Índice metabólico en mayas: asociación con hipercolesterolemia en pacientes con diabetes tipo 2 / Metabolic index in Mayas: association with hypercholesterolemia in patients with type 2 diabetes / Índice metabólico em Mayas: associação com hipercolesterolemia em pacientes com diabetes tipo 2

El objetivo del presente estudio fue evaluar la asociación entre el índice metabólico, una medida indirecta de resistencia a la insulina, y la hipercolesterolemia en población indígena maya con diabetes tipo 2 (DT2). Se incluyeron un total de 77 pacientes indígenas mayas con diagnóstico previo de DT2. Las variables bioquímicas se analizaron por métodos fotométricos estandarizados y se calculó el índice metabólico (GB x TG/HDL-C2). Se encontró en la muestra total una correlación entre el índice metabólico y los niveles de: glucosa basal (GB) (r=0,333, p=0,001), A1c (r=0,331, p=0,003), CT (r=0,255, p=0,026), TG (r=0,762, p=1,29x10-15), HDL-C (r= -0,735, p=4,2x10-14); mientras que no existió correlación con las concentraciones de LDL-C (r=0,120, p=0,300). La asociación entre el índice metabólico e hipercolesterolemia (B=1,590, p=0,041, Exp(B)=4,901 e I.C=1,066-22,544) fue independiente de la edad, género, IMC, tiempo de evolución de DT2 y de los niveles de A1c. El trabajo presenta evidencia de la asociación entre el índice metabólico y la hipercolesterolemia, y propone el potencial uso del índice metabólico como medida indirecta de riesgo aterogénico en población indígena maya con DT2.

It is already known that combination of insulin resistance (IR) and compensatory hyperinsulinemia increases the risk of hypertension, and atherogenic dyslipidemia. These changes increase the risk of cardiovascular disease. With that in mind, the aim of the present study was to evaluate the association between elevated metabolic index, an indirect measure of insulin resistance, and hypercholesterolemia in an indigenous Mayan population with type 2 diabetes (T2D). A total of 77 indigenous Mayan patients with a previous diagnosis of T2D were included. Biochemical variables were measured by standardized photometric methods and the metabolic index (GB x TG/HDL-C2) was calculated. A correlation between the metabolic index and the levels of GB (r=0.333, p=0.001), A1c (r=0.331, p=0.003), CT (r=0.255, p=0.026), TG (r=0.762, p=1.29x10-15), HDL-C (r=-0.735, p=4.2x10-14) was found; while there was no correlation with LDL-C concentrations (r=0.120, p=0.300). The association between the metabolic index and hypercholesterolemia (B=1.590, p=0.041, Exp(B)=4.901 and I.C=1.066-22.544) was independent of A1c levels, age, gender, BMI and evolution time of DT2. The study presents evidence of the association between the metabolic index and hypercholesterolemia, and proposes the potential use of the metabolic index as an indirect measure of atherogenic risk in an indigenous Mayan population with T2D.

O objetivo do presente estudo foi avaliar a associação entre a taxa metabólica, uma medida indireta de resistência à insulina e a hipercolesterolemia na população indígena maia com diabetes tipo 2 (DT2). Foram incluídos 77 pacientes indígenas maias com diagnóstico prévio de DT2. As variáveis bioquímicas foram medidas através de métodos fotométricos padronizados e foi calculado o índice metabólico (GB x TG/HDL-C2). Uma correlação entre o índice metabólico e os níveis de glicose basal (GB) (r=0,333, p=0,001), A1c (r=0,331, p=0,003), CT (r=0,255, p=0,026), TG (r=0,762, p=1,29x10-15), HDL-C (r=-0,735, p=4,2x10-14) foi encontrada na amostra total; enquanto que não houve correlação com as concentrações de LDL-C (r=0,120, p=0,300). A associação entre o índice metabólico e a hipercolesterolemia (B=1,590, p=0,041, Exp(B)=4,901 e I.C=1,066-22,544) foi independente da idade, sexo, IMC, tempo de evolução de DT2 e dos níveis de A1c. O trabalho apresenta evidência da associação entre o índice metabólico e a hipercolesterolemia, e propõe o potencial uso do índice metabólico como medida indireta do risco aterogênico na população indígena maia com DT2.

Intestinal parasites and genotyping of Giardia duodenalis in children: first report of genotype B in isolates from human clinical samples in Mexico

Giardia duodenalis is one of the most prevalent enteroparasites in children. This parasite produces several clinical manifestations. The aim of this study was to determine the prevalence of genotypes of G. duodenalis causing infection in a region of southeastern Mexico. G. duodenalis cysts were isolated (33/429) from stool samples of children and molecular genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis, targeting the triosephosphate isomerase ( tpi ) and glutamate dehydrogenase ( gdh ) genes. The tpi gene was amplified in all of the cyst samples, either for assemblage A (27 samples) or assemblage B (6 samples). RFLP analysis classified the 27 tpi -A amplicons in assemblage A, subgenotype I. Samples classified as assemblage B were further analysed using PCR-RFLP of the gdh gene and identified as assemblage B, subgenotype III. To our knowledge, this is the first report of assemblage B of G. duodenalis in human clinical samples from Mexico.