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RESUMEN Objetivo Analizar la asociación entre la etnicidad y la gravedad de la infección por el virus del dengue en población mexicana. Materiales y Métodos Se analizaron de manera retrospectiva los datos registrados por el Gobierno Federal de México con respecto a los casos confirmados de dengue. El análisis se realizó desde el 3 de enero hasta el 29 de noviembre de 2021. Se realizó un análisis exploratorio para evaluar la asociación de la etnicidad con la necesidad de hospitalización y muerte utilizando Chi-cuadrado. También se utilizaron modelos de regresión logística para evaluar otros indicadores de gravedad. Resultados Se evaluaron 5 759 pacientes; la media de edad fue 27 años y el 1,9 % era indígena. No se observó una asociación significativa entre la etnicidad y la gravedad del dengue tras analizar el porcentaje de muertes y hospitalizaciones. En el modelo crudo se encontró que los factores asociados a hospitalización fueron ser menor de edad (OR: 2,48; p<0,001), vivir en una entidad de alta marginación (OR: 2,06; p<0,001), tener cirrosis hepática (OR: 5,71; p=0,033), enfermedad renal crónica (OR: 4,76; p=0,008) o hipertensión (OR: 2,57, p<0,001). La asociación se mantuvo en la mayoría de variables evaluadas en el modelo ajustado. Conclusiones No fue posible demostrar asociación entre la etnicidad y la gravedad de la infección por el virus del dengue en el presente estudio. Son necesarios estudios prospectivos con la inclusión de una mayor cantidad de pacientes de etnia indígena.
ABSTRACT Objective The purpose of this study was to explore the association between ethnicity and severity of dengue infection in the Mexican population. Materials and Methods We analyzed a national database of confirmed patients with dengue; data was collected between January 3 to November 29, 2021. We extracted the following information: demographics, ethnicity, associated comorbidities and outcomes of interest (need for hospitalization and death). Exploratory analysis using Chi-square was undertaken to examine the relationship between dengue severity and ethnicity. Other covariates were also included in logistic regression models (unadjusted and adjusted). Results 5 759 patients were included in our analysis; the mean age was 27 years and 1,9% were indigenous people. There was no association between ethnicity and severity of dengue infection as measured by the percentage of people who died or required inpatient care. In the unadjusted model, we found an association between the following risk factors and need for hospitalization: age under 18 (OR: 2,48; p<0,001), living in rural areas (OR: 2,06; p<0,001), cirrhosis (OR: 5,71; p=0,033), chronic kidney disease (OR: 4,76; p=0,008) and arterial hypertension (OR: 2,57, p<0,001). In the adjusted model, chronic kidney disease, diabetes mellitus and arterial hypertension were found to be associated with hospitalization. Conclusions In this retrospective cohort study of patients with dengue, we could not find and association between ethnicity and severity of dengue infection. Prospective studies that consider ethnicity are urgently needed.
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IL-17A is an important pro-inflammatory cytokine involved in the inflammatory response in chronic obstructive pulmonary disease (COPD). To evaluate the role played by single nucleotide polymorphisms of IL17A and protein levels in susceptibility to COPD, 1,807 subjects were included in a case-control study; 436 had COPD related to tobacco smoking (COPD-S) and 190 had COPD related to biomass burning (COPD-BB). Six hundred fifty-seven smokers without COPD (SWOC) and 183 biomass burning-exposed subjects (BBES) served as the respective control groups. The CC genotype and C allele of rs8193036 were associated with COPD (COPD-S vs. SWOC: p < 0.05; OR = 3.01, and OR = 1.28, respectively), as well as a recessive model (p < 0.01; OR = 2.91). Significant differences in serum levels were identified between COPD-S vs. SWOC, COPD-S vs. COPD-BB, and SWOC vs. BBES (p < 0.01). By comparing genotypes in the COPD-BB group TT vs. CC and TC vs. CC (p < 0.05), we found lower levels for the CC genotype. Logistic regression analysis by co-variables was performed, keeping the associations between COPD-S vs. SWOC with both polymorphisms evaluated (p < 0.05), as well as in COPD-BB vs. BBES but with a reduced risk of exacerbation (p < 0.05). In conclusion, polymorphisms in IL17A are associated with COPD. Serum levels of IL-17A were higher in smokers with and without COPD.