Prevalencia de diabetes tipo 2 y obesidad en dos poblaciones aborígenes de Chile en ambiente urbano / Prevalence of type 2 diabetes and obesity in two Chilean aboriginal populations living in urban zones

BACKGROUND: The prevalence of cardiovascular risk factors is increasing in aboriginal populations in Chile. AIM: To study the prevalence of obesity, type 2 diabetes and serum lipids in two aboriginal populations, Mapuche and Aymara, that were transferred from a rural to a urban environment. SUBJECTS AND METHODS: Two groups of subjects over 20 years were analyzed, Mapuche and Aymara. The Mapuche group was formed by 42 men and 105 women, living in four urban communities of Santiago, and an Aymara group formed by 42 men and 118 women, living in Arica, in Northern Chile. Anthropometric measurements, blood pressure, lipid profile, oral glucose tolerance test, fasting insulin and serum leptin were determined. RESULTS: The prevalence of type 2 diabetes was 6.9% in Aymara and 8.2% in Mapuche subjects. The frequency of glucose intolerance was similar in both groups, but greater among men. A total blood cholesterol over 200 mg/dl was observed in 43.1% of Aymara and 27.9% of Mapuche subjects (p <0.008). Serum triglycerides over 150 mg/dl were observed in 16.9 and 23.1% of Aymara and Mapuche individuals, respectively (p= NS). CONCLUSIONS: The prevalence of type 2 diabetes and dyslipidemia in turban aboriginal populations is higher than that of their rural counterparts. A possible explanation for these results are changes in lifestyles that come along with urbanization, characterized by a high consumption of saturated fat and refined sugars and a low level of physical activity.

Persistencia de factores de riesgo coronario en pacientes diabéticos sometidos a cirugía de revascularización miocárdica / Persistence of coronary risk factors in diabetic patients submitted to myocardial revascularization

Se estudia la persistencia de factores de riesgo coronario en un grupo de 45 pacientes diabéticos tipo 2 operados de cirugía de revascularización miocárdica (CRVM)en el Hospital Regional de Temuco. Se mide: índice masa corporal, presión arterial, perfil lipídico, glicemia y tabaquismo antes y después de CRVM,Con seguimiento promedio de 44,9 meses se encuentra que, excepto el tabaquismo, ningún factor disminuye en el postoperatorio. este hallazgo debería llevar a la adopción de políticas de salud tendientes a prevenir y/o tratar estos factores deletéreos, para así mejorar los resultados a mediano y largo plazo de una cirugía de alto costo y riesgosa como la cirugía de revascularización miocardica

Predisposición genética para desarrollar diabetes mellitus insulino-dependiente: estudio en población de Santiago y Temuco, Chile / Genetic predisposition for developing insulin-dependent diabetes mellitus: study in population from Santiago and Temuco, Chile

Insulin dependent diabetes mellitus (IDDM) is strongly associated with particular HLA-DQ alpha/beta markers in white population. The heterodimers confirmation composed of a DQ alpha chain with an arginine at residue 52 (Arg52) combined to a DQ beta chain lacking an aspartic acid at residue 57 (non asp57) increase markedly the risk to develop IDDM. To confirm this association, 63 IDDM patients from Santiago de Chile registry, 20 IDDM patients from Temuco registry and 74 unrelated helathy non diabetic control subjects were studied. With polymerase chain reaction (PCR) and sequence specific oligonucleotide probes the individuals were typed for their HLA-DQA1 and DQB1 alleles, their DQA1/DQB1 genotype and heterodimers conformation were compared. In diabetic population both markers Arg52 homocygote and non Asp57 homocygote were increased regard to control subjects (R/R: 0.76 and 0.85 vs 0.33; ND/ND: 0.78 and 0.75 vs 0.50, p<0.05). A high relative risk (RR) was determined for both homocygote markers in IDDM groups.compared. Arg52 DQ alpha (R)/non Asp57 DQ beta (ND) heterodimers were strongly associated with susceptibility to IDDM. A high RR was observed in patients with four susceptibility DQ heterodimers (RR1: 13.7 in IDDM-Santiago and RR2: 18.6 in IDDM-Temuco, p<0.00003). The HLA-DQ alpha/beta markers and their risk heterodimers are increased in our diabetic population and could be considered as susceptibility markers to develop IDDM

Test de TRH en spray nasal / TRH test by nasal spray

Se estudió la utilidad clínica del test de TRH por vía nasal. Luego de la obtención de muestras basales se administró una dosis de 1 mg de TRH en cada fosa nasal y tanto la respuesta hiposifisiaria (TSH y PRL) como tiroidea (T4) a los 30 y 60 min. fueron analizadas en 12 pacientes, 6 normales 6 portadores de una Tiroiditis Crónica con disminución de la reserva Tiroidea. El grupo control presentó un peak de TSH a los 30 min que no superó los 25 uUl/ml (13.7 ñ 2.9 u Ul/ml) y de PRL de 68.9 ñ 4.3 ng/ml. Los 6 pacientes con una Tiroiditis Crónica, la respuesta TRH fue claramente mayor con un valor máximo de TSH de 43.5 ñ 4.4 uUl/ml y de PRL de 112 ñ 8 ng/ml a los 30 min. Se concluye que la administración de TRH por vía nasal es capaz de inducir una respuesta hipofisiaria tanto de los tirotropos como en los lactotropos, similar a la que se observa con TRH endovenoso