclusive breastfeeding (EBF) brings benefits for both mother and child. Nevertheless, Mexico has low number of EBF, due to different factors related to mother and her environment. The objective of this study was to identify barriers and facilitators of EBF in a sample of mothers from Mexico City. A cross-sectional study was performed in a University, including 500 healthy female mothers and their acquaintances, aged 19-45 y, whom their last child was 6-24 months of age. They responded a questionnaire to obtain information about the main barriers and facilitators for EBF and self-perception of EBF practice. Frequencies were calculated to identify main barriers and facilitators. A logistic regression model was performed using non-EBF as outcome. Main facilitators for EBF were good baby's position (54%, n=270), patience and perseverance (46% n=230). Main barriers were negative self-perception of EBF (OR:7.48; CI95%:3.78-14.98), being the main provider at home (OR:2.42; CI95%:1.25-4.68), being single mother (OR:1.92; CI95%:1.13-3.25), the sensation of no having milk (OR: 2.31; CI95%:1.27-4.20), and the lack of information regarding breastfeeding (OR: 1.91; CI 95%:1.01-2.98). There is a need to develop pre and postnatal educational programs about EBF, timely milk extraction and conservation and the strengthening of facilitators in every lactating mother, specifically those who have to work outside home(AU)
الموضوعات
Humans , Female , Infant , Adult , Breast Feeding/psychology , Maternal and Child Health , Diet, Food, and Nutrition , Health Promotionالملخص
Para favorecer una alimentación correcta la orientación alimentaria debe considerar factores socioculturales que condicionen patrones y preferencias del consumo de alimentos propios de cada población. El objetivo de esta investigación fue describir el contexto sociocultural del embarazo y su alimentación en el ámbito doméstico, mediante un enfoque cualitativo. Se realizaron entrevistas en profundidad a 6 mujeres con embarazo de alto riesgo bajo la técnica de saturación de la información. Las entrevistas se transcribieron y analizaron de acuerdo a Bardín con ayuda del programa Atlas TI. Se identificó: incertidumbre por el embarazo no planeado y poco apoyo de la pareja; ciertos cambios en la alimentación para mejorar la salud; percepción de una mala y buena alimentación, aunque ésta no cumplía con las características de una dieta correcta; omisión de la cena y del grupo de verduras y frutas. Las encargadas de preparar y servir los alimentos no siempre fueron las mujeres embarazadas; los alimentos percibidos peligrosos fueron consumidos y los benéficos presentaron consumo escaso. Resaltó la necesidad de capacitar a los profesionales de la salud para considerar al contexto sociocultural en la orientación alimentaria que proporcionen.
To promote a healthy diet, the dietary guidance should consider socio-cultural factors as they influence both the food standards and preferences of each population. The aim of this study was to describe the socio-cultural contexts of pregnancy and feeding in the domestic arena, using a qualitative approach. In-depth interviews were conducted using the data saturation technique with six women experiencing high-risk pregnancy. The interviews were transcribed and analyzed in accordance with the Bardin method and the IT Atlas program. The following aspects were identified: uncertainty due to unplanned pregnancy and limited partner support; a few dietary changes to improve health; perception of bad and good feeding habits, although it did not comply with the characteristics of a good diet; omission of fruit and vegetable group from dinner. The people in charge of preparing and serving food were not always the pregnant woman; food products perceived as being harmful were consumed and beneficial products were rarely consumed. This highlighted the need to train professionals to consider the socio-cultural context when providing dietary guidance.
الموضوعات
Adolescent , Adult , Female , Humans , Pregnancy , Young Adult , Cultural Characteristics , Diet , Feeding Behavior , Risk Factors , Sociological Factorsالملخص
La información sobre biomarcadores óseos en adolescentes y adultas durante el periodo posparto es incierta, por lo que el objetivo de este artículo fue analizar el patrón de biomarcadores óseos en adolescentes y adultas a 15, 90, 180 y 365 días posparto (dpp) y su asociación con la densidad mineral ósea (DMO) y lactancia materna. Se realizó un estudio de cohorte en 32 madres adolescentes ≤17 años y 41 adultas de 18 a 29 años de edad en el primer año posparto. Se realizaron medidas antropométricas, DMO y biomarcadores óseos y así como datos del tipo y la duración de lactancia. Como resultados se encontró asociación entre la concentración basal de N-telopéptidos ≤24 μg/L y mayor aumento de DMO. Las adolescentes tuvieron mayor concentración de N-telopéptidos (p≤0.004) y menor concentración de osteocalcina (5±3 vs13±4, p <0.001) que las adultas. La lactancia no afectó el cambio de DMO (p>0.050), ni de biomarcadores óseos. La osteocalcina se asoció con el cambio en DMO (p<0.040). La prolactina fue mayor entre las que practicaron lactancia materna exclusiva (p<0.001). A menor edad menores concentraciones de osteocalcina (p<0.001) y mayores concentraciones de N-telopéptidos (p<0.001). Se concluyó que a menor concentración de N-telopéptidos y mayor de osteocalcina hubo un mayor aumento de DMO, lo cual implica menor aumento de ésta en el grupo de adolescentes. La lactancia no afectó la DMO.
The objective of this study was to describe the trend of bone biomarkers in adults and adolescents women at 15, 90, 180 and 365 postpartum days (ppd) and its relation with bone mineral density (BMD). It was a prospective cohort of 32 teenagers ≤17 and 41 women from 18 to 29 years old. We evaluated diet, anthropometry, BMD, bone biomarkers and hormonal profile. In all, the concentration of N-telopeptide was higher at 15 days postpartum decreasing during first year postpartum, but adolescents had the highest concentration. The lowest N-telopeptide concentration was associated with highest increasing of the BMD. Osteocalcin concentration was lower in adolescents than in adults women (5 ± 3 vs 13 ± 4 ng/mL, p<0.001) during first year postpartum. Exclusive breastfeeding did not affect the BMD (p>0.050) or bone biomarkers. Osteocalcin concentration was positively associated with bone BMD (p<0.040), breastfeeding did not affect osteocalcin concentrations. Prolactin was higher among women who breastfed exclusively (p<0.001). Age and breastfeeding inversely correlated with bone biomarkers (p<0.001) N-telopeptide and PTHi respectively. We concluded that a lower N-telopeptide concentration and a higher osteocalcin concentration were associated with a higher increasing of BMD, so then, adolescents showed the lowest recovery of the BMD. Breastfeeding does not affect the BMD.
الموضوعات
Adolescent , Adult , Female , Humans , Male , Young Adult , Bone Density/physiology , Collagen Type I/blood , Lactation/blood , Osteocalcin/blood , Peptides/blood , Postpartum Period/blood , Absorptiometry, Photon , Biomarkers/blood , Cohort Studies , Lactation/physiology , Postpartum Period/physiologyالملخص
Introducción: Las adolescentes embarazadas son un grupo vulnerable nutricionalmente porque deben cumplir con sus propias necesidades de crecimiento y las del embarazo. El control prenatal es importante para un consumo de nutrimentos y una resolución del embarazo adecuado. Objetivo: Asociar el trimestre de inicio de control prenatal y el zinc sérico consumido con algunas características neonatales. Material y métodos: Estudio de cohorte, analítico y prospectivo con adolescentes embarazadas que se atendieron en el Instituto Nacional de Perinatología con las siguientes evaluaciones, en el último trimestre gestacional: consumo de zinc (frecuencia de consumo de alimentos), zinc sérico (espectrofotometría), antropométrica (peso, estatura) y revisión del expediente clínico (inicio del control prenatal y datos del neonato). Análisis estadístico: prueba t de Student, χ² de Pearson y regresión lineal. Aprobado por los comités de ética e investigación. Resultados: El 59% de las participantes inició el control prenatal en el primer trimestre gestacional; de ellas, el 56% tuvo parto vaginal, 92% de neonatos fueron a término, 85% con peso adecuado y mayor consumo de zinc. Las concentraciones séricas de zinc a la semana 28 y 32 de gestación explicaron 35% el peso al nacer R² = 0.358, β 2837 IC 1761, 3914, p = 0.001, 16% del perímetro cefálico (R² = 0.163 β = 35 EE = 1.9, IC 31.2, 39, p = 0.001), 25% de la edad gestacional (p = 0.003) y el 43% la longitud al nacer R² = 0.431, β 55.5 IC 49.62, p = 0.001). Conclusiones: El control prenatal en el primer trimestre se asoció a un mayor consumo de zinc. Las concentraciones de zinc sérico normales se asociaron con más frecuencia a neonatos a término y con mayor longitud, peso y perímetro cefálico.
Introduction: Adolescents pregnant are a vulnerable group in the nutritional area because they have their self growth requirements and for the child. Prenatal care is important to achieve healthy nutrition and better pregnant outcomes. Aims: To associate the gestational trimester beginning prenatal care, zinc (Zn) serum concentrations and its intake with neonatal characteristics. Methods: This is a cohort study with pregnant adolescents assisted by Perinatology National Institute. In the last trimester of gestation, we determine anthropometry characteristics, zinc intake (food frequency), serum zinc (espectrofotometry) and clinical records in order to get newborn somatometry. Statistic analysis: T Student, χ² de Pearson and lineal regression. The study was approved by INPer's Research and Ethic Committee. Results: More than 50% adolescents pregnant began their prenatal care at the first gestational trimester, 56% had eutocic part, 92% were at term, and 85% had newborn's normal weight and normal zinc intake. Normal zinc serum concentrations explained 35% of NB weight (R² = 0.358, IC 1761, 3914, p = 0.001), 16% of head circumference (R² = 0.163, IC 31.2, 39, p = 0.001), 25% of gestational age at term (p = 0.003), and 43% of newborn height (R² = 0.431, IC 49.62, p = 0.001). Conclusions: Prenatal care in the first trimester was associated with a higher zinc intake. Zinc normal serum concentration was associated with normal gestational age at term, higher weight, head circumference and height stature.
الملخص
La percepción corporal y su insatisfacción se relacionan con las conductas alimentarias de riesgo (CAR), pudiendo desarrollar trastornos de la conducta alimentaria (TAC) frecuentemente identificados en los adolescentes. El objetivo fue describir la asociación del índice de masa corporal (IMC) con los hábitos y las CAR en un grupo de adolescentes. Fue un estudio transversal, descriptivo realizado con 671 adolescentes de 12 a 15 años de edad, ambos sexos. Se aplicó una encuesta validada en población mexicana que identificó las CAR para el desarrollo de los TAC. Se obtuvo el IMC, además de información sobre práctica y conocimiento del consumo de alimentos. La prevalencia promedio de las CAR fue 12%, el sobrepeso u obesidad se presentó en 48% de los participantes, 20% de ellos no desayunaba, y sólo el 16% tomaba sus alimentos sin ningún distractor (p=0.012). La variables asociadas a las CAR para el desarrollo de TAC fueron: realizar cualquier actividad simultánea al consumo de alimentos (RM:4.23, p=0.006), sobrepeso u obesidad (RM:2.59, p=0.001), comer sin compañía (RM:2.04, p=0.005), no comer frutas (RM:1.96, p=0.008) y/o leche (RM:1.79, p=0.026), ser mujer (RM:1.74 p=0.024) y no desayunar (RM:1.57, p=0.035). El consumo de alimentos que los adolescentes practicaron fue diferente del que recomendaron para estar sanos, fue menor en verduras, frutas y leguminosas, y mayor en azúcares, lípidos y bebidas gaseosas. Se concluye que existe una asociación entre el IMC y las CAR. No se encontró coherencia entre lo que los adolescentes refirieron comer y lo que ellos recomiendan, según sus conocimientos.
Association between body mass index and risk feeding behaviors to develop eating disorders in Mexican adolescents. The body self-perception and its dissatisfaction are related with the risk for developing abnormal eating behaviors (AEB), especially in eating disorders (ED) in adolescents. The objective of this study was to identify the relationship between dietary habits and the risk for AEB and their association with body mass index (BMI) in a group of adolescents in the metropolitan area of Mexico City. It was a descriptive cross-sectional study conducted with a sample of 671 adolescents, both sex, between 12 and 15 years. A validated questionnaire was used to assess the risk for developing AEB. BMI was obtained, and information from the practice and knowledge of food consumption was available. The prevalence of the risk for developing AEB in this study was 12%. It showed that 48% of participants were overweight or obese, 20% did not eat breakfast, 16% took their food without doing other activity simultaneously (p=0.012). The variables associated with the risk AEB, for developing of ED were doing any activity simultaneously with food intake (OR:4.23 p=0.006), overweight-obesity (OR:2.59 p=0001), eating without company (OR:2.04 p=0.005), not eating fruit (OR:1.96 p=0.008) or milk (OR:1.79 p=0.026), being female (OR:1.74 p= 0.024) and skipping breakfast (OR:1.57 p=0,035). Food intake differed with what themselves recommended being healthy, which was lower in vegetables, fruits, leguminous and higher in sugars, fats and soda. We conclude there is a relationship between BMI and the risk for developing AEB. There was no consistency between what adolescents say they should eat to be healthy and what they eat.
الموضوعات
Adolescent , Child , Female , Humans , Male , Body Mass Index , Feeding and Eating Disorders/epidemiology , Feeding Behavior , Breakfast , Cross-Sectional Studies , Feeding and Eating Disorders/etiology , Health Knowledge, Attitudes, Practice , Mexico/epidemiology , Nutritional Status/physiology , Obesity/etiology , Prevalence , Risk Factors , Self Concept , Sex Factors , Socioeconomic Factors , Urban Populationالملخص
OBJETIVO: Analizar el patrón de la densidad mineral ósea (DMO), calcio y estradiol séricos, consumo de calcio, índice de masa corporal (IMC) y lactancia en adolescentes y adultas a 15, 90 y 365 días posparto (dpp). MATERIAL Y MÉTODOS: Cohorte prospectivo en 33 adolescentes y 39 adultas con evaluación antropométrica, dietética y ósea en L2-L4 y cuello de fémur; bioquímica con estradiol y calcio séricos. RESULTADOS: Las adolescentes aumentaron de los 15 a los 365 dpp 16 por ciento su DMO de L2-L4, las adultas 3 por ciento. La edad se asoció a este cambio (β=13.779, EE=3.5, p=0.001); la lactancia no se asoció (β=-0.705, EE=0.647, p=0.283). Las adultas presentaron mayor DMO de L2-L4 a 15, 90 y 365 dpp respectivamente (1.151vs 0.978g/cm², 1.195vs1.070g/cm², 1.195vs1.123g/cm², p<0.003). CONCLUSIONES: Las adolescentes incrementaron su DMO tres veces más que las adultas. El cambio en la DMO fue dependiente de la edad e independiente de la práctica de lactancia.
OBJECTIVE: To analyze the pattern of bone mineral density (BMD), serum concentrations of estradiol and calcium levels, dietary calcium, body mass index (BMI), and lactation in adolescents and adult women at 15, 90, and 365 postpartum days (ppd). MATERIAL AND METHODS: A prospective cohort study was conducted of 33 adolescents and 39 adult women. Anthropometric and dietetic evaluations were performed, as well as evaluations of bone mineral density in L2-L4 and femur neck. Estradiol concentrations and calcium serum levels were determined. RESULTS: L2-L4 BMD increased by 16 percent in adolescents, and 3 percent in adult women from day 15 to 365 ppd. While age was associated with this change (β=13.779, EE=3.5, p=0.001), lactation was not (β=-0.705, EE=0.647, p=0.283). The adult women had a higher L2-L4 BMD at 15, 90, and 635 ppd (1.151 vs 0.978g/cm², 1.195 vs 1.070g/cm², 1.195 vs 1.123g/cm², respectively) (p<0.003). CONCLUSIONS: Adolescents' BMD increased three times more than that of adult women. For all women, BMD was dependent of age and independent of lactation.