Risk factors for metabolic syndrome among overweight and obese Hispanic children attending a pediatric clinic in New Braunfels, Texas

Childhood obesity is a persistent problem in the U.S., especially among Hispanics. Health complications like hypertension, type II diabetes, and metabolic syndrome (Met-S) are being seen at younger ages, and current screening procedures may be inadequate. This study sought to describe the risk factors for Met-S present in a sample of 106 overweight and obese Hispanic children, aged 5-14 years, participating in Nutrition and Exercise Start Today (NEST), a randomized weight management intervention trial at a rural health clinic in New Braunfels, Texas; and to determine associations between these factors and other clinical and socio-demographic characteristics linked to obesity. Baseline data was analyzed for the prevalence of large waist circumference (WC), elevated blood pressure (BP), high fasting serum glucose and serum triglycerides (TG), and low serum HDL cholesterol, in relationship with selected sample characteristics. Main findings included high baseline prevalence rates of large WC (77%), reduced HDL (57%), and elevated BP (30%). WC was significantly associated with BMI percentile and the serum liver function test alanine aminotransferase (ALT) by Fisher's exact test (p<0.001 and p=0.032, respectively), while there were significant relationships between HDL and both female gender and ALT. BMI percentile and ALT were associated with all sets of Met-S diagnostic criteria examined. BMI percentile also had a strong association (p=0.005) with total number of Met-S risk factors, while ALT had a weaker association (p=0.093). WC is a low-cost, simple measure whose use may improve clinic surveillance for childhood obesity and complications like Met-S. WC, BP, HDL and ALT may be used as part of targeted screening for obesity complications like Met-S, particularly in situations where resources are limited.^

The association of nonfatal occupational injuries with non -work -related morbidity

A case-referent study of occupational injuries sustained by 474 workers employed in the heavy equipment machinery industry over a two year period, 1985-1986, was undertaken to examine the association of occupational injuries with non-work-related morbidity. Its specific aim was to evaluate whether employees who experienced a work-related injury had an increased prevalence of non-work-related morbidity, specifically for injuries, cardiovascular disease, mental disorders, all other disease outcomes and total morbidity, compared to employees who did not experience a work-related injury. In order to determine the direction of the relationship, the use of the previous calendar year was employed to assess non-work-related morbidity. A secondary objective of the study was the evaluation of the utility of two existing data sources, workers' compensation and group health insurance claims, and the feasibility of conducting studies based on these data.^ The association of non-work-related non-back injuries and subsequent occupational injury was statistically significant (OR = 1.31, 95% CI 1.02-1.67) for all WC claims. The strength of the association was supported by the elevated odds ratio for non-work-related injuries when severity of occupational injury was assessed by WC claim costs of $100 and greater (OR = 1.47, 1.09--1.97), and by lost workdays (OR = 1.37). Factors that predispose an individual to a non-back injury, such as personal attributes and lifestyle characteristics, also influence that individual's risk of subsequent occupational injury. These factors may be reflected in an employee's reaction to life stressors which influence susceptibility to injury. The role of employee assistance programs as a component of injury prevention strategies is suggested.^ An increased but nonsignificant prevalence of non-work-related injuries, cardiovascular disease, mental disorders, and other morbidity conditions was noted among cases. These findings do not provide support of a causal factor in the etiology of occupational injuries. In contrast to non-back injuries, these conditions are chronic in nature and their influence on risk of occupational injuries uncertain.^ In general, cases tended to file more group health insurance claims for other morbidity than did referents. The association with increased total morbidity was consistent whether worker compensation claims were analyzed by total number of claims, claims with costs of $100 and greater, or by lost workdays. Whether persons who sustained an occupational injury were in fact in poor general health than referents, warrant further investigation. ^