RESUMO
Data linking solar radiation with fractures are lacking. We found that lower solar radiation was associated with higher hip fracture admission rates in men from Chile. This supports the idea that solar radiation, a surrogate of vitamin D, may be involved in the development of fractures in older population. INTRODUCTION : To explore the associations between solar radiation and latitude with hip fracture admission rates in people aged 65 years or older in Chile, the country with the greatest variation in solar radiation in the world. METHODS: In this ecological study, we investigated the associations between regional solar radiation and latitude with hospitalizations due to hip fracture in population aged 65 years or older, by reviewing national records between 2013 and 2018. We also evaluated the role of sociodemographic factors such as poverty, education, indigenous ethnicity, and rurality rates. RESULTS: Between 2013 and 2018, there were 44,328 admissions due to hip fracture in people aged 65 years or older; 77.5% were women and 65.1% were aged 80 years or older. The national admission rate was 389.3 per 100,000 inhabitants (95% CI: 382.4-396.2). The highest admission rate was registered in the Region IX (445.3 per 100,000, 95% CI: 398.3-492.4), which has the highest poverty rates, indigenous ethnicity rates, and rurality rates. We found a north-south increasing gradient of admission rates in men (ß=1.5 [95% CI: 0 to 3], p=0.044) and a significant association between solar radiation and admission rates in men (ß=-4.4 [95% CI: -8 to 0.8], p=0.02). Admission rates in men were also associated with sociodemographic variables such as poverty (ß=2.4 [95% CI: 0 to 4.8], p=0.048) and rurality rates (ß=1.2 [95% CI: 0.1 to 2.4], p=0.039). CONCLUSION: Regional solar radiation and latitude were associated with hip fracture admission rates in men aged 65 years or older in Chile, with highest admission rates at higher latitudes and lower solar radiation.
Assuntos
Fraturas do Quadril , Idoso , Chile/epidemiologia , Feminino , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/etiologia , Hospitalização , Humanos , Masculino , Vitamina DRESUMO
A 1.8 ml iron supplementation of ferrous sulfate is administered for 90 days to 76 Mapuche infants, 12 months of age, male and female, from the rural area of the Cautin province of Chile. The iron nutrition is evaluated before and after the supplementation, through: hemoglobin, haematocrit, transferrin saturation and seric ferritin. Stools test are taken at the infant's home, to confirm the supplement intake and to measure the iron excreted. To study the contained of dietary Fe a Recordatory 24 hour Inquest (RI) is applied moreover a Proximal Chemical Analysis (PCHA) to meal test proceeding from the infant's homes. At 12 months before starting the supplementation, the anemia prevalence was of 28.3%, but it disappear as a result of the intervention. Also 65.3% of the infants showed and increase of 1 g or more on their hemoglobin, which indicates that they were anemic at the beginning of the iron supplementation. By means of this therapeutic test it was find 31% more of anemic infants, indicating more sensibility of this method. The high levels of anemia prevalence are due to the low iron intake, characteristic of the non lactious foods, which according results of the RI reaches an average of 2.8 +/- 1.2 mg of Fe/day, versus 4.8 +/- 4.0 mg of Fe/day according to PCHA. The observed difference between both test showed that there is a process of food environmental contamination, by the use of iron utensils and great soil contact. The high environmental contamination could also be proved by the high iron excretion stools (140 mg of Fe/100 g of stools). This method used to measure the Fe excretion of the supplement, would not be valid in rural population groups with similar characteristics to those of the studied group, because it does not discriminate between the intake and the extremely high environmental contamination. To prevent anemia due to iron absence in infants, it is absolutely necessary to have some iron fortified food starting at 6 months of age, as a complement for breast milk.
Assuntos
Ferro da Dieta/uso terapêutico , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/prevenção & controle , Chile , Feminino , Alimentos Fortificados , Humanos , Lactente , Ferro/administração & dosagem , Ferro/metabolismo , Masculino , Prevalência , Sulfatos/administração & dosagemRESUMO
Blood hemoglobin, serum iron, total iron binding capacity (TIBC) and serum ferritin were measured in 140 healthy rural mapuche (southern Chile's indigenous ethnic group) infants aged 8 to 15 months: 90 had been exclusively breast fed for the first 5 or 6 months of life, then solid foods were introduced but cow's milk was never given to them. The remaining 50, which were all weaned at nearly 4 months of age and then given cow's milk and solid foods at the corresponding age, were designated as controls. Anemia was detected in 4.5% of breast fed infants and in 38% of controls. Evidence of iron deficient erythropoiesis was found in 5% and 81% of cases and controls, respectively. Human milk apparently protects this ethnic group from iron deficiency anemia and this protection seems to be better in mapuche infants than in other groups of chilean infants, because these late have shown 30% incidence of anemia around the first year of life in other studies. More studies on differences in iron nutritional state among mapuche and non mapuche are needed and are under way.