Exploring the molecular basis for selective binding of homoserine dehydrogenase from Mycobacterium leprae TN toward inhibitors: a virtual screening study.

Homoserine dehydrogenase (HSD) from Mycobacterium leprae TN is an antifungal target for antifungal properties including efficacy against the human pathogen. The 3D structure of HSD has been firmly established by homology modeling methods. Using the template, homoserine dehydrogenase from Thiobacillus denitrificans (PDB Id 3MTJ), a sequence identity of 40% was found and molecular dynamics simulation was used to optimize a reliable structure. The substrate and co-factor-binding regions in HSD were identified. In order to determine the important residues of the substrate (L-aspartate semialdehyde (L-ASA)) binding, the ASA was docked to the protein; Thr163, Asp198, and Glu192 may be important because they form a hydrogen bond with HSD through AutoDock 4.2 software. neuraminidaseAfter use of a virtual screening technique of HSD, the four top-scoring docking hits all seemed to cation-π ion pair with the key recognition residue Lys107, and Lys207. These ligands therefore seemed to be new chemotypes for HSD. Our results may be helpful for further experimental investigations.

Molecular modeling and MM-PBSA free energy analysis of endo-1,4-ß-xylanase from Ruminococcus albus 8.

Endo-1,4-ß-xylanase (EC 3.2.1.8) is the enzyme from Ruminococcus albus 8 (R. albus 8) (Xyn10A), and catalyzes the degradation of arabinoxylan, which is a major cell wall non-starch polysaccharide of cereals. The crystallographic structure of Xyn10A is still unknown. For this reason, we report a computer-assisted homology study conducted to build its three-dimensional structure based on the known sequence of amino acids of this enzyme. In this study, the best similarity was found with the Clostridium thermocellum (C. thermocellum) N-terminal endo-1,4-ß-D-xylanase 10 b. Following the 100 ns molecular dynamics (MD) simulation, a reliable model was obtained for further studies. Molecular Mechanics/Poisson-Boltzmann Surface Area (MM-PBSA) methods were used for the substrate xylotetraose having the reactive sugar, which was bound in the -1 subsite of Xyn10A in the 4C1 (chair) and 2SO (skew boat) ground state conformations. According to the simulations and free energy analysis, Xyn10A binds the substrate with the -1 sugar in the 2SO conformation 39.27 kcal·mol(-1) tighter than the substrate with the sugar in the 4C1 conformation. According to the Xyn10A-2SO Xylotetraose (X4(sb) interaction energies, the most important subsite for the substrate binding is subsite -1. The results of this study indicate that the substrate is bound in a skew boat conformation with Xyn10A and the -1 sugar subsite proceeds from the 4C1 conformation through 2SO to the transition state. MM-PBSA free energy analysis indicates that Asn187 and Trp344 in subsite -1 may an important residue for substrate binding. Our findings provide fundamental knowledge that may contribute to further enhancement of enzyme performance through molecular engineering.

Theoretical study on the allosteric regulation of an oligomeric protease from Pyrococcus horikoshii by Cl- Ion.

The thermophilic intracellular protease (PH1704) from Pyrococcus horikoshii that functions as an oligomer (hexamer or higher forms) has proteolytic activity and remarkable stability. PH1704 is classified as a member of the C56 family of peptidases. This study is the first to observe that the use of Cl- as an allosteric inhibitor causes appreciable changes in the catalytic activity of the protease. Theoretical methods were used for further study. Quantum mechanical calculations indicated the binding mode of Cl- with Arg113. A molecular dynamics simulation explained how Cl- stabilized distinct contact species and how it controls the enzyme activity. The new structural insights obtained from this study are expected to stimulate further biochemical studies on the structures and mechanisms of allosteric proteases. It is clear that the discovery of new allosteric sites of the C56 family of peptidases may generate opportunities for pharmaceutical development and increases our understanding of the basic biological processes of this peptidase family.

[Construction and characterization of R169H mutant of aspartokinase from Corynebacterium pekinense].

OBJECTIVE: Increasing the activity of aspartokinase (AK) from Corynebacterium pekinense. METHODS: The gene of AK was constructed and mutated by site-specific mutagenesis. The mutational recombinant plasmid was heterologously expressed in Escherichia coli BL21. The mutational AK was purified by Ni(2+)-NTA column after ultrasonicating of the recombinant bacteria, and then identified by SDS-PAGE and Western blot. We compared the kinetic difference between R169H AK and WT AK by determining the enzymatic activities. Some other characteristics of R169H AK and WTAK were also studied. RESULTS: The mutant R169H was successfully constructed. The molecular weight of AK was 48kDa. V(max) of R169H AK was 226.3 U/mg x s(-1), which was 2.3 times higher than that of WT AK. The optimum reaction temperature of R169H AK was 26 degrees C, the same as that of WT AK. The optimum reaction pH of R169H AK was 9.0, slightly higher than that of WT AK. The half-life period of R169H AK under optimum temperature and pH were 5.5h, much higher than that of WT AK. Lysine, threonine and methionine had an active effect on the activity of R169H AK when they were in low concentration. CONCLUSION: The hydrogen bond between R169 and E92 was broken down in R169H AK, which could affect the degree of polymerization and further lowered the affinity of mutant AK with substrates and then decreased the inhibition inducing by the metabolites. Thus, the V(max) of mutant AK from R169H had increased by 2.3 times compared with that of WT AK.

Food-packaging applications and mechanism of polysaccharides and polyphenols in multicomponent protein complex system: A review.

With the increasingly mature research on protein-based multi-component systems at home and abroad, the current research on protein-based functional systems has also become a hot spot and focus in recent years. In the functional system, the types of functional factors and their interactions with other components are usually considered to be the subjective factors of the functional strength of the system. Because this process is accompanied by the transfer of protons and electrons in the system, it has antioxidant, antibacterial and anti-inflammatory properties. Polyphenols and polysaccharides have the advantages of wide source, excellent functionality and good compatibility with proteins, and have become excellent and representative functional factors. However, polyphenols and polysaccharides are usually accompanied by poor stability, poor solubility and low bioavailability when used as functional factors. Therefore, the effect of separate release and delivery will inevitably lead to non-significant or direct degradation. After forming a multi-component composite system with the protein, the functional factor will form a stable system driven by hydrogen bonds, hydrophobic forces and electrostatic forces between the functional factor and the protein. When used as a delivery system, it will protect the functional factor, and when released, through the specific recognition of the cell membrane receptor signal, the effect of fixed-point delivery is achieved. In addition, this multi-component composite system can also form a functional composite film by other means, which has a long-term significance for prolonging the shelf life of food and carrying out specific antibacterial.

The effect of conformational variability of phosphotriesterase upon N-acyl-L-homoserine lactone and paraoxon binding: insights from molecular dynamics studies.

The organophosphorous hydrolase (PTE) from Brevundimonas diminuta is capable of degrading extremely toxic organophosphorous compounds with a high catalytic turnover and broad substrate specificity. Although the natural substrate for PTE is unknown, its loop remodeling (loop 7-2/H254R) led to the emergence of a homoserine lactonase (HSL) activity that is undetectable in PTE (kcat/km values of up to 2 × 10(4)), with only a minor decrease in PTE paraoxonase activity. In this study, homology modeling and molecular dynamics simulations have been undertaken seeking to explain the reason for the substrate specificity for the wild-type and the loop 7-2/H254R variant. The cavity volume estimated results showed that the active pocket of the variant was almost two fold larger than that of the wild-type (WT) enzyme. pKa calculations for the enzyme (the WT and the variant) showed a significant pKa shift from WT standard values (ΔpKa = 3.5 units) for the His254 residue (in the Arg254 variant). Molecular dynamics simulations indicated that the displacement of loops 6 and 7 over the active site in loop 7-2/H254R variant is useful for N-acyl-L-homoserine lactone (C4-HSL) with a large aliphatic chain to site in the channels easily. Thence the expanding of the active pocket is beneficial to C4-HSL binding and has a little effect on paraoxon binding. Our results provide a new theoretical contribution of loop remodeling to the rapid divergence of new enzyme functions.

Ethnic and health correlates of diabetes-related amputations at the Texas-Mexico border.

OBJECTIVE: To examine the association between diabetes-related lower-extremity amputation (LEA) and ethnicity, age, source of payment, geographic location, diabetes severity, and health condition in adults with diabetes mellitus type 2 living in border and non-border counties in Texas, United States of America, and to assess intra-border region geographic differences in post-LEA treatment. METHODS: This correlational study was based on secondary data from the 2003 Texas Inpatient Hospital Discharge Data. The sample consisted of individuals 45 years of age and older with type 2 diabetes who had undergone a nontraumatic LEA (n = 5,865). Descriptive statistics and logistic regression analyses were applied. RESULTS: The following characteristics were predictors of LEA: being Hispanic or African American, male, ≥ 55 years old, and a Medicare or Medicaid user, and living in a border county. Persons with moderate diabetes and those who suffered from cardiovascular disease or stroke also had higher odds of undergoing an LEA. Post-LEA occupational therapy was significantly less prevalent among border residents (9.5%) than non-border residents (15.3%) (P < 0.001). CONCLUSION: Understanding the factors that influence diabetes-related LEA may lead to early detection and effective treatment of this disabling consequence of diabetes along the U.S.-Mexico border.

Sociodemographic and healthcare characteristics of Colonia residents: the role of life stage in predicting health risks and diabetes status in a disadvantaged Hispanic population.

An assessment of the risk or diagnosis of diabetes in a random sample of 386 adult border residents found 46% obese, 12% at risk for diabetes, and 18% diagnosed with diabetes. While obesity was associated with greater diabetes risk, > 50% of obese adults reported not being told of their diabetes risk. Independent of other characteristics, boomers were at increased risk (OR 3.88) for diabetes. Comorbidities increased the risk for actual diabetes diagnosis (OR 4.79). Skipping medications increased risk of developing diabetes (OR 2.98). Disadvantaged obese boomers are at particular risk, warranting culturally appropriate interventions before onset of chronic illnesses.

Health-related quality of life among Mexican Americans living in colonias at the Texas-Mexico border.

Understanding influences on health-related quality of life (HRQL) is critical in order to track and improve the health of poor, vulnerable populations and reduce health disparities. However, studies assessing HRQL of minorities are relatively scarce. The purpose of this study was to document personal and socioenvironmental correlates to HRQL. The study population is Mexican Americans in the Texas-Mexico border region living in colonias - unincorporated, impoverished settlements with substandard living conditions along the U.S.-Mexico border. Mexican Americans living in colonias are one of the most disadvantaged, hard-to-reach minority groups in the United States. We used data from the Integrated Health Outreach System Project collected in 2002 and 2003. Our sample included 386 participants randomly selected and interviewed face-to-face with a structured survey. We measured HRQL and examined personal and socioenvironmental correlates. Unadjusted and adjusted (multivariate) logistic regression models were used for data analyses. We found that border Mexican Americans living in colonias were of similar mental health status compared to the general population of the United States, but worse off in terms of physical health. Poor education and long-term residency in colonias were predictors of lower physical health. Women reported worse mental health than men. Length of time living in a colonia, co-morbidity status, and perceived problems with access to healthcare was associated with poorer mental health status. This study provides information for health professionals and policymakers and underscores the need to provide better preventive and medical services for underserved populations. Major findings indicate the need for additional research centered on further exploration of the impact of economic, cultural, and social influences on HRQL among severely disadvantaged populations.

Levels and correlates of exercise in a border mexican american population.

OBJECTIVE: To examine personal and environmental correlates of exercise among Mexican Americans living in the Texas-Mexico border region. METHODS: The study was based on data from a community health assessment conducted in 2 counties at the Texas-Mexico border region. A random-digit-dialed community survey was used in this cross-sectional study (n=933). RESULTS: A majority of border Mexican Americans (52%) did not exercise at all. Gender, age, and self-rated health were statistically significant correlates to exercise. CONCLUSIONS: Understanding personal and environmental factors that influence physical activity and exercise in this minority population is critical for the development of culturally sensitive health interventions.

Stereoselectivity of phosphotriesterase with paraoxon derivatives: a computational study.

The bacterial enzyme phosphotriesterase (PTE) exhibits stereoselectivity toward hydrolysis of chiral substrates with a preference for the Sp enantiomer. In this work, docking analysis and two explicit-solvent molecular dynamics (MD) simulations were performed to characterize and differentiate the structural dynamics of PTE bound to the Sp and Rp paraoxon derivative enantiomers (Rp-1 and Sp-1) hydrolyzed with distinct catalytic efficiencies. Comparative analysis of the molecular trajectories for PTE bound to Rp-1 and Sp-1 suggested that substrate binding induced conformational changes in the loops near the active site. After 100 ns of MD simulation, the Zn ß(2+) metal ion formed hexacoordinated- and tetracoordinated geometries in the Sp-1-PTE and Rp-1-PTE ensembles, respectively. Simulation results further showed that the hydrogen bond between Asp301 and His254 occurred with a higher probability after Sp-1 binding to PTE (47.5%) than that after Rp-1 binding (22.2%). These results provide a qualitative and molecular-level explanation for the 10 orders of magnitude increase in the catalytic efficiency of PTE toward the Sp enantiomer of paraoxon.

Reverse screening approach to identify potential anti-cancer targets of dipyridamole.

Dipyridamole (DIP) inhibits thrombus formation when given chronically, and causes vasodilation over a short time. To date, DIP can increase the anticancer drugs (5-fluorouracil, methotrexate, piperidine, vincristine) concentration in cancer cells and hence enhance the efficacy of treatment cancer. The inhibition of DIP may result in increased 5-fluorouracil efficacy and diminish the drug side effects. But the actual molecular targets remain unknown. In this study, reverse protein-ligands docking, and quantum mechanics were used to search for the potential molecular targets of DIP. The quantum mechanics calculation was performed by using Gaussian 03 program package. Reverse pharmacophore mapping was used to search for potential molecular target candidates for a given small molecule. The docking study was used for exploring the potential anti-cancer targets of dipyridamole. The two predicted binders with the statistically significant prediction are dihydropyrimidine dehydrogenase (DPD) (PDB Id: 1GTE) and human spindle checkpoint kinase Bub1 (PDB Id: 3E7E). Structure analysis suggests that electrostatic interaction and hydrogen bonding play an important role in their binding process. The strong functional linkage of DIP and 5FU supports our prediction. In conclusion, these results generate a tractable set of anticancer proteins. The exploration of polypharmacology will provide us new opportunities in treating systematic diseases, such as the cancers. The results would generate a tractable set of anticancer target proteins for future experimental validations.

Characterization of the PH1704 protease from Pyrococcus horikoshii OT3 and the critical functions of Tyr120.

The PH1704 protease from hyperthermophilic archaean Pyrococcus horikoshii OT3 is a member of DJ-1/ThiJ/PfpI superfamily with diverse functional subclasses. The recombinant PH1704 was efficiently purified and was systematically characterized by a combination of substrate specificity analysis, steady-state kinetics study and molecular docking research. The homogeneous protease was obtained as a presumed dodecamer with molecular weight of ∼240 kDa. Iodoacetamide strongly inhibited the peptidase activity, confirming that Cys100 is a nucleophilic residue. The recombinant protein was identified as both an aminopeptidase and an endopeptidase. Experimental data showed that L-R-amc was the best substrate of PH1704. Structural interaction fingerprint analysis (SIFt) indicated the binding pose of PH1704 and showed that Tyr120 is important in substrate binding. Kinetic parameters Kcat and Kcat/Km of the Y120P mutant with L-R-amc was about 7 and 7.8 times higher than that of the wild type (WT). For the endopeptidase Y120P with AAFR-amc, Kcat and Kcat/Km is 10- and 21-fold higher than that of WT. Experimental data indicate the important functions of Tyr120: involvement in enzyme activity to form a hydrogen bond with Cys100 and as an entrance gate of the substrate with Lys43. The results of this study can be used to investigate the DJ-1/ThiJ/PfpI superfamily.

Experimental and computational studies indicate the mutation of Glu12 to increase the thermostability of oligomeric protease from Pyrococcus horikoshii.

The intracellular protease from Pyrococcus horikoshii (PhpI) is a member of the DJ-1/ThiJ/PfpI superfamily, which is suggested to be involved in cellular protection against environmental stresses. In this study, flexible docking approach was employed to dock the ligand into the active site of PhpI. By analyzing the results, active site architecture and certain key residues responsible for substrate specificity were identified on the enzyme. Our docking result indicates that Glu12 plays an important role in substrate binding. The kinetic experiment conducted by Zhan shows that the E12T mutant is more stable than that of the wild-type. We also predict that Glu15, Lys43, and Tyr46 may be important in the catalytic efficiency and thermostability of enzyme. The new structural and mechanistic insights obtained from computational study should be valuable for detailed structures and mechanisms of the member of the DJ-1 superfamily.

Health-related quality of life in a binational population with diabetes at the Texas-Mexico border.

OBJECTIVES: To examine physical and mental health domains of health-related quality of life (HRQL) in a binational adult population with type 2 diabetes at the Texas-Mexico border, and to explore individual and social correlates to physical and mental health status. METHODS: Adults 18 years and older with type 2 diabetes residing in the South Texas Lower Rio Grande Valley and in Reynosa, Tamaulipas, Mexico, were recruited using a convenience sampling technique and interviewed face-to-face with a structured survey. HRQL was measured using physical and mental health summary components of the Medical Outcomes Study Short Form. HRQL correlates included demographic characteristics, health factors, access to healthcare, and family support. Samples characteristics were compared using the Student's t-test or Mann-Whitney U test. Associations between dependent and independent variables were examined using unadjusted and adjusted (multiple variable) logistic regression models. RESULTS: There were no significant differences between Valley and Reynosa respondents in physical or mental health status scores. Valley participants with lower socioeconomic status and those perceiving their supportive relative's level of diabetes-related knowledge as "low" were more likely to report worse physical health than those lacking those characteristics. In the Reynosa group, lower physical health status was associated with duration of diabetes and insulin use. Both sample populations with clinical depressive symptoms were more likely to have worse physical and mental health than those without such symptoms. CONCLUSIONS: HRQL is an important outcome in monitoring health status. Understanding the levels and influences of HRQL in U.S.-Mexico border residents with diabetes may help improve diabetes management programs.

Clinical depressive symptoms and diabetes in a binational border population.

BACKGROUND: Depression affects more Hispanics with type 2 diabetes than other ethnic groups. This exploratory, binational study examined the prevalence and correlates of clinical depressive symptoms in Hispanics of Mexican origin with type 2 diabetes living on both sides of the Texas Mexico border. METHODS: Two binational samples, consisting of 172 adult patients of Mexican origin with type 2 diabetes in South Texas and 200 from the Northeastern region of Mexico, were compared. Logistic regression analyses were used to test personal and social correlates to clinical depressive symptoms. RESULTS: The rate of clinical depressive symptoms was similar in both South Texas and Northeastern Mexico patients (39% and 40.5%, respectively). Gender, education, emergency department visits, and burden of diabetes symptoms were predictors of clinical depressive symptoms in the South Texas sample. Among respondents in the Northeastern Mexico sample, the only statistically significant correlate to clinical depressive symptoms was the burden of diabetes symptoms. CONCLUSIONS: Diabetes and depression must be addressed as priorities in diabetes initiatives at the US Mexico border region. Further research is warranted to examine the extent and impact of involving family practice physicians from both sides of the border in depression screenings among patients with type 2 diabetes.

Ethnic and health correlates of diabetes-related amputations at the Texas-Mexico border / Correlatos étnicos y de salud de las amputaciones relacionadas con la diabetes en la frontera entre Texas y México

OBJECTIVE: To examine the association between diabetes-related lower-extremity amputation (LEA) and ethnicity, age, source of payment, geographic location, diabetes severity, and health condition in adults with diabetes mellitus type 2 living in border and non-border counties in Texas, United States of America, and to assess intra-border region geographic differences in post-LEA treatment. METHODS: This correlational study was based on secondary data from the 2003 Texas Inpatient Hospital Discharge Data. The sample consisted of individuals 45 years of age and older with type 2 diabetes who had undergone a nontraumatic LEA (n = 5 865). Descriptive statistics and logistic regression analyses were applied. RESULTS: The following characteristics were predictors of LEA: being Hispanic or African American, male, > 55 years old, and a Medicare or Medicaid user, and living in a border county. Persons with moderate diabetes and those who suffered from cardiovascular disease or stroke also had higher odds of undergoing an LEA. Post-LEA occupational therapy was significantly less prevalent among border residents (9.5 percent) than non-border residents (15.3 percent) (P < 0.001). CONCLUSION: Understanding the factors that influence diabetes-related LEA may lead to early detection and effective treatment of this disabling consequence of diabetes along the U.S.-Mexico border.

OBJETIVO: Analizar la asociación entre las amputaciones de extremidades inferiores (AEI) relacionadas con la diabetes y el grupo étnico, la edad, la procedencia del pago, la ubicación geográfica, la gravedad de la diabetes y el estado de salud de los adultos que padecen diabetes tipo 2 residentes en los condados fronterizos y no fronterizos de Texas (Estados Unidos de América), y evaluar la diferencias geográficas dentro de la zona fronteriza en cuanto al tratamiento posterior a la amputación. MÉTODOS: Este estudio correlacional se basó en datos secundarios procedentes de la información de egreso de pacientes hospitalizados en Texas durante el año 2003. La muestra estuvo integrada por personas de 45 años o mayores con diabetes tipo 2, que habían sido sometidas a la amputación no traumática de una extremidad inferior (n = 5 865). Se aplicaron estadística descriptiva y análisis de regresión logística. RESULTADOS: Las siguientes características constituyeron factores predictivos de AEI: ser hispano o afroestadounidense, hombre, de 55 años o mayor, beneficiario de Medicare o Medicaid, y residente en un condado fronterizo. Las personas con diabetes moderada que padecían enfermedades cardiovasculares o habían sufrido un accidente cerebrovascular también tenían una mayor probabilidad de ser sometidas a una AEI. La terapia ocupacional posterior a la amputación fue significativamente menos prevalente entre los residentes fronterizos (9,5 por ciento) que entre los no fronterizos (15,3 por ciento) (P < 0,001). CONCLUSIONES: La comprensión de los factores que influyen en las AEI relacionadas con la diabetes puede conducir a la detección temprana y el tratamiento eficaz de esta secuela discapacitante en la zona fronteriza entre los Estados Unidos y México.

Health-related quality of life in a binational population with diabetes at the Texas-Mexico border

OBJECTIVES: To examine physical and mental health domains of health-related quality of life (HRQL) in a binational adult population with type 2 diabetes at the Texas-Mexico border, and to explore individual and social correlates to physical and mental health status. METHODS: Adults 18 years and older with type 2 diabetes residing in the South Texas Lower Rio Grande Valley and in Reynosa, Tamaulipas, Mexico, were recruited using a convenience sampling technique and interviewed face-to-face with a structured survey. HRQL was measured using physical and mental health summary components of the Medical Outcomes Study Short Form. HRQL correlates included demographic characteristics, health factors, access to healthcare, and family support. Samples characteristics were compared using the Student’s t-test or Mann-Whitney U test. Associations between dependent and independent variables were examined using unadjusted and adjusted (multiple variable) logistic regression models. RESULTS: There were no significant differences between Valley and Reynosa respondents in physical or mental health status scores. Valley participants with lower socioeconomic status and those perceiving their supportive relative’s level of diabetes-related knowledge as "low" were more likely to report worse physical health than those lacking those characteristics. In the Reynosa group, lower physical health status was associated with duration of diabetes and insulin use. Both sample populations with clinical depressive symptoms were more likely to have worse physical and mental health than those without such symptoms. CONCLUSIONS: HRQL is an important outcome in monitoring health status. Understanding the levels and influences of HRQL in U.S.-Mexico border residents with diabetes may help improve diabetes management programs.

OBJETIVOS: Analizar los dominios de salud física y mental de la calidad de vida relacionada con la salud (CVRS) en una población binacional de adultos con diabetes tipo 2 en la frontera Texas-México y explorar los factores individuales y sociales relacionados con el estado de la salud física y mental. MÉTODOS: Se realizó un muestreo de conveniencia de personas de 18 años de edad o más con diabetes tipo 2 que vivían en Lower Rio Grande Valley, al sur de Texas, y en Reynosa, Tamaulipas, México, y se les realizó una entrevista estructurada presencial. La CVRS se midió mediante los componentes abreviados de salud física y mental del MOS-SF8 (Medical Outcomes Study Short Form 8). Entre los factores relacionados con la CVRS estaban las características demográficas, los factores de salud, el acceso a la atención sanitaria y el apoyo familiar. Se compararon las características de las muestras mediante la prueba de la t de Student o la prueba de la U de Mann-Whitney. Las asociaciones entre las variables independientes y la dependiente se analizaron mediante modelos de regresión logística múltiple, ajustados y sin ajustar. RESULTADOS: No se encontraron diferencias significativas entre los entrevistados de Valley y de Reynosa en cuanto a la puntuación del estado de salud física y mental. Los participantes de Valley con menor estatus socioeconómico y los que consideraban que los parientes que los apoyaban tenían un "bajo" nivel de conocimiento sobre la diabetes presentaron una mayor probabilidad de informar un peor estado de salud física que los que no tenían esas características. En el grupo de Reynosa, el peor estado de salud física se asoció con la duración de la diabetes y el uso de insulina. En ambos grupos, las personas con síntomas clínicos de depresión tuvieron una mayor probabilidad de informar una peor salud física y mental que los que no presentaban esos síntomas. CONCLUSIONES: La CVRS es un importante criterio en el análisis del estado...