Laura Leiva B

Síndrome metabólico en niños y adolescentes: asociación con sensibilidad insulínica y con magnitud y distribución de la obesidad

Descriptive study in 489 children (273 females), aged from6 to 16 years, consulting in an obesity program. Body mass index, Tanner puberal development, waistcircumference, blood pressure, fasting blood glucose, insulin and lipid levels were measured. Insulinsensitivity was calculated using the mathematical models QUICKI and HOMA. MS was diagnosedwhen three or more of the following criteria were met: a waist circumference over percentile 90, ablood pressure over percentile 90, serum triglycerides over 110 mg/dl, HDL cholesterol of less than 40mg/dl or a fasting blood glucose level over 100 mg/dl.

La mantención de peso en humanos: ¿podría ser equivalente a la restricción calórica de los modelos animales?

Background: Energy restriction (ER) extends life span in animals, by decreasing oxidative stress. Aim: To compare adiposity, metabolic variables and DNA oxidative damage, among adults, reporting a constant body weight (weight maintainers), versus those reporting a progressive increase (weight gainers). Subjects and Methods: Clinical history, dietary recall, anthropometric measures, abdominal CT scan and fasting blood samples (to measure lipoproteins, glucose and insulin), were obtained in 44 males. These subjects were classified as weight maintainers if they had a change in weight of 3 kg or less in the last 10 years, or weight gainers, if they had a weight increment of more than 6 kg in the same lapse. Oxidative damage was assessed by 8-hydroxydeoxyguanosine (8-OHdG), in DNA extracted from circulating lymphocytes, in 5 weight maintainers, 8 weight gainers and 5 healthy elders. Results: Energy intake was 18% higher in weight gainers (p <0.01). Adiposity and central fat were higher among weight gainers (p <0.01). Abdominal fat correlated with serum lipoproteins, glucose and insulin sensitivity, assessed by the Homeostasis Model Assessment (HOMA). 8-OHdG levels did not differ between groups. Conclusions: The analysis of weight change based on the clinical history correlates with actual body composition, thus it may be a reliable indicator of long term energy intake. This method could be comparable to weight clamp models employed in animals to study aging (Rev Med Chile 2004; 132: 1166-72)

Perfil metabólico de riesgo cardiovascular en niños y adolescentes obesos con menor sensibilidad insulínica

Infantile obesity is associated with metabolicdisturbances (hiperinsulinism, impaired glucose, dislypidemia) that determine a higher risk oftype 2 diabetes, high blood pressure and atherosclerotic vascular disease in adulthood. Insulinresistance is a central mechanism of complications of obesity and is associated to body fat mass.

Características biológicas, familiares y metabólicas de la obesidad infantil y juvenil

Obesity is the most prevalent nutritional disease in people of less than 20 years old. Aim: To report biological, familial and metabolic characteristics in obese children. Patients and methods: A retrospective review of 187 children seen at obesity clinics and that had a complete metabolic study. Results: Ninety five prepuberal and 92 puberal children, aged 8.7±2.2 and 12.6±2.2 years old respectively, were studied. Body mass index was over 4 standard deviations in 48.4% of prepuberal children and in 39.1% of puberal children. Paternal obesity was twice more prevalent (30.2%) than in the general population. The daily caloric intake and basal metabolic rate (BMR) were within the normal range; nevertheless there was a positive caloric balance due to minimal physical activity. The mean daily fat intake was normal (26.4±8.5 and 25.3±9.1% of total calories in prepuberal and puberal children respectively). The daily fiber intake was under 70% of recommendation. The total cholesterol was over 200 mg/dl in 26.6 and 23.9% of prepuberal and puberal children. LDL cholesterol was over 130 mg/dl in 27.3 and 26.6% and triacylglycerol was over 150 mg/dl in 16.9 and 25% of prepuberal and puberal children respectively. Basal serum insulin was over 20 uIU/ml in 27.7 and 42.2% of prepuberal and puberal children, respectively. Post glucose serum insulin was over 60 uIU/ml in 40 and 63% of prepuberal and puberal children, respectively. Conclusions: Infantile and juvenile obesity is a chronic disease with a high incidence of metabolic alterations (Rev Med Chile 2001; 129: 1155-62)

Sensibilidad insulínica en niños de 6 a 15 años: asociación con estado nutricional y pubertad

Body mass index (BMI), totalbody fat percentage (%TBF) using the sum of 4 skin folds, abdominal obesity determined throughwaist circumference (WC), pubertal maturation using five Tanner stages, fasting glucose (Glu) andinsulin (Ins), were measured in 354 children aged 6 to 15 years (173 males). IS was evaluatedusing HOMA and QUICKI.

Nutrición de yodo en escolares de cuatro zonas de Chile en el año 2001

: A 6.4% goiter prevalence was found (5,9%in boys and 6,8% in girls). Grade Ia goiter was more common (5.0%), without detecting differ-ences between areas (7.3% in Calama, 5.9% in Santiago, 5.9 in Temuco and 6.7 in PuntaArenas). Iodine concentration in salt for human consumption of the areas was adequate ac-cording to the recent modification of Chilean legislation (25.4 mgI/g salt in Calama, 36.2 inSantiago, 27.7 in Temuco and 33.4 in Punta Arenas). Urinary iodine excretion was very highaccording to recommendation in boys and girls (2838 and 2852 mgI/g salt in Calama, 700and 837 in Santiago, 1318 and 1438 in Temuco, 407 and 312 in Punta Arenas).

DIAGNÓSTICO Y TRATAMIENTO DE LA DEFICIENCIA DE VITAMINA D

El estado nutricional de vitamina D ha cobrado importancia en los ultimos anos debido a que su deficiencia es altamente prevalente, y ademas por sus conocidos efectos en el metabolismo oseo, participa en la diferenciacion y proliferacion celular, funcion muscular y equilibrio, entre otros. La molecula activa es la 1,25(OH)2D, pero se recomienda medir niveles sericos de 25 OH vitamina D total (es decir la suma de ergocalciferol o vitamina D2 y colecalciferol o vitamina D3), como reflejo del status de vitamina D. La evidencia actual sugiere la necesidad de elevar las recomendaciones para la ingesta dietaria en adultos, hasta cifras cercanas a 1.000 Ul/dia. Sin embargo en casos de deficiencia puede ser necesario utilizar suplementos farmaceuticos conteniendo dosis superiores de esta vitamina, por cuanto aquellas utilizadas en el pasado no lograban corregir el deficit. En este articulo se presenta un listado de los preparados comerciales que contienen vitamina D disponibles en Chile. Al analizarlo se pone de mamfiesto la dificultad que representa elegir el preparado mas adecuado para corregir la deficiencia en un paciente individual, debido a que son pocas las preparaciones que contienen mas de 800 UI, ademas de que habitualmente se encuentra en asociacion con calcio, bifosfonatos o multiples otros minerales y vitaminas.

NUTRICION DE YODO EN ESCOLARES DE UNA ZONA CON ALTA INGESTA DE YODO (CALAMA) COMPARADA CON ZONA DE INGESTA NORMAL (PUNTA ARENAS)

Resumen es: Se evaluo la prevalencia de bocio por palpacion de la glandula tiroidea en 1296 escolares de educacion basica de una zona con alta ingesta de yodo (Calam...

APORTE DEL PAN A LA NUTRICION DE YODO DEL ESCOLAR CHILENO

Se describe la evolucion de la nutricion de yodo en el escolar chileno perteneciente a 4 zonas censorias del pais, destacando la excesiva excrecion urinaria de yodo a pesar que el Reglamento Sanitario de los Alimentos disminuyo el ano 2000 la concentracion de yodo en la sal de 100 ppm a un rango de 20 a 60 ppm. Nos intereso estudiar porque no disminuyeron las yodurias en los escolares. Para ello se midio el contenido de yodo en el pan, por tener un alto consumo en Chile (en promedio 250 g por dia). En diferentes tipos de pan se determino la concentracion de yodo que fue alrededor de 0.5 ug /g, valor 10 veces mas alta que en mediciones efectuadas en Inglaterra y Espana. Sin embargo se estimo que el consumo de pan en Chile aportaria alrededor de 130 ug I/dia, lo que no explicaria totalmente las altas cifras de excrecion de yodo actuales. De importancia es continuar indagando las causas de este alto consumo para evitar sus posibles complicaciones

Crecimiento y desarrollo de hijos de adolescentes de clase media-baja. II Parte: 30 meses de vida

A longitudinal study of children from teenager mothers belonging to a middle-low socioeconomic level In their first 30 months of life, was done. Weight, height, height velocity, bone age, plasmatic levels of zinc, cooper and hemoglobin, food intake, socioeconomic level, and stature of parents were studied. There were not differences in nutritional status, caloric intake, bone age, plasmatic levels of zinc, cooper and hemoglobin, and stature of parents betwen children of teenage and adult mothers. A progressive decrement in stature and in growth velocity of children of teenage compared with children of adult mothers was observed. A lower socioeconomic level and protein intake was found in children of adolescent mothers that may be playing a role at least in part in the growth failure presented by this children. Etiologycal factors of this growth failure discussed. (