Jorge Sapunar

Ejercicio físico interválico de alta intensidad mejora el control glicémico y la capacidad aeróbica en pacientes con intolerancia a la glucosa

BACKGROUND Proper exercise training modifies intra miocellular energy utilization, glucose transport and mitochondrial biogenesis. AIM To determine the therapeutic effects of a high intensity intermittent training (HIIT) program on glucose homeostasis, physical fitness and body fat in glucose intolerant patients. PATIENTS AND METHODS Eighteen patients with overweight or obesity and glucose intolerance were invited to participate in an exercise program consisting in three sessions per week for 3 months. Ten participants aged 35 ± 13 years who attended > 26 of the planned 36 sessions, were considered as adherent to exercise. The other eight participants aged 37 ± 17 years, who attended to a mean of 13 sessions, were considered as non-adherent. Both groups had similar body weight, body mass index, body fat, plasma glucose 2 h after an oral glucose load and maximal oxygen uptake. All these variables were measured at the end of exercise intervention. Each session consisted of 1 min exercise of cycling at maximal intensity until muscle fatigue followed by 2 min rest, repeated 10 times. RESULTS Among adherent participants, twelve weeks of HIIT improved significantly maximal oxygen uptake (6.1 + 3.6 mL/kg/min or 24.6%), reduced 2 h post load blood glucose (-33.7 + 47.9 mg/dL or -12.5%) and body fat (-4.3 + 5.6 kg). No significant changes were observed in the non-adherent group. CONCLUSIONS HIIT exercise reduces blood glucose after an oral load in glucose intolerant patients.

FTO gene is related to obesity in Chilean Amerindian children and impairs HOMA-IR in prepubertal girls.

The objective of this study was to investigate the allelic frequency of the fat mass and obesity‐associated (FTO) gene (rs9939609) and its influences on obesity and metabolic risk biomarkers in a cohort of normal weight and obese Chilean children determining its ethnicity.

Epidemiología del sobrepeso y obesidad infanto-juvenil en las comunas de Concepción, Coronel y Hualpén, VIII Región de Chile

En las ultimas decadas la prevalencia de sobrepeso y obesidad infanto-juvenil a nivel mundial ha aumentado progresivamente. En nuestro pais se han encontrado altas tasas de prevalencia para estos trastornos nutricionales, particularmente en ciertos grupos etarios. El proposito de nuestra investigacion fue conocer la prevalencia de sobrepeso y obesidad infanto-juvenil en las comunas de Concepcion, Coronel y Hualpen. Adicionalmente se busco identificar grupos de riesgo para estos trastornos nutricionales en la muestra de poblacion de interes. Para ello se solicito a la Junta Nacional de Auxilio Escolar y Becas (JUNAEB) los resultados de la evaluacion realizada a los establecimientos educacionales bajo su supervision el ano 2006 en las mencionadas comunas. Se incluyeron solo escolares entre 6 y 18 anos, considerando para el calculo de la edad la fecha del reporte (31 de Marzo del 2006). Las prevalencias de sobrepeso y obesidad de acuerdo al criterio CDC fueron 11,19% y 6,54% respectivamente. Al realizar las estimaciones mediante el criterio IOTF se encontro que la prevalencia de sobrepeso fue 13,19% y la de obesidad 4,03%. Independientemente del sexo, se observo una mayor frecuencia de sobrepeso y obesidad en el grupo etario

Es la etnia mapuche un factor de riesgo para padecer fractura de fémur proximal en adultos mayores

: A case control study. Cases were subjects over 55 years of age admit-ted, during one year, for hip fracture not associated to major trauma or tumors. Controls wererandomly chosen from other hospital services and paired for age with cases. The magnitude ofthe association between ethnicity and hip fracture was expressed as odds ratio in a logistic re-gression model.

Asociación entre polimorfismos del gen de adiponectina y estado nutricional en escolares de la comuna de Hualpén

Background: Several genetic polymorphisms of adiponectin have been associated to metabolic diseases as obesity and co-morbidities. Aim: To investigate if there are associations between +45TG, +276GT, -11,377CG y -11,391GA adiponectin SNPs (single nucleotide polymorphism) with obesity in a Chilean children population. Material and Methods: A case-control study was performed in 241 obese and 126 normal weight children (7-11 years old) from the urban community of Hualpen, Biobio region. Children were classified as normal or obese, according to age and gender-specificpercentiles defined by Centerfor Disease Control and Prevention (CDC). The analysis of serum markers was carried out using commercial kits. Adiponectin polymorphisms were determined through a High Resolution Melting (HRM)-enabled real time PCR and by DNA fragment sequencing. Results: The observed allelic frequencies of the studied SNPs were over 11%. The 11,377CG polymorphism was associated with a high risk of obesity, calculated by the additive inheritance model (odds ratio = 1.389, 95% confidence interval: 1.001-1.929,p = 0.049). Conclusions: Obese school children of the Biobio Region, have an increased risk of carrying the susceptibility allele polymorphism 11377CG of adiponectin gene.

II Consenso de la Sociedad Chilena de Endocrinología y Diabetes sobre resistencia a la insulina

Insulin resistance is a prevalent condition commonly associated with unhealthy lifestyles. It affects several metabolic pathways, increasing risk of abnormalities at different organ levels. Thus, diverse medical specialties should be involved in its diagnosis and treatment. With the purpose of unifying criteria about this condition, a scientific-based consensus was elaborated. A questionnaire including the most important topics such as cardio-metabolic risk, non-alcoholic fatty liver disease and polycystic ovary syndrome, was designed and sent to national experts. When no agreement among them was achieved, the Delphi methodology was applied. The main conclusions reached are that clinical findings are critical for the diagnosis of insulin resistance, not being necessary blood testing. Acquisition of a healthy lifestyle is the most important therapeutic tool. Insulin-sensitizing drugs should be prescribed to individuals at high risk of disease according to clinically validated outcomes. There are specific recommendations for pregnant women, children, adolescents and older people.Insulin resistance is a prevalent condition commonly associated with unhealthy lifestyles. It affects several metabolic pathways, increasing risk of abnormalities at different organ levels. Thus, diverse medical specialties should be involved in its diagnosis and treatment. With the purpose of unifying criteria about this condition, a scientific-based consensus was elaborated. A questionnaire including the most important topics such as cardio-metabolic risk, non-alcoholic fatty liver disease and polycystic ovary syndrome, was designed and sent to national experts. When no agreement among them was achieved, the Delphi methodology was applied. The main conclusions reached are that clinical findings are critical for the diagnosis of insulin resistance, not being necessary blood testing. Acquisition of a healthy lifestyle is the most important therapeutic tool. Insulin-sensitizing drugs should be prescribed to individuals at high risk of disease according to clinically validated outcomes. There are specific recommendations for pregnant women, children, adolescents and older people.

Efecto del estado nutricional neonatal en el riesgo de síndrome metabólico en niños obesos de 2 comunas de la Región del Bío-Bío

: A nested case/control study in a sample of 410 obese school children aged 10 to 16 years (57% males) was performed. The dichotomous response variable was the presence of MS defined as International Diabetes Federation (IDF) or Cook’s criteria. The ex-posure variable was having NPI < percentile (p) 10.BACKGROUND Neonatal malnutrition defined by birth weight (BW) is a risk factor for obesity and cardio-metabolic diseases in adults. Neonatal ponderal index (NPI) may have better diagnostic value than BW to establish nutritional status. AIM To determine the effect of neonatal nutritional status, established by the three NPI curves available in Chile, on the risk of Metabolic Syndrome (MS) in obese school children. MATERIAL AND METHODS A nested case/control study in a sample of 410 obese school children aged 10 to 16 years (57% males) was performed. The dichotomous response variable was the presence of MS defined as International Diabetes Federation (IDF) or Cooks criteria. The exposure variable was having NPI < percentile (p) 10. RESULTS The frequency of MS was 36 and 39% according to the IDF and Cook criteria, respectively. The proportion of children with neonatal malnutrition exceeded 20%. A significantly increased risk for MS was only found when PNI was defined according to Lagoss Table and MS was defined using IDF criteria. Having a PNI > p90, however, showed a trend towards a reduced risk of MS, which only reached significance using Lagoss Table and Cooks Criteria. CONCLUSIONS Neonatal malnutrition defined by NPI is common in obese school children. The condition of neonatal under nutrition defined as PNI < p10 may be a risk factor for developing MS. Instead, having a NPI > p90 could be protective.