RESUMEN

Introduction: Introduction: several studies have questioned body mass index (BMI) as an accurate diagnostic tool for obesity and therefore a predictor of cardiovascular risk. But BMI is widely used currently. Objective: we analyzed the sensitivity and specificity of BMI and compared cardiovascular risk factors in middle-income urban participants in Guanajuato, Mexico, at different ages. Design: an analytical and cross-sectional study was carried out in 385 apparently healthy subjects, stratified by age ranges (20 to 59 years old). A high global CVD risk was obtained with the Framingham risk score (Framingham Risk Score > 20 %). The odds ratio was used to assess the association between high global CVD risk and the dietetic and anthropometric variables. Sensitivity, specificity, and correlation statistical analyses were carried out between BMI and other anthropometric variables with high cardiovascular risk, and this was integrated to derive recommendations to improve risk factor detection (p < 0.05 and power of 80 %). Results: a high global CVD risk was found in 4 % of the sample. BMI ≥ 30 kg/m2 had a sensitivity of 77 % for the detection of high cardiovascular risk; waist circumference ≥ 90 cm (men) or ≥ 80 cm (women) and body fat percentage ≥ 2 5% (men) or ≥ 35 % (women) had a sensitivity of 100 %. BMI showed a significant association with high global CVD risk (OR = 6.1; 95 % CI, 1.6-22.6, p < 0.01), but was not able to predict high global CVD risk in at least 30 % of the cases. There was not significative difference by age group for waist circumference, body fat percentage, total cholesterol, and low-density lipoprotein. Regarding the comparison of dietary intake of the stratified population by age group, intake of cholesterol, added sugars, fiber, sodium were highest in the 20 years group. Conclusions: a higher intake of cholesterol, simple sugars, and sodium was observed in the 20-year-old age group. The use of BMI with waist circumference and percentage of body fat used together allow a better assessment of cardiovascular risk. We need to integrate this new recommendation to increase early detection of main risk factors for cardiovascular disease.

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Introducción: Introducción: diversos estudios han cuestionado el índice de masa corporal (IMC) como herramienta diagnóstica certera de la obesidad y por tanto predictor de riesgo cardiovascular. Pero el IMC es ampliamente utilizado actualmente. Objetivo: se analizó la sensibilidad y especificidad del IMC y se compararon factores de riesgo cardiovascular en participantes de diferentes edades de zonas urbanas de ingresos medios en Guanajuato, México. Diseño: se realizó un estudio analítico y transversal en 385 participantes, aparentemente sanos, estratificados por rangos de edad (20 a 59 años). El riesgo de CVD global alto se obtuvo con la puntuación de riesgo de Framingham (puntuación de riesgo de Framingham > 20 %). Se calculó la odds ratio para evaluar la asociación entre el alto riesgo global de ECV y las variables dietéticas y antropométricas. Se realizó un análisis estadístico de sensibilidad, especificidad y correlación entre el IMC y otras variables antropométricas con el alto riesgo cardiovascular, y se integró para derivar recomendaciones para mejorar la detección de factores de riesgo (p < 0,05 y potencia del 80 %). Resultados: se encontró un alto riesgo global de ECV en el 4 % de la muestra. El IMC ≥ 30 kg/m2 tuvo una sensibilidad del 77 % para la detección del alto riesgo cardiovascular; la circunferencia de la cintura ≥ 90 cm (hombre) o ≥ 80 cm (mujer) y el porcentaje de grasa corporal ≥ 25 % (hombre) o ≥ 35 % (mujer) tuvo una sensibilidad del 100 %. El IMC mostró una asociación significativa con un alto riesgo global de ECV (OR = 6,1; IC 95 % 1,6-22,6; p < 0,01) pero no fue capaz de predecir un alto riesgo global de ECV en al menos el 30 % de los casos. No hubo diferencia significativa por grupo de edad para circunferencia de cintura, porcentaje de grasa corporal, colesterol total y lipoproteínas de baja densidad. Con respecto a la comparación de la ingesta dietética de la población estratificada por grupos de edad, la ingesta de colesterol, azúcares añadidos y sodio fue mayor en el grupo de 20 años. Conclusiones: se observó una mayor ingesta de colesterol, azúcares simples y sodio en el grupo de edad de 20 años. El uso del IMC con la circunferencia de la cintura y el porcentaje de grasa corporal utilizados conjuntamente permiten lograr una mejor evaluación del riesgo cardiovascular. Necesitamos contar con herramientas para aumentar la detección temprana de los principales factores de riesgo de enfermedad cardiovascular.

Asunto(s)

Enfermedades Cardiovasculares , Adulto , Índice de Masa Corporal , Enfermedades Cardiovasculares/etiología , Estudios Transversales , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Lipoproteínas LDL , Masculino , México/epidemiología , Persona de Mediana Edad , Monosacáridos , Factores de Riesgo , Sodio , Azúcares , Circunferencia de la Cintura , Adulto Joven

RESUMEN

Adverse environmental factors in early life result in fetal metabolic programming and increased risk of adult diseases. Birth weight is an indirect marker of the intrauterine environment, modulated by nutrient availability and placental transport capacity. However, studies of placental transporters in idiopathic birth weight alterations and in maternal obesity in relation to neonatal metabolic outcomes are scarce. We aimed to analyze the placental nutrient transporter protein expression in small (SGA, n = 14), adequate (AGA, n = 18), and large (LGA n = 10) gestational age term for newborns from healthy or obese mothers (LGA-OB, n = 9) and their association with maternal fatty acids, metabolic status, placental triglycerides, and neonatal outcomes. The transporter expression was determined by Western blot. The fatty acid profile was evaluated by gas chromatography, and placental triglycerides were quantified by an enzymatic colorimetric method. GLUT1 was higher in LGA and lower in SGA and positively correlated with maternal HbA1c and placental weight (PW). SNAT2 was lower in SGA, while SNAT4 was lower in LGA-OB. FATP1 was lower in SGA and higher in LGA. SNAT4 correlated negatively and FATP1 correlated positively with the PW and birth anthropometry (BA). Placental triglycerides were higher in LGA and LGA-OB and correlated with pregestational BMI, maternal insulin, and BA. Maternal docosahexaenoic acid (DHA) was higher in SGA, specifically in male placentas, correlating negatively with maternal triglycerides, PW, cord glucose, and abdominal perimeter. Palmitic acid (PA) correlated positively with FATP4 and cord insulin, linoleic acid correlated negatively with PA and maternal cholesterol, and arachidonic acid correlated inversely with maternal TG and directly with FATP4. Our study highlights the importance of placental programming in birth weight both in healthy and obese pregnancies.

RESUMEN

The enzyme nicotidamide-N-methyltransferase (NNMT) regulates adipose tissue energy expenditure through increasing nicotinamide adenosine dinucleotide (NAD+) content. NNMT methylates nicotinamide to N1-methylnicotidamide (MNA-1) using S-adenosyl methionine. The rs694539 NNMT polymorphism is associated with non-alcoholic steatohepatitis, and rs1941404 is associated with hyperlipidemia. The rs1421085 FTO is related to poor eating behaviors, and rs3751723 IRX3 is associated with obesity. To investigate the association of rs694539 and rs1941404 NNMT, rs140285 FTO and rs3751723 IRX3 polymorphisms with MNA-1 concentrations, resting energy expenditure (REE) and BMI, we included clinically healthy Mexican subjects 30 to 50 years old, 100 subjects (35 men/65 women) with BMI > 30 kg/m2 and 100 subjects (32 men/68 women) with BMI < 25 kg/m2. Glucose, lipid profile, insulin, leptin, acylated ghrelin, and MNA-1 (LC-MS) were quantified. Resting energy expenditure (REE) was estimated using indirect calorimetry with a Fitmate instrument. Genotyping was performed using PCR-RFLP, and allelic discrimination was examined using TaqMan probes. MNA-1 concentrations and REE were significantly higher in obese subjects. Subjects with the rs694539AA NNMT genotype (recessive model) had lower weight, BMI, and REE. BMI showed an association with HDL-C, triglycerides, MNA-1, acetylated ghrelin, leptin, insulin concentrations, HOMA-IR, REE, and rs1421085. Subjects with the TC or CC genotypes of rs1421085 FTO showed 6 kg and 2 units of BMI more than did those with the TT wild type. The CG of the rs1421085 and rs3751723 haplotypes was associated with BMI. These findings showed that BMI was strongly associated with REE, rs1421085 FTO and the CG rs1421085 FTO and rs3751723 IRX3 haplotypes. We used the GMDR approach in obesity phenotype to show the interaction of four SNPs and metabolic variables.

Asunto(s)

Dioxigenasa FTO Dependiente de Alfa-Cetoglutarato/genética , Metabolismo Energético/genética , Proteínas de Homeodominio/genética , Nicotinamida N-Metiltransferasa/genética , Factores de Transcripción/genética , Adulto , Alelos , Índice de Masa Corporal , Femenino , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Genotipo , Haplotipos/genética , Humanos , Leptina/genética , Masculino , Persona de Mediana Edad , Obesidad/genética , Obesidad/patología , Polimorfismo de Nucleótido Simple/genética

RESUMEN

Metabolomics is a potential tool for the discovery of new biomarkers in the early diagnosis of diseases. An ultra-fast gas chromatography system equipped to an electronic nose detector (FGC eNose) was used to identify the metabolomic profile of Volatile Organic Compounds (VOCs) in type 2 diabetes (T2D) urine from Mexican population. A cross-sectional, comparative, and clinical study with translational approach was performed. We recruited twenty T2D patients and twenty-one healthy subjects. Urine samples were taken and analyzed by FGC eNose. Eighty-eight compounds were identified through Kovats's indexes. A natural variation of 30% between the metabolites, expressed by study groups, was observed in Principal Component 1 and 2 with a significant difference (p < 0.001). The model, performed through a Canonical Analysis of Principal coordinated (CAP), allowed a correct classification of 84.6% between healthy and T2D patients, with a 15.4% error. The metabolites 2-propenal, 2-propanol, butane- 2,3-dione and 2-methylpropanal, were increased in patients with T2D, and they were strongly correlated with discrimination between clinically healthy people and T2D patients. This study identified metabolites in urine through FGC eNose that can be used as biomarkers in the identification of T2D patients. However, more studies are needed for its implementation in clinical practice.

Asunto(s)

Cromatografía de Gases/métodos , Diabetes Mellitus Tipo 2/metabolismo , Nariz Electrónica , Metabolómica/métodos , Compuestos Orgánicos Volátiles/orina , Adulto , Anciano , Biomarcadores/orina , Estudios Transversales , Humanos , Persona de Mediana Edad , Proyectos Piloto

RESUMEN

Birth weight (BW) is an important indicator for newborn health. Both high and low BW is associated with increased risks for adult metabolic diseases. AMPK (AMP-activated protein kinase), mTOR (mechanistic target of rapamycin), and insulin/IGF1 (insulin-like growth factor 1) pathways may function as placental sensors of maternal hormonal and nutritional status. However, the physiological role of these pathways in placenta has not been completely elucidated. To evaluate expression and activation of AMPK, mTOR, and insulin/IGF1 pathways and its association with placental weight (PW), BW, and maternal hormonal and metabolic status, we performed a cross-sectional study in placentas from non-obese mothers with SGA (n = 17), AGA (n = 19) and LGA (n = 10) newborns. We analyzed placental expression of total and phosphorylated key proteins from the AMPK, mTOR and insulin/IGF1 pathways. Maternal and cord blood hormones were determined by ELISA. AMPK and LKB1 activation correlated negatively with PW and BW, cord leptin, and pregestational BMI. Placental SIRT1 inversely correlated with BW, cord leptin, neonatal HOMA-IR, and maternal IGF1. PGC1α correlated negatively with PW and BW. Phosphorylated mTOR positively correlated with maternal glucose, PW and BW. IGF1R was lower in SGA. No changes in p-IGF1R, INSRb, total AKT or p-AKT were found, and pPDK1 was lower in SGA and LGA. These results suggest that placental AMPK, insulin/IGF1, and mTOR pathways may influence fetal growth, perhaps regulating placental physiology, even in metabolically healthy pregnancies. Our study highlights these nutrient sensing pathways as potential molecular mechanisms modulating placental adaptations and, thus, long-term metabolic health.

Asunto(s)

Peso al Nacer , Regulación de la Expresión Génica , Nutrientes/análisis , Placenta/fisiología , Transducción de Señal , Adolescente , Adulto , Índice de Masa Corporal , Estudios Transversales , Femenino , Humanos , Recién Nacido , Factor I del Crecimiento Similar a la Insulina/metabolismo , Leptina/metabolismo , Embarazo , Receptor IGF Tipo 1/metabolismo , Serina-Treonina Quinasas TOR/metabolismo , Adulto Joven

RESUMEN

Women with previous gestational diabetes mellitus (pGDM) have a high risk of developing postpartum type 2 diabetes mellitus (T2DM). This study aimed to analyze the relationship between lactation, BMI, and TCF7L2 polymorphisms in the conversion to T2DM in women with pGDM. One hundred and fifty-three women con pGDM were recruited from public hospitals of León Guanajuato México. Three groups: normal glucose tolerance (NGT), impaired glucose intolerance (IGT), and T2DM after the oral glucose tolerance test were formed. Metabolic and hormone variables were measured, and genotyping was made by PCR-RFLP. The questionnaire included data on lactation (yes/no), duration of lactation, and full lactation. After 35 (21-49) months from the last partum, 54% of women had an NGT, 30.7% IGT, and 15% T2DM. BMI and rs12255372 are associated with the risk of conversion to IGT and T2DM [OR = 1.07 (95% IC 1.0-1.14, p = .041; OR =2.14, 95% IC 1.01-4.55, p = .04 respectively), while the lactation shows a strong protective effects OR = 0.15 (95% IC 0.062-0.39, p = .00007), and an apparent interaction with rs12255372T decreasing the risk in carriers (OR =2.15; 95% IC 0.97-4.7, p = .05). BMI is an independent risk factor of IGT/T2DM development. The lactation shows a strong protective effect and a possible interaction with rs12255372 polymorphism.

Asunto(s)

Diabetes Mellitus Tipo 2/etiología , Diabetes Gestacional/genética , Intolerancia a la Glucosa/genética , Lactancia/fisiología , Proteína 2 Similar al Factor de Transcripción 7/genética , Adulto , Alelos , Glucemia , Índice de Masa Corporal , Lactancia Materna , Diabetes Gestacional/fisiopatología , Femenino , Intolerancia a la Glucosa/fisiopatología , Prueba de Tolerancia a la Glucosa , Humanos , Polimorfismo de Nucleótido Simple , Embarazo , Factores de Riesgo

RESUMEN

BACKGROUND: Women after menopause increase risk for cardiovascular disease and several factors may be related. The purpose was to study biological and psychosocial factors associated with early cardiovascular damage in pre- and postmenopausal women, assessed with carotid intima-media thickness vs flow-mediated dilatation. METHODS: Women 45 to 57 years old were grouped in the pre- (n = 60), early (n = 58) and late post-menopause (n = 59). Anthropometric, metabolic and hormonal data were registered, as well as measures of depression, anxiety, submission, perceived stress, and sleep alterations. Heart Rate Variability was recorded to obtain the information regarding sympathovagal balance. Carotid intima-media thickness and flow-mediated dilatation were assessed by ultrasound. Two-way ANOVA and multiple regression model were used. RESULTS: At late postmenopause, the carotid intima-media was thicker (p < 0.001) and flow-mediated dilatation decreased (p < 0.001). Carotid intima-media thickness was associated positively with age (p < 0.001), submission score (p = 0.029), follicle stimulating hormone levels (p < 0.001), and body mass index (p = 0.009). Flow-mediated dilatation was associated only with age (p < 0.001). Regarding heart rate variability, the time domain pNN50 measurement was higher in premenopausal women (p = 0.001), Low Frequency (LF) was higher in the two groups of postmenopausal (p = 0.001) and High Frequency (HF) higher in the early postmenopausal women (p = 0.042). CONCLUSIONS: Under our conditions carotid intima-media thickness had higher predictive value for early cardiovascular damage at menopause. The finding of the association of the submission score, indicates de influence of stress on vascular damage.

Asunto(s)

Enfermedades Cardiovasculares/diagnóstico por imagen , Enfermedades Cardiovasculares/fisiopatología , Grosor Intima-Media Carotídeo , Menopausia/fisiología , Vasodilatación , Adulto , Factores de Edad , Ansiedad/etiología , Índice de Masa Corporal , Enfermedades Cardiovasculares/etiología , Depresión/etiología , Femenino , Frecuencia Cardíaca , Humanos , Menopausia/psicología , Persona de Mediana Edad , Factores de Riesgo , Trastornos del Sueño-Vigilia/etiología , Estrés Psicológico/etiología , Ultrasonografía

RESUMEN

OBJECTIVE: We examined the effect of restriction of foods with high fructose content in obese school children. METHODS: In a clinical study, we selected 54 obese children 6 to 11 years old with high fructose consumption (>70 g/day) in order indicate dietary fructose restriction (<20 g/day) for 6 weeks. Anthropometry, liver ultrasound as well as glucose, insulin, lipids, leptin, IGFBP1, and RBP4 serum levels were collected. RESULTS: The group of children had 80% adherence and reported decreased fructose consumption (110 ± 38.6 to 11.4 ± 12.0 g/day) and also a significant decrease in caloric (2,384 ± 568 to 1,757 ± 387 kcal/day) and carbohydrate consumption (302 ± 80.4 to 203 ± 56.0 g/day). The severity of steatosis improved significantly after fructose restriction (p < 0.000001). However, no changes in BMI, systolic blood pressure, or diastolic blood pressure were found. Only triglyceride levels decreased (1.44 ± 0.43 to 1.31 ± 0.38 mmol/l), High-densitiy lipoprotein cholesterol showed a marginal increase (1.45 ± 0.19 to 1.56 ± 0.44 mmol/l). Insulin resistance and RBP4 did not change. CONCLUSIONS: In school children, the restriction of high fructose foods with a decrease of caloric and carbohydrate intake at 6 weeks did not induce weight loss; however, triglyceride levels and hepatic steatosis decreased. Differences with other studies in regard to weight loss may be explained by adaptive changes on metabolic expenditure.

Asunto(s)

Hígado Graso/prevención & control , Jarabe de Maíz Alto en Fructosa/administración & dosificación , Obesidad Infantil/dietoterapia , Presión Sanguínea , Índice de Masa Corporal , Niño , Carbohidratos de la Dieta/administración & dosificación , Ingestión de Energía , Hígado Graso/etiología , Femenino , Fructosa/administración & dosificación , Humanos , Insulina/sangre , Resistencia a la Insulina , Leptina , Masculino , Obesidad Infantil/complicaciones , Triglicéridos/sangre , Pérdida de Peso

RESUMEN

Alterations in birth weight impact postnatal outcome and adult metabolic health. Therefore, fetal growth regulation is crucial for preventing chronic metabolic diseases. Leptin has been suggested to play an important role in placental and fetal growth, albeit its specific mechanisms of action have not been elucidated. The aim of this study was to analyze leptin concentrations in placenta, cord blood, and maternal blood of SGA, AGA, and LGA (small, adequate and large for gestational age, respectively) newborns, as well as placental leptin receptor (LEPRa and LEPRb) protein expression. We performed a cross-sectional comparative study in 3 groups of healthy mothers and their term newborns at delivery (SGA, AGA, and LGA, n=20 per group). Placental, maternal blood, and cord blood leptin content were measured by ELISA. Placental LEPRa and LEPRb protein expression were determined by Western Blot. Maternal leptin concentrations correlated positively with maternal weight before and at the end of gestation, without differences between groups. Cord leptin is higher in LGA and lower in SGA, whereas placental leptin is higher in SGA. Placental leptin was inversely correlated with placental weight, independently from maternal weight and gestational age. Both LEPRa and LEPRb expression are lower in SGA, while LEPRa positively correlated with placental weight and birthweight. The current findings indicate that placental leptin and its receptors are differentially expressed in SGA, AGA, and LGA newborns. We suggest that placental leptin and LEPR protein expression may influence placental growth and thus, birth weight.

Asunto(s)

Recién Nacido Pequeño para la Edad Gestacional/sangre , Leptina/sangre , Placenta/metabolismo , Receptores de Leptina/sangre , Adulto , Antropometría , Femenino , Sangre Fetal/metabolismo , Humanos , Recién Nacido , Tamaño de los Órganos , Embarazo , Receptores de Leptina/metabolismo

RESUMEN

Angiogenesis in inflammation are hallmarks for adipose tissue expansion in obesity. The role of angiopoietin/Tie-2 system in adipose tissue expansion and immune cell recruitment is unclear. We studied the effect of sleeve gastrectomy and the influence of FTO rs9930506 polymorphism on Tie-2, angiopoietin-1 and angiopoietin-2 expression in morbid obesity. Fifteen morbidly obese subjects (4 men and 11 women) aged 24-55 years were followed-up 3 and 6 months after sleeve gastrectomy. Serum sTie-2, angiopoietin-1, angiopoietin-2, and hypoxia-inducible factor-1α concentrations were determined by ELISA. Tie-2 and its ligands in visceral and subcutaneous adipose tissue were localized by immunohistochemistry. Tie-2 expression was measured by flow cytometry in circulating monocytes and infiltrated macrophages. Comparisons before and after sleeve gastrectomy were carried out using ANOVA for repeated measures. rs9930506FTO genotyping was performed by PCR-RFLP. Circulating sTie-2 and angiopoietin-2 were higher before sleeve gastrectomy. Tie-2 and angiopoietin-2 mRNA levels were higher in subcutaneous adipose tissue than visceral and both decreased after surgery. Monocytes and infiltrated macrophages showed a pro-inflammatory phenotype, with increased Tie-2 expression that decreased 3 and 6 months after sleeve gastrectomy. Baseline sTie-2 correlated inversely with adiponectin levels. At baseline the rs9930506FTO AG ó GG genotypes carriers had more 34 kg than genotype carriers of rs9930506 AA. Weight and body mass index decreased at 6 months. We found that angiopoietin/Tie-2 system is mainly expressed in subcutaneous adipose tissue, contributing to expandability, fat accumulation, and monocytes attachment in obesity. Bariatric surgery favorably modifies the pro-angiogenic profile, allowed a reduced angiogenic expression in the circulation and adipose tissue.

Asunto(s)

Dioxigenasa FTO Dependiente de Alfa-Cetoglutarato/genética , Angiopoyetinas/metabolismo , Gastrectomía , Obesidad Mórbida/metabolismo , Receptor TIE-2/metabolismo , Adulto , Antropometría , Femenino , Humanos , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Macrófagos/metabolismo , Masculino , Persona de Mediana Edad , Obesidad Mórbida/inmunología , Obesidad Mórbida/cirugía , Polimorfismo de Nucleótido Simple , Grasa Subcutánea/inmunología , Grasa Subcutánea/metabolismo , Adulto Joven

RESUMEN

Although ghrelin in cord blood has been associated to birth weight, its role in fetal and postnatal growth has not been elucidated. The aim of this study was to analyze total ghrelin, acyl ghrelin (AG), and des-acyl ghrelin (DAG) in cord blood of newborns with idiopathic birth weight alterations, and to evaluate protein expression of placental GHS-R1, in order to investigate their correlation with birth weight and placental weight. We performed a cross-sectional comparative study in umbilical cord blood and placentas from healthy mothers of SGA, AGA, and LGA (small, adequate and large for gestational age) term newborns (n = 20 per group). Cord blood total ghrelin, AG, and DAG were measured by ELISA, and placental GHS-R1 expression was evaluated by Western blot. Cord blood DAG was higher in SGA compared to AGA newborns (902.1 ± 109.1 and 597.4 ± 58.2 pg/ml, respectively, p = 0.01) while LGA and AGA showed similar values (627.2 ± 76.4 pg/ml for LGA, p = 0.80). DAG negatively correlated with birthweight (r = -0.31, p = 0.02) and placental weight (r = -0.33, p = 0.02). No differences in AG or total ghrelin were found. GHS-R1 protein in placenta was not differentially expressed among SGA, AGA, and LGA. Our results suggest a role of DAG in intrauterine growth. Further studies are needed in order to elucidate the mechanisms by which DAG participates in fetal growth.

Asunto(s)

Peso al Nacer/fisiología , Sangre Fetal/metabolismo , Edad Gestacional , Ghrelina/sangre , Placenta/metabolismo , Receptores de Ghrelina/metabolismo , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Recién Nacido , Recién Nacido Pequeño para la Edad Gestacional , Embarazo , Adulto Joven

RESUMEN

OBJECTIVE: To compare somatometric variables, lipid profile, diet, and physical activity between Mexican children living in México (MEX), and Mexican-American (MXA) and Non-Hispanic White (NHW) children from the United States (US) to examine the possible influence of ethnicity and residency on these factors. MATERIAL AND METHODS: Six to twelve years old children data from a study from central México and the US National Health and Nutrition Examination Survey was compared. Data were categorized to examine the effect of residency (MEX vs. MXA and NHW) and ethnicity (MEX vs. MXA and NHW) on the variables of interest. RESULTS: Living in the US was associated with higher cholesterol levels in younger boys and older girls (p < 0.05), and high saturated fat intake in all groups (p < 0.0001). Living in México increased the likelihood of abnormal HDL (p < 0.001), systolic (p < 0.001), and diastolic blood pressure (p < 0.0001). Caucasian young girls were more likely to have high cholesterol intake (p < 0.02) than their Mexican counterparts. CONCLUSIONS: These findings suggest that residency is linked to impaired lipid profile and blood pressure in children, whereas ethnicity seems to have an impact on dietary choices.

Asunto(s)

Dieta , Metabolismo de los Lípidos , Americanos Mexicanos , Población Blanca , Pesos y Medidas Corporales , Niño , Femenino , Humanos , Masculino , México , Estados Unidos

RESUMEN

BACKGROUND: Variation in TCF7L2 gene is associated with type 2 diabetes and with gestational diabetes mellitus in several populations, but there are no data in Mexican women with gestational diabetes mellitus. In this study, we examined metabolic and hormonal measurements as well as TCF7L2 genetic variants. METHODS: We selected 108 pregnant women with normal glucose tolerance and 90 with gestational diabetes mellitus according to 2010 American Diabetes Association criteria matched for gestational week. We collected data on blood pressure, body mass index (BMI) and concentrations of blood glucose, HbA1c , lipids profile, insulin and glucagon-like peptide-1 (GLP-1). The genotyping of rs7903146 and rs12255372 polymorphisms were made with polymerase chain reaction-restriction fragment length polymorphism. RESULTS: Actual and pre-gestational BMI, fasting glucose and HbA1c were higher (p < 0.001), and high-density lipoprotein cholesterol was lower (p < 0.02) in gestational diabetes mellitus women than euglycemic women. No significant differences were found for lipids, insulin and homeostasis model assessment-insulin resistance. Gestational diabetes mellitus women had high GLP-1 levels (32 vs 24, p < 0.004) and decreased ß-cell function (266 vs 438, p < 0.001). The frequency of rs12255372 risk allele in gestational diabetes women was significantly higher than that in euglycemic women (χ² = 8.96; p < 0.003) and confers a risk for gestational diabetes mellitus (OR = 9.1, 95% CI 2.8-29, p < 0.0002; and OR = 4.3, 95% CI 1.6-11.4, p < 0.003 based on dominant and co-dominant model, respectively). The generalized linear model showed that low beta function, high pre-gestational BMI and rs12255372 risk allele are independently associated with gestational diabetes. CONCLUSIONS: The elevated GLP-1 levels in gestational diabetes women suggested some abnormality in insulin secretion. The low ß-cell function, high pre-gestational BMI and rs12255372 risk allele are risk factors independently associated with the development of gestational diabetes.

Asunto(s)

Diabetes Gestacional/genética , Predisposición Genética a la Enfermedad , Polimorfismo de Nucleótido Simple , Proteína 2 Similar al Factor de Transcripción 7/genética , Adulto , Alelos , Índice de Masa Corporal , HDL-Colesterol/análisis , Estudios Transversales , Diabetes Gestacional/sangre , Diabetes Gestacional/etiología , Diabetes Gestacional/fisiopatología , Femenino , Estudios de Asociación Genética , Péptido 1 Similar al Glucagón/sangre , Humanos , Insulina/sangre , Insulina/metabolismo , Secreción de Insulina , Células Secretoras de Insulina/metabolismo , Fenómenos Fisiologicos Nutricionales Maternos , México , Sobrepeso/fisiopatología , Embarazo , Adulto Joven

RESUMEN

OBJECTIVE: Sleep disturbance is an important change in menopause because it affects quality of life and can lead to other conditions such as depression. This study measured sleep alterations and explored associated physical, emotional, hormonal, and lifestyle factors during perimenopause and postmenopause. METHODS: This cross-sectional study enrolled 160 women who were classified as perimenopausal (n = 85) or postmenopausal (n = 75). Using diaries, we collected data on duration of sleep, time awake in bed, and sleep efficiency. Follicle-stimulating hormone, 17ß-estradiol, and cortisol levels were quantified by radioimmunoassay, and serum anti-Müllerian hormone levels were measured using enzyme-linked immunosorbent assay. Correlations between sleep measurements and symptoms were assessed using a generalized linear model. RESULTS: The reported duration of sleep was similar for both groups of women (close to 6.9 h), and sleep efficiency was 88%. We did not find any factor that was associated with duration of sleep. Sleep efficiency was negatively associated with age, perimenopause/postmenopause status, loss of sexual interest, hot flashes, and depressed mood. Time awake in bed was positively associated with depressed mood (P < 0.000001), cigarette smoking (P < 0.000041), menopause status (P < 0.00009), and age (P < 0.0009). These associations remained after controlling for exercise, alcohol consumption, and caffeine consumption as confounding variables. Finally, morning salivary cortisol was reduced in postmenopausal women. CONCLUSIONS: Time awake in bed shows the most significant associations. Depressed mood, age, and menopause status are the main factors associated with sleep disturbances.

Asunto(s)

Sofocos/sangre , Menopausia , Trastornos del Sueño-Vigilia/sangre , Estudios Transversales , Estradiol/sangre , Femenino , Hormona Folículo Estimulante/sangre , Sofocos/complicaciones , Humanos , Hidrocortisona/sangre , Persona de Mediana Edad , Trastornos del Sueño-Vigilia/complicaciones

RESUMEN

BACKGROUND: Recent genome wide association studies (GWAS) and previous positional linkage studies have identified more than 50 single nucleotide polymorphisms (SNPs) associated with obesity, mostly in Europeans. We aimed to assess the contribution of some of these SNPs to obesity risk and to the variation of related metabolic traits, in Mexican children. METHODS: The association of six European obesity-related SNPs in or near FTO, NPC1, ENPP1, NEGR1, GNPDA2 and MC4R genes with risk of obesity was tested in 1,463 school-aged Mexican children (N(cases) = 514; N(controls) = 949). We also assessed effects of these SNPs on the variation of body mass index (BMI), fasting serum insulin levels, fasting plasma glucose levels, total cholesterol and triglyceride levels, in a subset of 1,171 nonobese Mexican children. RESULTS: We found a significant effect of GNPDA2 rs10938397 on risk of obesity (odds ratio [OR] = 1.30; P = 1.34 × 10-3). Furthermore, we found nominal associations between obesity risk or BMI variation and the following SNPs: ENPP1 rs7754561, MC4R rs17782313 and NEGR1 rs2815752. Importantly, the at-risk alleles of both MC4R rs17782313 and NPC1 rs1805081 showed significant effect on increased fasting glucose levels (ß = 0.36 mmol/L; P = 1.47 × 10(-3)) and decreased fasting serum insulin levels (ß = -0.10 µU/mL; P = 1.21 × 10(-3)), respectively. CONCLUSION: Our present results suggest that some obesity-associated SNPs previously reported in Europeans also associate with risk of obesity, or metabolic quantitative traits, in Mexican children. Importantly, we found new associations between MC4R and fasting glucose levels, and between NPC1 and fasting insulin levels.

Asunto(s)

Predisposición Genética a la Enfermedad/genética , Estudio de Asociación del Genoma Completo , Obesidad/genética , Polimorfismo de Nucleótido Simple/genética , Isomerasas Aldosa-Cetosa/genética , Alelos , Dioxigenasa FTO Dependiente de Alfa-Cetoglutarato , Índice de Masa Corporal , Proteínas Portadoras/genética , Moléculas de Adhesión Celular Neuronal/genética , Niño , Estudios Transversales , Femenino , Estudios de Seguimiento , Proteínas Ligadas a GPI/genética , Frecuencia de los Genes , Genotipo , Humanos , Péptidos y Proteínas de Señalización Intracelular , Masculino , Glicoproteínas de Membrana/genética , México/epidemiología , Proteína Niemann-Pick C1 , Obesidad/etnología , Hidrolasas Diéster Fosfóricas/genética , Proteínas/genética , Pirofosfatasas/genética , Receptor de Melanocortina Tipo 4/genética , Factores de Riesgo

RESUMEN

AIMS: We examined the possible association of the -308G/A polymorphism of the TNF-α promoter gene in type 2 diabetes mellitus (DM2) patients and in non-diabetic subjects with and without family history of DM2. METHODS: We studied 87 non-diabetic subjects without DM2 family history in at least one of two generations, 48 non-diabetic subjects with DM2 family history and 95 DM2 patients. Genotyping was carried out by PCR-RFLP. RESULTS: The frequency of TNF-α -308G/A genotype was significantly lower in non-diabetic subjects without DM2 relatives (6%) as compared to DM2 patients (24%) (odds ratio (OR)=5.24; 95% confidence interval (CI)=1.9-15.8, p<0.0005), but similar to non-diabetic subjects with DM2 relatives (29%) (OR=0.77; CI=0.3-1.7, p=0.4). Logistic regression analysis showed the association of TNF-α -308G/A polymorphism with DM2 family history (OR=5.80; CI=1.77-18.98, p<0.0003). CONCLUSIONS: Our results suggest that TNF-α -308G/A polymorphism is associated with DM2 family history and is a risk factor for DM2.

Asunto(s)

Diabetes Mellitus Tipo 2/genética , Polimorfismo Genético , Factor de Necrosis Tumoral alfa/sangre , Factor de Necrosis Tumoral alfa/genética , Adulto , Anciano , Estudios Transversales , Diabetes Mellitus Tipo 2/sangre , Femenino , Genotipo , Humanos , Resistencia a la Insulina , Masculino , México , Persona de Mediana Edad , Oportunidad Relativa , Polimorfismo de Longitud del Fragmento de Restricción

RESUMEN

OBJECTIVE: Several cutoff points of the homeostasis model assessment of insulin resistance (HOMA-IR; varying from 2.5 to 4.0) have been suggested for diagnosing IR in youth. In this study, we determined the distribution of the HOMA-IR in Mexican children and adolescents. DESIGN AND METHODS: A total of 6132 children and adolescents from San Luis Potosi, León, Queretaro, and Durango, which are cities in central and northern Mexico, were enrolled in a population-based cross-sectional study. Eligible participants were apparently healthy children and adolescents aged 6-18 years. Pregnancy and the presence of chronic illnesses were exclusion criteria. RESULTS: A total of 3701 (60.3%) girls and 2431 (39.7%) boys were included in this study. In the overall population, the mean body mass index, insulin levels, and fasting glucose levels were 21.8±1.3 kg/m(2), 7.1±3.2 µU/ml, and 86.2±10.0 mg/dl respectively. The concentrations of insulin and fasting glucose gradually increased from 6 to 12 years of age, whereas the concentrations tended to plateau in the 13- to 18-year-old population. The absolute mean of the HOMA-IR was 2.89±0.7. The HOMA-IR gradually increased with age and reached a plateau at 13 years of age. CONCLUSIONS: Because the insulin concentrations, glucose levels, and HOMA-IR exhibited a gradual increase with age that was not related to obesity, our results suggested that the evaluation of IR in children should be based on percentiles of the HOMA-IR rather than a dichotomous value derived from a single cutoff point.

Asunto(s)

Homeostasis , Resistencia a la Insulina/fisiología , Modelos Biológicos , Adolescente , Glucemia/análisis , Índice de Masa Corporal , Niño , Estudios Transversales , Femenino , Homeostasis/fisiología , Humanos , Insulina/sangre , Masculino , México/epidemiología , Obesidad/sangre , Obesidad/epidemiología , Obesidad/metabolismo , Sobrepeso/sangre , Sobrepeso/epidemiología , Sobrepeso/metabolismo , Prevalencia

RESUMEN

INTRODUCTION: Diverse psychosocial and cultural factors are related to adherence to treatment of type 2 Diabetes mellitus (DM2) such as social support, coping styles and the cost of medical attention. OBJECTIVE: To study the influence of diverse psychosocial factors on adherence to treatment in patients with DM2. MATERIAL AND METHODS: In a cross sectional design we studied adherence to diet and medication, and its relationship with CS for diabetes, belief in conventional medicine, social support, and the perception of the burden of treatment cost on family finances. RESULTS: We included 210 patients a mean age of 56.3 years, 9.4 years since diagnosis. Male DM patients had better adherence to medication (p<0.016) and social support (p<0.004), and higher rates for supportant CS (31.8 vs. 29.0; p<0.009). Adherence to diet was associated with belief in conventional medicine (p<0.035) and marginally related to fatalistic CS (p<0.05). After testing social security coverage as dummy variable, a marginal association was found (p<0.15). Adherence to medication was associated with supportant CS (p<0.02) and marginally with avoidant CS (p<0.05). CONCLUSIONS: Supportant CS was more frequent in men. Belief in conventional medicine, and supportant CS were associated with adherence to treatment. These factors should be considered for a more rational approach for the management of disease.

Asunto(s)

Adaptación Psicológica , Diabetes Mellitus Tipo 2/psicología , Cooperación del Paciente , Adulto , Anciano , Automonitorización de la Glucosa Sanguínea/psicología , Automonitorización de la Glucosa Sanguínea/estadística & datos numéricos , Costo de Enfermedad , Cultura , Negación en Psicología , Complicaciones de la Diabetes/psicología , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/economía , Dieta para Diabéticos/psicología , Femenino , Humanos , Hipoglucemiantes/administración & dosificación , Hipoglucemiantes/uso terapéutico , Masculino , Cumplimiento de la Medicación , México , Persona de Mediana Edad , Seguridad Social/estadística & datos numéricos , Apoyo Social

RESUMEN

OBJECTIVE: To examine the association between thyroid function and the components of the metabolic syndrome and insulin resistance in an Hispanic population. DESIGN: Cross-sectional study. METHODS: Subjects with no history of thyroid disease or diabetes were included. Thyroid function was stratified as euthyroid or subclinical hypothyroidism (SCH) status and subsequently by free thyroxine (FT(4)) and TSH tertiles. The association of the metabolic syndrome components (defined by 2004 Adult Treatment Panel III criteria) and insulin resistance with thyroid status, TSH, and FT(4) were examined. RESULTS: A total of 3148 subjects were analyzed. The prevalence of SCH was 8.3%. The prevalence of the metabolic syndrome was similar in euthyroid and SCH patients (31.6 vs 32.06%, P=0.89). Total cholesterol was higher in patients with SCH (5.51+/-1.19 vs 5.34+/-1.05 mmol/l, P<0.032). Serum TSH values showed a positive correlation (adjusted for age and sex) with total cholesterol, triglycerides, and waist circumference. In contrast, FT(4) showed a positive correlation with high-density lipoprotein cholesterol, and an inverse correlation with waist circumference, insulin, and HOMA-IR. CONCLUSION: SCH is not associated with an increased risk for the metabolic syndrome (as conceived as a diagnostic category defined by the National Cholesterol, Education Program, Adult Treatment Panel III criteria). Despite this, low thyroid function (even in the euthyroid state) predisposes to higher cholesterol, glucose, insulin, and HOMA-IR levels. The combined use of TSH and FT(4), compared with the assessment based on only FT(4), is a more convenient approach to evaluate the association between thyroid function and metabolic variables.

Asunto(s)

Hipotiroidismo/sangre , Hipotiroidismo/epidemiología , Síndrome Metabólico/epidemiología , Tirotropina/sangre , Tiroxina/sangre , Biomarcadores , Glucemia , HDL-Colesterol/sangre , Estudios Transversales , Femenino , Hispánicos o Latinos , Humanos , Insulina/sangre , Resistencia a la Insulina , Masculino , Síndrome Metabólico/sangre , México , Prevalencia , Factores de Riesgo , Índice de Severidad de la Enfermedad , Estadísticas no Paramétricas , Pruebas de Función de la Tiroides , Glándula Tiroides/metabolismo , Triyodotironina/sangre , Circunferencia de la Cintura

RESUMEN

OBJECTIVE: To investigate the influence of the Pro12Ala polymorphism of the PPAR gamma 2 gene on metabolic and hormonal response to pioglitazone treatment in obese postmenopausal women. DESIGN: We included 102 obese (body mass index [BMI] >or=30 kg/m2) and 97 nonobese (BMI

Asunto(s)

Predisposición Genética a la Enfermedad/genética , Hiperglucemia/tratamiento farmacológico , Obesidad/genética , PPAR gamma/genética , Polimorfismo de Nucleótido Simple/genética , Glucemia/genética , Estrógenos Conjugados (USP)/uso terapéutico , Femenino , Frecuencia de los Genes/genética , Humanos , Hiperglucemia/genética , Hipoglucemiantes/uso terapéutico , Persona de Mediana Edad , Pioglitazona , Posmenopausia , Tiazolidinedionas/uso terapéutico