árbara Angel B

Prevalencia de diabetes tipo 2 y obesidad en dos poblaciones aborígenes de Chile en ambiente urbano

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 urban 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 (Rev Med Chile 2004; 132: 1189-97). (Key Words: Diabetes Mellitus, type II; Hypercholesterolemia; Hyperlipidemia; Indians, South American)

Prevalencia familiar de patologías metabólicas en pacientes con síndrome de ovario poliquístico

Background: About 60% of patients with polycystic ovary syndrome (PCOS) have insulin resistance, predisposing them to the premature coronary disease and type 2 -diabetes mellitus. However, the history of metabolic disorders in family members of patients with PCOS has been seldom documented in the literature. Aim: To evaluate the family profile of metabolic disorders of PCOS patients and to determine their relative risk of developing one of them in comparison to a control group. Patients and Methods: Sixty PCOS patients were evaluated. The control group were 60 normal women. The data were obtained from the clinical history and personal interview with the patients, the controls and their relatives (brothers, parents and grandparents). The metabolic disorders considered were: dyslipidemia, obesity, hypertension and diabetes. Results: The ages were similar between groups (PCOS: 24.0 ± 6.3; control group: 24.8 ± 6.2 years). The prevalence of metabolic disorders was 62% in the relatives of the PCOS patients and 27.8% in the relatives of the control group (p <0.005). The probability to develop a metabolic disorder within the family was 2.7 (2.2-3.3) fold higher in the PCOS group compared to the control group. The risk of developing hypertension, dyslipidemia, obesity and diabetes was 2.1 (1.5-2.9); 1.8 (1.5-2.7); 3.6 (2.6-4.9) and 2.7 (1.8-3.9), respectively, in the PCOS group compared to the control group. Conclusions: The probability of finding a metabolic disorder in the families of PCOS patients, is 2.7 fold higher than in the control group families. The metabolic disorders are more frequent in parents and grandparents of the PCOS patients than in those of normal women (Rev Med Chile 2001; 129: 707-12)

Niveles plasmáticos de citoquinas IL-1ß, IL2 e IL-4 en niños diabéticos tipo 1 de diagnóstico reciente y su asociación con anticuerpos ß pancreáticos

9.1 pg/ml respectively, p=0,01). No differences in serum IL-4 were observed between diabetics and con-trol. Diabetic children with one or two positive autoantibodies (IA-2 and/or GAD65) had significantly higherlevels of IL-1s and IL-2 and lower levels of IL-4 than diabetic children without positive autoantibodies. Highconcentrations of IL-1s were associated with an early onset of the disease.

Incidencia de diabetes mellitus tipo 1 en Santiago de Chile: análisis por comunas de la Región Metropolitana en el período 2000-2004

BACKGROUND There are great geographical differences in the incidence of type I diabetes mellitus. AIM To determine the incidence rate of type 1 diabetes mellitus (DM1) in the Metropolitan Region of Santiago, Chile from January 1, 2000 to December 31, 2004 and to observe the distribution of cases in the different counties of Santiago. MATERIAL AND METHODS All the cases diagnosed with DM1 in the Metropolitan Region who fulfilled the following requirements were included in the study: age of onset <15 years, insulin treatment from onset, permanent residency in the area, and a diagnosis made between January, 2000 and December, 2004. RESULTS The incidence of DM1 was 6.58/100,000 inhabitants/year, and showed a significant increase from 2001 to 2004 (5.44 and 8.33 inhabitants/year, respectively, p <0.04). The incidence of DM1 also increased significantly in children younger than 4 years old. The incidence by counties exhibited large differences, ranging from 1.5 to 26.6/100,000 inhabitants. Counties with higher income, urbanization and low aborigine component showed a high incidence rate of type 1 diabetes. CONCLUSIONS In the Metropolitan Region of Santiago, an increase of the incidence of DM1 has occurred in the period 2000-2004, especially in children younger than 4 years old. Large differences among counties were observed.

Polimorfismo +49 A/G del gen del antígeno 4 del linfocito T citotóxico (CTLA-4) en la diabetes tipo 1: Asociación con el perfil de anticuerpos y citoquinas

Cytotoxic T lymphocyte associated antigen 4 (CTLA-4)has been one of the non HLA genes more commonly studied in type 1 diabetes mellitus (TID). CTLA-4 isa co-stimulation protein that has a key role in the negative regulation of T cells and is related with afunctional cytokine imbalance, generating a T helper (Th) 1 over Th2 dominance.

Síndrome de ovario poliquístico: la importancia de establecer su diagnóstico

Polycystic ovary syndrome (PCOS) is a very common disorder that occurs up to 10% of premenopausal women. Although PCOS is known to be associated with a higher reproductive morbility and increased risk of hormone dependent-cancer, its diagnosis is particularly important because PCOS is strongly linked to insulin resistance. This involves a major risk of early metabolic and cardiovascular complications. On the other hand, the prevalence of metabolic disorders associated with insulin resistance is higher in family members of patients with PCOS than in those of normal women, which suggests that the treatment of this syndrome should be preventive rather than symptomatic. For that reason, PCOS might be considered a signal of a family disorder, a route to diabetes and a public health problem.

Asociación de la variante GHRd3 del receptor de la hormona de crecimiento con autoinmunidad en la diabetes tipo 1

The allelefrequency for d3 was 24.8% in type 1 diabetics and 34.1% in controls (p =NS). Among type 1diabetic children, the carriers of the GHRd3 polymorphism had significantly higher levels ofinterleukin-1s than homozygous for the wild type genotype (5.7 and 17.7, pg/ml respectively, p<0.015). Carriers of d3 variant had a higher frequency of positive anti-insulin antibodies (anti-IAA) than children without this variant (39.6 and 17.7% respectively, p <0.01).

Expresión disminuida de caspasa 3 asociada al polimorfismo del gen del antígeno-4 asociado a linfocito T-citotóxico (CTLA4) en pacientes chilenos con diabetes tipo 1

BACKGROUND Several polymorphisms of the CTLA4 gene have been associated with autoimmune diseases. The activation of induced cell death is the major event and caspase 3 represents the main protein for the apoptotic machinery, especially in lymphocytes. AIM To correlate CTLA4 polymorphisms with caspase 3 expression in peripheral blood mononuclear cells (PBMC) simulating in vitro the glucose effect. MATERIAL AND METHODS CTLA4 polymorphisms were determined by restriction fragment length polymorphisms (RFLPs). PBMC from 21 patients with type 1 diabetes aged 8.5 ± 4.3 years and 21 healthy subjects aged 18.3 ± 1.8 years, were stimulated under normal (5 mM) and toxic (14 mM) glucose conditions to assess its effect on the expression and activity of caspase 3. Relative abundance of caspase 3 mRNA was measured by semi quantitative RT-PCR and its activity, by a colorimetric assay. RESULTS When stimulated with 14 mM glucose, PBMC of G allele carriers with type 1 diabetes had significantly lower relative mRNA abundance of caspase 3 (median value = 0.12, range 0.01-0.70 AU) compared with non-carriers (median value = 0.81, range 0.06-1.09 AU). When the incubation was carried out with the lower glucose concentration, a similar profile of caspase 3 activity was observed in diabetic patients carrying G allele (median value = 0.57, range 0.13-1.20 AU) as compared with non-carriers (median value = 0.89, range 0.14-5.50 AU). No significant changes after stimulating with glucose, were observed in PBMCs of the control group. CONCLUSIONS PBMC of recently diagnosed patients with T1D, carrying the G allele in + 49A/G polymorphisms of CTLA4, have a decreased expression and activity of caspase 3.