Cardiometabolic risk in young adults from northern Mexico: Revisiting body mass index and waist-circumference as predictors.

BACKGROUND: A body mass index (BMI) ≥30 kg/m(2) and a waist circumference (WC) ≥80 cm in women (WCF) or ≥90 cm in men (WCM) are reference cardiometabolic risk markers (CMM) for Mexicans adults. However, their reliability to predict other CMM (index tests) in young Mexicans has not been studied in depth. METHODS: A cross-sectional descriptive study evaluating several anthropometric, physiological and biochemical CMM from 295 young Mexicans was performed. Sensitivity (Se), specificity (Sp) and Youden's index (J) of reference BMI/WC cutoffs toward other CMM (n = 14) were obtained and their most reliable cutoffs were further calculated at Jmax. RESULTS: Prevalence, incidence and magnitude of most CMM increased along the BMI range (p < 0.01). BMI explained 81 % of WC's variance [Se (97 %), Sp (71 %), J (68 %), Jmax (86 %), BMI = 30 kg/m(2)] and 4-50 % of other CMM. The five most prevalent (≥71 %) CMM in obese subjects were high WC, low HDL-C, and three insulin-related CMM [Fasting insulin, HOMA-IR, and QUICKI]. For a BMI = 30 kg/m(2), J ranged from 16 % (HDL-C/LDL-C) to 68 % (WC), being moderately reliable (Jmax = 61-67) to predict high uric acid (UA), metabolic syndrome (MetS) and the hypertriglyceridemic-waist phenotype (HTGW). Corrected WCM/WCF were moderate-highly reliable (Jmax = 66-90) to predict HTGW, MetS, fasting glucose and UA. Most CMM were moderate-highly predicted at 27 ± 3 kg/m(2) (CI 95 %, 25-28), 85 ± 5 cm (CI 95 %, 82-88) and 81 ± 6cm (CI 95 %, 75-87), for BMI, WCM and WCF, respectively. CONCLUSION: BMI and WC are good predictors of several CMM in the studied population, although at different cutoffs than current reference values.

Plasma triglyceride/HDL-cholesterol ratio, insulin resistance, and cardiometabolic risk in young adults.

Studies in mature adults suggest that the plasma concentration ratio of triglyceride (TG)/HDL-cholesterol (HDL-C) provides a simple way to identify apparently healthy individuals who are insulin resistant (IR) and at increased cardiometabolic risk. This study extends these observations by examining the clinical utility of the TG/HDL-C ratio and the metabolic syndrome (MetS) in 2,244 healthy college students (17-24 years old) of Mexican Mestizo ancestry. The TG/HDL-C ratio separating the 25% with the highest value was used to identify IR and increased cardiometabolic risk. Cardiometabolic risk factors were more adverse in men and women whose TG/HDL-C ratios exceeded 3.5 and 2.5, respectively, and approximately one third were identified as being IR. The MetS identified fewer individuals as being IR, but their risk profile was accentuated. In conclusion, both a higher TG/HDL-C ratio and a diagnosis of the MetS identify young IR individuals with an increased cardiometabolic risk profile. The TG/HDL-C ratio identified a somewhat greater number of "high risk" subjects, whereas the MetS found a group whose risk profile was somewhat magnified. These findings suggest that the TG/HDL-C ratio may serve as a simple and clinically useful approach to identify apparently healthy, young individuals who are IR and at increased cardiometabolic risk.

Abdominal obesity is strongly associated to blood pressure in young Mexicans.

OBJECTIVE: The objective of this study was to determine associations between abdominal obesity (AOb) and the other components of metabolic syndrome (MetS) in young Mexicans in a cross-sectional survey completed during a 4 year period. METHODS: This cross-sectional study reports on components and prevalence of MetS by using Alberti et al. (16) criteria, as well as association between AOb and elevated blood pressure (BP) of 2,993 Mexican university students, ages 17 to 25 years (66% women) from central and northern Mexico, over a 4-year survey (2010-2013). RESULTS: The most prevalent MetS components in the total sample were low HDL-C concentration (43.6%) and AOb (41.1%). MetS prevalence was 11.8%, more men than women were classified with MetS (14.3% vs. 10.5%, p < 0.01). BP was the MetS component with the lowest prevalence (8.6%). A strong association between AOb and altered BP with in both men and women was found (OR 4.3, IC95% 2.5-7.4). CONCLUSIONS: Even BP was the component with the lowest prevalence, AOb was more strongly associated with it. This fact, could explain the prevalence of hypertension among young Mexican adults.

PREVALENCE OF METABOLIC SYNDROME IN YOUNG MEXICANS: A SENSITIVITY ANALYSIS ON ITS COMPONENTS.

INTRODUCTION: obesity is a worldwide epidemic, and the high prevalence of diabetes type II (DM2) and cardiovascular disease (CVD) is in great part a consequence of that epidemic. Metabolic syndrome is a useful tool to estimate the risk of a young population to evolve to DM2 and CVD. OBJECTIVE: to estimate the MetS prevalence in young Mexicans, and to evaluate each parameter as an independent indicator through a sensitivity analysis. METHODS: the prevalence of MetS was estimated in 6 063 young of the México City metropolitan area. A sensitivity analysis was conducted to estimate the performance of each one of the components of MetS, as an indicator of the presence of MetS itself. Five statistical of the sensitivity analysis were calculated for each MetS component and the other parameters included: sensitivity, specificity, positive predictive value or precision, negative predictive value, and accuracy. RESULTS: the prevalence of MetS in Mexican young population was estimated to be 13.4%. Waist circumference presented the highest sensitivity (96.8% women; 90.0% men), blood pressure presented the highest specificity for women (97.7%) and glucose for men (91.0%). When all the five statistical are considered triglycerides is the component with the highest values, showing a value of 75% or more in four of them. Differences by sex are detected for averages of all components of MetS in young without alterations. CONCLUSIONS: Mexican young are highly prone to acquire MetS: 71% have at least one and up to five MetS parameters altered, and 13.4% of them have MetS. From all the five components of MetS, waist circumference presented the highest sensitivity as a predictor of MetS, and triglycerides is the best parameter if a single factor is to be taken as sole predictor of MetS in Mexican young population, triglycerides is also the parameter with the highest accuracy.

Introducción: la obesidad es una epidemia mundial y la alta prevalencia de diabetes tipo II (DM2) y de enfermedad cardiovascular (ECV) es, en gran parte, consecuencia de esta epidemia. El síndrome metabólico (SMet) es una herramienta útil para estimar el riesgo de que una población de jóvenes evolucione a DM2 y ECV. Objetivo: estimar la prevalencia del SMet en jóvenes mexicanos, y evaluar cada parámetro como un indicador independiente mediante análisis de sensibilidad. Métodos: se estimó la prevalencia del SMet en 6.063 jóvenes del área metropolitana de Ciudad de México. Se realizó un análisis de sensibilidad para estimar la eficiencia de cada uno de los componentes del SMet como un indicador de la presencia del mismo SMet. Se calcularon cinco estadísticos del análisis de sensibilidad para cada uno de los componentes del SMet y otros parámetros, incluidos: sensibilidad, especificidad, valor predictivo positivo, valor predictivo negativo y precisión. Resultados: la prevalencia del SMet en la población de jóvenes mexicanos se estimó en 13.4%. La circunferencia de la cintura presentó la sensibilidad más alta (96.8% mujeres; 90.0% hombres); en las mujeres, la presión arterial presentó la más alta especificidad (97.7%) y en los hombres la glucosa (91.0%). Cuando se consideran los cinco estadísticos, los triglicéridos son el componente con los valores más altos, con valores del 75% o mayores para cuatro de estos. En los jóvenes sin alteraciones se detecta diferencia entre sexos para los promedios de todos los componentes del SMet. Conclusiones: los jóvenes mexicanos son altamente propensos a adquirir SMet: el 71% tiene cuando menos uno y hasta cinco parámetros del SMet alterados, y el 13.4% de ellos tiene SMet. De los cinco componentes del SMet, la circunferencia de la cintura presentó la más alta sensibilidad como predictor del SMet, y los triglicéridos es el mejor parámetro predictor en jóvenes mexicanos si solo se considera un factor predictor del SMet; también los triglicéridos son el parámetro con la más alta precisión.

Activation of the innate immune response against DENV in normal non-transformed human fibroblasts.

BACKGROUND: When mosquitoes infected with DENV are feeding, the proboscis must traverse the epidermis several times ("probing") before reaching a blood vessel in the dermis. During this process, the salivary glands release the virus, which is likely to interact first with cells of the various epidermal and dermal layers, cells which could be physiologically relevant to DENV infection and replication in humans. However, important questions are whether more abundant non-hematopoietic cells such as fibroblasts become infected, and whether they play any role in antiviral innate immunity in the very early stages of infection, or even if they might be used by DENV as primary replication cells. METHODOLOGY/PRINCIPAL FINDINGS: Fibroblasts freshly released from healthy skin and infected 12 hours after their isolation show a positive signal for DENV. In addition, when primary skin fibroblast cultures were established and subsequently infected, we showed DENV-2 antigen-positive intracellular signal at 24 hours and 48 hours post-infection. Moreover, the fibroblasts showed productive infection in a conventional plaque assay. The skin fibroblasts infected with DENV-2 underwent potent signaling through both TLR3 and RIG- 1, but not Mda5, triggering up-regulation of IFNß, TNFα, defensin 5 (HB5) and ß defensin 2 (HßD2). In addition, DENV infected fibroblasts showed increased nuclear translocation of interferon (IFN) regulatory factor 3 (IRF3), but not interferon regulatory factor 7 (IRF7), when compared with mock-infected fibroblasts. CONCLUSIONS/SIGNIFICANCE: In this work, we demonstrated the high susceptibility to DENV infection by primary fibroblasts from normal human skin, both in situ and in vitro. Our results suggest that these cells may contribute to the pro-inflammatory and anti-viral microenvironment in the early stages of interaction with DENV-2. Furthermore, the data suggest that fibroblast may also be used as a primary site of DENV replication and provide viral particles that may contribute to subsequent viral dissemination.

Prevalence of metabolic syndrome in young Mexicans: a sensitivity analysis on its components / Prevalencia del síndrome metabólico en jóvenes mexicanos: análisis de sensibilidad de sus componentes

Introduction: obesity is a worldwide epidemic, and the high prevalence of diabetes type II (DM2) and cardiovascular disease (CVD) is in great part a consequence of that epidemic. Metabolic syndrome is a useful tool to estimate the risk of a young population to evolve to DM2 and CVD. Objective: to estimate the MetS prevalence in young Mexicans, and to evaluate each parameter as an independent indicator through a sensitivity analysis. Methods: the prevalence of MetS was estimated in 6063 young of the México City metropolitan area. A sensitivity analysis was conducted to estimate the performance of each one of the components of MetS, as an indicator of the presence of MetS itself. Five statistical of the sensitivity analysis were calculated for each MetS component and the other parameters included: sensitivity, specificity, positive predictive value or precision, negative predictive value, and accuracy. Results: the prevalence of MetS in Mexican young population was estimated to be 13.4%. Waist circumference presented the highest sensitivity (96.8% women; 90.0% men), blood pressure presented the highest specificity for women (97.7%) and glucose for men (91.0%). When all the five statistical are considered triglycerides is the component with the highest values, showing a value of 75% or more in four of them. Differences by sex are detected for averages of all components of MetS in young without alterations. Conclusions: Mexican young are highly prone to acquire MetS: 71% have at least one and up to five MetS parameters altered, and 13.4% of them have MetS. From all the five components of MetS, waist circumference presented the highest sensitivity as a predictor of MetS, and triglycerides is the best parameter if a single factor is to be taken as sole predictor of MetS in Mexican young population, triglycerides is also the parameter with the highest accuracy (AU)

Introducción: la obesidad es una epidemia mundial y la alta prevalencia de diabetes tipo II (DM2) y de enfermedad cardiovascular (ECV) es, en gran parte, consecuencia de esta epidemia. El síndrome metabólico (SMet) es una herramienta útil para estimar el riesgo de que una población de jóvenes evolucione a DM2 y ECV. Objetivo: estimar la prevalencia del SMet en jóvenes mexicanos, y evaluar cada parámetro como un indicador independiente mediante análisis de sensibilidad. Métodos: se estimó la prevalencia del SMet en 6.063 jóvenes del área metropolitana de Ciudad de México. Se realizó un análisis de sensibilidad para estimar la eficiencia de cada uno de los componentes del SMet como un indicador de la presencia del mismo SMet. Se calcularon cinco estadísticos del análisis de sensibilidad para cada uno de los componentes del SMet y otros parámetros, incluidos: sensibilidad, especificidad, valor predictivo positivo, valor predictivo negativo y precisión. Resultados: la prevalencia del SMet en la población de jóvenes mexicanos se estimó en 13.4%. La circunferencia de la cintura presentó la sensibilidad más alta (96.8% mujeres; 90.0% hombres); en las mujeres, la presión arterial presentó la más alta especificidad (97.7%) y en los hombres la glucosa (91.0%). Cuando se consideran los cinco estadísticos, los triglicéridos son el componente con los valores más altos, con valores del 75% o mayores para cuatro de estos. En los jóvenes sin alteraciones se detecta diferencia entre sexos para los promedios de todos los componentes del SMet. Conclusiones: los jóvenes mexicanos son altamente propensos a adquirir SMet: el 71% tiene cuando menos uno y hasta cinco parámetros del SMet alterados, y el 13.4% de ellos tiene SMet. De los cinco componentes del SMet, la circunferencia de la cintura presentó la más alta sensibilidad como predictor del SMet, y los triglicéridos es el mejor parámetro predictor en jóvenes mexicanos si solo se considera un factor predictor del SMet; también los triglicéridos son el parámetro con la más alta precisión (AU)