RESUMEN
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by damage to multiple systems and a higher risk of cardiovascular disease. In addition, several studies have found that insulin resistance (IR) is more prevalent in SLE patients than controls, increasing the risk of prediabetes, type 2 diabetes mellitus (T2DM) and morbidity. The objective of this review article was to summarize the most relevant evidence about the relationship among IR, T2DM and SLE, including the effects of proinflammatory states, acute-phase proteins, pro-inflammatory cytokines, and pharmacological SLE treatment. A better understanding of the mechanisms involved in these comorbidities will allow better treatment strategies.
Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Resistencia a la Insulina , Lupus Eritematoso Sistémico , Humanos , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/diagnóstico , Lupus Eritematoso Sistémico/tratamiento farmacológico , ComorbilidadRESUMEN
BACKGROUND: The triglyceride/high-density lipoprotein (TG/HDL) index has been proposed as an indicator of cardiovascular risk. In Mexico, there is a study in young adults that relates it to insulin resistance, but no cutoff point that distinguishes subjects with metabolic syndrome has been defined. OBJECTIVE: To determine the cutoff point for the TG/HDL index that identifies subjects with metabolic syndrome in the Mexican population. METHODS: Metabolic syndrome was diagnosed using the criteria established in the Third Report of the Adult Treatment Panel of the National Cholesterol Education Program adapted to the Mexican population. To identify the TG/HDL index cutoff point, ROC curve analysis and the Youden index were used. RESULTS: 1,318 subjects aged 40.9 ± 13.0 years participated in the study; 65.6% were women and 34.4% men; 41.2% had metabolic syndrome. The TG/HDL index obtained an area under the curve of 0.85 and an optimal cutoff point value ≥ 3.46, with a sensitivity of 79.6% and specificity of 76.4%. CONCLUSIONS: TG/HDL index cutoff point ≥ 3.46 is suitable for identifying subjects with metabolic syndrome in the Mexican population.
ANTECEDENTES: El índice triglicéridos/lipoproteína de alta densidad (TG/HDL) ha sido propuesto como un indicador de riesgo cardiovascular. En México, existe un estudio en adultos jóvenes que lo relaciona con resistencia a la insulina, pero no se ha definido un punto de corte que distinga a sujetos con síndrome metabólico. OBJETIVO: Determinar el punto de corte para el índice TG/HDL que identifique a sujetos con síndrome metabólico en población mexicana. MÉTODOS: El síndrome metabólico se diagnosticó mediante los criterios establecidos en el Tercer Reporte del Panel de Tratamiento para Adultos del Programa Nacional de Educación en Colesterol adaptados a la población mexicana. Para identificar el punto de corte del índice TG/HDL se utilizó el análisis de curvas ROC y el índice de Youden. RESULTADOS: En el estudio participaron 1318 sujetos con edad de 40.9 ± 13.0 años; 65.6 % fuerin mujeres y 34.4 % hombres; 41.2% presentó síndrome metabólico. El índice TG/HDL obtuvo un valor del área bajo la curva de 0.85 y un valor óptimo de punto de corte ≥ 3.46, con sensibilidad de 79.6 % y especificidad de 76.4 %. CONCLUSIONES: El punto de corte ≥ 3.46 para el índice TG/HDL es adecuado para identificar a sujetos con síndrome metabólico en población mexicana.
Asunto(s)
Resistencia a la Insulina , Síndrome Metabólico , Masculino , Humanos , Femenino , Síndrome Metabólico/diagnóstico , Síndrome Metabólico/epidemiología , Lipoproteínas HDL , Triglicéridos , México , HDL-Colesterol , Factores de RiesgoRESUMEN
Resumen Antecedentes: El índice triglicéridos/lipoproteína de alta densidad (TG/HDL) ha sido propuesto como un indicador de riesgo cardiovascular. En México, existe un estudio en adultos jóvenes que lo relaciona con resistencia a la insulina, pero no se ha definido un punto de corte que distinga a sujetos con síndrome metabólico. Objetivo: Determinar el punto de corte para el índice TG/HDL que identifique a sujetos con síndrome metabólico en población mexicana. Métodos: El síndrome metabólico se diagnosticó mediante los criterios establecidos en el Tercer Reporte del Panel de Tratamiento para Adultos del Programa Nacional de Educación en Colesterol adaptados a la población mexicana. Para identificar el punto de corte del índice TG/HDL se utilizó el análisis de curvas ROC y el índice de Youden. Resultados: En el estudio participaron 1318 sujetos con edad de 40.9 ± 13.0 años; 65.6 % fuerin mujeres y 34.4 % hombres; 41.2% presentó síndrome metabólico. El índice TG/HDL obtuvo un valor del área bajo la curva de 0.85 y un valor óptimo de punto de corte ≥ 3.46, con sensibilidad de 79.6 % y especificidad de 76.4 %. Conclusiones: El punto de corte ≥ 3.46 para el índice TG/HDL es adecuado para identificar a sujetos con síndrome metabólico en población mexicana.
Abstract Background: The triglyceride/high-density lipoprotein (TG/HDL) index has been proposed as an indicator of cardiovascular risk. In Mexico, there is a study in young adults that relates it to insulin resistance, but no cutoff point that identifies subjects with metabolic syndrome has been defined. Objective: To determine the cutoff point for the TG/HDL index that identifies subjects with metabolic syndrome in the Mexican population. Methods: Metabolic syndrome was diagnosed using the criteria established by the Third Report of the Adult Treatment Panel of the National Cholesterol Education Program adapted to the Mexican population. To identify the TG/HDL index cutoff point, ROC curve analysis and the Youden index were used. Results: 1,318 subjects aged 40.9 ± 13.0 years participated in the study; 65.6% were women and 34.4% men; 41.2% had metabolic syndrome. The TG/HDL index obtained an area under the curve of 0.85 and an optimal cutoff point value ≥ 3.46, with a sensitivity of 79.6% and specificity of 76.4%. Conclusions: TG/HDL index cutoff point ≥ 3.46 is suitable for identifying subjects with metabolic syndrome in the Mexican population.
RESUMEN
INTRODUCTION: The low-density lipoprotein (LDL)/high-density lipoprotein (HDL) index is a predictive factor for atherosclerosis, which is associated with oxidative modifications. OBJECTIVE: To assess the association of the index with oxidative stress markers. METHODS: 444 subjects were included and were clinically, anthropometrically and biochemically characterized; superoxide dismutase, glutathione peroxidase 3 (GPx3), magnesium and oxidized LDL (oxLDL) index (oxLDL/HDL) were quantified. RESULTS: A decrease of 1.014 units in the LDL/HDL index was associated with a superoxide dismutase increase of 1 unit/mL (p = 0.030), while a decrease of 0.023 units was associated with a GPx3 increase of 1 nmol/min/mL (p < 0.0005). An increase of one unit in the index was associated with an increase of 0.831 in the oxLDL/HDL index (p < 0.05). After controlling for the effect of gender, age, smoking, obesity and insulin resistance, a reduction of 0.001 per index unit was associated with an increase of 1 µg/g of magnesium in the nails (p = 0.020). CONCLUSIONS: The LDL/HDL index shows an inverse relationship with the antioxidant status and a direct relationship with oxidation status, regardless of other cardiovascular and oxidative stress risk factors.
INTRODUCCIÓN: El índice de lipoproteínas de baja densidad (LDL)/lipoproteínas de alta densidad (HDL) es un factor predictivo de aterosclerosis, la cual está asociada con modificaciones oxidativas. OBJETIVO: Evaluar la asociación del índice con marcadores de estrés oxidativo. MÉTODO: Se incluyeron 444 sujetos, caracterizados clínica, antropométrica y bioquímicamente; se cuantificó superóxido dismutasa, glutation peroxidasa 3 (GPx3), magnesio e índice LDL oxidadas (oxLDL/HDL). RESULTADOS: La disminución en 1.014 unidades del índice LDL/HDL se asoció con aumento de 1 unidad/mL de superóxido dismutasa (p = 0.030) y la de 0.023 unidades con aumento de 1 nmol/minuto/mL de GPx3 (p < 0.0005). El aumento en 1 unidad del índice se asoció con aumento de 0.831 unidades en el índice oxLDL/HDL (p < 0.05). Después de controlar el efecto del sexo, edad, fumar, obesidad y resistencia a la insulina, la reducción de 0.001 por unidad del índice se asoció con aumento de 1 µg/g de magnesio en uñas (p = 0.020). CONCLUSIONES: El índice LDL/HDL presenta relación inversa con el estado antioxidante y relación directa con el estado de oxidación, independientemente de otros factores de riesgo cardiovascular y de estrés oxidativo.
Asunto(s)
Glutatión Peroxidasa/sangre , Lipoproteínas HDL/sangre , Lipoproteínas LDL/sangre , Superóxido Dismutasa/sangre , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Resistencia a la Insulina , Magnesio/análisis , Masculino , Persona de Mediana Edad , Obesidad/sangre , Estrés Oxidativo , Análisis de Regresión , Factores Sexuales , Fumar/sangre , Estadísticas no Paramétricas , Adulto JovenRESUMEN
OBJECTIVE: A protective function of vitamin D in metabolic syndrome (MetS) has been described. The objective of the present study was to examine the relationship between serum 25-hydroxyvitamin D (25(OH)D) concentrations and MetS in non-diabetic systemic lupus erythematosus (SLE) women. METHODS: Cross-sectional analyses of the relationship between concentrations of 25(OH)D, MetS, and its components were made in 160 non-diabetic SLE women. MetS was defined according to National Cholesterol Education Program Adult Treatment Panel III criteria. Serum 25(OH)D was measured by chemiluminescent immunoassay. Serum 25(OH)D concentrations were categorized into quartiles (<16.6, 16.6-21.1, 21.2-26.3, ≥26.4 ng/mL). RESULTS: A total of 79 (49.3%) SLE women had MetS. Without adjusting for body mass index (BMI) or smoking, the odds of having MetS decreased according to increasing quartiles of 25(OH)D concentrations (P for trend = .03). The odds ratio (OR) of having MetS was 0.4 (95% confidence interval: 0.2-0.9, P = .04) for the highest vs the lowest quartile of 25(OH)D concentrations when adjusted by age. The crude OR of having elevated hypertriglyceridemia decreased according to increasing quartiles of 25(OH)D concentrations (P for trend = .036). However, further adjustments for BMI and smoking removed the inverse association between 25(OH)D concentrations and MetS and its individual components. CONCLUSION: In non-diabetic SLE women with mild activity, 25(OH)D concentrations are not associated with MetS and its components.
Asunto(s)
Lupus Eritematoso Sistémico/sangre , Síndrome Metabólico/etiología , Vitamina D/análogos & derivados , Adulto , Biomarcadores/sangre , Estudios Transversales , Femenino , Humanos , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/diagnóstico , Síndrome Metabólico/sangre , Síndrome Metabólico/diagnóstico , Persona de Mediana Edad , Pronóstico , Medición de Riesgo , Factores de Riesgo , Vitamina D/sangreRESUMEN
Introduction: The low-density lipoprotein (LDL)/high-density lipoprotein (HDL) index is a predictive factor for atherosclerosis, which is associated with oxidative modifications. Objective: To assess the association of the index with oxidative stress markers. Methods: 444 subjects were included and were clinically, anthropometrically and biochemically characterized; superoxide dismutase, glutathione peroxidase 3 (GPx3), magnesium and oxidized LDL (oxLDL) index (oxLDL/HDL) were quantified. Results: A decrease of 1.014 units in the LDL/HDL index was associated with a superoxide dismutase increase of 1 unit/mL (p = 0.030), while a decrease of 0.023 units was associated with a GPx3 increase of 1 nmol/min/mL (p < 0.0005). An increase of one unit in the index was associated with an increase of 0.831 in the oxLDL/HDL index (p < 0.05). After controlling for the effect of gender, age, smoking, obesity and insulin resistance, a reduction of 0.001 per index unit was associated with an increase of 1 µg/g of magnesium in the nails (p = 0.020). Conclusions: The LDL/HDL index shows an inverse relationship with the antioxidant status and a direct relationship with oxidation status, regardless of other cardiovascular and oxidative stress risk factors.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Superóxido Dismutasa/sangre , Estrés Oxidativo , Glutatión Peroxidasa/sangre , Lipoproteínas HDL/sangre , Lipoproteínas LDL/sangre , Resistencia a la Insulina , Fumar , Factores Sexuales , Estudios Transversales , Factores de Edad , Magnesio/análisis , Uñas/química , ObesidadRESUMEN
INTRODUCTION: The low-density lipoprotein (LDL)/high-density lipoprotein (HDL) index is a predictive factor for atherosclerosis, which is associated with oxidative modifications. OBJECTIVE: To assess the association of the index with oxidative stress markers. METHODS: 444 subjects were included and were clinically, anthropometrically and biochemically characterized; superoxide dismutase, glutathione peroxidase 3 (GPx3), magnesium and oxidized LDL (oxLDL) index (oxLDL/HDL) were quantified. RESULTS: A decrease of 1.014 units in the LDL/HDL index was associated with a superoxide dismutase increase of 1 unit/mL (p = 0.030), while a decrease of 0.023 units was associated with a GPx3 increase of 1 nmol/min/mL (p < 0.0005). An increase of one unit in the index was associated with an increase of 0.831 in the oxLDL/HDL index (p < 0.05). After controlling for the effect of gender, age, smoking, obesity and insulin resistance, a reduction of 0.001 per index unit was associated with an increase of 1 µg/g of magnesium in the nails (p = 0.020). CONCLUSIONS: The LDL/HDL index shows an inverse relationship with the antioxidant status and a direct relationship with oxidation status, regardless of other cardiovascular and oxidative stress risk factors.
Asunto(s)
Glutatión Peroxidasa/sangre , Lipoproteínas HDL/sangre , Lipoproteínas LDL/sangre , Estrés Oxidativo , Superóxido Dismutasa/sangre , Adulto , Factores de Edad , Estudios Transversales , Femenino , Humanos , Resistencia a la Insulina , Magnesio/análisis , Masculino , Uñas/química , Obesidad , Factores Sexuales , FumarRESUMEN
AIM: To evaluate if the TG/HDL-C index can be considered as a reference criterion of MetS and low insulin sensitivity in apparently healthy subjects. METHODS: The subjects were Mexican mestizos who resided in Puebla City, Mexico, who were anthropometrically, biochemically, and clinically characterized. The TG/HDL-C index was calculated by dividing triglyceride (TG) levels by HDL-C levels. MetS was diagnosed by the Third Report from the Adult Treatment Panel-National Cholesterol Education Program (ATP-III NCEP) criteria, while insulin sensitivity was evaluated by the Quantitative Insulin sensitivity Check Index (QUICKI). RESULTS: The study included 813 subjects, with an average age of 38.6 ± 12.1 years, of which 564 were women and 249 men. An association was found between high TG/HDL-C index and low insulin sensitivity (Odds ratio [OR]: 4.09; p < 0.01) and with MetS (OR: 15.29; p < 0.01). A correlation was found between the TG/HDL-C index and QUICKI (rho: -0.4989; p < 0.01) and with MetS (rho: 0.6581; p < 0.01). CONCLUSION: The results indicate that the TG/HDL-C index is associated with low insulin sensitivity and MetS in apparently healthy subjects, suggesting this index as a reference criterion of risk for low insulin sensitivity and MetS.
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HDL-Colesterol/sangre , Resistencia a la Insulina , Lipoproteínas HDL/sangre , Síndrome Metabólico/metabolismo , Triglicéridos/sangre , Adulto , Femenino , Humanos , Masculino , Síndrome Metabólico/sangre , Síndrome Metabólico/epidemiología , México , Valores de Referencia , Medición de RiesgoRESUMEN
OBJECTIVES: To determine whether the well-known genetic structure of the Mexican population observed with other multiallelic markers can be detected by analyzing functional polymorphisms of cytokine and other inflammatory-response-related genes. METHODS: A total of 834 Mestizo individuals from five Mexican cities and 92 Lacandonians - an Amerindian group from southeastern Mexico - were genotyped for 14 polymorphisms in the CRP, IL10, IL6, TGFB1, TNFA, LTA, ICAM1 IFNG, and IL1RN genes. Allele and haplotype frequencies were used for genetic structure analysis using F-statistics pairwise distances and multidimensional scaling plot. Ancestry analysis was performed, as well. RESULTS: Significant interpopulational differences at the allele and haplotype frequency level were observed, mainly between Northern (Guadalajara, Monterrey, and Culiacan) and Southern (Tierra Blanca and Puebla) Mexican populations. Also, low but significant substructure was detected between some populations from these two broad regions. Interestingly, both Lacandonian populations were highly differentiated from each other and with respect to Mestizos. Consistent with previous data, Amerindian ancestry in the Southern Mexican groups was higher compared to Northern ones. CONCLUSIONS: The Mexican population exhibits regional differences in functional polymorphisms of inflammatory-response genes, as observed for other genetic markers. This information constitutes a reference for epidemiological studies that include these genetic markers to assess the susceptibility of the Mexican population to several immune-response-related diseases, such as diabetes, obesity, and renal disease, which have been shown to be common in the Mexican population but with prevalence differences within this country.
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Citocinas/genética , Polimorfismo Genético , Etnicidad/genética , Humanos , MéxicoRESUMEN
BACKGROUND: Metabolic syndrome (MetS) is considered a public health problem worldwide. Recently, oxidative stress (OS) has been proposed as a factor related with the genesis of MetS. Different studies have reported decreased antioxidant defense, such as superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GRed) activities, and reduced glutathione (GSH) concentration, and, on the other hand, an increase in nitrotyrosine concentration in MetS patients. However, it is not known whether there is a direct association of antioxidant defense with MetS in a Mexican population. The aim of the study was to determine the relationship between antioxidant defense and MetS in Mexican subjects. MATERIALS AND METHODS: The subjects were Mexican mestizos, who were anthropometrically, biochemically, and clinically characterized. MetS was diagnosed by National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III)-modified criteria. Antioxidant defense was determined by activity of SOD, GPx, GRed, and GSH concentrations; as a marker of OS, nitrotyrosine concentration was determined. RESULTS: The study included 376 subjects, among whom 152 subjects had MetS and 224 were assigned to the non-MetS group. Statistical association was found between MetS and SOD activity (Odds ratio: 167.1; P < 0.01; adjusted by age, gender, and waist circumference). It is noteworthy that a significant correlation between antioxidant defense (SOD and GPx activities, and GSH) and different MetS components was found and between MetS and nitrotyrosine concentration (P < 0.05). CONCLUSION: The results indicate that SOD activity is associated with MetS in Mexican subjects, allowing us to suggest that this enzyme plays an important role in the pathophysiology of MetS.
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Antioxidantes/metabolismo , Síndrome Metabólico/sangre , Superóxido Dismutasa/sangre , Adulto , Pesos y Medidas Corporales , Femenino , Glutatión/sangre , Glutatión Peroxidasa/sangre , Humanos , Masculino , Síndrome Metabólico/etnología , México/etnología , Persona de Mediana Edad , Estrés Oxidativo/fisiología , Adulto JovenRESUMEN
BACKGROUND AND AIMS: Glutathione peroxidase 3 (GPx3) plays a main role in removing hydro- and lipoperoxides from the body. Changes in concentration and several single-nucleotide polymorphisms (SNP) at the GPX3 gene have been associated with vascular diseases, but the relationship of GPx3 with metabolic syndrome (MetS) remains unexplored. We undertook this study to determine the association of GPx3 serum levels and several GPX3 SNPs with the presence of MetS in Mexican subjects. METHODS: Clinical, biochemical, and anthropometric evaluation were conducted in 426 subjects assigned to three groups: control (n = 42); risk group (RG, n = 200), and MetS group (n = 184). Insulin sensitivity (IS) and cardiovascular risk were determined by the QUICKI and TG/HDL-C index, respectively. Serum GPx3 was determined by enzyme immunoassay and polymorphisms within GPX3 gene were identified by nucleotide sequencing. RESULTS: MetS group showed low IS and increased cardiovascular risk with respect to controls as well as higher GPx3 serum levels (172.9 ± 32.2 vs. 145.6 ± 24.8 ng/dL; p <0.05). Only three of the ten GPX3 SNPs screened were polymorphic with two haplotypes observed (CCT and TTA-rs8177404, rs8177406, and rs8177409), indicating tight linkage disequilibrium in this genetic region. No differences for either genotype or allele frequencies among groups were observed, but rs8177409 (allele T) was associated with cardiovascular risk (odds ratio [OR], 4.5; p = 0.0125). CONCLUSION: This study shows that serum levels of GPx3 are increased in subjects with MetS and that rs8177409 SNP was associated with cardiovascular risk in a Mexican population.
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Glutatión Peroxidasa/sangre , Glutatión Peroxidasa/genética , Síndrome Metabólico/sangre , Síndrome Metabólico/genética , Polimorfismo de Nucleótido Simple , Adulto , Biomarcadores/sangre , Enfermedades Cardiovasculares/etiología , Estudios de Casos y Controles , Femenino , Frecuencia de los Genes , Marcadores Genéticos , Haplotipos , Humanos , Resistencia a la Insulina/genética , Desequilibrio de Ligamiento , Modelos Logísticos , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/diagnóstico , México , Persona de Mediana Edad , Oportunidad Relativa , Reacción en Cadena de la Polimerasa , Medición de Riesgo , Factores de Riesgo , Análisis de Secuencia de ADNRESUMEN
BACKGROUND AND AIMS: Defects in insulin sensitivity (IS) and insulin secretion have been recognized as risk factors for type 2 diabetes (T2D) and its complications. We undertook this study to establish the relationship between healthy type 2 diabetic offspring (OFD) from a Mexican population with IS. METHODS: A total of 602 Mexican subjects, 359 first-degree offspring of T2D (OFD+) and 243 first-degree non-offspring of T2D (OFD-) were classified as young adults (age range, 18-44 years) and middle-aged adults (age range, 45-65 years). Groups were clinically and biochemically characterized. Quantitative insulin sensitivity check index (QUICKI) was used to estimate IS and the homeostasis model assessment B (HOMA-B) was used to estimate B cell function. RESULTS: IS decreased significantly (p <0.05) in OFD+ middle-aged (QUICKI 0.330 ± 0.03) compared with OFD- (0. 370 ± 0.03). Middle-aged adults (OFD+) had the highest prevalence of increased fasting insulin levels (FIL) (13.6%) and decreased IS (22.9%) compared with OFD- groups (3.2%). A binary regression analysis showed the association of OFD+ with increased FIL (odds ratio [OR], 3.71; 95% confidence interval [95% CI], 1.68-8.2; p = 0.001), and QUICKI (OR, 10.87; 95% CI, 2.36-44.69; p <0.01) adjusted by gender, age, and obesity. CONCLUSIONS: Our results suggest that decreased IS itself could be recognized as one of the earliest detectable abnormalities in middle-aged adults. Moreover, prevalence increases with age and is associated with type 2 diabetic offspring, regardless of obesity.
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Diabetes Mellitus Tipo 2/prevención & control , Resistencia a la Insulina , Adulto , Factores de Edad , Anciano , Diabetes Mellitus Tipo 2/fisiopatología , Ayuno , Femenino , Humanos , Insulina/sangre , Insulina/metabolismo , Secreción de Insulina , Masculino , México , Persona de Mediana Edad , Obesidad/fisiopatología , Prevalencia , Análisis de Regresión , Factores de Riesgo , Adulto JovenRESUMEN
BACKGROUND AND AIMS: There is evidence that family history of type 2 diabetes (FHT2D) and single nucleotide polymorphisms (SNP) on the IL-6 gene promoter region are separately associated with the risk of developing type 2 diabetes. However the relationship between adult Mexican subjects with FHT2D and genotypes/haplotypes for IL-6 gene has not been explored. The aim of the present work was to study the prevalence of IL-6 -598G>A-572G>C-174G>C haplotypes among subjects with FHT2D and to determine whether their presence influences the relationship between FHT2D and risk factors for diabetes. METHODS: Two hundred fifty eight nondiabetic subjects participated in this study; 153 with and 105 without FHT2D. Polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP) was used for genotyping. Logistic regression analysis was employed to assess the impact of IL-6 haplotypes on FHT2D per se and hyperinsulinemia and insulin resistance as risk factors for diabetes. RESULTS: Subjects with FHT2D showed a higher prevalence of hyperinsulinemia and insulin resistance (IR) than those without FHT2D (14.4 vs. 5.7%, p = 0.029, and 14.2 vs. 7.0% p = 0.050, respectively). Lower prevalence of -598 -572-174 (AGC)-haplotype (19%) in subjects with FHT2D was observed as well as a lower prevalence of hyperinsulinemia and IR among AGC haplotype carriers (12 and 14%, respectively). The relationship between FHT2D and IR was modified by the presence of AGC haplotype (from OR, 2.70; 95% CI, 0.99-7.36; p = 0.050 OR, 30.08; 95% CI, 0.58-1,568.06; p = 0.092). CONCLUSIONS: IL-6 -598/-572/-174 (AGC) haplotype has a low prevalence among first-degree relatives of subjects with type 2 diabetes. Our results suggest that this haplotype is associated with decreased risk of type 2 diabetes in Mexican subjects with FHT2D.
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Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/genética , Predisposición Genética a la Enfermedad/genética , Haplotipos , Interleucina-6/genética , Adulto , Anciano , Femenino , Humanos , Resistencia a la Insulina/genética , Masculino , México/epidemiología , Persona de Mediana Edad , Polimorfismo de Longitud del Fragmento de Restricción , Polimorfismo de Nucleótido Simple , Prevalencia , Factores de RiesgoRESUMEN
BACKGROUND AND AIMS: Overweight and obesity are considered complex entities in which there are alterations in the concentration of antioxidant enzymes. It has been reported that glutathione peroxidase 3 (GPx3), an extracellular enzyme involved in the reduction of both hydro- and lipoperoxides, shows changes both in gene expression and protein concentration in animal models for type 2 diabetes (T2D) and obesity, but the variability of GPx3 levels in different human populations and under different health conditions are currently unclear. We undertook this study to determine the GPx3 levels in overweight and obese subjects from central Mexico. METHODS: Biochemical profile (serum glucose, insulin and lipid profile) and GPx3 concentrations were determined in 28 healthy subjects (control) and 133 subjects who were overweight or obese (OW-OB). RESULTS: The OW-OB group had a higher concentration of triacylglycerides (TAG) compared with the control group (201.2 ± 88.7 vs. 100.3 ± 46.4 mg/dL, p <0.05) and the TAG/high density lipoprotein-cholesterol (HDL-C) index (5.6 ± 2.8 vs. 2.1 ± 1.2, p <0.05), whereas the concentration of HDL-C decreased (38.2 ± 8.7 vs. 50.1 ± 14.5 mg/dL, p <0.05). Serum GPx3 was significantly higher in the OW-OB group than in the control group (175.4 ± 25.4 vs. 143.5 ± 23.1 ng/dL). GPx3 concentration correlated with insulin sensitivity (IS) and the TAG/HDL-C index (Rho = -0.2336 and Rho = 0.2275) (p <0.01). CONCLUSIONS: The TAG/HDL-C index and serum GPx3 concentration increased in the OW-OB group. In addition, GPx3 had a significant correlation with IS, weight, and the TAG/HDL-C index.
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Glutatión Peroxidasa/sangre , Obesidad/sangre , Sobrepeso/sangre , Adulto , Índice de Masa Corporal , HDL-Colesterol/sangre , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/metabolismo , Femenino , Humanos , Insulina/sangre , Resistencia a la Insulina , Masculino , México , Persona de Mediana Edad , Obesidad/enzimología , Sobrepeso/enzimologíaRESUMEN
BACKGROUND: Independent of obesity, family history of type 2 diabetes mellitus (FHT2DM) is another important risk factor for developing diabetes. AIM: To establish the association among FHT2DM, risk factors for diabetes and cardiovascular disease in subjects from central Mexico. SUBJECTS AND METHODS: Clinical and biochemical studies were performed in 383 first-degree relatives of patients with type 2 diabetes and 270 subjects unrelated to patients with type 2 diabetes-all subjects were from the city of Puebla in central Mexico. Logistic regressions were used to assess the association between FHT2DM and metabolic parameters. Cardiovascular risk was classified by dyslipidemia and the Framingham Risk Score (FRS). RESULTS: FHT2DM was associated with risk factors for diabetes, such as increased fasting insulin levels (OR = 1.731, 95% CI = 1.041-2.877), decreased insulin sensitivity (OR = 1.951, 95% CI = 1.236-3.080) and pre-diabetes (OR = 1.63, 95% CI = 1.14-2.33). FHT2DH was not associated with risk factors for cardiovascular disease, such as dyslipidemia (OR = 1.12, 95% CI = 0.70-1.79) and FRS (OR = 0.74, 95% CI = 0.40-1.36) when adjusted for gender, age, smoking and obesity. CONCLUSION: Diabetic risk factors, but not cardiovascular disease risk factors, are associated with a positive family history of diabetes in subjects from central Mexico, independent of the presence of obesity.
Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus/epidemiología , Adolescente , Adulto , Anciano , Diabetes Mellitus Tipo 2/genética , Dislipidemias/epidemiología , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Obesidad/epidemiología , Estado Prediabético/epidemiología , Factores de RiesgoRESUMEN
AIMS: The clinical diagnosis of metabolic syndrome does not find any parameters to evaluate the insulin sensitivity (IS) or ß-cell function. The evaluation of these parameters would detect early risk of developing metabolic syndrome. The aim of this study is to determine the relationship between ß-cell function and presence of metabolic syndrome in Mexican subjects. MATERIAL AND METHODS: This study is part of the Mexican Survey on the Prevention of Diabetes (MexDiab Study) with headquarters in the city of Puebla, Mexico. The study comprised of 444 subjects of both genders, aged between 18 and 60 years and allocated into two study groups: (1) control group of individuals at metabolic balance without metabolic syndrome and (2) group composed of subjects with metabolic syndrome and diagnosed according to the criteria of the Third Report of the National Cholesterol Education Program Expert Panel on Defection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Anthropometric, biochemical, and clinical assessments were carried out. RESULTS: Average age of the subjects in the control group (n = 254) was 35.7 ± 11.5 years and 42.0 ± 10.7 years for subjects in the metabolic syndrome group (n = 190). Subjects at metabolic balance without metabolic syndrome showed decreased IS, increased insulin resistance (IR), and altered ß-cell function. Individuals with metabolic syndrome showed a high prevalence (P ≤ 0.05) of family history of type 2 diabetes (T2D). This group also showed a significant metabolic imbalance with glucose and insulin levels and lipid profile outside the ranges considered safe to prevent the development of cardiovascular disease and T2D. CONCLUSION: The main finding in this study was the detection of altered ß-cell function, decreased IS, an increased IR in subjects at metabolic balance, and the progressive deterioration of ß-cell function and IS in subjects with metabolic syndrome as the number of features of metabolic syndrome increases.