Estado nutricional de yodo en la población escolar asturiana / Iodine nutritional status in Asturian schoolchildren

Introducción: El déficit de yodo es considerado un problema de salud pública. El estado nutricional de yodo de una población debería determinarse periódicamente. Objetivo: Conocer el estado de nutrición de yodo en Asturias y su relación con el uso de sal yodada y con otros parámetros sociodemográficos y nutricionales. Material y métodos: Estudio observacional descriptivo en una muestra aleatorizada de población escolar de 5 a 14 años, determinando yoduria mediante cromatografía líquida de alta resolución. Previamente, la familia de cada niño respondía una encuesta sobre consumo de lácteos, pescado, sal yodada y datos sociodemográficos. Resultados: Se estudió a 705 escolares (51,1% niñas), con una edad media de 9,9 años (DE 2,6). La yoduria media fue 204,1μg/L (DE 120,6), la mediana 180,7μg/L (P25-P75: 124-252,3μg/L; rango intercuartílico 128,3μg/L), en un total de 620 determinaciones válidas. La proporción de niños con yodurias<100μg/L fue del 16,6% del total y con yodurias muy bajas (<20μg/L) del 0,2%. Se consumía sal yodada en el 69,3% de los hogares y todos los comedores escolares la utilizaban. El consumo de lácteos se relacionó significativamente con la yoduria (p<0,0005). Conclusión: La nutrición de yodo en escolares asturianos es adecuada, aunque aún queda lejos el objetivo del 90% de consumo de sal yodada en los hogares. El adecuado estado de nutrición de yodo podría deberse a otras fuentes, como el consumo de lácteos. Son necesarias campañas de salud pública para fomentar el consumo de sal yodada en nuestra población, así como la evaluación periódica del estado nutricional de yodo (AU)

Introduction: Iodine deficiency is a public health problem, and iodine nutritional status should therefore be regularly measured. Objective: To ascertain iodine nutritional status in Asturias and its relation to use of iodized salt and to other sociodemographic and nutritional parameters. Material and methods: A descriptive, observational study was conducted in a random sample of schoolchildren aged 5 to 14 years, in whom urinary iodine levels were measured by high-performance liquid chromatography. Families completed a survey on use of iodized salt, consumption of dairy products and fish, and sociodemographic data. Results: The study sample consisted of 705 schoolchildren (51.1% females) with a mean age of 9.9 years (SD 2.6). In a total of 620 valid measurements, mean urinary iodine level was 204.1 μg/L (SD 120.6), while the median value was 180.7 μg/L (P25-P75: 124-252.3 μg/L, interquartile range 128.3 μg/L). Urinary iodine levels were <100 μg/L in 16.6% of children, and very low (<20 μg/L) in 0.2%. Iodized salt was used in 69.3% of all households, and in all school canteens. Consumption of dairy products was significantly associated to urinary iodine levels (P<.0005). Conclusion: Iodine nutrition of Asturian schoolchildren is adequate, although the target of use of iodized salt in 90% of households is still far away. Adequate iodine nutrition may be due to other sources, such as dairy products. Public health campaigns are required to promote iodized salt consumption. Regular assessment of iodine nutritional status is also needed (AU)

Iodine nutritional status in Asturian schoolchildren. / Estado nutricional de yodo en la población escolar asturiana.

INTRODUCTION: Iodine deficiency is a public health problem, and iodine nutritional status should therefore be regularly measured. OBJECTIVE: To ascertain iodine nutritional status in Asturias and its relation to use of iodized salt and to other sociodemographic and nutritional parameters. MATERIAL AND METHODS: A descriptive, observational study was conducted in a random sample of schoolchildren aged 5 to 14 years, in whom urinary iodine levels were measured by high-performance liquid chromatography. Families completed a survey on use of iodized salt, consumption of dairy products and fish, and sociodemographic data. RESULTS: The study sample consisted of 705 schoolchildren (51.1% females) with a mean age of 9.9 years (SD 2.6). In a total of 620 valid measurements, mean urinary iodine level was 204.1 µg/L (SD 120.6), while the median value was 180.7 µg/L (P25-P75: 124-252.3 µg/L, interquartile range 128.3 µg/L). Urinary iodine levels were <100 µg/L in 16.6% of children, and very low (<20 µg/L) in 0.2%. Iodized salt was used in 69.3% of all households, and in all school canteens. Consumption of dairy products was significantly associated to urinary iodine levels (P<.0005). CONCLUSION: Iodine nutrition of Asturian schoolchildren is adequate, although the target of use of iodized salt in 90% of households is still far away. Adequate iodine nutrition may be due to other sources, such as dairy products. Public health campaigns are required to promote iodized salt consumption. Regular assessment of iodine nutritional status is also needed.

Factors determining weight gain in adults and relation with glucose tolerance.

OBJECTIVE: Modifications in lifestyle, diet and certain clinical events are major contributors for the high prevalence of obesity. The aim of this study was to assess factors associated with weight gain in a population of Spanish adults. DESIGN: The study was undertaken in two population-based cohorts from the north and the south of Spain (baseline and after 6 years). The Asturias Study, in the north, included 1034 persons aged 30-75 years, of whom 701 were reassessed. The Pizarra Study, in the south, included 1226 persons aged 18-65 years, of whom 783 were re-evaluated. Both studies involved a nutritional questionnaire, a physical examination and an oral glucose tolerance test (OGTT). RESULTS: During the follow-up, 32.3% of the participants lost weight, 34.5% gained fewer than 4 kg and 33.2% gained more than 4 kg. Weight gain was greater in persons younger than 50 years and in those with an initial body mass index below 30. Weight gain was associated with a greater incidence of type 2 diabetes mellitus (T2DM) and abnormal glucose tolerance, whereas weight loss in persons with these disorders was associated with a normal OGTT 6 years later. Persons who took less exercise and those who reported a higher daily calorie intake experienced greater weight gain. CONCLUSION: The longitudinal changes in weight affect the development of T2DM and abnormal glucose tolerance. The weight is a dynamic phenomenon affected by several social customs.

Mortality risk in spanish adults with diagnosed diabetes, undiagnosed diabetes or pre-diabetes. The Asturias study 1998-2004.

INTRODUCTION AND OBJECTIVES: Although type-2 diabetes is a well-known cause of death, the mortality associated with undiagnosed diabetes and early-stage dysglycemia has not been clearly determined. METHODS: This study included 1015 individuals aged 30-75 years who took part in the first phase of the Asturias study (1998-1999). Participants completed a questionnaire and underwent a physical examination and an oral glucose tolerance test (OGTT). All deaths that occurred in the cohort within 6 years of follow-up (i.e. December 1998 to December 2004) were recorded. RESULTS: Participants were divided into four groups according to the condition indicated by their OGTT result in the first phase of the study: normoglycemia, pre-diabetes, undiagnosed diabetes or diagnosed diabetes (World Health Organization 1999 criteria). A total of 42 deaths were recorded during follow-up. With normoglycemic individuals acting as a control group, multivariate analysis showed that the relative risk of mortality was 2.5 (95% CI, 1-6.3) in the group with diagnosed diabetes, 2.7 (95% CI, 1.1-6.7) in the group with undiagnosed diabetes and 1.6 (95% CI, 0.7-4) in the group with pre-diabetes. CONCLUSIONS: Both individuals with diagnosed diabetes and those with undiagnosed diabetes had a risk of mortality around 2.5-3 times greater than individuals with normoglycemia. Those with pre-diabetes also had increased mortality relative to the control group, though the difference was not significant.

Riesgo de mortalidad en diabetes diagnosticada, diabetes no diagnosticada y prediabetes en población adulta española. Estudio Asturias 1998-2004 / Mortality risk in spanish adults with diagnosed diabetes, undiagnosed diabetes or pre-diabetes. The Asturias Study 1998–2004

Introducción y objetivos. Aunque la diabetes mellitus DM tipo 2 es una causa establecida de mortalidad, el riesgo de mortalidad asociado a DM no diagnosticada y a estadios previos de disglucemia no está claramente definido. Métodos. El estudio incluyó a 1.015 individuos de 30-75 años de edad que participaron en la primera fase del Estudio Asturias (1998-1999), realizando encuesta, exploración física y SOG. Se registraron los fallecimientos en la cohorte durante 6 años de seguimiento (diciembre de 1998 a diciembre de 2004). Resultados. Se clasificó a los sujetos en cuatro grupos según el resultado de la SOG en la primera fase del estudio: normoglucemia, prediabetes, DM ignorada y DM conocida (criterios de la OMS 1999). Se registraron 42 muertes durante el seguimiento. Respecto al grupo control con normoglucemia, el riesgo relativo (RR) de mortalidad en el modelo multivariable fue 2,5 (intervalo de confianza [IC] del 95%, 1-6,3) en el grupo con DM conocida, RR = 2,7 (IC del 95%, 1,1-6,7) en el grupo con DM ignorada y RR = 1,6 (IC del 95%, 0,7-4) en el grupo con prediabetes. Conclusiones. Tanto los individuos con DM conocida como los que tenían DM no diagnosticada presentaron un riesgo de mortalidad alrededor de 2,5-3 veces superior al de los individuos con normoglucemia. En individuos con prediabetes también se encontró un incremento de mortalidad frente al grupo control, aunque no estadísticamente significativo (AU)

Introduction and Objectives. Although type-2 diabetes is a well-known cause of death, the mortality associated with undiagnosed diabetes and early-stage dysglycemia has not been clearly determined. Methods. This study included 1015 individuals aged 30-75 years who took part in the first phase of the Asturias study (1998-1999). Participants completed a questionnaire and underwent a physical examination and an oral glucose tolerance test (OGTT). All deaths that occurred in the cohort within 6 years of follow-up (ie December 1998 to December 2004) were recorded. Results. Participants were divided into four groups according to the condition indicated by their OGTT result in the first phase of the study: normoglycemia, pre-diabetes, undiagnosed diabetes, or diagnosed diabetes (World Health Organization 1999 criteria). A total of 42 deaths were recorded during follow-up. With normoglycemic individuals acting as a control group, multivariate analysis showed that the relative risk of mortality was 2.5 (95% CI, 1-6.3) in the group with diagnosed diabetes, 2.7 (95% CI, 1.1-6.7) in the group with undiagnosed diabetes, and 1.6 (95% CI, 0.7-4) in the group with pre-diabetes. Conclusions. Both individuals with diagnosed diabetes and those with undiagnosed diabetes had a risk of mortality around 2.5-3 times greater than individuals with normoglycemia. Those with pre-diabetes also had increased mortality relative to the control group, though the difference was not significant. multivariate analysis showed that the relative risk of mortality was 2.5 (95% CI, 1-6.3) in the group with diagnosed diabetes, 2.7 (95% CI, 1.1-6.7) in the group with undiagnosed diabetes and 1.6 (95% CI, 0.7-4) in the group with pre-diabetes. Conclusions. Both individuals with diagnosed diabetes and those with undiagnosed diabetes had a risk of mortality around 2.5-3 times greater than individuals with normoglycemia. Those with pre-diabetes also had increased mortality relative to the control group, though the difference was not significant (AU)

Effects of novel maturity-onset diabetes of the young (MODY)-associated mutations on glucokinase activity and protein stability.

Glucokinase acts as the pancreatic glucose sensor and plays a critical role in the regulation of insulin secretion by the beta-cell. Heterozygous mutations in the glucokinase-encoding GCK gene, which result in a reduction of the enzymatic activity, cause the monogenic form of diabetes, MODY2 (maturity-onset diabetes of the young 2). We have identified and functionally characterized missense mutations in the GCK gene in diabetic families that result in protein mutations Leu165-->Phe, Glu265-->Lys and Thr206-->Met. The first two are novel GCK mutations that co-segregate with the diabetes phenotype in their respective families and are not found in more than 50 healthy control individuals. In order to measure the biochemical effects of these missense mutations on glucokinase activity, we bacterially expressed and affinity-purified islet human glucokinase proteins carrying the respective mutations and fused to GST (glutathione S-transferase). Enzymatic assays on the recombinant proteins revealed that mutations Thr206-->Met and Leu165-->Phe strongly affect the kinetic parameters of glucokinase, in agreement with the localization of both residues close to the active site of the enzyme. In contrast, mutation Glu265-->Lys, which has a weaker effect on the kinetics of glucokinase, strongly affects the protein stability, suggesting a possible structural defect of this mutant protein. Finally, none of the mutations tested appears to affect the interaction of gluco-kinase with the glucokinase regulatory protein in the yeast two-hybrid system.