RESUMO
AIM: To study the evolution of impaired fasting glucose (IFG), considering glucose and HbA1c levels and risk factors associated, in a period of 6 years. METHODS: We studied 94 subjects with impaired fasting glucose (IFG) that were diagnosed in 2005 and followed up to 2012. Glucose and HbA1c levels were determined. A descriptive analysis of contingence charts was performed in order to study the evolution in the development of type-2 diabetes mellitus (T2DM). RESULTS: Twenty-eight of ninety-four subjects became T2DM; 51/94 remained with IFG; and 20/94 presented normal fasting glucose. From the 28 diabetic subjects, 9 had already developed diabetes and were under treatment with oral hypoglycemic agents; 5 were diagnosed with plasma glucose < 126 mg/dL, but with HbA1c over 6.5%. In those who developed diabetes, 15/28 had a family history of T2DM in first relative degree. Also, diabetic subjects had a BMI significantly higher than nodiabetics (t test: P < 0.01). The individuals that in 2005 had the highest BMI are those who currently have diabetes. CONCLUSION: The IFG constitutes a condition of high risk of developing T2DM in a few years, especially over 110 mg/dL and in obesity patients.
Assuntos
Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Jejum/sangue , Transtornos do Metabolismo de Glucose/sangue , Administração Oral , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Índice de Massa Corporal , Chile/epidemiologia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/genética , Progressão da Doença , Feminino , Seguimentos , Predisposição Genética para Doença , Transtornos do Metabolismo de Glucose/diagnóstico , Transtornos do Metabolismo de Glucose/tratamento farmacológico , Transtornos do Metabolismo de Glucose/epidemiologia , Transtornos do Metabolismo de Glucose/genética , Hemoglobinas Glicadas/metabolismo , Humanos , Hipoglicemiantes/administração & dosagem , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/epidemiologia , Linhagem , Fatores de Risco , Fatores de TempoRESUMO
Metabolic syndrome (MS) is a core set of disorders, including abdominal obesity, dyslipidemia, hypertension and hypertriglyceridemia that together predict the development of diabetes type 2 and cardiovascular disease. This study investigated the relationship between liver enzyme levels and high-sensitivity C-reactive protein (hs-CRP) in subjects with and without MS. Alanine-aminotransferase (ALAT), aspartate-aminotransferase (ASAT), γ-glutamyl transferase (GGT) and hs-CRP were measured in 510 subjects, aged 40 to 65 years old. Patients were selected from 1007 subjects from the Research Program for Cardiovascular Disease Risk Factors in Talca, Chile. Results showed that women with MS presented higher liver enzyme levels than those who did not have MS. This was not observed in male patients for the enzymes ALAT and ASAT. However, GGT and hs-PCR levels were higher in male and female patients with MS than in those without MS. In conclusion, it is important to search for the presence of MS when diagnosing fatty liver. Moreover, the presence of liver disease in patients with MS should be further investigated.
RESUMO
BACKGROUND: The analysis of infant mortality from congenital malformations, which at present is the main group of causes of this mortality in Chile, suggests that it could be decreased with a good knowledge of its conditioning factors. AIM: To study infant mortality differentials from congenital malformations with linked records, in the 1993 to 1995 Chilean birth cohorts. MATERIAL AND METHODS: Analysis of mortality differentials in 1993, 1994 and 1995 birth cohorts. Multivariate logistic regression of mortality from congenital diseases. RESULTS: Univariate analysis showed that mortality is highest in the Southern regions of the country (VII to XII) and in rural areas. It is also higher in children from older and from very young mothers, it increases along with the birth order of the child and decreases with increasing educational level of the mother. Multiple logistic regression analysis, confirmed the higher mortality in the Southern regions, aged mothers, high birth order of the child and low educational level of the mother. However no significant influence of rurality nor greater mortality in children of very young mothers was found. CONCLUSIONS: These results can be attributed to the fact that this type of analysis permits the control with other variables. Although the mortality data showed interesting relationships with the independent variables, a registry of all live births and stillbirths with congenital anomalies, that would provide greater numbers and data on non fatal anomalies, would be desirable to better study their causal factors.
Assuntos
Anormalidades Congênitas/mortalidade , Adulto , Ordem de Nascimento , Criança , Chile/epidemiologia , Escolaridade , Feminino , Humanos , Modelos Logísticos , Análise por Pareamento , Idade Materna , Pessoa de Meia-Idade , Razão de Chances , Fatores de RiscoRESUMO
OBJECTIVE: To evaluate the effect of zinc supplementation on growth and development during infancy. DESIGN: We randomized 150 term neonates of low socioeconomic status to receive supplemental zinc 5 mg/d (SG) or a lactose placebo (PG); 112 completed a 1-year follow-up. All were breast-fed and given cow milk formula after weaning; solid foods and iron were added at 5 months. Anthropometry measured monthly, psychomotor development (PDI), mental development (MDI), and behavior including motor quality factor were assessed by Bayley Scales at 6 and 12 months. The groups were comparable in maternal characteristics, birth weight, home environment, and mother-infant interaction. RESULTS: No effects of zinc on weight, length, and weight for length at 12 months were found controlling for sex and breast-feeding. The mean PDI (SG: 84.5 +/- 11.5 vs PG: 87.6 +/- 9.9) and MDI (90.9 +/- 10.5 vs 88.9 +/- 9.1) were similar; however, 46 of 52 infants in the PG scored <100 in MDI vs 42 of 57 in the SG (P <.05). A smaller proportion of the SG, 2 of 57, scored low in motor quality factor at 6 months compared with the PG, 8 of 52 (P =.02). The mean at 12 months for the SG was 31.9 +/- 2.8 and for the PG 30.8 +/- 2.9 (P <.05); zinc supplementation entered the multiple regression at 12 months (P =.037). CONCLUSIONS: Zinc supplementation may have a beneficial effect on mental development and motor quality behavior of healthy term infants.
Assuntos
Desenvolvimento Infantil/efeitos dos fármacos , Crescimento/efeitos dos fármacos , Zinco/administração & dosagem , Chile , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Processos Mentais/efeitos dos fármacos , Desempenho Psicomotor/efeitos dos fármacos , Fatores Socioeconômicos , Zinco/deficiência , Zinco/farmacologiaRESUMO
This study evaluates the participation of psychosocial variables in the relation between breast feeding (BF) and psychomotor development (PMD) in dyads with different BF duration. We assessed 138 mother-infant dyads, divided in two groups: 86 received BF as unique source of milk feeding for at least 6 months (prolonged BF group) and 52 were weaned before 45 days of age (early weaning group). General information about pregnancy, delivery and feeding was collected in a non experimental prospective design. At 6-7 months of age a milk feeding situation was observed at home, and mother-infant interactional patterns were recorded through a specially designed scale. At 12 months of age the PMD was assessed (Bayley Scales of Infant Development). Infant temperament, home stimulation, mother depression and family stress were also measured. Similar family characteristics were observed in both study groups. Early bonding and first feeding experiences were different, both reported as better in the prolonged BF group. Moreover, dyads of this group showed a higher variety and quality of mother-infant interactional patterns during feeding, with a higher synchrony and reciprocity in the relationship. Mean Mental Development Index (MDI) and Psychomotor Developmental Index (PDI) were similar in both groups. Explicatory variables for MDI and PDI are different in both study groups. Dyads who attained prolonged BF conform from a psychosocial perspective--a different group than the early weaned.
Assuntos
Aleitamento Materno , Desenvolvimento Infantil , Relações Mãe-Filho , Desempenho Psicomotor , Adulto , Características da Família , Feminino , Humanos , Lactente , Masculino , Análise MultivariadaRESUMO
The purpose of this case-control study was to determine the association between very-mild-to-moderate enamel fluorosis and exposure during early childhood to fluoridated water, mainly through ingestion of powdered milk. Analysis was performed on 136 residents of the optimally fluoridated community of San Felipe in the Chilean Fifth Region, who were categorised into one of three groups according to their age when water fluoridation was introduced in 1986: Group I was born after 1986; Group II was 16-24 months old in 1986; and Group III was >24 months of age. The case and control subjects were selected on the basis of a clinical examination given in July 1996. Dean's scoring system was used to determine fluorosis status. Risk factor exposure was ascertained by a questionnaire used in interviews with mothers of participating children. Logistic regression analysis, after adjustment for confounding variables, revealed that very-mild-to-moderate enamel fluorosis of permanent central maxillary incisors (CMI) was strongly associated both with the age of the subjects when water fluoridation began and with breast-feeding duration for children belonging to Group I. Subjects in Group I were 20.44 times more likely (95% CI: 5.00-93.48) to develop CMI fluorosis than children who were older than 24 months (Group III) when fluoridation began. Subjects who were between 16 and 24 months old when water fluoridation began were 4.15 times more likely (95% CI: 1.05-16.43) to have CMI fluorosis than children older than 24 months. An inverse association was found with breastfeeding duration (OR=0.86, 95% CI: 0.75-0.98) among Group I subjects but not in Groups II and III. Results obtained suggest that the current fluoride concentration in drinking water may be contributing to fluorosis. Further studies will be necessary to determine the relative competing risks of dental fluorosis and dental caries in Chilean children in order to establish the most appropriate water fluoridation level in Chile.
Assuntos
Fluoretação/efeitos adversos , Fluorose Dentária/epidemiologia , Fluorose Dentária/etiologia , Análise de Variância , Aleitamento Materno , Criança , Pré-Escolar , Chile/epidemiologia , Humanos , Lactente , Modelos Logísticos , Prevalência , Fatores de Risco , Inquéritos e Questionários , Chá/efeitos adversos , Cremes Dentais/efeitos adversosRESUMO
The use of three statistical models yielded different estimates of the odds ratio relative to the association between the polymorphism in the HLA-DQ region and insulin-dependent diabetes mellitus (IDDM). The models used were: (1) the allele-dosage model which assumes that the number of susceptibility alleles has a linear effect on the logarithm of the odds; (2) the reference cell coding method used with alleles of susceptibility as a risk factor; or (3) a model that uses a classification of alpha/beta heterodimers as a susceptibility factor. We suggest that models which imply a log-linear relationship between a susceptibility marker and disease such as the first model are not appropriate in the assessment of the HLA-IDDM association. In contrast, although both latter models are valid, the third model is more compatible with current hypotheses of the pathological process of the disease. Once an estimation of the odds ratio is chosen, we use such an estimation to calculate an approximation of the prevalence of IDDM according to the polymorphism in HLA-DQ region using the iterative procedure of Newton-Raphson. These approaches are illustrated with data from a case-control study previously conducted in the city of Santiago, Chile.
Assuntos
Diabetes Mellitus Tipo 1/epidemiologia , Antígenos HLA-DQ/genética , Modelos Estatísticos , Alelos , Chile/epidemiologia , Estudos Transversais , Humanos , Polimorfismo GenéticoRESUMO
To analyze the effect of zinc supplementation on postnatal growth of infants born small for gestational age, we selected 68 infants at birth and followed them monthly for 6 months. They were randomly assigned to a supplemented group (group S, n = 35) receiving 3 mg of Zn (acetate) per day, or to a placebo (group P, n = 33), in a double-blind study. Weight increments in group S were significantly higher than those in group P at 2 months (p < 0.003); z scores showed catch-up growth only in group S. Length increments were also greater in group S than in group P, ending at 6 months were 64.9 +/- 1.8 versus 63.4 +/- 3.5 cm (mean +/- SD; p < 0.01); changes in z scores for 6 months were -1.28 to -0.66 in group S and -1.43 to -1.47 in group P (p < 0.001). Weight-for-length improved similarly in both groups (z score, -2.2 to +0.2). The increase in weight-for-age was higher in group S girls (p < 0.034), ending at 6 months with -0.13 +/- 0.59, versus -0.52 +/- 0.62 in group S boys, -1.15 +/- 0.49 in group P girls, and -1.05 +/- 0.80 in group P boys (+/- SD). More infants in group P received cow milk-based formula before 4 months because of inadequate weight increments. An additive effect on weight increase was observed between Zn supplementation (p < 0.02), exclusive breast-feeding after 4 months of age (p < 0.001), and gender (p < 0.02). Plasma and hair Zn values showed a downward trend, less marked in group S than in group P. We conclude that Chilean infants born small for gestational age have better weight and linear growth during the first 6 months of life if they receive Zn supplementation.
Assuntos
Recém-Nascido Pequeno para a Idade Gestacional/crescimento & desenvolvimento , Zinco/deficiência , Zinco/uso terapêutico , Acetatos/uso terapêutico , Ácido Acético , Índice de Apgar , Peso ao Nascer , Aleitamento Materno , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Lactente , Alimentos Infantis , Recém-Nascido , Masculino , Fatores de Tempo , Aumento de Peso , Zinco/metabolismoRESUMO
"The paper starts with a brief analysis of the sources and the quality of the data and the mortality indices [for trends in adult mortality from chronic diseases in Chile]....A comparison is made of mortality among the 13 regions of the country and an attempt is made to relate the observed differences to some environmental and life-style factors. Rural-urban and educational differences of mortality by cause of death are also analyzed. The paper ends by comparing mortality by chronic disease in Chile with that of other countries of the Latin American region, noting some difficulties [in] such a comparison and proposing hypotheses for future studies." (SUMMARY IN ENG)
Assuntos
Adulto , Causas de Morte , Doença Crônica , Coleta de Dados , Educação , Meio Ambiente , Geografia , Estilo de Vida , Mortalidade , Projetos de Pesquisa , Fatores Etários , América , Comportamento , Chile , Demografia , Países em Desenvolvimento , Doença , América Latina , População , Características da População , Dinâmica Populacional , Pesquisa , América do Sul , Estatística como AssuntoRESUMO
Aiming to describe the place that Chile has in the epidemiological transition, a descriptive study of the changes in demographic and epidemiological profiles of the country during the last 30 years is presented. The important decrease in general and child mortality rates, that has lead to an increase in life expectancy and ageing of the population, is emphasized. A 82% reduction in the proportion of deaths among less than one year old children and a 62% increase in mortality among people 65 years or older is observed. In agreement with these changes, non transmissible chronic diseases appear as the principal cause of mortality (65% of all deaths). However, regarding morbidity, an increase in digestive infectious and sexually transmitted diseases and a decrease in immuno-preventable diseases, excepting measles, is noted. It is concluded that, according to mortality, Chile is in a post transition stage, but there is persistence of some infectious diseases, typical of a pre-transition stage.