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Abstract Introduction The COVID-19 pandemic caused the cessation of academic activities from the face-to-face format to confinement and virtual classes, in which little is studied about its effect on mental health. Objective Determine levels of depression, anxiety, and stress in medical students in Mexico and Colombia during the COVID-19 pandemic. Furthermore, depression, anxiety, and stress were compared by gender, education status, and country. Method A cross-sectional study was carried out with 426 medical students. Data was collected using an online survey containing the Depression, Anxiety, Stress Scale (DASS-21) questionnaire. Results Overall scores for depression, anxiety, and stress were 6.7 ± 1.2, 8.8 ± 1.2, and 5.6 ± 1.2, respectively. Females had significantly higher overall scores for depression (.24-fold increase), anxiety (.25-fold increase), and stress (.40-fold increase) than males (p ≤ .01). The risk for anxiety and stress by school year showed that basic years were associated with higher scores than advanced years (.25 and .38-fold increase, respectively). For females, starting medical school did show an increased risk of depression when compared to male students in their basic years (.38-fold increase). Lastly, students from Mexico had an increased risk for depression and anxiety (p ≤ .022 and p ≤ .004, respectively) but not for stress (p ≤ .402), when compared to students from Colombia. Discussion and conclusion Significant anxiety and depression were observed in medical students from Mexico and Colombia. Factors associated with an increased risk of depression and anxiety are students in their basic years as well as being female.

Resumen Introducción La pandemia de COVID-19 provocó el cese de las actividades académicas desde el formato presencial al confinamiento de las clases virtuales, de las que poco se ha estudiado sobre su efecto en la salud mental. Objetivo Determinar los niveles de depresión, ansiedad y estrés en estudiantes de medicina de México y Colombia durante la pandemia de COVID-19; además de comparar depresión, ansiedad y estrés por género, nivel educativo y país. Método Se realizó un estudio transversal con 426 estudiantes de medicina. Los datos se recopilaron mediante una encuesta en línea que contenía el cuestionario DASS-21. Resultados Las puntuaciones generales de depresión, ansiedad y estrés fueron 6.7 ± 1.2, 8.8 ± 1.2 y 5.6 ± 1.2, respectivamente. Las mujeres tuvieron puntajes generales significativamente más altos para depresión (.24-fold increase), ansiedad (.25-fold increase) y estrés (.40-fold increase). El riesgo de ansiedad y estrés por año escolar mostró que los años básicos se asociaron con puntajes más altos que los estudiantes en años los avanzados (.25 y .38-fold increase). Para las mujeres, cursar años básicos mostró un mayor riesgo de depresión en comparación con los estudiantes varones (.38-fold increase). Por último, los estudiantes mexicanos tuvieron un mayor riesgo de depresión y ansiedad (p ≤ .022 y p ≤ .004, respectivamente) pero no de estrés (p ≤ .402) en comparación con los estudiantes Colombianos. Discusión y conclusión Se observó ansiedad y depresión significativas en estudiantes de medicina mexicanos y colombianos. Los factores asociados a un mayor riesgo de depresión y ansiedad fueron; ser estudiante en años básicos además de ser mujer.

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Oxidative stress plays an important role in vascular complications observed in patients with obesity and Type 2 Diabetes (T2D). Xanthine oxidase (XO) breaks down purine nucleotides into uric acid and contributes to the production of reactive oxygen species (ROS). However, the relationship between XO activity and glucose homeostasis in T2D subjects with obesity is unclear. We hypothesized that disordered glucose levels are associated with serum XO activity in overweight women and men with T2D and without hyperuricemia. We studied serum XO activity in women and men with and without T2D. Our results show that serum XO activity was greater in T2D patients with body mass index (BMI) ≥ 25 kg/m2 than in those with BMI < 25 kg/m2 (p < 0.0001). Sex-based comparative analyses of overweight T2D patients showed that serum XO activity correlated with homeostasis model assessment of ß-cell function (HOMA-ß), fasting plasma glucose (FPG), and hemoglobin A1C in overweight T2D women but not in overweight T2D men. In addition, as compared to overweight T2D men, women had higher high-sensitivity C-reactive protein (hs-CRP) levels. However, overweight T2D men had higher XO activity and uric acid levels than women. Our results suggest that XO activity is higher in overweight T2D patients, especially in men, but is more sensitive to disordered glucose levels in overweight women with T2D.

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Undiagnosed type 2 diabetes (T2D) remains a major public health concern. The global estimation of undiagnosed diabetes is about 46%, being this situation more critical in developing countries. Therefore, we proposed a non-invasive method to quantify glycated hemoglobin (HbA1c) and glucose in vivo. We developed a technique based on Raman spectroscopy, RReliefF as a feature selection method, and regression based on feed-forward artificial neural networks (FFNN). The spectra were obtained from the forearm, wrist, and index finger of 46 individuals. The use of FFNN allowed us to achieve an error in the predictive model of 0.69% for HbA1c and 30.12 mg/dL for glucose. Patients were classified according to HbA1c values into three categories: healthy, prediabetes, and T2D. The proposed method obtained a specificity and sensitivity of 87.50% and 80.77%, respectively. This work demonstrates the benefit of using artificial neural networks and feature selection techniques to enhance Raman spectra processing to determine glycated hemoglobin and glucose in patients with undiagnosed T2D.

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Background: In Mexico there is little information regarding the link between metabolic syndrome (MetS), socioeconomic status (SES) and quality of life (QoL). Objective: To assess the association between subjects who are at high risk of developing MetS with SES and QoL. Material and methods: Patients attending UMF-2 IMSS or Centro Urbano-SSA Clínica-1 were asked to participate. Anthropometric measures were collected, the AMAI, SF12, and ESF-I questionnaire where apply for SES, QoL, and MetS, respectively. Association were determined by calculating Spearman's rho and the risk (odds ratio and 95% confidence-interval) was assessed using logistic regression. Results: The difference of SES (193 ± 53 vs. 124 ± 50) and QoL (86.3 ± 14.8 vs. 56.0±25.4) questionnaires were significantly between low-risk and high-risk groups, respectively (p < 0.001). There was a negative correlation between ESF-I and SES (rho = -0.623, p < 0.001) as well as the QoL (rho = -0.719, p < 0.001). MetS risk was augmented by decreasing SES (C+: OR = 6.4, 95%IC: 3.2-13.0; D: OR = 66.1, 95%IC: 23.2-188.3), whereas increasing QoL attenuated it (OR = 0.93, 95%CI: 0.91-0.94). However, QoL mitigated the effect of SES (C+: OR = 4.5, 95%IC: 2.1-9.6; D: OR = 11.9, 95%IC: 3.8-37.6). Conclusions: Lower QoL and SES increased the risk of MetS in Central Mexico; however, improving the QoL can mitigated the effect SES has on developing MetS.

Introducción: en México existe escasa información respecto al vínculo entre el síndrome metabólico (MetS), el nivel socioeconómico (NSE) y la calidad de vida (CdV) de la población. Objetivo: evaluar la asociación entre sujetos que tienen alto riesgo de desarrollar MetS con NSE y CdV. Material y métodos: se invitó a participar a pacientes de la UMF-2 del IMSS y del Centro Urbano-SSA Clínica-1. Se recolectaron medidas antropométricas y se aplicaron los cuestionarios AMAI, SF12 y ESF-I para NSE, CdV y MetS, respectivamente. La asociación se determinó calculando rho de Spearman. El riesgo se evaluó mediante regresión logística (razon de momios e intervalo de confianza del 95%). Resultados: la diferencia entre NSE (193 ± 53 frente a 124 ± 50) y CdV (86.3 ± 14.8 frente a 56.0 ± 25.4) fue significativa entre los grupos de bajo y alto riesgo, respectivamente (p < 0.001). Hubo una fuerte correlación negativa entre las puntuaciones de la ESF-I y NSE (rho = -0.623, p < 0.001) así como con la CdV (rho = -0.719, p < 0.001). El riesgo de MetS aumentó al disminuir el NSE (C+: OR = 6.4, IC95%: 3.2 - 13.0; D: OR = 66.1, IC95%: 23.2 - 188.3), mientras que el aumento de la CdV lo atenuó (OR = 0.93, IC95%: 0.91 - 0.94). Interesantemente, la CdV mitigó el efecto del NSE (C+: OR = 4.5, IC95%: 2.1 - 9.6; D: OR = 11.9, IC95%: 3.8 - 37.6). Conclusión: Una menor CdV y NSE aumentan el riesgo de MetS en la región centro de México; sin embargo, el aumento en la CdV podría disminuir el efecto que tiene el NSE en el desarrollo de MetS.

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Introducción: en México existe escasa información respecto al vínculo entre el síndrome metabólico (MetS), el nivel socioeconómico (NSE) y la calidad de vida (CdV) de la población. Objetivo: evaluar la asociación entre sujetos que tienen alto riesgo de desarrollar MetS con NSE y CdV. Métodos: se invitó a participar a pacientes de la UMF-2 del IMSS y del Centro Urbano-SSA Clínica-1. Se recolectaron medidas antropométricas y se aplicaron los cuestionarios AMAI, SF12 y ESF-I para NSE, CdV y MetS, respectivamente. La asociación se determinó calculando rho de Spearman. El riesgo se evaluó mediante regresión logística (razon de momios e intervalo de confianza del 95%). Resultados: la diferencia entre NSE (193  53 frente a 124  50) y CdV (86.3  14.8 frente a 56.0  25.4) fue significativa entre los grupos de bajo y alto riesgo, respectivamente (p < 0.001). Hubo una fuerte correlación negativa entre las puntuaciones de la ESF-I y NSE (rho = -0.623, p < 0.001) así como con la CdV (rho = -0.719, p < 0.001). El riesgo de MetS aumentó al disminuir el NSE (C+: OR = 6.4, IC95%: 3.2 - 13.0; D: OR = 66.1, IC95%: 23.2 - 188.3), mientras que el aumento de la CdV lo atenuó (OR = 0.93, IC95%: 0.91 - 0.94). Interesantemente, la CdV mitigó el efecto del NSE (C+: OR = 4.5, IC95%: 2.1 - 9.6; D: OR = 11.9, IC95%: 3.8 - 37.6). Conclusión: Una menor CdV y NSE aumentan el riesgo de MetS en la región centro de México; sin embargo, el aumento en la CdV podría disminuir el efecto que tiene el NSE en el desarrollo de MetS.

Background: In Mexico there is little information regarding the link between metabolic syndrome (MetS), socioeconomic status (SES) and quality of life (QoL) Objective: To assess the association between subjects who are at high risk of developing MetS with SES and QoL. Methods: Patients attending UMF-2 IMSS or Centro Urbano-SSA Clínica-1 were asked to participate. Anthropometric measures were collected, the AMAI, SF12, and ESF-I questionnaire where apply for SES, QoL, and MetS, respectively. Association were determined by calculating Spearman's rho and the risk (odds ratio and 95% confidence-interval) was assessed using logistic regression. Results: The difference of SES (193  53 vs. 124  50) and QoL (86.3  14.8 vs. 56.025.4) questionnaires were significantly between low-risk and high-risk groups, respectively (p < 0.001). There was a negative correlation between ESF-I and SES (rho = -0.623, p < 0.001) as well as the QoL (rho = -0.719, p < 0.001). MetS risk was augmented by decreasing SES (C+: OR = 6.4, 95%IC: 3.2-13.0; D: OR = 66.1, 95%IC: 23.2-188.3), whereas increasing QoL attenuated it (OR = 0.93, 95%CI: 0.91-0.94). However, QoL mitigated the effect of SES (C+: OR = 4.5, 95%IC: 2.1-9.6; D: OR = 11.9, 95%IC: 3.8-37.6).

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OBJECTIVE: We performed a meta-analysis to determine the effect Interleukin-6 (IL-6) promoter polymorphism (-174 G>C, -572 G>C, and -597 G>A) have on the development rheumatoid arthritis (RA) by ethnicity. MATERIAL AND METHODS: PubMed, EBSCO, LILACS, and Scopus databases were searched for studies exploring the association between any IL6 polymorphisms and RA until November 2018. Genotype distributions were extracted and, depending on the level heterogeneity, determined by the ψ2-based Q test and the Inconsistency Index (I2), fixed-effects or random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (95%CIs) for the heterozygous, homozygous, dominant, recessive, and allelic genetic models. RESULTS: From 708 identified publications, 33 were used in this analysis. For the -174 polymorphism, Asians (ORheterozygous=7.57, 95%CI: 2.28-25.14, ORhomozygous=5.84, 95%CI: 2.06-16.56, ORdominant=7.21, 95%CI: 2.30-22.63, ORrecessive=5.04, 95%CI: 1.78-14.28, ORallelic=6.60, 95%CI: 2.26-19.28, p<.05) and Middle East countries (ORheterozygous=2.30, 95%CI: 1.10-4.81, ORdominant=2.27, 95%CI: 1.22-4.22, ORallelic=2.29, 95%CI: 1.24-4.23, p<.05) were associated with a significant risk of developing RA. Whereas, for Latinos, the C-allele was associated with a benefit (ORhomozygous=0.26, 95%CI: .08-.82, ORrecessive=.25, 95%CI: .08-.80, p<.05). For the -572 polymorphism, Asians demonstrated a significant association for the homozygous and recessive genetic models (8 studies, ORhomozygous=1.56, 95%CI: 1.16-2.09, ORrecessive=1.63, 95%CI: 1.08-2.45, p<.05). For the -597 polymorphism, no association was observed. CONCLUSIONS: Here, the -174 G>C polymorphism increased the risk of developing RA in Asians and Middle East populations. Interestingly, for Latinos, the polymorphism was associated with a benefit. For the -572 polymorphism, only the Asian population showed an increased risk of developing RA for the CC genotype.

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OBJECTIVE: Receptor activator of NF-κß ligand (RANKL) is crucial for the development of hepatic insulin resistance and poor glucose uptake; therefore, inhibiting RANKL with Denosumab could improve fasting plasma glucose (FPG) and insulin (FPI). METHODS: A systematic review was conducted to evaluate the effects of Denosumab on glycemic parameters. PubMed, SCOPUS, EBSCO, and LILACS databases were searched for studies that investigated the effect of Denosumab on FPG, glycated hemoglobin (HbA1c), FPI, and Homeostatic Model Assessment for Insulin Resistance (HOMA1-IR). The pooled standard difference in means (SDM) and 95% confidence intervals (95%CI) were calculated. The results were stratified into (1) Normal Glucose Tolerance (NGT) and (2) Impaired Glucose Tolerance (IGT). RESULTS: Six publications (1203 participants) were included. There was a significant association between Denosumab and FPG (SDM = -0.388, 95%CI: -0.705 to -0.070, p = .017) and with HOMA1-IR (SDM = -0.223, 95%CI: -0.388 to -0.058, p = .008), but not for HbA1c and FPI. When stratified by glucose tolerance, the association between Denosumab and FPG, HbA1c, and HOMA1-IR was present for the IGT group. Lastly, Denosumab had a time-dependent effect on HbA1c (slope = -0.037, 95%CI: -0.059 to -0.015, p < .005). CONCLUSIONS: Denosumab significantly improved glycemic parameters. This outcome was more prominent for subjects with compromised glucose tolerance, positing that Denosumab can be used as a treatment to improve glucose metabolism for persons with pre-diabetes and diabetes.

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ABSTRACT Purpose: Paraoxonase-1 activity is associated with age-related macular degeneration. Two polymorphisms (L55M and Q192R) were shown to increase paraoxonase-1 activity and have been implicated in the development of age-related macular degeneration. The results of studies that have examined these polymorphisms are conflicting, showing no effect, as well as increased or decreased risk. Therefore, this meta-analysis was conducted to determine the effect of these polymorphisms on age-related macular degeneration. Methods: PubMed, EBSCO, LILACS, and Scopus databases, as well as and the retrieved bibliographies of publications were searched for case-control studies that examined for paraoxonase-1 polymorphisms and age-related macular degeneration. Data were analyzed using the Comprehensive Meta-Analysis Version 2.2 and the NCSS Statistical Version 2020 software. Genotype distributions were extracted and, depending on the level of heterogeneity, fixed effects or random effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (95% CIs) for the heterozygous, homozygous, dominant, recessive, and allelic genetic models. Results: Overall, for the L55M polymorphism, none of the genetic models demonstrated a significant association. However, for non-Asian populations, a significant association was determined for the heterozygous and dominant genetic models (ORrange=1.24-1.27, p<0.05). For the Asian population, the heterozygous, dominant, and allelic genetic models demonstrated a benefit/protective factor (ORrange=0.29-0.35, p<0.05). For the Q192R polymorphism, none of the genetic models demonstrated a significant association. However, when the cohort was grouped by ethnicity, a significant association was determined in the Asian population for the recessive and allelic genetic models (ORrange=1.63-2.08, p<0.05). However, for the non-Asian population, there was no association observed. Also, there was no identifiable risk when the cohort was stratified into exudative and non-exudative cases. Conclusions: The paraoxonase-1L55M polymorphism increases the risk of developing age-related macular degeneration in non-Asian populations, whereas in Asian populations, the polymorphism exerts a protective effect. However, for the paraoxonase-1 Q192R polymorphism, only the Asian population demonstrated a risk of developing age-related macular degeneration.(AU)

RESUMO Objetivo: A atividade da paraoxonase1 está associada à degeneração macular relacionada à idade. Dois polimorfismos (L55M e Q192R) mostraram aumentar a atividade da paraoxonase1 e foram implicados no desenvolvimento da degeneração macular relacionada à idade. Os estudos que examinaram esses polimorfismos apresentaram resultados conflitantes: nenhum efeito, risco aumentado ou diminuído. Assim, esta meta-análise foi realizada para determinar o efeito desses polimorfismos na degeneração macular relacionada à idade. Métodos: Foi feita uma busca nos bancos de dados PubMed, EBSCO, LILACS e SCOPUS, bem como nas bibliografias compiladas das publicações, buscando-se estudos caso-controle que tivessem analisado os polimorfismos da paraoxonase1 e a degeneração macular relacionada à idade. Os dados foram analisados com software Comprehensive Meta-Analysis, versão 2.2, e NCSS Statistical, versão 2020. As distribuições de genótipos foram extraídas e, dependendo do nível de heterogeneidade, modelos de efeitos fixos ou aleatórios foram utilizados para calcular razões de probabilidade (RPs) combinadas, com intervalos de confiança de 95% (IC 95%) para os modelos genéticos heterozigoto, homozigoto, dominante, recessivo e alélico. Resultados: Em geral, nenhum dos modelos genéticos demonstrou associação significativa para o polimorfismo L55M. Entretanto, em populações não asiáticas, foi determinada uma associação significativa para os modelos genéticos heterozigoto e dominante (RPfaixa=1,24-1,27, p<0,05). Para a população asiática, os modelos heterozigoto, dominante e alélico mostraram um fator benéfico ou protetor (RPfaixa=0,29-0,35, p<0,05). Para o polimorfismo Q192R, nenhum dos modelos genéticos demonstrou qualquer associação significativa. Porém, quando a coorte foi agrupada por etnia, determinou-se uma associação significativa na população asiática para os modelos genéticos recessivo e alélico (RPfaixa=1,63-2,08, p<0,05). Contudo, nenhuma associação foi observada para a população não asiática. Não houve risco identificável quando a coorte foi estratificada em exsudativa e não exsudativa. Conclusões: Determinamos que o polimorfismo L55M da paraoxonase1 de fato aumenta o risco de desenvolvimento de degeneração macular relacionada à idade em populações não asiáticas, enquanto que em populações asiáticas, esse polimorfismo tem um efeito protetor. Porém, para o polimorfismo Q192R da paraoxonase1, apenas a população asiática demonstrou risco de desenvolver degeneração macular relacionada à idade.(AU)

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INTRODUCTION: Every 10 years, an adult's basal metabolic rate (BMR), independent of their BMI, decreases 1-2% due to skeletal muscle loss, thus decreasing an adult's energy requirement and promoting obesity. Increased obesity augments the risk of developing Metabolic Syndrome (MetS); however, an adult's healthy lifestyle, which increases BMR, can mitigate MetS development. To compare different BMRs for certain ages, Metabolic age (Met-age) was developed. AIM: To assess the association between Met-age and MetS and to determine if Met-age is an indicator of high-risk individuals for MetS. METHODS: Four hundred thirty-five attendees at 2 clinics agreed to participate and gave signed informed consent. MetS risk was assessed by the ESF-I questionnaire. Met-age was determined using a TANITA bio-analyzer. Strengthen of association was determined by calculating Spearman's rho and predictability was evaluated by the area-under-a-receiver-operating characteristic curve (AUC). Difference-in-age (DIA) = [chronological age - Met-age]. RESULTS: There was a difference between the low-risk (n = 155) and the high-risk (n = 280) groups' Met-age (37.8±16.7 v. 62.9±17.3) and DIA (1.3±17.4 v. - 10.5±20.8, p < 0.001). There was a positive correlation between the ESF-I questionnaire and Met-age (rho = - 0.624, p < 0.001) and a negative correlation for DIA (rho = - 0.358, p < 0.001). Met-age was strongly predictive (AUC = 0.84, 95% CI 0.80-0.88), suggesting a 45.5 years cutoff (sensitivity = 83.2%, specificity = 72.3%). DIA was a good predictor (AUC = 0.68, 95% CI 0.63-0.74) with a - 11.5 years cutoff (sensitivity = 52.5%, specificity = 82.8%). CONCLUSION: Met-age highly associated with and is an indicator of high-risk individuals for MetS. This would suggest that increases in Met-age are associated with augmented MetS severity, independent of the individual's chronological age.

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PURPOSE: Paraoxonase-1 activity is associated with age-related macular degeneration. Two polymorphisms (L55M and Q192R) were shown to increase paraoxonase-1 activity and have been implicated in the development of age-related macular degeneration. The results of studies that have examined these polymorphisms are conflicting, showing no effect, as well as increased or decreased risk. Therefore, this meta-analysis was conducted to determine the effect of these polymorphisms on age-related macular degeneration. METHODS: PubMed, EBSCO, LILACS, and Scopus databases, as well as and the retrieved bibliographies of publications were searched for case-control studies that examined for paraoxonase-1 polymorphisms and age-related macular degeneration. Data were analyzed using the Comprehensive Meta-Analysis Version 2.2 and the NCSS Statistical Version 2020 software. Genotype distributions were extracted and, depending on the level of heterogeneity, fixed effects or random effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (95% CIs) for the heterozygous, homozygous, dominant, recessive, and allelic genetic models. RESULTS: Overall, for the L55M polymorphism, none of the genetic models demonstrated a significant association. However, for non-Asian populations, a significant association was determined for the heterozygous and dominant genetic models (ORrange=1.24-1.27, p<0.05). For the Asian population, the heterozygous, dominant, and allelic genetic models demonstrated a benefit/protective factor (ORrange=0.29-0.35, p<0.05). For the Q192R polymorphism, none of the genetic models demonstrated a significant association. However, when the cohort was grouped by ethnicity, a significant association was determined in the Asian population for the recessive and allelic genetic models (ORrange=1.63-2.08, p<0.05). However, for the non-Asian population, there was no association observed. Also, there was no identifiable risk when the cohort was stratified into exudative and non-exudative cases. CONCLUSIONS: The paraoxonase-1L55M polymorphism increases the risk of developing age-related macular degeneration in non-Asian populations, whereas in Asian populations, the polymorphism exerts a protective effect. However, for the paraoxonase-1 Q192R polymorphism, only the Asian population demonstrated a risk of developing age-related macular degeneration.

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OBJECTIVES: Chronological age confers an increased risk for cardiovascular disease; however, chronological age does not reflect the subject's current health status. Therefore, we assessed whether Metabolic age (Met-age), based on free fat mass, is a predictor of cardiovascular risk (CVR). METHODS: Subjects attending either IMSS UMF-2 or CUSC-1 were asked to participate. CVR was assessed using the waist-to-height ratio (WHtR), whereas Met-age was determined using the TANITA bio-analyser (model: BC-545F Fitscan). The strengthen of association was determined by calculating Pearson's r and predictability was determined by the area-under-a-receiver-operating characteristic curve (AUC). RESULTS: 284 subjects participated in this study, of which 61.6% had increased CVR. As expected, the chronological age was significantly higher in the CVR(+) group than the CVR(-) group (47.3±14.4 v. 35.2±12.7, respectively, p<.001) as well as Met-age (59.3±15.5 v. 34.3±14.3, respectively, p<.001). There was a strong association between WHtR and Met-age (r=.720, p<.001) and a moderate association for chronological age (r=.407 p<.001); however, the correlation between WHtR and Met-age was significantly better than chronological age (Z=-5.91, p<.01). Met-age was a good predictor of CVR (AUC=.88, 95%CI: .83-.92, p<.001), whereas chronological age was a fair predictor (AUC=.72, 95%CI: .66-.78, p<.001). However, Met-age showed a higher discriminatory capacity for CVR than chronological age (z=-4.597, p<.001). CONCLUSIONS: Here, we determined that Met-age correlated with a CVR index, WHtR, and was able to predict subjects with increased CVR better than chronological age.

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OBJECTIVE: We performed a meta-analysis to determine the effect Interleukin-6 (IL-6) promoter polymorphism (-174 G>C, -572 G>C, and -597 G>A) have on the development rheumatoid arthritis (RA) by ethnicity. MATERIAL AND METHODS: PubMed, EBSCO, LILACS, and Scopus databases were searched for studies exploring the association between any IL6 polymorphisms and RA until November 2018. Genotype distributions were extracted and, depending on the level heterogeneity, determined by the ψ2-based Q test and the Inconsistency Index (I2), fixed-effects or random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (95%CIs) for the heterozygous, homozygous, dominant, recessive, and allelic genetic models. RESULTS: From 708 identified publications, 33 were used in this analysis. For the -174 polymorphism, Asians (ORheterozygous=7.57, 95%CI: 2.28-25.14, ORhomozygous=5.84, 95%CI: 2.06-16.56, ORdominant=7.21, 95%CI: 2.30-22.63, ORrecessive=5.04, 95%CI: 1.78-14.28, ORallelic=6.60, 95%CI: 2.26-19.28, p<.05) and Middle East countries (ORheterozygous=2.30, 95%CI: 1.10-4.81, ORdominant=2.27, 95%CI: 1.22-4.22, ORallelic=2.29, 95%CI: 1.24-4.23, p<.05) were associated with a significant risk of developing RA. Whereas, for Latinos, the C-allele was associated with a benefit (ORhomozygous=0.26, 95%CI: .08-.82, ORrecessive=.25, 95%CI: .08-.80, p<.05). For the -572 polymorphism, Asians demonstrated a significant association for the homozygous and recessive genetic models (8 studies, ORhomozygous=1.56, 95%CI: 1.16-2.09, ORrecessive=1.63, 95%CI: 1.08-2.45, p<.05). For the -597 polymorphism, no association was observed. CONCLUSIONS: Here, the -174 G>C polymorphism increased the risk of developing RA in Asians and Middle East populations. Interestingly, for Latinos, the polymorphism was associated with a benefit. For the -572 polymorphism, only the Asian population showed an increased risk of developing RA for the CC genotype.

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Our objective was to determine the association between the methylenetetrahydrofolate reductase polymorphisms (C677T and A1298C) and the risk of developing acute lymphoblastic leukemia (ALL), chronic myeloid leukemia (CML), acute myeloid leukemia (AML), and multiple myelomas (MM) in Latinos. PubMed, SCOPUS, EBSCO, LILACS, and other Latin-specific databases were searched for case-control studies that investigated the association between these polymorphisms and hematologic malignancies until November 2017. Genotype distributions were extracted and either fixed-effects or random-effects models were used to calculate the pooled crude odds ratios (ORs) for the heterozygous, homozygous, dominant, recessive, and allelic genetic models. No publication bias was detected by the Begg-Mazumdar's test and Egger's test. From 290 publications, we identified 15 studies on the C677T polymorphism and 13 studies on the A1298C polymorphism. We observed a significant decrease in risk for the C677T polymorphism (OR range=0.54-0.75, p<0.01) and a significant increase in risk for the A1298C polymorphism (OR range=1.28-2.52, p<0.05) in developing ALL for all genetic models. No associations were determined for CML, AML, or MM for either polymorphism. This meta-analysis demonstrated that the A1298C polymorphism was associated with an increased risk of developing ALL, whereas the C677T polymorphism was associated with a decreased risk (protective factor) in the Latino population.

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OBJECTIVE: To determine the reliability of a non-laboratorial questionnaire, the Encuesta de Identificación de Sujetos Metabólicamente Comprometidos en Fase-I (ESF-I) for identifying Metabolic Syndrome among a population in central Mexico. METHODS: Clinical and biochemical parameters were collected for 232 participants from 1 June 2012 - 31 August 2013. Three definitions of Metabolic Syndrome (Harmonizing, National Cholesterol Education Program Expert Panel and Adult Treatment Panel III [ATPIII], and International Diabetes Federation [IDF]) were used to allocate subjects to either the normal or Metabolic Syndrome positive (MetS+) group. The predictability of the questionnaire was determined by the Area-Under-the-Receiver-Operating Characteristic curve (AUC). Youden's index was calculated and the highest score was considered the optimal cutoff value. Cohen´s kappa (κ) was calculated to determine the level of agreement between the ESF-I questionnaire (max score: 15 based on 15 items) and Metabolic Syndrome. RESULTS: From 53.8% - 60.7% of the participants were determined to be MetS+. The average questionnaire score was significantly higher in the MetS+ group for each definition (4.0 vs. 8.0, P < 0.05). The ESF-I questionnaire was predictive for the Harmonizing definition (AUC = 0.841, 95%CI: 0.790 - 0.892), the ATPIII definition (AUC = 0.827, 95%CI: 0.774 - 0.880), and the IDF definition (AUC = 0.836, 95%CI: 0.785 - 0.887). A cutoff value of 7 was determined for each definition; therefore, the cohort was re-categorized based on questionnaire results. There was a strong agreement between the ESF-I questionnaire and MetS (Harmonizing: accuracy = 77.6%, κ = 0.554; ATPIII: accuracy = 74.1%, κ = 0.489; IDF: accuracy = 74.6%, κ = 0.495, P < 0.001). CONCLUSION: The ESF-I questionnaire can identify MetS+ patients, and therefore, lead to earlier diagnoses, reduced number of consultations, and lower costs with easier application.

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BACKGROUND: Previous meta-analyses have shown an ethnic dependency of the C677T and the A1298C methylenetetrahydrofolate reductase (MTHFR) polymorphisms, with no focus on the Latino population. For Latinos, many studies have examined these polymorphisms and breast cancer susceptibility, yielding no concise result. Therefore, we undertook this meta-analysis to determine the effect these polymorphisms have on breast cancer risk for Latinos. METHODS: PubMed, EBSCO, LILACS, Scopus, and Latin American-specific databases were searched for studies exploring the association between the MTHFR polymorphisms and breast cancer susceptibility in Latinos until January 2019. Genotype distributions were extracted and, depending on the level heterogeneity determined by the ψ2-based Q test and the I2 test, fixed-effects or random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (95% CIs) for the heterozygous, homozygous, dominant, recessive, and allelic genetic models. No publication bias was detected by the Begg-Mazumdar's test and Egger's test. RESULTS: Of the 280 retrieved publications, 9 studies were included: 9 for the C677T polymorphism and 5 for the A1298C polymorphism. For the C677T polymorphism, there was an elevated risk for the homozygous (OR 1.42, 95% CI 1.05-1.92), the dominant (OR 1.16, 95% CI 1.02-1.31), the recessive (OR 1.33, 95% CI 1.01-1.75), and the allelic model (OR 1.17, 95% CI 1.03-1.33, p < 0.01). No association between the A1298C polymorphism and the risk to develop breast cancer was determined. CONCLUSION: The results indicated that, for Latinos, the C677T polymorphism is associated with a significant risk for developing breast cancer, whereas the A1289C polymorphism does not.

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[ABSTRACT]. Objective. To determine the reliability of a non-laboratorial questionnaire, the Encuesta de Identificación de Sujetos Metabólicamente Comprometidos en Fase-I (ESF-I) for identifying Metabolic Syndrome among a population in central Mexico. Methods. Clinical and biochemical parameters were collected for 232 participants from 1 June 2012 – 31 August 2013. Three definitions of Metabolic Syndrome (Harmonizing, National Cholesterol Education Program Expert Panel and Adult Treatment Panel III [ATPIII], and International Diabetes Federation [IDF]) were used to allocate subjects to either the normal or Metabolic Syndrome positive (MetS+) group. The predictability of the questionnaire was determined by the Area-Under-the-Receiver-Operating Characteristic curve (AUC). Youden’s index was calculated and the highest score was considered the optimal cutoff value. Cohen´s kappa (κ ) was calculated to determine the level of agreement between the ESF-I questionnaire (max score: 15 based on 15 items) and Metabolic Syndrome. Results. From 53.8% – 60.7% of the participants were determined to be MetS+. The average questionnaire score was significantly higher in the MetS+ group for each definition (4.0 vs. 8.0, P < 0.05). The ESF-I questionnaire was predictive for the Harmonizing definition (AUC = 0.841, 95%CI: 0.790 – 0.892), the ATPIII definition (AUC = 0.827, 95%CI: 0.774 – 0.880), and the IDF definition (AUC = 0.836, 95%CI: 0.785 – 0.887). A cutoff value of 7 was determined for each definition; therefore, the cohort was re-categorized based on questionnaire results. There was a strong agreement between the ESF-I questionnaire and MetS (Harmonizing: accuracy = 77.6%, κ = 0.554; ATPIII: accuracy = 74.1%, κ = 0.489; IDF: accuracy = 74.6%, κ = 0.495, P < 0.001). Conclusion. The ESF-I questionnaire can identify MetS+ patients, and therefore, lead to earlier diagnoses, reduced number of consultations, and lower costs with easier application.

[RESUMEN]. Objetivo. Determinar la fiabilidad de un cuestionario en el que no se recurre al diagnóstico de laboratorio, la Encuesta de Identificación de Sujetos Metabólicamente Comprometidos en Fase-I (ESF-I), para detectar el síndrome metabólico en una población de la región central de México. Métodos. Se recogieron parámetros clínicos y bioquímicos de 232 participantes desde el 1 de junio del 2012 al 31 de agosto del 2013. Se usaron tres definiciones de síndrome metabólico (la unificadora, la del Grupo de Expertos en el Tratamiento de Adultos [ATPIII] del Programa Nacional de Educación sobre el Colesterol y la de la Federación Internacional de la Diabetes [FID]) para asignar los participantes al grupo normal o al grupo de síndrome metabólico positivo (SMet+). Se determinó la previsibilidad del cuestionario con el área bajo la curva de eficacia diagnóstica (curva ROC). Se calculó el índice de Youden y la puntuación más alta se consideró el valor de corte óptimo. El coeficiente (k) de Cohen se calculó para determinar el grade de acuerdo entre el cuestionario ESF-I (máxima puntuación: 15 sobre 15 ítems) y el síndrome metabólico. Resultados. Del 53,8 % al 60,7 % de los participantes se asignaron al grupo SMet+. La puntuación promedio del cuestionario fue significativamente mayor en el grupo de SMet+ para cada definición (4,0 vs. 8.0, P < 0.05). El cuestionario ESF-I fue predictivo para la definición unificadora (AUC = 0,841, 95 % CI: 0,790 – 0,892), la definición ATPIII (AUC = 0,827, 95 % CI: 0,774 – 0,880) y la definición de la FID (AUC = 0,836, 95 % CI: 0,785 – 0,887). Se determinó un el valor de corte óptimo de 7 para cada definición; por lo tanto, se reclasificó la cohorte según los resultados del cuestionario. Hubo una gran coincidencia entre el cuestionario ESF-I y SMet (unificadora: exactitud = 77,6 %, k = 0,554; ATPIII: exactitud = 74,1 %, k = 0,489; FID: exactitud = 74,6%, k = 0,495, P < 0,001). Conclusiones. El cuestionario ESF-I puede detectar pacientes con SMet+ y, por lo tanto, conducir a diagnósticos más tempranos, reducir la cantidad de consultas y reducir los costos con una aplicación más fácil.

[RESUMO]. Objetivo. Determinar a confiabilidade de um instrumento de coleta de dados não laboratoriais, Encuesta de Identificación de Sujetos Metabólicamente Comprometidos en Fase-I (pesquisa de identificação de indivíduos com comprometimento metabólico em fase I, ESF-I) para identificar síndrome metabólica em uma população da região central do México. Métodos. Foram coletados parâmetros clínicos e bioquímicos de 232 participantes da pesquisa entre 1o de junho de 2012 e 31 de agosto de 2013. O estudo se baseou em três definições de síndrome metabólica (definição harmonizada do Painel de Especialistas do Programa Nacional de Educação em Colesterol dos Estados Unidos [NCEP]; Painel para Tratamento de Adultos III [ATPIII]; e Federação Internacional de Diabetes [FIL]) para alocar os participantes em um grupo normal ou em um grupo com síndrome metabólica (SM). A previsibilidade do instrumento foi determinada pela área sob a curva ROC (característica de operação do receptor) (AUC). O índice de Youden foi calculado e o escore mais alto foi considerado o valor ideal de corte. O coeficiente kappa de Cohen (k) foi calculado para determinar o grau de concordância entre o questionário ESF-1 (pontuação máxima de 15 em 15 itens) e a síndrome metabólica. Resultados. Foi determinado que 53,8% a 60,7% dos participantes apresentavam SM. A pontuação média no instrumento foi significativamente maior no grupo SM com cada uma das definições usadas (4,0 vs. 8,0, P<0,05). O questionário ESF-I foi preditivo com a definição harmonizada (AUC 0,841; IC 95% 0,790–0,892), com a definição do ATPIII (AUC 0,827; IC 95% 0,774–0,880) e com a definição da FIL (AUC 0,836; IC 95% 0,785–0,887). Um valor de corte de 7 foi determinado para cada definição e a coorte foi recategorizada de acordo com os resultados do instrumento. Foi observada uma forte concordância entre o questionário ESF-I e o grupo SM (harmonizada: precisão = 77,6%, k = 0,554; ATPIII: precisão = 74,1%, k = 0,489; FIL: precisão = 74,6%, k = 0,495, P<0,001). Conclusão. O questionário ESF-I é capaz de identificar pacientes com síndrome metabólica, possibilitando o diagnóstico precoce, um número menor de consultas e um custo menor com uma aplicação mais simples.

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ABSTRACT Objective To determine the reliability of a non-laboratorial questionnaire, the Encuesta de Identificación de Sujetos Metabólicamente Comprometidos en Fase-I (ESF-I) for identifying Metabolic Syndrome among a population in central Mexico. Methods Clinical and biochemical parameters were collected for 232 participants from 1 June 2012 - 31 August 2013. Three definitions of Metabolic Syndrome (Harmonizing, National Cholesterol Education Program Expert Panel and Adult Treatment Panel III [ATPIII], and International Diabetes Federation [IDF]) were used to allocate subjects to either the normal or Metabolic Syndrome positive (MetS+) group. The predictability of the questionnaire was determined by the Area-Under-the-Receiver-Operating Characteristic curve (AUC). Youden's index was calculated and the highest score was considered the optimal cutoff value. Cohen´s kappa (κ) was calculated to determine the level of agreement between the ESF-I questionnaire (max score: 15 based on 15 items) and Metabolic Syndrome. Results From 53.8% - 60.7% of the participants were determined to be MetS+. The average questionnaire score was significantly higher in the MetS+ group for each definition (4.0 vs. 8.0, P < 0.05). The ESF-I questionnaire was predictive for the Harmonizing definition (AUC = 0.841, 95%CI: 0.790 - 0.892), the ATPIII definition (AUC = 0.827, 95%CI: 0.774 - 0.880), and the IDF definition (AUC = 0.836, 95%CI: 0.785 - 0.887). A cutoff value of 7 was determined for each definition; therefore, the cohort was re-categorized based on questionnaire results. There was a strong agreement between the ESF-I questionnaire and MetS (Harmonizing: accuracy = 77.6%, κ = 0.554; ATPIII: accuracy = 74.1%, κ = 0.489; IDF: accuracy = 74.6%, κ = 0.495, P < 0.001). Conclusion The ESF-I questionnaire can identify MetS+ patients, and therefore, lead to earlier diagnoses, reduced number of consultations, and lower costs with easier application.

RESUMEN Objetivo Determinar la fiabilidad de un cuestionario en el que no se recurre al diagnóstico de laboratorio, la Encuesta de Identificación de Sujetos Metabólicamente Comprometidos en Fase-I (ESF-I), para detectar el síndrome metabólico en una población de la región central de México. Métodos Se recogieron parámetros clínicos y bioquímicos de 232 participantes desde el 1 de junio del 2012 al 31 de agosto del 2013. Se usaron tres definiciones de síndrome metabólico (la unificadora, la del Grupo de Expertos en el Tratamiento de Adultos [ATPIII] del Programa Nacional de Educación sobre el Colesterol y la de la Federación Internacional de la Diabetes [FID]) para asignar los participantes al grupo normal o al grupo de síndrome metabólico positivo (SMet+). Se determinó la previsibilidad del cuestionario con el área bajo la curva de eficacia diagnóstica (curva ROC). Se calculó el índice de Youden y la puntuación más alta se consideró el valor de corte óptimo. El coeficiente (k) de Cohen se calculó para determinar el grade de acuerdo entre el cuestionario ESF-I (máxima puntuación: 15 sobre 15 ítems) y el síndrome metabólico. Resultados Del 53,8 % al 60,7 % de los participantes se asignaron al grupo SMet+. La puntuación promedio del cuestionario fue significativamente mayor en el grupo de SMet+ para cada definición (4,0 vs. 8.0, P < 0.05). El cuestionario ESF-I fue predictivo para la definición unificadora (AUC = 0,841, 95 % CI: 0,790 - 0,892), la definición ATPIII (AUC = 0,827, 95 % CI: 0,774 - 0,880) y la definición de la FID (AUC = 0,836, 95 % CI: 0,785 - 0,887). Se determinó un el valor de corte óptimo de 7 para cada definición; por lo tanto, se reclasificó la cohorte según los resultados del cuestionario. Hubo una gran coincidencia entre el cuestionario ESF-I y SMet (unificadora: exactitud = 77,6 %, κ = 0,554; ATPIII: exactitud = 74,1 %, κ = 0,489; FID: exactitud = 74,6%, κ = 0,495, P < 0,001). Conclusiones El cuestionario ESF-I puede detectar pacientes con SMet+ y, por lo tanto, conducir a diagnósticos más tempranos, reducir la cantidad de consultas y reducir los costos con una aplicación más fácil.

RESUMO Objetivo Determinar a confiabilidade de um instrumento de coleta de dados não laboratoriais, Encuesta de Identificación de Sujetos Metabólicamente Comprometidos en Fase-I (pesquisa de identificação de indivíduos com comprometimento metabólico em fase I, ESF-I) para identificar síndrome metabólica em uma população da região central do México. Métodos Foram coletados parâmetros clínicos e bioquímicos de 232 participantes da pesquisa entre 1° de junho de 2012 e 31 de agosto de 2013. O estudo se baseou em três definições de síndrome metabólica (definição harmonizada do Painel de Especialistas do Programa Nacional de Educação em Colesterol dos Estados Unidos [NCEP]; Painel para Tratamento de Adultos III [ATPIII]; e Federação Internacional de Diabetes [FIL]) para alocar os participantes em um grupo normal ou em um grupo com síndrome metabólica (SM). A previsibilidade do instrumento foi determinada pela área sob a curva ROC (característica de operação do receptor) (AUC). O índice de Youden foi calculado e o escore mais alto foi considerado o valor ideal de corte. O coeficiente kappa de Cohen (κ) foi calculado para determinar o grau de concordância entre o questionário ESF-1 (pontuação máxima de 15 em 15 itens) e a síndrome metabólica. Resultados Foi determinado que 53,8% a 60,7% dos participantes apresentavam SM. A pontuação média no instrumento foi significativamente maior no grupo SM com cada uma das definições usadas (4,0 vs. 8,0, P<0,05). O questionário ESF-I foi preditivo com a definição harmonizada (AUC 0,841; IC 95% 0,790-0,892), com a definição do ATPIII (AUC 0,827; IC 95% 0,774-0,880) e com a definição da FIL (AUC 0,836; IC 95% 0,785-0,887). Um valor de corte de 7 foi determinado para cada definição e a coorte foi recategorizada de acordo com os resultados do instrumento. Foi observada uma forte concordância entre o questionário ESF-I e o grupo SM (harmonizada: precisão = 77,6%, κ = 0,554; ATPIII: precisão = 74,1%, κ = 0,489; FIL: precisão = 74,6%, κ = 0,495, P<0,001). Conclusão O questionário ESF-I é capaz de identificar pacientes com síndrome metabólica, possibilitando o diagnóstico precoce, um número menor de consultas e um custo menor com uma aplicação mais simples.

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AIM: Insulin and uric acid were shown affect the prevalence of Metabolic Syndrome (MetS), but no studies examine their interaction. Therefore, we conducted this study to determine their biological interaction in subjects from central Mexico. METHODS: 433 subjects were enrolled for a cross-sectional study. MetS was defined according to the Harmonizing Definition. Hyperuricemia was defined as ≥7.0 mg/dL in males and ≥5.8 mg/dL in females. Hyperinsulinemia was defined as ≥11.0 µU/mL. Pearson correlation coefficient (r) was calculated to determine the association between uric acid or insulin and MetS. Logistic regression was used to determine the risk (odds ratio) of developing MetS. Biological interactions were determined by the PROCESS Macro and Anderson's method. RESULTS: Insulin and uric acid levels were elevated in MetS positive group (p < .05) and correlated with the number of MetS components (r = 0.276 and r = 0.166, p < .001, respectively). The interaction between uric acid and insulin was associated with the number of MetS components (PROCESS Model 1, interaction coefficient = -0.009, 95%CI: -0.017 to -0.001, p = .036). Johnson-Neyman analysis suggests the interaction is lost when uric acid concentration increased >7.0 mg/dL. When the cohort was separated by hyperinsulinemia and hyperuricemia, there was a significant risk of developing MetS for subjects with hyperuricemia (odds ratio = 2.3; 95%CI: 1.1-4.8, p < .05), hyperinsulinemia (odds ratio = 3.1; 95%CI: 1.9-4.9, p < .05), or both (odds ratio = 7.4; 95%CI: 3.2-17.2, p < .05); however, there was no multiplicative or additive interaction. CONCLUSION: Here, we show that uric acid and insulin augments the prevalence of MetS; however, no biological interaction was determined for hyperuricemia and hyperinsulinemia.

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AIMS: Since, resistin has been associated with coronary heart disease and with the progression of Type 2 Diabetes (T2D), our objective was to determine the correlation between resistin and cardiovascular risk (CVR) in subjects with increasing degrees of hyperglycemia. METHODS: Using a cross-sectional study design, the anthropometric and biochemical profiles were collected from 180 subjects from Puebla, Mexico. Subjects were separated into Normoglycemic (NGT), pre-diabetic (PT2D), or T2D. CVR was determined by the Atherosclerosis Coefficient ((total cholesterol-high-density lipoprotein)/high-density lipoprotein), Castelli 1 index (total cholesterol/high-density lipoprotein), Castelli 2 index (low-density lipoprotein/high-density lipoprotein), Framingham risk score (https://www.mdcalc.com/framingham-coronary-heart-disease-risk-score#next-steps), and the CVR index (CVRI=triglyceride/high-density lipoprotein). Differences between groups were determined using ANOVA. Partial correlation assessed the association between resistin and CVR indices. Logistic regression was used to determine the risk [Odds ratio (OR)] between resistin and CVR. RESULTS: Serum Resistin levels were similar between NGT, PT2D, and T2D. No correlation was observed between resistin and CVR indices for the NGT and PT2D. However, T2D demonstrated a strong negative association between the Framingham (r=-0.34, p=0.01), the Castelli 1 index (r=-0.29, p<0.01), and the CVRI (r=-0.38, p<0.05), when adjusted for sex and taking treatment for T2D. For T2D, when the subjects were separated by resistin into tertiles, elevated resistin was associated with a benefit for the Castelli 1 index (T1 v T3: OR=0.15, 95% CI: 0.03-0.070) and the CVRI (T1 v T3: OR=0.13, 95% CI: 0.03-0.66). CONCLUSIONS: Here, we demonstrate that, for T2D, elevated resistin levels lowered the CVR in Mexicans.

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AIMS: Hyperinsulinemia and insulin resistance are both associated with the development of Type 2 Diabetes and other pathologies; however, the influence of parental history of Type 2 diabetes (PH-T2D) has yet to be investigated. Therefore, this study was conducted to determine the effect of PH-T2D has on the risk of developing hyperinsulinemia and IR. MATERIALS AND METHODS: 1092 subjects (703 non-pregnant females and 389 males) were enrolled for a cross-sectional study. Clinical and biochemical parameters were collected. Subjects were allocated according to their PH-T2D: no parents, one parent, or both parents. Insulin resistance was calculated using the HOMA1 equation (HOMA1-IR). Logistic regression was used to determine the association (odds ratio) between PH-T2D and hyperinsulinemia or insulin resistance. RESULTS: Increasing degrees of PH-T2D were associated with significant increases in fasting plasma glucose, insulin, and HOMA1-IR (p <0.05). Subjects having one or both parents were associated with an increase risk of developing hyperinsulinemia (odds ratio=1.53, 95%CI: 1.12-2.09, and odds ratio=1.92, 95%CI: 1.21-3.06, respectively) and insulin resistance (odds ratio=1.47, 95%CI: 1.08-2.00 and odds ratio=1.77, 95%CI: 1.09-2.87, respectively), when adjusting for age, sex, BMI, fasting plasma glucose, and triglycerides. CONCLUSION: The presences of PH-T2D significantly increased the risk of developing hyperinsulinemia and insulin resistance.

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