Replication of Integrative Data Analysis for Adipose Tissue Dysfunction, Low-Grade Inflammation, Postprandial Responses and OMICs Signatures in Symptom-Free Adults.

We previously reported preliminary characterization of adipose tissue (AT) dysfunction through the adiponectin/leptin ratio (ALR) and fasting/postprandial (F/P) gene expression in subcutaneous (SQ) adipose tissue (AT) biopsies obtained from participants in the GEMM study, a precision medicine research project. Here we present integrative data replication of previous findings from an increased number of GEMM symptom-free (SF) adults (N = 124) to improve characterization of early biomarkers for cardiovascular (CV)/immunometabolic risk in SF adults with AT dysfunction. We achieved this goal by taking advantage of the rich set of GEMM F/P 5 h time course data and three tissue samples collected at the same time and frequency on each adult participant (F/P blood, biopsies of SQAT and skeletal muscle (SKM)). We classified them with the presence/absence of AT dysfunction: low (<1) or high (>1) ALR. We also examined the presence of metabolically healthy (MH)/unhealthy (MUH) individuals through low-grade chronic subclinical inflammation (high sensitivity C-reactive protein (hsCRP)), whole body insulin sensitivity (Matsuda Index) and Metabolic Syndrome criteria in people with/without AT dysfunction. Molecular data directly measured from three tissues in a subset of participants allowed fine-scale multi-OMIC profiling of individual postprandial responses (RNA-seq in SKM and SQAT, miRNA from plasma exosomes and shotgun lipidomics in blood). Dynamic postprandial immunometabolic molecular endophenotypes were obtained to move towards a personalized, patient-defined medicine. This study offers an example of integrative translational research, which applies bench-to-bedside research to clinical medicine. Our F/P study design has the potential to characterize CV/immunometabolic early risk detection in support of precision medicine and discovery in SF individuals.

Towards precision medicine: defining and characterizing adipose tissue dysfunction to identify early immunometabolic risk in symptom-free adults from the GEMM family study.

Interactions between macrophages and adipocytes are early molecular factors influencing adipose tissue (AT) dysfunction, resulting in high leptin, low adiponectin circulating levels and low-grade metaflammation, leading to insulin resistance (IR) with increased cardiovascular risk. We report the characterization of AT dysfunction through measurements of the adiponectin/leptin ratio (ALR), the adipo-insulin resistance index (Adipo-IRi), fasting/postprandial (F/P) immunometabolic phenotyping and direct F/P differential gene expression in AT biopsies obtained from symptom-free adults from the GEMM family study. AT dysfunction was evaluated through associations of the ALR with F/P insulin-glucose axis, lipid-lipoprotein metabolism, and inflammatory markers. A relevant pattern of negative associations between decreased ALR and markers of systemic low-grade metaflammation, HOMA, and postprandial cardiovascular risk hyperinsulinemic, triglyceride and GLP-1 curves was found. We also analysed their plasma non-coding microRNAs and shotgun lipidomics profiles finding trends that may reflect a pattern of adipose tissue dysfunction in the fed and fasted state. Direct gene differential expression data showed initial patterns of AT molecular signatures of key immunometabolic genes involved in AT expansion, angiogenic remodelling and immune cell migration. These data reinforce the central, early role of AT dysfunction at the molecular and systemic level in the pathogenesis of IR and immunometabolic disorders.

Secciones traumáticas de nervios periféricos en mano / Traumatic injury and repair in the peripheric nerve of the hand

Introducción: el pronóstico funcional de un nervio seccionado en mano se relaciona con la edad, naturaleza de la herida, complejidad de la lesión, técnica quirúrgica y rehabilitación. Objetivo: conocer la prevalencia de secciones traumáticas de nervios periféricos en mano, en pacientes de la Clínica de Mano, Hospital General de Zona 89, Instituto Mexicano del Seguro Social, Guadalajara Jalisco, durante el primer semestre del año 2000.Metodología: análisis de consultas de urgencias, expedientes clínicos y atención de pacientes en el servicio de urgencias. Resultados: se evaluaron 976 pacientes, 75.4 por ciento del género masculino; se trató de 57 lesiones traumáticas de nervios periféricos en mano; la prevalencia fue de 5.8 y 98 por ciento ocurrió en el centro de trabajo; el rango de edad osciló entre 15 y 59 años (media 26.3). Las lesiones por agentes cortantes sucedieron en 44 por ciento, aplastamiento 35 por ciento, amputaciones 21 por ciento, la mayoría se asoció con fracturas y lesiones tendinosas. Aunque los nervios digitales fueron los más afectados, los nervios mediano, cubital y radial fueron afectados en 37 por ciento. Las lesiones se repararon por técnicas quirúrgicas convencionales durante las primeras 12 horas de haberse producido.Conclusiones: los resultados obtenidos son útiles para conocer la prevalencia de secciones nerviosas en mano, mostrar las posibles complicaciones a largo plazo, para así promover medidas de prevención e instrumentar nuevas estrategias en la reparación de nervios periféricos.