[Association between metabolic syndrome, socioeconomic status and quality of life in mexicans]. / Asociación entre síndrome metabólico, nivel socioeconómico y calidad de vida en mexicanos.

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.

Asociación entre síndrome metabólico, nivel socioeconómico y calidad de vida en mexicanos / Association between metabolic syndrome, socioeconomic status and quality of life in mexicans

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).

Novel Assessment of Urinary Albumin Excretion in Type 2 Diabetes Patients by Raman Spectroscopy.

. Urinary albumin excretion remains the key biomarker to detect renal complications in type 2 diabetes. As diabetes epidemy increases, particularly in low-income countries, efficient and low-cost methods to measure urinary albumin are needed. In this pilot study, we evaluated the performance of Raman spectroscopy in the assessment of urinary albumin in patients with type 2 diabetes. The spectral Raman analysis of albumin was performed using artificial urine, at five concentrations of albumin and 24 h collection urine samples from ten patients with Type 2 Diabetes. The spectra were obtained after removing the background fluorescence and fitting Gaussian curves to spectral regions containing features of such metabolites. In the samples from patients with type 2 diabetes, we identified the presence of albumin in the peaks of the spectrum located at 663.07, 993.43, 1021.43, 1235.28, 1429.91 and 1633.91 cm-1. In artificial urine, there was an increase in the intensity of the Raman signal at 1450 cm-1, which corresponds to the increment of the concentrations of albumin. The highest concentration of albumin was located at 1630 cm-1. The capability of Raman spectroscopy for detection of small concentrations of urinary albumin suggests the feasibility of this method for the screening of type 2 diabetes renal complications.

Validation of a non-laboratorial questionnaire to identify Metabolic Syndrome among a population in central Mexico.

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.

Validation of a non-laboratorial questionnaire to identify Metabolic Syndrome among a population in central Mexico

[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.

Validation of a non-laboratorial questionnaire to identify Metabolic Syndrome among a population in central Mexico / Validación de un cuestionario en el que no se recurre al diagnóstico de laboratorio para detectar el síndrome metabólico en una población de la zona central de México / Validação de um instrumento de coleta de dados não laboratoriais para identificar síndrome metabólica em uma população da região central do México

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.

Low serum uric acid concentration augments insulin effects on the prevalence of metabolic syndrome.

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.

Serum resistin levels inversely associated with cardiovascular risk indices in type 2 diabetics from central Mexico.

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.

The impact of parental history of type 2 diabetes on hyperinsulinemia and insulin resistance in subjects from central Mexico.

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.

Triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) index as a reference criterion of risk for metabolic syndrome (MetS) and low insulin sensitivity in apparently healthy subjects.

AIM: To evaluate if the TG/HDL-C index can be considered as a reference criterion of MetS and low insulin sensitivity in apparently healthy subjects. METHODS: The subjects were Mexican mestizos who resided in Puebla City, Mexico, who were anthropometrically, biochemically, and clinically characterized. The TG/HDL-C index was calculated by dividing triglyceride (TG) levels by HDL-C levels. MetS was diagnosed by the Third Report from the Adult Treatment Panel-National Cholesterol Education Program (ATP-III NCEP) criteria, while insulin sensitivity was evaluated by the Quantitative Insulin sensitivity Check Index (QUICKI). RESULTS: The study included 813 subjects, with an average age of 38.6 ± 12.1 years, of which 564 were women and 249 men. An association was found between high TG/HDL-C index and low insulin sensitivity (Odds ratio [OR]: 4.09; p < 0.01) and with MetS (OR: 15.29; p < 0.01). A correlation was found between the TG/HDL-C index and QUICKI (rho: -0.4989; p < 0.01) and with MetS (rho: 0.6581; p < 0.01). CONCLUSION: The results indicate that the TG/HDL-C index is associated with low insulin sensitivity and MetS in apparently healthy subjects, suggesting this index as a reference criterion of risk for low insulin sensitivity and MetS.

Association of the Metabolic Syndrome with Antioxidant Defense and Outstanding Superoxide Dismutase Activity in Mexican Subjects.

BACKGROUND: Metabolic syndrome (MetS) is considered a public health problem worldwide. Recently, oxidative stress (OS) has been proposed as a factor related with the genesis of MetS. Different studies have reported decreased antioxidant defense, such as superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GRed) activities, and reduced glutathione (GSH) concentration, and, on the other hand, an increase in nitrotyrosine concentration in MetS patients. However, it is not known whether there is a direct association of antioxidant defense with MetS in a Mexican population. The aim of the study was to determine the relationship between antioxidant defense and MetS in Mexican subjects. MATERIALS AND METHODS: The subjects were Mexican mestizos, who were anthropometrically, biochemically, and clinically characterized. MetS was diagnosed by National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III)-modified criteria. Antioxidant defense was determined by activity of SOD, GPx, GRed, and GSH concentrations; as a marker of OS, nitrotyrosine concentration was determined. RESULTS: The study included 376 subjects, among whom 152 subjects had MetS and 224 were assigned to the non-MetS group. Statistical association was found between MetS and SOD activity (Odds ratio: 167.1; P < 0.01; adjusted by age, gender, and waist circumference). It is noteworthy that a significant correlation between antioxidant defense (SOD and GPx activities, and GSH) and different MetS components was found and between MetS and nitrotyrosine concentration (P < 0.05). CONCLUSION: The results indicate that SOD activity is associated with MetS in Mexican subjects, allowing us to suggest that this enzyme plays an important role in the pathophysiology of MetS.

C-Peptide Is a Sensitive Indicator for the Diagnosis of Metabolic Syndrome in Subjects from Central Mexico.

BACKGROUND: Metabolic Syndrome (MetS) is associated with elevated risk for developing diabetes and cardiovascular disease. A key component of MetS is the development of insulin resistance (IR). The homeostatic model assessment (HOMA) model can determine IR by using insulin or C-peptide concentrations; however, the efficiency of insulin and C-peptide to determine MetS has not been compared. The aim of the study was to compare the efficiency of C-peptide and insulin to determine MetS in Mexicans. METHODS: Anthropometrics, glucose, insulin, C-peptide, triglycerides, and high-density lipoproteins were determined in 156 nonpregnant females and 114 males. Subjects were separated into normal or positive for MetS. IR was determined by the HOMA2 calculator using insulin or C-peptide. Correlations were calculated using the Spearman correlation coefficient (ρ). Differences between correlations were determined by calculating Steiger's Z. The sensitivity was determined by the area under receiver operating characteristics curve (AUC) analysis. RESULTS: Independent of the MetS definition [Adult Treatment Panel III (ATP III), International Diabetes Federation (IDF), or World Health Organization (WHO)], C-peptide and insulin were significantly higher in MetS subjects (P < 0.05). C-peptide and insulin correlated with all components of MetS; however, for waist circumference, waist-to-hip ratio, and fasting plasma glucose, C-peptide correlated better than insulin (P < 0.05). Moreover, C-peptide (AUC = 0.72-0.78) was a better marker than insulin (AUC = 0.62-0.72) for MetS (P < 0.05). Finally, HOMA2-IR calculated with C-peptide (AUC = 0.80-0.84) was more accurate than HOMA2-IR calculated with insulin (AUC = 0.68-0.75, P < 0.05) at determining MetS. CONCLUSION: C-peptide is a strong indicator of MetS. Since C-peptide has recently emerged as a biomolecule with significant importance for inflammatory diseases, monitoring C-peptide levels will aid clinicians in preventing MetS.

Obese first-degree relatives of patients with type 2 diabetes with elevated triglyceride levels exhibit increased ß-cell function.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is characterized as a disease continuum that is marked by metabolic changes that are present for several years, sometimes well before frank diagnosis of T2DM. Genetic predisposition, ethnicity, geography, alterations in BMI, and lipid profile are considered important markers for the pathogenesis of T2DM through mechanisms that remain unresolved and controversial. The aim of this study was to investigate the relationship between triglycerides (TGs) and ß-cell function, insulin resistance (IR), and insulin sensitivity (IS) in obese first-degree relatives of patients with T2DM (FDR-T2DM) among subjects from central Mexico with normal glucose tolerance (NGT). METHODS: We studied 372 FDR-T2DM subjects (ages,18-65) and determined body mass index (BMI), fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), insulin, and TGs levels. Subjects were categorized based on glycemic control [NGT, prediabetes (PT2DM), or T2DM]. NGT subjects were further categorized by BMI [normal weight (Ob-) or obese (Ob+)] and TGs levels (TG-, <150 mg/dL, or TG+, ≥150 mg/dL). ß-cell function, IR, and IS were determined by the homeostasis model assessment of ß-cell function (HOMA2-ß), homeostasis model assessment of insulin resistance (HOMA2-IR), and Quantitative Insulin Sensitivity Check Index (QUICKI) indices, respectively. RESULTS: The obese subjects with elevated TGs levels had 21%-60% increased ß-cell function when compared to all groups (P<0.05). In addition, this group had insulin levels, IS, and IR similar to PT2DM. Furthermore, only in obese subjects did TGs correlate with ß-cell function (ρ=0.502, P<0.001). CONCLUSION: We characterized FDR-T2DM subjects from central Mexico with NGT and revealed a class of obese subjects with elevated TGs and ß-cell function, which may precede PT2DM.

Metallothionein-1 and nitric oxide expression are inversely correlated in a murine model of Chagas disease

Chagas disease, caused by Trypanosoma cruzi, represents an endemic among Latin America countries. The participation of free radicals, especially nitric oxide (NO), has been demonstrated in the pathophysiology of seropositive individuals with T. cruzi. In Chagas disease, increased NO contributes to the development of cardiomyopathy and megacolon. Metallothioneins (MTs) are efficient free radicals scavengers of NO in vitro and in vivo. Here, we developed a murine model of the chronic phase of Chagas disease using endemic T. cruzi RyCH1 in BALB/c mice, which were divided into four groups: infected non-treated (Inf), infected N-monomethyl-L-arginine treated (Inf L-NAME), non-infected L-NAME treated and non-infected vehicle-treated. We determined blood parasitaemia and NO levels, the extent of parasite nests in tissues and liver MT-I expression levels. It was observed that NO levels were increasing in Inf mice in a time-dependent manner. Inf L-NAME mice had fewer T. cruzi nests in cardiac and skeletal muscle with decreased blood NO levels at day 135 post infection. This affect was negatively correlated with an increase of MT-I expression (r = -0.8462, p < 0.0001). In conclusion, we determined that in Chagas disease, an unknown inhibitory mechanism reduces MT-I expression, allowing augmented NO levels.

Early decrease of insulin sensitivity in offspring of individuals with type 2 diabetes. The Mexican Diabetes Prevention Study.

BACKGROUND AND AIMS: Defects in insulin sensitivity (IS) and insulin secretion have been recognized as risk factors for type 2 diabetes (T2D) and its complications. We undertook this study to establish the relationship between healthy type 2 diabetic offspring (OFD) from a Mexican population with IS. METHODS: A total of 602 Mexican subjects, 359 first-degree offspring of T2D (OFD+) and 243 first-degree non-offspring of T2D (OFD-) were classified as young adults (age range, 18-44 years) and middle-aged adults (age range, 45-65 years). Groups were clinically and biochemically characterized. Quantitative insulin sensitivity check index (QUICKI) was used to estimate IS and the homeostasis model assessment B (HOMA-B) was used to estimate B cell function. RESULTS: IS decreased significantly (p <0.05) in OFD+ middle-aged (QUICKI 0.330 ± 0.03) compared with OFD- (0. 370 ± 0.03). Middle-aged adults (OFD+) had the highest prevalence of increased fasting insulin levels (FIL) (13.6%) and decreased IS (22.9%) compared with OFD- groups (3.2%). A binary regression analysis showed the association of OFD+ with increased FIL (odds ratio [OR], 3.71; 95% confidence interval [95% CI], 1.68-8.2; p = 0.001), and QUICKI (OR, 10.87; 95% CI, 2.36-44.69; p <0.01) adjusted by gender, age, and obesity. CONCLUSIONS: Our results suggest that decreased IS itself could be recognized as one of the earliest detectable abnormalities in middle-aged adults. Moreover, prevalence increases with age and is associated with type 2 diabetic offspring, regardless of obesity.

Metallothionein-1 and nitric oxide expression are inversely correlated in a murine model of Chagas disease.

Chagas disease, caused by Trypanosoma cruzi, represents an endemic among Latin America countries. The participation of free radicals, especially nitric oxide (NO), has been demonstrated in the pathophysiology of seropositive individuals with T. cruzi. In Chagas disease, increased NO contributes to the development of cardiomyopathy and megacolon. Metallothioneins (MTs) are efficient free radicals scavengers of NO in vitro and in vivo. Here, we developed a murine model of the chronic phase of Chagas disease using endemic T. cruzi RyCH1 in BALB/c mice, which were divided into four groups: infected non-treated (Inf), infected N-monomethyl-L-arginine treated (Inf L-NAME), non-infected L-NAME treated and non-infected vehicle-treated. We determined blood parasitaemia and NO levels, the extent of parasite nests in tissues and liver MT-I expression levels. It was observed that NO levels were increasing in Inf mice in a time-dependent manner. Inf L-NAME mice had fewer T. cruzi nests in cardiac and skeletal muscle with decreased blood NO levels at day 135 post infection. This affect was negatively correlated with an increase of MT-I expression (r = -0.8462, p < 0.0001). In conclusion, we determined that in Chagas disease, an unknown inhibitory mechanism reduces MT-I expression, allowing augmented NO levels.

Serum levels of glutathione peroxidase 3 in overweight and obese subjects from central Mexico.

BACKGROUND AND AIMS: Overweight and obesity are considered complex entities in which there are alterations in the concentration of antioxidant enzymes. It has been reported that glutathione peroxidase 3 (GPx3), an extracellular enzyme involved in the reduction of both hydro- and lipoperoxides, shows changes both in gene expression and protein concentration in animal models for type 2 diabetes (T2D) and obesity, but the variability of GPx3 levels in different human populations and under different health conditions are currently unclear. We undertook this study to determine the GPx3 levels in overweight and obese subjects from central Mexico. METHODS: Biochemical profile (serum glucose, insulin and lipid profile) and GPx3 concentrations were determined in 28 healthy subjects (control) and 133 subjects who were overweight or obese (OW-OB). RESULTS: The OW-OB group had a higher concentration of triacylglycerides (TAG) compared with the control group (201.2 ± 88.7 vs. 100.3 ± 46.4 mg/dL, p <0.05) and the TAG/high density lipoprotein-cholesterol (HDL-C) index (5.6 ± 2.8 vs. 2.1 ± 1.2, p <0.05), whereas the concentration of HDL-C decreased (38.2 ± 8.7 vs. 50.1 ± 14.5 mg/dL, p <0.05). Serum GPx3 was significantly higher in the OW-OB group than in the control group (175.4 ± 25.4 vs. 143.5 ± 23.1 ng/dL). GPx3 concentration correlated with insulin sensitivity (IS) and the TAG/HDL-C index (Rho = -0.2336 and Rho = 0.2275) (p <0.01). CONCLUSIONS: The TAG/HDL-C index and serum GPx3 concentration increased in the OW-OB group. In addition, GPx3 had a significant correlation with IS, weight, and the TAG/HDL-C index.