Prevalence of Sarcopenia in Community-Dwelling Chilean Elders According to an Adapted Version of the European Working Group on Sarcopenia in Older People (EWGSOP) Criteria.

BACKGROUND: Sarcopenia is the progressive loss of mass and skeletal muscle strength and has serious consequences on older people's health. The Chilean older population has a high life-expectancy, but the prevalence of functional dependence is also high. OBJECTIVE: To determine the prevalence of sarcopenia in Chilean older adults and its relationship with age, gender, and body mass index (BMI). DESIGN: Cross-sectional study. SETTING: Community. PARTICIPANTS: 1,006 non-disabled, community-dwelling subjects aged 60 years or older living in Santiago. MEASUREMENTS: Anthropometric measurements, handgrip strength, physical performance tests, and dual-energy-x-ray-absorptiometry (DXA) scan were performed. Sarcopenia was defined using the algorithm of the European Working Group on Sarcopenia in Older People (EWGSOP). Muscle mass was measured with DXA scan; skeletal muscle mass index (SMI) and hand dynamometry were defined with cut-off points obtained for the Chilean population. For a 3m walking speed we used the cut-off point of the EWGSOP definition. Nutritional status and obesity were defined according to World Health Organization standards. Association between sarcopenia and age, gender, BMI and lean/fat mass ratio was estimated by logistic regression models. RESULTS: The prevalence of sarcopenia was 19.1% (95%CI: 16.8%-21.8%), similar in men and women. There was an increasing trend of sarcopenia by age group and a decreasing trend with nutritional status. After logistic regression, sarcopenia was positively associated with age (OR=1.10; 95%CI:1.06-1.15) and falls (OR=1.83; 95%CI:1.07-3.15) and negatively associated with overweight (OR=0.31; 95%CI:0.16-0.59), obesity (OR=0.02; 95%CI:0.004-0.11), lean mass/fat mass ratio (OR=0.69; 95%CI:0.48-0.9997), knee height (OR=0.78; 95%CI:0.68-0.89) and calf circumference (OR=0.87; 95%CI:0.77-0.97). CONCLUSIONS: The total prevalence of sarcopenia was 19.1% increasing with age reaching 39.6% in people of 80 or more years of age. A negative association of sarcopenia with overweight, obesity and lean/fat mass ratio was observed. Although the high prevalence of obesity (35.9%), only 2% of obese people were sarcopenic.

Mini Nutritional Assessment Short-Form: Validation in Five Latin American Cities. SABE Study.

OBJECTIVES: To validate the short-form of the MNA (MNA-SF) and the cut-off point of 31 cm for calf circumference (CC) in older people in Latin America. METHODS: A cross-sectional study was conducted with 5,722 community-dwelling older subjects (range: 60-102 years) in Latin America´s five main cities: Sao Paulo (Brazil), Santiago (Chile), Havana (Cuba), Mexico DF (Mexico) and Montevideo (Uruguay). All participants underwent an interview, which included anthropometric measurements, completing the MNA and obtaining socio-demographic, nutrition and health information. The short-form of the MNA consists of only six questions from the original 18. It has two versions: one using body mass index (BMI) and the second using CC as a surrogate. Cohen's Kappa was calculated to assess the agreement between the MNA and the MNA-SF; diagnostic tests were performed, and Receiver-operating characteristic (ROC) curves were developed. Criterion-related validity was assessed in the Chilean sample. RESULTS: Both version of the MNA-SF showed high sensitivity and specificity with the MNA, showing good accuracy (0.88), although higher values were estimated for malnutrition and risk of malnutrition in the total sample by sex. The cut-off point of 31 cm for CC showed high sensitivity (74.6-94.4%), specificity (72.6-100%) and good area under the ROC curve (0.87-0.95) when compared with BMI. There was good agreement between MNA and both version of MNA-SF for identifying persons with malnutrition or a risk of malnutrition in the five cities (Kappa coefficient: 0.6193-0.7852). CONCLUSION: Both versions of the MNA-SF are population-screening tools of easy and fast application, with good accuracy for assessing malnutrition and risk of malnutrition in Latin American older people.

[Methods of body composition and four compartiments model in obese school children]. / Métodos de composición corporal y modelo de cuatro compartimentos en escolares obesos chilenos.

INTRODUCTION: In Chile, the prevalence of obesity in schoolchildren is 21.3%. The study and individual intervention of this malnutrition, it is necessary to have not only global indicators of nutritional status, but also indicators that give information on body composition. OBJECTIVE: To compare estimates of body fat isotopic dilution, plethysmography and radiographic absorptiometry 4C model in overweight schoolchildren. METHODS: We worked with 61 obese (BMI ≥ p 95) of both sexes, between 8 and 13 years, enrolled in a school in a district of the city of Santiago. The multicompartmental body composition determination, considered isotopic dilution, plethysmography and radiographic absorptiometry. Using as a reference standard four compartment model of Fuller. RESULTS: In both sexes, the method showed better agreement with the reference of 4 compartments was isotope dilution (r = 0.98, p < 0.01). In children, the isotopic dilution underestimates body fat in -0.40 kg. By contrast, DEXA and plethysmography overestimate body fat by 0.81 kg and 1.89 kg respectively. In women, all methods overestimate body fat, with less emphasis isotopic dilution value 0.46 kg, 0.52 kg after DEXA and plethysmography 1.31 kg. CONCLUSIONS: The deuterium isotopic dilution would be the most sensitive method for estimating body fat in research studies because it shows the best agreement with the gold standard multicompartmental model.

Métodos de composición corporal y modelo de cuatro compartimentos en escolares obesos chilenos / Methods of body composition and four compartiments model in obese school children

Introducción: En Chile, la prevalencia de obesidad en los escolares es de 21,3%. El estudio y la intervención individual de esta malnutrición, hacen necesario contar no sólo con indicadores globales de estado nutricional, sino también, indicadores que entreguen información de la composición corporal. Objetivo: Comparar las estimaciones de la grasa corporal de dilución isotópica, pletismografía y absorciometría radiográfica con el modelo de 4C en escolares obesos. Métodos: Se trabajó con 61 niños obesos (IMC > p 95) de ambos sexos, entre 8 y 13 años, reclutados en un colegio de una comuna de la ciudad de Santiago. La determinación de composición corporal multicompartimental, consideró dilución isotópica, pletismografía y absorciometría radiográfica; utilizando como patrón de referencia el modelo de cuatro compartimentos de Fuller. Resultados: En ambos sexos, el método que mejor concordancia mostró con el referente de 4 compartimentos fue la dilución isotópica (r = 0,98; p < 0,01). En niños, la dilución isotópica subestima la grasa corporal en -0,40 kg. Al contrario, la absorciometría radiográfica y la pletismografía sobreestiman la grasa corporal en 0,81 kg y 1,89 kg respectivamente. En mujeres, todos los métodos sobreestiman la grasa corporal, destacando con un menor valor la dilución isotópica (0,46 kg), luego la absorciometría radiográfica (0,52 kg) y la pletismografía (1,31 kg). Conclusiones: La dilución isotópica con deuterio sería el método más sensible para estimar grasa corporal en estudios de investigación ya que muestra la mejor concordancia con el gold estándar del modelo multicompartimental (AU)

Introduction: In Chile, the prevalence of obesity in schoolchildren is 21.3%. The study and individual intervention of this malnutrition, it is necessary to have not only global indicators of nutritional status, but also indicators that give information on body composition. Objective: To compare estimates of body fat isotopic dilution, plethysmography and radiographic absorptiometry 4C model in overweight schoolchildren. Methods: We worked with 61 obese (BMI > p 95) of both sexes, between 8 and 13 years, enrolled in a school in a district of the city of Santiago. The multicompartmental body composition determination, considered isotopic dilution, plethysmography and radiographic absorptiometry. Using as a reference standard four compartment model of Fuller. Results: In both sexes, the method showed better agreement with the reference of 4 compartments was isotope dilution (r = 0.98, p < 0.01). In children, the isotopic dilution underestimates body fat in -0.40 kg. By contrast, DEXA and plethysmography overestimate body fat by 0.81 kg and 1.89 kg respectively. In women, all methods overestimate body fat, with less emphasis isotopic dilution value 0.46 kg, 0.52 kg after DEXA and plethysmography 1.31 kg. Conclusions: The deuterium isotopic dilution would be the most sensitive method for estimating body fat in research studies because it shows the best agreement with the gold standard multicompartmental model (AU)

Lack of association between the fatty acid binding protein 2 (FABP2) polymorphism with obesity and insulin resistance in two aboriginal populations from Chile.

The aim of this study was to assess the frequency of fatty acid binding protein 2 (FABP2) Ala54Thr genetic polymorphism and to evaluate its association with obesity and insulin resistance in Chilean aboriginal populations. A sample of 96 urban Aymara and 111 urban Mapuche subjects aged 20-80 years were recruited for this cross-sectional study. Glucose, insulin and lipid profile were measured in fasting plasma samples. Insulin resistance was estimated through the HOMA-IR model. FABP2 Ala54Thr genotypes were determined by PCR followed by RFLP analysis. The allele frequency of Thr54 variant was estimated as 18.2% in Aymara subjects, which is one of the lowest reported to date. The corresponding frequency in Mapuche subjects was 31.9% (p<0.002). Regarding genotype-phenotype associations, no significant differences were found in any of the anthropometric or metabolic variables according to Ala54Thr genotypes. After adjustment by BMI and metabolic variables through a logistic regression analysis, the association of the FABP2 polymorphism with ethnic group persisted (Mapuche group: OR=2.37, 95% CI 1.319-4.277, p=0.004) It is unlikely that Ala54Thr polymorphism of the FABP2 gene plays a relevant role in obesity and insulin resistance in Chilean ethnic groups.

Adiposity and bone mineral density of Chilean elderly women in relation to toll-like receptor 4 gene polymorphisms.

BACKGROUND: It has been proposed that the toll-like receptor-4 gene (TLR4) may participate in the development of obesity and osteoporosis, in addition to its well-known role in the immune response. On the other hand, the adipose tissue of obese subjects shows an increased expression of the proinflammatory cytokine, tumour necrosis factor-alpha (TNF-alpha), which is released after lipopolysaccharide recognition by TLR4. AIM: To estimate the allele/genotype frequencies and linkage disequilibrium measures of Asp299Gly and Thr399Ile polymorphisms of the TLR4 gene in the Chilean elderly population, and to screen for their association with variables related to adiposity or bone mineral density. SUBJECTS AND METHODS: The study group included 227 unrelated Chilean elderly women (61-95 years) recruited from a population-based sample. Adiposity and bone mineral density measures were obtained using dual-energy X-ray absorptiometry. RESULTS: The allele frequencies for TNF -308A, TLR4 299Gly and TLR4 -399Ile were 9.3%, 4.6% and 4.4%, respectively, with Asp299Gly and Thr399Ile being in strong linkage disequilibrium (D' = 0.88). Although seriously restricted by the low frequency of the allele variants, no relevant association between genotypes and adiposity-related variables were found. Likewise, no significant association between osteoporosis status (categorized as osteoporosis, osteopenia or normal status) with TLR4 Asp299Gly or TNF -308G>A genotypes was found. CONCLUSION: It is unlikely that TLR4 Asp299Gly, TLR4 Thr399Ile or TNF -308G>A polymorphisms have a major influence on adiposity, bone mineral density or osteoporosis status in Chilean elderly women.

Anthropometric measurements in the elderly population of Santiago, Chile.

OBJECTIVE: There are few studies on anthropometry and nutritional status in large and representative samples of elderly populations in Chile and South America. We describe age and sex differences in weight, height, body mass index, knee height, waist circumference, midarm circumference, triceps skinfold thickness, arm muscle area, and calf circumference in Chilean elderly subjects. METHODS: This was a population-based, cross-sectional study. A total of 1220 elderly persons (819 women and 411 men; age range, 60-99 y) were recruited in the city of Santiago (Chile) through a probabilistic sampling procedure carried out from October to December 1999. RESULTS: Men were significantly heavier and taller than women in all age groups, whereas body mass index values were significantly higher in women than in men. All anthropometric variables showed a decrease in average values with aging in men and women. The apparent negative slopes for the decline in average values of body weight with aging was of greater magnitude in women than in men (-0.42 kg/y and -0.54 kg/y in male and female subjects, respectively). However, significant age x sex interaction was detected only for triceps skinfold thickness. In women, quadratic terms for age provided a significantly better fit than did the simple linear model for the association between age and weight, body mass index, waist circumference, triceps skinfold thickness, calf circumference, or midarm circumference. CONCLUSION: These observations indicated that body weight changes associated with aging might be more severe in Chilean women than in men, probably determining a differential pattern of lean and fat mass loss.

Nutritional status, food consumption and physical activity among Chilean school children: a descriptive study.

OBJECTIVE: To assess the nutritional status, food consumption and physical activity (PA) habits of Chilean school children, as a baseline for developing an educational intervention. DESIGN: Cross-sectional study. SUBJECTS: A total of 1701 children from 3rd to 7th grade in nine schools located in three geographical regions. METHODS: We determined body mass index, food consumption (quantified FFQ which we categorised into five groups), PA in terms of TV viewing and frequency of after school PA. The data were analysed according to age, nutritional status and gender. A logistic regression analysis was performed using obesity as outcome. RESULTS: Obesity was higher among boys; younger children presented higher prevalence in both genders. Daily intake of dairy products varied between 240 and 308 g, fruits/vegetables, between 197 and 271 g, energy-dense foods between 343 and 460 g. In all, 22.3 and 47% of the children watched over 3 h of TV during the week and weekend, respectively. Older children watched significantly more TV during the week, while on weekends all children increased this time significantly. Boys were more active than girls after school. The logistic regression analysis showed a significant association between obesity and low intake of dairy products. CONCLUSIONS: Prevalence of obesity among Chilean children is high. Although TV time, intake of energy dense foods and fruits/vegetables appeared as risk factors for obesity, only dairy consumption was significantly associated with obesity. SPONSORSHIP: FAO

DNA polymerase lambda (Pol lambda), a novel eukaryotic DNA polymerase with a potential role in meiosis.

A new gene (POLL) encoding a novel DNA polymerase (Pol lambda) has been identified at mouse chromosome 19. Murine Pol lambda, consisting of 573 amino acid residues, has a 32% identity to Pol beta, involved in nuclear DNA repair in eukaryotic cells. It is interesting that Pol lambda contains all the critical residues involved in DNA binding, nucleotide binding and selection, and catalysis of DNA polymerization, that are conserved in Pol beta and other DNA polymerases belonging to family X. Murine Pol lambda, overproduced in Escherichia coli, displayed intrinsic DNA polymerase activity when assessed by in situ gel analysis. Pol lambda also conserves the critical residues of Pol beta required for its intrinsic deoxyribose phosphate lyase (dRPase) activity. The first 230 amino acid residues of Pol lambda, that have no counterpart in Pol beta, contain a BRCT domain, present in a variety of cell-cycle check-point control proteins responsive to DNA damage and proteins involved in DNA repair. Northern blotting, in situ hybridization analysis and immunostaining showed high levels of Pol lambda specifically expressed in testis, being developmentally regulated and mainly associated to pachytene spermatocytes. These first evidences, although indirect, suggest a potential role of Pol lambda in DNA repair synthesis associated with meiosis.

DNA vaccination with HIV-1 expressing constructs elicits immune responses in humans.

Humoral and cellular immune responses have been produced by intramuscular vaccination with DNA plasmids expressing HIV-1 genes, suggesting possible immunotherapeutic and prophylactic value for these constructs. Vaccination with these constructs has decreased HIV-1 viral load in HIV-1-infected chimpanzees. In addition, naive (i.e. non-HIV-1-infected) chimpanzees were protected against a heterologous challenge with HIV-1. Ongoing phase I clinical trials show that therapeutic vaccinations indeed boost anti-HIV-1 immune responses in humans. A therapeutic phase I trial on humans with these constructs induced a good safety profile and also demonstrated an immunological potentiation. These findings indicate that further studies with these constructs in humans are warranted.

Pre-operative autologous blood donations. A five-year experience in Trinidad and Tobago.

A pre-operative autologous blood donation programme was started in 1988 and made available to all doctors offering elective surgical procedures. Two hundred and seventy-seven (277) patients presented for autologous donation over a five-year period. Nine point four per cent were rejected because of low haemoglobin ( < 10.5 g/dl). The single biggest user of the programme was the Princess Elizabeth Hospital for handicapped persons. Patients undergoing orthopaedic procedures gave 50% of the donations, and ranged in age from 10 to 73 years. The oldest donor was a 73-year-old man who had an abdominal aortic aneurysm replaced. Gynaecological surgeons in the public and private sectors together provided 43.9% of donors, 3.6% of these underwent elective Caesarean Section, each donating one unit of blood at 36 weeks. Patients undergoing general surgical procedures comprised 10.4% of donors. Autologous donors contributed 1.3% of the total number of donations over this period.

Pre-operative autologous blood donations: a five year experience in Trinidad and Tobago

A pre-operative autologous blood donation programme was started in 1988 and made available to all doctors offering elective surgical procedures. Two hundred and seventy-seven (277) patients presented for autologous donation over a five-year period. Nine point four per cent were rejected because of low haemoglobin (<10.5 g/dl). The single biggest user of the programme was the Princess Elizabeth Hospital for handicapped persons. Patients undergoing orthopaedic procedures gave 50 per cent of the donations, and ranged in age from 10 to 73 years. The oldest donor was a 73-year-old man who had an abdominal aortic aneurysm replaced. Gynaecological surgeons in the public and private sectors together provided 43.9 percent of donors, 3.6 percent of these underwent elective Caesarean Section, each donating one unit of blood at 36 weeks. Patients undergoing general surgical procedures comprised 10.4 percent of donors. Autologous donors contributed 1.3 percent of the total number of donations over this period (AU)

Pre-operative autologous blood donations: a five year experience in Trinidad and Tobago

A pre-operative autologous blood donation programme was started in 1988 and made available to all doctors offering elective surgical procedures. Two hundred and seventy-seven (277) patients presented for autologous donation over a five-year period. Nine point four per cent were rejected because of low haemoglobin (<10.5 g/dl). The single biggest user of the programme was the Princess Elizabeth Hospital for handicapped persons. Patients undergoing orthopaedic procedures gave 50 per cent of the donations, and ranged in age from 10 to 73 years. The oldest donor was a 73-year-old man who had an abdominal aortic aneurysm replaced. Gynaecological surgeons in the public and private sectors together provided 43.9 percent of donors, 3.6 percent of these underwent elective Caesarean Section, each donating one unit of blood at 36 weeks. Patients undergoing general surgical procedures comprised 10.4 percent of donors. Autologous donors contributed 1.3 percent of the total number of donations over this period