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Studies the prevalence of type 1 diabetes mellitus in Portugal during the years 1995-1999 by a cohort study of young Portuguese men. Study of database belonging to the Portuguese Army's Recruitment Directorate related to type 1 diabetes diagnosis and other information; Regional variation in the prevalence of diabetes; Average age of the diabetics and increase in prevalence of the disease; Confirmation of an increase in type 1 diabetes in Portugal from 1995 to 1999.

Objective: The aim of the present study was to evaluate iodine intake in portuguese school children in order to inform health authorities of eventual measures to be implemented., Introduction: Iodine is the key element for thyroid hormone synthesis and its deficiency even mild, as found in other European countries, may have deleterious effects in pregnancy resulting in cognitive problems of offsprings. In Portugal there are no recent data on iodine intake in schoolchildren., Population and Methods: 3680 children aged 6-12 years of both sexes, from 78 different schools were studied. Iodine intake was evaluated trough urine iodine (UI) determinations using a colorimetic method., Results: The global median UI value was 105.5 µg/L; the percentage of children with UI <100 µg/L was 47.1%, corresponding to 41% of the studied schools. The percentage of values <50 µg/L was 11.8%. The male gender, the south region of the country and the distribution of milk in school were significantly linked with a higher iodine elimination., Discussion: Our global results point to a borderline/ mildly insufficient iodine intake in the portuguese school population. However 47% of the children had UI under 100 µg /L. The comparison of our results with the available data from 30 years ago, point to a considerable improvement, due to silent prophylaxis. Male gender, geographical area and milk distribution influenced positively iodine intake.The importance of milk has been referred in numerous papers., Conclusions: The study of UI in the Portuguese school population points to a borderline iodine intake. However, in 47% of children iodine intake was inadequate. Compared with data from the eighties, a considerable increase in iodine elimination was found. Taking into account the potencial deleterious effects of inadequate iodine intake, a global prophylaxis with salt iodization has to be considered.

Background: Iodine is the key element for thyroid hormone synthesis, and its deficiency, even moderate, is harmful in pregnancy, when needs are increased, because of its potential deleterious effects on fetal brain development. In Portugal, no recent data on iodine intake exists. The objective of this countrywide study was to analyze iodine status in pregnant Portuguese women in order to propose adequate measures to the health authorities., Subjects and Methods: Using a fast colorimetric method, urine iodine concentration (UIC) was evaluated in 3631 pregnant women followed in 17 maternity hospitals from hinterland and coastal areas in Continental Portugal and the Portuguese islands of Açores and Madeira., Results: Median UIC value was 84.9 μg/l (range 67.6-124.1) in Continental Portugal, 69.5 μg/l in Madeira, and 50.0 μg/l in Açores. The percentage of satisfactory values (>150 μg/l) was 16.8, ranging from 8.8 to 34.1 in the Continent, and being 8.2 in Madeira and 2.3 in Açores. The percentage of values below 50 μg/l was 23.7, ranging from 14.0 to 37.4 in the Continent, 33.7 in Madeira, and 50.0 in Açores., Conclusions: Our results point to an inadequate iodine intake in pregnant women assisted in most Portuguese maternity hospitals. Considering the potential deleterious effects of inadequate iodine supply in pregnancy, iodine supplementation is strongly recommended in this period of life.

Introduction: Over the last decades, a progressive increase in height and weight has been observed throughout Europe. Increase in weight has been more marked however, with a resulting increase in overweight and obesity prevalence. RESULTS published have analyzed the relationship between body mass index (BMI) and educational level. Most studies indicate an inverse relationship between BMI and educational level in developed countries., Objective: This study's main objective was to evaluate the relationship between BMI and educational level (years of schooling) in young Portuguese males in 1995 and 1999., Methods: Transverse study of data (BMI and years of schooling) from the military inspection records of virtually the entire Portuguese male population with an average age of 20 years, examined in 1995 and 1999, totaling 81 363 and 71 254, respectively. Four classes of BMI (<20, 20-24.9, 25-29.9 and > or =30 kg/m2) and four schooling levels (<5, 5-9, 10-12, and >12 years) were considered. We applied the chi2 test for associations between BMI and educational level and the odds ratio to quantify categorical variables. The significance level was 5%., Results: In 1995, 15.2% were overweight (BMI> or =25 years), increasing to 20.8% in 1999. The percentage of obesity (BMI> or =30 years) was 1.4% in 1995 and 2.2% in 1999. The percentage of overweight and obesity increased directly in line with the increase in educational level, both in 1995 and 1999. In 1995, the percentage of subjects with obesity according to years of schooling was as follows: <5 years--1.4%; 5-9 years--1.4%; 10-12 years--1.5% and >12 years--1.7%. In 1999, the results were as follows: <5 years--1.4%; 5-9 years--2.2%; 10-12 years--2.8% and >12 years--3.2%., Conclusions: We can conclude that the prevalence of overweight and obesity in young male Portuguese increased in the last decade and that, unlike most developed countries, the higher the level of education, the greater the percentage of overweight and obesity, both in 1995 and 1999.

Introduction: Thyroid diseases are an area of particular interest to this Department, constituting 30% of the 3561 patients observed over the last 5 years (when group consultations were set up and outpatient data computerised)., Objectives: To determine the prevalence and aetiologies of Hyperthyroidism (HT) in outpatient clinic and characterise diagnostic and therapy practice., Methodology: All files of patients diagnosed with HT treated in the department over the last 5 years were reviewed. Of a total of 105 files, 96 were analysed. The data analysed included: demographic data, aetiology of disease, complementary diagnostic test reported, treatment options and follow-up. The data was analysed independently depending on whether 1st consultation occurred before or after 1999. The variables were analysed using descriptive statistical methods, namely frequency and contingency tables for categoric variables and mean, standard deviation, maximum and minimum values for continuous variables., Results: Of the patients evaluated, 72% were female and 28% male, with an average age of 50. 49.0% had Graves' Disease (GD); 14.6% toxic multinodular goitre (TMNG); 11.5% autoimmune HT; 10.4% iatrogenic HT; 7.3% subacute thyroiditis and 7.3% toxic adenoma (TA). Medical treatment was 1st option for 92% of patients with GD (40.4% of cases combined with levothyroxine); 5% received 131Iodine treatment and 3% underwent surgery. In this group, 6 months after suspension of medical treatment, 30.4% had suffered a relapse. Of the patients who suffered a relapse, 42% underwent surgery and 28% received 131Iodine treatment. The remaining 30% made a second attempt with synthetic antithyroid drugs. For patients with TMNG, surgery was the 1st treatment option for the majority of patients (78.5%), followed by 131Iodine (14.2%). 70% of patients with toxic adenoma underwent surgery and 30% 131Iodine treatment. For other pathologies, namely autoimmune HT, iatrogenic HT and subacute thyroiditis, the option was medical treatment., Conclusions: Hyperthyroidism was diagnosed in 3.5% of patients observed as outpatients in this Department. GD was the most prevalent form of HT (49%). Medical treatment is the first treatment option (92%) for GD. 6 months after suspension of medical treatment, 30% of patients had suffered a relapse of GD. For these patients, surgery was the 1st option. For both TMNG and TA, surgery was the first treatment option., Complications: The adverse effects that occurred with ATDs (antithyroid drugs) were detected in 4,1% patients; one case of agranulocytosis with propylthiouracil, 2 cases of allergic reactions--rash (one due to the use of methimazole and the other to propylthiouracil), and one case of minor hepatocellular toxicity. In all patients there was improvement after stopping medical treatment.

We designed a study to assess the prevalence of type 1 diabetes mellitus among the Portuguese population. The study was based on a cohort of young Portuguese men inspected at the different recruitment Centres of the Portuguese Armed Forces in 1995 and 1999. We found a prevalence of 1.28 and 1.58 cases per 1,000 young men aged 20 (median), in 1995 and 1999, respectively. As far as the geographical distribution of this population was concerned, the recruitment centres (RC) with highest prevalence of diabetes in 1995 were that of Oporto, Évora and Lisboa. In 1999, highest prevalence was in Évora, Faro and Lisbon. The greatest increase was found at the RCs in Faro, Évora and Vila Real. Although the regional asymmetries are not very significant, they point to a higher prevalence in the southern region and in the urban areas of Lisbon and Oporto.

Maturity-onset diabetes of the young (MODY) is a rare form of juvenile diabetes mellitus, defined by early onset, absence of ketosis, non-insulin-dependent diabetes and autosomal dominant inheritance. Advances in molecular genetic analysis have identified mutations accounting for different MODY subtypes, all of them associated with defects of insulin secretion. We present a case of a nine year-old boy, admitted to our outpatient clinic because of mild and intermittent osmotic symptoms (polyuria, polyphagia and polydipsia) and persistently high values of fasting blood glucose in the last year. He had a family history of diabetes in three consecutive generations compatible with autossomal dominant inheritance. His height was 138.5 cm (90th centile) and his weight was 33.5 Kg (90th centile). General examination was unremarkable, in a prepubertal boy. A standard oral glucose tolerance test was performed. The fasting blood glucose was 118 mg/dl with a two hour value of 160 mg/dl. ICA, IAA and GAD autoantibodies were undetectable. He started on diet therapy, keeping his fasting blood glucose measurements on the upper limits of normal and HbA1c in the normal range. He was diagnosed as having MODY 2 on a clinical basis, as it is not possible to perform molecular analysis of this pathology in Portugal. As MODY is recently thought to account for 2-5% of all cases of type 2 Diabetes Mellitus it is important to consider it as a possible diagnosis in children who present with incidental hyperglycaemia. Molecular genetic testing is very important as it enables us to make a firm diagnosis of MODY, to define a follow up plan and to reassure patients families, once the prognosis is significantly different among the different sub-types of MODY. We emphathize the need of creating national and international reference centres where such testing can be done.

Objective: To evaluate the relationship between the educational level, weight and obesity of young Portuguese males, aged 20 years., Design: Cross-sectional study, based on the national military census files of 1990, provided by the military selection centres of Portugal (north, centre, south--including Azores and Madeira islands)., Subjects and Methods: In Portugal, all males aged 20 must present themselves to the military authorities to be submitted to a health exam in order to be screened for the armed forces. The data of 70,858 young Portuguese males aged 20 were gathered. Height and weight were measured by skilled teams. The educational level was confirmed by the presentation of educational attainment certificates. The population was divided into deciles of body mass index (BMI). The whole group was classified as obese or non-obese, according to a cut-off point of 27.8 Kg/sqm. The educational level was classified in four groups: group A--less than 5 years of schooling; group B--5 to 6 years; group C--7 to 9 years; group D--> or = 10 years. The level of education in each decile of BMI was determined and the percentage of obese subjects was calculated for each level of schooling. The odds of obesity associated with each group of schooling was determined as well as their 95% confidence intervals. Statistical significance was considered to exist when p < 0.05., Results: The average BMI in the study population was 22.5 Kg/sqm. A slight increase in schooling was noticed from the lowest to the highest decile of BMI. The same result was obtained when we analysed the upper extreme of the BMI distribution in greater detail. According to our criteria for obesity, the percentages of obesity in each level of schooling were as follows: group A--4.2%; group B--5%; group C--5.1%; and group D--5.4%. The odds ratio (OR) of obesity according to each education level was higher in those with a higher level of education. In fact, those with 10 or more years of schooling presented an OR = 1.05(0.94;1.17) which was not statistically significant (ns) when compared to those with 7-9 years; while an OR = 1.08(0.97;1.21), was also ns when compared to those with 5-6 years, and, finally, an OR = 1.29(1.14;1.47) was statistically significant (p < 0.001) in comparison to those with only 0-4 years of schooling., Conclusions: As major conclusions one can say that the prevalence of obesity is low among young Portuguese males (4.9%), only 2.1% with a BMI > 30 Kg/sqm. Furthermore, our results show that, in Portugal, contrary to the results found mostly in western European countries, males aged 20 years with higher levels of education are slightly more prone to be obese than others with lower levels of schooling.

Objective: To examine the secular trend of weight, height and obesity among young Portuguese males at the time of military inspection for national conscription purposes in the region of Lisbon, during the last thirty years., Design: Cross-sectional study, based on the review of military census files., Setting: Military selection centre of Lisbon., Subjects and Methods: In Portugal, military service is obligatory and medical inspections are carried out every year on males at the age of twenty. For study purposes, representative samples were taken from the young male population undergoing inspection for the Armed Forces on a five year basis, between 1960 and 1990 in the region of Lisbon. Weight and height were evaluated by a trained team, using standard measurement instruments and procedures., Results: A progressive and significant increase in weight, height and BMI of the young male population was found between 1960 and 1990. For certain variables the increase was also statistically significant within a five-year period, as it was the case for height between 1965-1980 and for weight between 1985-1990. The increase in BMI experienced some minor fluctuation along the reference period, however, it was statistically significant between 1985-1990. The increase in weight and in BMI was greater in the highest percentiles and particularly noticeable between 1985 and 1990. The percentage of young males with BMI over 25 kg/m2 was of 8.1% in 1960 and of 18.0% in 1990, while those having a BMI over 27 kg/m2 varied between 3.6% and 6.4% in the same period, respectively. The percentage of young adult males with BMI higher than 25 kg/m2 doubled between 1960 and 1990.

Objective: To determine whether race is a factor of blood pressure levels in school-age children of similar social status, and to investigate other potential determinants of the levels of blood pressure., Design: Inquiry in schools of the suburbs of Lisbon., Setting: Three schools, four medical observers (general practitioners with school-health functions)., Subjects: Three hundred ninety seven children, aged 6-14 years, both sexes, 296 being white and 101 non-white., Interventions: Inquiry to the following individual characteristics--sex, age, race, birthplace, type of housing, house availability of water, electricity and waste water, type of transportation to school, number of cohabitans, family income, school marks. Individual determination of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), weight and height., Measurements and Main Results: Blood pressure values were cross-analyzed with all the determined variables, and the virtual correlations were checked. Main results as follows: Race does not influence either SBP or DBP. In this age group, sex does not influence blood pressure values. The used markers of socioeconomical status have equally no influence on blood pressure. Age has only a significant repercussion on SBP. No significant correlation was found between height and blood pressure. Body weight, however, influence either SBP or DBP. SBP was found to be lower in the second of two successive measurements, and the difference increases with age., Conclusions: In this school-aged biracial population, body weight seems to be the major factor of blood pressure levels, in the sense-bigger weight, higher SBP and DBP.