Predicción de diabetes mellitus basada en el índice triglicéridos y glucosa / Diabetes mellitus prediction based on the triglyceride and glucose index

Introducción: En México la diabetes mellitus tipo 2 (DM2) presenta niveles epidemiológicos, con una tasa de prevalencia del 9,12% y con los índices de sobrepeso y obesidad más altos del mundo. Para superar esta situación se deben crear estrategias enfocadas en la identificación de sujetos en riesgo. El índice triglicéridos y glucosa (TyG) fue creado para la detección de la resistencia a la insulina, y recientemente se ha empleado en la predicción de diabetes mellitus. El objetivo del presente estudio fue determinar el poder predictivo del índice TyG en una cohorte de la Ciudad de México.MétodosSe seleccionaron 3.195 pacientes de una cohorte de pacientes del área de crónico degenerativos de los Centros de Salud de los Servicios de Salud Pública de la Ciudad de México. Se evaluó la capacidad del índice TyG en la predicción de diabetes calculado como: ln (triglicéridos en ayunas [mg/dl]×glucosa en ayunas [mg/dl]/2) después de un seguimiento de al menos 4,5 años. Se determinó una prueba Chi-squared automated interaction detector analysis, que fue corroborada por una prueba ROC.ResultadosEl valor del índice de TyG fue significativamente mayor para los pacientes que desarrollar DM2. Los valores de área bajo la curva=0,934, intervalo de confianza (IC) 95%=0,924-0,924. Obteniendo un punto de corte de 9,45 en mujeres; en hombres: DM AUC=0.824, IC 95%=0,824-0,873 punto de corte 9.12.ConclusionesEl índice TyG es un buen marcador en la predicción de DM2 respaldado por la aplicación del algoritmo CHAID como herramienta útil para la predicción de DM2. (AU)

Introduction: In Mexico, type 2 Diabetes mellitus (DM2) presents epidemiological levels with a prevalence rate of 9.12% and with the highest overweight and obesity rates worldwide. To overcome this situation, strategies must be created focused on the identification of subjects at risk. The Triglyceride and Glucose (TyG) index, was created for the detection of insulin resistance, has recently been used in the prediction of DM. The objective of the present study was to determine the predictive power of the TyG index in a cohort from Mexico City.Methods3195 patients were selected from a cohort of patients from the chronic degenerative area of the Health Centers of the Public Health Services of Mexico City. The ability of the TyG index in predicting diabetes was evaluated as: ln [Fasting triglycerides (mg/dl) x fasting glucose (mg/dl)/2]. after a follow-up of at least 4.5 years. A CHAID test was determined that was corroborated by a ROC test.Resultsthe value of the TyG index was significantly higher for patients who develop DM2. Values of AUC=0.934, 95% CI: 0.924-0.924. Obtaining a cut-off point of 9.45 in women; in men: DM2 AUC=0.824, 95% CI: 0.824-0.873, and cut-off point 9.12.ConclusionsThe TyG index is a good marker in the prediction of DM2. The CHAID determination is a useful tool in the prediction of DM2. (AU)

[Diabetes mellitus prediction based on the triglyceride and glucose index]. / Predicción de diabetes mellitus basada en el índice triglicéridos y glucosa.

INTRODUCTION: In Mexico, type 2 Diabetes mellitus (DM2) presents epidemiological levels with a prevalence rate of 9.12% and with the highest overweight and obesity rates worldwide. To overcome this situation, strategies must be created focused on the identification of subjects at risk. The Triglyceride and Glucose (TyG) index, was created for the detection of insulin resistance, has recently been used in the prediction of DM. The objective of the present study was to determine the predictive power of the TyG index in a cohort from Mexico City. METHODS: 3195 patients were selected from a cohort of patients from the chronic degenerative area of the Health Centers of the Public Health Services of Mexico City. The ability of the TyG index in predicting diabetes was evaluated as: ln [Fasting triglycerides (mg/dl) x fasting glucose (mg/dl)/2]. after a follow-up of at least 4.5 years. A CHAID test was determined that was corroborated by a ROC test. RESULTS: the value of the TyG index was significantly higher for patients who develop DM2. Values of AUC=0.934, 95% CI: 0.924-0.924. Obtaining a cut-off point of 9.45 in women; in men: DM2 AUC=0.824, 95% CI: 0.824-0.873, and cut-off point 9.12. CONCLUSIONS: The TyG index is a good marker in the prediction of DM2. The CHAID determination is a useful tool in the prediction of DM2.

Correlación de los niveles plasmáticos del péptido natriurético tipo B con marcadores de riesgo metabólico / Correlation of plasma B-type natriuretic peptide levels with metabolic risk markers

Introducción y objetivos: El péptido natriurético tipo B (BNP) es un marcador de daño a nivel de miocardio, este péptido ha sido asociado con marcadores de riesgo metabólico, aunque existe controversia en este sentido. El objetivo del presente estudio fue determinar la correlación de los valores plasmáticos del BNP y los parámetros de riesgo metabólico. Material y métodos: Estudio retrospectivo, observacional con la inclusión de 152 sujetos, los cuales fueron clasificados con base a los componentes del síndrome metabólico. Se determinó la asociación de los valores plasmáticos del BNP con los parámetros del síndrome metabólico mediante la correlación de Spearman. Resultados: Se encontró una asociación inversa significativa con el peso (r=−0,408; p<0,0001) y con el IMC (r=−0,443; p<0,001). Mientras que se observó una correlación significativa con la presión sistólica (r=0,324; p<0,001). Se determinaron los valores del BNP con respecto al número de componentes del síndrome metabólico, encontrando una disminución dependiente del número de los componentes del síndrome metabólico (p<0,05). Conclusión: Con base a los datos obtenidos en este trabajo, podemos presumir que la determinación de BNP en plasma puede ser un buen marcador de daño metabólico

Background and objective: Natriuretic peptide type B (BNP) is a marker of myocardium injury. This peptide has been associated with metabolic risk markers, although controversy exists in this regard. The aim of the present study was to determine the correlation of plasma BNP levels with metabolic risk parameters. Materials and methods: A retrospective, observational study that included 152 patients, who were classified according to their clinical diagnosis as patients with metabolic syndrome. Plasma BNP levels and clinical metabolic parameters were assessed by using Spearmańs rank correlation coefficient. Results: A significant inverse association with weight (r=−.408; p<.0001) and BMI (r=−.443; p<.001) was obtained. While a positive significant association with systolic pressure (r=.324; p<.001) was observed. A significant decrease was found in BNP levels and components of metabolic syndrome (p<.05). Conclusion: Based on the results from this study, we can conclude that BNP determination could be an adequate metabolic marker

Correlation of plasma B-type natriuretic peptide levels with metabolic risk markers. / Correlación de los niveles plasmáticos del péptido natriurético tipo B con marcadores de riesgo metabólico.

BACKGROUND AND OBJECTIVE: Natriuretic peptide type B (BNP) is a marker of myocardium injury. This peptide has been associated with metabolic risk markers, although controversy exists in this regard. The aim of the present study was to determine the correlation of plasma BNP levels with metabolic risk parameters. MATERIALS AND METHODS: A retrospective, observational study that included 152 patients, who were classified according to their clinical diagnosis as patients with metabolic syndrome. Plasma BNP levels and clinical metabolic parameters were assessed by using Spearmans rank correlation coefficient. RESULTS: A significant inverse association with weight (r=-.408; p<.0001) and BMI (r=-.443; p<.001) was obtained. While a positive significant association with systolic pressure (r=.324; p<.001) was observed. A significant decrease was found in BNP levels and components of metabolic syndrome. (p<.05). CONCLUSION: Based on the results from this study, we can conclude that BNP determination could be an adequate metabolic marker.

Liver steatosis and nonalcoholic steatohepatitis: from pathogenesis to therapy. / Hígado graso y esteatohepatitis no alcohólica: patogénesis y tratamiento.

Non-alcoholic fatty liver disease refers to a disease spectrum that ranges from steatosis to non-alcoholic steatohepatitis, which leads to fibrosis, cirrhosis and hepatocellular carcinoma. Given the increasing prevalence of obesity worldwide, the incidence of non-alcoholic fatty liver disease has become a world health problem. Non-alcoholic fatty liver disease is considered to be the hepatic manifestation of metabolic syndrome associated with insulin resistance, central obesity, and type 2 diabetes mellitus. Allegedly, insulin resistance plays a pivotal role in its pathogenesis. Here we highlight non-alcoholic fatty liver disease epidemiology and pathophysiology, its progression towards steatohepatitis with particular emphasis in liver fibrosis and participation of advanced glycation end products. The different treatments reported are described here as well. We conducted a search in PubMed with the terms steatohepatitis, steatosis advanced glycation end products, liver fibrosis and adipocytokines. Articles were selected according to their relevance.

La enfermedad hepática no alcohólica se refiere a un espectro de enfermedades que va desde hígado graso, hasta esteatohepatitis y que puede cursar por fibrosis, cirrosis y hepatocarcinoma. Dado que a nivel mundial se ha incrementado la prevalencia de la obesidad, los cambios en el estilo de vida y la alimentación desbalanceada, la enfermedad hepática no alcohólica se ha convertido en un problema de salud pública. Se le considera como la manifestación hepática del síndrome metabólico, asociada a resistencia a la insulina, obesidad central, diabetes mellitus tipo 2, e hipertrigliceridemia. Se estima que la resistencia a la insulina, juega un papel detonador en la patogénesis de la enfermedad hepática no alcohólica. En este artículo se describen diferentes aspectos de la enfermedad hepática no alcohólica: la epidemiología, la patofisiología, su progresión hacia esteatohepatitis con particular énfasis en la fibrosis hepática, la participación de los productos finales de glicación avanzada, y los diferentes tratamientos reportados. Se realizó una búsqueda de artículos en la base de datos de PubMed con los términos esteatohepatitis, esteatosis, productos finales de glicación avanzada, fibrosis hepática y adipocinas. Los artículos fueron seleccionados por su relevancia en el tema.

Bis(trifluoromethyl)phosphinous acid (CF3)2P-O-H: an example of a thermally stable phosphinous acid--synthesis, gas-phase structure, and rotational isomers.

The bis(trifluoromethyl)phosphinous acid, (CF3)2P-O-H, is the only known example of a thermally stable phosphinous acid. Although this compound has been known since 1960, little is known about the chemistry of this extraordinary compound; this might be due to the tedious, and in some part risky, synthesis that was originally published. An improved, simple, and safe synthesis that is based on the treatment of the easily accessible (CF3)2PNEt2, with at least three equivalents of p-toluene sulfonic acid, is presented. The reaction results in a complete conversion to the phosphinous acid, which is isolated in almost 90 % yield. The compound exists in an equilibrium of two P--OH rotational isomers, a fact which is supported by quantum chemical calculations. The relative enthalpy difference of 6.4 kJ mol(-1), calculated at the B3PW91/6-311G(3d,p) level, is in excellent agreement with the experimental value of 5.9 kJ mol(-1), which was determined from the temperature dependence of the nu(OH) bands of the two rotational isomers. The complete experimental vibrational spectra of both rotamers, their predicted vibrational spectra obtained by using quantum chemical calculations, and an attempt at photoinduced isomerization of matrix-isolated (CF3)2POH is presented. The experimental structure, obtained from an electron-diffraction study in the gas phase, is reproduced very well by ab initio and density functional theory (DFT) methods.

Trifluoromethoxycarbonyl peroxynitrate, CF3OCOOONO2.

The trioxide, CF(3)OC(O)OOOC(O)OCF(3), reacts with NO(2) at 0 degrees C to yield the new peroxynitrate, CF(3)OC(O)OONO(2), which is stable for hours at room temperature. It is spectroscopically characterized and some thermal properties are reported. From the vapor pressure, ln(p/p(0)) = 14.06 - 4565/T, of the liquid above the melting point of -89 degrees C, the extrapolated boiling point is 52 degrees C. CF(3)OC(O)OONO(2) dissociates at higher temperatures and low pressures into the radicals CF(3)OC(O)OO and NO(2) as demonstrated by matrix isolation experiments. The matrix-isolated peroxy radicals consist in a rotameric mixture of trans,trans,trans-CF(3)OC(O)OO and trans,trans,cis-CF(3)OC(O)OO, where trans and cis denote dihedral angles of ca. 180 degrees and 0 degree, respectively, around beta F-C-O-C, beta C-O-C-O, and beta O-C-O-O, with an equilibrium composition dependent on the thermolysis temperature. The radical trans,trans,cis-CF(3)OC(O)OO is found to be ca. 3 kJ mol(-1) higher in enthalpy than trans,trans,trans-CF(3)OC(O)OO. DFT calculations are performed to support the vibrational assignments and to provide structural information about CF(3)OC(O)OONO(2).

Properties of chloroformyl peroxynitrate, ClC(O)OONO(2).

The synthesis of ClC(O)OONO(2) is accomplished by photolysis of a mixture of Cl(2), NO(2), and CO in large excess of O(2) at about -70 degrees C. The product is isolated after repeated trap-to-trap condensation. The solid compound melts at -84 degrees C, and the extrapolated boiling point is 80 degrees C. ClC(O)OONO(2) is characterized by IR, Raman, (13)C NMR, and UV spectroscopy. According to the IR matrix spectra, the compound exists at room temperature only as a single conformer. The molecular structure of ClC(O)OONO(2) is determined by gas electron diffraction. The molecule possesses a gauche structure with a dihedral angle of phi(COON) = 86.7(19) degrees , and the C=O bond is oriented syn with respect to the O-O bond. The short O-O bond (1.418(6) A) and the long N-O bond (1.511(8) A) are consistent with the facile dissociation of ClC(O)OONO(2) into the radicals ClC(O)OO and NO(2). The experimental geometry of ClC(O)OONO(2) is reproduced reasonably well by B3LYP/6-311+G(2df) calculations, whereas the MP2 approximation predicts the N-O bond considerably too long and the dihedral angle too small.

Thermal decomposition of the perfluorinated peroxides CF3OC(O)OOC(O)F and CF3OC(O)OOCF3.

Gas phase thermal decomposition of CF(3)OC(O)OOC(O)F and CF(3)OC(O)OOCF(3) was studied at temperatures between 64 and 98 degrees C (CF(3)OC(O)OOC(O)F) and 130-165 degrees C (CF(3)OC(O)OOCF(3)) using FTIR spectroscopy to follow the course of the reaction. For both substances, the decompositions were studied with N(2) and CO as bath gases. The rate constants for the decomposition of CF(3)OC(O)OOC(O)F in nitrogen and carbon monoxide fit the Arrhenius equations k(N)2 = (3.1 +/- 0.1) x 10(15) exp[-(29.0 +/- 0.5 kcal mol(-1)/RT)] and k(CO) = (5.8 +/- 1.3) x 10(15) exp[-(29.4 +/- 0.5 kcal mol(-1)/RT)], and that for CF(3)OC(O)OOCF(3) fits the equation k = (9.0 +/- 0.9) x 10(13) exp[-(34.0 +/- 0.7 kcal mol(-1)/RT)] (all in units of inverted seconds). Rupture of the O-O bond was shown to be the rate-determining step for both peroxides, and bond energies of 29 +/- 1 and 34.0 +/- 0.7 kcal mol(-1) were obtained for CF(3)OC(O)OOC(O)F and CF(3)OC(O)OOCF(3). The heat of formation of the CF(3)OCO(2)(*) radical, which is a common product formed in both decompositions, was calculated by ab initio methods as -229 +/- 4 kcal mol(-1). With this value, the heat of formation of the title species and of CF(3)OC(O)OOC(O)OCF(3) could in turn be obtained as Delta(f) degrees (CF(3)OC(O)OOC(O)F) = -286 +/- 6 kcal mol(-1), Delta(f) degrees (CF(3)OC(O)OOCF(3)) = -341 +/- 6 kcal mol(-1), and Delta(f) degrees (CF(3)OC(O)OOC(O)OCF(3)) = -430 +/- 6 kcal mol(-1).

Laboratory evidence for a key intermediate in the Venus atmosphere: peroxychloroformyl radical.

For two decades, the peroxychloroformyl radical, ClC(O)OO, has played a central role in models of the chemical stability of the Venus atmosphere. No confirmation, however, has been possible in the absence of laboratory measurements for ClC(O)OO. We report the isolation of ClC(O)OO in a cryogenic matrix and its infrared and ultraviolet spectral signatures. These experiments show that ClC(O)OO is thermally and photolytically stable in the Venus atmosphere. These experimental discoveries validate the existence of ClC(O)OO, confirm several longstanding model assumptions, and provide a basis for the astronomical search for this important radical species.

The matrix-isolated molecular complexes CO/XF (X=Cl,Br,I) and the molecular structure of FC(O)Br.

FC(O)Br has been synthesized, and its IR spectrum in the gas phase and isolated in an Ar matrix, as well as, its Raman spectrum in the solid state at -196 degrees C has been analyzed. Its molecular structure has been determined and its UV has been measured. FC(O)Br and FC(O)Cl has been photodissociated in an argon matrix at 17 K with a 193 nm laser. The photolysis produces CO and XF which recombine to form CO/XF complexes. The formation of complexes are followed by the shift of the normal vibration modes with respect to CO and XF isolated in argon matrix. In the case of FC(O)Br, three isomers are identified, OC...BrF, OC...FBr, and CO...BrF, whereas for FC(O)Cl only one isomer is observed, OC...ClF. High level quantum chemical calculations are used to help the assignment of the different isomers.

The open-chain trioxide CF3OC(O)OOOC(O)OCF3.

The open-chain trioxide CF(3)OC(O)OOOC(O)OCF(3) is synthesised by a photochemical reaction of CF(3)C(O)OC(O)CF(3), CO and O(2) under a low-pressure mercury lamp at -40 degrees C. The isolated trioxide is a colourless solid at -40 degrees C and is characterised by IR, Raman, UV and NMR spectroscopy. The compound is thermally stable up to -30 degrees C and decomposes with a half-life of 1 min at room temperature. Between -15 and +14 degrees C the activation energy for the dissociation is 86.5 kJ mol(-1) (20.7 kcal mol(-1)). Quantum chemical calculations have been performed to support the vibrational assignment and to discuss the existence of rotamers.

Perfluoromethyl fluorocarbonyl peroxide, CF3OOC(O)F: structure, conformations, and vibrational spectra studied by experimental and theoretical methods.

The conformational properties and the geometric structure of perfluoromethyl fluorocarbonyl peroxide, CF(3)OOC(O)F, have been studied by matrix IR spectroscopy, gas electron diffraction, and quantum chemical calculations (HF, B3LYP, and MP2 methods with 6-311G* basis sets). Matrix IR spectra imply a mixture of syn and anti conformers (orientation of the C=O bond relative to the O-O bond) with DeltaH degrees = H(anti) degrees - H(syn) degrees = 2.16(22) kcal/mol. At room temperature, the contribution of the anti rotamer is about 3.0%. The O-O bond (1.422(15) A) is within the experimental uncertainties equal to those in related symmetrically substituted peroxides CF(3)OOCF(3) and FC(O)OOC(O)F (1.419(20) and 1.419(9) A, respectively), and the dihedral angle delta(COOC) (111(5) degrees ) is intermediate between the values in these two compounds (123(4) degrees and 83.5(14) degrees, respectively).

Synthesis and characterization of trifluoromethyl fluoroformyl peroxycarbonate, CF3OC(O)OOC(O)F.

The synthesis of CF(3)OC(O)OOC(O)F is accomplished by the photolysis of a mixture of (CF(3)CO)(2)O, FC(O)C(O)F, CO, and O(2) at -15 degrees C using a low-pressure mercury lamp. The new peroxide is obtained in pure form in low yield after repeated trap-to-trap condensation and is characterized by NMR, IR, Raman, and UV spectroscopy. Geometrical parameters were studied by ab initio methods [B3LYP/6-311+G(d)]. At room temperature, CF(3)OC(O)OOC(O)F is stable for many days in the liquid or gaseous state. The melting point is -87 degrees C, and the boiling point is extrapolated to 45 degrees C from the vapor pressure curve log p = 8.384 - 1715/T (p/mbar, T/K). A possible mechanism for the formation of CF(3)OC(O)OOC(O)F is discussed, and its properties are compared with those of related compounds.