[Insulin resistance in overweight cystic fibrosis paediatric patients]. / Resistencia insulínica en pacientes pediátricos con fibrosis quística y sobrepeso.

AIM: To determine the prevalence of overweight in paediatric patients with cystic fibrosis (CF) and to analyse its role as diabetogenic insulin resistance factor and risk of hypertriglyceridaemia. PATIENTS AND METHODS: A total of 109 CF patients (47% males) between 5 and 18 years were divided into 3 groups according to body mass index (BMI): underweight, normal and overweight. Total cholesterol, triglycerides, C- reactive protein (CRP), glycosylated haemoglobin, HOMA-IR and QUICKI index were determined. Insulinogenic index, ISI composite and areas under the curve (AUC) for glucose and insulin were obtained by oral glucose tolerance test (OGTT). RESULTS: Six patients (5.5%) were overweight. All groups had similar distribution by age, sex and CFTR mutation, although the proportion of pancreatic sufficient (3/6, 50%) was higher in overweight patients (P=.003). The prevalence of glycaemic disorders was similar between groups. Baseline insulin, HOMA-IR, and insulin during the OGTT (peak and AUC) were higher in overweight patients. All patients had a delayed insulin response in OGTT. CONCLUSIONS: Overweight CF patients do not have a higher incidence of glycaemic disorders, but their hyperinsulinism and insulin resistance may be additional diabetogenic risk factors.

[Physical activity and leisure time in children. I: Relation to socioeconomic status]. / Actividad física y ocio en jóvenes. I: Influencia del nivel socioeconómico.

OBJECTIVE: To assess physical activity and leisure time activities in relation to socioeconomic status. PATIENTS AND METHODS: We have studied 1,078 boys and girls from 24 schools from areas of different geographical and socioeconomical status. Physical activity and leisure time activities were assessed by a questionnaire. RESULTS: We have observed that adolescents spend more time watching T.V. than doing physical activity (p = 0.0001). In general, boys prefer strong physical activity. Children from the lowest socioeconomic families did less physical activity than children from the highest socioeconomic families (p < or = 0.05). In girls, those with the lowest socioeconomic status spent the greatest amount of time watching T.V. (p = 0.0001). CONCLUSIONS: From our results, we deduce that we must improve physical activity habits in children, especially in those from the lowest socioeconomic families.

[Physical activity and leisure time in children. II: Relationship with dietary habits]. / Actividad física y ocio en jóvenes. II: Relación con los hábitos dietéticos.

OBJECTIVE: To investigate the relationship between physical activity, leisure time activities and dietary habits in adolescents. PATIENTS AND METHODS: We have studied 541 girls and 537 boys from 24 schools. Physical activity, leisure time activities and dietary habits were assessed by 3 different questionnaires, taking into account one week of normal activity and diet. RESULTS: Foods such as milk, fish, meat, egg, fruits, vegetables, pasta and snacks were consumed more frequently in children who spent more time doing sport, but difference were not statistically significant. Boys who spent more time watching T.V. ate greater amounts of almost all foods (p < 0.05). In girls, we have observed the same results, but differences were not statistically significant. CONCLUSIONS: Sports and T.V. watching are both related to a greater amount of food intake From our results we can deduce that in order to prevent obesity, and other cardiovascular risk factors, we must improve food intake related with sedentary habits.

[Behavior of insulin in children with constitutional short stature]. / Comportamiento de la insulina en niños con baja talla variante de la normalidad.

Secretion of insulin in a group of children with normal stature and without endocrine-metabolic (47 cases), versus another group with constitutional short stature (35 cases). Is study authors made a glucose tolerance test (1 g/kg) to both groups and they study the fisiologic secretion of insulin during 24 hours. It was observed that rates of insulin were similar after glucose tolerance test in both groups, but study of fisiologic secretion of insulin during 24 hours shows low rates of insulin in the group of constitutional short stature (p less than 0.005). The problem group rises higher rates of insulin after a glucose tolerance test than after the study of fisiologic secretion of insulin in 24 hours, but the other group shows similar answer in both tests.

Resistencia insulínica en pacientes pediátricos con fibrosis quística y sobrepeso / Insulin resistance in overweight cystic fibrosis paediatric patients

Introducción y objetivos: Conocer la prevalencia de sobrepeso en pacientes pediátricos con fibrosis quística (FQ) y su importancia como factor de resistencia insulínica diabetogénica y riesgo de hipertrigliceridemia. Material y métodos: Ciento nueve pacientes con FQ (47% varones) de 5-18 años se calificaron por su índice de masa corporal (IMC): desnutridos, normales o con sobrepeso. Se determinaron colesterol, triglicéridos y proteína C reactiva (PCR), glucohemoglobina y los índices HOMA-IR y QUICKI y en la sobrecarga oral de glucosa (SOG) su índice insulinogénico e ISI composite y áreas bajo la curva (ABC) de glucosa e insulina. Resultados: Seis pacientes (5,5%) tenían sobrepeso. Su edad, distribución sexual y base genética son similares al resto; aunque la proporción de suficientes pancreáticos (3/6; 50%) es superior (p=0,003). Los trastornos glucídicos no son más frecuentes que en el resto; pero la insulina basal, HOMA-IR, y la insulina durante la SOG (pico máximo y ABC) identifican su hiperinsulinismo, diferenciándolos de los otros dos grupos. Todos los pacientes muestran en la SOG respuesta insulínica tardía, sin diferencias en los índices derivados. Conclusiones: Entre los pacientes FQ con sobrepeso no hay mayor incidencia de trastornos glucídicos pero sí de hiperinsulinismo y resistencia insulínica, con el consiguiente riesgo añadido a la tendencia diabetogénica inherente a estos pacientes(AU)

Aim: To determine the prevalence of overweight in paediatric patients with cystic fibrosis (CF) and to analyse its role as diabetogenic insulin resistance factor and risk of hypertriglyceridaemia. Patients and methods: A total of 109 CF patients (47% males) between 5 and 18 years were divided into 3 groups according to body mass index (BMI): underweight, normal and overweight. Total cholesterol, triglycerides, C- reactive protein (CRP), glycosylated haemoglobin, HOMA-IR and QUICKI index were determined. Insulinogenic index, ISI composite and areas under the curve (AUC) for glucose and insulin were obtained by oral glucose tolerance test (OGTT). Results: Six patients (5.5%) were overweight. All groups had similar distribution by age, sex and CFTR mutation, although the proportion of pancreatic sufficient (3/6, 50%) was higher in overweight patients (P=.003). The prevalence of glycaemic disorders was similar between groups. Baseline insulin, HOMA-IR, and insulin during the OGTT (peak and AUC) were higher in overweight patients. All patients had a delayed insulin response in OGTT. Conclusions: Overweight CF patients do not have a higher incidence of glycaemic disorders, but their hyperinsulinism and insulin resistance may be additional diabetogenic risk factors(AU)

Influencia de la etnia y el sexo en la ingesta de alimentos como factores de riesgo de malnutrición en escolares / Influence of ethnicity and gender in school children food intake as malnutrition risk factors

La dieta de los niños en nuestro país suele ser deficitaria en frutas y verduras y rica en alimentos hipercalóricos. El objetivo del presente estudio es valorar la frecuencia de la ingesta de los grupos de alimentos en escolares de nuestro medio y la influencia sobre ella del sexo y la etnicidad. Se valoraron en una población de 383 niños de 2.º, 3.º y 4.º de Educación Primaria las características socioeconómicas y demográficas, los estilos de vida y la frecuencia de ingesta de grupos de alimentos. Los niños ingirieron más raciones diarias de alimentos ricos en hidratos de carbono (4,38 ± 1,6 frente a 3,97 ± 1,4; p=0,03) y más lácteos (3,23 ± 1,1 frente a 2,83 ± 1,0; p= 0,002) que las niñas; por otro lado, la niñas consumieron más golosinas que los niños (2,81 ± 3,9 frente a 2,01 ± 2,3 raciones por semana; p= 0,03). Un alto porcentaje de niños no cumplía con las recomendaciones habituales de ingesta por defecto de frutas y verduras (78,1%), lácteos (43,4%) e hidratos de carbono (42,8%), y por exceso de proteicos (8,1%), bollería (21,2%),golosinas (18,9%) y refrescos-snacks (8,7%). Los niños pertenecientes al grupo con etnicidad ingirieron significativamente menos lácteos, alimentos proteicos y fruta-verdura y, sin embargo, más bollería, golosinas y refrescos-snacks que los niños sin etnicidad. En el análisis de la relación entre los distintos grupos de alimentos se han encontrado dos asociaciones significativas (p <0,01): 1) la ingesta de frutas y verduras se asoció a un mayor consumo de hidratos de carbono y de pescado, y aun menor consumo de refrescos-snacks y tiempo frente al televisor; 2) la ingesta de bollería se asoció a un mayor consumo de refrescos/snacks y de golosinas. El estudio concluye que el sexo y la etnicidad son factores que influyen en la dieta de los niños en edad escolar y deben considerarse como factores de riesgo de malnutrición (AU)

Children’s diet in our country seems to be deficient in fruits and vegetables and rich in hyper caloric food. The purpose of this study is to access intake frequency of food groups in school children of our environment and the influence gender and ethnicity pose over it as well. We have evaluated the socioeconomic and demographic characteristics, lifestyles and the intake frequency of food groups in a population of 383 2nd, 3rd and 4th grade children from elementary school. Boys consume more daily servings of food rich in carbohydrates (4.38 ± 1.6 vs. 3.97 ± 1.4; p=0.03) and more dairy products (3.23 ± 1.1 vs. 2.83 ± 1.0; p= 0.002) than girls, and, on the other hand, girls eat more candy than boys (2.81 ± 3.9 vs. 2.01 ± 2.3 servings per week; p= 0.03). A high percentage of children did not meet regular recommended food percentages, both by deficiency: fruits and vegetables (78.1%), dairy products (43.4%) and carbohydrates (42.8%); and by excess: protein food (8.1%), pastries (21.2%), candy (18.9%), and sodas/snacks (8.7%). Children belonging to a certain ethnic group consume significantly less dairy products, protein products and fruits/vegetables; and, at the same time, more pastries, candy and sodas/snacks than children that do not belong to a specific ethnic group. Two significant associations (p <0.01) have been found in the analysis of the relationship between different food groups: 1) fruits and vegetables intake was associated with a higher consumption of carbohydrates and fish, and with alower consumption of sodas/snacks and time watching TV; and2) pastry intake was associated with a higher consumption of sodas/snacks and sweets. The study concludes that gender and ethnicity are factors that influence the school children´s diet and they shall be considered as risk factors for malnutrition (AU)