Fatalistic beliefs, self-care, and HbA1c in Mexican men with type 2 diabetes mellitus: A cross-sectional study.

The aim of this study is to examine the relationship between fatalistic beliefs, self-care, and glycemic control among Mexican men with type 2 diabetes mellitus. This is a cross-sectional study in men diagnosed with type 2 diabetes mellitus from 18 to 59 years of age from the Northeast of Mexico. Fatalistic beliefs, self-care, medication adherence, and HbA1C were evaluated. Patients were divided into glycemic control (<7% HbA1c) and without glycemic control (>7% HbA1c). Tests were performed to compare 2 independent groups, Student's t and U Mann Whitney. Correlation tests and multiple linear regression models were also performed. For statistical analysis, the SPSS v27 program was used. Forty-nine percent of the men had glycemic control (<7% HbA1c). Fatalistic beliefs were negatively correlated with self-care and medication adherence, but not with HbA1c. In multiple linear regression models, fatalistic beliefs were a negative predictor of self-care and medication adherence. In the model for HbA1c, the pessimism subdimension and self-care were the predictors. Fatalistic beliefs negatively affect self-care compliance and medication adherence, while the pessimism subdimension was related to the increase in HbA1c.

Feasibility of a Physical Training Intervention With Music in Community-Dwelling Older Women: A Quasi-Experimental Study.

Physical activity performed with music activates important brain areas associated with cognition, emotions, and motor skills. Limited information is available on the feasibility and acceptability of physical activity and music interventions. The current study aimed to (a) determine the feasibility of a physical training intervention with music in older women, and (b) describe the differences between pretest and posttest variables (i.e., cognitive state, immediate memory, executive function, gait parameters [cadence and gait speed], muscle strength, flexibility, and symptoms of depression). Results suggest that the intervention with physical training and music was feasible, given the high acceptability and retention rates, high level of attendance at the sessions, and absence of adverse events. Significant improvements were observed in immediate memory (p ≤ 0.01), executive function (p ≤ 0.05), cadence (p ≤ 0.01), leg strength (p ≤ 0.01), right arm strength (p ≤ 0.01), left arm strength (p ≤ 0.05), symptoms of depression (p ≤ 0.01), and left lower body flexibility (p ≤ 0.05). Therefore, a randomized clinical trial with a larger sample could confirm the effects of this intervention on memory, executive function, cadence, leg strength, arm strength, symptoms of depression, and left lower body flexibility. [Journal of Gerontological Nursing, 48(11), 37-43.].

Uso de la Realidad Virtual Inmersiva en la salud del adulto mayor, revisión sistemática / Use of Immersive Virtual Reality on the elderly health, systematic review

Introducción: El aumento del número de adultos mayores trae consigo un incremento de la prevalencia de enfermedades crónicas, que en conjunto con el deterioro asociado al envejecimiento conducen a una disminución temprana de las capacidades físicas y cognitivas. Dentro de esta problemática, la evidencia científica muestra que el uso de herramientas tecnológicas como la realidad virtual inmersiva tiene efectos positivos en la salud física y cognitiva en diversas poblaciones. Objetivo: Recopilar, revisar y analizar las intervenciones que utilizan sistemas de realidad virtual totalmente inmersivos en adultos mayores. Método: Por medio de los lineamientos del checklist PRISMA se realizó una búsqueda sistemática en las bases de datos: PubMed, Wiley Online Library, Science Direct y Google académico. La plataforma Web 3.0: Ficheros de Lectura Crítica se utilizó para analizar la calidad de los estudios. Resultados: Se incluyeron catorce estudios los cuales aportaron evidencia del uso, aceptación y tolerancia de la realidad virtual inmersiva, así como su efecto sobre la salud física y cognitiva. Conclusiones: Los estudios analizados revelan que la realidad virtual inmersiva es bien aceptada y tolerada por los adultos mayores, además de ser una herramienta prometedora para revertir o retrasar el deterioro físico y cognitivo. Sin embargo, los resultados no son consistentes debido a que existe una gran diversidad entre los sistemas de realidad virtual y contenido utilizado, así como estudios con muestras pequeñas y diseños no controlados. (AU)

Introduction: Due to the increase in the number of older adults, there is an increase in the prevalence of chronic diseases, which, together with the deterioration associated to aging, lead to an early decline in physical and cognitive abilities. Within this problem, scientific evidence shows that the use of technological tools such as immersive virtual reality has positive effects on physical and cognitive health in various population groups. Objective: Collect, review and assess interventions using fully immersive virtual reality systems in older adults. Method: Using the PRISMA checklist guidelines, a systematic search was carried out in the following databases: PubMed, Wiley Online Library, Science Direct and Google Scholar. The FLC 3.0 platform called “Ficheros de Lectura Crítica” (Critical Appraisal Tool) was used to assess the quality of the studies. Results: Fourteen studies were included, which provided evidence of the use, acceptance and tolerance of immersive virtual reality, as well as its effect on physical and cognitive health. Conclusions: The studies analyzed reveal that immersive virtual reality is well accepted and tolerated by older adults, as well as being a promising tool for reversing or delaying physical and cognitive decline. However, the results are not consistent due to the great diversity among virtual reality systems and content used, as well as studies with small samples and uncontrolled designs. (AU)

Riesgo de diabetes mellitus tipo 2 y sus determinantes / Risk of type 2 diabetes mellitus and its determinants

Objetivo: Describir la relación de los determinantes sociales de salud con el riesgo de DMT2 enpoblación mexicana.Métodos: Estudio descriptivo correlacional transversal, con una muestra de 256 individuos de unacomunidad rural de Sinaloa, México. La recolección de datos se realizó durante octubre de 2020 yfebrero de 2021. El muestreo fue no probabilístico por bola de nieve. Los instrumentos utilizados fueronel cuestionario internacional de actividad física (IPAQ) versión corta, IPAQ-A, IPAQ-C y una hoja deregistro datos sociodemográficos, antropométricos y clínicos.Resultados: Los indicadores de riesgo de DMT2 con mayor frecuencia para adultos fue padecerhipertensión arterial (81.7%) y SP/OB (68.6%) y para menores de edad fue tener SP/OB (34.9%).Resultó que el riesgo de DMT2 se acrecentaba según lo hacía la edad (r = .560, p < .01) perodisminuía al aumentar la escolaridad de las personas (r = -.127, p < .05).Conclusiones: El abordaje de factores de riesgo de DMT2 bajo la perspectiva de los DSS brinda laoportunidad de plantear estrategias de salud que contemplen factores contextuales simultáneos alestilo de vida que refuercen las acciones del personal de salud para contribuir a la reducción de losíndices de morbimortalidad causados por la DMT2 (AU)

Objective: Describe the relationship between social determinants of health and risk of type 2 diabetesmellitus in Mexican population.Methods: This was a cross-sectional descriptive correlational study of a sample of 256 individuals froma rural community in Sinaloa, Mexico. Data collection was carried out from October 2020 to February2021. A snowball non-probability sampling method was used. The Instruments used were theInternational Physical Activity Questionnaire (IPAQ), short version, the IPAQ-A for adults, the IPAQ-Cfor children, and a sociodemographic, anthropometric, and clinical data sheet.Results: The most frequent risk indicators for T2DM for adults are hypertension (81.7%) andoverweight/obesity (68.6%); in children, it was overweight/obesity (34.9%). The risk of T2DM increasedaccording to age (r = .560, p < .01) but decreased as education level increased (r = −.127, p < .05) (AU)

Replication of Integrative Data Analysis for Adipose Tissue Dysfunction, Low-Grade Inflammation, Postprandial Responses and OMICs Signatures in Symptom-Free Adults.

We previously reported preliminary characterization of adipose tissue (AT) dysfunction through the adiponectin/leptin ratio (ALR) and fasting/postprandial (F/P) gene expression in subcutaneous (SQ) adipose tissue (AT) biopsies obtained from participants in the GEMM study, a precision medicine research project. Here we present integrative data replication of previous findings from an increased number of GEMM symptom-free (SF) adults (N = 124) to improve characterization of early biomarkers for cardiovascular (CV)/immunometabolic risk in SF adults with AT dysfunction. We achieved this goal by taking advantage of the rich set of GEMM F/P 5 h time course data and three tissue samples collected at the same time and frequency on each adult participant (F/P blood, biopsies of SQAT and skeletal muscle (SKM)). We classified them with the presence/absence of AT dysfunction: low (<1) or high (>1) ALR. We also examined the presence of metabolically healthy (MH)/unhealthy (MUH) individuals through low-grade chronic subclinical inflammation (high sensitivity C-reactive protein (hsCRP)), whole body insulin sensitivity (Matsuda Index) and Metabolic Syndrome criteria in people with/without AT dysfunction. Molecular data directly measured from three tissues in a subset of participants allowed fine-scale multi-OMIC profiling of individual postprandial responses (RNA-seq in SKM and SQAT, miRNA from plasma exosomes and shotgun lipidomics in blood). Dynamic postprandial immunometabolic molecular endophenotypes were obtained to move towards a personalized, patient-defined medicine. This study offers an example of integrative translational research, which applies bench-to-bedside research to clinical medicine. Our F/P study design has the potential to characterize CV/immunometabolic early risk detection in support of precision medicine and discovery in SF individuals.

Teoría de rango medio: procesos familiares que predicen el descontrol glucémico en diabetes mellitus 2 / Middle range theory: family processes predicting glycemic uncontrolled in diabetes mellitus 2 / Teoria de médio alcance: processos familiares que predizem o descontrole glicêmico no diabetes mellitus 2

Objetivo: describir el desarrollo de una teoría de rango medio que contribuya en el abordaje de las perspectivas tanto del individuo como de los integrantes de la familia considerando las relaciones e interacciones que surgen en la dinámica de la vida diaria al experimentar una situación de cronicidad. Método: la teoría fue desarrollada deductivamente del modelo de la organización sistémica, un modelo empleado en la investigación y en la disciplina de enfermería para el abordaje del sistema familiar e individual. Los vínculos entre los conceptos de la teoría se desarrollan bajo los niveles de abstracción planteados por Smith y Liehr. Resultados: el desarrollo de la teoría procesos familiares e individuales y descontrol glucémico en adultos con diabetes mellitus 2 sirve para construir la ciencia de enfermería mediante la integración de la teoría de enfermería existente y el conocimiento empírico. Conclusión: esta teoría ayuda a comprender de mejor forma como se percibe y otorga el apoyo al interior de la familia y la influencia con el automanejo del integrante con diabetes mellitus 2 reflejado en el control glucémico.(AU)

Objective: to describe the development of a mid-range theory that contributes to the approach of the perspectives of both the individual and the members of the family considering the relationships and interactions that arise in the dynamics of daily life when experiencing a situation of chronicity. Method: the theory was developed deductively from the model of the systemic organization, a model used in research and in the discipline of nursing for the approach of the family and individual system. The links between the concepts of the theory are developed under the levels of abstraction proposed by Smith and Liehr. Results: the development of the theory: Family and Individual Processes and Glycemic Decontrol in adults with diabetes mellitus 2 serves to build nursing science through the integration of existing nursing theory and empirical knowledge. Conclusion: this theory helps to better understand how it is perceived and gives support to the interior of the family and the influence with the self-management of the member with diabetes mellitus 2 reflected in glycemic control.(AU)

Objetivo: descrever o desenvolvimento de uma teoria de médio alcance que contribua para abordagem das perspectivas tanto do indivíduo quanto dos membros da familia, considerando as relações e interações que surgem na dinâmica da vida diária ao experimentar uma situação de cronicidade. Método: teoria desenvolvida dedutivamente a partir do modelo de organização sistêmica, um modelo usado na investigação e disciplina de enfermagem para abordar a família e sistema individual. As ligações entre os conceitos da teoria são desenvolvidas sob os níveis de abstração levantados por Smith e Liehr. Resultados: o desenvolvimento da teoria processos familiares e individuais, e descontrole glicémico em adultos com diabetes mellitus 2 serve para construir a ciência de enfermagem mediante a integração da teoría de enfermagem existente e o conhecimento empírico. Conclusão: esta teoria ajuda a compreender de melhor forma como se percebe e fornece o apoio no interior da familia e a influência com o automanejo do integrante com diabetes mellitus 2 refletido no controle glicémico.(AU)

Social Factors Contributing to the Development of Allostatic Load in Older Adults: A Correlational-Predictive Study / Factores sociales que contribuyen al desarrollo de la carga alostática en adultos mayores: un estudio correlacional-predictivo / Fatores sociais que contribuem para o desenvolvimento da carga alostática em idosos: um estudo preditivo correlacional

ABSTRACT Objective: To determine if social factors, such as housing conditions, satisfaction with one's house, neighborhood characteristics, social support, family relations and church attendance affect allostatic load in older adults. Materials and method: A correlational-predictive, cross-sectional study was conducted. The instruments used were sociodemographic data, the perceived family relationships instrument, the Medical Outcomes Study-Social Support Survey and the abbreviated version of the Neighborhood Environment Walkability Scale. The allostatic load biomarkers used were: systolic and diastolic blood pressure, body mass index, waist circumference, waist-hip ratio, total cholesterol, high density lipoprotein, glycated hemoglobin, fibrinogen, and C-reactive protein. Sample size was estimated to contrast the no relation (R2= 0) hypotheis in a multiple lineal regression model with 11 covariables, with a significance level of .05, power of 90% (.90), when coefficient of determination (R2) is .15, resulting in a sample of 131 older adults. The statistical analysis included descriptive measures and generalized linear models. Results: The participants had either medium- or high-risk allostatic load. Multivariate linear regression model analysis showed that better housing conditions, satisfaction with own house, presence of dead-end streets, and church attendance reduce allostatic load, while dangerous traffic increases allostatic load. Conclusions: There are several social factors contributing to the development of allostatic load in older adults. It is necessary to create nursing care strategies toward the social environment to decrease allostatic load in older adults.

RESUMEN Objetivo: determinar si factores sociales como las condiciones de vivienda, la satisfacción con la casa, las características del vecindario, el apoyo social, las relaciones familiares y la asistencia a la iglesia contribuyen al desarrollo de la carga alostática en los adultos mayores. Materiales y método: se realizó un estudio correlacional y predictivo de corte transversal. Los instrumentos utilizados fueron una hoja de datos sociodemográficos, el instrumento de relaciones familiares percibidas, el cuestionario de Apoyo Social y la Escala de Movilidad Activa en el Entorno Comunitario, versión corta. Los biomarcadores de carga alostática utilizados fueron: presión arterial sistólica y diastólica, índice de masa corporal, circunferencia de la cintura, relación cintura-cadera, colesterol total, lipoproteína de alta densidad, hemoglobina glicosilada, fibrinógeno y proteína C-Reactiva. La muestra se calculó para para el contraste de la hipótesis de no relación (R2= 0), en un modelo de regresión lineal múltiple con 11 covariables, con un nivel de significancia del .05 y una potencia del 90 % (.90), cuando el coeficinete de determinación poblacional (R2) es .15, tamaño de muestra que resultó en 131 adultos mayores. El análisis estadístico incluyó medidas descriptivas y modelos lineales generalizados. Resultados: los participantes tenían un riesgo medio o alto de carga alostática. El análisis del modelo de regresión lineal multivariante mostró que las mejores condiciones de vivienda, la satisfacción con la propia casa, la presencia de calles sin salida y la asistencia a la iglesia reducen la carga alostática y que el tráfico peligroso aumenta la carga alostática. Conclusiones: existen varios factores sociales que contribuyen al desarrollo de la carga alostática en adultos mayores. Es necesario crear estrategias de cuidado de enfermería hacia el entorno social para disminuir la carga alostática en el adulto mayor.

RESUMO Objetivo: determinar se fatores sociais, como as condições de moradia, a satisfação com a casa, as características do bairro, o apoio social, as relações familiares e a freqüência à igreja afetam a carga alostática em idosos. Materiais e método: um estudo de correlação transversal e preditivo foi realizado. Os instrumentos utilizados foram dados sociodemográficos, o instrumento de relações familiares percebido, o Medical Outcomes Study-Social Support Survey e a Abbreviated Neighborhood Environment Walkability Scale. Os biomarcadores de carga alostática utilizados foram: pressão arterial sistólica e diastólica, índice de massa corporal, circunferência da cintura, relação cintura-quadril, colesterol total, lipoproteína de alta densidade, hemoglobina glicada, fibrinogênio e proteína C-reativa. A amostra foi calculada para o contraste do hipóseo de nenhuma relação (R2 = 0), em um modelo de regresión múltiple linear con 11 covariáveis, com um nível de significância de 0.05 e uma potencia de 90% (0.90), quando o coeficiente de determinação populacional (R2) es .15, o tamanho da amostra resultou em 131 idosos. A análise estatística incluiu medidas descritivas e modelos lineares generalizados. Resultados: os participantes tinham risco médio ou alto de carga alostática. A análise multivariada do modelo de regressão linear mostrou que melhores condições de moradia, satisfação com a casa própria, presença de ruas sem saída e freqüência à igreja reduzem a carga alostática e o tráfego perigoso aumenta a carga alostática. Conclusões: existem vários fatores sociais que contribuem para o desenvolvimento da carga alostática em idosos. É necessário criar estratégias de cuidados de enfermagem em direção ao ambiente social para diminuir a carga alostática no idoso.

Factors associated with glycemic status and ability to adapt to changing demands in people with and without type 2 diabetes mellitus: A cross-sectional study.

OBJECTIVES: Type 2 diabetes mellitus studies focus on metabolic indicators and different self-reported lifestyle or care behaviors. Self-reported instruments involve conscious process therefore responses might not reflect reality. Meanwhile implicit responses involve automatic, unconscious processes underlying social judgments and behavior. No studies have explored the combined influence of both metabolic indicators and implicit responses on lifestyle practices in type 2 diabetes mellitus patients. The purpose was to investigate the explained variance of socio-demographic, metabolic, anthropometric, clinical, psychosocial, cognitive, and lifestyle variables on glycemic status and on the ability to adapt to changing demands in people with and without type 2 diabetes mellitus in Monterrey, Mexico. METHODS: Adults with (n = 30, mean age 46.90 years old, 33.33% male) and without (n = 32, mean age: 41.69 years old, 21.87% male) type 2 diabetes mellitus were studied. Glycemic status was assessed using Bio-Rad D-10 Hemoglobin A1c Program, which uses ion-exchange high-performance chromatography. Stroop 2 test was used to assess the ability to changing demands. RESULTS: In participants with type 2 diabetes mellitus, less years of education, negative self-actualization, and higher levels of cholesterol and triglycerides explained more than 50% of the variance in glycemic status. In participants without type 2 diabetes mellitus, the variance (38.7%) was explained by total cholesterol, metabolic syndrome, high-density lipoprotein, and self-actualization scores; the latter in opposite direction. The ability to adapt to changing demands was explained by total cholesterol, malondialdehyde, insulin resistance, and triglycerides. In participants without type 2 diabetes mellitus, the contributing variables were metabolic syndrome and nutrition scores. CONCLUSION: Results showed significant effect on at least one of the following variables (socio-demographic, metabolic, or lifestyle subscale) on glycemic status in people with and without type 2 diabetes mellitus. The ability to adapt to changing demands was explained by metabolic variables but only in participants without type 2 diabetes mellitus. Preference for unhealthy behaviors (implicit or automatic responses) outweighs healthy lifestyle practices in people with and without type 2 diabetes mellitus.

Mini-Review: The Contribution of Intermediate Phenotypes to GxE Effects on Disorders of Body Composition in the New OMICS Era.

Studies of gene-environment (GxE) interactions describe how genetic and environmental factors influence the risk of developing disease. Intermediate (molecular or clinical) phenotypes (IPs) are traits or metabolic biomarkers that mediate the effects of gene-environment influences on risk behaviors. Functional systems genomics discovery offers mechanistic insights into how DNA variations affect IPs in order to detect genetic causality for a given disease. Disorders of body composition include obesity (OB), Type 2 diabetes (T2D), and osteoporosis (OSTP). These pathologies are examples of how a GxE interaction contributes to their development. IPs as surrogates for inherited genotypes play a key role in models of genetic and environmental interactions in health outcomes. Such predictive models may unravel relevant genomic and molecular pathways for preventive and therapeutic interventions for OB, T2D, and OSTP. Annotation strategies for genomes, in contrast to phenomes, are well advanced. They generally do not measure specific aspects of the environment. Therefore, the concepts of deep phenotyping and the exposome generate new avenues to exploit with high-resolution technologies for analyzing this sophisticated phenome. With the successful characterization of phenomes, exposomes, and genomes, environmental and genetic determinants of chronic diseases can be united with multi-OMICS studies that better examine GxE interactions.

Autopsia verbal en hombres adultos con diabetes tipo 2: estudio cualitativo / Verbal autopsy of adult men with diabetes type 2: qualitative study / Autópsia verbal em homens adultos com diabetes tipo 2: estudo qualitativo

INTRODUCCIÓN: La diabetes mellitus tipo 2 (DMT2) es un padecimiento crónico cuya incidencia se incrementa en forma alarmante. El objetivo fue identificar los factores asociados al no autocuidado en hombres con muerte prematura y diagnóstico de DMT2. MATERIALES Y MÉTODOS: Se realizaron seis entrevistas cualitativas a familiares de hombres con DMT2 que fallecieron por complicaciones de su enfermedad, utilizando la metodología de la autopsia verbal. Los resultados se analizaron mediante el análisis de contenido. RESULTADOS: Dentro de los factores que surgieron como limitantes para el autocuidado fueron: la negación de la DMT2, el trabajo, el machismo, preferencia en los alimentos, apoyo familiar, el consumo de alcohol, el consumo de tabaco y la depresión. DISCUSIÓN: Los hombres con DMT2 se ven influenciados por diversas circunstancias que limitan cuidarse, atenderse y por consiguiente presentar desventajas de salud, complicaciones e incluso una muerte temprana. CONCLUSIONES: Desde la perspectiva de enfermería los resultados ayudan a comprender el comportamiento de los hombres ante esta enfermedad en donde se requiere cuidado constante, a la par que una conciencia legítima de que no se deja de ser hombre por cuidarse.

INTRODUCTION: Diabetes mellitus type 2 (DMT2) is a chronic disease whose incidence increases in alarming manner. The objective was to identify the factors associated to no self-care in men with premature death and diagnosis of DMT2. MATERIALS AND METHODS: Six qualitative interviews, using the verbal autopsy methodology, were conducted with relatives of men with DMT2 who died due to complications of their disease. The results were analyzed through content analysis. RESULTS: Denial of the DMT2, work, male chauvinism, food preference, family support, alcohol consumption, smoking, and depression were among the factors the participants suggested as limiting self-care. DISCUSSION: Men with DMT2 are influenced by diverse circumstances that limit caring for themselves and, consequently, presenting health disadvantages, complications, and even an early death. CONCLUSIONS: From the nursing perspective, the results help to understand the behavior of the men regarding this disease, which requires constant care, while gaining a legitimate awareness that self-care does not threaten their manhood.

INTRODUÇÃO: Diabetes mellitus tipo 2 (DMT2) é uma condição crônica, cuja incidência aumenta de uma forma alarmante. O objetivo foi identificar os fatores associados ao não autocuidado em homens com morte prematura e diagnóstico de DMT2. MATERIAIS E MÉTODOS: Foram realizadas seis entrevistas qualitativas aos familiares de homens com DMT2 que morreram por complicações da sua doença, utilizando a metodologia de autópsia verbal. Os resultados foram analisados pela análise de conteúdo. RESULTADOS: Dentro dos fatores que surgiram como limitações para o autocuidado foram: negação da DMT2, trabalho, machismo, preferência alimentar, apoio familiar, consumo de álcool, consumo de tabaco e depressão. DISCUSSÃO: Os homens com DMT2 são influenciados por diversas circunstâncias que limitam cuidarem de si mesmo, prestar atenção e, portanto, têm desvantagens de saúde, complicações e até mesmo a morte precoce. CONCLUSÕES: Da perspectiva de enfermagem, os resultados ajudam a compreender o comportamento dos homens diante desta doença, quando necessário cuidado constante, ao mesmo tempo, uma consciência legítima que não se deixa de ser homem por se cuidar.

[Bone mineral density and its association with body composition and metabolic biomarkers of insulin-glucose axis, bone and adipose tissue in women]. / Densidad mineral ósea y su asociación con la composición corporal y biomarcadores metabólicos del eje insulino-glucosa, hueso y tejido adiposo en mujeres.

INTRODUCTION: There are few studies integrating the common causes of osteoporosis and obesity (disorders of body composition). A first step is to investigate correlations between their biological phenotypes to determine their common integrative physiology. OBJECTIVE: To correlate the variation of bone mineral density with phenotypes of body composition and biomarkers of bone physiology, insulin-glucose axis, and adipose tissue. METHODS: Cross-sectional study of 75 women (aged 18-45 years). MEASUREMENTS: Body mass index, waist, fat mass, lean mass (dual-energy X-ray absorptiometry), glucose, insulin, osteocalcin, leptin, tumor necrosis factor alpha. STATISTICAL ANALYSIS: multivariate general linear model, SPSS v.22, p<0.05. RESULTS: Age: 32.08±7.33. Bone mineral content multivariate general linear model 1 with two phenotypes excluded (glucose, insulin): osteocalcin (ß=-0.228, p=0.011), lean mass (ß=0.606, p=0.001) and fat mass (ß=1.237, p=0.001) in 62.0%. The bone mineral density multivariate general linear model 2 with three phenotypes excluded (body mass index, glucose, tumor necrosis factor alpha): insulin (ß=0.250, p=0.024), osteocalcin (ß=-0.362, p=0.001), lean mass (ß=0.512, p=0.001) and fat mass (ß=0.701, p=0.001) in 46.3%. CONCLUSIONS: Results show that body composition with an increased lean mass is beneficial to bone. This study reaffirms the importance of performing regular exercise to prevent muscle loss.

Análisis evolutivo del concepto de adaptación a la diabetes tipo 2 / Evolutionary Analysis of the Concept of Adaptation to Type 2 Diabetes / Análise evolutiva do conceito de adaptação à diabete tipo 2

El concepto de adaptación tiene diferentes aplicaciones y acepciones. En personas que viven con diabetes tipo 2 (DT2) se asocia con la observancia del tratamiento y el control glucémico. Es utilizado frecuentemente en la literatura de salud, pero no está claro qué significa en personas que viven con esta enfermedad, por lo que el propósito de esta investigación fue analizar el concepto de adaptación a la DT2. Metodología: se utilizó el método de análisis evolutivo de concepto de Rodgers. Los datos se codificaron por autor, 16 en total, palabras clave, hallazgos, antecedentes, atributos y consecuencias, conceptos relativos y sustitutos. La guía del análisis respondió a tres preguntas: ¿cómo define el concepto el autor? ¿Qué características o atributos se establecen? ¿Qué idea da el autor acerca del concepto? Resultados: el concepto de adaptación muestra atributos que permiten definirlo como un proceso que se presenta en tres fases: reacción, asimilación y respuesta. Los antecedentes corresponden a conductas previas al proceso, los resultados incluyen desafíos y cambios. Conclusiones: los atributos, los antecedentes y las consecuencias ofrecen guías para la investigación; es necesario ampliar el estudio en el contexto del hogar, la familia, el trabajo y el hospital.

The concept of adaptation has different applications and meanings. In persons who live with type 2 diabetes (T2D), it is associated with treatment adherence and glycemic control. It is used frequently in health literature, but it is unclear what it means to those living with the disease. Accordingly, the purpose of this study was to analyze the concept of adaptation to T2D. Method: Rogers' evolutionary concept analysis was the method used. The data were coded by author (16 in total), key words, findings, antecedents, attributes, consequences, and surrogate and relative concepts. The analysis guide answered three questions: How the author defines the concept? What features or attributes are established? What idea does the author provide about the concept? Findings: The concept of adaptation has attributes that enable it to be defined as a process that occurs in three phases: reaction, assimilation and response. The antecedents pertain to preprocess behavior, while the results include challenges and changes. Conclusions: The attributes, antecedents and consequences offer guidelines for research. It is necessary to broaden this research to include the context of home, family, work and the hospital.

O conceito de adaptação tem diferentes aplicações e acepções. Em pessoas que vivem com diabete tipo 2 (DT2), se associa com a observância do tratamento e o controle glicêmico. É utilizado frequentemente na literatura de saúde, mas não está claro o que significa em pessoas que vivem com essa doença; por isso, o propósito desta pesquisa foi analisar o conceito de adaptação à DT2. Metodología: utilizou-se o método de análise evolutiva de conceito de Rodgers. Os dados se codificaram por autor (16 em total), palavras-chave, antecedentes, atributos e consequências, conceitos relativos e substitutos. O guia da análise respondeu a três perguntas: como o autor define o conceito? Que características ou atributos são estabelecidos? Que ideia o autor dá sobre o conceito? Resultados: o conceito de adoção mostra atributos que permitem defini-lo como um processo que se apresenta em três fases: reação, assimilação e resposta. Os antecedentes correspondem a condutas prévias ao processo; os resultados incluem desafios e mudanças. Conclusões: os atributos, os antecedentes e as consequências oferecem guias para a pesquisa. É necessário ampliar o estudo no contexto do lar, da família, do trabalho e do hospital.

A physical-cognitive intervention to enhance gait speed in older Mexican adults.

PURPOSE: To test the effects of a physical-cognitive exercise intervention on gait parameters under dual-task conditions in community-dwelling older adults. DESIGN: A repeated-measures quasi-experimental design, with control and exercise groups, was used. SETTING: Study participants consist of a convenience sample recruited from senior citizens' centers in Monterrey, Mexico. SUBJECTS: A total of 143 sedentary participants ages 65 to 92 years per group participated. INTERVENTION: A combined 45- to 60-minute program of physical and cognitive exercises was conducted in three weekly sessions during 12 weeks for the exercise group. Measures . The spatial gait parameters of speed (cm/s), step width, and stride length (cm); and the temporal parameters of single and double support time, cadence (steps per minute), and swing time(s) were measured using the GaitRite. Counting backwards or naming animals represented cognitive performance. ANALYSIS: Two (groups: exercise group vs. control group) by three (time: baseline, week 6, and week 12) repeated-measures multivariate analysis of variance (MANOVA) was applied. RESULTS: Repeated-measures multivariate analysis of variance revealed a significant group effect (Wilks lambda F4,279 = 6.78, p < .001); univariate analysis showed significant differences for gait speed (m/s), stride length, cadence, step width, and double support time. Time-by-group interaction showed significance in gait speed and stride length. CONCLUSION: The exercise group participants showed increased gait speed, cadence, and stride length, and reduced their step width and time spent with both feet on the ground. Walking while simultaneously performing a cognitive task might prepare older adults for competing/interfering demands from their environments. The protective health benefits of this intervention remain to be investigated.

Hierarchical clusters in families with type 2 diabetes.

Families represent more than a set of individuals; family is more than a sum of its individual members. With this classification, nurses can identify the family health-illness beliefs obey family as a unit concept, and plan family inclusion into the type 2 diabetes treatment, whom is not considered in public policy, despite families share diet, exercise, and self-monitoring with a member who suffers type 2 diabetes. The aim of this study was to determine whether the characteristics, functionality, routines, and family and individual health in type 2 diabetes describes the differences and similarities between families to consider them as a unit. We performed an exploratory, descriptive hierarchical cluster analysis of 61 families using three instruments and a questionnaire, in addition to weight, height, body fat percentage, hemoglobin A1c, total cholesterol, triglycerides, low-density lipoprotein and high-density lipoprotein. The analysis produced three groups of families. Wilk's lambda demonstrated statistically significant differences provided by age (Λ = 0.778, F = 2.098, p = 0.010) and family health (Λ = 0.813, F = 2.650, p = 0.023). A post hoc Tukey test coincided with the three subsets. Families with type 2 diabetes have common elements that make them similar, while sharing differences that make them unique.

Replication of obesity and diabetes-related SNP associations in individuals from Yucatán, México.

The prevalence of type 2 diabetes (T2D) is rising rapidly and in Mexicans is ~19%. T2D is affected by both environmental and genetic factors. Although specific genes have been implicated in T2D risk few of these findings are confirmed in studies of Mexican subjects. Our aim was to replicate associations of 39 single nucleotide polymorphisms (SNPs) from 10 genes with T2D-related phenotypes in a community-based Mexican cohort. Unrelated individuals (n = 259) living in southeastern Mexico were enrolled in the study based at the University of Yucatan School of Medicine in Merida. Phenotypes measured included anthropometric measurements, circulating levels of adipose tissue endocrine factors (leptin, adiponectin, pro-inflammatory cytokines), and insulin, glucose, and blood pressure. Association analyses were conducted by measured genotype analysis implemented in SOLAR, adapted for unrelated individuals. SNP Minor allele frequencies ranged from 2.2 to 48.6%. Nominal associations were found for CNR1, SLC30A8, GCK, and PCSK1 SNPs with systolic blood pressure, insulin and glucose, and for CNR1, SLC30A8, KCNJ11, and PCSK1 SNPs with adiponectin and leptin (p < 0.05). P-values greater than 0.0014 were considered significant. Association of SNPs rs10485170 of CNR1 and rs5215 of KCNJ11 with adiponectin and leptin, respectively, reached near significance (p = 0.002). Significant association (p = 0.001) was observed between plasma leptin and rs5219 of KCNJ11.

[Phenotypes of bone and adipose tissue metabolism. A systematic review of their relationship]. / Los fenotipos del metabolismo óseo y del tejido adiposo. Revisión sistemática de su relación.

BACKGROUND: There is a central regulation of bone remodeling in the hypothalamus, a pathway that appears regulate the adipose tissue metabolism as well. The aim of the present review was to explore the evidence in literature on the relationships between bone mineral density and body composition phenotypes, leptin, adipose tissue and the insulin-glucose axis. METHODS: A systematic search was conducted in electronic databases, in order to review publications addressing discussions on the link between bone mineral metabolism and adipose tissue integrative biology, published between January 2005 and November 2011. RESULTS: Two hundred and sixty-two articles were reviewed, out of which 12 met strict inclusion criteria (methodological design, study population and information quality control). The results suggest that cardiovascular risk phenotypes of metabolic origin and body fat are correlated with bone turnover markers and bone mineral density. Osteoporosis and obesity are two pathologies classified as body composition alterations. CONCLUSIONS: The literature review demonstrates that the fat-bone relationship involves common epidemiological, genetic and molecular aspects. These findings reflect the advances in the study of bone metabolism and adipose tissue.

INTRODUCCIÓN: existe una regulación central de la remodelación ósea en el hipotálamo, vía que al parecer también regula el metabolismo del tejido adiposo. El objetivo de la revisión que se presenta fue explorar la evidencia bibliográfica sobre las relaciones entre la densidad ósea mineral y los fenotipos de la composición corporal, leptina, tejido adiposo y del eje insulina-glucosa. MÉTODOS: se efectuó una búsqueda sistemática en bases de datos electrónicas, para examinar los documentos que abordan discusiones sobre la vinculación del metabolismo óseo mineral y la biología integrativa del tejido adiposo, publicados entre enero de 2005 y noviembre de 2011. RESULTADOS: se revisaron 262 artículos, 12 de los cuales cumplieron con estrictos criterios de inclusión (diseño metodológico, población estudiada y control de calidad de la información). Los resultados sugieren que los fenotipos de riesgo cardiovascular de origen metabólico y la grasa corporal se correlacionan con marcadores de recambio óseo y densidad mineral ósea. La osteoporosis y la obesidad son dos patologías catalogadas como alteraciones de la composición corporal. CONCLUSIONES: la revisión bibliográfica evidencia que la relación grasa-hueso involucra aspectos epidemiológicos, genéticos y moleculares comunes. Estos descubrimientos reflejan los avances en el estudio del metabolismo óseo y el tejido adiposo.

[Relationship among anthropometric and gluco-metabolic parameters, bone mineral density and endometriosis]. / Parámetros antropométricos y glucometabólicos, densidad mineral ósea y endometriosis.

BACKGROUND: women with endometriosis may have a decreased bone mineral density (BMD). Several studies have shown that accumulation of adipose tissue profoundly affects BMD. It has also been documented that excess body fat is associated with risk of developing endometriosis. The aim was to analyze the relationship between BMD, fat mass, and the insulin-glucose axis in women with endometriosis. METHODS: thirty women with a diagnosis of endometriosis established by surgery were enrolled to participate in an observational prospective study. Anthropometry was performed to determine body mass index, and a dual X-ray densitometry to collect data on body composition and BMD. Glucose and insulin determinations were performed. Women were divided in two groups: with normal weight (n = 18) or overweight (n = 12). For the analysis of the results, we used descriptive statistics and Pearson's test. RESULTS: normal weight/overweight: mean age 32.5/35.2 years; body mass index 21.5/30.2; adiposity index: 27.7 %/36.1 %; fat mass index: 35.4/45.8 %; overweight women showed a significant value with p < 0.05. CONCLUSIONS: overweight, high values of adiposity index and fat mass index were related to endometriosis. This could support the hypothesis about a common pathogenesis among endometriosis, osteoporosis, diabetes and obesity.

Introducción: las mujeres con endometriosis cursan con una densidad mineral ósea (DMO) disminuida. Varios estudios han demostrado que la acumulación del tejido adiposo afecta profundamente la DMO. También se ha documentado que un exceso de grasa corporal se asocia con el desarrollo de endometriosis. Nuestro objetivo fue analizar la relación entre la DMO, la masa grasa corporal y el eje insulina-glucosa en mujeres con endometriosis. Métodos: treinta mujeres con diagnóstico laparoscópico de endometriosis aceptaron participar en este estudio. Se les efectuó antropometría y densitometría dual de rayos X para determinar su índice de masa corporal, su composición corporal y su DMO. Se les determinaron mediciones de insulina y glucosa en ayuno y posprandiales. Resultados: para el análisis de los resultados, se utilizaron metodologías de estadística descriptiva y prueba de Pearson. Existió un patrón entre cada fenotipo caracterizado y el T-score de la DMO en nuestras participantes con endometriosis.Conclusiones: la importancia de encontrar correlaciones clínico-observacionales entre enfermedades prevalentes que afectan la composición corporal en la población femenina (endometriosis, osteoporosis, diabetes y obesidad) podría dar lugar a hipótesis sobre una génesis causal común entre estas condiciones patológicas.

Spanish-speaking patients' engagement in interactive voice response (IVR) support calls for chronic disease self-management: data from three countries.

We measured Spanish-speaking patients' engagement in Interactive Voice Response (IVR) calls using data from self-management support studies in Honduras, Mexico and the US. A total of 268 patients with diabetes or hypertension participated in 6-12 weeks of weekly IVR follow-up. Participants had an average of 6.1 years of education, and 73% of them were women. After 2443 person-weeks of follow-up, patients had completed 1494 IVR assessments. The call completion rates were higher in the US (75%) than in Honduras (59%) or Mexico (61%; P < 0.001). Patients participating with an informal caregiver were more likely to complete calls (adjusted odds ratio 1.5; P = 0.03) while patients reporting fair or poor health at enrolment were less likely (adjusted odds ratio 0.59; P = 0.02). Satisfaction rates were high, with 98% of patients reporting that the system was easy to use, and 86% reporting that the calls helped them a great deal in managing their health problems. IVR self-management support is feasible among Spanish-speaking patients with chronic disease, including those living in less-developed countries. Involving informal caregivers may increase patient engagement.

Life-space mobility, perceived health, and depression symptoms in a sample of Mexican older adults.

Mobility in older adults is essential to preserving their physical independence and health. Changes in mobility are related to cognitive, physical, and emotional factors, among others. We explored symptoms of depression as a mediator variable between chronic diseases and comorbidities and the outcomes of perceived health and life-space mobility in a convenience sample of 135 older Mexican adults. A cross-sectional design was used. Simple and multiple linear regression models were adjusted to verify the assumptions of mediation using Baron and Kenny's model. Chronic diseases and comorbidities served as independent variables in two separate models, perceived health and life-space mobility served as dependent variables, and depressive symptoms as the mediator variable. Results showed that perceived health and life-space mobility are affected by chronic diseases and comorbidities. However, when symptoms of depression enter the equation, the ß coefficients decreased suggesting partial mediation. It is important to assess and treat depression symptoms in older adults rather than assuming that, at their age, depression is normal.

Integrating genomic analysis with the genetic basis of gene expression: preliminary evidence of the identification of causal genes for cardiovascular and metabolic traits related to nutrition in Mexicans.

Whole-transcriptome expression profiling provides novel phenotypes for analysis of complex traits. Gene expression measurements reflect quantitative variation in transcript-specific messenger RNA levels and represent phenotypes lying close to the action of genes. Understanding the genetic basis of gene expression will provide insight into the processes that connect genotype to clinically significant traits representing a central tenet of system biology. Synchronous in vivo expression profiles of lymphocytes, muscle, and subcutaneous fat were obtained from healthy Mexican men. Most genes were expressed at detectable levels in multiple tissues, and RNA levels were correlated between tissue types. A subset of transcripts with high reliability of expression across tissues (estimated by intraclass correlation coefficients) was enriched for cis-regulated genes, suggesting that proximal sequence variants may influence expression similarly in different cellular environments. This integrative global gene expression profiling approach is proving extremely useful for identifying genes and pathways that contribute to complex clinical traits. Clearly, the coincidence of clinical trait quantitative trait loci and expression quantitative trait loci can help in the prioritization of positional candidate genes. Such data will be crucial for the formal integration of positional and transcriptomic information characterized as genetical genomics.