QTL mapping of human retina DNA methylation identifies 87 gene-epigenome interactions in age-related macular degeneration.

DNA methylation provides a crucial epigenetic mark linking genetic variations to environmental influence. We have analyzed array-based DNA methylation profiles of 160 human retinas with co-measured RNA-seq and >8 million genetic variants, uncovering sites of genetic regulation in cis (37,453 methylation quantitative trait loci and 12,505 expression quantitative trait loci) and 13,747 DNA methylation loci affecting gene expression, with over one-third specific to the retina. Methylation and expression quantitative trait loci show non-random distribution and enrichment of biological processes related to synapse, mitochondria, and catabolism. Summary data-based Mendelian randomization and colocalization analyses identify 87 target genes where methylation and gene-expression changes likely mediate the genotype effect on age-related macular degeneration. Integrated pathway analysis reveals epigenetic regulation of immune response and metabolism including the glutathione pathway and glycolysis. Our study thus defines key roles of genetic variations driving methylation changes, prioritizes epigenetic control of gene expression, and suggests frameworks for regulation of macular degeneration pathology by genotype-environment interaction in retina.

QTL mapping of human retina DNA methylation identifies 87 gene-epigenome interactions in age-related macular degeneration.

DNA methylation (DNAm) provides a crucial epigenetic mark linking genetic variations to environmental influence. We analyzed array-based DNAm profiles of 160 human retinas with co-measured RNA-seq and > 8 million genetic variants, uncovering sites of genetic regulation in cis (37,453 mQTLs and 12,505 eQTLs) and 13,747 eQTMs (DNAm loci affecting gene expression), with over one-third specific to the retina. mQTLs and eQTMs show non-random distribution and enrichment of biological processes related to synapse, mitochondria, and catabolism. Summary data-based Mendelian randomization and colocalization analyses identify 87 target genes where methylation and gene-expression changes likely mediate the genotype effect on age-related macular degeneration (AMD). Integrated pathway analysis reveals epigenetic regulation of immune response and metabolism including the glutathione pathway and glycolysis. Our study thus defines key roles of genetic variations driving methylation changes, prioritizes epigenetic control of gene expression, and suggests frameworks for regulation of AMD pathology by genotype-environment interaction in retina.

Asociación entre nivel educacional y sospecha de deterioro cognitivo en personas mayores chilenas: resultados de la Encuesta Nacional de Salud 2016-2017 / Association between educational level and suspicion of cognitive imparirment in Chilean older people

BACKGROUND: A low education level has been associated with cognitive impairment in older adults. AIM: To determine the association between educational attainment and suspicion of cognitive imparirment in older Chilean population. MATERIAL AND METHODS: Data from 2,005 adults aged ≥ 60 years assessed during 2016-2017 Chilean National Health Survey were included. Education was self-reported and categorized as primary: ≤ 8 years; secondary: 9 to 12 years and beyond secondary: > 12 years. suspicion of cognitive imparirment was assessed with the Mini-Mental questionnaire. RESULTS: Men and women with low education attainment had a higher prevalence of cognitive impairment (33% [95% confidence intervals (CI): 24; 41] and 27% [95% CI: 21; 33], respectively). Men who reported less schooling (≤ 8 years) were more likely to be at risk of suspicion of cognitive imparirment (Odds ratio (OR): 4.53 [95% CI: 1.10, 18.62]) compared to their peers. Women showed a substantially higher magnitude of association than men. The probability of suspicion of cognitive imparirment increased 9-times (OR: 9.96 [95% CI: 1.24; 79.6]) for 9-12 years and 18-times for ≤ 8 years of education (OR: 18.8 [95% CI: 2.42; 146.1]) compared to women with higher education. CONCLUSIONS: Older adults with low education attainment had an increased likelihood of developing suspicion of cognitive imparirment. However, the risk differs by sex, being higher in women than men.

Sustainability of Cocoa (Theobroma cacao) Cultivation in the Mining District of Ponce Enríquez: A Trace Metal Approach.

Historically, cocoa (Theobroma cacao) has been one of Ecuador's most important export crops. In the Ponce Enriquez district, artisanal and small gold mining (ASGM), and quarrying account for 42% of economic activities, while agriculture and livestock farming account for 30%, making the analysis of their synergy and interaction key to understanding the long term viability of the different activities. In this study, we evaluated the concentration of potentially toxic metals in different parts of the cocoa plant and fruit, in relation to mining activities within the area. Gold extraction generates pollution, including potentially toxic metals such as mercury (Hg), cadmium (Cd), arsenic (As), copper (Cu), lead (Pb) and zinc (Zn). In order to understand the mobility of these metals within the cocoa plant and fruit, the analysis was conducted separately for leaves, pod, husk and cocoa bean. Concentrations of the target metals in the different plant parts and soil were measured using ICP-MS, and the mobility and risk factors were calculated using the transfer factor (TF) and the risk ratio (HQ). The results suggest that Zn, Cd and Cu are indeed moving from the soil to cocoa leaves and beans. Furthermore, the results show that the concentrations of toxic metals in the different parts of the cocoa fruit and plant, particularly in the cocoa bean, which is used for chocolate manufacture, are not higher than those regulated by FAO food standards, as is the case of Cd, which is limited to 0.2 mg Cd/kg and in the samples analyzed does not exceed this limit. Even though the concentration of these metals does not exceed the safety standard, the presence of these potentially hazardous metals, and the fact they are absorbed by this important local crop, are worrying for the long-term sustainability of cocoa cultivation in the area. Therefore, it is fundamental to monitor the local environment, understanding the distribution of heavy metal pollution, and work with the local authorities in landscape management to minimize the exposure of crops to ASGM pollution.

High-resolution genome topology of human retina uncovers super enhancer-promoter interactions at tissue-specific and multifactorial disease loci.

Chromatin organization and enhancer-promoter contacts establish unique spatiotemporal gene expression patterns in distinct cell types. Non-coding genetic variants can influence cellular phenotypes by modifying higher-order transcriptional hubs and consequently gene expression. To elucidate genomic regulation in human retina, we mapped chromatin contacts at high resolution and integrated with super-enhancers (SEs), histone marks, binding of CTCF and select transcription factors. We show that topologically associated domains (TADs) with central SEs exhibit stronger insulation and augmented contact with retinal genes relative to TADs with edge SEs. Merging genome-wide expression quantitative trait loci (eQTLs) with topology map reveals physical links between 100 eQTLs and corresponding eGenes associated with retinal neurodegeneration. Additionally, we uncover candidate genes for susceptibility variants linked to age-related macular degeneration and glaucoma. Our study of high-resolution genomic architecture of human retina provides insights into genetic control of tissue-specific functions, suggests paradigms for missing heritability, and enables the dissection of common blinding disease phenotypes.

[Association between educational level and suspicion of cognitive imparirment in Chilean older people]. / Asociación entre nivel educacional y sospecha de deterioro cognitivo en personas mayores chilenas: resultados de la Encuesta Nacional de Salud 2016-2017.

BACKGROUND: A low education level has been associated with cognitive impairment in older adults. AIM: To determine the association between educational attainment and suspicion of cognitive imparirment in older Chilean population. MATERIAL AND METHODS: Data from 2,005 adults aged ≥ 60 years assessed during 2016-2017 Chilean National Health Survey were included. Education was self-reported and categorized as primary: ≤ 8 years; secondary: 9 to 12 years and beyond secondary: > 12 years. suspicion of cognitive imparirment was assessed with the Mini-Mental questionnaire. RESULTS: Men and women with low education attainment had a higher prevalence of cognitive impairment (33% [95% confidence intervals (CI): 24; 41] and 27% [95% CI: 21; 33], respectively). Men who reported less schooling (≤ 8 years) were more likely to be at risk of suspicion of cognitive imparirment (Odds ratio (OR): 4.53 [95% CI: 1.10, 18.62]) compared to their peers. Women showed a substantially higher magnitude of association than men. The probability of suspicion of cognitive imparirment increased 9-times (OR: 9.96 [95% CI: 1.24; 79.6]) for 9-12 years and 18-times for ≤ 8 years of education (OR: 18.8 [95% CI: 2.42; 146.1]) compared to women with higher education. CONCLUSIONS: Older adults with low education attainment had an increased likelihood of developing suspicion of cognitive imparirment. However, the risk differs by sex, being higher in women than men.

HiCRes: a computational method to estimate and predict the genomic resolution of Hi-C libraries.

Three-dimensional (3D) conformation of the chromatin is crucial to stringently regulate gene expression patterns and DNA replication in a cell-type specific manner. Hi-C is a key technique for measuring 3D chromatin interactions genome wide. Estimating and predicting the resolution of a library is an essential step in any Hi-C experimental design. Here, we present the mathematical concepts to estimate the resolution of a dataset and predict whether deeper sequencing would enhance the resolution. We have developed HiCRes, a docker pipeline, by applying these concepts to several Hi-C libraries.

Fuerza de prensión manual y calidad de vida en personas mayores autovalentes / Hand grip strength and quality of life in functional elderly

Introducción: Durante el envejecimiento se observa involución de algunos sistemas corporales. Entre estos cambios, los que afectan al sistema osteomuscular como la sarcopenia y la debilidad muscular, pueden alterar el desarrollo de actividades de la vida diaria, y por lo tanto, afectar la calidad de vida relacionada con la salud. Objetivo: Determinar la relación entre la fuerza de prensión manual y la calidad de vida relacionada con la salud en personas mayores. Métodos: Estudio descriptivo, correlacional. Evaluó 79 personas mayores (63 mujeres y 16 hombres) entre 65 y 78 años, de tres organizaciones sociales de la ciudad de Talca, Chile, seleccionados a través de un muestreo no probabilístico por conveniencia. Para medir la fuerza de prensión manual se utilizó un dinamómetro de mano y el cuestionario SF-36 fue usado para valorar la calidad de vida relacionada con la salud. Resultados: Se observaron relaciones significativas entre la fuerza de prensión manual y las dimensiones de la calidad de vida función física (p = 0,03; r = 0,76), dolor corporal (p = 0,01; r = 0,44) y salud general (p = 0,05; r = 0,48). Conclusiones: Existe relación entre la fuerza de prensión manual y tres dimensiones de la calidad de vida relacionada con la salud de personas mayores. Estos hallazgos corroboran la relevancia de evaluar la fuerza muscular en personas mayores como un marcador de salud y calidad de vida en estas(AU)

Introduction: During aging, involution of some body systems is observed. Among these changes, those that affect the musculoskeletal system such as sarcopenia and muscle weakness can alter the development of activities of daily life, and therefore affect health-related quality of life. Objective: to determine the relationship between hand grip strength and quality of life in elderly. Methods: Cross-sectional study. A total of 79 elderly (63 women and 13 men) between 65 and 78 years of age from three social organizations of Talca, Chile was included. A non-probabilistic convenience sample was used. To measure manual grip strength and the SF-36 questionnaire was used. Results: Significant relationships between hand grip strength and dimensions of quality of life, physical function (p = 0,03; r = 0,76), body pain (p = 0,01; r = 0,44) and general health (p = 0,05; r = 0,48) were observed. Conclusions: There is a relationship between hand grip strength and three measurements of quality of life in elderly. These findings corroborate the relevance of evaluating muscle strength in older people as a marker of health and quality of life in elderly(AU)

Aging of the Retina: Molecular and Metabolic Turbulences and Potential Interventions.

Multifaceted and divergent manifestations across tissues and cell types have curtailed advances in deciphering the cellular events that accompany advanced age and contribute to morbidities and mortalities. Increase in human lifespan during the past century has heightened awareness of the need to prevent age-associated frailty of neuronal and sensory systems to allow a healthy and productive life. In this review, we discuss molecular and physiological attributes of aging of the retina, with a goal of understanding age-related impairment of visual function. We highlight the epigenome-metabolism nexus and proteostasis as key contributors to retinal aging and discuss lifestyle changes as potential modulators of retinal function. Finally, we deliberate promising intervention strategies for promoting healthy aging of the retina for improved vision.

Artisanal and Small Gold Mining and Petroleum Production as Potential Sources of Heavy Metal Contamination in Ecuador: A Call to Action.

Mining and petroleum production are the source of many elements and base materials fundamental for our modern way of life. The flip side of these keystone industries is the environmental degradation they can cause if not properly managed. Metallic mining and petroleum production can contaminate the local ecosystem with sediments, chemicals used in the industrial processes and heavy metals, part of the metallic ore or oil reservoir. The objective of this project was to analyze the spatial distribution of the presence of different potentially hazardous elements that make up the metallic deposits and oil reservoirs in Ecuador, focused mainly on artisanal and small-scale gold mining (ASGM) districts. Additionally, we were interested in analyzing this information under the local political and administrative contexts which are key to determining how likely it is that mismanagement of the local mineral deposits and petroleum exploitation projects will end up causing environmental degradation. An extensive and intensive literature search was conducted for information on the presence and concentration of 19 potentially harmful elements. We analyzed data on 11 metallic deposits throughout Ecuador and a major oilfield in the Ecuadorian Amazon basin. We used geographic information systems to analyze the spatial distribution of these reservoirs and their mineral compositions. The results indicated a widespread distribution and high concentration of elements potentially harmful for human health, such as mercury, cadmium and arsenic, throughout the metallic deposits in Ecuador. This is particularly true for long-exploited ASGM districts, such as Ponce-Enríquez, Portovelo-Zaruma and Nambija. This study highlights the importance of understanding geological diversity and its potential risks to better protect the biological diversity and public health of its inhabitants. Furthermore, we consider our work not as a call to stop ASGM mining nor petroleum production, but on the contrary as a strong call to plan every mining and petroleum production project considering these risks. Moreover, our work is a call to action by the local government and authorities to stop corruption and fulfill their duties overseeing the activities of mining and petroleum companies, stopping illegal mining, helping ASGM communities to improve their environmental standards, finding alternative income sources and protecting the local environment.

In Vivo Antitumor Effect against Murine Cells of CT26 Colon Cancer and EL4 Lymphoma by Autologous Whole Tumor Dead Cells.

Active immunotherapy against cancer is based on immune system stimulation, triggering efficient and long-lasting antigen-specific immune responses. Immunization strategies using whole dead cells from tumor tissue, containing specific antigens inside, have become a promising approach, providing efficient lymphocyte activation through dendritic cells (DCs). In this work, we generate whole dead tumor cells from CT26, E.G7, and EL4 live tumor cells as antigen sources, which termed immunogenic cell bodies (ICBs), generated by a simple and cost-efficient starvation-protocol, in order to determine whether are capable of inducing a transversal anticancer response regardless of the tumor type, in a similar way to what we describe previously with B16 melanoma. We evaluated the anticancer effects of immunization with doses of ICBs in syngeneic murine tumor models. Our results showed that mice's immunization with ICBs-E.G7 and ICBs-CT26 generate 18% and 25% of tumor-free animals, respectively. On the other hand, all carrying tumor-animals and immunized with ICBs, including ICBs-EL4, showed a significant delay in their growth compared to not immunized animals. These effects relate to DCs maturation, cytokine production, increase in CD4+T-bet+ and CD4+ROR-γt+ population, and decrease of T regulatory lymphocytes in the spleen. Altogether, our data suggest that whole dead tumor cell-based cancer immunotherapy generated by a simple starvation protocol is a promising way to develop complementary, innovative, and affordable antitumor therapies in a broad spectrum of tumors.

Asociación entre la velocidad de marcha y el riesgo de deterioro cognitivo en personas mayores que viven en la comunidad / Association between self-reported walking pace and cognitive impairment in older adults no institutionalized in Chile

OBJETIVOS: Determinar si la velocidad de marcha lenta se asocia a un mayor riesgo de deterioro cognitivo en personas mayores de 60 años, sanas, que viven en la comunidad, e investigar si esta asociación es modificable según niveles de actividad física y tiempo que permanecen sentados. MÉTODOS: Estudio correlacional, transversal y retrospectivo. Se incluyeron 1082 personas mayores de 60 años de la Encuesta Nacional de Salud (ENS) 2009-2010 de Chile. La velocidad de la marcha (normal o lenta) fue autorreportada y el riesgo de deterioro cognitivo se evaluó con el cuestionario Mini-Mental State Examination. Las variables sociodemográficas y de estilos de vida se obtuvieron mediante la aplicación de cuestionarios validados en la ENS 2009-2010. Adicionalmente se evaluó el estado nutricional a través del índice de masa corporal. RESULTADOS: Las personas mayores que presentaban una menor velocidad de marcha evidenciaron un mayor riesgo de presentar deterioro cognitivo en comparación con aquellos que caminan a velocidad de paso normal (OR:1,62 [IC 95%:1,06;2,54], p = 0,036). Esta asociación fue independiente de factores sociodemográficos, obesidad, tiempo sedente, actividad física y estilos de vida. CONCLUSIÓN: Las personas mayores que reportaron caminar a un paso más lento que sus pares de la misma edad presentan un mayor riesgo de deterioro en comparación con aquellos que tienen una velocidad de la marcha normal. La probabilidad de deterioro cognitivo en personas mayores con marcha lenta aumenta en aquellas que no cumplen con las recomendaciones de actividad física dadas por la Organización Mundial de Salud o pasan más de 4 horas diarias en actividades sedentarias. Estos resultados refuerzan la idea de que la velocidad de la marcha podría ser usada como una herramienta de detección de riesgo de deterioro cognitivo en personas mayores

OBJECTIVES: To determine if slow walking speed is associated with an increased risk of cognitive impairment in older Chilean adults, and to investigate if this association is modify according to levels of physical activity (PA) and sitting time. METHODS:1,082 adults over 60 years of age participants from the cross-sectional 2009-2010 Chilean National Health Survey were included in this study. The speed of walking (normal or slow) was self-reported, the risk of cognitive deterioration was assessed with the Mini-Mental State Examination questionnaire. The sociodemographic and lifestyle variables were obtained through the application of questionnaires validated in the ENS 2009-2010, nutritional status was also assessed through body mass index. RESULTS: Older adults who presented a lower walking speed showed a greater risk of presenting cognitive impairment compared to those who walked at a normal gait speed (OR: 1.62 [95% CI: 1.06, 2.54], p = 0.036). This association was independent of sociodemographic, anthropometric, lifestyle variables. CONCLUSION: Older adults who reported walking at a slower gait speed than their peers of the same age presented an increased risk of cognitive impairment compared to those who had a normal gait speed. The probability of cognitive impairment in older adults with slow gait speed increased in those who did not comply with the PA recommendations given by the World Health Organization or had four or more hours per day in sedentary activities

Prevalencia de debilidad muscular en personas mayores chilenas: resultados de la Encuesta Nacional de Salud 2016-2017

Background: Handgrip strength is an indicator of frailty in older people. Aim: To determine the prevalence of low handgrip strength in older Chilean adults. Material and Methods: A cross-sectional analysis of 244 individuals aged 60 years or more, participating in the 2016-2017 Chilean National Health Survey, was carried out. Handgrip strength was evaluated by a hand dynamometer and low grip strength was determined as a grip strength ≤ 15 kg and ≤ 27 kg for women and men, respectively. Results: Twenty nine percent of participants had low grip strength. The average grip strength among 60-year-old men and women was 34.7 and 22.1 kg, respectively. These figures decreased to 28.8 kg and 17.2 kg among 90-year-old men and women, respectively. The prevalence of low grip strength in men and women aged 60 years was 18%. In 90-year-old men and women, these figures increased to 79% and 56.3%, respectively. Conclusions: The prevalence of low grip strength increased substantially with age.

Personas mayores en Chile: el nuevo desafío social, económico y sanitario del Siglo XXI / Older people in Chile: the new social, economic and health challenge for the 21st century

Ageing will be one of the most significant social transformations of the 21st century worldwide. In the last 40 years, Chile has tripled its older adult population. As a result, by 2050 the country will have the highest proportion of older adults in Latin America. This remarkable growth reinforces the need to identify their current situation and to revise what is the society doing to maintain older people as active members. In this context, this narrative revision aimed to describe the sociodemographic, epidemiologic and sociocultural profile of the older Chilean adults. Besides, programs and public policies focused on the improvement of their quality of life were identified.

Genome-wide Profiling Identifies DNA Methylation Signatures of Aging in Rod Photoreceptors Associated with Alterations in Energy Metabolism.

Aging-associated functional decline is accompanied by alterations in the epigenome. To explore DNA modifications that could influence visual function with age, we perform whole-genome bisulfite sequencing of purified mouse rod photoreceptors at four ages and identify 2,054 differentially methylated regions (DMRs). We detect many DMRs during early stages of aging and in rod regulatory regions, and some of these cluster at chromosomal hotspots, especially on chromosome 10, which includes a longevity interactome. Integration of methylome to age-related transcriptome changes, chromatin signatures, and first-order protein-protein interactions uncover an enrichment of DMRs in altered pathways that are associated with rod function, aging, and energy metabolism. In concordance, we detect reduced basal mitochondrial respiration and increased fatty acid dependency with retinal age in ex vivo assays. Our study reveals age-dependent genomic and chromatin features susceptible to DNA methylation changes in rod photoreceptors and identifies a link between DNA methylation and energy metabolism in aging.

[Older people in Chile: the new social, economic and health challenge for the 21st century]. / Personas mayores en Chile: el nuevo desafío social, económico y sanitario del Siglo XXI.

Ageing will be one of the most significant social transformations of the 21st century worldwide. In the last 40 years, Chile has tripled its older adult population. As a result, by 2050 the country will have the highest proportion of older adults in Latin America. This remarkable growth reinforces the need to identify their current situation and to revise what is the society doing to maintain older people as active members. In this context, this narrative revision aimed to describe the sociodemographic, epidemiologic and sociocultural profile of the older Chilean adults. Besides, programs and public policies focused on the improvement of their quality of life were identified.

[Prevalence of low hand grip strength in Chilean older adults. Findings from the national health survey 2016-2017]. / Prevalencia de debilidad muscular en personas mayores chilenas: resultados de la Encuesta Nacional de Salud 2016-2017.

BACKGROUND: Handgrip strength is an indicator of frailty in older people. AIM: To determine the prevalence of low handgrip strength in older Chilean adults. MATERIAL AND METHODS: A cross-sectional analysis of 244 individuals aged 60 years or more, participating in the 2016-2017 Chilean National Health Survey, was carried out. Handgrip strength was evaluated by a hand dynamometer and low grip strength was determined as a grip strength ≤ 15 kg and ≤ 27 kg for women and men, respectively. RESULTS: Twenty nine percent of participants had low grip strength. The average grip strength among 60-year-old men and women was 34.7 and 22.1 kg, respectively. These figures decreased to 28.8 kg and 17.2 kg among 90-year-old men and women, respectively. The prevalence of low grip strength in men and women aged 60 years was 18%. In 90-year-old men and women, these figures increased to 79% and 56.3%, respectively. CONCLUSIONS: The prevalence of low grip strength increased substantially with age.

Tissue-resident memory CD8+ T cells amplify anti-tumor immunity by triggering antigen spreading through dendritic cells.

Tissue-resident memory CD8+ T (Trm) cells mediate potent local innate and adaptive immune responses and play a central role against solid tumors. However, whether Trm cells cross-talk with dendritic cells (DCs) to support anti-tumor immunity remains unclear. Here we show that antigen-specific activation of skin Trm cells leads to maturation and migration to draining lymph nodes of cross-presenting dermal DCs. Tumor rejection mediated by Trm cells triggers the spread of cytotoxic CD8+ T cell responses against tumor-derived neo- and self-antigens via dermal DCs. These responses suppress the growth of intradermal tumors and disseminated melanoma lacking the Trm cell-targeted epitope. Moreover, analysis of RNA sequencing data from human melanoma tumors reveals that enrichment of a Trm cell gene signature associates with DC activation and improved survival. This work unveils the ability of Trm cells to amplify the breath of cytotoxic CD8+ T cell responses through DCs, thereby strengthening anti-tumor immunity.

¿Cuál es la prevalencia de obesidad metabólicamente saludable en población chilena? / What is the prevalence of metabolically healthy obesity in Chile?

RESUMEN La obesidad es un importante factor de riesgo cardiovascular. No obstante, no todas las personas obesas tienen un perfil metabólico alterado ni todas las personas normo-peso poseen un perfil metabólico normal. Objetivo: determinar la prevalencia de diferentes fenotipos metabólicos asocia-dos al estado nutricional en Chile. Métodos: se incluyeron 1.733 participantes de la Encuesta Nacional de Salud 2009-2010. El estado nutricional (obesidad o normo-peso) fue determinado a través del IMC mientras que la condición metabólica (saludable o no) en base a cuatro parámetros: glicemia, presión arterial, colesterol HDL y triglicéridos. Con estos parámetros de determinaron 4 fenotipos, entre ellos, MUNO: metabólicamente no saludable no obeso y MHO: obeso metabólicamente saludable. Resultados: La prevalencia de MHO fue de 3,3% mientras que un 17,4% presentaba MUNO. Adicionalmente, la prevalencia de MHO disminuyó en la medida que aumentó la edad y la mayor proporción de individuos metabólicamente saludables se encontraba en el grupo de altos ingresos y con un nivel educacional superior (técnico-universitario). Conclusión: Se evidencia una baja prevalencia de MHO, así como también una alta prevalencia de individuos MUNO en la población chilena. Futuras acciones preventivas deberían no sólo considerar el estado nutricional sino también la condición metabólica de la población.

ABSTRACT Obesity is an important cardiovascular risk factor. However, not all obese individuals have an unhealthy metabolic pro-file and vice versa. Therefore, the aim of this study was to determine the prevalence of different metabolic phenotypes by nutritional status in Chile. Methods: 1,733 individuals from the National Health Survey 2009-10 were included in this study. Nutritional status (obesity or normal-weight) was determined by BMI whereas metabolic profile was determined through four parameters: Glycaemia, blood pressure, HDL cholesterol and triglycerides. Four metabolic phenotypes were derived, among them: MUNO: metabolically unhealthy and non-obese and MHO: metabolically healthy obesity. Results: The prevalence of MHO in the Chilean population was 3.3% while the prevalence of MUNO was 17.4%. Moreover, the prevalence of MHO decreased as age increased and a greater proportion of metabolically healthy individuals were in the highest gross income group and in the technical-university educational level. Conclusion: This study shows a low prevalence of MHO and a higher prevalence of MUNO in the Chilean population. Future preventive actions should take into account not only the nutritional status, but also the metabolic profile of the population.

Long-term quality of life in octogenarians and nonagenarians with nonvalvular atrial fibrillation following WATCHMAN™ device implantation.

OBJECTIVES: To assess the impact of WATCHMAN™ on quality of life (QoL) in octogenarians and nonagenarians. BACKGROUND: QoL after WATCHMAN™ device in the elderly remains unknown. METHODS: This is a prospective and retrospective cohort study of patients that underwent WATCHMAN™ implantation in a tertiary cardiovascular center from April 1, 2015 to September 27, 2017. The primary outcome was a prospective assessment of QoL via the SF-12v2 Health Survey (SF-12v2) in those aged ≥80 and ≥90 years. Secondary outcomes include major bleeding, stroke, vascular complications, pericardial effusion, device related thrombus (DRT), prolonged length of stay (LOS), acute kidney injury (AKI), and recurrent hospitalizations. RESULTS: This cohort of 151 patients included 48/151 (32%) females with a mean age of 80 ± 7.7 years. Mean CHA2 DS2 -VASc was 4.38 ± 1.36 and mean HAS-BLED was 3.27 ± 1.17. Octogenarians 65/81(80%) and nonagenarians 16/81(20%) comprised 81/151(54%) of patients (mean age 86 ± 4.3 years) from which 36/65 (55%) octogenarians and 10/16 (63%) nonagenarians completed SF-12v2 evaluation at 22 ± 10 and 30 ± 10-months. Octogenarians demonstrated enhanced physical component scores (PCS), and nonagenarians equal PCS versus the age-adjusted norm (45.43 ± 9.84 versus 38.68 ± 11.04, P = 0.0003, and 41.26 ± 12.36 versus 38.68 ± 11.04, P = 0.6463, respectively). The mental component scores (MCS) of octogenarians and nonagenarians remained comparable (51.80 ± 9.56 and 48.97 ± 9.92 versus 50.06 ± 10.94, respectively, P = 0.4659). No stroke, vascular complications, pericardial effusions, or readmissions related to WATCHMAN™ occurred. No difference among patients <80, ≥80, and ≥90 years was found in major bleeding events, DRT, prolonged LOS, or AKI (P = 0.0569, 0.116, 0.498, and 0.795, respectively). CONCLUSIONS: Octogenarians and nonagenarians experience favorable long-term QoL after WATCHMAN™, with acceptable bleeding risk and low incidence of procedure-related complications.