F. Olea-Serrano

Human exposure to endocrine-disrupting chemicals and prenatal risk factors for cryptorchidism and hypospadias: a nested case-control study

Background Exposure to xenoestrogens during pregnancy may disturb the development and function of male sexual organs. Objective In this study we aimed to determine whether the combined effect of environmental estrogens measured as total effective xenoestrogen burden (TEXB) is a risk factor for male urogenital malformations. Methods In a case–control study, nested in a mother–child cohort (n = 702) established at Granada University Hospital, we compared 50 newborns with diagnosis of cryptorchidism and/or hypospadias with 114 boys without malformations matched by gestational age, date of birth, and parity. Controls did not differ from the total cohort in confounding variables. TEXB and levels of 16 organochlorine pesticides were measured in placenta tissues. Characteristics of parents, pregnancy, and birth were gathered by questionnaire. We used conditional and unconditional regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results TEXB from organohalogenated compounds was detectable in 72% and 54% of case and control placentas, respectively. Compared with controls, cases had an OR for detectable versus non-detectable TEXB of 2.82 (95% CI, 1.10–7.24). More pesticides were detected in cases than in controls (9.34 ± 3.19 vs. 6.97 ± 3.93). ORs for cases with detectable levels of pesticides, after adjusting for potential confounders in the conditional regression analysis, were o,p′-DDT (OR = 2.25; 95% CI, 1.03–4.89), p,p′-DDT (OR = 2.63; 95% CI, 1.21–5.72), lindane (OR = 3.38; 95% CI, 1.36–8.38), mirex (OR = 2.85; 95% CI, 1.22–6.66), and endosulfan alpha (OR = 2.19; 95% CI, 0.99–4.82). Engagement of mothers in agriculture (OR = 3.47; 95% CI, 1.33–9.03), fathers’ occupational exposure to xenoestrogens (OR = 2.98; 95% CI, 1.11–8.01), and history of previous stillbirths (OR = 4.20; 95% CI, 1.11–16.66) were also associated with risk of malformations. Conclusions We found an increased risk for male urogenital malformations related to the combined effect of environmental estrogens in placenta.

Estrogenic effect of a series of bisphenol analogues on gene and protein expression in MCF-7 breast cancer cells.

Bisphenols constitute a family of compounds, which includes many substances that have as a common chemical structure two phenolic rings joined together through a bridging carbon. In the present study, we aimed to determine whether several events triggered by 17 beta-estradiol (E(2)) in MCF-7 breast cancer cells were also observed in response to various bisphenol-A (BPA) analogues. We studied the expression of estrogen controlled genes by measuring the induction of pS2 (mRNA and protein) and progesterone receptor (PgR) as well as the expression of a luciferase reporter gene transfected into MVLN cells. These data were compared to the cell proliferation potency and effectiveness as the latest expression of estrogen controlled functions. Bisphenols showed an agonistic effect in all our assays, suggesting that these compounds may act through all the response pathways triggered by the natural hormone. We found differences between the assays in the potency of bisphenols, defined as the minimum concentration required to produce a maximal effect. In the cell proliferation assay, all tested compounds needed a lower concentration than in the other assays to give maximal response. Our results suggest that the polarity and nature of the substituent in the central carbon determines the estrogenic potency. Presence of two propyl chains at the central carbon appears to confer the greatest potency in both gene and protein expression assays.

Diet quality of young people in southern Spain evaluated by a Mediterranean adaptation of the Diet Quality Index-International (DQI-I)

The aim of this study was to assess whether the recently developed Diet Quality Index-International (DQI-I) was useful to evaluate the diet quality of a young Mediterranean population. A cross-sectional nutritional survey was carried out in southern Spain (Granada-Andalucia) from 2002 to 2005. Dietary information (24 h recall and FFQ) and socio-demographic and lifestyle data were collected from a representative sample of the population (n 288, 44.1 % females and 55.9 % males) aged 6-18 years (mean 12.88 (sd 2.78) years). DQI-I was designed according to the method of Kim et al. modified by Tur et al. for Mediterranean populations. It focused on four main characteristics of a high-quality diet (variety, adequacy, moderation and overall balance). This young population from southern Spain obtained 56.31 % of the total DQI-I score, indicating a poor-quality diet. A higher score was associated with a longer breakfast and greater physical activity. The DQI-I may require further modification for application in Mediterranean populations, differentiating between olive oil and saturated fats, among other changes. Further research is needed to develop a new diet quality index adapted to the Mediterranean diet.

Organochlorine pesticides in umbilical cord blood serum of women from Southern Spain and adherence to the Mediterranean diet

Exposure of pregnant women to organochlorine (OC) pesticides largely derives from contaminated food, but environmental, occupational, and domestic factors have also been implicated. We investigated the presence of nine OC residues in the umbilical cord blood of newborns in Southern Spain and analyzed the relationship of this exposure with maternal and pregnancy variables, including maternal adherence to the Mediterranean Diet (MD). OCs were detected in 95% of umbilical cord blood samples from the 318 mothers, who had a mean degree of adherence to the MD of 56.77 (SD: 16.35) (range, 0-100). The MD prioritizes consumption of vegetable and fruit over meat and dairy products, and OCs are generally lipophilic molecules that accumulate in foods of animal origin. Consumption of meat, fish, and dairy products was associated with dichlorodiphenyldichloroethylene (DDE) in umbilical cord serum, and dairy product intake with lindane. Vegetable consumption was also associated with lindane and fruit intake with endosulfan I. We found no significant association between MD adherence and the presence of OC residues in serum. However, closer adherence to the MD may offer greater protection against OC exposure because of its reduced content in meat and dairy products.

Dietary exposure assessment of pregnant women to bisphenol-A from cans and microwave containers in Southern Spain

Bisphenol-A (BPA), material for polycarbonate and epoxy resin synthesis, has been detected in canned food, among other food containers. In mammal studies, BPA transferred from mother to fetus, caused abnormality of reproductive organs, and advanced female puberty. BPA from canned food and microwave containers was analyzed using high performance liquid chromatography and gas chromatography-mass spectrometry. Population was cohort of mother-son pairs established at Granada University Hospital. Frequency of food consumption (including canned food) was studied with a semi-quantitative questionnaire. The most frequently consumed products were fish and juice cans, consumed 1-3 times/week by 34.7% and 22.3% of the study population, respectively. The women made little use of polymer microwave containers, 52.8% never using them and 45.9% using them <3 times/month. Estimated mean (standard deviation) intake of BPA was 1.1(0.839) microgram/day. No relationship was found between BPA exposure and maternal socio-demographic variables or newborn characteristics. This study offers the first estimate of BPA dietary intake by pregnant women in Southern Spain. The consumption of canned foods and drinks by these women means that their exposure was lower than EFSA estimates for the European population. Nevertheless it remains of concern, given the proven undesirable effects of low-level exposure and higher susceptibility of pregnant women.

Human exposure to endocrine-disrupting chemicals: assessing the total estrogenic xenobiotic burden

Abstract A relationship has been hypothesized between adverse effects on human and wildlife reproductive health and a number of chemical substances capable of altering hormonal homeostasis. A testing system to screen for endocrine activities and the development of appropriate biomarkers of cumulative exposure are required. This article reports the work of our group in the following areas 1. (i) the identification of chemical agents with estrogenic hormonal activity, 2. (ii) existing evidence on forms and sources of human exposure, and 3. (iii) developing a methodology to assess the total estrogenic burden, defined as the estrogenic activity in a bioassay of human samples from which ovarian estrogens have been previously eliminated.

Assays to Measure Estrogen and Androgen Agonists and Antagonists

Substantial evidence has surfaced on the hormone-like effects of many xenobiotics in fish, wildlife and humans (Colborn et al., 1993). The endocrine and reproductive effects of xenobiotics are believed to be due to their 1) mimicking the effects of endogenous hormones such as estrogens and androgens, 2) antagonizing the effects of normal, endogenous hormones, 3) altering the pattern of synthesis and metabolism of natural hormones, and 4) modifying the hormone receptor levels. Estrogen mimics (xenoestrogens) are among the environmental chemicals found to cause reproductive impairment in wildlife and humans. All of these compounds were found to be estrogenic long after they had been released into the environment. A single causal agent can be identified in cases in which humans have had occupational exposures, whereas in cases where wildlife have shown signs of reproductive damage the exposure is usually a combination of endocrine disruptors that may have acted cumulatively. It has been hypothesized that environmental estrogens may play a role in the decrease of human semen quantity and quality of human semen during the last 50 years. They may also be partly responsible for the increased incidence of testicular cancer and cryptorchidism in males and breast cancer incidence in both females and males in the industrialized word. Testing this hypothesis will require: 1) the identification of xenoestrogens among the chemicals present in the environment, 2) the development of a methodology to assess the interactions among mixtures of xenoestrogens to which humans are exposed, and 3) the discovery of markers of estrogen exposure. The development of fast and sensitive bioassays is central to the achievement of these three goals.

Perspectivas en disrupción endocrina

Resumen La descripcion de alteraciones en la funcion reproductora de algunas especies de animales salvajes, junto a la demostracion de la exposicion humana y animal a sustancias quimicas con actividad hormonal ‐agonista y antagonista‐ genero, hace dos decadas, lo que se conoce hoy dia como hipotesis de disrupcion endocrina. Se trata de un problema emergente de salud medioambiental que ha cuestionado algunos de los paradigmas en que se fundamenta el control y la regulacion de uso de los compuestos quimicos. La necesidad de incluir en los tests toxicologicos habituales nuevos objetivos de investigacion, que se refieren especificamente al desarrollo y crecimiento de las especies y a la homeostasis y funcionalidad de los sistemas hormonales, ha venido a complicar tanto la evaluacion de los nuevos compuestos quimicos como la revaluacion de los existentes. Sus repercusiones sobre la reglamentacion y el comercio internacional no se han hecho esperar y a ambos lados del Atlantico se han disenado y establecido sistemas de cribado de disruptores endocrinos y se han desarrollado programas de investigacion con objeto de cualificar y cuantificar los efectos adversos sobre la salud humana y animal y poder actuar con medidas de prevencion. Palabras clave: Disruptores endocrinos. Exposicion medioambiental. Evaluacion del riesgo.

Proposal for a Breakfast Quality Index (BQI) for children and adolescents

OBJECTIVE To propose and apply an instrument to assess the breakfast quality of children and adolescents in the Mediterranean area. DESIGN Randomized, cross-sectional survey of breakfast consumption using a validated semi-quantitative FFQ administered at school by trained dietitians between Tuesday and Friday. A Breakfast Quality Index (BQI) score was developed, assigning a positive value to the consumption of cereals, fruit, vegetables, dairy products, MUFA, Ca and compliance with energy recommendations, and to the absence of SFA and trans-rich fats. Data were analysed by Students t test and ANOVA. SETTING Schools in Granada and Balearic Islands (Spain). SUBJECTS All schoolchildren (n 4332) aged 8-17 years at randomly selected and representative schools between 2006 and 2008, stratified by age and sex. RESULTS Breakfast was not consumed by 6·5 % of participants. BQI score was highest for children aged 7-9 years and decreased with age (P = 0·001). Females scored higher in all age groups. The lowest score was in males aged 14-17 years and the highest in females aged 7-9 years (P = 0·006). CONCLUSIONS The proposed BQI appears useful to estimate the breakfast quality of schoolchildren and to form a basis for nutrition education.

Valoración de la dieta de escolares granadinos e influencia de factores sociales

Objective: To investigate the prevalence of trematode Aspidogastrea in the freshwater mussels in the Yangtze River basin within Anhui province, China. Methods: We initially harvested the freshwater mussels living in the Yangtze River running through Anhui area, and labeled them with corresponding number. Then the samples were dissected for isolating the flukes, which were identified by conventional staining. Results: Infection rate of trematode Aspidogastrea in freshwater mussels in the Yangtze River basin within the territory of Anhui province was 30.38℅(103/339)in general, and a total of 912 flukes of Aspidogastrea were detected in the 103 mussels, with average infection rate of 8.85 for each mussel. Conclusion: Trematode Aspdogastrea is prevalent in the freshwater bivalves living in the Yangtze River basin running through Anhui area, and the treamatode was identified as Aspidogaster sp. belong to Aspidogaste under Aspidogastridae of Aspidogastrea.Objective: to assess the use of oral nutritional supplements analyzing the reason for prescription and its implication in caloric-protein intake. Setting: study performed at a university hospital of 350 beds with medical and surgical specialties. Subjects, patients: Patients inclusion was done by selecting all starting oral nutritional supplement prescription. Exclusion criteria were being younger than 18 years, being admitted to the Intensive Care Unit, having cognition or communication impairments, being on concomitant parenteral nutrition or requiring complete enteral diet, and/or using nasogastric tube for feeding. We also excluded special enteral diets, specifically designed for certain conditions. Interventions: One-year long prospective study on prescription of oral nutritional supplements. Through clinical chart review and personal interview, we recorded demographic data, nutritional parameters, characteristics of the diet and supplement, and caloricprotein intake prescribed and ingested. The data were introduced in an Access97 database and processed by means of SPSS software for Windows®. We performed a descriptive study of quantitative and qualitative variables, a χ2 analysis between qualitative variables, and a comparative analysis between means of all paired data by means of the student’s t test, and variance analysis between quantitative variables. The significance level was set at p < 0.05. Results: we were only able to analyze 77 out of 130 prescriptions for nutritional supplements since we could not adequately interview the remaining patients, mainly due to neurological impairments. Mean age was 74.8 years (SD = 12) and 50.6% were women. The departments prescribing the highest number of supplements were hematology (22.1%) and internal medicine (20.8%). GI neoplasm was the most frequent diagnosis at admission (27.3%). The most frequent indication was kwashiorkor (45.5%), with 15.6% of patients being well nourished. Mean therapy duration was 11 days (SD = 11.1), and the main reason for termination was hospital discharge (70.1%). The supplement was concomitantly prescribed with the meals in 70.6% of the cases, and more than halfMaterial y metodos: Estudio retrospectivo de 55 pacientes de 65,4 ± 14,7 anos, 35,7% mujeres y 64,3% varones con un IMC 27,87 ± 5,56 kg/m (0% con IMC 30 kg/m ) en tratamiento con NPT con una duracion de 28 ± 5 dias (mas de 20 dias en el 75% de los casos). El 16,1% presentaba Diabetes Mellitus previa al inicio de NPT. En el 64,3% de los pacientes, la fistula ocurria tras cirugia reciente: en un 38.8% tras reseccion de colon, 16,6% de intestino delgado y 13,9% de estomago. La NPT se planificaba para aportar diariamente 1,5 × Gasto Energetico Basal, 1,5 g/kg/dia de proteinas, 6 mg de vitamina B 12 y 414 μg de acido folico. Ninguna solucion contenia hierro.Objective. To assess the impact of weight loss in clinical progression of the comorbidities in a group of morbid obese patients submitted to surgical treatment with the duodenal switch technique. Study setting. Between 2001-2006, we have operated by the duodenal crossing technique a total of 118 morbid obese patients (97 women and 21 men), mean age 42.6 years. Average pre-surgical BMI was 49.7, with average overweight of 69.1 kg. After surgical intervention, we have prospectively assessed the progression of the main comorbidities (arterial hypertension, diabetes, OSAS, osteoarticular pathology, dyslipidemia), according to the subscale of the BAROS scoring system. Postsurgical controls are done at months 3, 6, 12, 18, and 24 and annually thereafter. We have followed-up 110 patients, of whom 90 presented comorbidities, being the ones studied. Results. At 3 months post-surgery, we observed a decrease in the mean value of %WL to 31%, and a mean BMI value of 41.3, the percentage of lost BMI being 40.3%. Most of the weight loss occurred within 2 years, with %WL of 74.8% and a percentage of lost BMI of 97.7%. In 68 patients (75.5%) there was resolution of their comorbidities, 14.4% having improvement, and 10% with no improvement in spite of the surgery. Of patients achieving complete resolution, almost all of them achieved it within two years after surgery. Cure rates correlate with weight loss, so that at 3 months, with a mean weight loss of 25 kg (BMI decrease of 8.4 points) the comorbidity resolution rate is 45.5%. At 12 months, with a mean decrease in BMI of 16.4 points, %WL of 61.6% and % of lost BMI of 70.4%, the comorbidity resolution rate is 89.7%. At two years, by the time most of the main comorbidities resolved (68 patients), the BMI decreased by 22.4 points, the %WL 74.8% and the % of lost BMI 97.9%. Conclusion. The aim of bariatric surgery is weight loss and overweight-associated comorbidities improvement. In our study, most of the comorbidities improvement started at the third month, with the highest improvement rate occurring within two years, verifying that there is a direct relationship between post-surgical weight loss comorbidities improvement and resolution in most of the cases.Objective: To investigate the breeding rate and breeding density of Carpoglyphus lactis in stored Fructus Jujubae in Anhui, China in order to provide a scientific basis for prevention of Carpoglyphus lactis(C. lactis) from spoiling the dried fruit of such category. Methods： By the breeding nature of C. lactis, we collected samples of Fructus Jujubae, which were kept over 6 months in general, from the dried fruit shop and (or) Chinese herbal medicine warehouse, and isolated C. lactis from those samples. The mite specimens were prepared, and microscopically and morphologically identified. Species classification was done in accordance with Hughes (1976). Result:C. lactis was identified in 19 of the 300 samples, with breeding density and breeding rate of 6.52 heads/g and 6.33%. Constitute ratio at distinct developmental phase was associated with adult (including nymph, 85.71%), larva(12.27%), hypopus (0.56%) and egg(1.45%), respectively. The richness index, diversity index and evenness index was1.644, 1.644 and 0.923, respectively. Conclusion： Carpoglyphus lactis appears infesting in large quantity in the Fructus Jujubae stored in the above places in Anhui province, and the density is higher. Therefore, it is urgent to take effective measures to prevent C. lactis from spreading over other dried products stored in the same room and potential human intestinal acariasis as a result of the biological contamination.Objective: To determine possible associations between the risk of breast cancer in Brazilian women and demographic, social and economical variables, and past dietary intake. Methods: A case-control study was conducted in Joinville, Santa Catarina, Brazil, between june and november 2003 involving a group of 33 women recently diagnosed with breast cancer and a control group of 33 healthy women volunteers. Personal details, health history and past dietary intake were obtained via questionnaires and interviews. Data between groups were compared using χ2, Fisher, and Student’s t test, whilst associations were evaluated using a non-conditional logistic regression method and odds ratio (OR). Results: Statistically significant differences between the two groups were revealed with respect to age distribution (P = 0.007), family income level (P = 0.02), educational level (P 45 years), low family income (<