Esther C. Gallegos-Cabriales

Replication of obesity and diabetes-related SNP associations in individuals from Yucatán, México

The prevalence of type 2 diabetes (T2D) is rising rapidly and in Mexicans is ~19%. T2D is affected by both environmental and genetic factors. Although specific genes have been implicated in T2D risk few of these findings are confirmed in studies of Mexican subjects. Our aim was to replicate associations of 39 single nucleotide polymorphisms (SNPs) from 10 genes with T2D-related phenotypes in a community-based Mexican cohort. Unrelated individuals (n = 259) living in southeastern Mexico were enrolled in the study based at the University of Yucatan School of Medicine in Merida. Phenotypes measured included anthropometric measurements, circulating levels of adipose tissue endocrine factors (leptin, adiponectin, pro-inflammatory cytokines), and insulin, glucose, and blood pressure. Association analyses were conducted by measured genotype analysis implemented in SOLAR, adapted for unrelated individuals. SNP Minor allele frequencies ranged from 2.2 to 48.6%. Nominal associations were found for CNR1, SLC30A8, GCK, and PCSK1 SNPs with systolic blood pressure, insulin and glucose, and for CNR1, SLC30A8, KCNJ11, and PCSK1 SNPs with adiponectin and leptin (p < 0.05). P-values greater than 0.0014 were considered significant. Association of SNPs rs10485170 of CNR1 and rs5215 of KCNJ11 with adiponectin and leptin, respectively, reached near significance (p = 0.002). Significant association (p = 0.001) was observed between plasma leptin and rs5219 of KCNJ11.

Integrating genomic analysis with the genetic basis of gene expression: preliminary evidence of the identification of causal genes for cardiovascular and metabolic traits related to nutrition in Mexicans

Whole-transcriptome expression profiling provides novel phenotypes for analysis of complex traits. Gene expression measurements reflect quantitative variation in transcript-specific messenger RNA levels and represent phenotypes lying close to the action of genes. Understanding the genetic basis of gene expression will provide insight into the processes that connect genotype to clinically significant traits representing a central tenet of system biology. Synchronous in vivo expression profiles of lymphocytes, muscle, and subcutaneous fat were obtained from healthy Mexican men. Most genes were expressed at detectable levels in multiple tissues, and RNA levels were correlated between tissue types. A subset of transcripts with high reliability of expression across tissues (estimated by intraclass correlation coefficients) was enriched for cis-regulated genes, suggesting that proximal sequence variants may influence expression similarly in different cellular environments. This integrative global gene expression profiling approach is proving extremely useful for identifying genes and pathways that contribute to complex clinical traits. Clearly, the coincidence of clinical trait quantitative trait loci and expression quantitative trait loci can help in the prioritization of positional candidate genes. Such data will be crucial for the formal integration of positional and transcriptomic information characterized as genetical genomics.

Validez de dos pruebas para evaluar la percepción materna del peso del hijo

Objective. To assess maternal perception of their children weight using words (PP) and using images (PI) and evaluate the validity of the two tests by determining their sensitivity and specificity. Material and Methods. A total of 418 motherchild diads were selected from urban areas in the Monterrey, Nuevo Leon area. A questionnaire was administered to the mothers about perceptions regarding physical appearance and health. Sensitivity and specificity were calculated and the body mass index measurement of the child was the gold standard. Results. Mothers underestimated overweight (SP) and obesity (OB), with 20.34% of mothers of children with SP and 7.41% of children with OB perceiving their child’s condition with the PP test, and 62.71% of mothers of children with SP and 81.48% of those of children with OB perceiving it with the PI test. The tests had 12% sensitivity and 21% specificity for PP and 75% sensitivity and 15% specificity for PI. Conclusions. The mothers of children with SP-OB underestimate the weight of their children. Images are useful for mothers to recognize their child’s condition.

Hierarchical clusters in families with type 2 diabetes

Families represent more than a set of individuals; family is more than a sum of its individual members. With this classification, nurses can identify the family health-illness beliefs obey family as a unit concept, and plan family inclusion into the type 2 diabetes treatment, whom is not considered in public policy, despite families share diet, exercise, and self-monitoring with a member who suffers type 2 diabetes. The aim of this study was to determine whether the characteristics, functionality, routines, and family and individual health in type 2 diabetes describes the differences and similarities between families to consider them as a unit. We performed an exploratory, descriptive hierarchical cluster analysis of 61 families using three instruments and a questionnaire, in addition to weight, height, body fat percentage, hemoglobin A1c, total cholesterol, triglycerides, low-density lipoprotein and high-density lipoprotein. The analysis produced three groups of families. Wilk’s lambda demonstrated statistically significant differences provided by age (Λ = 0.778, F = 2.098, p = 0.010) and family health (Λ = 0.813, F = 2.650, p = 0.023). A post hoc Tukey test coincided with the three subsets. Families with type 2 diabetes have common elements that make them similar, while sharing differences that make them unique.

Factors associated with glycemic status and ability to adapt to changing demands in people with and without type 2 diabetes mellitus: A cross-sectional study

Objectives: Type 2 diabetes mellitus studies focus on metabolic indicators and different self-reported lifestyle or care behaviors. Self-reported instruments involve conscious process therefore responses might not reflect reality. Meanwhile implicit responses involve automatic, unconscious processes underlying social judgments and behavior. No studies have explored the combined influence of both metabolic indicators and implicit responses on lifestyle practices in type 2 diabetes mellitus patients. The purpose was to investigate the explained variance of socio-demographic, metabolic, anthropometric, clinical, psychosocial, cognitive, and lifestyle variables on glycemic status and on the ability to adapt to changing demands in people with and without type 2 diabetes mellitus in Monterrey, Mexico. Methods: Adults with (n = 30, mean age 46.90 years old, 33.33% male) and without (n = 32, mean age: 41.69 years old, 21.87% male) type 2 diabetes mellitus were studied. Glycemic status was assessed using Bio-Rad D-10 Hemoglobin A1c Program, which uses ion-exchange high-performance chromatography. Stroop 2 test was used to assess the ability to changing demands. Results: In participants with type 2 diabetes mellitus, less years of education, negative self-actualization, and higher levels of cholesterol and triglycerides explained more than 50% of the variance in glycemic status. In participants without type 2 diabetes mellitus, the variance (38.7%) was explained by total cholesterol, metabolic syndrome, high-density lipoprotein, and self-actualization scores; the latter in opposite direction. The ability to adapt to changing demands was explained by total cholesterol, malondialdehyde, insulin resistance, and triglycerides. In participants without type 2 diabetes mellitus, the contributing variables were metabolic syndrome and nutrition scores. Conclusion: Results showed significant effect on at least one of the following variables (socio-demographic, metabolic, or lifestyle subscale) on glycemic status in people with and without type 2 diabetes mellitus. The ability to adapt to changing demands was explained by metabolic variables but only in participants without type 2 diabetes mellitus. Preference for unhealthy behaviors (implicit or automatic responses) outweighs healthy lifestyle practices in people with and without type 2 diabetes mellitus.

Middle-Range Theory: Coping and Adaptation with Active Aging

Various disciplines focus on a multiplicity of aspects of aging: lifestyles, personal biological factors, psychological conditions, health conditions, physical environment, and social and economic factors. The aforementioned are all related to the determinants of active aging. The aim is to describe the development of a middle-range theory based on coping and adaptation with active aging. Concepts and relationships derived from Roy’s model of adaptation are included. The proposed concepts are hope, health habits, coping with aging, social relations, and active aging.

Mini-Review: The Contribution of Intermediate Phenotypes to GxE Effects on Disorders of Body Composition in the New OMICS Era

Studies of gene-environment (GxE) interactions describe how genetic and environmental factors influence the risk of developing disease. Intermediate (molecular or clinical) phenotypes (IPs) are traits or metabolic biomarkers that mediate the effects of gene-environment influences on risk behaviors. Functional systems genomics discovery offers mechanistic insights into how DNA variations affect IPs in order to detect genetic causality for a given disease. Disorders of body composition include obesity (OB), Type 2 diabetes (T2D), and osteoporosis (OSTP). These pathologies are examples of how a GxE interaction contributes to their development. IPs as surrogates for inherited genotypes play a key role in models of genetic and environmental interactions in health outcomes. Such predictive models may unravel relevant genomic and molecular pathways for preventive and therapeutic interventions for OB, T2D, and OSTP. Annotation strategies for genomes, in contrast to phenomes, are well advanced. They generally do not measure specific aspects of the environment. Therefore, the concepts of deep phenotyping and the exposome generate new avenues to exploit with high-resolution technologies for analyzing this sophisticated phenome. With the successful characterization of phenomes, exposomes, and genomes, environmental and genetic determinants of chronic diseases can be united with multi-OMICS studies that better examine GxE interactions.

Relação entre competência, usabilidade, ambiente e risco de quedas em idosos

Objetivo: determinar a relacao entre competencia, usabilidade e ambiente com risco de quedas em idosos. Metodo: estudo descritivo correlacional, incluindo 123 homens e mulheres idosos de 70 anos para mais. Os dados foram coletados com os instrumentos Escala de Tinetti, Escala CESD-7, Avaliacao Cognitiva Montreal, Questionario de Usabilidade na Moradia e Housing Enabler; e um instrumento de coleta de dados para antecedentes sociodemograficos e de saude. Para a analise dos dados, foi utilizada estatistica descritiva e inferencial, em que foram ajustados modelos lineares multivariados e de regressao logistica. Resultados: 42,0% dos idosos apresentaram quedas, sendo maior a prevalencia nas mulheres e no grupo de 70-75 anos. Como risco de quedas, foram encontrados o ambiente fisico da moradia, caminhada e usabilidade. Encontrou-se relacao negativa entre usabilidade com sintomas depressivos, saude cognitiva, equilibrio, caminhada, ambiente social e fisico p<0,05; e forte correlacao positiva entre caminhada e equilibrio p<0,05. Conclusao: o estudo contribui para melhor compreensao formal do fenomeno das quedas ao encontrar relacao entre a usabilidade com o risco de quedas, e com outras variaveis que se relacionam com as quedas.Objective: to determine connections between competence, usability, environment and risk of falls in elderly adults. Method: correlational descriptive study, 123 elderly adults, both male and female, aged 70 years and older were included. Data was collected via the Tinetti Scale, CESD-7 Scale, Montreal Cognitive Assessment, Usability Questionnaire on Housing and Housing Enabler; and sociodemographic and health background certificate data. For data analysis, descriptive and inferential statistics were used, multivariate linear and logistic regression models were adjusted. Results: 42.0% of the elderly adults had presented with falls, with a higher prevalence in women, and in the group of 70-75 years. The physical environment of the house, gait, and usability were set as risk factors for falls. A negative relationship between usability and depressive symptoms, cognitive health, balance, gait, the social and physical environment was found, p <0.05; and a strong positive correlation between walking and balance, p <0.05. Conclusion: this study helps to better understand the phenomenon of falling, to find a connection between usability with the risk of falls, and other variables.Objetivo: determinar la relacion de la competencia, usabilidad y del entorno con el riesgo de caidas en el adulto mayor. Metodo: estudio descriptivo correlacional, se incluyeron 123 adultos mayores hombres y mujeres de 70 anos y mas. Los datos fueron recolectados con los instrumentos Escala de Tinetti, Escala CESD-7, Evaluacion Cognitiva Montreal, Cuestionario de Usabilidad en la Vivienda y Housing Enabler; y una cedula de datos para antecedentes sociodemograficos y de salud. Para el analisis de datos se utilizo una estadistica descriptiva e inferencial, en donde se ajustaron modelos lineales multivariados y de regresion logistica. Resultados: el 42,0% de los adultos mayores habia presentado caidas, con una mayor prevalencia en las mujeres y en el grupo de 70-75 anos. El entorno fisico de la vivienda, marcha y usabilidad se establecieron como riesgos de caida. Se encontro una relacion negativa entre la usabilidad y los sintomas depresivos, la salud cognitiva, el equilibrio, la marcha, el entorno social y fisico p<0,05; y una fuerte correlacion positiva entre la marcha y el equilibrio p<0,05. Conclusion: el estudio contribuye a comprender mejor el fenomeno de las caidas al encontrar relacion entre la usabilidad con el riesgo de caida, y con otras variables.Descriptores: Factores de Riesgo; Ambiente; Accidentes por Caidas; Adulto Mayor.1139

Relación entre competencia, usabilidad, entorno y riesgo de caídas en el adulto mayor

Objetivo: determinar a relacao entre competencia, usabilidade e ambiente com risco de quedas em idosos. Metodo: estudo descritivo correlacional, incluindo 123 homens e mulheres idosos de 70 anos para mais. Os dados foram coletados com os instrumentos Escala de Tinetti, Escala CESD-7, Avaliacao Cognitiva Montreal, Questionario de Usabilidade na Moradia e Housing Enabler; e um instrumento de coleta de dados para antecedentes sociodemograficos e de saude. Para a analise dos dados, foi utilizada estatistica descritiva e inferencial, em que foram ajustados modelos lineares multivariados e de regressao logistica. Resultados: 42,0% dos idosos apresentaram quedas, sendo maior a prevalencia nas mulheres e no grupo de 70-75 anos. Como risco de quedas, foram encontrados o ambiente fisico da moradia, caminhada e usabilidade. Encontrou-se relacao negativa entre usabilidade com sintomas depressivos, saude cognitiva, equilibrio, caminhada, ambiente social e fisico p<0,05; e forte correlacao positiva entre caminhada e equilibrio p<0,05. Conclusao: o estudo contribui para melhor compreensao formal do fenomeno das quedas ao encontrar relacao entre a usabilidade com o risco de quedas, e com outras variaveis que se relacionam com as quedas.Objective: to determine connections between competence, usability, environment and risk of falls in elderly adults. Method: correlational descriptive study, 123 elderly adults, both male and female, aged 70 years and older were included. Data was collected via the Tinetti Scale, CESD-7 Scale, Montreal Cognitive Assessment, Usability Questionnaire on Housing and Housing Enabler; and sociodemographic and health background certificate data. For data analysis, descriptive and inferential statistics were used, multivariate linear and logistic regression models were adjusted. Results: 42.0% of the elderly adults had presented with falls, with a higher prevalence in women, and in the group of 70-75 years. The physical environment of the house, gait, and usability were set as risk factors for falls. A negative relationship between usability and depressive symptoms, cognitive health, balance, gait, the social and physical environment was found, p <0.05; and a strong positive correlation between walking and balance, p <0.05. Conclusion: this study helps to better understand the phenomenon of falling, to find a connection between usability with the risk of falls, and other variables.Objetivo: determinar la relacion de la competencia, usabilidad y del entorno con el riesgo de caidas en el adulto mayor. Metodo: estudio descriptivo correlacional, se incluyeron 123 adultos mayores hombres y mujeres de 70 anos y mas. Los datos fueron recolectados con los instrumentos Escala de Tinetti, Escala CESD-7, Evaluacion Cognitiva Montreal, Cuestionario de Usabilidad en la Vivienda y Housing Enabler; y una cedula de datos para antecedentes sociodemograficos y de salud. Para el analisis de datos se utilizo una estadistica descriptiva e inferencial, en donde se ajustaron modelos lineales multivariados y de regresion logistica. Resultados: el 42,0% de los adultos mayores habia presentado caidas, con una mayor prevalencia en las mujeres y en el grupo de 70-75 anos. El entorno fisico de la vivienda, marcha y usabilidad se establecieron como riesgos de caida. Se encontro una relacion negativa entre la usabilidad y los sintomas depresivos, la salud cognitiva, el equilibrio, la marcha, el entorno social y fisico p<0,05; y una fuerte correlacion positiva entre la marcha y el equilibrio p<0,05. Conclusion: el estudio contribuye a comprender mejor el fenomeno de las caidas al encontrar relacion entre la usabilidad con el riesgo de caida, y con otras variables.Descriptores: Factores de Riesgo; Ambiente; Accidentes por Caidas; Adulto Mayor.1139

Connection between competence, usability, environment and risk of falls in elderly adults

Objetivo: determinar a relacao entre competencia, usabilidade e ambiente com risco de quedas em idosos. Metodo: estudo descritivo correlacional, incluindo 123 homens e mulheres idosos de 70 anos para mais. Os dados foram coletados com os instrumentos Escala de Tinetti, Escala CESD-7, Avaliacao Cognitiva Montreal, Questionario de Usabilidade na Moradia e Housing Enabler; e um instrumento de coleta de dados para antecedentes sociodemograficos e de saude. Para a analise dos dados, foi utilizada estatistica descritiva e inferencial, em que foram ajustados modelos lineares multivariados e de regressao logistica. Resultados: 42,0% dos idosos apresentaram quedas, sendo maior a prevalencia nas mulheres e no grupo de 70-75 anos. Como risco de quedas, foram encontrados o ambiente fisico da moradia, caminhada e usabilidade. Encontrou-se relacao negativa entre usabilidade com sintomas depressivos, saude cognitiva, equilibrio, caminhada, ambiente social e fisico p<0,05; e forte correlacao positiva entre caminhada e equilibrio p<0,05. Conclusao: o estudo contribui para melhor compreensao formal do fenomeno das quedas ao encontrar relacao entre a usabilidade com o risco de quedas, e com outras variaveis que se relacionam com as quedas.Objective: to determine connections between competence, usability, environment and risk of falls in elderly adults. Method: correlational descriptive study, 123 elderly adults, both male and female, aged 70 years and older were included. Data was collected via the Tinetti Scale, CESD-7 Scale, Montreal Cognitive Assessment, Usability Questionnaire on Housing and Housing Enabler; and sociodemographic and health background certificate data. For data analysis, descriptive and inferential statistics were used, multivariate linear and logistic regression models were adjusted. Results: 42.0% of the elderly adults had presented with falls, with a higher prevalence in women, and in the group of 70-75 years. The physical environment of the house, gait, and usability were set as risk factors for falls. A negative relationship between usability and depressive symptoms, cognitive health, balance, gait, the social and physical environment was found, p <0.05; and a strong positive correlation between walking and balance, p <0.05. Conclusion: this study helps to better understand the phenomenon of falling, to find a connection between usability with the risk of falls, and other variables.Objetivo: determinar la relacion de la competencia, usabilidad y del entorno con el riesgo de caidas en el adulto mayor. Metodo: estudio descriptivo correlacional, se incluyeron 123 adultos mayores hombres y mujeres de 70 anos y mas. Los datos fueron recolectados con los instrumentos Escala de Tinetti, Escala CESD-7, Evaluacion Cognitiva Montreal, Cuestionario de Usabilidad en la Vivienda y Housing Enabler; y una cedula de datos para antecedentes sociodemograficos y de salud. Para el analisis de datos se utilizo una estadistica descriptiva e inferencial, en donde se ajustaron modelos lineales multivariados y de regresion logistica. Resultados: el 42,0% de los adultos mayores habia presentado caidas, con una mayor prevalencia en las mujeres y en el grupo de 70-75 anos. El entorno fisico de la vivienda, marcha y usabilidad se establecieron como riesgos de caida. Se encontro una relacion negativa entre la usabilidad y los sintomas depresivos, la salud cognitiva, el equilibrio, la marcha, el entorno social y fisico p<0,05; y una fuerte correlacion positiva entre la marcha y el equilibrio p<0,05. Conclusion: el estudio contribuye a comprender mejor el fenomeno de las caidas al encontrar relacion entre la usabilidad con el riesgo de caida, y con otras variables.Descriptores: Factores de Riesgo; Ambiente; Accidentes por Caidas; Adulto Mayor.1139