Laura Ávila-Jiménez

Iodine deficiency and its association with intelligence quotient in schoolchildren from Colima, Mexico

OBJECTIVE To determine the prevalence of iodine deficiency, its causes and its association with intelligence quotient (IQ) in Mexican schoolchildren. DESIGN Cross-sectional analytical study, in which determinations of thyroid gland size, urinary iodine excretion, IQ, iron nutritional status, physical anthropometry, family consumption of goitrogenic foods, type/origin and iodine saturation of salt consumed at home and coliform organisms in drinking water were performed, and the association of each variable with IQ scores was evaluated by multiple regression analyses. SETTING Municipality of Cuauhtémoc, in Colima, Mexico (altitude: 600-2700 m above sea level). Sea salt is extracted manually nearby and often used for human consumption. Goitre remains present in the region despite over half a century of mandatory salt iodination in the country. SUBJECTS Three hundred and three children, similar proportions of boys and girls, mean age 9.3 years, randomly selected from 19 public elementary schools. RESULTS Overall goitre rate was 21.4%; low urinary iodine excretion was found in 19.5% of the children, high urinary iodine excretion in 32.0%. IQ scores were transformed into percentile values, with the following categorisation: < or = P5 (low IQ), 48.5%; > P5 to < or = P25 (below average), 24.2%; > P25 to < P75 (average), 18.8%; > or = P75 to < P95 (above average), 3.6%; > or = P95 (high IQ), 4.9%. Ninety-two per cent of the population used iodinated salt, but deficient iodine saturation (<50 ppm) was found in 86.8% of salt samples. The main goitrogenic foods consumed were peanuts (by 31.5% of the sample), cabbage (30.1%), broccoli (27.7%) and cauliflower (25.7%). Median counts of coliform organisms (colony-forming units/100 ml of drinking water) were: 207.5 (well water), 151 (cisterns), 52 (private homes), 25 (elementary schools) and 12 (kindergartens). Moderate iodine deficiency was associated (P < 0.05) with a 4.26 times higher risk of low IQ. CONCLUSIONS There is a perturbing negative impact of these findings on human capital acquisition for the region and the country. More attention is needed to ensure effective salt iodination processes, particularly in regions where goitrogens may contribute to the negative effects of iodine deficiency on the intellectual development of children.

Asociación del control glicémico con el apoyo familiar y el nivel de conocimientos en pacientes con diabetes tipo 2

Background: Family interventions may improve glycemic control among diabetic patients Aim: To evaluate the association of glycemic control with family support and level of knowledge in patients with type 2 diabetes. Material and Methods: Patients with type 2 diabetes completed a demographic survey. Glycosylated hemoglobin (HbA1c) was determined and glycemic control was defined as a value < 6,5%. Two validated instruments were applied to evaluate family support, stratifying it in three categories (low, medium and high) and the level of knowledge about diabetes. Results: We studied 81 patients aged 32 to 65 years (53 females). Thirty six percent had an adequate glycemic control. Participants with a medium family support had three times greater risk of having an uncontrolled blood glucose than subjects with high family support. No significant association was found between the level of knowledge and glycemic control. Conclusions: Family support but not knowledge about the disease is associated with a better glycemic control of patients with type 2 diabetes.

Intoxicación por plomo y nivel de marginación en recién nacidos de Morelos, México

Objective: To determine the prevalence of lead (Pb) poisoning at birth in Morelos, analyze its distribution by social marginalization level, and estimate the association with the use of lead glazed ceramics (LGC). Materials and methods: Blood lead level (BLL) in umbilical cord was measured in a representative sample of 300 randomly selected births at the Morelos Health Services and state IMSS. Results: The prevalence of Pb poisoning at birth (BLL> 5μg/dL) was 14.7% (95%CI: 11.1, 19.3) and 22.2% (95%CI: 14.4, 32.5) in the most socially marginalized municipalities. 57.1% (95%CI: 51.3, 62.7) of the mothers used LGC during pregnancy, and the frequency of use was significantly associated with BLL. Conclusion: This is the first study to document the proportion of newborns with Pb poisoning who are at risk of experiencing the related adverse effects. It is recommended to monitor BLL at birth and take action to reduce this exposure, especially in socially marginalized populations.Resumen: Objetivo: Determinar la prevalencia de intoxicacion por plomo (IPb) al nacimiento en Morelos, analizar su distribucion por nivel de marginacion y estimar la asociacion con el uso de barro vidriado (BV). Material y metodos: Se midio plomo en sangre (PbS) en cordon umbilical de una muestra representativa de 300 nacimientos seleccionados aleatoriamente de aquellos atendidos por los Servicios de Salud de Morelos e IMSS estatal. Resultados: La prevalencia de IPb al nacimiento (PbS>5µg/dL) fue 14.7% (IC95%: 11.1, 19.3), y 22.2% (IC95%: 14.4, 32.5) en los municipios mas marginados. 57.1% (IC95%: 51.3, 62.7) de las madres usaron BV durante el embarazo y la frecuencia de uso se asocio significativamente con PbS. Conclusion: Este es el primer estudio que documenta la proporcion de recien nacidos con IPb que estan en riesgo de sufrir los consecuentes efectos adversos. Se recomienda monitorear PbS al nacimiento y emprender acciones para reducir esta exposicion, especialmente en poblaciones marginadas.