[Childhood overweight and obesity: A biomedical challenge in Mexico]. / Sobrepeso y obesidad infantil: un reto biomédico en México.

In Mexico, 1 out of 3 schoolchildren aged 5 to 11 years is overweight or obese, which represents one of the main public health concerns, due to the fact that this condition in the child population is highly associated with the development of metabolic complications in adults. To date, dietary and physical activity interventions to prevent this problem have shown modest results worldwide. Biomedical studies in Mexico have shown that the pathophysiology of childhood overweight and obesity presents different molecular patterns, inflammation and oxidative stress, possibly associated with specific variants in the genome. However, the challenge is to achieve a secure characterization of this evidence so that it can be used in intervention studies aimed to improve the ability to predict and treat childhood overweight and obesity in Mexico. The biomedical challenge is to make knowledge a prevention strategy in families, in society and in the country, in order to fight the serious problem of obesity and its consequences.

En México 1 de cada 3 escolares de 5 a 11 años presenta sobrepeso u obesidad, lo cual representa una de las principales preocupaciones de salud pública, debido a que en la población infantil este padecimiento se asocia altamente con el desarrollo de complicaciones metabólicas en el adulto. Hasta el momento las intervenciones dietéticas y de actividad física para prevenir este problema han mostrado resultados modestos a nivel mundial. Los estudios biomédicos en México han demostrado que la fisiopatología del sobrepeso y la obesidad infantil presenta diferentes patrones moleculares, de inflamación y de estrés oxidativo, posiblemente asociados a variantes específicas en el genoma. Sin embargo, el reto es lograr la caracterización segura de estas evidencias para que sea posible emplearlas en los estudios de intervención encaminados a mejorar la capacidad de predicción y tratamiento del sobrepeso y la obesidad infantil en México. El reto biomédico es hacer del conocimiento una estrategia de prevención en las familias, en la sociedad y en el país, a fin de combatir el grave problema de la obesidad y sus consecuencias.

Electroacupuncture efficacy in diabetic polyneuropathy: Study protocol for a double-blinded randomized controlled multicenter clinical trial.

BACKGROUND: Diabetic peripheral neuropathy (DPN) is the most common complication of type 2 diabetes mellitus (T2DM); its diagnosis and treatment are based on symptomatic improvement. However, as pharmacological therapy causes multiple adverse effects, the implementation of acupunctural techniques, such as electroacupuncture (EA) has been suggested as an alternative treatment. Nonetheless, there is a lack of scientific evidence, and its mechanisms are still unclear. We present the design and methodology of a new clinical randomized trial, that investigates the effectiveness of EA for the treatment of DPN. METHODS: This study is a four-armed, randomized, controlled, multicenter clinical trial (20-week intervention period, plus 12 weeks of follow-up after concluding intervention). A total of 48 T2DM patients with clinical signs and symptoms of DPN; and electrophysiological signs in the Nerve Conduction Study (NCS); will be treated by acupuncture specialists in outpatient units in Mexico City. Patients will be randomized in a 1:1 ratio to one of the following four groups: (a) short fibre DPN with EA, (b) short fibre DPN with sham EA, (c) axonal DPN with EA and (d) axonal DPN with sham EA treatment. The intervention will consist of 32 sessions, 20 min each, per patient over two cycles of intervention of 8 weeks each and a mid-term rest period of 4 weeks. The primary outcome will be NCS parameters, and secondary outcomes will include DPN-related symptoms and pain by Michigan Neuropathy Screening Instrument (MNSI), Michigan Diabetic Neuropathy Score (MDNS), Dolour Neuropatique Score (DN-4), Semmes-Westein monofilament, Numerical Rating Scale (NRS) for pain assessment, and the 36-item Short Form Health Survey (SF-36). To measure quality of life and improve oxidative stress, the inflammatory response; and genetic expression; will be analysed at the beginning and at the end of treatment. DISCUSSION: This study will be conducted to compare the efficacy of EA versus sham EA combined with conventional diabetic and neuropathic treatments if needed. EA may improve NCS, neuropathic pain and symptoms, oxidative stress, inflammatory response, and genetic expression, and it could be considered a potential coadjutant treatment for the management of DPN with a possible remyelinating effect. TRIAL REGISTRATION: ClinicalTrials.gov. NCT05521737 Registered on 30 August 2022. International Clinical Trials Registry Platform (ICTRP) ISRCTN97391213 Registered on 26 September 2022 [2b].

GrimAge is elevated in older adults with mild COVID-19 an exploratory analysis.

COVID-19 has been contained; however, the side effects associated with its infection continue to be a challenge for public health, particularly for older adults. On the other hand, epigenetic status contributes to the inter-individual health status and is associated with COVID-19 severity. Nevertheless, current studies focus only on severe COVID-19. Considering that most of the worldwide population developed mild COVID-19 infection. In the present exploratory study, we aim to analyze the association of mild COVID-19 with epigenetic ages (HorvathAge, HannumAge, GrimAge, PhenoAge, SkinAge, and DNAmTL) and clinical variables obtained from a Mexican cohort of older adults. We found that all epigenetic ages significantly differ from the chronological age, but only GrimAge is elevated. Additionally, both the intrinsic epigenetic age acceleration (IEAA) and the extrinsic epigenetic age acceleration (EEAA) are accelerated in all patients. Moreover, we found that immunological estimators and DNA damage were associated with PhenoAge, SkinBloodHorvathAge, and HorvathAge, suggesting that the effects of mild COVID-19 on the epigenetic clocks are mainly associated with inflammation and immunology changes. In conclusion, our results show that the effects of mild COVID-19 on the epigenetic clock are mainly associated with the immune system and an increase in GrimAge, IEAA, and EEAA.

[From genotype to phenotype: amylase gene in childhood obesity]. / Del genotipo al fenotipo: gen de la amilasa en obesidad infantil.

Worldwide, Mexico is one of the countries with the highest rate of obesity, which is a condition considered the main risk factor for type 2 diabetes. Among the mechanisms that predispose to obesity, the interaction between food intake and genetic components has been little explored. Recently we evidenced a significant association between the copy number (CN) of AMY1A and AMY2A genes, the enzymatic activity of salivary and pancreatic amylase, and the frequency of childhood obesity in Mexico, a particular population due to the high consumption of starch in the diet and the high prevalence of obesity in children and adults. This review aims to find a better understanding of the role of amylase in obesity through a description of the evolution of the CN of its genes, the association of its enzymatic activity with obesity, and the effect of its interaction with starch intake on Mexican children. In addition, it denotes the importance of the experimental perspectives of further investigation regarding the mechanism by which amylase could regulate the abundance of oligosaccharide-fermenting bacteria and producers of short-chain fatty acids and/or branched-chain amino acids that could contribute to the alteration of the physiological processes associated with intestinal inflammation and metabolic deregulation that predispose to the development of obesity.

A nivel mundial, México es uno de los países con la tasa más alta de obesidad, un padecimiento considerado como el principal factor de riesgo de diabetes tipo 2. Dentro de los mecanismos que predisponen a la obesidad, la interacción entre la ingesta alimentaria y el componente genético ha sido poco explorada. Recientemente evidenciamos la asociación del número de copias (NC) de los genes AMY1A y AMY2A, y la actividad enzimática de amilasa salival y pancreática con la frecuencia de obesidad infantil en México, una población que se caracteriza por presentar alto consumo de almidón en la dieta y alta prevalencia de obesidad. La presente revisión busca conseguir un mejor entendimiento del papel de la amilasa en la obesidad por medio de una descripción de la evolución del NC de sus genes, la asociación de su actividad enzimática con la obesidad y el efecto de su interacción con la ingesta de almidón en niños mexicanos. Además, refiere las perspectivas experimentales que permitirían profundizar en la investigación del mecanismo por el cual la amilasa podría regular la abundancia de bacterias fermentadoras de oligosacáridos y productoras de ácidos grasos de cadena corta o aminoácidos de cadena ramificada que podrían contribuir con la alteración de los procesos fisiológicos asociados con la inflamación intestinal y la desregulación metabólica que predispone al desarrollo de obesidad.

[Activation of endoplasmic reticulum stress sensors by metabolic disease-associated diets and COVID-19]. / Activación de sensores del estrés del retículo endoplásmico por dietas asociadas a enfermedades metabólicas y COVID-19.

The endoplasmic reticulum is an abundant, dynamic and energy-sensing organelle. Its abundant membranes, rough and smooth, are distributed in different proportions depending on the cell lineage and requirement. Its function is to carry out protein and lipid synthesis, and it is the main intracellular Ca2+ store. Caloric overload and glycolipotoxicity generated by hypercaloric diets cause alteration of the endoplasmic reticulum, activating the Unfolded Protein Response (UPR) as a reaction to cellular stress related to the endoplasmic reticulum and whose objective is to restore the homeostasis of the organelle by decreasing oxidative stress, protein synthesis and Ca2+ leakage. However, during chronic stress, the UPR induces reactive oxygen species formation, inflammation and apoptosis, exacerbating the state of the endoplasmic reticulum and propagating a deleterious effect on the other organelles. This is why endoplasmic reticulum stress has been considered an inducer of the onset and development of metabolic diseases, including the aggravation of COVID-19. So far, few strategies exist to reestablish endoplasmic reticulum homeostasis, which are targeted to sensors that trigger UPR. Therefore, the identification of new mechanisms and novel therapies related to mitigating the impact of endoplasmic reticulum stress and associated complications is urgently warranted.

El retículo endoplásmico es un organelo abundante, dinámico y sensor de energía. Sus abundantes membranas, rugosa y lisa, se encuentran distribuidas en diferentes proporciones dependiendo del linaje y requerimiento celular. Su función es llevar a cabo la síntesis de proteínas y lípidos, y es el almacén principal de Ca2+ intracelular. La sobrecarga calórica y la glucolipotoxicidad generada por dietas hipercalóricas provoca la alteración del retículo endoplásmico, activando la respuesta a proteínas mal plegadas (UPR, Unfolded Protein Response, por sus siglas en inglés) como reacción al estrés celular relacionado con el retículo endoplásmico y cuyo objetivo es restablecer la homeostasis del organelo al disminuir el estrés oxidante, la síntesis de proteínas y la fuga de Ca2+. Sin embargo, durante un estrés crónico, la UPR induce formación de especies reactivas de oxígeno, inflamación y apoptosis, exacerbando el estado del retículo endoplásmico y propagando un efecto nocivo para los demás organelos. Es por ello que el estrés del retículo endoplásmico se ha considerado un inductor del inicio y desarrollo de enfermedades metabólicas, incluido el agravamiento de COVID-19. Hasta el momento, existen pocas estrategias para reestablecer la homeostasis del retículo endoplásmico, las cuales son dirigidas a los sensores que desencadenan la UPR. Por tanto, se justifica con urgencia la identificación de nuevos mecanismos y terapias novedosas relacionadas con mitigar el impacto del estrés del retículo endoplásmico y las complicaciones asociadas.

Activación de sensores del estrés del retículo endoplásmico por dietas asociadas a enfermedades metabólicas y COVID-19 / Activation of endoplasmic reticulum stress sensors by metabolic disease-associated diets and COVID-19

El retículo endoplásmico es un organelo abundante, dinámico y sensor de energía. Sus abundantes membranas, rugosa y lisa, se encuentran distribuidas en diferentes proporciones dependiendo del linaje y requerimiento celular. Su función es llevar a cabo la síntesis de proteínas y lípidos, y es el almacén principal de Ca2+ intracelular. La sobrecarga calórica y la glucolipotoxicidad generada por dietas hipercalóricas provoca la alteración del retículo endoplásmico, activando la respuesta a proteínas mal plegadas (UPR, Unfolded Protein Response, por sus siglas en inglés) como reacción al estrés celular relacionado con el retículo endoplásmico y cuyo objetivo es restablecer la homeostasis del organelo al disminuir el estrés oxidante, la síntesis de proteínas y la fuga de Ca2+. Sin embargo, durante un estrés crónico, la UPR induce formación de especies reactivas de oxígeno, inflamación y apoptosis, exacerbando el estado del retículo endoplásmico y propagando un efecto nocivo para los demás organelos. Es por ello que el estrés del retículo endoplásmico se ha considerado un inductor del inicio y desarrollo de enfermedades metabólicas, incluido el agravamiento de COVID-19. Hasta el momento, existen pocas estrategias para reestablecer la homeostasis del retículo endoplásmico, las cuales son dirigidas a los sensores que desencadenan la UPR. Por tanto, se justifica con urgencia la identificación de nuevos mecanismos y terapias novedosas relacionadas con mitigar el impacto del estrés del retículo endoplásmico y las complicaciones asociadas.

The endoplasmic reticulum is an abundant, dynamic and energy-sensing organelle. Its abundant membranes, rough and smooth, are distributed in different proportions depending on the cell lineage and requirement. Its function is to carry out protein and lipid synthesis, and it is the main intracellular Ca2+ store. Caloric overload and glycolipotoxicity generated by hypercaloric diets cause alteration of the endoplasmic reticulum, activating the Unfolded Protein Response (UPR) as a reaction to cellular stress related to the endoplasmic reticulum and whose objective is to restore the homeostasis of the organelle by decreasing oxidative stress, protein synthesis and Ca2+ leakage. However, during chronic stress, the UPR induces reactive oxygen species formation, inflammation and apoptosis, exacerbating the state of the endoplasmic reticulum and propagating a deleterious effect on the other organelles. This is why endoplasmic reticulum stress has been considered an inducer of the onset and development of metabolic diseases, including the aggravation of COVID-19. So far, few strategies exist to reestablish endoplasmic reticulum homeostasis, which are targeted to sensors that trigger UPR. Therefore, the identif ication of new mechanisms and novel therapies related to mitigating the impact of endoplasmic reticulum stress and associated complications is urgently warranted.

[Scientific evidence of the consequences of modernity]. / La evidencia científica de las consecuencias de la modernidad.

The prevalence of type 2 diabetes (T2D) in Mexico is 14.4%. This disease is characterized by a state of hyperglycemia and chronic inflammation secondary to inadequate insulin secretion and its resistance. Among its risk factors for metabolic diseases development, the interaction between obesity, sedentary lifestyle, hypercaloric diets and genetic variants play an important role. For decades, different basic and applied research groups have worked in an interdisciplinary way to provide scientific evidence that has helped to understand the mechanisms involved in the pathophysiology of T2D in Mexicans. However, today the urgency of the advance and better proposals for prevention and management of patients with T2D makes it necessary to use translational medicine, which integrates scientific knowledge with the use of innovative technologies to provide comprehensive health care. In this sense, the present document concisely describes, with a translational approach, the implications of the interaction of environmental and genetic risk factors in the development of childhood obesity and T2D in Mexico.

La prevalencia de diabetes tipo 2 (DT2) en México es del 14.4%. La enfermedad se caracteriza por un estado de hiperglucemia e inflamación crónica secundaria a la resistencia y la secreción inadecuada de insulina. Dentro de sus factores de riesgo destacan la obesidad, el sedentarismo, las dietas hipercalóricas y las variantes genéticas. Durante décadas, diferentes grupos de investigación básica y aplicada han trabajado de forma interdisciplinaria para ofrecer evidencia científica que ha ayudado a entender los mecanismos implicados en la fisiopatología de la DT2 en pacientes mexicanos. Sin embargo, hoy en día la urgencia de conseguir mejores propuestas de prevención y manejo del paciente con DT2 hace necesario el uso de la medicina traslacional, que integra el conocimiento científico con el uso de tecnologías innovadoras para brindar una atención integral. El presente documento describe de forma concisa y con un enfoque traslacional las implicaciones de la interacción de factores de riesgo ambientales y genéticos en el desarrollo de obesidad infantil y DT2 en México.

La evidencia científica de las consecuencias de la modernidad / Scientific evidence of the consequences of modernity

Resumen La prevalencia de diabetes tipo 2 (DT2) en México es del 14.4%. La enfermedad se caracteriza por un estado de hiperglucemia e inflamación crónica secundaria a la resistencia y la secreción inadecuada de insulina. Dentro de sus factores de riesgo destacan la obesidad, el sedentarismo, las dietas hipercalóricas y las variantes genéticas. Durante décadas, diferentes grupos de investigación básica y aplicada han trabajado de forma interdisciplinaria para ofrecer evidencia científica que ha ayudado a entender los mecanismos implicados en la fisiopatología de la DT2 en pacientes mexicanos. Sin embargo, hoy en día la urgencia de conseguir mejores propuestas de prevención y manejo del paciente con DT2 hace necesario el uso de la medicina traslacional, que integra el conocimiento científico con el uso de tecnologías innovadoras para brindar una atención integral. El presente documento describe de forma concisa y con un enfoque traslacional las implicaciones de la interacción de factores de riesgo ambientales y genéticos en el desarrollo de obesidad infantil y DT2 en México.

Abstract The prevalence of type 2 diabetes (T2D) in Mexico is 14.4%. This disease is characterized by a state of hyperglycemia and chronic inflammation secondary to inadequate insulin secretion and its resistance. Among its risk factors for metabolic diseases development, the interaction between obesity, sedentary lifestyle, hypercaloric diets and genetic variants play an important role. For decades, different basic and applied research groups have worked in an interdisciplinary way to provide scientific evidence that has helped to understand the mechanisms involved in the pathophysiology of T2D in Mexicans. However, today the urgency of the advance and better proposals for prevention and management of patients with T2D makes it necessary to use translational medicine, which integrates scientific knowledge with the use of innovative technologies to provide comprehensive health care. In this sense, the present document concisely describes, with a translational approach, the implications of the interaction of environmental and genetic risk factors in the development of childhood obesity and T2D in Mexico.

Childhood obesity: current situation in Mexico. / Situación actual de la obesidad infantil en México

Introduction: Mexico has reported in 2016 a combined prevalence of obesity and overweight of 33.2% in children. The objective of this work was to make a literature review of the factors associated with obesity in Mexican children, such as genetic factors, feeding patterns, sedentary lifestyle and gut microbiota. We found that in Mexican children SNP (single nucleotide polymorphism) is present in genes such as MC4R, FTO and ADRB1, associated with obesity, and that PON-1192 polymorphism increases the risk of suffering insulin resistance. On the other hand, the variant of the ADIPOR2 gene (rs11061971) protects Mexican children against obesity, as well as a greater number of copies of the AMY gene was found in children with normal weight. The evidence of the number of copies is very important, since the current diet of the Mexican population is rich in carbohydrates and fats, origin of a nutritional transition that includes sedentary activities and a high consumption of sugary drinks. The consumption of certain foods causes important changes in the gut microbiota that contribute to the development of obesity and insulin resistance. It has been found that Mexican children with obesity have a higher abundance of phylum Firmicutes and B. eggerhii bacteria. Therefore, as obesity is so diverse, it is essential to diversify the treatment in which government authorities, parents and health authorities should get involved, as well as reinforcing nutrition and healthy eating issues in primary education in the country in order to reverse the prevalence and prevent the development of other pathologies in Mexican children.

Introducción: México ha reportado en el año 2016 una prevalencia combinada de obesidad y sobrepeso del 33,2% en niños. El objetivo de este trabajo fue hacer una revisión bibliográfica de los factores asociados a la obesidad en niños mexicanos, como factores genéticos, patrones de alimentación, sedentarismo y microbiota intestinal. Se encontró que en niños mexicanos existe la presencia de SNP (single nucleotide polymorphism) en genes como MC4R, FTO y ADRB1, asociados a la obesidad, y que el polimorfismo PON1-192 incrementa el riesgo de padecer resistencia a la insulina. Por otro lado, la variante del gen ADIPOR2 (rs11061971) protege a los niños mexicanos contra la obesidad, al tiempo que un mayor número de copias del gen AMY fue encontrada en niños con peso normal. La evidencia del número de copias es de gran importancia, ya que la dieta actual del mexicano es rica en carbohidratos y grasas, origen de una transición nutricional que incluye actividades sedentarias y un alto consumo de bebidas azucaradas. El consumo de determinados alimentos provoca cambios importantes en la microbiota intestinal que contribuyen al desarrollo de la obesidad y la resistencia a la insulina. Se ha encontrado que niños mexicanos con obesidad presentan mayor abundancia de bacterias del phylum Firmicutes y de la especie B. eggerhii. Al ser tan diverso el tema de obesidad, es indispensable diversificar el tratamiento en el que se involucren autoridades gubernamentales, padres de familia e instancias sanitarias, así como reforzar temas de nutrición y alimentación saludable en la educación primaria del país para revertir las cifras y prevenir el desarrollo de otras patologías en los niños mexicanos.

Molecular alterations induced by fructose and its impact on metabolic diseases / Alteraciones moleculares inducidas por fructosa y su impacto en las enfermedades metabólicas

Scientific evidence has identified that the excessive consumption of products made from high-fructose corn syrup is a trigger for obesity, whose prevalence increased in recent years. Due to the metabolic characteristics of fructose, a rapid gastric emptying is produced, altering signals of hunger-satiety and decreasing the appetite. In addition to the hepatic level during catabolism, triose phosphate is generated and adenosine triphosphate (ATP) is reduced, producing uric acid. Triose phosphate triggers the synthesis of fatty acids that increase the production and accumulation of triglycerides, diacylglycerols and ceramides that induce insulin resistance. Hyperlipidemia, insulin resistance and hyperuricemia contribute to the development of hypertension, cardiovascular disease, kidney failure, non-alcoholic fatty liver disease and some kinds of cancer. Understanding the molecular mechanisms and signaling pathways altered by the consumption of fructose is relevant to understand the development of metabolic diseases, as well as to seek therapeutic strategies to improve quality of life.

Las evidencias científicas identifican que el excesivo consumo de productos elaborados con jarabe de maíz de alta fructosa es el detonante de la obesidad, cuya prevalencia incrementó en los últimos años. Debido a las características metabólicas de la fructosa, se produce un rápido vaciado gástrico que altera las señales de hambre-saciedad y disminuye el apetito. A nivel hepático, durante su catabolismo se generan triosas fosfato y decrece el trifosfato de adenosina (ATP, por sus siglas en inglés), lo cual produce ácido úrico. Las triosas fosfato son dirigidas hacia la síntesis de ácidos grasos, incrementando la producción y la acumulación de triacilglicéridos, diacilglicerol y ceramidas que inducen resistencia a la insulina. La hiperlipidemia, la resistencia a la insulina y la hiperuricemia contribuyen al desarrollo de hipertensión, enfermedad cardiovascular, enfermedad renal crónica, hígado graso no alcohólico y algunos tipos de cáncer. Entender los mecanismos moleculares y las vías de señalización alteradas por el consumo de fructosa es relevante para comprender el desarrollo de enfermedades metabólicas, así como la búsqueda de estrategias terapéuticas para procurar una mejor calidad de vida.

Expression of candidate genes associated with obesity in peripheral white blood cells of Mexican children.

INTRODUCTION: Obesity is a chronic, complex, and multifactorial disease, characterized by excess body fat. Diverse studies of the human genome have led to the identification of susceptibility genes that contribute to obesity. However, relatively few studies have addressed specifically the association between the level of expression of these genes and obesity. MATERIAL AND METHODS: We studied 160 healthy and obese unrelated Mexican children aged 6 to 14 years. We measured the transcriptional expression of 20 genes associated with obesity, in addition to the biochemical parameters, in peripheral white blood cells. The detection of mRNA levels was performed using the OpenArray Real-Time PCR System (Applied Biosystems). RESULTS: Obese children exhibited higher values of fasting glucose (p = 0.034), fasting insulin (p = 0.004), low-density lipoprotein (p = 0.006), triglycerides (p < 0.001), systolic blood pressure and diastolic blood pressure (p < 0.001), and lower values of high-density lipoprotein (p < 0.001) compared to lean children. Analysis of transcriptional expression data showed a difference for ADRB1 (p = 0.0297), ADIPOR1 (p = 0.0317), GHRL (p = 0.0060) and FTO (p = 0.0348) genes. CONCLUSIONS: Our results suggest that changes in the expression level of the studied genes are involved in biological processes implicated in the development of childhood obesity. Our study contributes new perspectives for a better understanding of biological processes involved in obesity. The protocol was approved by the National Committee and Ethical Committee Board from the Mexican Social Security Institute (IMSS) (IMSS FIS/IMSS/PRIO/10/011).

The interleukin-1ß-511 T>C (rs16944) gene polymorphism is associated with risk of developing silent myocardial ischemia in diabetic patients.

Silent myocardial ischemia (SMI) is a multifactorial and polygenic disorder that results from an excessive inflammatory response. Considering the prominent role of IL-1ß, IL-1F10 and IL-1RN as regulators of the inflammatory process and vascular physiology, the aim of the present study was to analyze whether IL-1ß, IL-1F10 and IL-1RN single nucleotide polymorphisms (SNPs) are associated with SMI. One polymorphism was associated with risk of SMI. Under co-dominant, recessive and additive models, the IL-1ß-511 T>C polymorphism was associated with increased risk of SMI when compared to healthy controls (OR=4.68, 95%CI=2.21-9.92, pCCo-dom=0.0048; OR=3.97, 95%CI=1.97-7.99, pCRec=0.0024; OR=2.02, 95%CI=1.41-2.90, pCAdd=0.0024, respectively). All models were adjusted for gender, age and smoking. Linkage disequilibrium analysis showed four haplotypes (CTCC, CCTC, CCCT and CTCC) with increased frequency in SMI patients when compared to healthy controls (OR=2.53, 95%CI=1.47-4.36, pC=0.0009, OR=2.34, 95%CI=1.15-4.74, pC=0.02, OR=2.44, 95%CI=1.14-5.18, pC=0.02, OR=5.11, 95%CI=1.37-19.05, pC=0.01, respectively). In summary, our data suggest that the IL-1ß-511 T>C polymorphism plays an important role in the development of SMI in diabetic patients. In addition, in our study was possible to distinguish one protective and four risk haplotypes for development of SMI.

[Genetics of pediatric obesity]. / Genética de la obesidad infantil.

Obesity is a major health problem around the globe. The statistics of overweight and obesity at early ages have reached alarming levels and placed our country in the first place in regard to childhood obesity. In the development of obesity two major factors take part, one genetic and the other one environmental. From the perspective of environmental changes both overweight and obesity result from the imbalance in the energy balance: people ingest more energy than they expend. Despite people live in the same obesogenic environment not all of them develop obesity; it requires genetic factors for this to happen. This review focuses on the description of the main methodologies to find genetic markers, as well as the main loci in candidate genes, whose single nucleotide polymorphisms (SNPs) are associated with obesity and its comorbidities in children, highlighting the association of these genes in the Mexican population. Knowledge of the genetic markers associated with obesity will help to understand the molecular and physiological mechanisms, the genetic background and changes in body mass index in the Mexican population. This information is useful for the planning of new hypotheses in the search for new biomarkers that can be used in a predictive and preventive way, as well as for the development of new therapeutic strategies.

La obesidad es uno de los principales problemas de salud a nivel mundial. Las cifras de sobrepeso y obesidad a edades tempranas han alcanzado niveles alarmantes y ubican a nuestro país en el primer lugar de obesidad infantil. En el desarrollo de la obesidad participan dos grandes factores, uno genético y otro ambiental. Desde la perspectiva de las alteraciones ambientales, tanto el sobrepeso como la obesidad resultan del desequilibrio en el balance energético: las personas ingieren mayor cantidad de energía de la que gastan. A pesar de que las personas vivan en el mismo ambiente obesógeno, no todos desarrollan obesidad; para que esto ocurra, se requiere de los factores genéticos. Esta revisión se enfoca en la descripción de las principales metodologías para la búsqueda de marcadores genéticos, así como los principales loci en genes candidatos, cuyos polimorfismos de un solo nucííleótido (SNP, por sus siglas en inglés) se encuentran asociados con la obesidad y sus comorbilidades en la población infantil, de lo cual resalta la asociación de estos genes en la población mexicana. El conocimiento de los marcadores genéticos asociados a la obesidad ayudará a comprender los mecanismos moleculares y fisiológicos, el fondo genético y las modificaciones en el índice de masa corporal en la población mexicana. Esta información es de gran utilidad para el planteamiento de nuevas hipótesis en la búsqueda de nuevos biomarcadores que puedan ser utilizados de una manera predictiva y preventiva, así como para el desarrollo de nuevas estrategias terapéuticas.

Single nucleotide polymorphisms of the angiotensin-converting enzyme (ACE) gene are associated with essential hypertension and increased ACE enzyme levels in Mexican individuals.

AIM: To explore the role of the ACE gene polymorphisms in the risk of essential hypertension in Mexican Mestizo individuals and evaluate the correlation between these polymorphisms and the serum ACE levels. METHODS: Nine ACE gene polymorphisms were genotyped by 5' exonuclease TaqMan genotyping assays and polymerase chain reaction (PCR) in 239 hypertensive and 371 non- hypertensive Mexican individuals. Haplotypes were constructed after linkage disequilibrium analysis. ACE serum levels were determined in selected individuals according to different haplotypes. RESULTS: Under a dominant model, rs4291 rs4335, rs4344, rs4353, rs4362, and rs4363 polymorphisms were associated with an increased risk of hypertension after adjusting for age, gender, BMI, triglycerides, alcohol consumption, and smoking. Five polymorphisms (rs4335, rs4344, rs4353, rs4362 and rs4363) were in strong linkage disequilibrium and were included in four haplotypes: H1 (AAGCA), H2 (GGATG), H3 (AGATG), and H4 (AGACA). Haplotype H1 was associated with decreased risk of hypertension, while haplotype H2 was associated with an increased risk of hypertension (OR = 0.77, P = 0.023 and OR = 1.41, P = 0.004 respectively). According to the codominant model, the H2/H2 and H1/H2 haplotype combinations were significantly associated with risk of hypertension after adjusted by age, gender, BMI, triglycerides, alcohol consumption, and smoking (OR = 2.0; P = 0.002 and OR = 2.09; P = 0.011, respectively). Significant elevations in serum ACE concentrations were found in individuals with the H2 haplotype (H2/H2 and H2/H1) as compared to H1/H1 individuals (P = 0.0048). CONCLUSION: The results suggest that single nucleotide polymorphisms and the "GGATG" haplotype of the ACE gene are associated with the development of hypertension and with increased ACE enzyme levels.

[Guideline for the assessment of clinical research proposals. Comisión Nacional de Investigación Científica del Instituto Mexicano del Seguro Social]. / Guía para evaluar protocolos de investigación clínica.

BACKGROUND: Medical research is a fundamental tool to achieve the advancement of science, through the improvement of strategies aimed to protect, promote and restore an individual's and society's health. Three characteristics are required to obtain approval of the research proposal: scientific relevance, technical quality and the accomplishment of ethical issues. OBJECTIVES: The present review aimed at the determination of the specific criteria to perform a critical review of research proposals. METHODS: A research was carried out in the PubMed, Medline, Ovid and Google Scholar databases, using the terms: peer review, research proposals, review and protocols, and reviewers. A total of 3546 related articles were reviewed, without finding a guide to critically assess research proposals. The guides to assess research articles consider that the quality criteria of the study should have been present since the study's conception; many of the issues described to review articles are incorporated in the review of the research proposals. RESULTS: The specific criteria were integrated to allow the reviewer to critically assess research proposals of different areas with scientific basis. CONCLUSIONS: The reviewer of research proposals should be considered as a professional that contributes to the promotion of knowledge advancement through his/her comments, which allow researchers to improve the quality of research proposals.

Antecedentes: la investigación médica es una herramienta fundamental para lograr el avance de la ciencia al mejorar las acciones encaminadas a proteger, promover y restaurar la salud del individuo y de la sociedad en general. Las tres características imprescindibles para que un protocolo de investigación sea autorizado son: relevancia científica, calidad técnica y el cumplimiento de los aspectos éticos. Material y métodos: estudio retrospectivo efectuado con base en la búsqueda específica en Pubmed, Medline, Ovid y Google Scholar con los términos: peer review, research proposals, review and protocols and reviewers. Debido a que no se identificó ningún artículo que refiriera específicamente los criterios para evaluar protocolos de investigación clínica, se hizo un consenso entre los vocales de la Comisión Nacional de Investigación Científica del Instituto Mexicano del Seguro Social, que está integrada por investigadores titulares de la institución, todos pertenecientes al Sistema Nacional de Investigadores. Se discutieron los criterios que debieran componer una revisión adecuada y cuáles debieran ser los rubros que deben incluirse en el análisis. Resultados: se integraron los criterios específicos que le permitirán al revisor de un protocolo de investigación realizar una crítica con bases metodológicas aceptadas por un consenso de investigadores. Conclusiones: un revisor debe ser considerado como un promotor del avance del conocimiento científico que, mediante sus comentarios y su dictamen, permite que los investigadores incrementen la calidad de sus protocolos de investigación.

Association of Gly972Arg polymorphism of IRS1 gene with type 2 diabetes mellitus in lean participants of a national health survey in Mexico: a candidate gene study.

Type 2 diabetes mellitus (T2D) is a main public health problem in the Mexican population. It is characterized by insulin resistance in peripheral tissues and a relative deficiency in the pancreatic beta-cell functions. Diverse single nucleotide polymorphisms (SNPs) of the IRS1 gene have been associated with insulin resistance and T2D risk. The aim of this study was to identify the association between known IRS1 polymorphisms (Pro512Ala, Asn1137Asp, Gly972Arg, and Arg158Pro) in a sample of diabetic patients compared with healthy controls selected from Mexico's 2000 National Health Survey, both with normal body mass index (BMI). We identified 444 diabetes cases that were age matched with the same number of controls. Genotypic and allelic frequencies were evaluated, and conditional logistic regression was used to evaluate the association between the SNPs and diabetes risk. Of the 4 SNPs studied, only Gly972Arg showed significant differences between cases and controls, with allele frequency of 2.6% in controls as compared with 7.9% in cases. Subjects with at least 1 copy of the Gly972Arg polymorphism of the IRS1 gene showed a greater risk for diabetes, with a crude odds ratio of 3.26 (95% confidence interval, 2.00-5.33); after adjusting for BMI, age, family history of T2D, and sex, the odds ratio was 2.91 (95% confidence interval, 1.73-4.90). Our results suggest the participation of Gly972Arg polymorphism of IRS1 in the genetic susceptibility to TD2 in Mexican population. The restriction of including only participants with normal BMI might increase the power to detect genetic determinants of T2D.