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Meneses-León J, Hernández-Salazar S, Torres-Ibarra L, Hernández-López R, Rivera-Paredez B, Robles-Rivera K, Lazcano-Ponce E, García-Vera A, Godínez-Pérez M, León-Maldonado L, Salmerón J. Performance of urine samples compared to cervical samples for detection of precancer lesions among HPV-positive women attending colposcopy clinic in Mexico City. Cancer Causes Control 2024:10.1007/s10552-024-01852-w. [PMID: 38368574 DOI: 10.1007/s10552-024-01852-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 01/14/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND High-risk human papillomavirus (hrHPV) detection in self-collected urine samples (SeCUS) may be a promising alternative for cervical cancer screening because of its greater acceptability, as long as it can offer comparable sensitivity to clinician-collected cervical samples (CCoS) for detecting precancer lesions. OBJECTIVE To evaluate the performance of the SeCUS compared to that of the CCoS for cervical intraepithelial neoplasia grade 3 (CIN3) detection among hrHPV-positive women receiving colposcopy in Mexico City using different specific extended HPV typing procedures: HPV16/18, HPV16/18/35/39/68 or HPV16/18/35/39/68/31. METHODS From March 2017 to August 2018, 4,158 female users of the cervical cancer screening program at Tlalpan Sanitary Jurisdiction in Mexico City were invited to participate in the FRIDA-Tlalpan study. All participants provided ≥ 30 mL of SeCUS, and then a CCoS was obtained with Cervex-Brush®, which was used for hrHPV typing. Participants who tested positive for hrHPV in CCoS were referred for colposcopy for diagnostic confirmation, and all SeCUS of these women were also tested for hrHPV typing. RESULTS In total, 561 hrHPV-positive women were identified by CCoS via colposcopy, and 82.2% of the SeCUS of these women were also hrHPV positive. From both CCoS and SeCUS, 7 cases of CIN3 were detected. Considering HPV16/18 typing, CCoS and SeCUS detected 4 cases of CIN3, but after HPV16/18/35/39/68/31 extension typing, both CCoS and SeCUS detected all 7 of the CIN3 cases among the hrHPV-positive women. CONCLUSIONS Using extended hrHPV typing based on HPV16/18/35/39/68/31, our results suggest that the performance of SeCUS may be equivalent to that of CCoS for detecting CIN3 lesions. Although our results are inconclusive, they support the hypothesis that SeCUS may be an attractive alternative worthy of further research.
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Affiliation(s)
- Joacim Meneses-León
- Facultad de Medicina, Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico, Mexico
| | - Sonia Hernández-Salazar
- Facultad de Medicina, Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico, Mexico
| | - Leticia Torres-Ibarra
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Rubí Hernández-López
- Oficina de Análisis del Plan de Salud, Subgerencia Técnica del Plan de Salud, Gerencia de Administración del Plan de Salud, Banco de México, Mexico, Mexico
| | - Berenice Rivera-Paredez
- Facultad de Medicina, Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico, Mexico
| | - Karina Robles-Rivera
- Facultad de Medicina, Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico, Mexico
| | | | - Alba García-Vera
- Facultad de Medicina, Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico, Mexico
| | - Mélany Godínez-Pérez
- Facultad de Medicina, Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico, Mexico
| | - Leith León-Maldonado
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Jorge Salmerón
- Facultad de Medicina, Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Mexico, Mexico.
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King J, Flores YN, Meneses-León J, Hernández-Salazar S, Robles-Rivera K, Rivera-Paredez B, León-Maldonado L, Hernández-López R, Torres-Ibarra L, Lazcano-Ponce E, Salmerón J. Clinical Performance of hrHPV Primary Screening Using Vaginal versus Cervical Samples to Detect High-grade Intraepithelial Lesions. Cancer Prev Res (Phila) 2023; 16:681-687. [PMID: 37788346 DOI: 10.1158/1940-6207.capr-23-0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/03/2023] [Accepted: 09/29/2023] [Indexed: 10/05/2023]
Abstract
High-risk human papillomavirus (hrHPV) testing is now the most recommended primary method for cervical cancer screening worldwide. Clinician-collected cervical sampling continues to be the main sampling method, but hrHPV vaginal self-sampling is an appealing alternative because of its greater acceptability and potentially higher cost-effectiveness. This study aimed to determine whether hrHPV vaginal self-sampling is comparable with clinician-collected cervical sampling for detecting histologically confirmed high-grade cervical intraepithelial neoplasia (CIN2/3) as part of a cervical cancer screening program in Mexico. We analyzed data from 5,856 women screened during a hrHPV-based screening study. Clinical performance and diagnostic efficiency metrics were estimated for the two sampling methods for the CIN3 and CIN2+ endpoints, using three triage strategies: HPV16/18 genotyping, HPV16/18/33/58 extended genotyping, and HPV16/18/31/33/58 extended genotyping. hrHPV-positivity was found in 801 (13.7%) cervical and 897 (15.3%) vaginal samples. All women with hrHPV-positive samples were referred to colposcopy, which detected 17 total CIN3 cases before considering retrospective triage strategies. Using the HPV16/18/31/33/58 extended genotyping strategy, 245 women had hrHPV-positive cervical samples and 269 had hrHPV-positive vaginal samples. Ten CIN3 cases were detected each among women with hrHPV-positive cervical samples and among those with hrHPV-positive vaginal samples when using this strategy, with no significant differences in sensitivity and specificity observed. We observe that self- and clinician-collected sampling methods are comparable for detecting CIN3 and CIN2+ regardless of the triage strategy used. These findings can help public health officials to develop more cost-effective cervical cancer screening programs that maximize participation. PREVENTION RELEVANCE We found that hrHPV vaginal self-sampling is comparable with hrHPV clinician cervical sampling when using any triage strategy to refer women to colposcopy, so self-sampling is a viable cervical screening method. Therefore, policymakers should consider incorporating self-sampling into cervical screening programs to increase screening coverage and reduce cervical cancer burden. See related Spotlight, p. 649.
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Affiliation(s)
- Jonathan King
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California
| | - Yvonne N Flores
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Morelos, Instituto Mexicano del Seguro Social, Colonia Centro, Cuernavaca, México
- Department of Health Policy and Management, Fielding School of Public Health, UCLA, Los Angeles, California
- Center for Cancer Prevention and Control Research and UCLA-Kaiser Permanente Center for Health Equity, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, California
| | - Joacim Meneses-León
- Research Center in Policy, Population and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Sonia Hernández-Salazar
- Research Center in Policy, Population and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Karina Robles-Rivera
- Research Center in Policy, Population and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Berenice Rivera-Paredez
- Research Center in Policy, Population and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Leith León-Maldonado
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | - Leticia Torres-Ibarra
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | | | - Jorge Salmerón
- Research Center in Policy, Population and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
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Meneses-León J, Hernández-López R, Hernández-Salazar S, Torres-Ibarra L, Rivera-Paredez B, León-Maldonado L, Magis-Rodríguez C, Lazcano-Ponce E, Salmerón J. Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in Tlaxcala, Mexico. Epidemiol Infect 2023; 151:e198. [PMID: 38012851 PMCID: PMC10728986 DOI: 10.1017/s0950268823001899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 10/30/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023] Open
Abstract
Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widely recognised as two prevalent sexually transmitted infections that can have detrimental effects on women's reproductive health. Previous research has concentrated on studying high-risk populations, resulting in limited epidemiological data regarding the general population. Therefore, the objective of this study was to estimate the prevalence of CT and NG among women attending public primary health care in Tlaxcala, Mexico. The study sample included 2,396 women already participating in the cervical cancer screening programme, from July to November 2014. After obtaining informed consent, the CT and NG tests were conducted on cervical samples, using a nucleic acid amplification test. We estimate the prevalence with 95% confidence intervals (CIs). Women who tested positive were promptly notified and provided with appropriate treatment. In our study population, CT and NG prevalences were 3.2 (95% CI: 2.6-4.0) and 0.01 (95% CI: 0.01-0.03), respectively. CT prevalence was higher in younger women (age < 40), although the results indicate a low prevalence; due to the potentially significant impact of CT and NG on women's health, we require adequate surveillance, and guaranteeing rapid referral to the correct treatment is a priority for the control of these diseases.
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Affiliation(s)
- Joacim Meneses-León
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Rubí Hernández-López
- Oficina de Análisis del Plan de Salud, Subgerencia Técnica del Plan de Salud, Gerencia de Administración del Plan de Salud, Banco de México, Ciudad de México, México
| | - Sonia Hernández-Salazar
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Leticia Torres-Ibarra
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Berenice Rivera-Paredez
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Leith León-Maldonado
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Carlos Magis-Rodríguez
- Facultad de Medicina, Departamento de Salud Pública, Universidad Nacional Autónoma de México, Ciudad de México, México
| | | | - Jorge Salmerón
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
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Brenes-Monge A, Yáñez-Álvarez I, Meneses-León J, Poblano-Verástegui O, Vértiz-Ramírez JDJ, Saturno-Hernández PJ. [Approach to the quality of care during pregnancy,delivery and postpartum in women withobstetric risk factors in Mexico]. Salud Publica Mex 2021; 62:798-809. [PMID: 33620976 DOI: 10.21149/11974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/13/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To assess the quality of care of women with obstetric risk factors during pregnancy, childbirth, and post-partum. MATERIALS AND METHODS We use data from The National Survey of Health and Nutrition 2018-19. Women were classified by the presence of obstetric risk factors (ORF) in their last pregnancy. The quality of care provided to women was evaluated with indicators of structure and process dur-ing antenatal care (ANC) and, delivery and postpartum care (DPC). RESULTS Compliance with process indicators in ANC and DPC for women with ORF was 56.9%. In the face of complications during pregnancy or delivery, it decreased in ANC, and in the face of social vulnerability compliance of ANC and DPC indicators decreases. CONCLUSIONS It is necessary to systematically improve the quality of care during pregnancy, childbirth, and postpartum, regardless the presence of ORF, with special attention to vulnerable groups.
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Affiliation(s)
- Alexander Brenes-Monge
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Iraís Yáñez-Álvarez
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Joacim Meneses-León
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Ofelia Poblano-Verástegui
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - José de Jesús Vértiz-Ramírez
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
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Álvarez-Ponce CE, Barrios E, López-Gómez J, Rosas-Guerra OX, Perez-Yañez JDJ, Meneses-León J, Ramírez-Ramírez A. Performing an intestinal stoma with placement of an Artificial Sphincter® Intestinal Valve (VITEA): A case report. Int J Surg Case Rep 2020; 77:378-382. [PMID: 33217657 PMCID: PMC7683287 DOI: 10.1016/j.ijscr.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/20/2020] [Accepted: 11/01/2020] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Intestinal stomas are created for distinct clinical conditions. They may involve the small bowel (ileostomy) or the large bowel (colostomy), depending on the objective or site of the stoma. Intestinal stomas may be temporary or permanent; they cause loss control of intestinal transit due to the absence of a sphincter that regulates its exit, provoking a continuous passage of fecal matter through the stoma. Within the environment of the ostomized patients, there are several important complications involving their quality of life. CASE PRESENTATION The Intestinal Valve Type Artificial Sphincter (VITEA) device is placed in a patient diagnosed with cervical cancer, who has a vaginal-rectum fistula that requires a definitive colostomy. DISCUSSION Intestinal stomas have been validated for over a century. We present the case with a similar complication rate to those described after performing a stoma with conventional open technique in terms of quality of life and cost-benefit ratio. The proportion of complications and the quality of life found in the ostomized patient with the VITEA* device is acceptable, and also eliminates the colostomy bags, providing the function of an artificial sphincter by everting the mucosa on the same device. No complications were found during the follow-up. CONCLUSIONS The results from this proposal will allow to evaluate the safety and efficacy profile associated with a stomal bags.
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Affiliation(s)
| | - Elizabeth Barrios
- Planning, Development and Statistics Department Director, Civil Service Social Security and Services Institute ISSSTE, Mexico City, Mexico.
| | - Javier López-Gómez
- Department of Oncologic Surgery, National Cancer Institute, Mexico City, Mexico.
| | | | | | - Joacim Meneses-León
- Research Center in Policy, Population and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.
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Ramírez-Palacios P, Chen A, Flores YN, Crespi CM, Lazcano-Ponce E, Alvarez-Escobedo D, Torres-Ibarra L, Rivera-Paredez B, León-Maldonado L, Hernández-López R, Mendiola-Pastrana IR, Méndez-Hernández P, Cuzick J, Carmona E, Figueroa H, Montiel-Cordero F, Meneses-León J, Rao J, Salmerón J. Benefit of double-reading cytology smears as a triage strategy among high-risk human papillomavirus-positive women in Mexico. Cancer Cytopathol 2020; 128:715-724. [PMID: 32520446 DOI: 10.1002/cncy.22303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 05/01/2020] [Accepted: 05/11/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The goal of this study was to determine whether the detection of histologically confirmed cases of cervical high-grade squamous intraepithelial lesions or worse (HSIL+) can be increased by having each liquid-based cytology (LBC) slide read by 2 cytotechnologists as part of routine screening. METHODS Over 36,212 women aged 30 to 64 years participated in the Forwarding Research for Improved Detection and Access for Cervical Cancer Screening and Triage (FRIDA) Study in Mexico between 2013 and 2016. For each participant, 2 cervical samples were collected at the same clinic visit, one to test for high-risk human papillomavirus (hrHPV) and the other for LBC, which was used to triage those with a hrHPV positive result. LBC slides were evaluated by 7 cytotechnologists, with each slide read independently by 2 blinded cytotechnologists. All women with atypical cells of undetermined significance or a worse result were referred to colposcopy for further evaluation and diagnosis. Three pathologists evaluated the biopsy specimens to confirm the final HSIL+ diagnosis. The HSIL+ detection rates for the single versus double reading were estimated and compared. RESULTS A total of 3,914 women with a positive hrHPV result were triaged with LBC. The first and second cytology readings resulted in 43 HSIL+ cases detected; the double-reading strategy detected 9 additional HSIL+ cases, resulting in a total of 52 HSIL+ cases. The HSIL+ detection rate increased from 10.99/1000 with a single reading to 13.29/1000 with the double-reading strategy (P = .004). CONCLUSION A 20.9% increase in HSIL+ cases detected was achieved with a double reading of the LBC slides in this sample of hrHPV-positive women.
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Affiliation(s)
- Paula Ramírez-Palacios
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Mexico
| | - Aiyu Chen
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, California
| | - Yvonne N Flores
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Mexico
- Department of Health Policy and Management and Kaiser Permanente Center for Health Equity, Fielding School of Public Health, University of California, Los Angeles, California
- UCLA Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California
| | - Catherine M Crespi
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, California
- UCLA Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California
| | - Eduardo Lazcano-Ponce
- Centro de Investigación en Salud Poblacional. Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Daniel Alvarez-Escobedo
- Unidad de Medicina Familiar, Hospital General Regional No. 1, Instituto Mexicano del Seguro Social, Cuernavaca, Mexico
| | - Leticia Torres-Ibarra
- Centro de Investigación en Salud Poblacional. Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Berenice Rivera-Paredez
- Centro de Investigación en Salud Poblacional. Instituto Nacional de Salud Pública, Cuernavaca, Mexico
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Rubí Hernández-López
- Centro de Investigación en Salud Poblacional. Instituto Nacional de Salud Pública, Cuernavaca, Mexico
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Indira R Mendiola-Pastrana
- Centro de Investigación en Salud Poblacional. Instituto Nacional de Salud Pública, Cuernavaca, Mexico
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Pablo Méndez-Hernández
- Departamento de Calidad y Educación en Salud, Secretaria de Salud Tlaxcala, Santa Ana Chiautempan, Mexico
- Facultad de Ciencias de la Salud, Universidad Autónoma de Tlaxcala, Zacatelco, Mexico
| | - Jack Cuzick
- Wolfson Institute of Preventive Medicine, Centre for Cancer Prevention, Queen Mary University of London, London, United Kingdom
| | | | - Héctor Figueroa
- Laboratorio de Citología, Laboratorio Estatal de Salud Pública, Tlaxcala, México
| | | | - Joacim Meneses-León
- Centro de Investigación en Salud Poblacional. Instituto Nacional de Salud Pública, Cuernavaca, Mexico
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Jianyu Rao
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, California
| | - Jorge Salmerón
- Centro de Investigación en Salud Poblacional. Instituto Nacional de Salud Pública, Cuernavaca, Mexico
- Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Meneses-León J, León-Maldonado L, Macías N, Torres-Ibarra L, Hernández-López R, Rivera-Paredez B, Flores M, Flores YN, Barrientos-Gutiérrez T, Quezada-Sánchez AD, Velázquez-Cruz R, Salmerón J. Sugar-sweetened beverage consumption and risk of hyperuricemia: a longitudinal analysis of the Health Workers Cohort Study participants in Mexico. Am J Clin Nutr 2020; 112:652-660. [PMID: 32644154 PMCID: PMC7458765 DOI: 10.1093/ajcn/nqaa160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 05/29/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The elevated consumption of sugar-sweetened beverages (SSBs) in Mexico is an important public health concern. However, the association between SSB consumption and hyperuricemia has been scarcely studied and not well documented. OBJECTIVES To prospectively evaluate the association between SSB consumption and risk of hyperuricemia in Mexican adults. METHODS A longitudinal analysis was conducted using data from the Health Workers Cohort Study. Participants were followed from 2004 to 2018, with measurements every 6 y. The analysis sample consisted of 1300 adults, aged 18 to 85 y. SSB consumption during the previous year was evaluated through a semiquantitative FFQ. Hyperuricemia was defined as a concentration of uric acid ≥7.0 mg/dL in men and ≥5.7 mg/dL in women. We evaluated the association of interest using 2 methodologies: fixed-effects logistic regression and generalized estimating equations (GEEs). Potential confounders were included in both approaches. RESULTS At baseline, median intake of SSBs was 472.1 mL/wk (IQR: 198.8-1416.4 mL/wk), and 233 participants had hyperuricemia. Uric acid was higher in participants with an SSB intake ≥7 servings/wk, compared with those with an intake <1 serving/wk (P < 0.001). Participants who changed from the lowest to the highest category of servings consumption experienced 2.6 increased odds of hyperuricemia (95% CI: 1.27, 5.26). Results from the GEE model indicated the odds of hyperuricemia increased by 44% (OR=1.44; 95% CI: 1.13, 1.84) in the 2-6 servings/wk group, and by 89% (OR=1.89; 95% CI: 1.39, 2.57) in the ≥7 servings/wk categories, compared with the <1 serving/wk category. Diet soft drinks were not associated with hyperuricemia. CONCLUSIONS Our results suggest that the consumption of SSBs is associated with an increased risk of hyperuricemia in Mexican adults, but diet soft drink consumption is not, which supports the need to strengthen existing recommendations to reduce the intake of SSBs.The Health Workers Cohort Study (HWCS) has been approved by the Institutional Review Board of the Mexican Social Security Institute (12CEI 09 006 14), and the National Institute of Public Health of Mexico (13CEI 17 007 36).
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Affiliation(s)
- Joacim Meneses-León
- Research Center in Policy, Population, and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Leith León-Maldonado
- CONACYT, Center for Population Health Research, National Institute for Public Health, Cuernavaca, Morelos, Mexico
| | - Nayeli Macías
- Center for Nutrition and Health Research, National Institute for Public Health, Cuernavaca, Morelos, Mexico
| | - Leticia Torres-Ibarra
- Research Center in Policy, Population, and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico,Center for Population Health Research, National Institute for Public Health, Cuernavaca, Morelos, Mexico
| | - Rubí Hernández-López
- Research Center in Policy, Population, and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Berenice Rivera-Paredez
- Research Center in Policy, Population, and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Mario Flores
- Center for Nutrition and Health Research, National Institute for Public Health, Cuernavaca, Morelos, Mexico
| | - Yvonne N Flores
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, Mexico,UCLA Department of Health Policy and Management, Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | | | | | - Rafael Velázquez-Cruz
- Genomics of Bone Metabolism Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Jorge Salmerón
- Research Center in Policy, Population, and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
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Denova-Gutiérrez E, Flores YN, Gallegos-Carrillo K, Ramírez-Palacios P, Rivera-Paredez B, Muñoz-Aguirre P, Velázquez-Cruz R, Torres-Ibarra L, Meneses-León J, Méndez-Hernández P, Hernández-López R, Salazar-Martínez E, Talavera JO, Tamayo J, Castañón S, Osuna-Ramírez I, León-Maldonado L, Flores M, Macías N, Antúnez D, Huitrón-Bravo G, Salmerón J. Health workers cohort study: methods and study design. Salud Publica Mex 2018; 58:708-716. [PMID: 28225947 DOI: 10.21149/spm.v58i6.8299] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 11/23/2016] [Indexed: 01/27/2023] Open
Abstract
Objective: To examine different health outcomes that are associated with specific lifestyle and genetic factors. Materials and methods: From March 2004 to April 2006, a sample of employees from three different health and academic institutions, as well as their family members, were enrolled in the study after providing informed consent. At baseline and follow-up (2010-2013), participants completed a self-administered questionnaire, a physical examination, and provided blood samples. Results: A total of 10 729 participants aged 6 to 94 years were recruited at baseline. Of these, 70% were females, and 50% were from the Mexican Social Security Institute. Nearly 42% of the adults in the sample were overweight, while 20% were obese. Conclusion: Our study can offer new insights into disease mechanisms and prevention through the analysis of risk factor information in a large sample of Mexicans.
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Affiliation(s)
- Edgar Denova-Gutiérrez
- Unidad de Investigación en Epidemiología Clínica, Hospital Infantil de México Federico Gómez. Ciudad de México, México
| | - Yvonne N Flores
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social. Cuernavaca Morelos, México.,UCLA Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center. Los Angeles, California, USA
| | - Katia Gallegos-Carrillo
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social. Cuernavaca Morelos, México
| | - Paula Ramírez-Palacios
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social. Cuernavaca Morelos, México
| | - Berenice Rivera-Paredez
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social. Cuernavaca Morelos, México
| | - Paloma Muñoz-Aguirre
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social. Cuernavaca Morelos, México
| | - Rafael Velázquez-Cruz
- Laboratorio de Genómica del Metabolismo Óseo, Instituto Nacional de Medicina Genómica. Ciudad de México, México
| | - Leticia Torres-Ibarra
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, México
| | - Joacim Meneses-León
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social. Cuernavaca Morelos, México
| | - Pablo Méndez-Hernández
- Facultad de Ciencias de la Salud, Universidad Autónoma de Tlaxcala. Tlaxcala, México.,Secretaría de Salud de Tlaxcala. Tlaxcala, México
| | - Rubí Hernández-López
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social. Cuernavaca Morelos, México
| | - Eduardo Salazar-Martínez
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, México
| | - Juan O Talavera
- Centro de Adiestramiento e Investigación Clínica, Hospital de Especialidades CMN SXXI, Instituto Mexicano del Seguro Social. Ciudad de México, México
| | - Juan Tamayo
- Comité Mexicano para la Prevención de la Osteoporosis. Ciudad de México, México
| | - Susana Castañón
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social. Cuernavaca Morelos, México
| | - Ignacio Osuna-Ramírez
- Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Sinaloa. Culiacán, Sinaloa, México
| | - Leith León-Maldonado
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, México
| | - Mario Flores
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Nayeli Macías
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Daniela Antúnez
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social. Cuernavaca Morelos, México
| | | | - Jorge Salmerón
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social. Cuernavaca Morelos, México.,Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, México
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