No abstract

Diabetes mellitus (DM) is currently one of the leading causes of mortality worldwide. However, the disease evolves differently across countries. This study intends to characterize the trends and assess the potential effects of marginalization on DM mortality between 1990 and 2019 in Mexico. We analyzed death certificates that listed DM as the underlying cause of death (N = 1,907,173), as well as the extent to which DM mortality changes were associated with marginalization through an age-period-cohort analysis. DM mortality increased in Mexico between 1990 and 2019; the change was faster in the first half and slowed down after 2004. The highest marginalization quintiles drove the changes in DM mortality trends during the study period, with a higher risk of dying in these quintiles as age increased. In recent cohorts, the highest marginalization quintiles doubled the risk of dying from DM as compared to the lowest. Renal complications was the main death driver among persons with DM, with a marked increase between 1999 and 2001. In conclusion, Mexico continues to have a substantially high DM mortality, but its pace slowed over time. Moreover, subnational differences in marginalization can partially explain such a trend.

Background Child neurodevelopment has been positively linked to maternal intake of polyunsaturated fatty acids (PUFAs) during pregnancy; however, it is unknown if that relationship persists among populations exposed to environmental neurotoxicants. Objective The aim of this work was to assess whether maternal dietary intake of PUFAs during pregnancy is positively associated with child neurodevelopment, whose mothers were environmentally exposed to 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT). Methods A prospective cohort study with 276 mother–child pairs was performed in Mexico. Neurodevelopment was assessed by Bayley Scales II from children age 1 to 30 months. Dietary PUFAs intake was estimated by Food Frequency Questionnaire at 1st and 3rd trimester of pregnancy. DDE (1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene, the main metabolite of DDT) maternal serum levels were determined by electron capture gas chromatography. Longitudinal multivariate linear mixed-effects analysis, which combines mental (MDI) and motor (PDI) Bayley scales in a single model, were performed. Results Our results show that in a sample environmentally exposed to DDT, maternal ingestion of DPA during the first trimester of pregnancy was positively associated with MDI (β = 0.10, 95% CI 0.02, 0.18) in children from 1 to 30 months. Likewise, our results suggest that dietary ALA may be also related to MDI. Conclusion DPA may benefit neurodevelopment even in populations exposed to DDT. Our results strengthen the importance of PUFAs intake during the prenatal period. Electronic supplementary material The online version of this article (10.1186/s12940-019-0456-8) contains supplementary material, which is available to authorized users.

Globally, diabetes mellitus (DM) is one of the leading causes of mortality. However, this behavior may differ over time for countries given their intrinsic factors. The objective of the study is to characterize the trend and assess the potential effect of marginalization on DM mortality during 1990-2019 in Mexico. We analyzed death certificates where DM was listed as the underlying cause of death (N=1,907,173) and the extent to which DM mortality changes, were associated with marginalization from an age-period-cohort analysis. DM mortality has increased for Mexico in the 1990-2019 period, this change was faster in the first half of our study and slowed after 2004. The highest marginalization quintiles drove the changes in DM mortality trends during 1990-2019 in Mexico, with higher risk of dying in these quintiles with aging than the lowest. In the most recent cohorts, the highest marginalization quintiles showed twice the risk of dying from DM than the lowest. Renal complications were the leading cause of death in persons with DM during 1990-2019, with a marked increase since 1999-2001. In conclusion, Mexico continues with a very high DM mortality, but this has slowed over time, and subnational differences in the marginalization can partially explain this trend.