Elevated serum uric acid is a facilitating mechanism for insulin resistance mediated accumulation of visceral adipose tissue.

OBJECTIVE: Serum uric acid (SUA) has been associated with cardiometabolic conditions such as insulin resistance (IR) and visceral adipose tissue (VAT) accumulation. Here, we aimed to clarify a unifying mechanism linking elevated SUA to IR and VAT. METHODS: We conducted analyses in 226 subjects from the UIEM cohort with both euglycemic hyperinsulinemic clamp (EHC) and dual X-ray absorptiometry (DXA) measurements for IR and VAT accumulation and explored the role of SUA and adiponectin by developing a network of causal mediation analyses to assess their impact on IR and VAT. These models were then translated to two population-based cohorts comprising 6337 subjects from NHANES 2003-2004 and 2011-2012 cycles in the US and ENSANUT Medio Camino 2016 in Mexico, using HOMA2IR and adipoIR as indicators of peripheral and adipose tissue IR, and METS-VF as a surrogate for VAT accumulation. RESULTS: SUA has a mediating role inside a bidirectional relationship between IR and visceral obesity, which was similar using either gold standard measurements or surrogate measures for IR and VAT. Furthermore, adiponectin acts as a linking mediator between elevated SUA and both peripheral IR and VAT accumulation. The proportion of the mechanism for IR-mediated (in either peripheral or adipose tissue) VAT accumulation was greater, compared to VAT-mediated IR accumulation (10.53% [9.23%-12.00%] to 5.44% [3.78%-7.00%]). Normal-range SUA levels can be used to rule-out underlying cardio-metabolic abnormalities in both men and women. CONCLUSIONS: Elevated SUA acts as a mediator inside the bidirectional relationship between IR and VAT accumulation and these observations could be applicable at a phenotype scale.

Toward Understanding the Molecular Recognition of Fungal Chitin and Activation of the Plant Defense Mechanism in Horticultural Crops.

Large volumes of fruit and vegetable production are lost during postharvest handling due to attacks by necrotrophic fungi. One of the promising alternatives proposed for the control of postharvest diseases is the induction of natural defense responses, which can be activated by recognizing molecules present in pathogens, such as chitin. Chitin is one of the most important components of the fungal cell wall and is recognized through plant membrane receptors. These receptors belong to the receptor-like kinase (RLK) family, which possesses a transmembrane domain and/or receptor-like protein (RLP) that requires binding to another RLK receptor to recognize chitin. In addition, these receptors have extracellular LysM motifs that participate in the perception of chitin oligosaccharides. These receptors have been widely studied in Arabidopsis thaliana (A. thaliana) and Oryza sativa (O. sativa); however, it is not clear how the molecular recognition and plant defense mechanisms of chitin oligosaccharides occur in other plant species or fruits. This review includes recent findings on the molecular recognition of chitin oligosaccharides and how they activate defense mechanisms in plants. In addition, we highlight some of the current advances in chitin perception in horticultural crops.

Development and validation of a predictive model for incident type 2 diabetes in middle-aged Mexican adults: the metabolic syndrome cohort.

BACKGROUND: Type 2 diabetes mellitus (T2D) is a leading cause of morbidity and mortality in Mexico. Here, we aimed to report incidence rates (IR) of type 2 diabetes in middle-aged apparently-healthy Mexican adults, identify risk factors associated to ID and develop a predictive model for ID in a high-risk population. METHODS: Prospective 3-year observational cohort, comprised of apparently-healthy adults from urban settings of central Mexico in whom demographic, anthropometric and biochemical data was collected. We evaluated risk factors for ID using Cox proportional hazard regression and developed predictive models for ID. RESULTS: We included 7636 participants of whom 6144 completed follow-up. We observed 331 ID cases (IR: 21.9 per 1000 person-years, 95%CI 21.37-22.47). Risk factors for ID included family history of diabetes, age, abdominal obesity, waist-height ratio, impaired fasting glucose (IFG), HOMA2-IR and metabolic syndrome. Early-onset ID was also high (IR 14.77 per 1000 person-years, 95%CI 14.21-15.35), and risk factors included HOMA-IR and IFG. Our ID predictive model included age, hypertriglyceridemia, IFG, hypertension and abdominal obesity as predictors (Dxy = 0.487, c-statistic = 0.741) and had higher predictive accuracy compared to FINDRISC and Cambridge risk scores. CONCLUSIONS: ID in apparently healthy middle-aged Mexican adults is currently at an alarming rate. The constructed models can be implemented to predict diabetes risk and represent the largest prospective effort for the study metabolic diseases in Latin-American population.

Changes in the phenylalanine ammonia lyase activity, total phenolic compounds, and flavonoids in Prosopis glandulosa treated with cadmium and copper.

The aim of the present work is to evaluate the changes on the phenylalanine ammonia lyase (PAL) activity, phenolic compounds accumulation and photochemical efficiency in leaves of P. glandulosa treated with Cd2+ (0.001 M) and Cu2+ (0.52 M) concentrations for 96 h under hydroponic conditions. The results showed that only leaves treated with copper had a decrease in photochemical efficiency and leaf epidermal polyphenols in P. glandulosa leaves after 96 h of exposure. On the other hand the reverse-phase HPLC analysis revealed higher levels of phenolic compound (gallic, vanillic and caffeic acids) and flavonoids (rutin and kaempferol-3-O-glucosides) in plant leaves from Cu and Cd-treatments with respect to control plants. Finally, highest increments in PAL activity was observed in extracts of leaves treated with Cu and Cd (about 205 and 284%), respectively, with respect to control plants after 96 h treatment. These suggest that activation of phenylpropanoid pathway represent a source of nonenzymatic antioxidants that protect at P. glandulosa against oxidative stress when exposed to cadmium and copper. Hence future studies are necessary to elucidate the participation of phenylpropanoid pathway in the reduction of metal toxicity in Prosopis species.

Poor early childhood outcomes attributable to maternal depression in Mexican women.

We aimed to estimate the population fraction of poor early child health and developmental outcomes attributable to maternal depressive symptoms (DS) contrasting it between low- and middle/high-income households. We used a nationally representative probabilistic sample of 4240 children younger than 5 years old and their mothers, derived from the Mexican National Health and Nutrition Survey Data (ENSANUT 2012). Complex survey design, sampling, and analytic weights were taken into account in analyses. DS was measured by CESD-7. Child outcomes were as follows: breastfeeding, attending well-child check-ups, respiratory disease, diarrhea and general health problems, immunization, accidents, growth, obesity, and food insecurity. Prevalence of DS among mothers was 21.36%. In low-SES households, DS was associated with higher risk of never being breastfed (RR = 1.77; p < .05), health problems (RR = 1.37; p < .05), acute respiratory disease (RR = 1.51; p < .05), accidents requiring child hospitalization (RR = 2.16; p < .01), and moderate or severe food insecurity (RR = 1.58; p < .001). In medium- or high-SES households, DS was associated with higher risk of never attending a developmental check-up (RR = 2.14; p < .05) and moderate or severe food insecurity (RR = 1.75; p < .01). Population risks attributable to DS ranged from 2.30 to 17.45%. Prevention of DS could lead to reduction of problematic early childhood outcomes in both low and medium/high SES.

[Contraception in Mexican adolescents in upper secondary schools: use and unmet needs]. / Anticoncepción en adolescentes mexicanos de escuelas del nivel medio superior: uso y necesidades insatisfechas.

OBJECTIVE: To describe sexual behavior and contraceptive use in adolescent students. MATERIALS AND METHODS: National representative survey in upper secondary schools in Mexico 2014. Logistic regressions identify the factors associated with contraceptive use and unmet needs for contraception (UNC). RESULTS: For male adolescents, non-contraceptive use in the last sexual relation is associated with non-contraceptive use in the sexual debut (OR=11.5; IC95%:5.6,23.4) and not recognizing effective contraceptive methods (OR=2.4;IC95%:1.04,5.5). For female adolescents, non-contraceptive use is associated with non-contraceptive use in sexual debut (OR=4.5;IC95%:2.3,8.4) and low self-efficacy towards condom use and negotiation (OR=3.1; IC95%:1.1,8.2). UNC were associated with insecure attitudes towards condom use and negotiation (OR=3.5;IC95%:1.3,9.4), non-contraceptive use in sexual debut (OR=9.0;IC95%:2.5,32.4) and use of alcohol or drugs during sexual relations (OR=3.0;IC95%:1.1,8.1). CONCLUSIONS: Strategies to ensure contraceptive use from sexual debut onwards are required, promoting self-efficacy and safe sex practices among adolescents.

OBJETIVO: Describir el comportamiento sexual y el uso de anticonceptivos en adolescentes escolarizados. MATERIAL Y MÉTODOS: Encuesta representativa nacional en escuelas de educación media superior en México, realizada en 2014. Modelos logísticos identifican factores asociados al uso de anticonceptivos y a necesidades insatisfechas de anticoncepción (NIA). RESULTADOS: Entre los hombres, no emplear anticonceptivos en la última relación sexual se asocia con la no utilización de éstos durante el debut sexual (RM=11.5; IC95% 5.6-23.4) y desconocer anticonceptivos efectivos (RM=2.4; IC95% 1.04-5.5). Entre las mujeres, no emplear anticonceptivos se asocia con el no uso de éstos durante el debut sexual (RM=4.5; IC95% 2.3-8.4) y la falta de autoeficacia en el uso/negociación del condón (RM=3.1; IC95% 1.18.2). Las NIA se asocian con baja autoeficacia respecto al uso/negociación del condón (RM=3.5; IC95% 1.3-9.4), no usar anticonceptivos en el debut sexual (RM=9.0; IC95% 2.5-32.4) y usar alcohol o drogas en relaciones sexuales (RM=3.0; IC95% 1.1-8.1). CONCLUSIONES: Se requieren estrategias que garanticen el uso de anticonceptivos desde el debut sexual y que promuevan la autoeficacia y las prácticas seguras entre los adolescentes.

[Comprehensive sexual education in Mexico: an analysis of coverage, comprehensiveness and continuity of contents in Mexican public and private schools]. / Educación sexual integral: cobertura, homogeneidad, integralidad y continuidad en escuelas de México.

OBJECTIVE:: To analyze coverage of comprehensive sex education (CSE) in high schools in Mexico and describe whether it is comprehensive, homogeneous and has continuity based on student reports of exposure to topics in three dimensions: reproductive and sexual health, self-efficacy and rights and relations. MATERIALS AND METHODS:: Within a probabilistic, cross-sectional survey with stratified, cluster sampling, a nationally representative sample of 3 824 adolescents attending 45 public and private high-schools in urban and rural areas completed questionnaires on CSE. RESULTS:: The proportion of adolescents reporting having received sex education from school personnel varies depending on topics and grade level. Topics most frequently covered are those related to sexual and reproductive health while rights and relations are least frequently dealt with. Most sex education topics are covered during junior high school and much less frequently in elementary or high school. CONCLUSIONS:: CSE needs to be comprehensive and homogenous in terms of content, ensure inclusion of priority topics, meet national and international recommendations, ensure continuity and adapt contents to student age through all education levels.

Child labor and severe functioning difficulties and disability in Mexican children and adolescents 5-17 years of age.

OBJECTIVE: To describe the characteristics of Mexican children and adolescents 5-17 years with severe functioning difficulties and disability and explore their participation in child labor. MATERIALS AND METHODS: Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used logistic regression to explore the association between this condition and child labor. RESULTS: While 11.2% of Mexicans 5-17 years-old has severe functioning difficulties or disability, 13.4% work. The functioning difficulty and disability domains with the highest prevalence are experiencing anxiety (5.4%) and depression (1.5%) daily. Children and adolescents with severe functioning difficulties and disability are 70% more likely to do child labor [OR=1.7, 95%CI:1.2,2.4]. Educational lag doubles the likelihood of doing child labor [OR=2.2, 95%CI:1.5,3.3]. CONCLUSIONS: Guaranteeing educational opportunities and respect for the rights of children with severe functioning difficulties and disability is essential to achieve development of their full potential.

Prevalence of functioning difficulties and disability in Mexican adolescent women and their populational characteristics.

OBJECTIVE: Report prevalence of functioning difficulties and disabilities among Mexican adolescent women 15-17 years old and identify differences in characteristics of those with and without a functioning difficulty or disability. MATERIALS AND METHODS: Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used chi square tests for independence and logistic regression to explore associations between this condition and various characteristics. RESULTS: Of Mexican adolescent women 15-17 years old, 11.1% had a functioning difficulty or disability. The group of domains of functioning difficulty and disability with by far the highest prevalence was socio-emotional and behavioral functioning difficulties or disability with 8.6%. Being employed, rural residence and self-reported depression symptoms were associated with having functioning difficulties or disability. CONCLUSIONS: This survey constitutes an important initial step in collecting data on functioning difficulty and disability in Mexico although larger samples should be studied.

Poly(lactic-co-glycolic acid) nanoparticles for sustained release of allyl isothiocyanate: characterization, in vitro release and biological activity.

The objective of this study is to establish the ability of entrap allyl isothiocyanate (AITC) into polymeric nanoparticles to extend its shelf life and enhance its antiproliferative properties. Natural compounds, such as AITC, have showed multi-targeting activity resulting in a wide-range spectrum of therapeutic properties in chronic and degenerative diseases, conversely with most current pharmaceutical drugs showing single targeting activity and often result in drug resistance after extended administration periods. Apparently, AITC-loaded poly(lactic-co-glycolic acid) nanoparticles (PLGA NPs) reduced AITC degradation and volatility and were able to extend AITC shelf life compared with free AITC (65% vs. 20% in 24 h, respectively). Cell viability and uptake of AITC-loaded nanoparticles were studied in vitro, showing that the protection and sustained release of AITC from polymeric NPs involved a larger toxicity of tumoral cells. These nanoparticles could be used as protective systems for enhancing a biological activity.

[Methodological bases and implementation results of Mexico's National Survey of Children and Women 2015]. / Bases metodológicas y resultados de la implementación de la Encuesta Nacional de Niños, Niñas y Mujeres en México 2015.

OBJECTIVE:: To describe the methodology and the implementation survey results from National Survey of Children and Women Mexico's (ENIM 2015). MATERIALS AND METHODS:: The ENIM 2015 is a probability survey with multistage, stratified and cluster sample, with regional, rural and urban strata, and indigenous population representation.We applied questionnaires to get information from the household, women aged 15 to 49 years, children under five years and children and adolescents aged 5-17 years. RESULTS:: The response rate for households and women was 94%, obtaining information from 10 760 households and 12 110 women; while for children and adolescents and children under five years was 98%, 11 607 and 8 066, respectively. CONCLUSION:: The ENIM 2015 probabilistic design allows generate indicators that can be stratified into five regions, rural and urban strata and from indigenous population, as well as a baseline for 15 indicators of the ODS.

[Antifungal effect of phenolic and carotenoids extracts from chiltepin (Capsicum annum var. glabriusculum) on Alternaria alternata and Fusarium oxysporum]. / Efecto antifúngico de extractos fenólicos y de carotenoides de chiltepín (Capsicum annum var. glabriusculum) en Alternaria alternata y Fusarium oxysporum.

The effect of phenolic and carotenoid extracts from chiltepin fruits on mycelial growth and the inhibition of conidial germination of Alternaria alternata and Fusarium oxysporum were investigated in the present work. Phenolic extracts inhibited mycelial growth of A.alternata by 38.46%, and significantly reduced conidial germination on the fifth day after treatment to 92% in relation to control. No significant changes were observed in the inhibition of mycelial growth in Fusarium oxysporum; however, the number of germinated conidia was reduced, showing 85% inhibition five days after treatment in relation to control. Moreover, carotenoid extracts showed 38.5% inhibition of mycelial growth and 85.3% inhibition of conidial germination of A.alternata, five days after treatment. Carotenoid extracts showed less inhibition of mycelial growth (20.3%) in F.oxysporum, with respect to A.alternata; while there was greater inhibition of conidial germination (96%) on the fifth day after treatment. Phenolic and carotenoid extracts from chiltepin may be a promising alternative as a natural fungicide against fungi of agricultural importance.

Specimen self-collection and HPV DNA screening in a pilot study of 100,242 women.

Since cervical cancer remains common in Mexico despite an established cytology screening program, the Ministry of Health recently introduced pilot front-line HPV testing into the Mexican cervical cancer screening program (CCSP). Here, we present the key field performance metrics of this population-based study. High-risk HPV DNA (hrHPV) testing was conducted on self-collected vaginal specimens from 100,242 women aged 25-75 years residing in Morelos State. All hrHPV positive women and a random sample of 3.2% (n = 2,864) of hrHPV negative participants were referred for colposcopic examination. The main disease endpoint of interest was cervical intraepithelial neoplasia grade 2 or higher (CIN2+). We calculated relative risk, positive predictive value and negative predictive value adjusted for screening test verification bias. The overall prevalence of hrHPV was 10.8% (95% CI 10.6-11.0). Women positive for hrHPV had a relative risk of 15.7 for histologically detectable CIN2+. The adjusted positive predictive value of the hrHPV test was 2.4% (95% CI 2.1-2.7); whereas the adjusted negative predictive value was 99.8% (95% CI 99.8-99.9). These findings suggest that large-scale vaginal hrHPV testing in a middle-income country can identify women at greater risk of advanced cervical abnormalities in a programmatically meaningful way but care is warranted to ensure that disease not detectable at colposcopy is kept to a minimum. PASS shows areas that need improvement and sets the stage for wider use of hrHPV screening of self-collected vaginal specimens in Mexico.

[Prevalence and factors associated with intimate partner abuse in female users of public health services in Mexico: a comparative analyses]. / Prevalencia y factores asociados a violencia de pareja en usuarias de servicios de públicos de salud en México: un análisis comparativo.

OBJECTIVE: To analyze the evolution of the prevalence in intimate partner violence during the years 2003 and 2006 in Mexico, identifying factors associated with its severity, comparing our results with findings from 2003. MATERIAL AND METHODS: Data from the Encuesta Nacional de Violencia contra las Mujeres (ENVIM 2006) was used; it has urban-rural national representation of female users of Mexican public health services. A total of 22,318 women above 14 years of age were interviewed. A multinomial logistic regression model was adjusted. The dependent variable was the Index of Intimate Partner Abuse. RESULTS: Intimate partner abuse increased 17% in comparison to the year 2003. Women's personal history of childhood abuse (ORA= 5.12, 95% CI4.15-6.30) and rape (ORA = 3.5, 95% CI = 2.66-4.62) were the most important women's factors that were found associated with severe violence. Male partner's daily alcohol consumption increased eleven fold the possibility of severe violence; higher disagreement with traditional female gender roles and higher education of both partners were protective factors. Factors associated with violence and their severities were consistent with findings reported in 2003. CONCLUISIONS: Intimate partner violence is a highly prevalent social problem which requires comprehensive strategies supporting empowerment of women through higher education, early detection and care of those battered, as well as structured interventions to prevent violence in future generations.

Covalent Pectin/Arabinoxylan Hydrogels: Rheological and Microstructural Characterization.

This research aimed to evaluate the gelation process of ferulated pectin (FP) and ferulated arabinoxylan (AXF) in a new mixed hydrogel and determine its microstructural characteristics. FP from sugar beet (Beta vulgaris) and arabinoxylan from maize (Zea mays) bran were gelled via oxidative coupling using laccase as a crosslinking agent. The dynamic oscillatory rheology of the mixed hydrogel revealed a maximum storage modulus of 768 Pa after 60 min. The scanning electron microscopy images showed that mixed hydrogels possess a microstructure of imperfect honeycomb. The ferulic acid content of the mixed hydrogel was 3.73 mg/g, and ferulic acid dimer 8-5' was the most abundant. The presence of a trimer was also detected. This study reports the distribution and concentration of ferulic acid dimers, and the rheological and microstructural properties of a mixed hydrogel based on FP and AXF, which has promising features as a new covalent biopolymeric material.

Cervical cancer screening in the US-Mexico border region: a binational analysis.

Cervical cancer mortality is high along the US-Mexico border. We describe the prevalence of a recent Papanicolaou screening test (Pap) among US and Mexican border women. We analyzed 2006 cross-sectional data from Mexico's National Survey of Health and Nutrition and the US Behavioral Risk Factor Surveillance System. Women aged 20-77 years in 44 US border counties (n = 1,724) and 80 Mexican border municipios (n = 1,454) were studied. We computed weighted proportions for a Pap within the past year by age, education, employment, marital status, health insurance, health status, risk behaviors, and ethnicity and adjusted prevalence ratios (APR) for the US, Mexico, and the region overall. Sixty-five percent (95 %CI 60.3-68.6) of US women and 32 % (95 %CI 28.7-35.2) of Mexican women had a recent Pap. US residence (APR = 2.01, 95 %CI 1.74-2.33), marriage (APR = 1.31, 95 %CI 1.17-1.47) and insurance (APR = 1.38, 95 %CI 1.22-1.56) were positively associated with a Pap test. Among US women, insurance and marriage were associated (APR = 1.21, 95 %CI 1.05-1.38 and 1.33, 95 %CI 1.10-1.61, respectively), and women aged 20-34 years were about 25 % more likely to have received a test than older women. Insurance and marriage were also positively associated with Pap testing among Mexican women (APR = 1.39, 95 %CI 1.17-1.64 and 1.50; 95 %CI 1.23-1.82, respectively), as were lower levels of education (≤8th grade or 9th-12th grade versus some college) (APR = 1.74; 95 %CI 1.21-2.52 and 1.60; 95 %CI 1.03-2.49, respectively). Marriage and insurance were associated with a recent Pap test on both sides of the border. Binational insurance coverage increases and/or cost reductions might bolster testing among unmarried and uninsured women, leading to earlier cervical cancer diagnosis and potentially lower mortality.

Arabinoxylans Release from Brewers' Spent Grain Using Extrusion and Solid-State Fermentation with Fusarium oxysporum and the Antioxidant Capacity of the Extracts.

Brewers' spent grain (BSG) is the most abundant byproduct generated from the beer-brewing process. BSG is a material rich in hemicellulose, composed of arabinoxylans (AX). However, the high crosslinking of this material causes low availability of AX, for which it is necessary to apply different treatments. The objective of this research is to increase the release of arabinoxylans through solid-state fermentation with Fusarium oxysporum f. sp. lycopersici using extruded brewery spent grain. First, the BSG is subjected to two types of physical treatments: extrusion at 20% moisture, 200 rpm and 50 °C (BSGe), and blade milling (BSGm). The chemical composition is determined for each sample (BSG, BSGe and BSGm). Subsequently, the solid-state fermentation process (SSF) is carried out on each sample. The fermentation kinetics at 30 °C are monitored for 7 days. Once the SSF concludes, AX are extracted, and the purity of AX is determined by the phloroglucinol colorimetric assay. Finally, the total phenolic compounds, phenolic acids and antioxidant capacity by DPPH are quantified. No significant differences (p ≥ 0.05) in the protein, lipid, ash or total dietary fiber contents are found among the samples. No significant difference (p ≥ 0.05) in the content of soluble fiber is found, although BSGe and BSGm have higher values than BSG. On the other hand, the yields of soluble AX exhibit significant differences (p ≤ 0.05) among nonfermented samples (BSG, 0.03%; BSGm, 0.53%; BSGe, 0.70%) and with SSF (BSG, 2.95%; BSGm, 6.24%; and BSGe, 9.58%). In addition, the contents of free phenolic compounds and free phenolic acids and the percent inhibition of free extracts by 2,2-diphenyl-1-picrylhydrazyl (DPPH) differ significantly (p ≤ 0.05) between samples subjected to SSF and nonfermented samples. Therefore, extrusion and SSF treatment increase AX release from BSG as well as the antioxidant capacity of the extracts.

Early-onset type 2 diabetes in a Mexican survey: results from the National Health and Nutrition Survey 2006.

OBJECTIVE: To describe the characteristics of patients with type 2 diabetes diagnosed before age 40 (early-onset type 2 diabetes) identified in a nation-wide, population-based study. MATERIALS AND METHODS: The survey was done in Mexico during 2006. Medical history, anthropometric and biochemical measurements were obtained in every subject. RESULTS: Cases diagnosed before (n=181) and after age 40 (n=659) were included. Early-onset type 2 diabetes was present in 13.1% of the previously diagnosed, 30.3% of the cases identified during the survey and 21.5% of the whole population with diabetes. These individuals had a greater prevalence of obesity and hypertriglyceridemia compared to the cases diagnosed after age 40. CONCLUSIONS: Early-onset type 2 diabetes was present in 21.5 % of patients with type 2 diabetes in Mexico. Close to 70% of them were obese or overweight and had the clinical profile of the metabolic syndrome.

Trends for type 2 diabetes and other cardiovascular risk factors in Mexico from 1993-2006.

OBJECTIVE: To describe the trends in the prevalence of type 2 diabetes (T2D), and other cardiovascular risk factors in three national health surveys (1993, 2000 and 2006). MATERIALS AND METHODS: The databases of three surveys: ENEC 1993, ENSA 2000 and ENSANUT 2006 were gathered. Calculations of published data were reprocessed to do appropriate adjustments to assure comparability among surveys. RESULTS: From 1993 to 2006 the prevalence of type 2 diabetes (6.7-14.4%), metabolic syndrome (26.6-36.8%), hypertension (23.8-30.7%), hypercholesterolemia (27-43.6%), and high LDL-cholesterol (31.6-46%) increased rapidly. The prevalence of low HDL cholesterol was very high (60.5-63%) in all surveys and remained remarkably unchanged among surveys. CONCLUSIONS: This increasing trends for the prevalence of T2D and cardiovascular risk factors predicts larger increments in the near future for T2D and cardiovascular morbidity and mortality. Intensification of the preventive and remedy strategies is mandatory in order curve the foreseen dramatic increment in the disease burden.

Prevalence and distribution of type 2 diabetes mellitus in Mexican adult population: a probabilistic survey.

OBJECTIVE: To describe the prevalence, distribution and degree of control of type 2 diabetes (T2D) in Mexican population. MATERIAL AND METHODS: Subjects were classified as previously diagnosed T2D (PD); or as "finding of the survey" (FS) (glucose >or=126 mg/dL). Hemoglobin A1c was measured in PD-subjects. RESULTS: The prevalence for PD-T2D was 7.34% (95%CI 6.3, 8.5) and for FS 7.07% (95%CI 6.1, 8.1), summing 14.42%; (7.3 million diabetics). 5.3% of PD-T2D were in good, 38.4% in poor and 56.2% very poor control. Older age (OR=0.96, 95%CI 0.94, 0.97), lower BMI (OR=0.95, 95%CI 0.91, 1.0), were protective for poor control. Affiliation to private services (OR=1.77, 95%CI 0.98, 3.13), larger T2D duration (OR=1.05, 95%CI 1.01, 1.08), and combining oral medication and insulin (OR=16.1, 95%CI 1.61, 161) were riskier. CONCLUSIONS: We found an alarming prevalence of T2D in Mexican population; the majority of PD diabetics are in poor control. Research on the latter is warranted.