Papers by Carmen M . Santos-Hernandez
Monografía. ANTHROPOS, 2007.1er Congreso Iberoamericano de Antropología.https://doi.org/10.1525/an.2007.48.6.37.1.ISBN 959-282-043-0;First published: 24 December 2008 https://doi.org/10.1525/an.2007.48.6.37.1, 2007
ECronicon ECNUTRITION, 2023
It has been difficult to compare the prevalence of bone fractures and some body composition indic... more It has been difficult to compare the prevalence of bone fractures and some body composition indices in various regions of the world because studies differ in their techniques, sample selection criteria, as well as in the definitions used to classify ethnicity and diagnostic criteria.
Geographical, climatic and historical factors have contributed to the patterns of human genetic variation observed in the world today. For example, population processes associated with colonisation, periods of geographical isolation, socially reinforced inbreeding and natural selection. In general, however, the antiquity of our common ancestors and the continuous gene flow between human groups has limited genetic differentiation in our species.
Ethnicity, sex and their influence on body composition have been taken into account by several authors, but there are not enough examples in the literature of this aspect and the manifestations that have characterised it as components to be studied in the pathophysiology of some diseases. But labels such as "Hispanic", "black", "Mexican-American", "white", "Asian", "European" or "African" can have ambiguous or contradictory meanings among researchers, research subjects and the general public. The use of such broad labels without careful definitions can undermine scientific understanding and imply that distinctions between socially defined populations are genetically well-established1,2,3.
When finally feasible and available, individual genetic assessment of relevant genes is likely to be more useful than race in medical decision-making; in the meantime, ethnicity or race may in some cases provide useful information, as may other categories such as sex or age in biomedical contexts 1,2,3,4.
Caucasian women in the United States, for whom there is abundant and detailed information, appear to have an incidence twice as high as that reported in the Hispanic population, which includes immigrants from Mexico, Central and South America in some authors' criteria5,6. In this sense, the great heterogeneity and variation produced by the frequent miscegenation among these populations is recognised.
In the case of men, this situation is more complex due to the scarcity of research using population-based samples and inclusion criteria that rigorously take into account the absence of disease to analyse bone mass and body composition in young populations.
The ethnological analysis of the populations of Cuba, Puerto Rico, Dominican Republic and Venezuela constitutes one of the variables that allow us to establish links between these territories and form the hypothesis of a Spanish Caribbean.
- In all of them we can observe the presence or traces of three ethnic groups that make up the populations of the same countries, although the intensity varies according to how each of them projects or influences the formation of particular ethno-consciousnesses. These are the Aborigines, the Europeans and the Africans. The Cuban, Caribbean and Central American populations are the product of miscegenation between the ancestors of the Spanish colonialists and black African slaves, mainly from the coasts of West Africa and, to a lesser extent, Chinese and native aborigines1. An alternative to the use of racial or ethnic categories in genetic research is to categorise individuals in terms of ancestry. Ancestry can be defined geographically and can recognise a single predominant source or multiple sources. Ancestry can be attributed to an individual by an observer, as was the case with the US census before 1960; it can be identified by an individual from a list of possibilities or with the use of terms drawn from that person's experience; or it can be calculated from genetic data using loci with geographically differing allele frequencies, as described above.
For example, the degree of skin pigmentation in some sub-Saharan African,South Indian and Melanesian populations is similar because of adaptive evolution. But, genetically these populations are quite dissimilar.By contrast, the Ainu of northern Japan are morphologically different (for example, they have less skin pigmentation and more body hair) from other East Asian populations, but are genetically very similar to them.Overall, the degree of differentiation in QUANTITATIVE TRAITS often exceeds that observed for neutral markers, indicating that these traits have been subject to natural selection. Therefore, their distribution does not necessarily reflect the distribution of neutral polymorphisms nor are they good predictors of group membership. Indeed, these characteristics might imply that there is a closer degree of relatedness than exists or vice versa. Inferences of population structure based on polymorphisms that have been subject to natural selection can also be unreliable.
In a study carried out in Cuba between 1998 and 2007, a reduction in bone density was observed in men in the four anatomical locations evaluated from the fourth decade of life onwards: Ward's triangle density (-12.1%), femoral neck (-8.5%), trochanter (-6.9%) and lumbar vertebrae (-2.7%). These bone mass losses in men had an interesting behaviour according to ethnic origin, with a significant decrease for mestizos (p<0.05).The changes in men according to age, highlighting the highly significant decreases according to Anova (p<0.000) in Ward's triangle density (-30%) and in femoral neck density (-20%,) according to height ratios throughout the life cycle. Our men, according to these criteria, have a lower risk of fracture at the anatomical sites assessed than the Rochester population and are slightly above the Canadian men .The Havana man aged 50-59 years has a femoral neck fracture risk of 2.6%, but this rises to 12.1% in the case of Ward's triangle, according to the Hispanic reference of the DEXA Lunar computer programme.
In our research, the genotype of the Vitamin D receptor (VDR) alleles marker present in genetic equilibrium, according to the Hardy-Weinberg principle, and its frequencies do not differ from those reported by others authors.
The allelic frequencies were B=0.361 and b=0.639 and the genotypic frequencies were bb=0.395, Bb=0.488 and BB=0.117. When analysed in relation to differences in bone density according to the type of vitamin D receptor gene in the population under 40 years of age. Eight percent of the 121 genetic studies carried out in the subsample showed polymorphism of the vitamin D receptor gene (BB), showing interesting associations with the decrease in the density of lumbar vertebrae. In this research, a lower density of the vertebra/stature ratio - with a non-significant difference - was observed in young women and men with the homozygous BB gene, - at a time in the life cycle when differences according to age and in the relationship with peak bone mass - are not expected to exist.
It could be considered as an interesting fact from the analysis of this Havana population that the higher frequency of homozygous Havana population, that the highest frequency of polymorphism of the vitamin D receptor gene was observed in those identified with the ancestral classification of europoid (67%) and in a lower proportion in the europoid-negroids (33%)
Best_Practice_Research_Clinical_Rheumatology, 2010
Rev Española Nutr Comunitaria, 2005
En el medio cubano los factores de riesgo que condicionan calidad de vida en la mujer han sido po... more En el medio cubano los factores de riesgo que condicionan calidad de vida en la mujer han sido poco estudiados. Material y métodos: Se presentan resultados del estudio transversal de composición corporal en cuerpos totales y cifras de densidad de masa ósea en cuatro sitios anatómicos de una población habanera de 1074 mujeres sanas entre 20 a 70 años, obtenidos durante los años 1998 al 2002, según origen étnico de acuerdo a criterios del Programa Biológico Internacional. Se establecieron composiciones de masa magra (kg), índice de adiposidad, tejido graso (kg), composición relativa (%) para cuerpos totales y región anatómica y densidades minerales óseas (DMO) vértebras lumbares (L1-L4) vista anteroposterior, cuello de fémur, triángulo de Ward y trocánter por técnica de absorciometría de rayos X de doble haz de fotones de Dexa Lunar. Resultados: Los resultados demuestran tendencia a centralización de adiposidad, incremento del sedentarismo y declinación de masa magra y masa ósea con el ciclo de vida. La frecuencia de obesidad según índice de adiposidad es del 40% en las mujeres entre 50 a 59 años. De acuerdo al predominio del modelo de distribución grasa en tronco y brazos (p<0.00), se discute probabilidad de asociación con riesgo de hipertensión, dislipidemia, diabetes y osteoporosis para nuestra población a partir de 50 años de edad. Conclusiones: Los hábitos de actividad física, la composición de la dieta en momentos críticos y la organización biopsicosocial en que se desarrolla la mujer cubana marcan la expectativa de calidad de vida en su tercera edad.
, epidemic optic and peripheral neuropathy affected more than 50,000 people in Cuba. The number o... more , epidemic optic and peripheral neuropathy affected more than 50,000 people in Cuba. The number of new cases decreased after the initiation of vitamin supplementation in the population. In September 1993, Cuban and U.S. investigators conducted a study to characterize and identify risk factors for the optic form of the syndrome. Methods. We conducted ophthalmologic and neurologic examinations, assessed exposure to potential toxins, administered a semiquantitative food-frequency questionnaire, and assessed serum measures of nutritional status in 123 patients with severe optic neuropathy, matched for sex and age to randomly chosen normal subjects. Results. In the case patients, prominent clinical features were subacute loss of visual acuity with field de-fects, diminished color vision, optic-nerve pallor, and decreased sensitivity to vibration and temperature in the legs. Tobacco use, particularly cigar smoking, was associated with an increased risk of optic neuropathy. The risk was reduced among subjects with higher dietary intakes of methionine, vitamin B 12 , riboflavin, and niacin and higher serum concentrations of antioxidant carotenoids. The risk was also reduced among subjects who raised chickens at home or had relatives living overseas -factors that may be indirect measures of increased food availability. Conclusions. The epidemic of optic and peripheral neuropathy in Cuba between 1991 and 1993 appears to be linked to reduced nutrient intake caused by the country's deteriorating economic situation and the high prevalence of tobacco use. (N Engl J Med 1995;333:1176-82.
Publicación Científica sobre Nutrición Clínica, 2002, Volumen XI numero 4 Págs. 121-132. ISSN 0327-8611, 2002
Abstract.It is presented the result of four hundred and fifty eight (458) menopausal women who fo... more Abstract.It is presented the result of four hundred and fifty eight (458) menopausal women who formed part of an investigation about Bone Mass Cuban Population.It includes a sample of 3000 people of both healthy sexes from 20 to 80 years old, who don’t have metabolic ,renal , thyroid , parathyroid or articular bone system sickness and they haven t taken any esteroids, corticoesteroids, thiazids and anticonceptive oral pills, anticonvulsives or hormonal therapy replacement.
The variables have been analyzed of bone mineral density (g/cm2) for lumbar vertebras (l1-l4) , the femoral neck, ward triangle and the whole body according to the technique for Dexa Lunar, ( dual-energy X-ray absorptiometry),taking into consideration t and z score , comparing them with the reference literature and the World Health Organization criteria.
We have discussed the behaviour of this subpopulation, the subdivision according to amenorrhea’s time (< 5 years and > 5 years) and of the ethnic origin , comparing the figures of distribution and the multivaried analysis with the characteristics of some nutritional variables : the calcium consumption on the puberty and on the previous week of the study and sedentarism’s time (time sitting down).
The femoral neck score t shows significative declination for p< 0.01 in the European women ,when they were compared with afro-cuban and mestize from 49 years old.The whole bodies showed similar declination tied to the ethnic group from 46 years on.When we analyze amenorrhea’s time influence, femoral neck’s score t has a declination p < 0.01 (high signification) for the women with more than 5 years .It keeps also significative correlation with sedentarism’s time p< 0.05.The behaviour of cuban women density is similar to the population of reference ; the femoral neck according to the ethnic procedence ,keeps higher figures than population mentioned by Luckey.
Vertebral/height2 density coefficient decreased when they were compared with the Cuban woman's bone mass peak density, with mean changing percent of –2.82% in the 1 to 5 years amenorrhea’s time group, while climateric woman with amenorrhea’s time greater than five years had -7.05% lost of bone density , with significatives differences according to ethnical procedence.The highest lost of density was for europoides(-10.6%), when the amenorrhea’s time was greater than 5 years.
Key words:Bone mineral density(BMD); Dual-energy X-ray absorptiometry (DXA); femoral neck; lumbar spine,ethnical procedence, amenorrhea’s time,calcium consumption, vertebral/height 2 density coefficient..
Publicación Científica sobre Nutrición Clínica, 2002, Volumen XI numero 4 Págs. 121-132. ISSN 0327-8611, 2002
Abstract.It is presented the result of four hundred and fifty eight (458) menopausal women who fo... more Abstract.It is presented the result of four hundred and fifty eight (458) menopausal women who formed part of an investigation about Bone Mass Cuban Population.It includes a sample of 3000 people of both healthy sexes from 20 to 80 years old, who don’t have metabolic ,renal , thyroid , parathyroid or articular bone system sickness and they haven t taken any esteroids, corticoesteroids, thiazids and anticonceptive oral pills, anticonvulsives or hormonal therapy replacement.
The variables have been analyzed of bone mineral density (g/cm2) for lumbar vertebras (l1-l4) , the femoral neck, ward triangle and the whole body according to the technique for Dexa Lunar, ( dual-energy X-ray absorptiometry),taking into consideration t and z score , comparing them with the reference literature and the World Health Organization criteria.
We have discussed the behaviour of this subpopulation, the subdivision according to amenorrhea’s time (< 5 years and > 5 years) and of the ethnic origin , comparing the figures of distribution and the multivaried analysis with the characteristics of some nutritional variables : the calcium consumption on the puberty and on the previous week of the study and sedentarism’s time (time sitting down).
The femoral neck score t shows significative declination for p< 0.01 in the European women ,when they were compared with afro-cuban and mestize from 49 years old.The whole bodies showed similar declination tied to the ethnic group from 46 years on.When we analyze amenorrhea’s time influence, femoral neck’s score t has a declination p < 0.01 (high signification) for the women with more than 5 years .It keeps also significative correlation with sedentarism’s time p< 0.05.The behaviour of cuban women density is similar to the population of reference ; the femoral neck according to the ethnic procedence ,keeps higher figures than population mentioned by Luckey.
Vertebral/height2 density coefficient decreased when they were compared with the Cuban woman's bone mass peak density, with mean changing percent of –2.82% in the 1 to 5 years amenorrhea’s time group, while climateric woman with amenorrhea’s time greater than five years had -7.05% lost of bone density , with significatives differences according to ethnical procedence.The highest lost of density was for europoides(-10.6%), when the amenorrhea’s time was greater than 5 years.
Key words:Dual-energy X-ray absorptiometry (DXA); femoral neck; lumbar spine,ethnical procedence, amenorrhea’s time,calcium consumption, vertebral/height 2 density coefficient
Publicación Científica sobre Nutrición Clínica, 2002, Volumen XI numero 4 Págs. 121-132. ISSN 0327-8611
RCAN Rev Cubana Aliment Nutr, 2020
Justificación: El status antropométrico del paciente atendido por trauma raquimedular (TRM)puede ... more Justificación: El status antropométrico del paciente atendido por trauma raquimedular (TRM)puede estar deteriorado en grado variable en el momento del inicio del programa de restauración neurológica (PRN). Se espera entonces que el PRN mejore la masa magra corporal del enfermo, y
con ello, la autonomía y el validismo del mismo. Objetivo: Determinar el impacto del PRN sobre el status antropométrico de los pacientes atendidos por TRM. Locación del estudio: Centro Internacional de Restauración Neurológica (CIREN) de La Habana Cuba). Serie de estudio: Treinta pacientes (Hombres: 80.0 %; Edad promedio: 29.3 ± 9.1 años) atendidos en el CIREN por TRM (Nivel de la lesión neurológica: T2 – T6: 50.0 %; T7 – T12: 40.0 %; L1 – L2: 10.0 %; Tiempo de evolución de la lesión neuromotora: Hasta 3 años: 46.7 %; Entre 3 años 1 día – 6 años: 33.3 %; Más de 6 años 1 día: 20.0 %; Escala ASIA: Grado A: Daño medular completo: 66.7 %; Grado B: Solo daño motor: 20.0 %; y Grado C: Daño motor incompleto pero sin capacidad de movimiento activo: 13.3 %; Escala de Barthel: Independientes: 6.7 %; Levemente dependientes: 60.0 %;
Moderadamente dependientes: 16.7 %; y Dependientes de forma importante: 16.7 %), y que completaron 8 semanas de un PRN entre Enero del 2018 – Diciembre del 2018 (ambos inclusive).
Métodos: Se obtuvieron los valores corrientes de la talla (cm), el peso corporal (kg), la circunferencia del brazo (CB, cm), y el pliegue cutáneo tricipital (PCT, cm). El Índice de Masa Corporal (IMC, kg.m-2) y la circunferencia muscular del brazo (CMB, cm) se calcularon correspondientemente. Se evaluó el cambio ocurrido en las variables antropométricas a la conclusión del PRN. Resultados: Los valores promedio de las variables antropométricas fueron como sigue: Al inicio del PRN: IMC: 24.0 ± 4.8 kg.m-2; CB: 32.4 ± 8.6 cm; PCT: 1.4 ± 0.6 cm;
CMB: 27.7 ± 3.9 cm; A la conclusión del PRN: IMC: 23.3 ± 4.8 kg.m-2 ( = +0.7; p > 0.05); CB: 34.8 ± 9.5 cm ( = -2.4; p < 0.05); PCT: 1.3 ± 0.5 cm ( = -0.1; p > 0.05); CMB: 30.1 ± 4.8 cm ( = -2.4; p < 0.05); respectivamente. El PRN también trajo consigo mejorías (si bien no significativas) en las escalas de ASIA (Grado A: 17; = +3; Grado B: 9; = -3; Grado C: 4; = 0; p > 0.05) y Barthel (Independientes: 2; = 0; Levemente dependientes: 21; = -3; Moderadamente dependientes: 6; = -1; Dependientes de forma importante: 1; = +4; p > 0.05). Conclusiones: La conducción de un PRN resulta en un aumento de la masa magra corporal del sujeto. Es probable que este cambio positivo en la masa magra se traslade a la recuperación del daño medular y la mejoría de la autosuficiencia del enfermo. Zamora Pérez F, González Martínez CS, Hernández González E, Díaz de la Fe A, García Lujardo Y, Santos Hernández C. Impacto de un programa de
restauración neurológica sobre el status antropométrico del paciente con trauma raquimedular dorsolumbar. RCAN Rev Cubana Aliment Nutr 2020;30(2):339-351. RNPS: 2221. ISSN: 1561-2929.
Revista Habanera de Ciencias Médicas, 2022
Este es un artículo de Acceso Abierto distribuído según los términos de la Licencia Creative Comm... more Este es un artículo de Acceso Abierto distribuído según los términos de la Licencia Creative Commons Atribución-No Comercial 4.0 que permite el uso, distribución y reproducción no comerciales y sin restricciones en cualquier medio, siempre que sea debidamente citada la fuente primaria de publicación.
Revista Española de Nutrición Comunitaria, 2010
Relative risk of osteoporosis according to bone mineral density in healthy menopausal women from ... more Relative risk of osteoporosis according to bone mineral density in healthy menopausal women from the western region of Cuba
Abstract
Introduction. The highest specificity in the measurement of the magnitude of relative risk of osteoporosis and bone fracture among women is obtained when autochthonous ranges of bone mineral density (BMD), obtained from a normal population, are taken as reference values. These ranges are not sufficiently well established in Latin America. Objectives: To characterize changes in bone mass according to absorptiometry measurements and the relative risk of osteoporosis in a selected female population (healthy, working women aged more than 49 years old) using BMD risk margins in an autochthonous population as reference values.
Materials and methods: We performed a cross-sectional survey in the western region of Cuba in 307 healthy women, aged 50 to 59 years old, from 1998 to 2007. BMD was measured with a dual-energy X-ray absorptiometry densitometer (DEXA Lunar) in the lumbar spine (anterior-posterior), femoral neck, Ward triangle, trochanter and whole body. Bone density (g/cm2) was obtained and was also expressed as a quotient according to height for each skeletal site (g/m). The percent decrease in bone mass and the frequency of women at relative risk of fracture were calculated. Distributions in percentiles were determined and means and standard deviation were calculated according to ethnic origin. Differences in BMD according to length of amenorrhea, ethnic origin, quotients according to height, and results taking the World Health Organization criteria as reference (safety margins ≤1 standard deviation and risk ≤ 2.5 standard deviation) were evaluated in a young Cuban population and in other reference populations by means of analysis of variance (ANOVA) and Student’s t test for independent samples. Data were processed by SPSS, version 11.5 for Windows.
Results: In the average woman with less than 5 years of amenorrhea, the femur / height quotient, showed a decrease of 7.7% when compared with peak bone mass in the young population. The frequency of women at risk of fracture increased for fractures of the lumbar spine and femoral neck when the Cuban population was used as reference. According to the risk margin (g/cm2), in the population aged between 50 and 59 years, not differentiated by ethnic origin, the relative risk of fracture of the femoral neck was 4.4 %, that for fracture of the lumbar vertebra was 8.1% and that for whole-body fracture was 7.7%. When the Cuban reference was applied for whole body fracture, the presence of risks was similar to the DEXA Lunar criteria.
Conclusions: The prevalence of risk of osteoporosis and decline in bone mass were determined in the study group. Our results provide further evidence of the highest specificity in skeletal sites when measurements are adjusted by height, using the criteria of risk margins in the autochthonous population as a reference.
© 2010 SENC. Published by Elsevier España, S.L. All rights reserved.
Revista Cubana De Salud Publica, Jun 1, 2013
Objetivo: caracterizar el nivel de los conocimientos, habilidades y valores salubristas en docent... more Objetivo: caracterizar el nivel de los conocimientos, habilidades y valores salubristas en docentes del Premédico de la Escuela Latinoamericana de Medicina. Conclusiones: los limitados conocimientos y habilidades salubristas en el plan de estudio del curso Premédico y en los docentes, justifica replantearse estrategias para el perfeccionamiento en esta fase del proceso docente del futuro médico.
Estudio de la recuperación nutricional“. Rev. Cub Ped 52: 17-26, 1980
Revista cubana de pediatría
La insuficiencia renal crónica (IRC) consiste en la pérdida lenta y progresiva, casi siempre irre... more La insuficiencia renal crónica (IRC) consiste en la pérdida lenta y progresiva, casi siempre irreversible, de las funciones
Encuesta de egresados de hogares de recuperación nutricional Rev. Cub Pediatría 43, pp. 391-410, 1977
Revista cubana de pediatría
Caracterización de la masa ósea en una población de jóvenes cubanos. 1998-1999
Revista Cubana De Reumatologia Rcur, Dec 30, 1999
La mujer habanera. Análisis sobre la composición corporal y cambios según factores de riesgo
Revista Espanola De Nutricion Comunitaria Spanish Journal of Community Nutrition, 2005
Correspondencia: Escuela Latinoamericana de Medicina, carretera Panamericana km 3 1/2 Santa Fe, P... more Correspondencia: Escuela Latinoamericana de Medicina, carretera Panamericana km 3 1/2 Santa Fe, Playa, Ciudad de La Habana, Cuba E-mail: carmen.santos@infomed.sld.cu csantos@elacm.sld.cu ... Introducción: En el medio cubano los factores de riesgo que ...
Panorama Cuba Y Salud, Jul 3, 2006
Objetivo: Analizar la magnitud del riesgo de osteoporosis en una población femenina. Métodos: Se ... more Objetivo: Analizar la magnitud del riesgo de osteoporosis en una población femenina. Métodos: Se presentan los resultados de un estudio realizado en 1074 mujeres sanas, habaneras, de 20 a 70 años de edad durante los años 1998-2004, mediante la densitometría de haz de Rayos X de doble haz de fotones por un equipo DEXA Lunar. Los sitios anatómicos estudiados fueron: vértebras lumbares (antero-posterior), cuello de fémur, triángulo de Ward, trocánter y cuerpo total. Se realiza análisis comparativo de la densidad ósea (gm/cm 2) y declinación (%), según edades, origen étnico y cocientes relativos según estatura del día de medición, así como las diferencias con algunas poblaciones de referencia. Se evalúa la frecuencia de riesgo de fractura según los criterios de la OMS y la población femenina joven cubana, presentándose sus límites de distribución y normalidad para las medias y desviación estándar, en conjunto y subdivididas según origen étnico. Los datos fueron procesados por el Sistema SPSS en versión 11.5 para Windows. Resultados: La frecuencia de riesgo de fractura de cuello de fémur es de 3,8 % en la mujer con más de 5 años de amenorrea entre 50 y 59 años de edad, según la referencia hispana del software. La magnitud de riesgo de fractura, según la cantidad de casos por debajo de más de-2,5 desviaciones del promedio para los respectivos sitios anatómicos, se incrementa solamente para la vértebra lumbar (4,5%) y el triángulo de Ward (7,4%) para el grupo de mujeres sin diferenciarlas por origen étnico. Conclusiones: Se destaca el triángulo de Ward como sitio anatómico con mayor nivel de declinación desde la cuarta década de la vida.
Composición corporal y masa ósea criterios de referencia para diagnóstico biofísico de desnutrición, obesidad, y osteoporosis población adulta
Composición corporal y masa ósea criterios de referencia para diagnóstico biofísico de desnutrición, obesidad, y osteoporosis población adulta
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Papers by Carmen M . Santos-Hernandez
Geographical, climatic and historical factors have contributed to the patterns of human genetic variation observed in the world today. For example, population processes associated with colonisation, periods of geographical isolation, socially reinforced inbreeding and natural selection. In general, however, the antiquity of our common ancestors and the continuous gene flow between human groups has limited genetic differentiation in our species.
Ethnicity, sex and their influence on body composition have been taken into account by several authors, but there are not enough examples in the literature of this aspect and the manifestations that have characterised it as components to be studied in the pathophysiology of some diseases. But labels such as "Hispanic", "black", "Mexican-American", "white", "Asian", "European" or "African" can have ambiguous or contradictory meanings among researchers, research subjects and the general public. The use of such broad labels without careful definitions can undermine scientific understanding and imply that distinctions between socially defined populations are genetically well-established1,2,3.
When finally feasible and available, individual genetic assessment of relevant genes is likely to be more useful than race in medical decision-making; in the meantime, ethnicity or race may in some cases provide useful information, as may other categories such as sex or age in biomedical contexts 1,2,3,4.
Caucasian women in the United States, for whom there is abundant and detailed information, appear to have an incidence twice as high as that reported in the Hispanic population, which includes immigrants from Mexico, Central and South America in some authors' criteria5,6. In this sense, the great heterogeneity and variation produced by the frequent miscegenation among these populations is recognised.
In the case of men, this situation is more complex due to the scarcity of research using population-based samples and inclusion criteria that rigorously take into account the absence of disease to analyse bone mass and body composition in young populations.
The ethnological analysis of the populations of Cuba, Puerto Rico, Dominican Republic and Venezuela constitutes one of the variables that allow us to establish links between these territories and form the hypothesis of a Spanish Caribbean.
- In all of them we can observe the presence or traces of three ethnic groups that make up the populations of the same countries, although the intensity varies according to how each of them projects or influences the formation of particular ethno-consciousnesses. These are the Aborigines, the Europeans and the Africans. The Cuban, Caribbean and Central American populations are the product of miscegenation between the ancestors of the Spanish colonialists and black African slaves, mainly from the coasts of West Africa and, to a lesser extent, Chinese and native aborigines1. An alternative to the use of racial or ethnic categories in genetic research is to categorise individuals in terms of ancestry. Ancestry can be defined geographically and can recognise a single predominant source or multiple sources. Ancestry can be attributed to an individual by an observer, as was the case with the US census before 1960; it can be identified by an individual from a list of possibilities or with the use of terms drawn from that person's experience; or it can be calculated from genetic data using loci with geographically differing allele frequencies, as described above.
For example, the degree of skin pigmentation in some sub-Saharan African,South Indian and Melanesian populations is similar because of adaptive evolution. But, genetically these populations are quite dissimilar.By contrast, the Ainu of northern Japan are morphologically different (for example, they have less skin pigmentation and more body hair) from other East Asian populations, but are genetically very similar to them.Overall, the degree of differentiation in QUANTITATIVE TRAITS often exceeds that observed for neutral markers, indicating that these traits have been subject to natural selection. Therefore, their distribution does not necessarily reflect the distribution of neutral polymorphisms nor are they good predictors of group membership. Indeed, these characteristics might imply that there is a closer degree of relatedness than exists or vice versa. Inferences of population structure based on polymorphisms that have been subject to natural selection can also be unreliable.
In a study carried out in Cuba between 1998 and 2007, a reduction in bone density was observed in men in the four anatomical locations evaluated from the fourth decade of life onwards: Ward's triangle density (-12.1%), femoral neck (-8.5%), trochanter (-6.9%) and lumbar vertebrae (-2.7%). These bone mass losses in men had an interesting behaviour according to ethnic origin, with a significant decrease for mestizos (p<0.05).The changes in men according to age, highlighting the highly significant decreases according to Anova (p<0.000) in Ward's triangle density (-30%) and in femoral neck density (-20%,) according to height ratios throughout the life cycle. Our men, according to these criteria, have a lower risk of fracture at the anatomical sites assessed than the Rochester population and are slightly above the Canadian men .The Havana man aged 50-59 years has a femoral neck fracture risk of 2.6%, but this rises to 12.1% in the case of Ward's triangle, according to the Hispanic reference of the DEXA Lunar computer programme.
In our research, the genotype of the Vitamin D receptor (VDR) alleles marker present in genetic equilibrium, according to the Hardy-Weinberg principle, and its frequencies do not differ from those reported by others authors.
The allelic frequencies were B=0.361 and b=0.639 and the genotypic frequencies were bb=0.395, Bb=0.488 and BB=0.117. When analysed in relation to differences in bone density according to the type of vitamin D receptor gene in the population under 40 years of age. Eight percent of the 121 genetic studies carried out in the subsample showed polymorphism of the vitamin D receptor gene (BB), showing interesting associations with the decrease in the density of lumbar vertebrae. In this research, a lower density of the vertebra/stature ratio - with a non-significant difference - was observed in young women and men with the homozygous BB gene, - at a time in the life cycle when differences according to age and in the relationship with peak bone mass - are not expected to exist.
It could be considered as an interesting fact from the analysis of this Havana population that the higher frequency of homozygous Havana population, that the highest frequency of polymorphism of the vitamin D receptor gene was observed in those identified with the ancestral classification of europoid (67%) and in a lower proportion in the europoid-negroids (33%)
The variables have been analyzed of bone mineral density (g/cm2) for lumbar vertebras (l1-l4) , the femoral neck, ward triangle and the whole body according to the technique for Dexa Lunar, ( dual-energy X-ray absorptiometry),taking into consideration t and z score , comparing them with the reference literature and the World Health Organization criteria.
We have discussed the behaviour of this subpopulation, the subdivision according to amenorrhea’s time (< 5 years and > 5 years) and of the ethnic origin , comparing the figures of distribution and the multivaried analysis with the characteristics of some nutritional variables : the calcium consumption on the puberty and on the previous week of the study and sedentarism’s time (time sitting down).
The femoral neck score t shows significative declination for p< 0.01 in the European women ,when they were compared with afro-cuban and mestize from 49 years old.The whole bodies showed similar declination tied to the ethnic group from 46 years on.When we analyze amenorrhea’s time influence, femoral neck’s score t has a declination p < 0.01 (high signification) for the women with more than 5 years .It keeps also significative correlation with sedentarism’s time p< 0.05.The behaviour of cuban women density is similar to the population of reference ; the femoral neck according to the ethnic procedence ,keeps higher figures than population mentioned by Luckey.
Vertebral/height2 density coefficient decreased when they were compared with the Cuban woman's bone mass peak density, with mean changing percent of –2.82% in the 1 to 5 years amenorrhea’s time group, while climateric woman with amenorrhea’s time greater than five years had -7.05% lost of bone density , with significatives differences according to ethnical procedence.The highest lost of density was for europoides(-10.6%), when the amenorrhea’s time was greater than 5 years.
Key words:Bone mineral density(BMD); Dual-energy X-ray absorptiometry (DXA); femoral neck; lumbar spine,ethnical procedence, amenorrhea’s time,calcium consumption, vertebral/height 2 density coefficient..
The variables have been analyzed of bone mineral density (g/cm2) for lumbar vertebras (l1-l4) , the femoral neck, ward triangle and the whole body according to the technique for Dexa Lunar, ( dual-energy X-ray absorptiometry),taking into consideration t and z score , comparing them with the reference literature and the World Health Organization criteria.
We have discussed the behaviour of this subpopulation, the subdivision according to amenorrhea’s time (< 5 years and > 5 years) and of the ethnic origin , comparing the figures of distribution and the multivaried analysis with the characteristics of some nutritional variables : the calcium consumption on the puberty and on the previous week of the study and sedentarism’s time (time sitting down).
The femoral neck score t shows significative declination for p< 0.01 in the European women ,when they were compared with afro-cuban and mestize from 49 years old.The whole bodies showed similar declination tied to the ethnic group from 46 years on.When we analyze amenorrhea’s time influence, femoral neck’s score t has a declination p < 0.01 (high signification) for the women with more than 5 years .It keeps also significative correlation with sedentarism’s time p< 0.05.The behaviour of cuban women density is similar to the population of reference ; the femoral neck according to the ethnic procedence ,keeps higher figures than population mentioned by Luckey.
Vertebral/height2 density coefficient decreased when they were compared with the Cuban woman's bone mass peak density, with mean changing percent of –2.82% in the 1 to 5 years amenorrhea’s time group, while climateric woman with amenorrhea’s time greater than five years had -7.05% lost of bone density , with significatives differences according to ethnical procedence.The highest lost of density was for europoides(-10.6%), when the amenorrhea’s time was greater than 5 years.
Key words:Dual-energy X-ray absorptiometry (DXA); femoral neck; lumbar spine,ethnical procedence, amenorrhea’s time,calcium consumption, vertebral/height 2 density coefficient
Publicación Científica sobre Nutrición Clínica, 2002, Volumen XI numero 4 Págs. 121-132. ISSN 0327-8611
con ello, la autonomía y el validismo del mismo. Objetivo: Determinar el impacto del PRN sobre el status antropométrico de los pacientes atendidos por TRM. Locación del estudio: Centro Internacional de Restauración Neurológica (CIREN) de La Habana Cuba). Serie de estudio: Treinta pacientes (Hombres: 80.0 %; Edad promedio: 29.3 ± 9.1 años) atendidos en el CIREN por TRM (Nivel de la lesión neurológica: T2 – T6: 50.0 %; T7 – T12: 40.0 %; L1 – L2: 10.0 %; Tiempo de evolución de la lesión neuromotora: Hasta 3 años: 46.7 %; Entre 3 años 1 día – 6 años: 33.3 %; Más de 6 años 1 día: 20.0 %; Escala ASIA: Grado A: Daño medular completo: 66.7 %; Grado B: Solo daño motor: 20.0 %; y Grado C: Daño motor incompleto pero sin capacidad de movimiento activo: 13.3 %; Escala de Barthel: Independientes: 6.7 %; Levemente dependientes: 60.0 %;
Moderadamente dependientes: 16.7 %; y Dependientes de forma importante: 16.7 %), y que completaron 8 semanas de un PRN entre Enero del 2018 – Diciembre del 2018 (ambos inclusive).
Métodos: Se obtuvieron los valores corrientes de la talla (cm), el peso corporal (kg), la circunferencia del brazo (CB, cm), y el pliegue cutáneo tricipital (PCT, cm). El Índice de Masa Corporal (IMC, kg.m-2) y la circunferencia muscular del brazo (CMB, cm) se calcularon correspondientemente. Se evaluó el cambio ocurrido en las variables antropométricas a la conclusión del PRN. Resultados: Los valores promedio de las variables antropométricas fueron como sigue: Al inicio del PRN: IMC: 24.0 ± 4.8 kg.m-2; CB: 32.4 ± 8.6 cm; PCT: 1.4 ± 0.6 cm;
CMB: 27.7 ± 3.9 cm; A la conclusión del PRN: IMC: 23.3 ± 4.8 kg.m-2 ( = +0.7; p > 0.05); CB: 34.8 ± 9.5 cm ( = -2.4; p < 0.05); PCT: 1.3 ± 0.5 cm ( = -0.1; p > 0.05); CMB: 30.1 ± 4.8 cm ( = -2.4; p < 0.05); respectivamente. El PRN también trajo consigo mejorías (si bien no significativas) en las escalas de ASIA (Grado A: 17; = +3; Grado B: 9; = -3; Grado C: 4; = 0; p > 0.05) y Barthel (Independientes: 2; = 0; Levemente dependientes: 21; = -3; Moderadamente dependientes: 6; = -1; Dependientes de forma importante: 1; = +4; p > 0.05). Conclusiones: La conducción de un PRN resulta en un aumento de la masa magra corporal del sujeto. Es probable que este cambio positivo en la masa magra se traslade a la recuperación del daño medular y la mejoría de la autosuficiencia del enfermo. Zamora Pérez F, González Martínez CS, Hernández González E, Díaz de la Fe A, García Lujardo Y, Santos Hernández C. Impacto de un programa de
restauración neurológica sobre el status antropométrico del paciente con trauma raquimedular dorsolumbar. RCAN Rev Cubana Aliment Nutr 2020;30(2):339-351. RNPS: 2221. ISSN: 1561-2929.
Abstract
Introduction. The highest specificity in the measurement of the magnitude of relative risk of osteoporosis and bone fracture among women is obtained when autochthonous ranges of bone mineral density (BMD), obtained from a normal population, are taken as reference values. These ranges are not sufficiently well established in Latin America. Objectives: To characterize changes in bone mass according to absorptiometry measurements and the relative risk of osteoporosis in a selected female population (healthy, working women aged more than 49 years old) using BMD risk margins in an autochthonous population as reference values.
Materials and methods: We performed a cross-sectional survey in the western region of Cuba in 307 healthy women, aged 50 to 59 years old, from 1998 to 2007. BMD was measured with a dual-energy X-ray absorptiometry densitometer (DEXA Lunar) in the lumbar spine (anterior-posterior), femoral neck, Ward triangle, trochanter and whole body. Bone density (g/cm2) was obtained and was also expressed as a quotient according to height for each skeletal site (g/m). The percent decrease in bone mass and the frequency of women at relative risk of fracture were calculated. Distributions in percentiles were determined and means and standard deviation were calculated according to ethnic origin. Differences in BMD according to length of amenorrhea, ethnic origin, quotients according to height, and results taking the World Health Organization criteria as reference (safety margins ≤1 standard deviation and risk ≤ 2.5 standard deviation) were evaluated in a young Cuban population and in other reference populations by means of analysis of variance (ANOVA) and Student’s t test for independent samples. Data were processed by SPSS, version 11.5 for Windows.
Results: In the average woman with less than 5 years of amenorrhea, the femur / height quotient, showed a decrease of 7.7% when compared with peak bone mass in the young population. The frequency of women at risk of fracture increased for fractures of the lumbar spine and femoral neck when the Cuban population was used as reference. According to the risk margin (g/cm2), in the population aged between 50 and 59 years, not differentiated by ethnic origin, the relative risk of fracture of the femoral neck was 4.4 %, that for fracture of the lumbar vertebra was 8.1% and that for whole-body fracture was 7.7%. When the Cuban reference was applied for whole body fracture, the presence of risks was similar to the DEXA Lunar criteria.
Conclusions: The prevalence of risk of osteoporosis and decline in bone mass were determined in the study group. Our results provide further evidence of the highest specificity in skeletal sites when measurements are adjusted by height, using the criteria of risk margins in the autochthonous population as a reference.
© 2010 SENC. Published by Elsevier España, S.L. All rights reserved.