Milton Fabian Suárez-Ortegón

Prevalence of Metabolic Syndrome in Urban Colombian Adolescents Aged 10–16 Years Using Three Different Pediatric Definitions

The aim of this study was to evaluate the metabolic syndrome (MetS) prevalence in adolescents using three different definitions for this age group. The evaluated sample consisted of 718 male and 743 female adolescents. Definitions by Cook et al., de Ferranti et al. and International Diabetes Federation (IDF) for adolescents were used to estimate the prevalence of MetS. The prevalence of MetS was 8.5, 2.5 and 1.2% by de Ferranti et al., Cook et al. and IDF definitions, respectively. High fasting glucose component had the lower prevalence whereas high triglycerides levels component was the most prevalent. In obese adolescents, the prevalence of MetS was higher. MetS classification in adolescents strongly depends on the definition chosen. Further research is required for the evaluation of the current definitions (multicentric studies), and for addition or design of new and useful criteria.

Circulating hepcidin in type 2 diabetes: A multivariate analysis and double blind evaluation of metformin effects.

SCOPE Very few studies have evaluated serum hepcidin in patients with type 2 diabetes and they have reported conflicting results. In addition, the effect of antidiabetic drugs on circulating hepcidin has not been explored so far. The aims of the study were to evaluate hepcidin concentrations and hepcidin/ferritin ratio in type 2 diabetes subjects and healthy non-diabetic controls and to evaluate the effect of metformin on hepcidin concentrations. METHODS AND RESULTS Study 1: Cross-sectional multivariate study of 239 non-diabetic individuals and 65 people with type 2 diabetes. The multivariate analysis included covariates of chronic inflammation, BMI, pharmacological treatment, menopausal status and insulin resistance. Study 2: Randomized, double-blinded, placebo-controlled 4-month trial metformin compared to placebo among 36 type 2 diabetic patients. In both groups diet was controlled by maintaining a hypocaloric intake across the trial. Hepcidin levels were significantly lower in patients with type 2 diabetes than in non-diabetic individuals either in crude or adjusted regression models (P<0.05). Hepcidin decreased in both arms of the trial (Placebo, p = 0.004; metformin, p = 0.022). CONCLUSION Circulating hepcidin was significantly and independently lower in type 2 diabetes. Metformin treatment is not associated with reductions in hepcidin but hypocaloric diet could be involved.

Dietary zinc intake is inversely associated to metabolic syndrome in male but not in female urban adolescents.

To evaluate the relationship of copper and zinc dietary intakes with metabolic syndrome (MetS) in adolescents.

Asociación entre adiposidad y factores de riesgo cardiovascular en infantes pre-púberes

INTRODUCTION AND OBJECTIVES To examine the relationships between of four measures of adiposity, namely waist circumference (WC), body mass index (BMI), and subscapular and abdominal skinfolds, with different cardiovascular risk factors in prepubertal children. METHODS Four hundred and ninety-four prepubertal children aged 6-10 years participated in this cross-sectional study. The subscapular and abdominal skinfolds, WC, and BMI were measured to assess adiposity, and cardiovascular risk factors (CVRFs) were assessed by measuring systolic (SBP) and diastolic blood pressures (DBP), glucose, triglycerides (TG), and high density (HDL-C) and low density lipoprotein cholesterol (LDL-C). Dichotomous variables were created based on whether or not the subjects were in the upper quartile (Q4) for the WC, BMI, and skinfold variables. RESULTS No CVRF was found in 52.8% of children, 33.4% had one factor, and 10.9% and 2.8% had 2 and 3 factors respectively. An adjusted logistic regression analysis showed that being in Q4 of anthropometric variables and CVRFs was associated to TG levels ≥ 100 mg/dL. Glucose levels ≥ 96 mg/dL were associated to Q4 and abdominal fold. Presence of 2 or more CVRFs was significantly associated to Q4 in all anthropometric variables despite adjustment for age, gender, and calorie intake. The subscapular skinfold was the adiposity marker associated to the highest risk. CONCLUSIONS Children with a more unfavorable adiposity profile tend to have a greater cardiovascular risk in the prepubertal stage.

Nutrients intake as determinants of blood lead and cadmium levels in Colombian pregnant women

To evaluate the relationship between nutrients intake in the first trimester of pregnancy and blood levels of lead and cadmium during the first and third trimesters of gestation.

Waist:height ratio, waist circumference and metabolic syndrome abnormalities in Colombian schooled adolescents: a multivariate analysis considering located adiposity.

Very few large studies in Latin America have evaluated the association between waist:height ratio (W-HtR) and cardiometabolic risk in children and adolescents. Further, multivariable analyses verifying the independence of located subcutaneous fat have not been conducted so far. The aim of this study was to evaluate the associations of W-HtR and waist circumference (WC) with metabolic syndrome abnormalities and high LDL-cholesterol levels in schooled adolescents before and after adjusting for trunk skinfolds and BMI. The sample consisted of 831 boys and 841 girls aged 10-17 years. Biochemical, blood pressure and anthropometrical variables were measured. Age- and sex-specific quartiles of W-HtR and WC were used in Poisson regression models to evaluate the associations. High WC values (highest quartile v. quartiles 1-3) were associated with high TAG levels in both sexes (prevalence ratio, boys: 2·57 (95 % CI 1·91, 3·44); girls: 1·92 (95 % CI 1·49, 2·47); P0·05). High W-HtR (highest quartile v. quartiles 1-3) was only independently associated with high TAG in female adolescents (1·99 (95 % CI 1·55, 2·56); P<0·05). In conclusion, WC showed better association with cardiometabolic risk than W-HtR in the children of this study. This observation does not support W-HtR as a relevant adiposity marker for cardiovascular and metabolic risk in adolescence.

Relationship between maternal and newborn endothelial function and oxidative stress

To evaluate the Relationship between maternal and newborn endothelial function and oxidative stress.

Soluble transferrin receptor levels are positively associated with insulin resistance but not with the metabolic syndrome or its individual components.

The metabolic syndrome (MetS) is known to be associated with elevated serum ferritin levels. The possible association with other Fe markers has been less well studied. We aimed to investigate the cross-sectional association of soluble transferrin receptor (sTfR) and ferritin levels with the MetS components, insulin resistance and glycosylated Hb (HbA1C). The sample consisted of 725 adults, aged 19-93 years (284 men, 151 premenopausal and 290 postmenopausal women), from the Croatian island of Vis. Serum sTfR and ferritin levels were measured by immunoturbidimetry and electrochemiluminescence assays, respectively. The MetS was defined using modified international consensus criteria. Logistic and linear regression analyses were conducted to investigate the associations adjusting for age, fibrinogen, smoking status, alcohol consumption and BMI. Prevalence of the MetS was 48·7 %. Standardised values of ferritin were positively associated with all of the MetS components (except high blood pressure and waist circumference) in men (P0·05). sTfR levels could be spuriously elevated in subjects with insulin resistance and without association with the MetS or its components. We conclude that different markers of Fe metabolism are not consistently associated with cardiometabolic risk.

Patient safety incidents and adverse events in ambulatory dental care: A systematic scoping review

BACKGROUND There have been efforts to understand the epidemiology of iatrogenic harm in hospitals and primary care and to improve the safety of care provision. There has in contrast been very limited progress in relation to the safety of ambulatory dental care. OBJECTIVES To provide a comprehensive overview of the range and frequencies of existing evidence on patient safety incidents and adverse events in ambulatory dentistry. METHODS We searched MEDLINE and EMBASE for articles reporting events that could have or did result in unnecessary harm in ambulatory dental care. We extracted and synthesized data on the types and frequencies of patient safety incidents and adverse events. RESULTS Forty articles were included. We found that the frequencies varied very widely between studies; this reflected differences in definitions, populations studied, and sampling strategies. The main 5 PSIs we identified were errors in diagnosis and examination, treatment planning, communication, procedural errors, and the accidental ingestion or inhalation of foreign objects. However, little attention was paid to wider organizational issues. CONCLUSIONS Patient safety research in dentistry is immature because current evidence cannot provide reliable estimates on the frequency of patient safety incidents in ambulatory dental care or the associated disease burden. Well-designed epidemiological investigations are needed that also investigate contributory factors.

Adiposity markers and cardiovascular risk in urban Colombian adolescents: Heterogeneity in association patterns

OBJECTIVE The aim of this study was to evaluate the relationship of tricipital (TS), abdominal (AS), subscapular (SS), and suprailiac (SIS) skinfolds, Body Mass Index (BMI), and Waist Circumference (WC) with 1) variables related to cardiovascular risk (CVR) and 2) the clustering of cardiovascular risk factors (CVRF) - referenced pediatric cut-off points - in a multivariate analysis. MATERIALS/METHODS The sample was 1672 adolescents. Glucose, lipid profile, blood pressure and anthropometric variables were measured. RESULTS Adjusting for age, gender, and caloric intake, the highest quartile (Q4) of adiposity markers was associated to Q4 of biochemical and blood pressure variables. However, the association was not found for WC, SS and TS with glucose, and for diastolic blood pressure (DBP) with TS, SS, and SIS. Triglycerides Q4 was related to Q4 of SS, AS, and SIS after further adjustments, as well as HDL cholesterol (HDL-C) Q1 with Q4 of SS and AS. Glucose Q4 was associated to BMI, AS (Not adjusting for BMI and SIS), and SIS Q4 (Not adjusting for BMI and TS). LDL-Cholesterol (LDL-C) Q4 was associated to TS and SS Q4. The associations of LDL-C Q4 and HDL-C Q1 with WC Q4 were not significant after further adjustments. All the adiposity markers, except WC and TS, were associated to CVRF clustering in all the adjustments. CONCLUSIONS In the adolescents, subcutaneous fat from the trunk (SS, AS, SIS) was better and independently associated to CVR variables and with CVRF clustering than visceral fat (WC). Further research is required to explain the specificity in the described associations.