Juan Manuel Guízar-Mendoza

Catch-up growth in infants born small for gestational age - : A longitudinal study

BACKGROUND Epidemiological studies correlate low birth weight and the subsequent development of diabetes mellitus (DM). Early changes in insulin resistance in infants with catch-up growth (CUG) have not been evaluated in our population. AIM To identify dietary and metabolic features associated with CUG in infants born small for gestational age (SGA) at 1 year old. METHODS In a cohort study of 88 term infants (44 SGA and 44 appropriate for gestational age [AGA]), breastfeeding and weaning age were registered. Anthropometric measurements, glucose, insulin, and leptin concentrations were measured at birth and at 1 year old. RESULTS A history of DM in a second-degree relative (p = 0.01) and complementary breastfeeding (p = 0.0003) were higher in SGA compared to AGA infants. Ten (13.6%) infants showed CUG in length and weight combined. They had lower weight, glucose, IR index, and leptin concentrations at birth than those without CUG. After logistic regression analysis for factors related to weight CUG, gender, weaning age, birth weight and leptin concentration at birth were included in the model (R2 = 0.31; p = 0.00004). CONCLUSIONS Female gender, early weaning, lower birth weight, and lower leptin concentration at birth are related to weight CUG in Mexican infants.

Heart sympathetic activity and pulmonary function in obese pregnant women

Objective. To estimate autonomic balance and pulmonary function in obese women according to their baseline weight and weight gain during pregnancy. Design. A cohort study. Setting. Hospital of Gynecology and Obstetrics in Leon, Mexico. Population. One hundred and seventy‐eight healthy pregnant women (88 obese and 90 non‐obese). Methods. At first visit of pregnancy and in the third trimester blood pressure, anthropometric measurements, glucose, insulin, and leptin levels were evaluated and spirometry, oximetry, and 60 minutes electrocardiograph monitoring were performed. Main outcome measures. Heart rate variability and pulmonary function. Results. Blood pressure levels, glucose, insulin, and leptin levels were higher in obese women, whereas total power of heart rate variability was lower in this group than in non‐obese women at the beginning of pregnancy. In the third trimester, the standard deviation of all the normal R–R intervals was lower in obese women, whereas blood pressure and glucose levels remain higher. In the multiple regression analysis, the change in forced expiratory volume at 1 second/forced vital capacity (FEV1/FVC) ratio and leptin levels independently of weight gain were associated to low‐frequency/high‐frequency (LF/HF) index at third trimester (R2 = 0.21; p<0.001 for the model) only in obese women. Conclusions. LF/HF index at third trimester of pregnancy is associated with increase in leptin levels and decrease in FEV1/FVC in obese women independently of weight gain.

Omega 3 Fatty Acids Supplementation and Oxidative Stress in HIV-Seropositive Patients. A Clinical Trial.

HIV-seropositive patients show high incidence of coronary heart disease and oxidative stress has been described as relevant key in atherosclerosis development. The aim of this study was to assess the effect of omega 3 fatty acids on different markers of oxidative stress in HIV-seropositive patients. We performed a randomized parallel controlled clinical trial in The Instituto Mexicano del Seguro Social, a public health hospital. 70 HIV-seropositive patients aged 20 to 55 on clinical score A1, A2, B1 or B2 receiving highly active antiretroviral therapy (HAART) were studied. They were randomly assigned to receive omega 3 fatty acids 2.4 g (Zonelabs, Marblehead MA) or placebo for 6 months. At baseline and at the end of the study, anthropometric measurements, lipid profile, glucose and stress oxidative levels [nitric oxide catabolites, lipoperoxides (malondialdehyde plus 4-hydroxialkenals), and glutathione] were evaluated. Principal HAART therapy was EFV/TDF/FTC (55%) and AZT/3TC/EFV (15%) without difference between groups. Treatment with omega 3 fatty acids as compared with placebo decreased triglycerides (-0.32 vs. 0.54 mmol/L; p = 0.04), but oxidative stress markers were not different between groups. Trial Registration ClinicalTrials.gov NCT02041520

Antenatal dexamethasone and renal vascular resistance in preterm infants

Objective:  To compare vascular resistance, renal volume and insulin levels in preterm infants with and without antenatal steroids.