Sandra Wilches-Duran

Optimal cutoff for the evaluation of insulin resistance through triglyceride-glucose index: A cross-sectional study in a Venezuelan population

Background: Insulin resistance (IR) evaluation is a fundamental goal in clinical and epidemiological research. However, the most widely used methods are difficult to apply to populations with low incomes. The triglyceride-glucose index (TGI) emerges as an alternative to use in daily clinical practice. Therefore the objective of this study was to determine an optimal cutoff point for the TGI in an adult population from Maracaibo, Venezuela. Methods: This is a sub-study of Maracaibo City Metabolic Syndrome Prevalence Study, a descriptive, cross-sectional study with random and multi-stage sampling. For this analysis, 2004 individuals of both genders ≥18 years old with basal insulin determination and triglycerides < 500 mg/dl were evaluated.. A reference population was selected according to clinical and metabolic criteria to plot ROC Curves specific for gender and age groups to determine the optimal cutoff point according to sensitivity and specificity.The TGI was calculated according to the equation: ln [Fasting triglyceride (mg / dl) x Fasting glucose (mg / dl)] / 2. Results: The TGI in the general population was 4.6±0.3 (male: 4.66±0.34 vs. female: 4.56±0.33, p=8.93x10 -10). The optimal cutoff point was 4.49, with a sensitivity of 82.6% and specificity of 82.1% (AUC=0.889, 95% CI: 0.854-0.924). There were no significant differences in the predictive capacity of the index when evaluated according to gender and age groups. Those individuals with TGI≥4.5 had higher HOMA2-IR averages than those with TGI <4.5 (2.48 vs 1.74, respectively, p<0.001). Conclusions: The TGI is a measure of interest to identify IR in the general population. We propose a single cutoff point of 4.5 to classify individuals with IR. Future studies should evaluate the predictive capacity of this index to determine atypical metabolic phenotypes, type 2 diabetes mellitus and even cardiovascular risk in our population.

Biochemical and clinical characterization of metabolic phenotypes: a cross-sectional study from Maracaibo city, Venezuela

In 1980, Reuben Andresen observed that in certain Background: individuals, obesity did not increase mortality, introducing an atypical phenotype called “healthy obese”. Other studies reported that 10-15 % of lean individuals presented insulin resistance, hyperglycemia and dyslipidemia. The objective of this study was to evaluate biochemical and clinical characteristics of metabolic phenotypes in Maracaibo city. A descriptive, cross-sectional sub-analysis of The Maracaibo Methods: City Metabolic Syndrome Prevalence Study, with a randomized multistage sampling was performed including 1226 non diabetic individuals from both sexes. For phenotype definition, the subjects were first classified according to their BMI into Normal-Weight, Overweight and Obese; then divided in metabolically healthy and unhealthy using a two-step analysis cluster being predictive variables: HOMA2-IR, HOMA2-βcell, triglycerides. To evaluate the relationship with coronary risk, a multiple logistic regression model was performed. In the studied population, 43.9% (n=538) were healthy normal Results: weight, 5.2% (n=64) unhealthy normal weight, 17.4% (n=217) healthy obese and 33.5% (n=411) unhealthy obese subjects. Atypical phenotypes, Metabolically Unhealthy Normal-Weight (MUNW) was more frequent in males (56.3%), whereas Metabolically Unhealthy Obese (MUO) was more frequent in females (51.3%). This phenotypes had a higher coronary event risk, especially for obese individuals (MHO: OR=1.85 CI95%: 1.11-3.09; p=0.02 and MUO: OR=2.09 CI95%: 1.34-3.28; p<0.01). Individuals with atypical metabolic phenotypes are common in Conclusion: Maracaibo city. Related factors may include insulin resistance, basal glucose, and triglycerides levels. Lastly, obese subjects show a higher 1,2 2,3 2 2 2 2 4 2 1 1 1 1 1 1

Approximation of a R+D+I program for the agro-industry of Stevia rebaudiana (Bertoni), as a substitution alternative of Erythroxylum coca (Lam) for the Post-conflict in Catatumbo, Colombia

The purpose of this dissertation is to investigate if the cultivation of Stevia rebaudiana (Bertoni) may be an effective alternative to replace Erythroxylum coca (Lam) from the ground; secondly, to design an approximation of a R+D+I program that could provide cognitive and methodological support of the processes of introduction, establishment and substitution in the framework of armed post-conflict in Catatumbo, Colombia. The methodology used consisted of a documentary research, resulting in phases or aspects to be considered for the program, which are: study and zoning of agro-climatic conditions in the region of Catatumbo; Evaluation and introduction of cultivars; Design and validation of the technological pattern of production, such as monoculture and polyculture; Post-harvest handling, Artisanal and Industrial processing; Exploration of medicinal, food and industrial applications; Marketing and national and international trade, and the economic, social, environmental and political aspects of the introduction and establishment of this agro-industrial chain in Catatumbo. It is concluded that planting Stevia rebaudiana (Bertoni), is an effective alternative to replace Erythroxylum coca (Lam) and the presented program can be a cognitive and methodological support to its introduction and sustainable

Educación Superior y la Formación en Emprendimiento Interdisciplinario: Un Caso de Estudio

espanolLa investigacion que se presenta analiza desde el paradigma positivista deductivo-logico, la relacion entre la interdisciplinariedad de equipos emprendedores, y las evaluaciones sobre innovacion e impacto en la sociedad de ideas de negocio propuestas por una muestra de 540 estudiantes universitarios agrupados en 116 equipos (formados por 4 o 5 estudiantes). Se calcula el Indice de Variacion Cualitativa (IQV) para determinar el nivel de interdisciplinariedad de los equipos. Para el contraste de hipotesis de asociacion entre las variables independientes y dependientes se emplea analisis de varianza (ANOVA). Despues de confirmar la existencia de diferencias significativas, se aplica la prueba Post-hoc para establecer los niveles donde se hallaban dichas diferencias. Se concluye que el promedio de la evaluacion obtenido en innovacion y el impacto social de la ideas de negocios es significativamente mayor en los grupos con mayor nivel de interdisciplinariedad, que en los conformados por estudiantes de la misma disciplina. EnglishThis research analyzes from a deductive-logical positivist paradigm, the relationship between interdisciplinary of teams of entrepreneurs and the evaluation of innovation and impact on society of business ideas proposed by a sample of 540 university students grouped in 116 teams (formed by 4 or 5 students). Index of Qualitative Variation (IQV) is calculated to determine the level of interdisciplinary teams. To test the hypothesis of association between the independent variable and dependent variable the statistical technique analysis of variance (ANOVA) was used. After checking that there are significant differences the Post-hoc multiple comparisons test is applied, to determine the levels where such differences occurred. It is concluded that average evaluation obtained in innovation and the impact on society of the business ideas is significantly higher in the groups with higher level of interdisciplinary, than in those that are conformed by students of the same discipline.