[Association between birth weight and cardiometabolic risk factors in children of Bucaramanga, Colombia>]. / Asociación entre peso al nacer y factores de riesgo cardiometabólicos en niños de Bucaramanga, Colombia.

BACKGROUND: Birth weight could be a medium-term risk factor in the development of overweight and obesity and a long-term risk factor of cardio-metabolic diseases. OBJECTIVE: To evaluate the association between birth weight and cardio-metabolic risk factors in children from Bucaramanga, Colombia. METHODS: This cross-sectional study included 1,282 children between five and eleven years of age in Bucaramanga. Dependent variables: arterial hypertension, arterial prehypertension, overweight/obesity, glucose intolerance, insulin resistance, dyslipidemia. The main independent variable: birth weight (grams). The association between the independent and dependent variables was evaluated through logistic and multiple linear regression. Data analysis was performed using Stata v. 12.0 software. RESULTS: The overweight prevalence (overweight or obesity) was 22.93% (95% CI 20.64%-25.33%), while the low birth weight prevalence was 3.70% (95% CI 2.65%-5.00%). The most prevalent cardiovascular risk factor was overweight, followed by high LDL-cholesterol levels (17.24%, 95% CI 15.20-19.41%). Following an adjustment by age, sex, socioeconomic level and physical activity and obstetric maternal history, overweight, BMI Z-scores for age and systolic blood pressure had a statistically significant association with birth weight (OR: 1.44; 95% CI 1.10-1.89; p = 0.006, ß= 0.23, 95% CI: 0.10-0.36, p = 0.001 and ß= 1.18, CI 95%: 0.24-2.12, p = 0.013, respectively). CONCLUSIONS: Children with higher birth weight showed more likely to develop overweight or obesity during childhood.

Asociación entre peso al nacer y factores de riesgo cardiometabólicos en niños de Bucaramanga, Colombia / Association between birth weight and cardiometabolic risk factors in children of Bucaramanga, Colombia

Introducción: el peso a nacer puede ser un factor de riesgo a mediano plazo en el desarrollo de sobrepeso y obesidad, y a largo plazo como determinante de enfermedades cardiovasculares. Objetivo: evaluar la asociación entre peso al nacer y factores de riesgo cardiometabólicos en niños de Bucaramanga, Colombia. Métodos: estudio de corte transversal analítico en niños de cinco a once años (n = 1.282). Variables dependientes: hipertensión arterial, prehipertensión arterial, sobrepeso/obesidad, glucosa alterada, resistencia a la insulina, dislipidemia. Principal variable independiente: peso al nacer (g). Se emplearon modelos de regresión logística y lineal múltiple. Los datos fueron analizados en el programa estadístico Stata 12.0. Resultados: la prevalencia de exceso de peso (sobrepeso u obesidad) fue del 22,93% (IC 95%: 20,64-25,33%), mientras que la de bajo peso al nacer fue del 3,70% (IC 95%: 2,65-5,00%). De los factores de riesgo, el más prevalente fue el exceso de peso seguido del colesterol LDL elevado (17,24%, IC 95%: 15,20-19,41%). El exceso de peso, el puntaje Z del índice de masa corporal (IMC) para la edad y la presión arterial sistólica se asociaron de manera significativa con el peso al nacer (OR: 1,44; IC 95%: 1,10-1,89, p = 0,006; β = 0,23, IC 95%: 0,10-0,36, p = 0,001, y β = 1,18, IC 95%: 0,24-2,12, p = 0,013, respectivamente), después de ajustar por edad, sexo, nivel socioeconómico, actividad física y antecedentes ginecoobstétricos maternos. Conclusiones: los niños con mayor peso al nacer presentaron mayor probabilidad de desarrollar sobrepeso u obesidad y mayores niveles de presión arterial sistólica durante la etapa de su niñez (AU)

Background: Birth weight could be a medium-term risk factor in the development of overweight and obesity and a long-term risk factor of cardio-metabolic diseases. Objective: To evaluate the association between birth weight and cardio-metabolic risk factors in children from Bucaramanga, Colombia. Methods: This cross-sectional study included 1,282 children between five and eleven years of age in Bucaramanga. Dependent variables: arterial hypertension, arterial prehypertension, overweight/obesity, glucose intolerance, insulin resistance, dyslipidemia. The main independent variable: birth weight (grams). The association between the independent and dependent variables was evaluated through logistic and multiple linear regression. Data analysis was performed using Stata v. 12.0 software. Results: The overweight prevalence (overweight or obesity) was 22.93% (95% CI 20.64%-25.33%), while the low birth weight prevalence was 3.70% (95% CI 2.65%-5.00%). The most prevalent cardiovascular risk factor was overweight, followed by high LDL-cholesterol levels (17.24%, 95% CI 15.20-19.41%). Following an adjustment by age, sex, socioeconomic level and physical activity and obstetric maternal history, overweight, BMI Z-scores for age and systolic blood pressure had a statistically significant association with birth weight (OR: 1.44; 95% CI 1.10-1.89; p = 0.006, β = 0.23, 95% CI: 0.10-0.36, p = 0.001 and β = 1.18, CI 95%: 0.24-2.12, p = 0.013, respectively). Conclusions: Children with higher birth weight showed more likely to develop overweight or obesity during childhood (AU)

Cardiovascular Risk and Its Associated Factors in Health Care Workers in Colombia: A Study Protocol.

BACKGROUND: Cardiovascular diseases are the leading cause of mortality worldwide, for this reason, they are a public health problem. In Colombia, cardiovascular diseases are the main cause of mortality, having a death rate of 152 deaths per 100,000 population. There are 80% of these cardiovascular events that are considered avoidable. OBJECTIVE: The objective of the study is to determine the prevalence of the cardiovascular risk and its associated factors among the institution's workers in order to design and implement interventions in the work environment which may achieve a decrease in such risk. METHODS: An analytical cross-sectional study was designed to determine the cardiovascular risk and its associated factors among workers of a high complexity health care institution. A self-applied survey will be conducted considering sociodemographic aspects, physical activity, diet, alcohol consumption, smoking, level of perceived stress, and personal and family history. In a second appointment, a physical examination will be made, as well as anthropometric measurements and blood pressure determination. Also, blood samples for evaluating total and high density lipoprotein cholesterol, triglycerides, and fasting blood sugar will be taken. A ten-year global risk for cardiovascular disease will be determined using the Framingham score. A descriptive analysis of the population's characteristics and a stratified analysis by sex, age, and occupation will be made. Bivariate and multivariate analysis will be made using logistic regression models to evaluate the association between cardiovascular risk and the independent variables. The research protocol was approved by the Scientific and Technical Committee and the Ethics Committee on Research of the Fundación Cardiovascular de Colombia. RESULTS: The protocol has already received funding and the enrollment phase will begin in the coming months. CONCLUSIONS: The results of this study will give the foundation for the design, implementation, and evaluation of a program based on promoting healthy lifestyles, such as performing regular physical activity and healthy food intake in order to avoid and/or control the cardiovascular risk in the workers of a high complexity health care institution.

Caso problema: retardo mental como secuela de enfermedad neurometabólica / Case discussion: mental retardation as sequel of neurometabolic disease

Los errores innatos del metabolismo representan un grupo paradigmático en el contexto de las enfermedades poco conocidas, aunque son más de 500 perfectamente definidas. Gracias a los avances de la biología molecular y la bioquímica, muchas de estas enfermedades no caracterizadas se han ido adicionando al grupo de errores innatos del metabolismo. El conocimiento de las bases moleculares de estas patologías, ha mejorado las posibilidades de diagnóstico prenatal y neonatal en la población a riesgo, lo que permite la posibilidad de implementar programas de manejo preventivo, así como, la aplicación del tratamiento y un consejo genético precoz. Se reporta el caso de un adolescente de 17 años con retardo mental y epilepsia mioclónica progresiva degenerativa, con hallazgos en neuroimágenes de enfermedad de sustancia blanca asociado a alteraciones metabólicas, lo cual es compatible con una impresión diagnóstica de Aciduria Glutárica tipo 1; lo cual es sustentado en el paciente, por la favorable respuesta terapéutica. Además del presente reporte, se busca analizar a través de una revisión de la literatura, el enfoque diagnóstico y terapéutico que permite considerar los errores innatos del metabolismo, como aquellas patologías cada vez más comunes en la práctica médica, que precisan de un manejo multidisciplinario. (MÉD.UIS. 2014;27(1):69-74).

Inborn errors of metabolism represent a paradigmatic group in the context of little known diseases, although more than 500 well-defined. Thanks to advances in molecular biology and biochemistry, many of these diseases have been characterized not adding to the group of inborn errors of metabolism. Knowledge of the molecular basis of these diseases, enhanced the possibilities of prenatal diagnosis and neonatal risk in the population, allowing the possibility of implementing preventive management programs, as well as the implementation of early treatment and genetic counseling. The case of a 17 -year mental retardation and myoclonic epilepsy progressive degenerative with findings in neuroimaging disease white matter associated with metabolic abnormalities are reported, which is consistent with a picture of glutaric aciduria type 1, this diagnosis is supported in the patient, by the favorable therapeutic response. In addition to this report, seeks to analyze through a review of literature, the diagnostic and therapeutic approach that allows considering the inborn errors of metabolism, such as those increasingly common diseases in medical practice, which require a multidisciplinary approach. (MÉD.UIS. 2014;27(1):69-74).

Estado actual del embarazo gemelar: Revisión de la literatura / Current status of twin pregnancy: A literature review

En la actualidad el diagnóstico de embarazo gemelar le confiere al binomio madre e hijo características específicas que los convierte en una población de alto riesgo para patologías que comprometen el estado de bienestar fetal como: prematurez, ruptura prematura de membranas, restricción de crecimiento intrauterino, malformaciones congénitas, problemas de entrecruzamiento del cordón, abruptio placentae, distocias de presentación y síndrome de trasfusión feto-fetal. Además de los determinantes de morbilidad materna, los cuales han incrementado su prevalencia según la etiología asociada, ya sean los trastornos de hipertensión asociados al embarazo, sepsis secundario a ruptura prematura de membranas y hemorragia postparto. En tanto así, recobra vital importancia realizar una revisión acuciosa dirigida por ejes temáticos sobre las patologías de mayor prevalencia asociadas al embarazo gemelar. Salud UIS 2012; 44 (3): 41-48.

Nowadays the diagnosis of twin pregnancy confers to the binomial mother and son specific characteristics that make them into a high risk population for pathologies that compromise the wellbeing of the fetus such as: prematurity, uterine overdistention, premature rupture of membranes and intrauterine growth restriction, congenital malformations, trouble with crossing over umbilical cord, abruptio placentae, presentation dystocia and twin-to-twin transfusion syndrome. Besides the risk determinants of maternal morbidity which have increased its prevalence accord to the etiology associated, such as hypertensive disorders associates with pregnancy, sepsis secondary to premature rupture of membranes and postpartum bleeding. Therefore, is really important to make an accurate review by thematic items about major prevalence pathologies associated with twin pregnancy. Salud UIS 2012; 44 (3): 41-48.