Comparison of an increased waist circumference with a positive hydrogen breath test as a clinical predictor of lactose intolerance

ABSTRACT Introduction. Lactose intolerance is a common disease in pediatrics, and its wrong diagnosis will lead to morbidity. The primary objective of this study was to assess the usefulness of an increased waist circumference during the hydrogen breath test as a predictor of lactose intolerance. The secondary objective was to analyze the impact of body mass index, waist circumference measurement, and age on the abdominal distension of patients with lactose intolerance. Population and methods. A total of 138 subjects aged 3 to 15 years were included. They underwent serial measurements of the waist circumference and hydrogen levels in the breath every 30 minutes over 3 hours during the hydrogen breath test. Results. Out of the entire sample, 35 (25.4%) patients had lactose intolerance. An increase of 0.85 cm in waist circumference compared to the baseline waist circumference results in a sensitivity of 88% and a specificity of 85% to predict lactose intolerance (odds ratio: 42.14, 95% confidence interval: 13.08-135.75, p ≤ 0.001). The body mass index and waist circumference measurement did not affect abdominal distension (p= not significant); however, age modified the time of distension. Conclusions. A 0.85 cm increase in waist circumference compared to the baseline waist circumference during the hydrogen breath test is a useful parameter for the diagnosis of lactose intolerance in pediatrics. Variations in relation to body mass index and waist circumference did not affect the usefulness of an increased waist circumference, unlike age. Key words: lactose intolerance, waist circumference, diagnosis, exhaled hydrogen breath, child

Body composition by dual X-ray absorptiometry in Mexican schoolchildren with or without obesity

Objective: Apply dual X-ray absorptiometry (DXA) to determine the amount of fat mass, lean mass, and bone mineral density in Mexican schoolchildren with and without obesity. Material and methods: We performed an observational, analytical, comparative, cross-sectional study of 80 Mexican schoolchildren who attended the Nutrition Clinic of the Pediatric Medical Center in Monterrey, Mexico during the period of January to April 2005. Body mass index (BMI) was determined to classify the participants according to the growth charts of the Centers for Disease Control and Prevention. Two groups of 40 children each (with and without obesity) were formed and DXA was carried out on each individual. Cronbach’s Alpha was used to determine instrument reliability and the Kolmogorov-Smirnov test was used to test the normality of numerical variables. Means were compared using Student´s t test. Results: Statistically signiicant differences were found in fat mass (p≤0.001) and lean mass (p≤0.001), but not in bone mineral content (p=0.051) between both groups. Conclusions: Differences exist in fat mass and lean mass in both groups, but not in bone mineral content between both groups. A signiicant positive correlation was found between fat mass, determined by DXA, and BMI in schoolchildren with and without obesit

Leptina, insulina y glucosa en niños a término, medidas antropométricas, género y dieta a los tres meses de vida

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid. Facultad de Medicina. Departamento de Pediatría. Fecha de lectura: 31-10-200

Association between umbilical cord leptin and weight gain according to feeding type in the early postnatal period, a brief report

Antecedentes. La ganancia de peso en la infancia depende del estado nutricional in utero y el crecimiento posnatal, así como de las prácticas de alimentación, cultura, accesibilidad a los alimentos y el nivel educativo de los padres. Objetivo. Evaluar la relación de los niveles de leptina del cordón umbilical y la influencia del tipo de alimentación (seno materno vs. fórmula) en la ganancia de peso a los tres meses de vida en recién nacidos sanos. Material y métodos. Noventa y nueve recién nacidos a término (masculinos, n = 48; femenino, n = 51) fueron incluidos en dos grupos de acuerdo con el tipo de alimentación: alimentados al seno materno (n = 49) y alimentados con fórmula (n = 50). La leptina fue medida de la sangre obtenida de la vena del cordón umbilical. Resultados. Las concentraciones de leptina del cordón umbilical y la ganancia de peso a los tres meses tuvieron una correlación inversa en lactantes alimentados con fórmula (r = -0.294, P = 0.038), estos hallazgos no fueron reflejados en lactantes alimentados al seno materno (r = -0.212, P = 0.144). Conclusiones. En esta cohorte mexicana de alimentación al seno materno, los niveles de leptina en el cordón umbilical fueron un predictor significativo de la ganancia de peso en infantes alimentados con fórmulaBackground. Weight gain in infancy depends on in utero nutritional status, with postnatal growth also dependent on feeding practices, culture, food accessibility and parents’ education. Objective. To evaluate the relationship between umbilical cord blood leptin levels and feeding mode (breast-fed vs. formula) on weight gain at three months of life. Material and methods. Ninety-nine full-term newborns (male, n = 48; female, n = 51) were included in two groups according to feeding type: breast-fed (n = 49) and formula-fed (n = 50). Leptin was measured in blood obtained from the umbilical cord vein. Results. Umbilical cord leptin levels and weight gain at three months had a significant inverse correlation in formula-fed infants (r = -0.294, P = 0.038). This finding was not reflected in breast-fed infants (r = -0.212, P = 0.144). Conclusions. In our Mexican breastfeeding cohort, umbilical cord leptin levels were a significant predictor of weight gain in formula-fed infantsThis work was supported by grants from the Universidad Autónoma de Nuevo León through the Scientific and Technological Research Support Program (PAICYT) (SA1463-06)

Prevalence of liver fibrosis in an unselected general population with high prevalence of obesity and diabetes mellitus. Time for screening?

Introduction: Cirrhosis and liver cancer are currently common causes of death worldwide. The global epidemic of obesity has increased the incidence of nonalcoholic fatty liver disease (NAFLD) and cirrhosis in recent years. Advanced fibrosis increases the morbimortality rate in NAFLD. The Mexican population has one of the highest prevalence of obesity and diabetes mellitus (DM) worldwide. Aim: To determine the prevalence of advanced liver fibrosis in Mexican general population. Methods: Adult individuals, without a history of liver disease nor heavy alcohol consumption were randomly sampled from 20,919 participants of a health and nutrition survey applied to the general population. Clinical and laboratory evaluations were performed to calculate the NAFLD fibrosis score (NFS) (an extensively validated non-invasive method). Two cut-off points were used. Advanced fibrosis was defined as a result >0.676. Results: In total 695 individuals were included. The mean age was 47.8 ± 16.4. The majority were between 20 and 50 years (59%), 70.2% were female, 35.5% showed obesity and 15.8% DM. The 93% had normal serum ALT. Based on the NFS results, 56 individuals (8.1%) had a high probability of fibrosis. Most patients from this subgroup showed normal serum ALT (92.9%), 89.3% were >45 yr. old, 52% were obese and 27% suffered from DM. Conclusions: Based on these results, 8.1% of Mexican general population without a history of liver disease is at high risk of having advanced liver fibrosis and complications and death derived from cardiovascular disease and cirrhosis. Most of them showed normal ALT serum levels

Deficiencia de vitamina D en madres y neonatos mexicanos

El objetivo es establecer la prevalecencia de la deficiencia de vitamina D en madres y sus neonatos, y analizar factores de riesgo asociado