Low muscle mass index is associated with type 2 diabetes risk in a Latin-American population: a cross-sectional study.

Objective: Diabetes mellitus is a growing disease with severe complications. Various scores predict the risk of developing this pathology. The amount of muscle mass is associated with insulin resistance, yet there is no established evidence linking muscle mass with diabetes risk. This work aims to study that relationship. Research methods and procedures: This cross-sectional study included 1,388 employees. The FINDRISC score was used to assess type 2 diabetes risk, and bioimpedance was used for body composition analysis. Appendicular skeletal muscle mass adjusted by body mass index (ASM/BMI) was analyzed. Sociodemographic, clinical and anthropometric measures were evaluated, logistic regression models with sex stratification were conducted and ROC curves were calculated to determine the ability of ASM/BMI index to predict T2D risk. Results: It was observed that patients with higher ASM/BMI had a lower FINDRISC score in both men and women (p < 0.001). A logistic regression model showed and association between ASM/BMI and diabetes risk in women [OR: 0.000 (0.000-0.900), p = 0.048], but not in men [OR: 0.267 (0.038-1.878), p = 0.185]. However, when the body mass index variable was excluded from the model, an association was found between muscle mass adjusted to BMI and diabetes risk in both men [OR: 0.000 (0.000-0.016), p < 0.001], and women [OR:0.001 (0.000-0.034), p < 0.001]. Other risk factors were having a low level of physical activity, waist circumference, age and sedentary lifestyle. A ROC curve was built and the optimal ASM/BMI cut-of value for predicting T2D risk was 0.82 with a sensitivity of 53.71% and specificity of 69.3% [AUC of 0.665 (0.64-0.69; p < 0.0001)]. Conclusion: When quantifying the risk of type 2 diabetes in both women and men, assessing muscle mass can help detect adult individuals with a high risk of developing type 2 diabetes.

Very Low Calorie Ketogenic Diet: What Effects on Lipid Metabolism?

PURPOSE OF REVIEW: This review aims to critically examine how VLCKD affects plasma lipoprotein, lipid and cholesterol metabolism. Cardiovascular disease is a worldwide health problem affecting millions of people and leading to high rates of mortality and morbidity. There is a well-established association between cardiovascular disease and circulating cholesterol. Various dietary recommendations are currently available for the management of dyslipidemia. RECENT FINDINGS: The very low-calorie ketogenic diet (VLCKD) is becoming increasingly popular as a treatment option for several pathological conditions, including dyslipidemia. In addition to being low in calories, the VLCKD's main feature is its unique calorie distribution, emphasizing a reduction in carbohydrate consumption in favor of fat as the primary calorie source. Lowering calorie intake through a VLCKD can reduce the endogenous production of cholesterol. However, if the foods consumed are from animal sources, dietary cholesterol intake may increase due to the higher fat content of animal products. When combined, these dietary practices may have opposing effects on plasma cholesterol levels. Studies investigating the impact of VLCKD on plasma cholesterol and low-density lipoprotein cholesterol levels report contradictory findings. While some studies found an increase in low-density lipoprotein cholesterol levels, others showed a decrease in total cholesterol and low-density lipoprotein cholesterol, along with an increase in high-density lipoprotein cholesterol.

Epigenetics in Obesity and Diabetes Mellitus: New Insights.

A long-term complication of obesity is the development of type 2 diabetes (T2D). Patients with T2D have been described as having epigenetic modifications. Epigenetics is the post-transcriptional modification of DNA or associated factors containing genetic information. These environmentally-influenced modifications, maintained during cell division, cause stable changes in gene expression. Epigenetic modifications of T2D are DNA methylation, acetylation, ubiquitylation, SUMOylation, and phosphorylation at the lysine residue at the amino terminus of histones, affecting DNA, histones, and non-coding RNA. DNA methylation has been shown in pancreatic islets, adipose tissue, skeletal muscle, and the liver. Furthermore, epigenetic changes have been observed in chronic complications of T2D, such as diabetic nephropathy, diabetic retinopathy, and diabetic neuropathy. Recently, a new drug has been developed which acts on bromodomains and extraterminal (BET) domain proteins, which operate like epigenetic readers and communicate with chromatin to make DNA accessible for transcription by inhibiting them. This drug (apabetalone) is being studied to prevent major adverse cardiovascular events in people with T2D, low HDL cholesterol, chronic kidney failure, and recent coronary events. This review aims to describe the relationship between obesity, long-term complications such as T2D, and epigenetic modifications and their possible treatments.

Gut microbiota and obesity: New insights.

Obesity is a pathology whose incidence is increasing throughout the world. There are many pathologies associated with obesity. In recent years, the influence of the microbiota on both health and pathological states has been known. There is growing information related to changes in the microbiome and obesity, as well as its associated pathologies. Changes associated with age, exercise, and weight changes have been described. In addition, metabolic changes associated with the microbiota, bariatric surgery, and fecal matter transplantation are described. In this review, we summarize the biology and physiology of microbiota in obese patients, its role in the pathophysiology of several disorders associated, and the emerging therapeutic applications of prebiotics, probiotics, and fecal microbiota transplantation.

Síndrome metabólico, obesidad y actividad física en el sur de Ecuador / Metabolic syndrome, obesity and physical activity insouthern of Ecuador

Contexto: En Ecuador, el síndrome metabólico (SM) en adultos tuvo para el 2012 una prevalencia de 27 % a nivel nacional, según criterios de la International Diabetes Federation(IDF)y se asocia a obesidad y sedentarismo. Objetivo: Determinar la relación entre SM con actividad física e índice de masa corporal (IMC). studio transversal, descriptivo-observacional. Lugar y sujetos: 326 trabajadores universitarios de Loja, Ecuador, con edad promedio de 39,6 años (DS 8,58). Mediciones principales: variables antropométricas y parámetros séricos para diagnóstico de SM y de IMC. El International Physical Activity Questionnaire(IPAQ) se empleó para medir actividad física. Resultados: La prevalencia global de SM fue 16,9 %, según criterios NCEP/ATP III(National Cholesterol Education Program ́s Adults Treatment Panel III) y de 27,3 % por los de IDF. El SM fue más frecuente en obesos, en mujeres y en el grupo etario mayor a 50 años. Los parámetros más frecuentes de SM fueron colesterol-HDL(c-HDL) disminuido e hipertrigliceridemia. 2/19Revista científica digital INSPILIP Código ISSN 2588-0551DOI: 10.31790/inspilip.v3i1.80.g149Revista científica INSPILIP. Disponible en: http://www.inspilip.gob.ec/Junio de 2019Los hombres tuvieron valores significativamente (p<0,001) más elevados de todos los parámetros de SM, excepto glicemia. Se encontró asociación (p<0,001) entre SM e IMC, pero no con nivel de actividad física. Conclusión: La prevalencia de SM en trabajadores universitarios de Loja, Ecuador, es similar a la prevalencia nacional. El sobrepeso y la obesidadestán asociados a SM, acompañado principalmente de dislipidemia, a pesar de un nivel de actividad física entre moderada e intensa, todo lo cual destaca la importancia de implementar medidas de prevención, destacando los aspectos nutricional.

Context: In Ecuador, the metabolic syndrome (MS) in adults, had a prevalence of 27% nationwide by 2012 according to criteria of the International Diabetes Federation (IDF) and is associated with obesity and sedentary lifestyle. Objective:To determine the relationship between SM with physical activity and body mass index (BMI). Design:Cross-sectional, descriptive-observational study. Place and subjects: 326 university workers from Loja, Ecuador, with an average age of 36.6 years (SD 8.58). Main measurements:anthropometric measurements and serum parameters for diagnosis of MS and BMI. The International Physical Activity Questionnaire (IPAQ) was used to measure physical activity. Results:The global prevalence of MS was 16.9% according to NCEP / ATP III criteria (National Cholesterol Education Program's Adults Treatment Panel III) and 27.3% by IDF. The SM was more frequent in obese, in women and in the age group over 50 years. The most frequent parameters of MS were decreased HDL-Cholesterol and hypertriglyceridemia. Men had significantly higher values (p <0.001) of all SM parameters, except glycaemia. Association was found (p <0.001) between SM and BMI, but not with physical activity level. Conclusion:the prevalence of MS among university workers in Loja, Ecuador, is similar to the national prevalence. Overweight and obesity are associated with MS, mainly accompanied by dyslipidemia, despite a moderate to intense level of physical activity, all of which highlights the importance of implementing preventive measures, highlighting the nutritional aspects.

Histidinemia atípica y desarrollo cognitivo / Atypical hystidinemia and the cognitive development

Introducción: la histidinemia es un defecto metabólico dentro del grupo de aminoacidemias. El defecto enzimático de la histidasa (histidin-amono-liasa) provoca alta concentración de histidina en sangre, líquido cefalorraquídeo, en la orina y en el sudor. Métodos: un estudio de caso muestra el desarrollo evolutivo de un niño con histidinemia atípica y el impacto de la rehabilitación desde la edad temprana hasta la edad escolar. Resultados: la condición patológica causada por la histidinemia atípica limita el desarrollo motor, neurológico, neuropsicológico, conductual y escolar del niño. La rehabilitación temprana muestra que las habilidades primarias de la marcha se adquieren en la etapa esperada, pero los problemas motores complejos mantienen su limitación en el desarrollo. Las dificultades en el lenguaje oral persisten en toda la edad temprana, la rehabilitación posibilita su perfeccionamiento con la edad. Conclusiones: la histidinemia atípica muestra en el desarrollo alteraciones neurológicas, neuropsicológicas, neurofisiológicas, conductuales y académicas. La rehabilitación temprana brinda mejores condiciones de vida del infante. El carácter crónico de la enfermedad posibilita un pronóstico negativo en áreas esenciales como la conducta y la vida escolar.(AU)

Introduction: histidinemia is a metabolic defect within the group of aminoacidemias. The enzymatic defect of histidase (histidin-amono-lyase) cause high histidine concentration in the blood, the cerebrospinal fluid, in urine, and sweat. Methods: a case study showed the developmental evolution of a child with atypical histidinemia and the impact of rehabilitation from early age to school age. Results: the pathological condition caused by atypical histidinemia limits the motor, neurological, neuropsychological, behavioural and educational development of the child. The early rehabilitation shows that primary gait abilities are acquired in the expected phase, but the complex motor problems remained in the development phase. The language difficulties persist throughout the early childhood, but rehabilitation makes it possible to improve oral expression as age increases. Conclusions: atypical histidinemia reveals neurological, neuropsychological, neurophysiological, behavioural and academic alterations in the development of the child. The early rehabilitation provides better living conditions to the child. The chronic nature of the disease indicates a negative prognosis in essential areas such as behaviour and education.(AU)

Histidinemia atípica y desarrollo cognitivo / Atypical hystidinemia and the cognitive development

Introducción: la histidinemia es un defecto metabólico dentro del grupo de aminoacidemias. El defecto enzimático de la histidasa (histidin-amono-liasa) provoca alta concentración de histidina en sangre, líquido cefalorraquídeo, en la orina y en el sudor. Métodos: un estudio de caso muestra el desarrollo evolutivo de un niño con histidinemia atípica y el impacto de la rehabilitación desde la edad temprana hasta la edad escolar. Resultados: la condición patológica causada por la histidinemia atípica limita el desarrollo motor, neurológico, neuropsicológico, conductual y escolar del niño. La rehabilitación temprana muestra que las habilidades primarias de la marcha se adquieren en la etapa esperada, pero los problemas motores complejos mantienen su limitación en el desarrollo. Las dificultades en el lenguaje oral persisten en toda la edad temprana, la rehabilitación posibilita su perfeccionamiento con la edad. Conclusiones: la histidinemia atípica muestra en el desarrollo alteraciones neurológicas, neuropsicológicas, neurofisiológicas, conductuales y académicas. La rehabilitación temprana brinda mejores condiciones de vida del infante. El carácter crónico de la enfermedad posibilita un pronóstico negativo en áreas esenciales como la conducta y la vida escolar(AU)

Introduction: histidinemia is a metabolic defect within the group of aminoacidemias. The enzymatic defect of histidase (histidin-amono-lyase) cause high histidine concentration in the blood, the cerebrospinal fluid, in urine, and sweat. Methods: a case study showed the developmental evolution of a child with atypical histidinemia and the impact of rehabilitation from early age to school age. Results: the pathological condition caused by atypical histidinemia limits the motor, neurological, neuropsychological, behavioural and educational development of the child. The early rehabilitation shows that primary gait abilities are acquired in the expected phase, but the complex motor problems remained in the development phase. The language difficulties persist throughout the early childhood, but rehabilitation makes it possible to improve oral expression as age increases. Conclusions: atypical histidinemia reveals neurological, neuropsychological, neurophysiological, behavioural and academic alterations in the development of the child. The early rehabilitation provides better living conditions to the child. The chronic nature of the disease indicates a negative prognosis in essential areas such as behaviour and education(AU)

Infectious diseases in Mexico. A survey from 1995-2000.

Data obtained at a central laboratory for emerging, re-emerging, and other infectious diseases in Mexico from 1995-2000 are presented. An outstanding increase of DEN-3 circulation was identified. Aedes aegypti, the dengue vector, is widely distributed. Leptospirosis has become the most important differential diagnosis for dengue. Identification of rabies virus variants allowed cataloging of new transmitters of rabies. Rotavirus showed a clear seasonal distribution, while different proportions of pathogenic classes of Escherichia coli under endemic and outbreak conditions were seen. Serotypes of several bacteria are reported as well as the sources of isolation and frequency of Shigella, Salmonella, and Vibrio cholerae. Rise and disappearance of cholera could be followed along the past decade. Influenza strains were identified, as were several pathogens causing sexually transmitted infections. Laboratory support was important for surveillance after Hurricane Mitch. Multidrug-resistant strains of Mycobacterium tuberculosis are emerging and primary resistance is very high. It is now mandatory to search for antibodies to Trypanosoma cruzi in blood banks. Triatoma barberi, a peridomestic bug, is the main vector of Chagas disease. Localized cutaneous leishmaniosis increased in regions having a guerrilla element in Chiapas. Modern immunodiagnostic techniques are used for control studies of cysticercosis and similar techniques were recently standardized for Trichinella spiralis detection. Low iodine values in children's urine were found in several Mexican states; therefore, use of iodized salt should be encouraged.

Medio de cultivo de Leptospiras para la producción industrial de la Vacuna Cubana para Animales / Culture media of Leptospira for industrial production of Cuban Vaccine for animals

La reproducción de las leptospiras siempre ha sido un dilema, ya que son bacterias algo delicadas en sus requerimientos nutricionales, más aún si se necesita obtener una concentración bacteriana alta, como es el caso que se presenta en la procucción de vacuna.En el presente trabajo se exponen los resultados de un medio de cultivo logrado principalmente con materias primas cubanas. Esencialmente y lo más importante fue la obtención de un medio de cultivo que satisface los requerimientos de estas células bacterianas lográndose la concntración necesaria y no afectando ni la virulencia, ni la inmunogenicidad u otras características del microorganismo. Para ello se usó una sustancia estimulante de ciertas especies de pescado, sustituyendo totalmente en el cuarto pase o pase industrial, al suero de conejo, que encarecía extraordinariamente el producto. La conclusión, después de realizar innumerables experimentos con este medio y de pasar a la fase industrial con la producción de varios lotes de vacuna, es que el nuevo medio sustituye al medio Korthof incluso, se acorta el período de reproducción bacteriana favoreciendo que el ciclo de producción se abrevie y se gane en productividad.(AU)

Diagnóstico educativo sobre la enfermedad en pacientes diabéticos de la tercera edad / Educational diagnosis on the disease in elderly diabetic patients

Se realizó una investigación diagnóstica, de corte transversal, en un grupo de pacientes ancianos que asisten al Centro de Atención de Diabético para identificar las principales características y limitaciones de la educación en diabetes, en la tercera edad. Los pacientes tenían 60 años y más. Lasvariables generales y clínicas fueron tomadas de sus historias clíncias. Se exploró mediante cuestionario de conocimientos, encuestas y observación directa el grado de información teórica que poseían sobre la enfermedad; las destrezas para cumplir el tratamiento y su percepción sobre el grado de dificultad para entenderlo y cumplirlo. Se entrevistó al personal de salud que los atendía para indagarsobre las principales características, dificultades y necesidades educativas delgrupo. Más del 80 por ciento de los pacientes reflejó tener un nivel informativoaceptable sobre la enfermedad, pero las destrezas para ejecutar las diferentes técnicas de tratamiento y control eran suficientes en más del 50 por ciento de los pacientes. Un alto porcentaje (>50 por ciento) declaró que los consejos y orientaciones recibidos no eran fáciles de entender y/o llevar a cabo (AU)