Albuminuria, Disease Duration, and Glycated Hemoglobin Are Related With Bone Mineral Density in Type 1 Diabetes: A Cross-sectional Study.

OBJECTIVE: Studies have found a significant decrease in bone mineral density (BMD) in individuals with type 1 diabetes (T1D) compared to healthy controls. Factors associated with this phenomenon have yet to be defined; therefore, this study aimed to explore the association of glycated hemoglobin (HbA1c), disease duration, albuminuria, and glomerular filtration rate with BMD in adults with T1D. METHODS: A cross-sectional study was carried out in tertiary care center. BMD analysis was performed by dual x-ray absorptiometry. Linear models were constructed considering variables associated with BMD. Approval from the ethics committees and informed consent were obtained. RESULTS: We included 128 participants, of whom 59% were women, and 16% had menopause. The median age was 33 (26-42) years. The average age of diabetes diagnosis was 15.3 ± 6.3 years, and the median disease duration was 19.5 (12-27) years. In the adjusted analysis, higher albuminuria (P < .01) and disease duration (P < .05) were associated with a lower BMD in the femoral neck and total hip, independently of age, sex, and body mass index (BMI). Higher HbA1c (P < .01) was associated with a lower spine BMD after adjustment for age, sex, and BMI. CONCLUSION: Studied factors specific to T1D, including albuminuria, disease duration, and HbA1c have an association with BMD regardless of BMI, age, and sex.

Mala nutrición en población escolar mexicana: factores geográficos y escolares asociados.

OBJETIVOS: Determinar prevalencias de mala nutrición [sobrepeso u obesidad (Sp+O) y talla baja (TB)] en población mexicana de 6 a 12 años de edad de nivel básico de primaria, y su asociación con características geográficas (ámbito, marginación y región del país), y de la escuela (tipo, turno y grado). MÉTODOS: Con información de 10 528 676 escolares, se estimaron prevalencias (e I.C. 95%), a nivel nacional y por características de interés, y su asociación mediante modelos de regresión logística. RESULTADOS: La prevalencia nacional de Sp+O fue 34.4%, 36.5% en ámbito urbano y 40.2% en escuelas privadas. La prevalencia nacional de TB fue 8.7%; en área rural, 13.7% y 28.8% en escuelas tipo indígenas. El Sp+O y la TB se asociaron significativamente con características geográficas y de escuelas. CONCLUSIONES: Existe una polarización nutricional en el contexto escolar del país. Es importante continuar con sistemas de monitoreo y vigilancia nutricional.

[Metabolic syndrome in children aged 6 to 12 years with obesity in public schools of seven municipalities in the State of Mexico]. / Síndrome metabólico en niños de 6 a 12 años con obesidad, en escuelas públicas de siete municipios del Estado de México.

OBJECTIVE: To estimate the prevalence of Metabolic Syndrome (MS), its components and its association with obesity and cardiovascular risk in school age children. MATERIALS AND METHODS: A cross-sectional study of 1,017 children from 6 to 12 years of age. Anthropometric information, blood pressure, glucose, insulin, cholesterol, HDLc, LDLc and triglycerides were collected. The presence of MS and its components were determined by criteria of Cook et. al. (2003), modified for children and adolescents. In the analysis, the children were grouped by aged group of 6 to 9 and 10 to 12 years. The association between MS, obesity and cardiovascular risk was estimated using Student's t-test and Mann-Whitney U test, Chi-square test and logistic regression. RESULTS: The MS was present with 54.6% in obese children. Obesity was the characteristic of greater association to suffer from MS with an OR=8.62 p<0.001. CONCLUSIONS: MS is high among children with obesity, and is mostly associated with insulin resistance and atherogenic risk.

OBJETIVO: Estimar la prevalencia de síndrome metabólico(SM), sus componentes y su asociación con la obesidad y el riesgo cardiovascular en niños en edad escolar. MATERIAL Y MÉTODOS: Estudio transversal de 1 017 niños de 6 a 12 años de edad. Se recabó información antropométrica, presión sanguínea, glucosa, insulina, colesterol, colesterol de las lipoproteínas de alta densidad (HDLc, por sus siglas en inglés), colesterol de las lipoproteínas de baja densidad (LDLc, por sus siglas en inglés) y triglicéridos. La presencia de SM y sus componentes se determinaron a partir de los criterios de Cook y colaboradores (2003), modificados para niños y adolescentes. Para el análisis se establecieron dos grupos de edad, con niños de 6 a 9, por un lado, y de 10 a 12 años de edad, por el otro. La asociación entre SM, obesidad y riesgo cardiovascular fue estimada mediante las pruebas t de Student y U de Mann-Whitney, ji cuadrada y regresión logística. RESULTADOS: El SM estuvo presente en 54.6% de los niños obesos. La obesidad fue la característica de mayor asociación para padecer SM, con una razón de momios (RM) de 8.62 (p<0.001). CONCLUSIONES: El SM es alto en niños con obesidad, y su asociación con la resistencia a la insulina y el riesgo aterogénico es considerable.

Síndrome metabólico en niños de 6 a 12 años con obesidad, en escuelas públicas de siete municipios del Estado de México / Metabolic syndrome in children aged 6 to 12 years with obesity in public schools of seven municipalities in the State of Mexico

Resumen Objetivo Estimar la prevalencia de síndrome metabólico (SM), sus componentes y su asociación con la obesidad y el riesgo cardiovascular en niños en edad escolar. Material y métodos Estudio transversal de 1 017 niños de 6 a 12 años de edad. Se recabó información antropométrica, presión sanguínea, glucosa, insulina, colesterol, colesterol de las lipoproteínas de alta densidad (HDLc, por sus siglas en inglés), colesterol de las lipoproteínas de baja densidad (LDLc, por sus siglas en inglés) y triglicéridos. La presencia de SM y sus componentes se determinaron a partir de los criterios de Cook y colaboradores (2003), modificados para niños y adolescentes. Para el análisis se establecieron dos grupos de edad, con niños de 6 a 9, por un lado, y de 10 a 12 años de edad, por el otro. La asociación entre SM, obesidad y riesgo cardiovascular fue estimada mediante las pruebas t de Student y U de Mann-Whitney, ji cuadrada y regresión logística. Resultados: El SM estuvo presente en 54.6% de los niños obesos. La obesidad fue la característica de mayor asociación para padecer SM, con una razón de momios (RM) de 8.62 (p<0.001). Conclusiones El SM es alto en niños con obesidad, y su asociación con la resistencia a la insulina y el riesgo aterogénico es considerable.

Abstract Objective To estimate the prevalence of Metabolic Syndrome (MS), its components and its association with obesity and cardiovascular risk in school age children. Materials and methods A cross-sectional study of 1,017 children from 6 to 12 years of age. Anthropometric information, blood pressure, glucose, insulin, cholesterol, HDLc, LDLc and triglycerides were collected. The presence of MS and its components were determined by criteria of Cook et al. (2003), modified for children and adolescents. In the analysis, the children were grouped by aged group of 6 to 9 and 10 to 12 years. The association between MS, obesity and cardiovascular risk was estimated using Student's t-test and Mann-Whitney U test, Chi-square test and logistic regression. Results The MS was present with 54.6% in obese children. Obesity was the characteristic of greater association to suffer from MS with an OR=8.62 p<0.001. Conclusions MS is high among children with obesity, and is mostly associated with insulin resistance and atherogenic risk.

Novel association of the R230C variant of the ABCA1 gene with high triglyceride levels and low high-density lipoprotein cholesterol levels in Mexican school-age children with high prevalence of obesity.

BACKGROUND AND AIMS: Metabolic syndrome (MetS) is a disorder that includes a cluster of several risk factors for the development of type 2 diabetes and cardiovascular disease. The R230C variant of the ABCA1 gene has been associated with low HDL-cholesterol in several studies, but its association with MetS in children remains to be determined. The aim of this study was to analyze the association of the R230C variant with MetS and other metabolic traits in school-aged Mexican children. METHODS: The study was performed in seven urban primary schools in the State of Mexico. Four hundred thirty-two Mexican school-age children 6-13 years old were recruited. MetS was identified using the International Diabetes Federation definition. The R230C variant of the ABCA1 gene was genotyped to seek associations with MetS and other metabolic traits. RESULTS: The prevalence of MetS was 29% in children aged 10-13 years. The R230C variant was not associated with MetS (OR = 1.65; p = 0.139). Furthermore, in the whole population, the R230C variant was associated with low HDL-cholesterol levels (ß coefficient = -3.28, p <0.001). Interestingly, in the total population we found a novel association of this variant with high triglyceride levels (ß coefficient = 14.34; p = 0.027). CONCLUSIONS: We found a new association of the R230C variant of the ABCA1 gene with high triglyceride levels. Our findings also replicate the association of this variant with low HDL-cholesterol levels in Mexican school-age children.

Conocimientos en nutrición, sobrepeso u obesidad en mujeres de estratos socioeconómicos bajos de la Ciudad de México

El objetivo de este estudio fue identificar la asociación entre los conocimientos sobre nutrición con el sobrepeso u obesidad en mujeres responsables del hogar, de familias de estratos socioeconómicos bajos de la Ciudad de México, provenientes de la Encuesta Urbana de Alimentación y Nutrición en la Zona Metropolitana de la Ciudad de México 2002 (ENURBAL 2002), con un diseño estratificado, polietápico y por conglomerados. Se utilizó un modelo de regresión logística ordinal para evaluar la asociación entre obesidad y sobrepeso u obesidad con conocimientos sobre nutrición y otras variables sociodemográficas y dietéticas. Los factores asociados para sobrepeso u obesidad fueron el tener conocimientos correctos sobre nutrición (OR=2,00; IC95%=1,13- 3,54) o regulares (OR=1,54; IC95%=1,03-2,30); ser mayor de 30 años de edad (OR=3,00; IC95%=1,94-4,64); ser analfabeta o tener primaria incompleta (OR=2,00; IC95%=1,14- 3,51), así como pertenecer al nivel socioeconómico medio bajo (OR=2,04; IC95%=1,33-3,15) y el consumo alto de grasas (OR=1,65; IC95%=1,07-2,55). Para obesidad fueron ser mayor de 30 años de edad (OR=2,42; IC95%=1,48-3,94) y el consumo alto de grasas (OR=1,67; IC95%=1,05-2,66). Se concluye que los resultados ayudan a identificar factores asociados con sobrepeso u obesidad en mujeres de estratos socioeconómicos bajos, en específico con conocimientos sobre nutrición. Se pone de manifiesto la importancia de considerar los conocimientos que tiene la población, para plantear estrategias de intervención en el control y en la prevención del sobrepeso y de la obesidad.

The objective of this study was to identify the association between knowledge about nutrition with the presence of obesity or overweight in women with low income in Mexico City. Data was obtained with the Urban Food and Nutrition Survey 2002 in the Metropolitan Area of Mexico City (ENURBAL 2002), a stratified multistage and clustered design survey. An ordinal logistic regression model was used in order to estimate the probability to present obesity and overweight or obesity, in relation to nutritional knowledge, age, education, employment, socioeconomic status, and total fat consumption. The variables that were related to overweight or obesity: correct or regular nutrition knowledge (OR=2,00; CI95%=1,13-3,54) and (OR=1,54; CI95%= 1,03-2,30), respectively; age 30 years (OR=3,00; CI95%= 1,94-4,64), , belonging to a medium - low socioeconomic status (OR=2,04; CI95%=1,33-3,15), and high fat consumption (OR=1,65; CI95%=1,07-2,55). For obesity was age 30 years (OR=2,42; IC95%=1,48-3,94) and high fat consumption (OR=1,67; IC95%=1,05-2,66). Our results helped to identify associated factors in women with obesity and overweight from low income households, mainly those concerning with nutrition knowledge. This emphasizes the importance of improving knowledge about nutrition, in planning the strategy for interventions aimed to prevent overweight and obesity.

[Nutritional knowledge and its association with overweight and obesity in Mexican women with low socioeconomic level]. / Conocimientos en nutrición, sobrepeso u obesidad en mujeres de estratos socioeconómicos bajos de la Ciudad de México.

The objective of this study was to identify the association between knowledge about nutrition with the presence of obesity or overweight in women with low income in Mexico City. Data was obtained with the Urban Food and Nutrition Survey 2002 in the Metropolitan Area of Mexico City (ENURBAL 2002), a stratified multistage and clustered design survey. An ordinal logistic regression model was used in order to estimate the probability to present obesity and overweight or obesity, in relation to nutritional knowledge, age, education, employment, socioeconomic status, and total fat consumption. The variables that were related to overweight or obesity: correct or regular nutrition knowledge (OR = 2,00; CI95% = 1,13-3,54) and (OR = 1,54; CI 95%= 1,03-2,30), respectively; age 30 years (OR = 3,00; CI 95% = 1,94-4,64), belonging to a medium- low socioeconomic status (OR = 2,04; CI 95% = 1,33-3,15), and high fat consumption (OR = 1,65; CI 95% = 1,07-2,55). For obesity was age 30 years (OR = 2,42; IC 95% = 1,48-3,94) and high fat consumption (OR = 1,67; IC 95% = 1,05-2,66). Our results helped to identify associated factors in women with obesity and overweight from low income households, mainly those concerning with nutrition knowledge. This emphasizes the importance of improving knowledge about nutrition, in planning the strategy for interventions aimed to prevent overweight and obesity.