Carlos A Aguilar Salinas

The ATP-Binding Cassette Transporter Subfamily A Member 1 (ABC-A1) and Type 2 Diabetes: An Association Beyond HDL Cholesterol

Recent findings from several groups demonstrate that ABC-A1 participates in the pathogenesis of the metabolic syndrome and type 2 diabetes. A variant of the ABC-A1 gene (R230C) is associated with the metabolic syndrome and its co-morbidities in Mexicans. Its presence is associated with an increased risk for obesity, the metabolic syndrome and type 2 diabetes. R230C is found exclusively in Amerindian and Amerindian-derived populations. Moreover, animal models confirm the participation of ABC-A1 in the pathogenesis of diabetes. Mice lacking AbcA1 specifically in beta cells had glucose intolerance at 8 weeks of age. The absence of ABC-A1 led to cholesterol accumulation within the beta cell plasma membrane, suggesting that cholesterol may play a role in the insulin secretory pathway. In conclusion, ABC-A1 may be more than a determinant of HDL-cholesterol. It may provide a link between components of the metabolic syndrome and atherosclerosis.

Erectile Dysfunction: A Chronic Complication of the Diabetes Mellitus

Eulises Diaz-Diaz1, Mario Cardenas Leon1, Nesty Olivares Arzuaga2, Carlos M. Timossi3, Rita Angelica Gomez Diaz4, Carlos Aguilar Salinas5 and Fernando Larrea1 1Department of Reproductive Biology, 2Department of Experimental Pathology, 5Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion: “Salvador Zubiran” 3Duplicarte, Medical Editorial 4 Medical Unit of Investigation in Clinical Epidemiology. Hospital de Especialidades, Centro Medico Nacional “Siglo XXI”, Instituto Mexicano del Seguro Social Mexico

Funcionamiento cognoscitivo en la diabetes tipo 2: una revisión

SUMMARY The aim of this work is to offer an updated review of the major cognitive difficulties that appear in Type 2 Diabetes Mellitus (T2DM), and its association with the patient compliance related factors proposed by the Panamerican Health Organization (PAHO), such as characteristics of patient, of the disease and of treatment. The review included electronic databases search (PubMed, PsycINFO and SpringerLink) from January 2000 to December 2011, predominating research from the United States, Canada, Holland, UK, Japan, Mexico and Germany. Most of the reviewed articles identified that factors which have shown to be associated with cognitive functioning in T2DM include: glycemic fluctuations, disease duration and pharmacological treatment. As for the changes that occur in the Central Nervous System (CNS), to date there is no consensus as to whether these are purely degenerative, vascular or a combination of both. Most affected cognitive abilities are: verbal memory, working memory, verbal fluency, attention, mental planning and psychomotor speed. The latter have been related with frontal, temporal and hyppocampal structure functioning, which are also compromised on T2DM. In the cognitive aspect, it is reported that T2DM is a risk factor for developing mild cognitive impairment. Also, chronicity of this condition associated with hypertension, inadequate glycemic control, and macrovascular complications increases the odds for vascular dementia to occur. It is concluded that even though some risk factors of the cognitive deficiencies have been identified on T2DM, it is important to determine how they interact, and to what degree they affect overall cognitive performance, and specific functions in this population.

Effect of bariatric surgery on heart failure

ABSTRACT Introduction: Obesity increases the risk of heart failure (HF), which continues to be a significant proportion of all cardiovascular diseases and affects increasingly younger populations. The cross-talk between adipose and the heart involves insulin resistance, adipokine signaling and inflammation, with the capacity of adipose tissue to mediate hemodynamic signals, promoting progressive cardiomyopathy. Areas covered: From a therapeutic perspective, there is not yet a single obesity-related pathway that when addressed, can ameliorate cardiomyopathy in obese patients and this is a matter of ongoing research. There is poor evidence of the beneficial long-term effect of small nonsurgical intentional weight loss on HF outcomes, in contrast to the field of HF accompanying severe obesity where observational studies have shown that bariatric surgery is associated with improved cardiac structure/function in severely obese patients with HF and preserved ejection fraction (HFpEF) as well as with improved cardiac structure/function in those with HF and reduced ejection fraction (HFrEF). Few studies report positive outcomes in subjects with obesity and HF, both severe, who underwent bariatric surgery as a rescue treatment, including bridge to heart transplantation. Expert commentary: The fast growing prevalence of obesity will continue to require the development of appropriate interventions directed at controlling or slowing pathways of cardiac damage in these patients, but at present, bariatric surgery should be considered an option to try to decrease morbidity associated with HF in severely obese adults.

Setting the Lipid Component of the Diet: A Work in Process

Some of the most relevant yet controversial issues in nutrition are those surrounding the guidelines on quality and quantity of dietary fat in the prevention and treatment of cardiovascular diseases and coronary heart diseases. Conflicting evidence questions the credibility of the previous dietary guidelines, particularly the quality of the evidence on which these recommendations were based. It is therefore important to explore the changes that have occurred in these guidelines and their influence on the adoption of different dietary patterns over time. In this review, we summarize the evolution of the fat component of the dietary guidelines, discuss controversial aspects, and highlight the areas in which additional evidence is still needed. Over the years, the scientific community has shown an obsession for calories in a diet instead of focusing on the quality of the food that makes up the diet. This is why certain authors have identified the importance of evaluating a diet focusing on diet patterns, rather than single isolated nutrients. This approach has been proposed in the most recent Dietary Guidelines for Americans.