[Obesity and metabolic syndrome. A challenge for the Mexican Institutes of Health]. / La obesidad y el síndrome metabólico. Un reto para los Institutos Nacionales de Saluda.

Numerous efforts for the development of basic and clinical research in obesity are being made by the National Institutes of Health and Federal Reference Hospitals in Mexico. However, greater interaction among researchers and stronger efforts towards the dissemination of the results are needed. The document outlines the general ideas and proposals of the Academic Group for the Study, Prevention and Treatment of Obesity and Metabolic Syndrome of the Coordinating Committee of the National Institutes of Health and High Specialty Hospitals (CCINSHAE). This is the first step in developing common objectives, with the aim of understanding the effect of these entities in public health and to establish guidelines to limit and eventually overcome them. We discuss the appropriateness of analyzing obesity and the metabolic syndrome together, and the current management of these entities at the National Institutes of Health in Mexico. The problems that arise in clinical practice lead to the need to generate a new model of medical care, including a new health worker and a new patient. It is imperative to establish permanent lines of communication and education with health personnel and with patients. The group proposes an integrated approach for research in these areas. Finally, a master plan that links the National Institutes of Health, particularly in the areas of research and programs within the institutions, is required as a first step in seeking answers useful in solving the problem. The second step would be linking the first and second levels of care through concrete actions needed to limit and reduce obesity and metabolic syndrome in the population.

The activity of calpains in lymphocytes is glucose-dependent and is decreased in diabetic patients.

Calpains are nonlysosomal calcium-dependent cysteine proteases that participate in insulin secretion and action. Polymorphisms in the calpain-10 gene have been shown to increase the risk for type 2 diabetes. Since white blood cells have been used to study glucose homeostasis, the present study was carried to find out if calpains have different activity and/or expression in accessible cells such as lymphocytes of individuals with or without type 2 diabetes. Fasting blood glucose concentration was significantly higher in diabetic subjects, whereas the difference in the activity of calpains evaluated in basal and stimulating extracellular glucose concentration was significantly higher in the lymphocytes from the control group. The mRNA expression of calpain-10 was similar in the lymphocytes of both patients and controls. The protein blots showed four bands that ranged between 75 and 50 kDa; however, no statistical differences were observed in the expression of the calpain-10 isoforms between controls and patients. Data obtained showed that human lymphocytes express calpain-10 mRNA and protein, showing a similar expression between diabetic and control subjects, nevertheless in the diabetic group calpain activity was less glucose-sensitive.

Hiperhomocisteinemia: un nuevo factor de riesgo coronario / Hyperhomocysteinemia: a new factor in coronary risk

Las enfermedades cardiovasculares son la principal causa de mortalidad tanto en México como en otros países occidentales. Los factores de riesgo ateroscleróticos convencionales tales como: el tabaquismo, la hipertensión arterial sistémica, diabetes mellitus e hipercolesterolemia no explican totalmente esta asociación. Recientemente se ha reconocido que la hiperhomocisteinemia contribuye al proceso aterosclerótico de manera directa o en asociación a estos factores de riesgo al promover una lesión endotelial e inducir estrés oxidativo en la pared vascular. La homocisteína es un aminoácido generado en condiciones fisiológicas tras la ingesta de alimentos protéicos, utilizada en diversas vías metabólicas. Niveles elevados de este amino ácido en plasma (mayores de 15 mmol/L o menores en presencia de otros factores de riesgo coronario), promueven el desarrollo de aterosclerosis. El uso de suplementos de ácido fólico, vitamina B6 y B12 disminuyen de manera efectiva los niveles de homocisteína en plasma, por lo que es posible que tengan un papel importante en la prevención y manejo de la enfermedad vascular aterosclerótica.

Dos casos de feminización testicular / Two cases of testicular feminization

Se presentan los casos de dos hermanos con síndrome de resistencia a los andrógenos en su variante de feminización testicular. Las edades al momento del diagnóstico fueron 14 y 17 años respectivamente; el más joven de los dos acudió a consulta por una tumoración en la región inguinal que resultó ser un testículo; el hermano fue estudiado porque al realizar su historia clínica se encontró que tenía amenorrea. Se describen los hallazgos físicos, los estudios psicológico y genético, y se explica el tratamiento que se les dio.