Rosa Olivia Méndez

Background: Chronic kidney disease (CKD) is commonly attributed to diabetes and hypertension and induces bone mineral density (BMD) losses, resulting in health implications. Objective: To detect CKD in patients with diabetes and/or hypertension and to evaluate their BMD of the lumbar spine and femoral regions, and total alkaline phosphatase (T-ALP). Methods: In a repeated cross-sectional screening with confirmatory testing, we identified CKD patients by testing albuminuria and estimated glomerular filtration rate (eGFR). We measured body mass index, BMD of the lumbar spine and femoral regions, and T-ALP, and analyzed the data using Tukey–Kramer, Chi², Kruskal–Wallis tests, Spearman correlation, and ANCOVA with adjusted variables. Results: We identified 54 newly detected at-risk CKD and CKD patients: 34 in the at-risk/early stages, 19 in the intermediate stage, and 1 in the advanced stage, plus 28 previously diagnosed patients, bringing the advanced-stage group to 29. The BMDs of femoral regions in CKD patients were significantly higher (p = 0.001) in the at-risk/early and intermediate stages than in the advanced stage for the femoral neck, although 50% and 69% in the at-risk/early and intermediate stages presented bone loss. There were low negative correlations between T-ALP and femoral BMD. Conclusions: We detected CKD or its risk in 54/104 patients with diabetes and/or hypertension, and their BMD was more affected in advanced stages than in at-risk/early and intermediate ones; years of suffering from diabetes and hypertension were factors for the development of intermediate- and advanced-stage CKD. Diagnosis and treatment of CKD in at-risk patients should help prevent comorbidities.

La dieta en países en vías de desarrollo está constitui da por cereales y legumbres que si bien aportan cantidades impor tantes de hierro (Fe) y zinc (Zn), resultan ser minerales de baja dis ponibilidad. Los objetivos del presente trabajo fueron: 1) cuantificar el contenido total y dializable de Fe y Zn en alimentos del norte (Sonora) y del sur (Oaxaca) de México; 2) evaluar el efecto de la presencia de carne sobre los valores de Fe y Zn dializables. La cuantificación de Fe y Zn total y dializable se hizo por el método de la AOAC y de Shen et al, respectivamente. Los resultados obtenidos para Fe total en alimentos de Sonora presentaron un rango de 0.78±0.0 a ll.59±0.03 mg/lOOg (base seca, BS); y en los de Oaxaca de 0.86+0.18 a 8.8±0.57 mg/lOOg (BS). Para Zn total los valores varia ron de 0.91±0.00 a 13.58±0.05 mg/lOOg (BS) en Sonora y de O.64±0.18 a 20.80±0.33 mg/100g(BS) en Oaxaca. En los alimentos de Sonora se tuvieron valores de 0.1+0.04% a 10.610.36% para Fe dializable y de 4.0+0.21 % a 55.3210.14% para Zn dializable. En los de Oaxaca el rango fue de 0.2210.06 % a 9.4010.14% para Fe dializable y de 2.4110.26% a 54.2711.49% para Zn dializable. Se obtuvo un promedio mayor en el contenido de Fe dializable en los alimentos que contenían carne, respecto a los que no la contenían y entre el frijol pinto y las tortillas de maíz de Sonora respecto al frijol negro y tortillas de maíz rurales de Oaxaca. El contenido de Zn dializable no mostró diferencias significativas entre los alimentos de las dos regiones.

El inicio de la maduración sexual en los individuos es un parámetro utilizado para conocer la calidad de vida de una población. En mujeres, el indicador más utilizado es la edad de la menarquia. Considerando que en esta región no existen estudios que muestren esta información, los objetivos del presente trabajo fueron obtener la edad de la menarquia en mujeres escolares del Noroeste de México y establecer la relación de ésta con el nivel socioeconómico, el peso y la talla. Se seleccionó al azar una muestra de 857 mujeres escolares de 7 a 17 años de edad, a las cuales se les determinó la edad de la menarquia por medio del método statu quo. Para la menarquia el valor encontrado fue de 12.06 ± 0.44 años, encontrándose una relación significativa con la talla (p < 0.01) y con el nivel socioeconómico (p < 0.01). En conclusión, el valor encontrado en este estudio es semejante al reportado en otras poblaciones latinoamericanas. Por otra parte, considerando que alrededor del 70% de la población mexicana tiene un nivel socioeconómico bajo, es posible que la edad de la menarquia sea el resultado de interacciones genéticas y ambientales.

Background: Dental fluorosis (DF) is an irreversible alteration of tooth enamel formation caused by excessive fluoride (F) consumption during tooth growth, leading to skeletal fluorosis development due to the high F content of tap water, which should be detected. Objective: To detect the signs of skeletal fluorosis by comparison of the bone mineral density (BMD) of the lumbar spine, femoral neck, and total femur, and the fluor (F) intake from water between adults without and with DF from northwestern Mexico. Methods: Participants were 36 adults without DF (G1) and 42 with DF (G2). Dean criteria, DEXA, and SPADNS methods were used to evaluate DF, BMD, and F content in water, respectively. Results. G1 participants consumed 0.789 ± 1.55 mg F/d from water with 0.385 ± 0.32 mg F/L, while G2 participants drank 2.42 ± 2.65 mg F/d from water with 1.46 ± 0.59 mg F/L. The binary variable DF and BMD values were not associated (p > 0.05); however, according to severity degree, questionable DF was associated with total femur BMD (p = 0.025). BMD in the evaluated regions was no different between both groups and could be related to actual moderate levels of F in the tap water and to the partial or total consumption of bottled water. Conclusions. There was no association between DF and the measured BMD to infer skeletal fluorosis. Bone region BMD was no different between both evaluated groups and could be related to adequate F intake, with moderate F levels in tap water, and the consumption of negligible F content bottled water.

Extracellular vesicles (EVs) are implicated in several biological conditions, including bone metabolism disturbances in breast cancer patients (BCPs). These disorders hinder the adjustment of nutrition interventions due to changes in bone mineral density (BMD). The biophysical properties of EVs (e.g., size or electrostatic repulsion) affect their cellular uptake, however, their clinical relevance is unclear. In this study, we aimed to investigate the association between the biophysical properties of the plasma-derived EVs and BMDs in BCPs who received an individualized nutrition intervention during the first six months of antineoplastic treatment. As part of the nutritional assessment before and after the intervention, body composition including bone densitometry and plasma samples were obtained. In 16 BCPs, EVs were isolated using ExoQuick^® and their biophysical properties were analyzed using light-scattering techniques. We found that the average hydrodynamic diameter of large EVs was associated with femoral neck bone mineral content, lumbar spine BMD, and neoplasms’ molecular subtypes. These results provide evidence that EVs play a role in BCPs’ bone disorders and suggest that the biophysical properties of EVs may serve as potential nutritional biomarkers. Further studies are needed to evaluate EVs’ biophysical properties as potential nutritional biomarkers in a clinical context.

Introducción: Caracterizada por un exceso del tejido adiposo visceral (TAV), la obesidad abdominal incrementa el riesgo del síndrome metabólico. El método más popular para evaluar la obesidad infantil es el índice de masa corporal para la edad (IMC), aunque estudios recientes sugieren la circunferencia de cintura (CC) o el índice cintura-estatura (ICE). Objetivo: Evaluar la eficiencia de indicadores antropométricos para predecir TAV y clasificar sobrepeso más obesidad (SO/OB). Material y Método: Estudio transversal, analítico y comparativo. Se evaluaron 59 niños (47.5% mujeres) de 10.6 ± 2.1 años de edad en escuelas públicas de Hermosillo, Sonora, México; se examinaron variables antropométricas, estimando el IMC e ICE, se determinó el TAV mediante Absorciometría Dual de Rayos X (DEXA); se analizó mediante: regresión lineal múltiple, concordancia con el modelo de Bland y Altman e índice Kappa de Cohen. Resultados: El modelo más eficiente para predecir TAV fue el de la CC (R2=0.90). Los indicadores antropométricos tuvieron buena concordancia entre sí en el diagnóstico de SO/OB (Kappa ≥ 0.6), aunque el análisis de Bland y Altman indicó buena concordancia entre CC-TAV e ICE-TAV. Conclusiones: Los mejores predictores del TAV fueron CC e ICE. Los resultados sugieren que CC e ICE resultan los mejores indicadores para evaluar obesidad abdominal y diagnosticar SO/OB en niños y adolescentes mexicanos.

Age- and obesity-related body composition changes could influence the hydration factor (HF) and, as a result, body composition estimates derived from hydrometry. The aim of the present study was to compare the HF in older Hispanic-American adults to some published values. This cross-sectional study included a sample of 412 subjects, men and women, aged ≥60 years from northern Mexico. HF values were calculated based on the ratio of total body water-using the deuterium dilution technique-to fat-free mass, derived from the four-compartment model. The mean HF value for the total sample (0.748 ± 0.034) was statistically (p ≤ 0.01) higher than the traditionally assumed value of 0.732 derived from chemical analysis, the “grand mean’’ value of 0.725 derived from in vivo methods, and the 0.734 value calculated for older French adults via the three-compartment model. The HF of the older women did not differ across the fat mass index categories, but in men the obese group was lower than the normal and excess fat groups. The hydration factor calculated for the total sample of older Hispanic-American people is higher than the HF values reported in the literature. Therefore, the indiscriminate use of these assumed values could produce inaccurate body composition estimates in older Hispanic-American people.

The objective of this study was to compare current measurements of bone mineral density (BMD) of the lumbar spine (LS), femoral neck (FN), and total femur (TF) regions with initial values recorded 12 years ago in women from Northwest Mexico, and evaluate their correlation with dietary, anthropometric, and reproductive variables. BMD was assessed by Dual-energy X-ray absorptiometry. Participants were grouped as follows: Nulliparous (G1); women who were mothers 12 years ago (G2); and women who were nulliparous 12 years ago, but are now mothers (G3). In all three groups, current LS BMD was higher than initial (p ≤ 0.05) and current TF BMD in G2 was higher than initial values (p ≤ 0.05). When comparing current FN and TF BMD among the three groups, G2 had higher values than G3 (p ≤ 0.05). G2 also showed higher LS BMD than G1 and G3 (p = 0.006). Age at menarche was inversely-correlated with FN and TF BMD in G1 (p < 0.01), while the body mass index (BMI) correlated positively with all three bone regions in G2 (p < 0.05). This study shows that in women without and with children, age at menarche, BMI, and age were factors associated to BMD in healthy subjects in reproductive age.

Breast cancer is the most deadly malignancy in Mexican women. Although treatment has improved, it may significantly affect bone mineral status in those who receive it. The aim of this study was to assess the impact of cancer treatment on bone mineral density (BMD) and bone mineral content (BMC), in patients with breast cancer and explore the interaction of menopausal status and clinical stage with cancer treatment on such changes. A quasi-experimental design was applied with measurements before and after a chemotherapy treatment in 40 patients with primary diagnosis of invasive breast cancer. BMD and body composition measurements were taken by dual X-ray absorptiometry (DXA) and changes in these variables due to therapy were analyzed using mixed regression for repeated measurements. Significant loss was found in femoral neck and L2-L4 BMD (p < 0.001). Patients diagnosed with osteopenia or osteoporosis received calcium + vitamin D supplementation (600 mg/200 IU day). It showed a protective effect in the decrease of femoral neck BMD and total BMC. BMD loss in both femoral neck and L2-L4 BMD was higher in premenopausal women: 0.023 g/cm2 in femoral neck and 0.063 g/cm2 in L2-L4 (p < 0.001), while in postmenopausal women BMD loss was 0.015 g/cm2 in femoral neck and 0.035 g/cm2 in L2-L4 (p = 0.021 and p = 0.001 respectively). Change in lumbar spine BMD was prominent in premenopausal women with advanced clinical stage (IIB, IIIA, IIIB): 0.066 g/cm2 (p = 0.003). The antineoplastic breast cancer treatment with chemotherapy had a negative impact on BMD, in premenopausal women overall, although a differential effect was found according to clinical stage and calcium supplementation status.