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Avila-Montiel D, Vilchis-Gil J, Miranda-Lora AL, Velázquez-López L, Klünder-Klünder M. The Effects of an Educational Intervention About Front-of-Package Labeling on Food and Beverage Selection Among Children and Their Caregivers: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e54783. [PMID: 38557591 PMCID: PMC11019414 DOI: 10.2196/54783] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Overweight and obesity pose a global public health challenge and have a multifactorial origin. One of these factors includes obesogenic environments, which promote ultraprocessed foods characterized by being high in calories, saturated fats, added sugars, and sodium. In Mexico, it has been estimated that 30% of the total energy consumed comes from processed foods. The Modification to the Official Mexican Standards introduces nutritional information through black octagonal seals that alert consumers about products with excessive amounts of some components for a better food selection in the population. However, the effects of warning labels on processed food selection and purchases among children remain unknown. OBJECTIVE We aimed to evaluate the impact of a digital educational intervention focusing on front-of-package warning labels on the food selection and purchasing behavior of elementary schoolchildren and their caregivers. METHODS Children from 4 elementary schools in Mexico City, 2 public and 2 private schools, will participate in a randomized controlled trial. The schools will be chosen by simple random sampling. Schools will be randomized into 2 groups: intervention and control. In the control group, the dyads (caregiver-schoolchildren) will receive general nutritional education, and in the intervention group, they will receive guidance on reading labels and raising awareness about the impact of consuming ultraprocessed products on health. The educational intervention will be conducted via a website. Baseline measurements will be taken for both groups at 3 and 6 months. All participants will have access to an online store through the website, allowing them to engage in exercises for selecting and purchasing food and beverages. In addition, other measures will include a brief 5-question exam to evaluate theoretical understanding, a 24-hour reminder, a survey on food habits and consumption, application of a food preference scale, anthropometric measurements, and recording of school lunch choices. RESULTS Registration and funding were authorized in 2022, and we will begin data collection in September 2024. Recruitment has not yet taken place, but the status of data analysis and expected results will be published in April 2025. CONCLUSIONS The study is expected to contribute to evaluating whether reinforcing front-of-package warning labels with education enhances its effects and makes them more sustainable. Conducting this study will allow us to propose whether or not it is necessary to develop new intervention strategies related to front-of-package labeling for a better understanding of the population, improved food choices, and better health outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT06102473; https://clinicaltrials.gov/study/NCT06102473. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54783.
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Affiliation(s)
- Diana Avila-Montiel
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, CDMX, Mexico
| | - Jenny Vilchis-Gil
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, CDMX, Mexico
| | - América Liliana Miranda-Lora
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, CDMX, Mexico
| | - Lubia Velázquez-López
- Clinical Epidemiology Research Unit Dr. Carlos Mac Gregor Sánchez Navarro, Mexican Social Security Institute, CDMX, Mexico
| | - Miguel Klünder-Klünder
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, CDMX, Mexico
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Diaz-Garcia H, Vilchis-Gil J, Castro-Cerritos KV, Rivera-Susunaga LE, Klünder-Klünder M, Granados-Riveron JT, Gómez-López J, López-Torres A, Sánchez-Urbina R. Association between maternal diet, smoking, and the placenta MTHFR 677C/T genotype and global placental DNA methylation. Placenta 2024; 146:17-24. [PMID: 38160599 DOI: 10.1016/j.placenta.2023.12.017] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION The placenta provides nutrients to the fetus, and it has protective effects against harmful substances. Unhealthy maternal diets and toxic agents might increase free radical (FR) production. Elevated FR levels are associated with a high risk of oxidative stress, which may cause DNA damage. DNA might be oxidized in the placenta, occasionally affecting its methylation profile due to 8-hidroxy-2'-deoxyguanosine formation. METHODS This study assessed 130 mothers and their children. The maternal's nutritional patterns were determined using the Food Frequency Questionnaire. Information on smoking and alcohol consumption was collected during the medical examination. Data on placental DNA were obtained to determine the MTHFR 677C/T genotype and the proportion of placental DNA methylation (pDNAm). RESULTS Consumption of vitamins and folic acid was above 85%. The pDNAm was found to be correlated with gestational age and coffee intake. Mothers with a smoking history had a low pDNAm. Placentas with the TT genotype had a higher but not significant pDNAm. In the placentas with the CC/CT genotype, the pDNAm was positively associated with carbohydrate and biotin intake. However, the TT genotype was negatively associated with folate and vegetable intake. DISCUSSION The pDNAm was positively associated with coffee intake, but not with macro-, and micronutrient intake. However, it was negatively associated with cigarette smoking. The placentas with the CC/CT genotype had a lower pDNAm than those with the TT genotype. In the placentas with the CC/CT or TT genotype, methylation was positively, and negatively associated with micro- or macronutrients, respectively.
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Affiliation(s)
- Hector Diaz-Garcia
- Centro de Investigación en Malformaciones Congénitas, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico; Escuela Superior de Enfermería y Obstetricia, Instituto Politécnico Nacional, Mexico City 07738, Mexico
| | - Jenny Vilchis-Gil
- Unidad de Investigación Epidemiológica en Endocrinología y Nutrición, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico; Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | | | - Luis E Rivera-Susunaga
- Centro de Investigación en Malformaciones Congénitas, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico; Escuela Superior de Medicina del Instituto Politécnico Nacional, Mexico City 11340, Mexico
| | - Miguel Klünder-Klünder
- Subdirección de la Gestión de la Investigación, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico
| | - Javier T Granados-Riveron
- Centro de Investigación en Malformaciones Congénitas, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico
| | - Jaqueline Gómez-López
- Hospital Militar de Especialidades de la Mujer y Neonatología, Secretaria de la Defensa Nacional, Mexico City 11200, Mexico
| | - Adolfo López-Torres
- Instituto de Química Aplicada, Universidad del Papaloapan, Tuxtepec, Oaxaca 68301, Mexico
| | - Rocío Sánchez-Urbina
- Centro de Investigación en Malformaciones Congénitas, Hospital Infantil de México Federico Gómez, Mexico City 06720, Mexico; Escuela Superior de Medicina del Instituto Politécnico Nacional, Mexico City 11340, Mexico.
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Chávez-Vázquez AG, Klünder-Klünder M, Garibay-Nieto NG, López-González D, Sánchez-Curiel Loyo M, Miranda-Lora AL. Evaluation of height prediction models: from traditional methods to artificial intelligence. Pediatr Res 2024; 95:308-315. [PMID: 37735232 DOI: 10.1038/s41390-023-02821-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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/17/2023] [Accepted: 09/02/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Traditional methods for predicting adult height (AHP) rely on manual readings of bone age (BA). However, the incorporation of artificial intelligence has recently improved the accuracy of BA readings and their incorporation into AHP models. METHODS This study aimed to identify the AHP model that fits the current average height for adults in Mexico. Using a cross-sectional design, the study included 1173 participants (5-18 yr). BA readings were done by two experts (manually) and with an automated method (BoneXpert®). AHP was carried out using both traditional and automated methods. The best AHP model was the one that was closest to the population mean. RESULTS All models overestimated the population mean (males: 0.7-6.7 cm, females: 0.9-3.7 cm). The AHP models with the smallest difference were BoneXpert for males and Bayley & Pinneau for females. However, the manual readings of BA showed significant interobserver variability (up to 43% of predictions between observers exceeded 5 cm using the Bayley & Pinneau method). CONCLUSION Traditional AHP models relying on manual BA readings have high interobserver variability. Therefore, BoneXpert is the most reliable option, reducing such variability and providing AHP models that remain close to the mean population height. IMPACT Traditional models for predicting adult height often result in overestimated height predictions. The manual reading of bone age is prone to interobserver variability, which can introduce significant biases in the prediction of adult height. The BoneXpert method minimizes the variability associated with traditional methods and demonstrates consistent results in relation to the average height of the population. This study is the first to assess adult height prediction models specifically in the current generations of Mexican children.
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Affiliation(s)
- Ana G Chávez-Vázquez
- Unit of Epidemiological Research in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Research Subdirectorate, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Nayely G Garibay-Nieto
- Pediatric Obesity Clinic and Wellness Unit, Hospital General de México "Dr. Eduardo Liceaga" and Hospital Ángeles del Pedregal, Mexico City, Mexico
| | - Desirée López-González
- Research Unit in Clinical Epidemiology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | - América L Miranda-Lora
- Unit of Epidemiological Research in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
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Alaniz-Arcos JL, Ortiz-Cornejo ME, Larios-Tinoco JO, Klünder-Klünder M, Vidal-Mitzi K, Gutiérrez-Camacho C. Differences in the absolute muscle strength and power of children and adolescents with overweight or obesity: a systematic review. BMC Pediatr 2023; 23:474. [PMID: 37726719 PMCID: PMC10510195 DOI: 10.1186/s12887-023-04290-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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/05/2023] [Indexed: 09/21/2023] Open
Abstract
This study aimed to describe absolute muscle strength and power in children and adolescents with obesity, overweight and normal weight, and the assessment tests and tools used. We retrieved observational studies from MEDLINE (PubMed), TripDataBase, Epistemonikos, EBSCO essentials, NICE, SCOPUS, and LILACs up to February 2023. In addition, we recovered data from studies with at least three comparison groups (obesity, overweight, normal weight) and with a description of the absolute muscle strength and power and the assessment tests and instruments used. The methodologic quality of the studies was assessed with the Joanna Briggs checklist, and the review was carried out using the PRISMA 2020 methodology. Eleven studies with 13,451 participants from 6 to 18 years of age were once included, finding that the absolute muscle strength of their upper extremities was greater when they were overweight or obese; however, in the same groups, absolute muscle strength was lower when they carried their body weight. In addition, lower limb absolute muscle strength was significantly lower in obese participants than in normal weight, regardless of age and gender. The most used tools to measure the absolute muscle strength of the upper limbs were the grip dynamometers and push-up exercises. In contrast, different jump tests were used to measure the power of the lower limbs. There are great differences in muscle strength and power between overweight or obese children and adolescents and those with normal weight. Therefore, it is recommended to use validated tests, preferably that assess strength through the load of the patient's body weight, either of the upper or lower limbs, for greater evaluation objectivity that facilitates the management of these children and adolescents.
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Affiliation(s)
- José Luis Alaniz-Arcos
- Physiotherapy Research Unit, Faculty of Medicine, Universidad Nacional Autónoma de México, Dr. Márquez 162 Colonia Doctores, Mexico City, CP 06720 Mexico
| | - Ma. Elena Ortiz-Cornejo
- Physiotherapy Research Unit, Faculty of Medicine, Universidad Nacional Autónoma de México, Dr. Márquez 162 Colonia Doctores, Mexico City, CP 06720 Mexico
| | - José Omar Larios-Tinoco
- Physiotherapy Research Unit, Faculty of Medicine, Universidad Nacional Autónoma de México, Dr. Márquez 162 Colonia Doctores, Mexico City, CP 06720 Mexico
| | - Miguel Klünder-Klünder
- Research Headmaster’s Office, Hospital Infantil de México Federico Gómez, Mexico City, México
| | - Karla Vidal-Mitzi
- Physiotherapy Research Unit, Faculty of Medicine, Universidad Nacional Autónoma de México, Dr. Márquez 162 Colonia Doctores, Mexico City, CP 06720 Mexico
| | - Claudia Gutiérrez-Camacho
- Physiotherapy Research Unit, Faculty of Medicine, Universidad Nacional Autónoma de México, Dr. Márquez 162 Colonia Doctores, Mexico City, CP 06720 Mexico
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Koretzky SG, Olivar-López V, Chávez-López A, Sienra-Monge JJ, Klünder-Klünder M, Márquez-González H, Salazar-García M, de la Rosa-Zamboni D, Parra-Ortega I, López-Martínez B. Behavior of immunoglobulin G antibodies for SARS-COV-2 in Mexican pediatric patients with comorbidities: a prospective comparative cohort study. Transl Pediatr 2023; 12:1319-1326. [PMID: 37575905 PMCID: PMC10416121 DOI: 10.21037/tp-22-454] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 04/18/2023] [Indexed: 08/15/2023] Open
Abstract
Background More than two years after the pandemic of COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) there is a great lack of information. The presence of immunoglobulin G (IgG) have been related with disease severity. Patients with comorbidities could develop more severe infection; however, the evaluation of the humoral response in pediatric population are needed especially in patients with comorbidities. Our aim was to describe the behavior of IgG in pediatric patients and to know if there is a difference between patients with comorbidities. Methods A prospective comparative cohort study was carried out in a single center from June 2020 to January 2021, with a follow-up of 6 months. The study included all the subjects with confirmatory test for SARS-CoV-2 from 1 month to 17 years 11 months, the follow-up of the disease's evolution and measurement of IgG antibodies was collected. We obtained the clinical data, and comorbidities like arterial hypertension, diabetes, obesity, and cancer, the initial symptoms were recorded as well as the evolution regarding the severity of COVID-19 and the need for hospitalization, intensive care unit or mechanical ventilation. The follow up was carried out through medical consultation with an appointment every month that included direct interrogation, examination, and peripheral blood collection for the IgG quantification. The antibodies detection was done through peripheral blood and chemiluminescence microparticle immunoassay. Results A total of 237 patients with positive polymerase chain reaction (PCR) for SARS-COV-2 were included, of which 147 presented IgG antibodies (62%), 112 (76%) without comorbidity and 35 (24%) with comorbidities, by the sixth month only 2.7% continue with positive antibody measurements. Patients with comorbidities reach higher IgG levels than patients without comorbidities the basal titters were: 5.17 for patients without comorbidities vs. 6.96 for the group with comorbidities (P<0.001). Conclusions We found an association between the presence of comorbidities and high levels of IgG units in pediatric patients with COVID-19. Additionally, patients with more severe course of the disease have higher levels of IgG and by the third month less than 35% have immunity.
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Affiliation(s)
| | - Victor Olivar-López
- Pediatric Emergency Service, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Adrián Chávez-López
- Department of Pediatric Intensive Care, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | | | | | | | | | - Israel Parra-Ortega
- Clinical Laboratory, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Briseida López-Martínez
- Auxiliary Diagnostic Resources, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
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Vazquez-Moreno M, Sandoval-Castillo M, Rios-Lugo MJ, Klünder-Klünder M, Cruz M, Martínez-Navarro I, Romero-Guzmán ET, Victoria-Campos CI, Vilchis-Gil J, Hernández-Mendoza H. Overweight and Obesity Are Positively Associated with Serum Copper Levels in Mexican Schoolchildren. Biol Trace Elem Res 2023; 201:2744-2749. [PMID: 35951159 DOI: 10.1007/s12011-022-03383-4] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/06/2022] [Indexed: 11/02/2022]
Abstract
Due to its relationship with oxidative stress and inflammation responses, obesity and its cardiometabolic implications have been related with serum copper (Cu). Hence, we analyzed the association of overweight (OW) and obesity (OB) status and cardiometabolic traits with serum Cu level in Mexican schoolchildren. Anthropometrical data and cardiometabolic traits were analyzed in this cross-sectional study. Serum Cu level was measured by inductively coupled plasma mass spectrometry. The study involved 191 schoolchildren (93 girls and 98 boys) with a mean age of 8.054 ± 1.170 years. Children with OW and OB had higher serum Cu levels than children with normal weight (NW) (mean difference: OW vs NW = 51.85 µg dL-1, OB vs NW = 47.22 µg dL-1, p < 0.001). In a multiple linear regression model, OW and OB status were positively associated with serum Cu levels (βOW = 49.85, 95% confidence interval (95% CI) 35.84-63.87, p < 0.001; βOB = 44.38, 95% CI 27.70-61.05, p < 0.001). We did not identify any significant association between cardiometabolic traits and serum Cu level. In conclusion, our results show an association of the presence of OW and OB with higher serum Cu levels, for the first time in Mexican schoolchildren. However, further functional studies are needed to better understand the role of Cu in the pathophysiology of obesity.
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Affiliation(s)
- Miguel Vazquez-Moreno
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico
| | - Marián Sandoval-Castillo
- Unidad de Posgrado, Facultad de Enfermería y Nutrición, Universidad Autónoma de San Luis Potosí, Avda. Niño Artillero 130, CP 78210, San Luis Potosí, S.L.P., México
| | - María Judith Rios-Lugo
- Unidad de Posgrado, Facultad de Enfermería y Nutrición, Universidad Autónoma de San Luis Potosí, Avda. Niño Artillero 130, CP 78210, San Luis Potosí, S.L.P., México
- Sección de Medicina Molecular y Traslacional, Centro de Investigación en Ciencias de Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, Avda Sierra Leona 550, CP 78210, San Luis, S.L.P., México
| | - Miguel Klünder-Klünder
- Subdirección de Investigación, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Del. Cuauhtémoc, 06720, Ciudad de México, Mexico
| | - Miguel Cruz
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico
| | - Israel Martínez-Navarro
- Sección de Medicina Molecular y Traslacional, Centro de Investigación en Ciencias de Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, Avda Sierra Leona 550, CP 78210, San Luis, S.L.P., México
| | - Elizabeth Teresita Romero-Guzmán
- Departamento de Química, Instituto Nacional de Investigaciones Nucleares, Carretera México-Toluca S/N, C.P. 52750, La Marquesa Ocoyoacác, México
| | - Claudia Inés Victoria-Campos
- Unidad de Posgrado, Facultad de Enfermería y Nutrición, Universidad Autónoma de San Luis Potosí, Avda. Niño Artillero 130, CP 78210, San Luis Potosí, S.L.P., México
- Sección de Medicina Molecular y Traslacional, Centro de Investigación en Ciencias de Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, Avda Sierra Leona 550, CP 78210, San Luis, S.L.P., México
| | - Jenny Vilchis-Gil
- Unidad de Investigación Epidemiológica en Endocrinología y Nutrición, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Del. Cuauhtémoc, 06720, Ciudad de México, México.
| | - Héctor Hernández-Mendoza
- Instituto de Investigación de Zonas Desérticas, Universidad Autónoma de San Luis Potosí, Altair 200, CP 78377, San Luis, S.L.P., México.
- Universidad del Centro de México, Capitán Caldera 75, CP 78250, San Luis, S.L.P., México.
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Molina-Díaz JM, Vargas-Terrez BE, Medina-Bravo PG, Martínez-Ambrosio A, Miranda-Lora AL, Klünder-Klünder M. Prevalence of type 2 diabetes mellitus in the pediatric population of a third-level care hospital in Mexico City in 2013 and 2018. World J Diabetes 2023; 14:290-298. [PMID: 37035230 PMCID: PMC10075026 DOI: 10.4239/wjd.v14.i3.290] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/15/2023] [Accepted: 02/14/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Diabetes mellitus type 2 (T2DM) is a state of hyperglycemia due to a defect in the secretion and/or action of insulin, and it represents the most common form of diabetes worldwide. In Mexico, 10.3% of the adult population have been diagnosed with T2DM and it is expanding to the pediatric population. AIM To evaluate and compare the prevalence of T2DM in the pediatric population at the Children's Hospital, "Hospital Infantil de México Federico Gómez (HIMFG)", at two time periods: 2013 vs 2018. METHODS A comparison of two cross-sectional studies was done (2013 and 2018). The study population was comprised of children and adolescents 8-17 years old, from the Diabetes Clinic at the aforementioned institution. A comprehensive interrogation regarding family history and perinatal antecedents was performed. Complete blood work after 12 h of fasting was obtained to determine serum levels of glucose, glycated hemoglobin, lipid profile, C-peptide, and insulin. The data were analysed using the statistical software package SPSS v. 23.0. A P value of < 0.05 was considered statistically significant. RESULTS A total of 151 patients were included: 47 from 2013, and 104 from 2018. There were age differences noted between the two periods with younger patients presenting T2DM in 2013. Also, T2DM predominated in the male sex in 55.36% in 2013 vs 32.7% in 2018. An increased prevalence of T2DM was noted from 2013 to 2018 (20.2% vs 33.0%, respectively), which was a statistically significant 12.8% increase (P < 0.0001). The illness phenotype was more aggressive in the 2018 group with the presence of a higher proportion of obesity, insulin resistance, and adverse lipid profiles. CONCLUSION The prevalence of T2DM at the HIMFG institution from 2013 to 2018 increased by 12.8% (20.2% vs 33.0%, respectively). The study results demonstrate the need for vigilance in T2DM trends, and to strengthen programs of healthy nutrition and physical activity as well as early detection and risk factors for obesity, data on insulin resistance, and metabolic syndrome, with the aim of preventing the development of T2DM.
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Affiliation(s)
- Jorge Mario Molina-Díaz
- Department of Child Endocrinology, Children’s Hospital Federico Gomez, Autonomous University of Mexico, Mexico City 06250, Mexico
| | | | | | - Antonia Martínez-Ambrosio
- Department of Nursing and Endocrinology, Children’s Hospital Federico Gómez, Mexico City 06720, Mexico
| | - América Liliana Miranda-Lora
- Epidemiological Research Unit in Endocrinology and Nutrition, Children’s Hospital Federico Gomez, Mexico City 06720, Mexico
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Vilardell-Dávila A, Martínez-Andrade G, Klünder-Klünder M, Miranda-Lora AL, Mendoza E, Flores-Huerta S, Vargas-González JE, Duque X, Vilchis-Gil J. A Multi-Component Educational Intervention for Addressing Levels of Physical Activity and Sedentary Behaviors of Schoolchildren. Int J Environ Res Public Health 2023; 20:3003. [PMID: 36833697 PMCID: PMC9966386 DOI: 10.3390/ijerph20043003] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/16/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
Physical inactivity and a sedentary lifestyle are risk factors for excess weight and obesity in childhood. It is, therefore, necessary to adopt strategies which can modify these behaviors during childhood, the age at which habits are formed. This study aimed to evaluate the impact of an educational intervention using digital media and face-to-face activities involving children, parents, and the school community on the level of physical activity and sedentary behavior among schoolchildren. This was a secondary analysis of data obtained from a community trial in which students from four primary schools in Mexico City participated. Two schools were assigned to the intervention group (IG) and two to the control group (CG). The intervention lasted 12 months and included a face-to-face component, which involved sessions and workshops for parents and children, as well as visual material for children and a distance component utilizing electronic means (web portal and text messages to mobile phones) for parents. Anthropometric measurements were taken and information was collected on moderate to vigorous physical activity performed by the children and on the time that the schoolchildren spent in front of screens at the beginning of the study and at 6 and 12 months. Information on 201 children from the IG and 167 children from the CG was included in the analysis. At 12 months, the IG showed a mean decrease of 33.4 min/d [95% CI: -53.5 to -13.3] in screen time, while the CG showed an increase of 12.5 min/d [CI 95%: -10.5 to 35.6], p = 0.003. After 12 months of follow-up, applying this educational intervention reduced the time that schoolchildren spent in front of screens. Educational intervention is a feasible and accessible strategy for promoting changes in sedentary behaviors in the school-age population.
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Affiliation(s)
- Ana Vilardell-Dávila
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City 06720, Mexico
| | - Gloria Martínez-Andrade
- Mexican Academic Area of Nutrition, Institute of Health Sciences, Autonomous University of the State of Hidalgo, Pachuca 42039, Mexico
| | - Miguel Klünder-Klünder
- Deputy Director of Research, Mexico Children’s Hospital Federico Gómez, Mexico City 06720, Mexico
| | - América Liliana Miranda-Lora
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City 06720, Mexico
| | - Eugenia Mendoza
- Unit of Medical Research in Infectious and Parasitic Diseases, Mexican Institute of Social Security (IMSS), Mexico City 06720, Mexico
| | - Samuel Flores-Huerta
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City 06720, Mexico
| | - Jorge Eduardo Vargas-González
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City 06720, Mexico
| | - Ximena Duque
- Unit of Medical Research in Infectious and Parasitic Diseases, Mexican Institute of Social Security (IMSS), Mexico City 06720, Mexico
| | - Jenny Vilchis-Gil
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City 06720, Mexico
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9
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Angeles-Floriano T, Sanjuan-Méndez A, Rivera-Torruco G, Parra-Ortega I, Lopez-Martinez B, Martinez-Castro J, Marin-Santiago S, Alcántara-Hernández C, Martínez-Martínez A, Márquez-González H, Klünder-Klünder M, Olivar-López V, Zaragoza-Ojeda M, Arenas-Huertero F, Torres-Aguilar H, Medina-Contreras O, Zlotnik A, Valle-Rios R. Leukocyte surface expression of the endoplasmic reticulum chaperone GRP78 is increased in severe COVID-19. J Leukoc Biol 2023; 113:1-10. [PMID: 36822163 DOI: 10.1093/jleuko/qiac017] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Indexed: 01/12/2023] Open
Abstract
Hyperinflammation present in individuals with severe COVID-19 has been associated with an exacerbated cytokine production and hyperactivated immune cells. Endoplasmic reticulum stress leading to the unfolded protein response has been recently reported as an active player in inducing inflammatory responses. Once unfolded protein response is activated, GRP78, an endoplasmic reticulum-resident chaperone, is translocated to the cell surface (sGRP78), where it is considered a cell stress marker; however, its presence has not been evaluated in immune cells during disease. Here we assessed the presence of sGRP78 on different cell subsets in blood samples from severe or convalescent COVID-19 patients. The frequency of CD45+sGRP78+ cells was higher in patients with the disease compared to convalescent patients. The latter showed similar frequencies to healthy controls. In patients with COVID-19, the lymphoid compartment showed the highest presence of sGRP78+ cells versus the myeloid compartment. CCL2, TNF-α, C-reactive protein, and international normalized ratio measurements showed a positive correlation with the frequency of CD45+sGRP78+ cells. Finally, gene expression microarray data showed that activated T and B cells increased the expression of GRP78, and peripheral blood mononuclear cells from healthy donors acquired sGRP78 upon activation with ionomycin and PMA. Thus, our data highlight the association of sGRP78 on immune cells in patients with severe COVID-19.
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Affiliation(s)
- Tania Angeles-Floriano
- División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.,Programa de Maestría y Doctorado en Ciencias Médicas Odontológicas y de la Salud, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.,Unidad de Investigación en Inmunología y Proteómica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Adriana Sanjuan-Méndez
- División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.,Unidad de Investigación en Inmunología y Proteómica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.,Programa de Maestría en Biomedicina Experimental, Facultad de Medicina y Cirugía, Universidad Autónoma Benito Juárez de Oaxaca, Oaxaca City, Mexico
| | - Guadalupe Rivera-Torruco
- División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.,Unidad de Investigación en Inmunología y Proteómica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.,Departamento de Fisiología y Neurociencias, Centro de Investigación y de Estudios Avanzados (CINVESTAV), Mexico City, Mexico
| | - Israel Parra-Ortega
- Departamento de Laboratorio Clínico, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Briceida Lopez-Martinez
- Departamento de Laboratorio Clínico, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Jesús Martinez-Castro
- Departamento de Medicina Interna, Centro Médico Lic, Adolfo López Mateos de Toluca, Toluca City, Mexico
| | - Sergio Marin-Santiago
- Departamento de Medicina Interna, Centro Médico Lic, Adolfo López Mateos de Toluca, Toluca City, Mexico
| | | | - Araceli Martínez-Martínez
- Departamento de Medicina Interna, Centro Médico Lic, Adolfo López Mateos de Toluca, Toluca City, Mexico
| | - Horacio Márquez-González
- Departamento de Investigación Clínica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Subdirección de Investigación, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Victor Olivar-López
- Departamento de Urgencias Pediátricas, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Montserrat Zaragoza-Ojeda
- Laboratorio de Investigación en Patología Experimental, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Francisco Arenas-Huertero
- Laboratorio de Investigación en Patología Experimental, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Honorio Torres-Aguilar
- Facultad de Ciencias Químicas, Universidad Autónoma Benito Juárez de Oaxaca, Oaxaca City, Mexico
| | - Oscar Medina-Contreras
- Unidad de Investigación Epidemiológica en Endocrinología y Nutrición, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Albert Zlotnik
- Department of Physiology and Biophysics, University of California, Irvine, CA, United States
| | - Ricardo Valle-Rios
- División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico.,Unidad de Investigación en Inmunología y Proteómica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
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10
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Martínez-Navarro I, Vilchis-Gil J, Cossío-Torres PE, Hernández-Mendoza H, Klünder-Klünder M, Layseca-Espinosa E, Galicia-Cruz OG, Rios-Lugo MJ. Relationship of Serum Zinc Levels with Cardiometabolic Traits in Overweight and Obese Schoolchildren from Mexico City. Biol Trace Elem Res 2022:10.1007/s12011-022-03533-8. [PMID: 36572827 PMCID: PMC9792317 DOI: 10.1007/s12011-022-03533-8] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/13/2022] [Indexed: 12/28/2022]
Abstract
Zinc (Zn) participates as a cofactor for many enzymes in the cellular metabolism, and its serum levels have been associated with different metabolic diseases, especially obesity (OB). Nevertheless, its associations are not clear in the children population. The objective of this study is to evaluate the association between serum Zn levels (SZn) with overweight/obesity status (OW/OB), as well as its cardiometabolic traits in a population of children in Mexico City. Anthropometrical data (body mass index z score (BMIz)), demographic variables (age and sex), and cardiometabolic traits (total cholesterol (TC), high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), triglycerides (TG), fasting plasma glucose (FPG), and insulin) were analyzed in this cross-sectional study. SZn were measured by inductively coupled plasma mass spectrometry (ICP-MS). The population included 210 children from Mexico City (girls (n = 105) and boys (n = 105)) between ages 6 and 10 years. Normal-weight (NW) schoolchildren had higher SZn concentrations (66 µg/dL; IQR: 48 to 91) compared to OW or OB schoolchildren (61 µg/dL; IQR: 45 to 76). The data showed a significant negative association between SZn and BMIz without sex exclusion (r = - 0.181 and p = 0.009). The boy's population did not show an association between the SZn and BMIz compared to the girl's population which showed a significant negative association (r = - 0.277 and p = 0.004). In addition, other associations were found between SZn and TC (boys (r = 0.214 and p = 0.025), LDLc (boys (r = 0.213 and p = 0.029), and TG (girls (r = - 0.260 and p = 0.007)). Moreover, 38.6% of the total children in our population study had Zn deficiency (ZnD). NW schoolchildren had higher SZn concentrations compared to OW or OB schoolchildren. A diet low in Zn can be a factor to evaluate in the development of childhood OB in Mexico. However, further studies need to be performed on the children Mexican population to replicate and confirm our findings.
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Affiliation(s)
- Israel Martínez-Navarro
- Posgrado de Ciencias Basicas, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Av. Venustiano Carranza 2405, CP 78210, San Luis Potosí, S.L.P, México
| | - Jenny Vilchis-Gil
- Unidad de Investigación Epidemiológica en Endocrinología y Nutrición, Hospital Infantil de México Federico Gómez, Secretaría de Salud, CP 06720, Ciudad de Mexico, México
| | - Patricia Elizabeth Cossío-Torres
- Departamento de Salud Pública y Ciencias Médicas, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Av. Venustiano Carranza 2405, CP 78210, San Luis Potosí, S.L.P, México
| | - Héctor Hernández-Mendoza
- Instituto de Investigación de Zonas Desérticas, Universidad Autónoma de San Luis Potosí, Altair 200, CP 78377, San Luis, S.L.P, México.
- Hospital General de Soledad de Graciano Sánchez, Secretaría de Salud, Valentín Amador 1112, Soledad de Graciano Sánchez, CP 78435, San Luis Potosí, S.L.P., Mexico.
| | - Miguel Klünder-Klünder
- Dirección de Investigación, Hospital Infantil de México Federico Gómez, Secretaría de Salud, CP 06720, Ciudad de Mexico, México
| | - Esther Layseca-Espinosa
- Centro de Investigación en Ciencias de La Salud y Biomedicina, Sección de Medicina Molecular y Traslacional, Universidad Autónoma de San Luis Potosí, Avda Sierra Leona 550, CP 78210, San Luis Potosí, S.L.P, México
| | - Othir Gidalti Galicia-Cruz
- Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, Av. Venustiano Carranza 2405, CP 78210, San Luis Potosí, S.L.P, México
| | - María Judith Rios-Lugo
- Centro de Investigación en Ciencias de La Salud y Biomedicina, Sección de Medicina Molecular y Traslacional, Universidad Autónoma de San Luis Potosí, Avda Sierra Leona 550, CP 78210, San Luis Potosí, S.L.P, México.
- Facultad de Enfermería y Nutrición, Unidad de Posgrado, Universidad Autónoma de San Luis Potosí, Avda. Niño Artillero 130, CP 78210, San Luis Potosí, S.L.P, México.
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11
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Solórzano-Santos F, Miranda-Lora AL, Márquez-González H, Klünder-Klünder M. Survival analysis and mortality predictors of COVID-19 in a pediatric cohort in Mexico. Front Public Health 2022; 10:969251. [PMID: 36589967 PMCID: PMC9801985 DOI: 10.3389/fpubh.2022.969251] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/08/2022] [Indexed: 12/23/2022] Open
Abstract
Background The new coronavirus SARS-CoV-2 pandemic has been relatively less lethal in children; however, poor prognosis and mortality has been associated with factors such as access to health services. Mexico remained on the list of the ten countries with the highest case fatality rate (CFR) in adults. It is of interest to know the behavior of COVID-19 in the pediatric population. The aim of this study was to identify clinical and sociodemographic variables associated with mortality due to COVID-19 in pediatric patients. Objective Using National open data and information from the Ministry of Health, Mexico, this cohort study aimed to identify clinical and sociodemographic variables associated with COVID-19 mortality in pediatric patients. Method A cohort study was designed based on National open data from the Ministry of Health, Mexico, for the period April 2020 to January 2022, and included patients under 18 years of age with confirmed SARS-CoV-2 infection. Variables analyzed were age, health services used, and comorbidities (obesity, diabetes, asthma, cardiovascular disease, immunosuppression, high blood pressure, and chronic kidney disease). Follow-up duration was 60 days, and primary outcomes were death, hospitalization, and requirement of intensive care. Statistical analysis included survival analysis, prediction models created using the Cox proportional hazards model, and Kaplan-Meier estimation curves. Results The cohort included 261,099 cases with a mean age of 11.2 ± 4 years, and of these, 11,569 (4.43%) were hospitalized and 1,028 (0.39%) died. Variables associated with risk of mortality were age under 12 months, the presence of comorbidities, health sector where they were treated, and first wave of infection. Conclusion Based on data in the National database, we show that the pediatric fatality rate due to SARS-CoV-2 is similar to that seen in other countries. Access to health services and distribution of mortality were heterogeneous. Vulnerable groups were patients younger than 12 months and those with comorbidities.
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Affiliation(s)
- Fortino Solórzano-Santos
- Unidad de Investigación en Enfermedades Infecciosas, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, Mexico
| | - América Liliana Miranda-Lora
- Unidad de Investigación Epidemiológica en Endocrinología y Nutrición, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, Mexico
| | - Horacio Márquez-González
- Departamento de Investigación Clínica, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, Mexico,*Correspondence: Horacio Márquez-González
| | - Miguel Klünder-Klünder
- Subdirección de Investigación, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, Mexico,Miguel Klünder-Klünder
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12
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Barajas-Torres GC, Klünder-Klünder M, Garduño-Espinosa J, Parra-Ortega I, Franco-Hernández MI, Miranda-Lora AL. Effects of Carbonated Beverage Consumption on Oral pH and Bacterial Proliferation in Adolescents: A Randomized Crossover Clinical Trial. Life (Basel) 2022; 12:1776. [PMID: 36362931 PMCID: PMC9696556 DOI: 10.3390/life12111776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/12/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 09/15/2023] Open
Abstract
Sugary soft drinks modify salivary pH and favor bacterial proliferation and are associated with the development of caries. Information on the effects of consuming carbonated drinks without sucrose is limited. Methods: In this crossover clinical trial, salivary and dental biofilm pH were determined at 0, 5, 10, 15, 30, 45, and 60 min after the participants (n = 18) ingested a soft drink with sucrose, a soft drink with aspartame/acesulfame K, carbonated water, and plain water on different days. Dental biofilm cultures were conducted at 0- and 120-min. Results: Salivary pH decreased significantly after ingestion of the sucrose-containing soft drink when compared with the other types of beverages (median difference, -0.3--0.4, p ≤ 0.05), and the greatest difference was found with mineral water. A greater bacterial proliferation (Colony Forming Units [CFU]) was observed after ingestion of the drink with sucrose (↑310 × 103 CFU, p ≤ 0.01), followed by the drink with aspartame/acesulfame K (↑160 × 103 CFU, p ≤ 0.01) and carbonated water (↑60 × 103 CFU, p ≤ 0.05). No significant changes in bacterial proliferation were observed after the consumption of natural water. Conclusions: Ingestion of sucrose-containing soft drinks favors the acidification of salivary pH and the bacterial proliferation of dental biofilm. Although to a lesser extent, soft drinks containing aspartame/acesulfame K also favor bacterial proliferation.
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Affiliation(s)
- Guadalupe Carolina Barajas-Torres
- Departamento de Investigación Clínica, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Dr. Márquez No. 162, Col Doctores, Delegación Cuauhtémoc, Mexico City 06720, Mexico
| | - Miguel Klünder-Klünder
- Departamento de Gestión de la Investigación, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Dr. Márquez No. 162, Col Doctores, Delegación Cuauhtémoc, Mexico City 06720, Mexico
| | - Juan Garduño-Espinosa
- Dirección de Investigación, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Dr. Márquez No. 162, Col Doctores, Delegación Cuauhtémoc, Mexico City 06720, Mexico
| | - Israel Parra-Ortega
- Laboratorio Clínico, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Dr. Márquez No. 162, Col Doctores, Delegación Cuauhtémoc, Mexico City 06720, Mexico
| | - María Isabel Franco-Hernández
- Laboratorio Clínico, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Dr. Márquez No. 162, Col Doctores, Delegación Cuauhtémoc, Mexico City 06720, Mexico
| | - América Liliana Miranda-Lora
- Unidad de Investigación Epidemiológica en Endocrinología y Nutrición, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Dr. Márquez No. 162, Col Doctores, Delegación Cuauhtémoc, Mexico City 06720, Mexico
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13
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Flores-Moreno BJ, Martínez-Andrade G, Klünder-Klünder M, Miranda-Lora AL, Beristain-Lujano B, Flores-Huerta S, Mendoza E, Mayorga-Lima A, Duque X, Vilchis-Gil J. Evidence of Unhealthy Dietary Patterns in the School Lunch Sent from Home for Children in Mexico City. Int J Environ Res Public Health 2022; 19:11650. [PMID: 36141913 PMCID: PMC9517523 DOI: 10.3390/ijerph191811650] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
The identification and characterization of dietary patterns are tools that are used to assess associations between diet and health or disease conditions. In Mexico, studies have examined dietary patterns in children for breakfast or for the whole day, but not specifically for their school lunch. The aim was to describe dietary patterns identified in school lunch and their association with the nutritional status and metabolic parameters of schoolchildren. In this cross-sectional study on schoolchildren from four elementary schools of Mexico City, we recorded anthropometry measurements, a fasting blood sample was collected, and metabolic parameters were determined. We obtained information on the foods and beverages that children brought for their school lunch; estimated the caloric and nutritional content; and created food groups to obtain dietary patterns from the energy provided by those groups. Among the 350 schoolchildren (mean age, 7.9 ± 1.2 years) included, 24.9% and 21.7% presented having overweight and obesity, respectively. A total of 89.4% of schoolchildren brought the school lunch from home. Using the K-means method, the following four dietary patterns were identified: (1) sandwiches, tortas, and sweetened dairy products were consumed by 13.1% (n = 46) of the schoolchildren; (2) sweet snacks were consumed by 50.3% (n = 176); (3) sweetened dairy products were brought by 15.1% of the children (n = 53); and (4) sandwiches and tortas were brought by 21.4% (n = 75). These four patterns showed significant differences in terms of the caloric and nutritional contents (p < 0.001). Energy sources in the identified patterns were primarily sugars (15.8-40%). No association was found between the anthropometric and metabolic parameters of children and the dietary patterns. No dietary pattern obtained from the school lunch could be considered as healthy, since all of them had high energy content, and a high percentage of the energy was from sugars from ultra-processed foods and beverages.
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Affiliation(s)
- Brenda Jazmín Flores-Moreno
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Mexico City 06720, Mexico
| | - Gloria Martínez-Andrade
- Academic Area of Nutrition, Institute of Health Sciences, Autonomous University of the State of Hidalgo, Pachuca Hidalgo 42000, Mexico
| | - Miguel Klünder-Klünder
- Research Division, Mexico Children’s Hospital Federico Gómez, Mexico City 06720, Mexico
- Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN), Mexico City 06720, Mexico
| | - América Liliana Miranda-Lora
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Mexico City 06720, Mexico
| | - Brenda Beristain-Lujano
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Mexico City 06720, Mexico
| | - Samuel Flores-Huerta
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Mexico City 06720, Mexico
| | - Eugenia Mendoza
- Infectious Diseases Research Unit, Pediatric Hospital, Mexican Institute of Social Security, Mexico City 06600, Mexico
| | - Ariana Mayorga-Lima
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Mexico City 06720, Mexico
| | - Ximena Duque
- Infectious Diseases Research Unit, Pediatric Hospital, Mexican Institute of Social Security, Mexico City 06600, Mexico
| | - Jenny Vilchis-Gil
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Mexico City 06720, Mexico
- Medicine Faculty, National Autonomous University of Mexico, Mexico City 06320, Mexico
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14
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Cortés-Sarabia K, Cruz-Rangel A, Flores-Alanis A, Salazar-García M, Jiménez-García S, Rodríguez-Martínez G, Reyes-Grajeda JP, Rodríguez-Téllez RI, Patiño-López G, Parra-Ortega I, Del Moral-Hernández O, Illades-Aguiar B, Klünder-Klünder M, Márquez-González H, Chávez-López A, Luna-Pineda VM. Clinical features and severe acute respiratory syndrome-coronavirus-2 structural protein-based serology of Mexican children and adolescents with coronavirus disease 2019. PLoS One 2022; 17:e0273097. [PMID: 35969583 PMCID: PMC9377623 DOI: 10.1371/journal.pone.0273097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 08/02/2022] [Indexed: 12/24/2022] Open
Abstract
Severe acute respiratory syndrome (SARS)-coronavirus (CoV)-2 infection in children and adolescents primarily causes mild or asymptomatic coronavirus disease 2019 (COVID-19), and severe illness is mainly associated with comorbidities. However, the worldwide prevalence of COVID-19 in this population is only 1%–2%. In Mexico, the prevalence of COVID-19 in children has increased to 10%. As serology-based studies are scarce, we analyzed the clinical features and serological response (SARS-CoV-2 structural proteins) of children and adolescents who visited the Hospital Infantil de México Federico Gómez (October 2020–March 2021). The majority were 9-year-old children without comorbidities who were treated as outpatients and had mild-to-moderate illness. Children aged 6–10 years and adolescents aged 11–15 years had the maximum number of symptoms, including those with obesity. Nevertheless, children with comorbidities such as immunosuppression, leukemia, and obesity exhibited the lowest antibody response, whereas those aged 1–5 years with heart disease had the highest levels of antibodies. The SARS-CoV-2 spike receptor-binding domain-localized peptides and M and E proteins had the best antibody response. In conclusion, Mexican children and adolescents with COVID-19 represent a heterogeneous population, and comorbidities play an important role in the antibody response against SARS-CoV-2 infection.
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Affiliation(s)
- Karen Cortés-Sarabia
- Laboratorio de Inmunobiología y Diagnóstico Molecular, Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Guerrero, México
| | - Armando Cruz-Rangel
- Laboratorio de Bioquímica de Enfermedades Crónicas, Instituto Nacional de Medicina Genómica, Mexico City (Ciudad de México), México
| | - Alejandro Flores-Alanis
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City (Ciudad de México), México
| | - Marcela Salazar-García
- Laboratorio de Biología del Desarrollo y Teratogénesis Experimental, Hospital Infantil de México Federico Gómez, Mexico City (Ciudad de México), México
- Laboratorio de Investigación en COVID-19, Hospital Infantil de México Federico Gómez, Mexico City (Ciudad de México), México
| | - Samuel Jiménez-García
- Laboratorio de Biomedicina Molecular, Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Guerrero, México
| | - Griselda Rodríguez-Martínez
- Laboratorio de Investigación en COVID-19, Hospital Infantil de México Federico Gómez, Mexico City (Ciudad de México), México
| | - Juan Pablo Reyes-Grajeda
- Laboratorio de Bioquímica de Enfermedades Crónicas, Instituto Nacional de Medicina Genómica, Mexico City (Ciudad de México), México
| | - Rosa Isela Rodríguez-Téllez
- Unidad de Investigación en Inmunología y Proteómica, Hospital Infantil de México Federico Gómez, Mexico City (Ciudad de México), México
| | - Genaro Patiño-López
- Unidad de Investigación en Inmunología y Proteómica, Hospital Infantil de México Federico Gómez, Mexico City (Ciudad de México), México
| | - Israel Parra-Ortega
- Laboratorio Central, Hospital Infantil de México Federico Gómez, Mexico City (Ciudad de México), México
| | - Oscar Del Moral-Hernández
- Laboratorio de Virología, Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Guerrero, México
| | - Berenice Illades-Aguiar
- Laboratorio de Biomedicina Molecular, Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Guerrero, México
| | - Miguel Klünder-Klünder
- Subdirección de Gestión de la Investigación, Hospital Infantil de México Federico Gómez, Mexico City (Ciudad de México), México
| | - Horacio Márquez-González
- Investigación Clínica, Hospital Infantil de México Federico Gómez, Mexico City (Ciudad de México), México
| | - Adrián Chávez-López
- Departamento de la Unidad de Terapia Intensiva Pediátrica, Hospital Infantil de México Federico Gómez, Mexico City (Ciudad de México), México
| | - Victor M. Luna-Pineda
- Laboratorio de Investigación en COVID-19, Hospital Infantil de México Federico Gómez, Mexico City (Ciudad de México), México
- Unidad de Investigación en Inmunología y Proteómica, Hospital Infantil de México Federico Gómez, Mexico City (Ciudad de México), México
- * E-mail:
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Gil Guevara R, Marroquín Yáñez MDL, Jiménez-Juárez RN, Olivar Lopez V, Chávez Lopez A, Sienra Monge JJL, Jamaica Balderas LMDC, Martínez Herrera SA, Domínguez-Barrera C, Erdmenger Orellana J, Márquez González H, Klünder-Klünder M, Nieto Zermeño J, Villa Guillen M, González García N, Castilla-Peon MF. Characteristics and Outcomes of Cases of Children and Adolescents With Pediatric Inflammatory Multisystem Syndrome in a Tertiary Care Center in Mexico City. Front Pediatr 2022; 10:849388. [PMID: 35615633 PMCID: PMC9124926 DOI: 10.3389/fped.2022.849388] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background Pediatric inflammatory multisystem syndrome (PIMS) is a complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children that resembles Kawasaki syndrome and places them at high risk of cardiorespiratory instability and/or cardiac damage. This study aims to describe the clinical presentation and outcomes of patients with PIMS in Mexico City. Methods This was an observational study of children hospitalized for PIMS based on the Centers for Disease Control and Prevention case definition criteria, in a single tertiary care pediatric center in Mexico City between May 1, 2020, and September 30, 2021. Demographic characteristics, epidemiological data, medical history, laboratory tests, cardiologic evaluations, treatment, and clinical outcomes were analyzed. Results Seventy-five cases fulfilled the case definition criteria for PIMS [median age: 10.9 years, Interquartile range (IQR): 5.6-15.6]. Fifteen (20%) patients had a severe underlying disease, 48 (64%) were admitted to the intensive care unit, 33 (44%) required invasive mechanical ventilation and 39 (52%) received vasopressor support. The patients were clustered through latent class analysis based on identified symptoms: Cluster 1 had rash or gastrointestinal symptoms (n = 60) and cluster 2 were those with predominantly respiratory manifestations (n = 15). Two patients (2.7%) died, and both had severe underlying conditions. Five patients (6.7%), all from cluster 1, developed coronary aneurysms. Conclusion There were a high proportion of patients with severe respiratory involvement and positive RT-PCR SARS-CoV-2 and very few cases of coronary aneurysms in our study which suggests that a high proportion of the children had severe acute COVID-19. The clinical manifestations and outcomes are comparable to previously reported international studies.
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Affiliation(s)
- Ricardo Gil Guevara
- Department of Emergency Medicine, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico City, Mexico
| | | | - Rodolfo Norberto Jiménez-Juárez
- Department of Infectious Diseases, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico City, Mexico
- Department of Pediatrics, Infectious Diseases Hospital, UMAR National Medical Center “La Raza,” Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Víctor Olivar Lopez
- Department of Emergency Medicine, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico City, Mexico
| | - Adrián Chávez Lopez
- Pediatric Intensive Care Unit, Hospital Infantil de Mexico Instituto Nacional de Salud, Mexico City, Mexico
| | - Juan José Luis Sienra Monge
- Ambulatory Pediatrics, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud Instituto Nacional de Salud, Mexico City, Mexico
| | | | | | - Clemen Domínguez-Barrera
- Department of Infectious Diseases, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico City, Mexico
| | - Julio Erdmenger Orellana
- Department of Cardiology, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico City, Mexico
| | - Horacio Márquez González
- Department of Clinical Research, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Research Division, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico City, Mexico
| | - Jaime Nieto Zermeño
- Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico City, Mexico
| | - Mónica Villa Guillen
- Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico City, Mexico
| | - Nadia González García
- Neruosciences Research Laboratory, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico City, Mexico
| | - Maria F. Castilla-Peon
- Research Division, Hospital Infantil de Mexico Federico Gomez Instituto Nacional de Salud, Mexico City, Mexico
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Villasis-Keever MA, López-Alarcón MG, Miranda-Novales G, Zurita-Cruz JN, Barrada-Vázquez AS, González-Ibarra J, Martínez-Reyes M, Grajales-Muñiz C, Santacruz-Tinoco CE, Martínez-Miguel B, Maldonado-Hernández J, Cifuentes-González Y, Klünder-Klünder M, Garduño-Espinosa J, López-Martínez B, Parra-Ortega I. Efficacy and Safety of Vitamin D Supplementation to Prevent COVID-19 in Frontline Healthcare Workers. A Randomized Clinical Trial. Arch Med Res 2022; 53:423-430. [PMID: 35487792 PMCID: PMC9013626 DOI: 10.1016/j.arcmed.2022.04.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/25/2022] [Accepted: 04/11/2022] [Indexed: 12/16/2022]
Abstract
Background Associations between vitamin D (VD) deficiency and the risk of SARS-CoV-2 infection have been documented in cross-sectional population studies. Intervention studies in patients with moderate to severe COVID-19 have failed to consistently document a beneficial effect. Objective To determine the efficacy and safety of VD-supplementation in the prevention of SARS-CoV-2 infection in highly exposed individuals. Methods A double-blind, parallel, randomized trial was conducted. Frontline healthcare workers from four hospitals in Mexico City, who tested negative for SARS-CoV-2 infection, were enrolled between July 15 and December 30, 2020. Participants were randomly assigned to receive 4,000 IU VD (VDG) or placebo (PG) daily for 30 d. RT-PCR tests were taken at baseline and repeated if COVID-19 manifestations appeared during follow-up. Serum 25-hydroxyvitamin D3 and antibody tests were measured at baseline and at day 45. Per-protocol and intention-to-treat analysis were conducted. Results Of 321 recruited subjects, 94 VDG and 98 PG completed follow-up. SARS-CoV-2 infection rate was lower in VDG than in PG (6.4 vs. 24.5%, p <0.001). The risk of acquiring SARS-CoV-2 infection was lower in the VDG than in the PG (RR: 0.23; 95% CI: 0.09–0.55) and was associated with an increment in serum levels of 25-hydroxyvitamin D3 (RR: 0.87; 95% CI: 0.82–0.93), independently of VD deficiency. No significant adverse events were identified. Conclusions Our results suggest that VD-supplementation in highly exposed individuals prevents SARS-CoV-2 infection without serious AEs and regardless of VD status.
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Affiliation(s)
- Miguel A Villasis-Keever
- Unidad de Investigación en Análisis y Síntesis de la Evidencia, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Mardia G López-Alarcón
- Unidad de Investigación Médica en Nutrición, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
| | - Guadalupe Miranda-Novales
- Unidad de Investigación en Análisis y Síntesis de la Evidencia, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Jessie N Zurita-Cruz
- Facultad de Medicina, Universidad Nacional Autónoma de México; Hospital Infantil de México Federico Gómez, Ciudad de México, México
| | - Aly S Barrada-Vázquez
- Unidad de Investigación Médica en Nutrición, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Joaquín González-Ibarra
- Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Monserrat Martínez-Reyes
- Unidad de Investigación Médica en Nutrición, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Concepción Grajales-Muñiz
- Laboratorio Central de Epidemiología, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Clara E Santacruz-Tinoco
- Laboratorio Central de Epidemiología, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Bernardo Martínez-Miguel
- Laboratorio Central de Epidemiología, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Jorge Maldonado-Hernández
- Unidad de Investigación Médica en Nutrición, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Yazmín Cifuentes-González
- Unidad de Investigación Médica en Nutrición, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
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Márquez-González H, Hernández-Vásquez JG, Del Valle-Lom M, Yáñez-Gutiérrez L, Klünder-Klünder M, Almeida-Gutiérrez E, Koretzky SG. Failures of the Fontan System in Univentricular Hearts and Mortality Risk in Heart Transplantation: A Systematic Review and Meta-Analysis. Life (Basel) 2021; 11:1363. [PMID: 34947894 PMCID: PMC8709145 DOI: 10.3390/life11121363] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/12/2021] [Accepted: 11/13/2021] [Indexed: 02/07/2023] Open
Abstract
The Fontan procedure (FP) is the standard surgical treatment for Univentricular heart diseases. Over time, the Fontan system fails, leading to pathologies such as protein-losing enteropathy (PLE), plastic bronchitis (PB), and heart failure (HF). FP should be considered as a transitional step to the final treatment: heart transplantation (HT). This systematic review and meta-analysis aims to establish the risk of death following HT according to the presence of FP complications. There was a total of 691 transplanted patients in the 18 articles, immediate survival 88% (n = 448), survival from 1 to 5 years of 78% (n = 427) and survival from 5.1 to 10 years of 69% (n = 208), >10 years 61% (n = 109). The relative risk (RR) was 1.12 for PLE (95% confidence interval [CI] = 0.89-1.40, p = 0.34), 1.03 for HF (0.7-1.51, p = 0.88), 0.70 for Arrhythmias (0.39-1.24, p = 0.22), 0.46 for PB (0.08-2.72, p = 0.39), and 5.81 for CKD (1.70-19.88, p = 0.005). In patients with two or more failures, the RR was 1.94 (0.99-3.81, p = 0.05). After FP, the risk of death after HT is associated with CKD and with the presence of two or more failures.
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Affiliation(s)
- Horacio Márquez-González
- Department of Clinical Research, Federico Gómez Children’s Hospital, Mexico City 06720, Mexico; (H.M.-G.); (J.G.H.-V.); (M.D.V.-L.); (M.K.-K.)
- Centro Médico Nacional Siglo XXI, IMSS, Department Congenital Heart Diseases, Mexico City 06720, Mexico; (L.Y.-G.); (E.A.-G.)
| | - Jose Gustavo Hernández-Vásquez
- Department of Clinical Research, Federico Gómez Children’s Hospital, Mexico City 06720, Mexico; (H.M.-G.); (J.G.H.-V.); (M.D.V.-L.); (M.K.-K.)
| | - Montserrat Del Valle-Lom
- Department of Clinical Research, Federico Gómez Children’s Hospital, Mexico City 06720, Mexico; (H.M.-G.); (J.G.H.-V.); (M.D.V.-L.); (M.K.-K.)
| | - Lucelli Yáñez-Gutiérrez
- Centro Médico Nacional Siglo XXI, IMSS, Department Congenital Heart Diseases, Mexico City 06720, Mexico; (L.Y.-G.); (E.A.-G.)
| | - Miguel Klünder-Klünder
- Department of Clinical Research, Federico Gómez Children’s Hospital, Mexico City 06720, Mexico; (H.M.-G.); (J.G.H.-V.); (M.D.V.-L.); (M.K.-K.)
| | - Eduardo Almeida-Gutiérrez
- Centro Médico Nacional Siglo XXI, IMSS, Department Congenital Heart Diseases, Mexico City 06720, Mexico; (L.Y.-G.); (E.A.-G.)
| | - Solange Gabriela Koretzky
- Department of Clinical Research, Nacional de Cardiología “Ignacio Chávez”, Mexico City 14080, Mexico
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18
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Márquez-González H, Méndez-Galván JF, Reyes-López A, Klünder-Klünder M, Jiménez-Juárez R, Garduño-Espinosa J, Solórzano-Santos F. Corrigendum: Coronavirus Disease-2019 Survival in Mexico: A Cohort Study on the Interaction of the Associated Factors. Front Public Health 2021; 9:754703. [PMID: 34660524 PMCID: PMC8515255 DOI: 10.3389/fpubh.2021.754703] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fpubh.2021.660114.].
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Affiliation(s)
- Horacio Márquez-González
- Department of Clinical Research, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Jorge F Méndez-Galván
- Centre for Research in Emerging Diseases, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Alfonso Reyes-López
- Centre for Health Economics, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | - Rodolfo Jiménez-Juárez
- Clinical Infectious Disease Department, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Juan Garduño-Espinosa
- Clinical Research Direction, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Fortino Solórzano-Santos
- Infectious Diseases Research Department, Hospital Infantil de México Federico GómezMéxico Federico Gómez, Mexico City, Mexico
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19
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Márquez-González H, Méndez-Galván JF, Reyes-López A, Klünder-Klünder M, Jiménez-Juárez R, Garduño-Espinosa J, Solórzano-Santos F. Coronavirus Disease-2019 Survival in Mexico: A Cohort Study on the Interaction of the Associated Factors. Front Public Health 2021; 9:660114. [PMID: 34386471 PMCID: PMC8353107 DOI: 10.3389/fpubh.2021.660114] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/24/2021] [Indexed: 12/15/2022] Open
Abstract
The pandemic caused by the new coronavirus Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is currently affecting more than 200 countries. The most lethal clinical presentation is respiratory insufficiency, requiring attention in intensive care units (ICU). The most susceptible people are over 60 years old with comorbidities. The health systems organization may represent a transcendental role in survival. Objective: To analyze the correlation of sociodemographic factors, comorbidities and health system organization variables with survival in cases infected by SARS-CoV-2 during the first 7 months of the pandemic in Mexico. Methods: The cohort study was performed in a health system public basis from March 1st to September 30th, 2020. The included subjects were positive for the SARS-CoV-2 test, and the target variable was mortality in 60 days. The risk variables studied were: age, sex, geographic distribution, comorbidities, health system, hospitalization, and access to ICU. Bivariate statistics (X2-test), calculation of fatality rates, survival analyses and adjustment of confusing variables with Cox proportional-hazards were performed. Results: A total of 753,090 subjects were analyzed, of which the 52% were men. There were 78,492 deaths (10.3% of general fatality and 43% inpatient). The variables associated with a higher risk of hospital mortality were age (from 60 years onwards), care in public sectors, geographic areas with higher numbers of infection and endotracheal intubation without management in the ICU. Conclusions: The variables associated with a lower survival in cases affected by SARS-CoV-2 were age, comorbidities, and respiratory insufficiency (with endotracheal intubation without care in the ICU). Additionally, an interaction was observed between the geographic location and health sector where they were treated.
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Affiliation(s)
- Horacio Márquez-González
- Department of Clinical Research, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Jorge F. Méndez-Galván
- Centre for Research in Emerging Diseases, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Alfonso Reyes-López
- Centre for Health Economics, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | - Rodolfo Jiménez-Juárez
- Clinical Infectious Disease Department, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Juan Garduño-Espinosa
- Clinical Research Direction, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Fortino Solórzano-Santos
- Infectious Diseases Research Department, Hospital Infantil de México Federico GómezMéxico Federico Gómez, Mexico City, Mexico
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20
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Pérez-Acosta A, Duque X, Trejo-Valdivia B, Flores-Huerta S, Flores-Hernández S, Martínez-Andrade G, González-Unzaga M, Turnbull B, Escalante-Izeta E, Klünder-Klünder M, Carranco-Hernández T, Mendoza E, Sotelo-Ham EI, Pineda A, Medina-Escobedo C, Martinez H. Cut-off points for serum ferritin to identify low iron stores during the first year of life in a cohort of Mexican infants. Matern Child Nutr 2021; 17:e13205. [PMID: 34036744 PMCID: PMC8476433 DOI: 10.1111/mcn.13205] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/08/2021] [Accepted: 04/28/2021] [Indexed: 12/31/2022]
Abstract
The aim of this study was to identify serum ferritin (SF) cut‐off points (COPs) in a cohort of healthy full‐term normal birth weight infants who had repeated measurements of SF and haemoglobin every 3 months during the first year of life. The study included 746 full‐term infants with birth weight ≥2,500 g, having uncomplicated gestations and births. Participants received prophylactic iron supplementation (1 mg/day of iron element) from the first to the 12th month of life and did not develop anaemia during the first year of life. Two statistical methods were considered to identify COPs for low iron stores at 3, 6, 9 and 12 months of age: deviation from mean and cluster analysis. According to the K‐means cluster analysis results by age and sex, COPs at 3 and 6 months for girls were 39 and 21 μg/L and for boys 23 and 11 μg/L, respectively. A single COP of 10 μg/L was identified, for girls and boys, at both 9 and 12 months. Given the physiological changes in SF concentration during the first year of life, our study identified dynamic COPs, which differed by sex in the first semester. Adequate SF COPs are necessary to identify low iron stores at an early stage of iron deficiency, which represents one of the most widespread public health problems around the world, particularly in low‐ and middle‐income countries.
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Affiliation(s)
- Azucena Pérez-Acosta
- Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Ximena Duque
- Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Belem Trejo-Valdivia
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Samuel Flores-Huerta
- Unidad de Investigación en Salud Comunitaria, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, México
| | - Sergio Flores-Hernández
- Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Gloria Martínez-Andrade
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Marco González-Unzaga
- Unidad de Investigación en Epidemiología Nutricional, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Bernardo Turnbull
- Académico de tiempo, Universidad Iberoamericana, Ciudad de México, México
| | - Ericka Escalante-Izeta
- Departamento de Ciencias de la Salud, Universidad Iberoamericana, San Andrés Cholula, Puebla, Mexico
| | - Miguel Klünder-Klünder
- Subdirección de Investigación, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, México
| | - Tania Carranco-Hernández
- Dirección de Prestaciones Económicas y Sociales, Coordinación del Servicio de Guardería para el Desarrollo Integral Infantil, División de Desarrollo Integral Infantil, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Eugenia Mendoza
- Unidad de Investigación Médica en Enfermedades Infecciosas y Parasitarias, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Elma Ivonne Sotelo-Ham
- Coordinación Delegacional de Investigación de Zacatecas, Instituto Mexicano del Seguro Social, Zacatecas, México
| | - Alicia Pineda
- Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Colima, México
| | - Carolina Medina-Escobedo
- Dirección de Educación e Investigación en Salud. Unidad Médica de Alta Especialidad, Hospital de Especialidades Centro Médico Nacional "Ignacio García Téllez" en Mérida, Instituto Mexicano del Seguro Social, Mérida, México
| | - Homero Martinez
- Dirección de Investigación, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, México.,Global Technical Services, Nutrition International, Ottawa, Ontario, Canada
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Miranda-Lora AL, Vilchis-Gil J, Juárez-Comboni DB, Cruz M, Klünder-Klünder M. A Genetic Risk Score Improves the Prediction of Type 2 Diabetes Mellitus in Mexican Youths but Has Lower Predictive Utility Compared With Non-Genetic Factors. Front Endocrinol (Lausanne) 2021; 12:647864. [PMID: 33776940 PMCID: PMC7994893 DOI: 10.3389/fendo.2021.647864] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 02/18/2021] [Indexed: 01/07/2023] Open
Abstract
Background Type 2 diabetes (T2D) is a multifactorial disease caused by a complex interplay between environmental risk factors and genetic predisposition. To date, a total of 10 single nucleotide polymorphism (SNPs) have been associated with pediatric-onset T2D in Mexicans, with a small individual effect size. A genetic risk score (GRS) that combines these SNPs could serve as a predictor of the risk for pediatric-onset T2D. Objective To assess the clinical utility of a GRS that combines 10 SNPs to improve risk prediction of pediatric-onset T2D in Mexicans. Methods This case-control study included 97 individuals with pediatric-onset T2D and 84 controls below 18 years old without T2D. Information regarding family history of T2D, demographics, perinatal risk factors, anthropometric measurements, biochemical variables, lifestyle, and fitness scores were then obtained. Moreover, 10 single nucleotide polymorphisms (SNPs) previously associated with pediatric-onset T2D in Mexicans were genotyped. The GRS was calculated by summing the 10 risk alleles. Pediatric-onset T2D risk variance was assessed using multivariable logistic regression models and the area under the receiver operating characteristic curve (AUC). Results The body mass index Z-score (Z-BMI) [odds ratio (OR) = 1.7; p = 0.009] and maternal history of T2D (OR = 7.1; p < 0.001) were found to be independently associated with pediatric-onset T2D. No association with other clinical risk factors was observed. The GRS also showed a significant association with pediatric-onset T2D (OR = 1.3 per risk allele; p = 0.006). The GRS, clinical risk factors, and GRS plus clinical risk factors had an AUC of 0.66 (95% CI 0.56-0.75), 0.72 (95% CI 0.62-0.81), and 0.78 (95% CI 0.70-0.87), respectively (p < 0.01). Conclusion The GRS based on 10 SNPs was associated with pediatric-onset T2D in Mexicans and improved its prediction with modest significance. However, clinical factors, such the Z-BMI and family history of T2D, continue to have the highest predictive utility in this population.
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Affiliation(s)
- América Liliana Miranda-Lora
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Jenny Vilchis-Gil
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | - Miguel Cruz
- Medical Research Unit in Biochemistry, Hospital de Especialidades Centro Médico Nacional SXXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Research Subdirectorate, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
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22
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Dorantes-Acosta E, Ávila-Montiel D, Klünder-Klünder M, Juárez-Villegas L, Márquez-González H. Survival and Complications in Pediatric Patients With Cancer and COVID-19: A Meta-Analysis. Front Oncol 2021; 10:608282. [PMID: 33552980 PMCID: PMC7861039 DOI: 10.3389/fonc.2020.608282] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 09/19/2020] [Accepted: 12/02/2020] [Indexed: 12/24/2022] Open
Abstract
Background The pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected all age groups, including the pediatric population, in 3–5% of all cases. We performed a meta-analysis to understand the survival and associated complications in pediatric cancer patients as well as their hospitalization, intensive care, and ventilation care (supplemental oxygen/endotracheal intubation) needs. Methods A systematic search was performed using MEDLINE, TRIP Database, International Clinical Trials Registry Platform (WHO), The Cochrane Library, Wiley, LILACS, and Google Scholar. Additionally, a search using the snowball method was performed in Nature, New England Journal of Medicine, Science, JAMA, ELSEVIER editorial, Oxford University Press, The Lancet, and MedRxiv. Searches were conducted until July 18, 2020. A total of 191 cancer patients with coronavirus disease 2019 (COVID-19) were integrated from 15 eligible studies. In a sub-analysis, patients were stratified into two groups: hematological cancer and solid tumors. Outcome measures were overall survival, risk of hospitalized or needing intensive care, and need for ventilatory support in any modality. The random effects statistical analysis was performed with Cochran’s chi square test. The odds ratio (OR) and heterogeneity were calculated using the I2 test. Results The overall survival was 99.4%. There were no statistically significant differences in the risk of hospitalization between hematological malignancies and solid tumors (95% confidence interval [CI] 0.48–18.3; OR = 2.94). The risk of being admitted to the intensive care unit was also not different between hematological malignancies and other tumors (95% CI 0.35–5.81; OR = 1.42). No differences were found for the need of ventilatory support (95% CI 0.14–3.35; OR = 0.68). Although all the studies were cross-sectional, the mortality of these patients was 0.6% at the time of analysis. Conclusions In the analyzed literature, survival in the studied group of patients with COVID-19 was very high. Suffering from hematological neoplasia or other solid tumors and COVID-19 was not a risk factor in children with cancer for the analyzed outcomes.
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Affiliation(s)
- Elisa Dorantes-Acosta
- Biobanco de Investigación en Células Leucémicas, Hospital Infantil de México Federico Gómez, México City, Mexico
| | - Diana Ávila-Montiel
- Subdirección de Investigación, Hospital Infantil de México Federico Gómez, México City, Mexico
| | - Miguel Klünder-Klünder
- Subdirección de Investigación, Hospital Infantil de México Federico Gómez, México City, Mexico
| | - Luis Juárez-Villegas
- Departamento de Onco-Hematología, Hospital Infantil de México Federico Gómez, México City, Mexico
| | - Horacio Márquez-González
- Investigación Clínica, Hospital Infantil de México Federico Gómez, México City, Mexico.,Cardiopatías Congénitas. Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), México City, Mexico
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Klünder-Klünder M, Espinosa-Espindola M, Lopez-Gonzalez D, Loyo MSC, Suárez PD, Miranda-Lora AL. Skeletal Maturation in the Current Pediatric Mexican Population. Endocr Pract 2021; 26:1053-1061. [PMID: 33471706 DOI: 10.4158/ep-2020-0047] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/01/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The most commonly used methods for bone age (BA) reading were described in the Caucasian population decades ago. However, there are secular trends in skeletal maturation and different BA patterns between ethnic groups. Automated BA reading makes updating references easier and more precise than human reading. The objective of the present study was to present automated BA reference curves according to chronological age and gender in the Mexican population and compare the maturation tempo with that of other populations. METHODS The study included 923 healthy participants aged 5 to 18 years between 2017 and 2018. A hand radio-graph was analyzed using BoneXpert software to obtain the automated BA reading according to Greulich and Pyle (G&P) and Tanner-Whitehouse 2 (TW2) references. We constructed reference curves using the average difference between the BA and chronological age according to sex and age. RESULTS The G&P and TW2 automated reference curves showed that Mexican boys exhibit delays in BA during middle childhood by 0.5 to 0.7 (95% confidence interval [CI], -0.9 to -0.2) years; however, they demonstrate an advanced BA of up to 1.1 (95% CI, 0.8 to 1.4) years at the end of puberty. Mexican girls exhibited a delay in BA by 0.3 to 0.6 (95% CI, -0.9 to -0.1) years before puberty and an advanced BA of up to 0.9 (95% CI, 0.7 to 1.2) years at the end of puberty. CONCLUSION Mexican children aged <10 years exhibited a delay in skeletal maturity, followed by an advanced BA by approximately 1 year at the end of puberty. This may affect the estimation of growth potential in this population.
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Affiliation(s)
- Miguel Klünder-Klünder
- Deputy Director of Research, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Montserrat Espinosa-Espindola
- Endocrinological and Nutritional Epidemiology Research Unit, Universidad Nacional Autónoma de México and Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Desiree Lopez-Gonzalez
- Clinical Epidemiology Research Unit, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | - Pilar Dies Suárez
- Radiology Department, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - América Liliana Miranda-Lora
- Endocrinological and Nutritional Epidemiology Research Unit, Universidad Nacional Autónoma de México and Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
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24
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Márquez-González H, Klünder-Klünder M, de la Rosa-Zamboni D, Ortega-Riosvelasco F, López-Martínez B, Jean-Tron G, Chapa-Koloffon G, Ávila-Hernández AV, Garduño-Espinosa J, Villa-Guillén M, Nieto-Zermeño J. Risk conditions in healthcare workers of a pediatric coronavirus disease center in Mexico City. Bol Med Hosp Infant Mex 2021; 78:110-115. [PMID: 33465059 DOI: 10.24875/bmhim.20000355] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The new evere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by its high capacity to transmit. Health-care personnel is highly susceptible to becoming infected. This study aimed to determine the characteristics and known risk factors for contagion and severe outcomes of SARS-CoV-2 disease in health-care personnel of a pediatric coronavirus disease (COVID) center in Mexico City. METHODS In the last week of March 2020 (at the beginning of phase 2 of the Ministry of Health's national campaign in Mexico), a study was conducted on healthcare workers of a pediatric COVID hospital in Mexico City. Using a virtual interview, we evaluated comorbidities, mobility, areas and functions where they carry out the activities, protection measures, contact history, and vaccination. According to their activities, healthcare workers were classified into the following areas: medical, nursing, other health-care personnel (researchers, nutritionists, rehabilitation, imaging, and laboratory), administrative, and other services. We compared the variables between the groups of healthcare workers with the X2 test. RESULTS We included 812 participants. The mean age was 41 ± 11 years, and 33% were overweight or obese, 18% were over 60 years old, and 19% had high blood pressure. Medical and nursing personnel presented a higher proportion in the use of standard protection measures. CONCLUSIONS Among healthcare workers, there are risk conditions for the development of complications in case of SARS-CoV-2 infection. Most medical and nursing personnel use standard protective measures.
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Affiliation(s)
| | - Miguel Klünder-Klünder
- Dirección de Investigación, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | | | - Briceida López-Martínez
- Recursos Auxiliares de Diagnóstico, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Guadalupe Jean-Tron
- Dirección de Investigación, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Gina Chapa-Koloffon
- Dirección de Investigación, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | - Juan Garduño-Espinosa
- Dirección de Investigación, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Mónica Villa-Guillén
- Dirección Médica, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Jaime Nieto-Zermeño
- Dirección General. Hospital Infantil de México Federico Gómez, Mexico City, Mexico
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25
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Márquez-González H, López-Martínez B, Parra-Ortega I, de la Rosa-Zamboni D, Salazar-García M, Olivar-López V, Klünder-Klünder M. Analysis of the Behaviour of Immunoglobulin G Antibodies in Children and Adults Convalescing From Severe Acute Respiratory Syndrome-Coronavirus-2 Infection. Front Pediatr 2021; 9:671831. [PMID: 34485190 PMCID: PMC8415966 DOI: 10.3389/fped.2021.671831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/08/2021] [Indexed: 11/21/2022] Open
Abstract
The pandemic caused by SARS CoV-2 (COVID-19) has affected millions of people since 2020. There are clinical differences and in mortality between the adult and paediatric population. Recently, the immune response through the development of antibodies has gained relevance due to the risk of reinfection and vaccines' development. Objective: Was to compare the association of clinical history and the clinical presentation of the disease with the development of IgG antibodies against SARS-CoV-2 in paediatric and adult patients with a history of positive reverse transcriptase-polymerase chain reaction (RT-PCR) results. Methods: Cross-sectional observational study carried out in a Paediatric Hospital in Mexico City included patients under 18 years of age and health personnel with positive RT-PCR for COVID-19 comparing antibody expression. The development of specific IgG antibodies was measured, the presence of comorbidities, duration, and severity of symptoms was determined. Results: Sixty-one subjects (20 < 18 years and 41 > 18 years) were analysed. The median sample collection was 3 weeks. There were no differences in the expression of specific antibodies; no differences were shown according to the symptoms' severity. A positive correlation (r = 0.77) was demonstrated between the duration of symptoms and antibody levels. Conclusions: In conclusion, there is a clear association between the duration of the symptoms associated with SARS-CoV-2 infection and the IgG units generated in paediatric and adult patients convalescing from COVID-19.
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Affiliation(s)
| | - Briceida López-Martínez
- Auxiliary Diagnostic Resources, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Israel Parra-Ortega
- Clinical Laboratory, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | | | - Victor Olivar-López
- Pediatric Emergency Service, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Management of Clinical Research, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
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26
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Dorantes-Acosta E, Ávila-Montiel D, Klünder-Klünder M, Juárez-Villegas L, Márquez-González H. Survival in pediatric patients with cancer during the COVID-19 pandemic: scoping systematic review. Bol Med Hosp Infant Mex 2020; 77:234-241. [PMID: 33064683 DOI: 10.24875/bmhim.20000174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Coronavirus disease (COVID)-19 has currently affected 8,015,502 million people worldwide with global mortality around 5%. Information in pediatric cancer patients is still limited, but it is emerging day by day. The objective of this scoping review was to analyze the available data associated with COVID-19 infection and mortality in pediatric cancer patients and to provide useful information to plan and design strategies in this group. Methods A search was conducted, and eight articles were obtained for qualitative analysis; 110 patients were included, all from cross-sectional studies. At the time of publication, all the analyzed documents reported no deaths associated with COVID-19. Results According to the information, COVID-19 infection appears to be less severe in the pediatric population in comparison with adults and does not appear to be a cause of mortality in patients with childhood cancer. Conclusions Given the nature of preliminary reports and a short follow-up in cancer patients, it is necessary to have medium- and long-term follow-up studies to determine the effects of infection and modifications to the treatments of these patients.
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Affiliation(s)
- Elisa Dorantes-Acosta
- Biobanco de Investigación en Células Leucémicas. Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Diana Ávila-Montiel
- Investigación Clínica. Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Subdirección de Investigación. Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Luis Juárez-Villegas
- Departamento de Onco-Hematología. Hospital Infantil de México Federico Gómez, Mexico City, Mexico
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27
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López-Contreras IN, Vilchis-Gil J, Klünder-Klünder M, Villalpando-Carrión S, Flores-Huerta S. Dietary habits and metabolic response improve in obese children whose mothers received an intervention to promote healthy eating: randomized clinical trial. BMC Public Health 2020; 20:1240. [PMID: 32795294 PMCID: PMC7427732 DOI: 10.1186/s12889-020-09339-4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lifestyles habits such as eating unhealthy foodscommence at home and are associated with the development of obesity and comorbidities such as insulin resistance, metabolic syndrome, and chronic degenerative diseases, which are the main causes of death in adults. The present study compared changes in dietary habits, behaviors and metabolic profiles of obese children whose mothers attended at the hospital to group sessions, with those who received the usual nutritional consultation. METHODS Randomized clinical trial, 177 mother/obese child pairs participated, 90 in the intervention group and 87 in the control group. The intervention group attended six group education sessions to promote healthy eating, being this an alternative of change of habits in children with obesity. The control group received the usual nutritional consultation; both groups were followed up for 3 months. Frequency of food consumption, behaviors during feeding in the house and metabolic profile was evaluated. Mixed effect linear regression models were used to evaluate the effect of the intervention on the variables of interest, especially in HOMA-IR. RESULTS The intervention group reduced the filling of their dishes (p = 0.009), forcing the children to finish meals (p = 0.003) and food substitution (p < 0.001), moreover increased the consumption of roasted foods (p = 0.046), fruits (p = 0.002) and vegetables (p < 0.001). The children in the control group slightly increased HOMA-IR levels (0.51; 95% CI - 0.48 to 1.50), while the children in the intervention group significantly decreased (- 1.22; 95% CI - 2.28 to - 1.16). The difference in HOMA-IR between the control and intervention group at the end of the follow-up was - 1.67; 95% CI: - 3.11 to - 0.24. CONCLUSIONS The educational intervention improved some eating habits at home, as well as HOMA-IR levels; why we consider that it can be an extra resource in the management of childhood obesity. TRIAL REGISTRATION Clinicaltrials.gov, NCT04374292 (Date assigned: May 5, 2020). Retrospectively registered.
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Affiliation(s)
- Iris Nallely López-Contreras
- Gastroenterology and Nutrition Department, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico
| | - Jenny Vilchis-Gil
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Dr. Márquez No 162, 06720, Mexico City, Mexico.,Medicine Faculty, National Autonomous University of Mexico, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Deputy Director of Research, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico.,Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN), Mexico City, Mexico
| | - Salvador Villalpando-Carrión
- Gastroenterology and Nutrition Department, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico
| | - Samuel Flores-Huerta
- Epidemiological Research Unit in Endocrinology and Nutrition, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Dr. Márquez No 162, 06720, Mexico City, Mexico.
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Vázquez-Moreno M, Mejía-Benítez A, Sharma T, Peralta-Romero J, Locia-Morales D, Klünder-Klünder M, Cruz M, Meyre D. Association of AMY1A/AMY2A copy numbers and AMY1/AMY2 serum enzymatic activity with obesity in Mexican children. Pediatr Obes 2020; 15:e12641. [PMID: 32314532 DOI: 10.1111/ijpo.12641] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mexican children are characterized by a high-starch intake diet and high prevalence of obesity. OBJECTIVES To investigate the association of AMY1A/AMY2A copy numbers (CNs) and AMY1/AMY2 serum enzymatic activity with childhood obesity in up to 427 and 337 Mexican cases and controls. METHODS Anthropometric and dietary starch intake data were collected. CN of AMY1A/AMY2A and AMY1/AMY2 serum enzymatic activity were determined using droplet digital PCR (ddPCR) and enzymatic colorimetry, respectively. An individual participant level data meta-analysis of association between AMY1A CNVs and obesity was also performed. RESULTS A positive association between AMY1A/AMY2A CNs and their corresponding AMY1/AMY2 serum enzyme activity was observed in children with normal weight and obesity. The serum enzyme activity of AMY1 and AMY2 was negatively associated with childhood obesity risk, and the association was restricted to kids eating medium/high amount of starch (Pinteraction = .004). While no association between AMY1A and AMY2A CNs and childhood obesity was observed in our sample, we confirmed a significant association between AMY1A CN and obesity in a meta-analysis of 3100 Mexican children. CONCLUSIONS Our data suggest that genetically determined salivary and pancreatic amylase activity can increase/decrease the risk of obesity in Mexican children, this effect being blunted by a low-starch diet.
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Affiliation(s)
- Miguel Vázquez-Moreno
- Hospital de Especialidades, Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Bioquímica, Mexico City, Mexico.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Aurora Mejía-Benítez
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Tanmay Sharma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Jesús Peralta-Romero
- Hospital de Especialidades, Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Bioquímica, Mexico City, Mexico
| | - Daniel Locia-Morales
- Hospital de Especialidades, Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Bioquímica, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Departamento de Investigación en Salud Comunitaria, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
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- Instituto Mexicano del seguro social, Mexico City, Mexico
| | - Miguel Cruz
- Hospital de Especialidades, Centro Médico Nacional Siglo XXI del Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Bioquímica, Mexico City, Mexico
| | - David Meyre
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.,Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada
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Gutiérrez-Camacho C, Méndez-Sánchez L, Klünder-Klünder M, Clark P, Denova-Gutiérrez E. Association between Sociodemographic Factors and Dietary Patterns in Children Under 24 Months of Age: A Systematic Review. Nutrients 2019; 11:E2006. [PMID: 31454895 PMCID: PMC6770717 DOI: 10.3390/nu11092006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/21/2019] [Accepted: 08/23/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Understanding early-life complementary feeding dietary patterns and their determining factors could lead to better ways of improving nutrition in early childhood. The purpose of this review was to evaluate evidence of the association between sociodemographic factors and dietary patterns (DPs) in children under 24 months. METHODS Medline (PubMed), Cochrane Central, NICE guidelines, and Trip database were searched for observational studies that evaluated sociodemographic factors and their associations with DP. RESULTS Seven studies were selected for the present review. High education level among mothers was inversely associated with unhealthy DPs and positively associated with healthy DPs. Higher household income was negatively associated with unhealthy DPs. Four studies showed a positive association between low household income and unhealthy DPs and three studies showed a positive association between higher household income and healthy DPs. Additionally, in younger mothers, body mass index (BMI ≥ 30.0 kg/m2) and number of children were positively associated with unhealthy DPs. CONCLUSIONS This review provides evidence of a positive association between mothers' higher education level, higher household income, higher maternal age, and healthy dietary patterns as well as a negative association between these factors and unhealthy dietary patterns. Further studies from low- and middle-income countries are needed for comparison with associations showed in this review.
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Affiliation(s)
- Claudia Gutiérrez-Camacho
- Physical Therapy Research Unit, Hospital Infantil de México Federico Gómez, and Medicine Faculty of Autonomous National University, Mexico City 06720, Mexico
| | - Lucia Méndez-Sánchez
- Clinical Epidemiology Research Unit, Hospital Infantil de México Federico Gómez, and Medicine Faculty of Autonomous National University, Mexico City 06720, Mexico.
| | - Miguel Klünder-Klünder
- Research Headmaster's Office, Hospital Infantil de México Federico Gómez, Ciudad de México 06720, Mexico
| | - Patricia Clark
- Clinical Epidemiology Research Unit, Hospital Infantil de México Federico Gómez, and Medicine Faculty of Autonomous National University, Mexico City 06720, Mexico
| | - Edgar Denova-Gutiérrez
- Nutrition and Health Research Center, National Institute of Public Health, Cuernavaca 62100, Morelos.
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30
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Miranda-Lora AL, Zamora-Nava LE, Marín-Rosas DL, Klünder-Klünder M, Sánchez-Curiel M, Dies-Suárez P. Resolution of fatty liver disease after growth hormone replacement in a pediatric survivor of thyroid cancer. Bol Med Hosp Infant Mex 2019; 76:138-145. [PMID: 31116731 DOI: 10.24875/bmhim.18000114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background A rare case of primary papillary thyroid cancer (PTC) and growth hormone (GH) deficiency in a pediatric patient is described. In addition, the patient developed fatty liver disease attributed to GH deficiency. Case report A 10-year-old male with a history of PTC with extension to the cervical nodes detected at 5 years of age was referred to the endocrinology consultation due to a low growth rate. On examination, GH deficiency was detected (height -3.51 standard deviations and low insulin-like growth factor-1 levels). This hormonal deficiency was not associated with thyroid cancer or treatment. Furthermore, elevated transaminases (~300 IU/ml), lipids, and fally liver disease by ultrasound were detected. These data suggested fatty liver disease, which was attributed to GH deficiency. Regardless of the risk of recurrence, somatotropin was administered due to liver dysfunction and very short stature of the patient. A considerable improvement in growth, transaminases, and lipid profile was observed. At present, at 14 years of age, resolution of hepatic steatosis and a considerable increase in his growth rate without recurrence of thyroid cancer 9 years after its diagnosis and 4 years after the initiation of GH treatment are confirmed. Conclusions GH therapy could be a good therapeutic option for pediatric cancer survivors to address impaired growth and fatty liver disease. However, additional medical evidence based on clinical trials is necessary to determine the benefits.
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Affiliation(s)
- América L Miranda-Lora
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez. Mexico City, Mexico
| | - Luis E Zamora-Nava
- Departamento de Endoscopia, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Mexico City, Mexico
| | - Deyanira L Marín-Rosas
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez. Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Subdirección de Gestión de la Investigación, Hospital Infantil de México Federico Gómez. Mexico City, Mexico.,Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN). Mexico City, Mexico
| | - Mariana Sánchez-Curiel
- Departamento de Radiología, Hospital Infantil de México Federico Gómez. Mexico City, Mexico
| | - Pilar Dies-Suárez
- Departamento de Radiología, Hospital Infantil de México Federico Gómez. Mexico City, Mexico
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31
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Miranda-Lora AL, Molina-Díaz M, Cruz M, Sánchez-Urbina R, Martínez-Rodríguez NL, López-Martínez B, Klünder-Klünder M. Genetic polymorphisms associated with pediatric-onset type 2 diabetes: A family-based transmission disequilibrium test and case-control study. Pediatr Diabetes 2019; 20:239-245. [PMID: 30652413 DOI: 10.1111/pedi.12818] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/12/2018] [Accepted: 01/04/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Genetics play a very strong role in the development of pediatric-onset type 2 diabetes (T2D); however, little information exists about specific common single nucleotide polymorphisms (SNPs) associated with T2D in this age group. The aim of the study was to analyze the association and parental transmission of 64 obesity-related SNPs with pediatric-onset T2D in Mexican families. METHODS A total of 57 pedigrees containing 171 probands with pediatric-onset T2D and 119 unrelated controls older than 18 years were included. The participants were genotyped for 64 polymorphisms. Association of each variant with pediatric-onset T2D was analyzed through a parent-offspring transmission disequilibrium test (TDT) and in a case-control comparison by χ2 analysis. RESULTS Five SNPs exhibited associations with pediatric-onset T2D in the combined case-parent trio and case-control analysis: LINGO/rs10968576 (odds ratio [OR] 1.82, P = 0.003), POC5/rs2112347 (OR 1.96, P = 2.4E-5), RPS10-NUDT3/rs206936 (OR 1.40, P = 0.023), GLIS3/rs7034200 (OR 2.34, P = 1.2E-6), and VEGFA/rs6905288 (OR 1.58, P = 0.015). The first three were also associated with obesity status. The SNPs POC5/rs2112347 and RPS10-NUDT3/rs206936 were significantly associated through the maternal allele and GLIS3/rs7034200 through the paternal allele (P < 0.05). CONCLUSIONS These findings suggest that certain SNPs associated with obesity and other metabolic traits may also be involved in risk of pediatric-onset T2D in Mexican families. We also identified preferential transmission of parental alleles in some variants.
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Affiliation(s)
- América L Miranda-Lora
- Research Unit of Medicine Based on Evidence, Mexico Children's Hospital Federico Gómez, Mexico City, Mexico
| | - Mario Molina-Díaz
- Department of Endocrinology, Mexico Children's Hospital Federico Gómez, Mexico City, Mexico
| | - Miguel Cruz
- Medical Research Unit in Biochemistry, Hospital de Especialidades Centro Médico Nacional SXXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Rocío Sánchez-Urbina
- Research Laboratory in Developmental Biology and Experimental Teratogenesis, Mexico Children's Hospital Federico Gómez, Mexico City, Mexico
| | - Nancy L Martínez-Rodríguez
- Departament of Community Health Research, Mexico Children's Hospital Federico Gómez, Mexico City, Mexico
| | - Briceida López-Martínez
- Deputy Director of Auxiliary Diagnostic Services, Mexico Children's Hospital Federico Gómez, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Deputy Director of Research, Mexico Children's Hospital Federico Gómez, Mexico City, Mexico.,Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN), Mexico City, Mexico
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De la Rosa-Zamboni D, Ochoa SA, Laris-González A, Cruz-Córdova A, Escalona-Venegas G, Pérez-Avendaño G, Torres-García M, Suaréz-Mora R, Castellanos-Cruz C, Sánchrez-Flores YV, Vázquez-Flores A, Águila-Torres R, Parra-Ortega I, Klünder-Klünder M, Arellano-Galindo J, Hernández-Castro R, Xicohtencatl-Cortes J. Everybody hands-on to avoid ESKAPE: effect of sustained hand hygiene compliance on healthcare-associated infections and multidrug resistance in a paediatric hospital. J Med Microbiol 2018; 67:1761-1771. [PMID: 30372411 DOI: 10.1099/jmm.0.000863] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
PURPOSE Hand hygiene is the most important strategy for preventing healthcare-associated infections (HCAIs); however, the impact of hand hygiene in middle-income countries has been poorly described. In this work, we describe the impact of the programme 'Let's Go for 100' on hand hygiene adherence, HCAIs rates and multidrug-resistant (MDR) bacteria, including the molecular typing of methicillin-resistant Staphylococcus aureus (MRSA) strains. METHODOLOGY A multimodal, hospital-wide hand hygiene programme was implemented from 2013. 'Let's Go for 100' involved all healthcare workers and encompassed education, awareness, visual reminders, feedback and innovative strategies. Monthly hand hygiene monitoring and active HCAI surveillance were performed in every ward. Molecular typing of MRSA was analysed by pulsed-field gel electrophoresis (PFGE).Results/Key findings. Hand hygiene adherence increased from 34.9 % during the baseline period to 80.6 % in the last 3 months of this study. The HCAI rate decreased from 7.54 to 6.46/1000 patient-days (P=0.004). The central line-associated bloodstream infection (CLABSIs) rate fell from 4.84 to 3.66/1000 central line-days (P=0.05). Negative correlations between hand hygiene and HCAIs rates were identified. The attack rate of MDR-ESKAPE group bloodstream infections decreased from 0.54 to 0.20/100 discharges (P=0.024). MRSA pulsotypes that were prevalent during the baseline period were no longer detected after the 5th quarter, although new strains were identified. CONCLUSIONS A multimodal hand hygiene programme in a paediatric hospital in a middle-income country was effective in improving adherence and reducing HCAIs, CLABSIs and MDR-ESKAPE bloodstream infections. Sustaining hand hygiene adherence at a level of >60 % for one year limited MRSA clonal transmission.
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Affiliation(s)
- Daniela De la Rosa-Zamboni
- 1Departamento de Epidemiología. Hospital Infantil de México Federico Gómez. Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Sara A Ochoa
- 2Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Almudena Laris-González
- 1Departamento de Epidemiología. Hospital Infantil de México Federico Gómez. Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Ariadnna Cruz-Córdova
- 2Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Gerardo Escalona-Venegas
- 2Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Georgina Pérez-Avendaño
- 1Departamento de Epidemiología. Hospital Infantil de México Federico Gómez. Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Margarita Torres-García
- 1Departamento de Epidemiología. Hospital Infantil de México Federico Gómez. Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Roselia Suaréz-Mora
- 1Departamento de Epidemiología. Hospital Infantil de México Federico Gómez. Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Carmen Castellanos-Cruz
- 3Laboratorio Central de Bacteriología, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Yadhira V Sánchrez-Flores
- 1Departamento de Epidemiología. Hospital Infantil de México Federico Gómez. Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Adalberto Vázquez-Flores
- 1Departamento de Epidemiología. Hospital Infantil de México Federico Gómez. Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Rosalinda Águila-Torres
- 1Departamento de Epidemiología. Hospital Infantil de México Federico Gómez. Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Israel Parra-Ortega
- 3Laboratorio Central de Bacteriología, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Miguel Klünder-Klünder
- 4Subdirección de Investigación, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - José Arellano-Galindo
- 5Departamento de Infectología, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
| | - Rigoberto Hernández-Castro
- 6Departamento de Ecología de Agentes Patógenos, Hospital General Dr. Manuel Gea González, Tlalpan, 14080, Ciudad de México, México
| | - Juan Xicohtencatl-Cortes
- 2Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez, Dr. Márquez 162, Col. Doctores, Cuauhtémoc 06720. Ciudad de México, México
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Vilchis-Gil J, Klünder-Klünder M, Flores-Huerta S. Effect on the Metabolic Biomarkers in Schoolchildren After a Comprehensive Intervention Using Electronic Media and In-Person Sessions to Change Lifestyles: Community Trial. J Med Internet Res 2018; 20:e44. [PMID: 29402762 PMCID: PMC5818679 DOI: 10.2196/jmir.9052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/07/2017] [Accepted: 12/01/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Obesity is a chronic low-intensity state of inflammation with metabolic alterations that, when acquired during childhood, lead to severe illness in adults. Encouraging healthy eating habits and physical activity is the basis for preventing and treating obesity and its complications. OBJECTIVE To evaluate how a comprehensive intervention promoting healthy eating habits and physical activities in schools affects children's metabolic biomarkers. METHODS Of four Mexico City primary schools in this study, two groups of children that were recruited at their schools were assigned to a 12-month intervention group (IG) and the other two were assigned to control groups (CGs). The intervention had two components: (1) parents/schoolchildren attended in-person educational sessions promoting healthy eating and physical activity habits, and were provided printed information; and (2) parents were able to seek information through a website, and also received brief weekly mobile phone text messages. Anthropometric measurements and fasting blood samples were taken from both groups of children at baseline and again after 12 months. RESULTS The study involved 187 children in the IG and 128 in the CG. Regardless of each child's nutritional status at the beginning of the study, the intervention improved metabolic parameters; the IG showed a negative effect on glucose concentrations (-1.83; CI 95% -3.06 to -0.60), low-density lipoprotein-cholesterol (-2.59; CI 95% -5.12 to -0.06), insulin (-0.84; CI 95% -1.31 to -0.37), and homeostasis model to assess the insulin resistance index (HOMA-IR; -0.21; CI 95% -0.32 to -0.09) in comparison to the CG. HOMA-IR improved in children who had higher than baseline body mass index z-scores. CONCLUSIONS Intervention through multiple components that promoted healthier eating and physical activity habits improved the metabolic parameters of the children in the study after one year, regardless of their nutritional status.
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Affiliation(s)
- Jenny Vilchis-Gil
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
| | - Miguel Klünder-Klünder
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
- Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition, Ciudad de México, Mexico
| | - Samuel Flores-Huerta
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Ciudad de México, Mexico
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Miranda-Lora AL, Cruz M, Molina-Díaz M, Gutiérrez J, Flores-Huerta S, Klünder-Klünder M. Associations of common variants in the SLC16A11, TCF7L2, and ABCA1 genes with pediatric-onset type 2 diabetes and related glycemic traits in families: A case-control and case-parent trio study. Pediatr Diabetes 2017; 18:824-831. [PMID: PMID: 28101933 DOI: 10.1111/pedi.12497] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is evidence of associations of single-nucleotide polymorphisms (SNPs) with type 2 diabetes (T2D) and related glycemic traits in adults, but there is a little information about such associations in youths. OBJECTIVE The aim of this study was to evaluate the associations of SNPs in the TCF7L2, SLC16A11, and ABCA1 genes with T2D and related glycemic traits in Mexican children and adolescents. SUBJECTS A total of 99 families with children with T2D (n = 327) and 83 families with children without the disease (n = 212). METHODS The associations between SNPs of TCF7L2 (rs7903146 and rs12255372), SLC16A11 (rs13342232), and ABCA1 (rs9282541) with T2D were analyzed. We also evaluated the effects of SNPs on quantitatively related glycemic traits after adjusting for age, sex, and the presence of overweight or obesity. RESULTS The G allele of SLC16A1 /rs13342232 was associated with T2D in adults (adjusted odds ratio [ORadj] = 1.89; 95% confidence interval [CI]: 1.18; 3.06) and children (ORadj = 1.94; 95% CI: 1.25; 3.00). In addition, the combined analysis of case-control and case-parent trio was also significant (OR = 1.43; 95% CI: 1.12; 1.74). After adjusting for known confounding factors, we found a significant association between TCF7L2/rs122555372 and C-peptide (β = -0.76, P = .005) in patients with diabetes and between fasting glucose (β = 2.05, P = .039) and homeostatic model assessment of β-cell function (β = -32.14, P = .025) levels in individuals without diabetes. CONCLUSIONS The results suggest that SLC16A1 /rs13342232 might be involved in the risk of pediatric-onset T2D in Mexican families. Moreover, TCF7L2/rs122555372 was associated with pancreatic reserve in patients with T2D and with fasting glucose and β-cell function in individuals without diabetes.
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Affiliation(s)
- América L Miranda-Lora
- Research Unit of Medicine Based on Evidence, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Miguel Cruz
- Medical Research Unit in Biochemistry, Hospital de Especialidades Centro Médico Nacional SXXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Mario Molina-Díaz
- Department of Endocrinology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Jorge Gutiérrez
- Medical Research Unit in Biochemistry, Hospital de Especialidades Centro Médico Nacional SXXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Samuel Flores-Huerta
- Department of Community Health Research, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Department of Community Health Research, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
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Miranda-Lora AL, Cruz M, Aguirre-Hernández J, Molina-Díaz M, Gutiérrez J, Flores-Huerta S, Klünder-Klünder M. Exploring single nucleotide polymorphisms previously related to obesity and metabolic traits in pediatric-onset type 2 diabetes. Acta Diabetol 2017; 54:653-662. [PMID: PMID: 28401323 DOI: 10.1007/s00592-017-0987-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 03/27/2017] [Indexed: 12/21/2022]
Abstract
AIMS To evaluate the association of 64 obesity-related polymorphisms with pediatric-onset type 2 diabetes and other glucose- and insulin-related traits in Mexican children. METHODS Case-control and case-sibling designs were followed. We studied 99 patients with pediatric-onset type 2 diabetes, their siblings (n = 101) without diabetes, 83 unrelated pediatric controls and 137 adult controls. Genotypes were determined for 64 single nucleotide polymorphisms, and a possible association was examined between those genotypes and type 2 diabetes and other quantitative traits, after adjusting for age, sex and body mass index. RESULTS In the case-pediatric control and case-adult control analyses, five polymorphisms were associated with increased likelihood of pediatric-onset type 2 diabetes; only one of these polymorphisms (CADM2/rs1307880) also showed a consistent effect in the case-sibling analysis. The associations in the combined analysis were as follows: ADORA1/rs903361 (OR 1.9, 95% CI 1.2; 3.0); CADM2/rs13078807 (OR 2.2, 95% CI 1.2; 4.0); GNPDA2/rs10938397 (OR 2.2, 95% CI 1.4; 3.7); VEGFA/rs6905288 (OR 1.4, 95% CI 1.1; 2.1) and FTO/rs9939609 (OR 1.8, 95% CI 1.0; 3.2). We also identified 16 polymorphisms nominally associated with quantitative traits in participants without diabetes. CONCLUSIONS ADORA/rs903361, CADM2/rs13078807, GNPDA2/rs10938397, VEGFA/rs6905288 and FTO/rs9939609 are associated with an increased risk of pediatric-onset type 2 diabetes in the Mexican population.
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Affiliation(s)
| | - Miguel Cruz
- Medical Research Unit in Biochemistry, Hospital de Especialidades Centro Médico Nacional SXXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Jesús Aguirre-Hernández
- Laboratory of Genomics, Genetics and Bioinformatics, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Mario Molina-Díaz
- Department of Endocrinology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Jorge Gutiérrez
- Medical Research Unit in Biochemistry, Hospital de Especialidades Centro Médico Nacional SXXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Samuel Flores-Huerta
- Department of Community Health Research, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Department of Community Health Research, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
- Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN), Mexico City, Mexico.
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Sánchez-Gómez MC, García-Mejía KA, Pérez-Díaz Conti M, Díaz-Rosas G, Palma-Lara I, Sánchez-Urbina R, Klünder-Klünder M, Botello-Flores JA, Balderrábano-Saucedo NA, Contreras-Ramos A. MicroRNAs Association in the Cardiac Hypertrophy Secondary to Complex Congenital Heart Disease in Children. Pediatr Cardiol 2017; 38:991-1003. [PMID: 28382463 DOI: 10.1007/s00246-017-1607-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 03/20/2017] [Indexed: 12/14/2022]
Abstract
Complex congenital heart disease (CHD) affects cardiac blood flow, generating a pressure overload in the compromised ventricles and provoking hypertrophy that over time will induce myocardial dysfunction and cause a potential risk of imminent death. Therefore, the early diagnosis of complex CHD is paramount during the first year of life, with surgical treatment of patients favoring survival. In the present study, we analyzed cardiac tissue and plasma of children with cardiac hypertrophy (CH) secondary to CHD for the expression of 11 miRNAs specific to CH in adults. The results were compared with the miRNA expression patterns in tissue and blood of healthy children. In this way, we determined that miRNAs 1, 18b, 21, 23b, 133a, 195, and 208b constitute the expression profile of the cardiac tissue of children with CHD. Meanwhile, miRNAs 21, 23a, 23b, and 24 can be considered specific biomarkers for the diagnosis of CH in infants with CHD. These results suggest that CH secondary to CHD in children differs in its mechanism from that described for adult hypertrophy, offering a new perspective to study the development of this pathology and to determine the potential of hypertrophic miRNAs to be biomarkers for early CH.
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Affiliation(s)
- Ma C Sánchez-Gómez
- Laboratory of Developmental Biology Research and Experimental Teratogenicity, Children's Hospital of Mexico Federico Gomez (HIMFG), CP 06720, Mexico City, Mexico.,School of Medicine, National Polytechnic Institute (IPN), Mexico City, Mexico
| | - K A García-Mejía
- Laboratory of Developmental Biology Research and Experimental Teratogenicity, Children's Hospital of Mexico Federico Gomez (HIMFG), CP 06720, Mexico City, Mexico
| | | | - G Díaz-Rosas
- Laboratory of Developmental Biology Research and Experimental Teratogenicity, Children's Hospital of Mexico Federico Gomez (HIMFG), CP 06720, Mexico City, Mexico
| | - I Palma-Lara
- School of Medicine, National Polytechnic Institute (IPN), Mexico City, Mexico
| | - R Sánchez-Urbina
- Laboratory of Developmental Biology Research and Experimental Teratogenicity, Children's Hospital of Mexico Federico Gomez (HIMFG), CP 06720, Mexico City, Mexico
| | | | - J A Botello-Flores
- Laboratory of Developmental Biology Research and Experimental Teratogenicity, Children's Hospital of Mexico Federico Gomez (HIMFG), CP 06720, Mexico City, Mexico
| | | | - A Contreras-Ramos
- Laboratory of Developmental Biology Research and Experimental Teratogenicity, Children's Hospital of Mexico Federico Gomez (HIMFG), CP 06720, Mexico City, Mexico.
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Miranda-Lora AL, Vilchis-Gil J, Molina-Díaz M, Flores-Huerta S, Klünder-Klünder M. Heritability, parental transmission and environment correlation of pediatric-onset type 2 diabetes mellitus and metabolic syndrome-related traits. Diabetes Res Clin Pract 2017; 126:151-159. [PMID: 28242438 DOI: 10.1016/j.diabres.2017.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 12/27/2016] [Accepted: 02/02/2017] [Indexed: 01/16/2023]
Abstract
AIM To estimate the heritability, parental transmission and environmental contributions to the phenotypic variation in type 2 diabetes mellitus and metabolic syndrome-related traits in families of Mexican children and adolescents. METHODS We performed a cross-sectional study of 184 tri-generational pedigrees with a total of 1160 individuals (99 families with a type 2 diabetes mellitus proband before age 19). The family history of type 2 diabetes mellitus in three generations was obtained by interview. Demographic, anthropometric, biochemical and lifestyle information was corroborated in parents and offspring. We obtained correlations for metabolic traits between relative pairs, and variance component methods were used to determine the heritability and environmental components. RESULTS The heritability of early-onset of type 2 diabetes mellitus was 0.50 (p<1.0e-7). The heritability was greater than 0.5 for hypertension, hypoalphalipoproteinemia, hypercholesterolemia, body mass index, waist circumference, blood pressure, 2-h insulin, and cholesterol (p<0.001). In contrast, we observed a high environmental correlation (>0.50) for blood pressure, HbA1c and HDL-cholesterol after multivariate adjustment (p<0.05). Several traits, such as type 2 diabetes mellitus and insulin resistance, were significantly correlated only through the mother and others, such as hypertriglyceridemia, were significantly correlated only through the father. CONCLUSION This study demonstrates that type 2 diabetes mellitus and metabolic syndrome-related traits are highly heritable among Mexican children and adolescents. Furthermore, several cardiometabolic factors have strong heritability and/or high environmental contributions that highlight the complex architecture of these alterations.
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Affiliation(s)
- América L Miranda-Lora
- Research Unit of Medicine Based on Evidence, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Jenny Vilchis-Gil
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Mario Molina-Díaz
- Department of Endocrinology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Samuel Flores-Huerta
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Miguel Klünder-Klünder
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Mexico City, Mexico; Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN), Mexico City, Mexico.
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Barbosa-Cortés L, López-Alarcón M, Mejía-Aranguré JM, Klünder-Klünder M, del Carmen Rodríguez-Zepeda M, Rivera-Márquez H, de la Vega-Martínez A, Martin-Trejo J, Shum-Luis J, Solis-Labastida K, López-Aguilar E, Matute-González G, Bernaldez-Rios R. Adipokines, insulin resistance, and adiposity as a predictors of metabolic syndrome in child survivors of lymphoma and acute lymphoblastic leukemia of a developing country. BMC Cancer 2017; 17:125. [PMID: 28193268 PMCID: PMC5307882 DOI: 10.1186/s12885-017-3097-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 01/31/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There is a growing body of evidence indicating that pediatric survivors of cancer are at a greater risk of developing metabolic syndrome. This study evaluated some probable predictors of metabolic syndrome (MS), such as leptin and adiponectin concentrations, the leptin/adiponectin ratio, insulin resistance, and adiposity, in a sample of child survivors of lymphoma and leukemia in Mexico City. METHODS Fifty two children (leukemia n = 26, lymphoma n = 26), who were within the first 5 years after cessation of therapy, were considered as eligible to participate in the study. Testing included fasting insulin, glucose, adipokines and lipids; body fat mass was measured by DXA. The MS components were analyzed according to tertiles of adipokines, insulin resistance, and adiposity. Comparisons between continuous variables were performed according to the data distribution. The MS components were analyzed according to tertiles of adipokines, insulin resistance, and adiposity. With the purpose of assessing the risk of a present MS diagnosis, odds ratios (OR) with a 95% confidence interval (95% IC) were obtained using logistic regression analysis according to the various metabolic markers. RESULTS The median children age was 12.1 years, and the interval time from the completion of therapy to study enrollment was 4 years. Among the MS components, the prevalence of HDL-C low was most common (42%), followed by central obesity (29%). The HOMA-IR (OR 9.0, 95% CI 2.0; 41.1), body fat (OR 5.5, 95% CI 1.6; 19.3), leptin level (OR 5.7, 95% CI 1.6; 20.2) and leptin/adiponectin ratio (OR 9.4, 95% CI 2.0; 49.8) in the highest tertile, were predictive factors of developing MS; whereas the lowest tertile of adiponectin was associated with a protective effect but not significant. CONCLUSIONS Biomarkers such as HOMA-IR, leptin and leptin/adiponectin are associated with each of the components of the MS and with a heightened risk of suffering MS among children survivors of cancer. Given the close relationship between MS with risk of developing type 2 diabetes and cardiovascular disease, it is imperative to implement prevention measures in this population and especially in developing countries where these pathologies have become the leading cause of death.
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Affiliation(s)
- Lourdes Barbosa-Cortés
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, MexicanInstitute of Social Security, México City, México
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, Mexican Institute of Social Security, Avenida Cuauhtémoc 330 Col. Doctores, México City, C.P. 06720 México
| | - Mardia López-Alarcón
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, MexicanInstitute of Social Security, México City, México
| | - Juan Manuel Mejía-Aranguré
- Health Research Coordination, 21st Century Pediatric Hospital, National Medical Center, Mexican Institute of Social Security, México City, México
| | - Miguel Klünder-Klünder
- Department of Community Health Research, Federico Gómez Children’s, México Secretary of Health, and Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN), México City, México
| | - María del Carmen Rodríguez-Zepeda
- Department of Hematology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
| | - Hugo Rivera-Márquez
- Department of Hemato-Oncology, General Hospital of México, México Secretary of Health, México City, México
| | - Alan de la Vega-Martínez
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, MexicanInstitute of Social Security, México City, México
| | - Jorge Martin-Trejo
- Department of Hematology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
| | - Juan Shum-Luis
- Department of Hematology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
| | - Karina Solis-Labastida
- Department of Hematology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
| | - Enrique López-Aguilar
- Department of Oncology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
| | - Guadalupe Matute-González
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, MexicanInstitute of Social Security, México City, México
| | - Roberto Bernaldez-Rios
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, MexicanInstitute of Social Security, México City, México
- Health Research Coordination, 21st Century Pediatric Hospital, National Medical Center, Mexican Institute of Social Security, México City, México
- Department of Community Health Research, Federico Gómez Children’s, México Secretary of Health, and Research Committee, Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN), México City, México
- Department of Hematology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
- Department of Hemato-Oncology, General Hospital of México, México Secretary of Health, México City, México
- Department of Oncology, Pediatric Hospital, 21st Century National Medical Center, Mexican Institute of Social Security, México City, México
- Medical Nutrition Research Unit, 21st Century Pediatric Hospital, National Medical Center, Mexican Institute of Social Security, Avenida Cuauhtémoc 330 Col. Doctores, México City, C.P. 06720 México
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Vilchis-Gil J, Klünder-Klünder M, Duque X, Flores-Huerta S. Decreased Body Mass Index in Schoolchildren After Yearlong Information Sessions With Parents Reinforced With Web and Mobile Phone Resources: Community Trial. J Med Internet Res 2016; 18:e174. [PMID: 27342650 PMCID: PMC4963027 DOI: 10.2196/jmir.5584] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 05/10/2016] [Accepted: 05/27/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The obesity pandemic has now reached children, and households should change their lifestyles to prevent it. OBJECTIVE The objective was to assess the effect of a comprehensive intervention on body mass index z-score (BMIZ) in schoolchildren. METHODS A yearlong study was conducted at 4 elementary schools in Mexico City. Intervention group (IG) and control group (CG) were split equally between governmental and private schools. Three educational in-person parents and children sessions were held at 2-month intervals to promote healthy eating habits and exercise. To reinforce the information, a website provided extensive discussion on a new topic every 2 weeks, including school snack menus and tools to calculate body mass index in children and adults. Text messages were sent to parents' mobile phones reinforcing the information provided. The IG contained 226 children and CG 181 children. We measured their weight and height and calculated BMIZ at 0, 6, and 12 months. RESULTS The CG children showed a change of +0.06 (95% CI 0.01, 0.11) and +0.05 (95% CI 0.01, 0.10) in their BMIZ at 6 and 12 months, respectively. The BMIZ of IG children decreased by -0.13 (95% CI -0.19 to -0.06) and -0.10 (95% CI -0.16 to -0.03), respectively, and the effect was greater in children with obesity. CONCLUSIONS The comprehensive intervention tested had beneficial effects, preserved the BMIZ of normal weight children, and reduced the BMIZ of children with obesity.
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Affiliation(s)
- Jenny Vilchis-Gil
- Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Community Health Research Department, Mexico City, Mexico
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López-Martínez B, Vilchis Ordoñez A, Salazar Garcia M, Klünder-Klünder M, Parra-Ortega I, Dorantes-Acosta E, Angeles-Floriano T. Thymidine Kinase: A Biomarker for Recently Diagnosed Acute Leukemia in Pediatric Patients According to the Cell Line Involved. Arch Med Res 2015; 46:630-4. [PMID: 26656666 DOI: 10.1016/j.arcmed.2015.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 05/25/2015] [Accepted: 11/23/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS Acute leukemia (AL) is a heterogeneous group of diseases characterized by a disorganized clone proliferation of hematopoietic cells. Thymidine kinase (TK) is a cell enzyme involved in DNA synthesis and is considered a cellular proliferation marker in some solid tumors. METHODS A cross-sectional prospective and comparative study was performed in the Federico Gomez Children's Hospital in Mexico (HIMFG, in Spanish) in 125 samples of patients of the HIMFG with AL and 138 samples of children without leukemia. Serum TK levels were determined for both groups. RESULTS Of the children with AL, 90 presented B-cell acute lymphoblastic leukemia (B-ALL); 13, T-cell acute lymphoblastic leukemia (T-ALL); and 22, acute myeloid leukemia (AML). A median (m) TK level of 23.7 IU (IQR 17-35.7) was observed in the group without AL and 91 IU (IQR 98-392) in the AL group. This difference was statistically significant (p <0.0001). When analyzing TK levels according to the type of leukemia, the m was as follows: 68 IU (IQR 35-118) for B-ALL, 470 IU (IQR 88-750) for AML, and 1678 IU (IQR 288-2108) for T- ALL. CONCLUSION TK is an enzyme showing heterogeneous levels in B-ALL although it is significantly increased in 90% of patients with T-ALL and AML.
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Affiliation(s)
- Briceida López-Martínez
- Division of Auxiliary Diagnostic Services, Hospital Infantil de México Federico Gómez, México, D.F., México
| | - Armando Vilchis Ordoñez
- Department of Clinical Laboratory, Hospital Infantil de México Federico Gómez, México, D.F., México
| | - Marcela Salazar Garcia
- Research Laboratory in Developmental Biology and Experimental Teratogenesis, Hospital Infantil de México Federico Gómez, México, D.F., México
| | - Miguel Klünder-Klünder
- Research Department in Community Health, Hospital Infantil de México Federico Gómez, México, D.F., México
| | - Israel Parra-Ortega
- Department of Clinical Laboratory, Hospital Infantil de México Federico Gómez, México, D.F., México
| | - Elisa Dorantes-Acosta
- Hematology-Oncology Department, Hospital Infantil de México Federico Gómez, México, D.F., México
| | - Tania Angeles-Floriano
- Department of Clinical Laboratory, Hospital Infantil de México Federico Gómez, México, D.F., México.
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Gallardo JM, Gómez-López J, Medina-Bravo P, Juárez-Sánchez F, Contreras-Ramos A, Galicia-Esquivel M, Sánchez-Urbina R, Klünder-Klünder M. Maternal obesity increases oxidative stress in the newborn. Obesity (Silver Spring) 2015; 23:1650-4. [PMID: 26193060 DOI: 10.1002/oby.21159] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 04/27/2015] [Accepted: 04/28/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Obesity before pregnancy is associated with a greater risk for the offspring to develop obesity and diabetes in childhood and adulthood. The aim of the present study was to determine the association between maternal overweight or obesity before pregnancy and newborn oxidative stress (OS). METHODS Seventy-two mother-child pairs were divided according to the pre-gestational body mass index (BMI) of the mothers as follows: eutrophic (n = 21), overweight (n = 32), and obese (n = 19). Malondialdehyde (MDA) and nitric oxide (NO) were measured in the plasma of a blood sample from the newborn's umbilical cord. RESULTS The MDA levels of newborns increased with maternal BMI (P = 0.001), as did the levels of NO (P = 0.019). There was a direct correlation between MDA and NO levels in each of the three groups (eutrophic: R(2) = 0.59, P < 0.001; overweight: R(2) = 0.45, P < 0.001; and obese: R(2) = 0.26, P = 0.024). CONCLUSIONS Maternal overweight and obesity before pregnancy are associated with increased OS in the offspring.
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Affiliation(s)
- Juan Manuel Gallardo
- Unidad De Investigación Médica En Enfermedades Nefrológicas, Hospital De Especialidades Centro Médico Nacional "Siglo XXI," Instituto Mexicano Del Seguro Social, México City, México
| | - Jaqueline Gómez-López
- Hospital De La Mujer, Secretaria De La Defensa Nacional, México City, México
- Escuela Superior De Medicina, Instituto Politécnico Nacional, México City, México
| | - Patricia Medina-Bravo
- Departamento de Endocrinología, Hospital Infantil de México Federico Gomez, México City, México
| | - Francisco Juárez-Sánchez
- Unidad De Investigación Médica En Enfermedades Nefrológicas, Hospital De Especialidades Centro Médico Nacional "Siglo XXI," Instituto Mexicano Del Seguro Social, México City, México
| | - Alejandra Contreras-Ramos
- Laboratorio De Investigación en Biología Del Desarrollo y Teratogénesis Experimental, Hospital Infantil de México Federico Gomez, México City, México
| | - Matilde Galicia-Esquivel
- Laboratorio De Investigación en Biología Del Desarrollo y Teratogénesis Experimental, Hospital Infantil de México Federico Gomez, México City, México
| | - Rocío Sánchez-Urbina
- Laboratorio De Investigación en Biología Del Desarrollo y Teratogénesis Experimental, Hospital Infantil de México Federico Gomez, México City, México
| | - Miguel Klünder-Klünder
- Departamento de Investigación en Salud Comunitaria, Hospital Infantil de México Federico Gomez, México City, México
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Vilchis-Gil J, Galván-Portillo M, Klünder-Klünder M, Cruz M, Flores-Huerta S. Food habits, physical activities and sedentary lifestyles of eutrophic and obese school children: a case-control study. BMC Public Health 2015; 15:124. [PMID: 25885348 PMCID: PMC4331306 DOI: 10.1186/s12889-015-1491-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 01/29/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Civilization has produced lifestyle changes; currently, people ingest more calories than are expended, resulting in obesity. This study assessed the association between dietary habits, physical activities, and sedentary behaviors and the risk of obesity in schoolchildren in Mexico City. METHODS Of 1,441 children (6-12 years old) screened in elementary schools, 202 obese (BMI ≥95(th) pc) and 200 normal-weight children (BMI 25(th)- 75(th) pc), as defined by the 2000 CDC criteria, were included in a case-control study. The children's eating, physical activity and sedentary lifestyle habits were recorded using validated questionnaires. The quantity and quality of the foods were obtained, and the energy that was expended was transformed into METs. Sedentary behavior was assessed in hours. Logistic regression models were used to determine the risks of certain habits and their association with obesity. RESULTS Obese children ingested around of 270 Kcal less than eutrophic children. However, compared with the eutrophic children, obese children had significantly worse lifestyle habits; the children with healthy dietary habits (eating breakfast at home, bringing a school lunch, and not bringing money to purchase food) had a lower risk of obesity (OR 0.59, CI 0.46; 0.75). The quality of the eaten food was associated with a risk of obesity. Consuming fruit demonstrated an inverse association with risk of obesity (p Trend = 0.01); consumption of sweetened beverages (p Trend < 0.04) and refined carbohydrates with added fat (p Trend = 0.002) were associated with an increased risk of obesity. Children who were more physically active at school had an OR of 0.37 (CI 0.16; 0.89), those who had 3-4 televisions at home had an OR of 2.13 (CI 1.20; 3.78), and the risk of developing obesity was independent of caloric intake. CONCLUSIONS Poorer eating habits as well as less physical activity were associated with the risk of obesity. An obesogenic environment could change if teachers and parents worked together to form healthy food intake and physical activity habits.
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Affiliation(s)
- Jenny Vilchis-Gil
- Community Health Research Department, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Mexico City, Mexico.
| | - Marcia Galván-Portillo
- Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
| | - Miguel Klünder-Klünder
- Community Health Research Department, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Mexico City, Mexico.
| | - Miguel Cruz
- Medical Research Unit in Biochemistry, UMAE Bernardo Sepulveda, IMSS, Mexico City, Mexico.
| | - Samuel Flores-Huerta
- Community Health Research Department, Hospital Infantil de México Federico Gomez, Ministry of Health (SSA), Mexico City, Mexico.
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Mejía-Benítez MA, Bonnefond A, Yengo L, Huyvaert M, Dechaume A, Peralta-Romero J, Klünder-Klünder M, García Mena J, El-Sayed Moustafa JS, Falchi M, Cruz M, Froguel P. Beneficial effect of a high number of copies of salivary amylase AMY1 gene on obesity risk in Mexican children. Diabetologia 2015; 58:290-4. [PMID: 25394825 DOI: 10.1007/s00125-014-3441-3] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 09/29/2014] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS Childhood obesity is a major public health problem in Mexico, affecting one in every three children. Genome-wide association studies identified genetic variants associated with childhood obesity, but a large missing heritability remains to be elucidated. We have recently shown a strong association between a highly polymorphic copy number variant encompassing the salivary amylase gene (AMY1 also known as AMY1A) and obesity in European and Asian adults. In the present study, we aimed to evaluate the association between AMY1 copy number and obesity in Mexican children. METHODS We evaluated the number of AMY1 copies in 597 Mexican children (293 obese children and 304 normal weight controls) through highly sensitive digital PCR. The effect of AMY1 copy number on obesity status was assessed using a logistic regression model adjusted for age and sex. RESULTS We identified a marked effect of AMY1 copy number on reduced risk of obesity (OR per estimated copy 0.84, with the number of copies ranging from one to 16 in this population; p = 4.25 × 10(-6)). The global association between AMY1 copy number and reduced risk of obesity seemed to be mostly driven by the contribution of the highest AMY1 copy number. Strikingly, all children with >10 AMY1 copies were normal weight controls. CONCLUSIONS/INTERPRETATION Salivary amylase initiates the digestion of dietary starch, which is highly consumed in Mexico. Our current study suggests putative benefits of high number of AMY1 copies (and related production of salivary amylase) on energy metabolism in Mexican children.
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Affiliation(s)
- María A Mejía-Benítez
- Departamento de Genética y Biología Molecular, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico
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Garcés MJ, Hernández J, Queipo G, Klünder-Klünder M, Bustos M, Herrera A, López-Alvarenga JC, Quispe-Siccha R, Espinosa A, Garibay N. Novel gender-specific visceral adiposity index for Mexican pediatric population. Revista Médica Del Hospital General De México 2014. [DOI: 10.1016/j.hgmx.2014.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Juárez-López C, Klünder-Klünder M, Madrigal-Azcárate A, Flores-Huerta S. Omega-3 polyunsaturated fatty acids reduce insulin resistance and triglycerides in obese children and adolescents. Pediatr Diabetes 2013; 14:377-83. [PMID: 23438101 DOI: 10.1111/pedi.12024] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 01/04/2013] [Accepted: 01/04/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Approximately 50% of obese children are insulin resistant. It has been suggested that pharmacological and nutritional options should be considered to improve the management of insulin resistance (IR). OBJECTIVE To assess the effect of metformin (Met) or omega-3 (ω-3) polyunsaturated fatty acids (PUFA) on the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index, lipid profile, and body mass index (BMI) of obese children. METHODS We included 201 obese and insulin-resistant children and adolescents. Ninety-eight of them received 500 mg of Met, and 103 received 1.8 g of ω-3 PUFA for 12 wk. This was an open-label study with assignment of treatment based on which school the child attended. At the baseline and at the end of study, the following parameters were measured: weight, height, waist circumference, blood pressure, insulin, glucose, lipid profile, and HOMA-IR index. There were no lifestyle interventions. RESULTS At baseline, the age, BMI, and IR in children of both groups were comparable. The treatment assigned for each group was well tolerated. Metabolic changes were adjusted for age, sex, and change in BMI. Concerning the IR profile at the end of intervention, ω-3 significantly decreased the concentrations of glucose and insulin while reducing HOMA-IR values; meanwhile, Met negligibly affected insulin levels. Regarding lipids, Met increased high density lipoprotein cholesterol (HDL-C) and decreased low density lipoprotein cholesterol (LDL-C), but triglycerides were not affected; in contrast, triglycerides were decreased significantly by ω-3. The effects on BMI were marginal under Met but were significant with ω-3. CONCLUSION The results of this work suggest that ω-3 may be useful as an adjuvant therapy in obese children and adolescents with IR.
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Affiliation(s)
- Carlos Juárez-López
- Department for Innovation and Quality, Institute for Decentralized Public Health Services, INDESALUD, Campeche, Campeche 24040, Mexico
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Mejía-Benítez A, Klünder-Klünder M, Yengo L, Meyre D, Aradillas C, Cruz E, Pérez-Luque E, Malacara JM, Garay ME, Peralta-Romero J, Flores-Huerta S, García-Mena J, Froguel P, Cruz M, Bonnefond A. Analysis of the contribution of FTO, NPC1, ENPP1, NEGR1, GNPDA2 and MC4R genes to obesity in Mexican children. BMC Med Genet 2013; 14:21. [PMID: 23375129 PMCID: PMC3577489 DOI: 10.1186/1471-2350-14-21] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 01/29/2013] [Indexed: 11/11/2022]
Abstract
Background Recent genome wide association studies (GWAS) and previous positional linkage studies have identified more than 50 single nucleotide polymorphisms (SNPs) associated with obesity, mostly in Europeans. We aimed to assess the contribution of some of these SNPs to obesity risk and to the variation of related metabolic traits, in Mexican children. Methods The association of six European obesity-related SNPs in or near FTO, NPC1, ENPP1, NEGR1, GNPDA2 and MC4R genes with risk of obesity was tested in 1,463 school-aged Mexican children (Ncases = 514; Ncontrols = 949). We also assessed effects of these SNPs on the variation of body mass index (BMI), fasting serum insulin levels, fasting plasma glucose levels, total cholesterol and triglyceride levels, in a subset of 1,171 nonobese Mexican children. Results We found a significant effect of GNPDA2 rs10938397 on risk of obesity (odds ratio [OR] = 1.30; P = 1.34 × 10-3). Furthermore, we found nominal associations between obesity risk or BMI variation and the following SNPs: ENPP1 rs7754561, MC4R rs17782313 and NEGR1 rs2815752. Importantly, the at-risk alleles of both MC4R rs17782313 and NPC1 rs1805081 showed significant effect on increased fasting glucose levels (β = 0.36 mmol/L; P = 1.47 × 10-3) and decreased fasting serum insulin levels (β = −0.10 μU/mL; P = 1.21 × 10-3), respectively. Conclusion Our present results suggest that some obesity-associated SNPs previously reported in Europeans also associate with risk of obesity, or metabolic quantitative traits, in Mexican children. Importantly, we found new associations between MC4R and fasting glucose levels, and between NPC1 and fasting insulin levels.
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Affiliation(s)
- Aurora Mejía-Benítez
- Departamento de Genética y Biología Molecular, Centro de Investigación yde Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico
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Klünder-Klünder M, Mejía-Benitez MA, Flores-Huerta S, Burguete-García AI, García-Mena J, Cruz M. rs12255372 variant of TCF7L2 gene is protective for obesity in Mexican children. Arch Med Res 2012; 42:495-501. [PMID: 22136959 DOI: 10.1016/j.arcmed.2011.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 05/12/2011] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS Variants in the transcription factor 7-like 2 (TCF7L2) gene are consistently associated with type 2 diabetes in adults, but the association of TCF7L2 with weight-related traits and body fat in humans is unclear. The aim of this study was to determine the relationship between the TCF7L2 gene (rs12255372) and obese phenotype in Mexican school-age children. METHODS The study was performed in schools in Mexico City; 186 obese and 194 control children were studied. Fasting insulin and glucose, total cholesterol, LDL-C, HDL-C and triglycerides concentration were determined. The variant rs12255372 of the TCF7L2 gene was genotyped. We used age- and sex-adjusted linear models to test for association with metabolic measurements with this variant. RESULTS Genotype of the TCF7L2 rs12255372 gene was associated with lower fasting plasma glucose (p = 0.001) and lower homeostasis model assessment of insulin resistance (HOMA-R; p = 0.001) in nonobese children. Heterozygous carriers for this variant were more prevalent in lean children (32.5%) than in the obese group (23.7%), which resulted in a strong protective effect for the normal weight condition (OR = 0.56, 0.32-0.97). CONCLUSIONS TCF7L2 rs12255372 polymorphism protects Mexican children from obesity. Further research in other large, population-based studies is needed to replicate these findings.
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Affiliation(s)
- Miguel Klünder-Klünder
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Ministry of Health, Mexico City, Mexico
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Flores-Huerta S, Klünder-Klünder M, Muñoz-Hernández O. Feeding practices and nutritional status of Mexican children affiliated to the Medical Insurance for a New Generation. Salud pública Méx 2012; 54 Suppl 1:S20-7. [DOI: 10.1590/s0036-36342012000700004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 07/01/2011] [Indexed: 11/21/2022] Open
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Flores-Huerta S, Klünder-Klünder M, Muñoz-Hernández O. Physical growth and nutritional status of Mexican infants from newborn to two years of age. Salud pública Méx 2012; 54 Suppl 1:S82-9. [DOI: 10.1590/s0036-36342012000700011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 09/08/2011] [Indexed: 11/22/2022] Open
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Klünder-Klünder M, Flores-Huerta S. Waist circumference values according to height percentiles: a proposal to evaluate abdominal obesity in Mexican children and adolescents between 6 and 16 years of age. Arch Med Res 2011; 42:515-22. [PMID: 21925222 DOI: 10.1016/j.arcmed.2011.09.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 08/24/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Waist circumference (WC) is a good anthropometric indicator for diagnosing abdominal obesity across different age groups, including children and adolescents. It is unknown whether height may modify this indicator independent of other variables such as age, gender and ethnicity. We undertook this study to determine whether WC of children and adolescents shows variations in size according to height percentiles and propose these values as reference to assess abdominal obesity in children. METHODS We carried out a cross-sectional analytical study in which weight, height and WC were measured in children and adolescents attending elementary schools in Mexico City. Included in the study were 3378 individuals between 6 and 16 years of age. Using quantile regression, estimated values of WC were obtained according to age and gender for the following percentiles of height: 10(th), 25(th), 50(th), 75(th) and 90(th). Likewise, for each of these height percentiles, the following percentiles of WC were calculated: 50(th), 75(th) and 90(th). RESULTS Among males, WC values increased 2.0 cm for ten units of height percentiles and 2.5 cm for each year of age. Among females, WC increased 1.0 cm and 2.8 cm, respectively. WC values of individuals of the same age and gender in the lower height percentiles were less than those of individuals in the upper height percentiles. CONCLUSIONS WC demonstrates variations directly associated with height percentiles.
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Affiliation(s)
- Miguel Klünder-Klünder
- Community Health Research Department, Hospital Infantil de México Federico Gómez, Mexico, D.F., Mexico
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