Association of tyrosine hydroxylase 01 (TH01) microsatellite and insulin gene (INS) variable number of tandem repeat (VNTR) with type 2 diabetes and fasting insulin secretion in Mexican population.

PURPOSE: A variable number of tandem repeats (VNTR) in the insulin gene (INS) control region may be involved in type 2 diabetes (T2D). The TH01 microsatellite is near INS and may regulate it. We investigated whether the TH01 microsatellite and INS VNTR, assessed via the surrogate marker single nucleotide polymorphism rs689, are associated with T2D and serum insulin levels in a Mexican population. METHODS: We analyzed a main case-control study (n = 1986) that used univariate and multivariate logistic regression models to calculate the risk conferred by TH01 and rs689 loci for T2D development; rs689 results were replicated in other case-control (n = 1188) and cross-sectional (n = 1914) studies. RESULTS: TH01 alleles 6, 8, 9, and 9.3 and allele A of rs689 were independently associated with T2D, with differences between sex and age at diagnosis. TH01 alleles with ≥ 8 repeats conferred an increased risk for T2D in males compared with ≤ 7 repeats (odds ratio, ≥ 1.46; 95% confidence interval, 1.1-1.95). In females, larger alleles conferred a 1.5-fold higher risk for T2D when diagnosed ≥ 46 years but conferred protection when diagnosed ≤ 45 years. Similarly, rs689 allele A was associated with T2D in these groups. In males, larger TH01 alleles and the rs689 A allele were associated with a significant decrease in median fasting plasma insulin concentration with age in T2D cases; the reverse occurred in controls. CONCLUSION: Larger TH01 alleles and rs689 A allele may potentiate insulin synthesis in males without T2D, a process disabled in those with T2D.

[Factors related to mortality in neonatal tetanus in the rural area of Jalisco]. / Factores asociados a la mortalidad por tétanos neonatal en el área rural de Jalisco.

In this article, we report the results of a survey taken in towns with less than 2,500 inhabitants in the rural tetanigenic zone of the State of Jalisco. The purpose was to know the Infant Mortality Rate (IMR), the Neonatal Tetanus Mortality Rate (NTMR), the incidence of neonatal tetanus, and a partial register of these indicators, as well as the identification of the risk factors associated with fatalities from this disease. The sampling was multistaged with random selection of the conglomerates. The results were as follows: 75 deaths in children of less than one year of age with an IMR of 34.7 per 1,000 Live Births Registered (LBR), 40 deaths in those of less than 29 days old (Neonatal Mortality Rate of 18.5 per 1,000 LBR), eight deaths by neonatal tetanus (NTMR of 3.7 per 1,000 LBR), the estimated annual incidence rate of neonatal tetanus was 4.6 per 1,000 LBR, and the proportion of neonatal deaths due to tetanus was 20 per cent. The main factors studied which were statistically found to be significantly associated with the mortality rate from neonatal tetanus were: a maternal history of two or more prior child deaths having an Odds Ratio (OR) of seven; the existence of cramped living conditions greater than 3.5 persons per room (OR = 7.93); maternal illiteracy (OR = 7.22); and birth at the home (OR = 17.89). When the logistics model was used to control some of the misleading factors and obtain adjusted OR estimates, place of birth and the maternal history or two or more prior child deaths were found to be significant.