The effect of femoral bone mineral density (BMD) and several parameters of femoral neck geometry (hip axis length, neck-shaft angle and mean femoral neck width) on hip fracture risk in a Spanish population was assessed in a cross-sectional study. All parameters were determined by dual-energy X-ray absorptiometry. There were 411 patients (116 men, 295 women; aged 60-90 years) with hip fractures in whom measurements were taken in the contralateral hip. Controls were 545 persons (235 men, 310 women; aged 60-90 years) who participated in a previous study on BMD in a healthy Spanish population. Femoral neck BMD was significantly lower, and neck-shaft angle and mean femoral neck width significantly higher, in fracture cases than in controls. The logistic regression analysis adjusted by age, height and weight showed that a decrease of 1 standard deviation (SD) in femoral neck BMD was associated with an odds ratio of hip fracture of 4.52 [95% confidence interval (CI) 2.93 to 6.96] in men and 4.45 (95% CI 3.11 to 6.36) in women; an increase of 1 SD in neck-shaft angle of 2.45 (95% CI 1.73 to 3.45) in men and 3.48 (95% CI 2.61 to 4.65) in women; and an increase of 1 SD in mean femoral neck width of 2.15 (95% CI 1.55 to 2.98) in men and 2.40 (95% CI 1.79 to 3.22) in women. The use of a combination of femoral BMD and geometric parameters of the femoral neck except for hip axis length may improve hip fracture risk prediction allowing a better therapeutic strategy for hip fracture prevention.

A community-based study of explanatory factors for the excess risk for early renal function decline in blacks vs whites with diabetes: the Atherosclerosis Risk in Communities study.

BackgroundFamily history of type 2 diabetes mellitus (T2DM) is one of risk factors for that in future a subject can develop diabetes. Insulin resistance (IR) is important in the pathogenesis of T2DM. There is evidence that oxidative stress plays an important role in the etiology and/or progression of diabetes. Myeloperoxidase (MPO) participates in developing of inflammation. The objective was to investigate if MPO is associated with IR and inflammation in individuals with first-degree relatives of T2DM.MethodsCross-sectional study in 84 overweight individuals with family history of T2DM divided in two groups according to IR, group with IR (homeostasis model assessment [HOMA] ≥2.5; n=43) and control group (CG; HOMA <2.5; n=41). Complete clinical history and a venous blood sample were collected for measuring glucose and lipids profile, insulin, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), MPO, glutathione reductase (GRd), glutathione peroxidase, and superoxide dismutase.ResultsMPO, TNF-α, and IL-6 were higher in patients with IR than in CG (MPO: 308.35 [190.85 to 445.42] vs. 177.35 [104.50 to 279.85], P=0.0001; TNF-α: 13.46 [10.58 to 18.88] vs. 9.39 [7.53 to 11.25], P=0.0001; IL-6: 32.93 [24.93 to 38.27] vs. 15.60 [12.93 to 26.27]; P=0.0001, respectively). MPO was associated with IR (rho de Spearman=0.362, P=0.001). In the analysis of lineal regression, MPO predicts IR (β, 0.263; t, 2.520; P=0.014). In the univariate analysis, MPO had an odds ratio of 9.880 for risk of IR (95% confidence interval, 2.647 to 36.879).ConclusionMPO had relation with IR and inflammation parameters in overweight subjects with first-degree relatives of T2DM. We need studies on a casual relationship and molecular mechanisms among the increased serum MPO levels, inflammation markers, and IR.

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Objetivo: identificar la relación entre obesidad y depresión infantil en escolares de 8 a 12 años de edad de la unidad de medicina familiar (umf) no. 80, Instituto Mexicano del Seguro Social (imss), Morelia, Michoacán. Métodos: estudio prospectivo, transversal y observacional, se estudiaron 165 niños, de ambos sexos, con obesidad y peso normal a los cuales se les aplicó la Children’s Depression Scale (cds). Las diferencias en las medias se analizaron con la prueba t de Student para muestras independientes; χ2 y regresión logística se utilizaron para establecer asociación y riesgo, respectivamente. Resultados: de los 165 niños, 78 (47.3%) eran obesos y 87 (52.7%) no obesos; 91 (55.2%) niñas y 74 (44.8%) niños; del total, 34 (20.6%) tuvieron depresión; de estos últimos 22 (64.7%) eran obesos y 12 (35.3%) no obesos; 25 (70.5%) eran mujeres y nueve (26.5.4%) hombres. La obesidad materna se asoció con la obesidad infantil (χ2=11.733, p&lt;0.0001); los problemas sociales (ps) (χ2=5.100, p=0.019; or=2.380, ic 95% 1.108-5.112, p=0.026) y una autoestima (ae) baja (χ2=4.329, p=0.029; or=2.236, ic 95% 1.037-4.823, p=0.040), evaluados con las subescalas del cds, se asocian y confieren riesgo de depresión infantil. Conclusiones: la obesidad infantil se asocia con el desarrollo de depresión en la población infantil y el cds es un instrumento útil para identificarla. Se requiere la implementación de programas especiales o reforzar los existentes para prevenirla y controlarla.

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