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Rodriguez-Moran M.,Mexican Social Security Institute | Rodriguez-Moran M.,Research Group on Diabetes and Chronic Illnesses | Guerrero-Romero F.,Mexican Social Security Institute | Guerrero-Romero F.,Research Group on Diabetes and Chronic Illnesses | And 6 more authors.
Pediatric Diabetes | Year: 2010

Objective: To determine whether the association between family history of diabetes (FHD) and impaired fasting glucose (IFG) is independent of body mass index (BMI) in children and adolescents. Methods: In all 443 (11.9%) children and adolescents with FHD, and 3280 (88.1%) without FHD were enrolled in a population-based cross-sectional study. Eligible subjects to participate were apparently healthy children and adolescents aged 7-15 yr from Middle and Northern Mexico. Obesity was defined by age- and gender-specific BMI ≥ 95th percentile. FHD was defined as positive if at least one first degree relative had diabetes. The IFG was defined by fasting plasma glucose ≥ 100 mg/dL and < 126 mg/dL. Results: IFG was identified in 390 (88.0%) and 62 (1.9%) children and adolescents with and without FHD, respectively. In the group with positive FHD, IFG was diagnosed in 146 (37.4%), 79 (20.2%), and 165 (42.3%) children and adolescents who were obese, overweight, and normal-weight, respectively. On the other hand, in the group without FHD, IFG was identified in 21 (33.9%), 14 (22.6%), and 27 (43.5%) children and adolescents who were obese, overweight, and normal-weight, respectively. In the overall population, the age-, sex-, and BMI-adjusted logistic regression analysis showed a strong and independent association between FHD and IFG [odds ratio (OR) -11.7; 95% CI 9.5-21.2]. This association remained strong for girls and boys in a subsequent analysis stratified for BMI category. Conclusions: The presence of FHD in a first degree relative is associated with IFG, even in the absence of obesity. © 2009 John Wiley & Sons A/S.


Guerrero-Romero F.,Mexican Social Security Institute | Guerrero-Romero F.,Research Group on Diabetes and Chronic Illnesses | Simental-Mendia L.E.,Mexican Social Security Institute | Simental-Mendia L.E.,Research Group on Diabetes and Chronic Illnesses | And 9 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2010

Context: To meet the worldwide challenge of emerging diabetes, accessible and inexpensive tests to identify insulin resistance are needed. Objective: To evaluate the sensitivity and specificity of the product of fasting, we compared the triglycerides and glucose (TyG) index, a simple measure of insulin resistance, with the euglycemichyperinsulinemic clamp test. Design and Setting: We conducted a cross-sectional study of the general population and outpatients of the Internal Medicine Department at the Medical Unit of High Specialty of the Specialty Hospital at the West National Medical Center in Guadalajara, Mexico. Patients: Eleven nonobese healthy subjects, 34 obese normal glucose tolerance individuals, 22 subjects with prediabetes, and 32 diabetic patients participated in the study. Intervention: We performed a euglycemic-hyperinsulinemic clamp test. Main Outcome Measures: Sensitivity and specificity of the TyG index [Ln(fasting triglycerides) (mg/dl) x fasting glucose (mg/dl)/2] were measured, as well as the area under the curve of the receiver operating characteristic scatter plot and the correlation between the TyG index and the total glucose metabolism (M) rates. Results: Pearson's correlation coefficient between the TyG index and M rates was -0.681 (P < 0.005). Correlation between the TyG index and M rates was similar between men (-0.740) and women (-0.730), nonobese (-0.705) and obese (-0.710), and nondiabetic (-0.670) and diabetic (-0.690) individuals. The best value of the TyG index for diagnosis of insulin resistance was 4.68, which showed the highest sensitivity (96.5%) and specificity (85.0%; area under the curve + 0.858). Conclusions: The TyG index has high sensitivity and specificity, suggesting that it could be useful for identification of subjects with decreased insulin sensitivity. Copyright © 2010 by The Endocrine Society.


Rodriguez-Hernandez H.,Mexican Social Security Institute | Rodriguez-Hernandez H.,Research Group on Diabetes and Chronic Illnesses | Rodriguez-Hernandez H.,Mexico State University | Cervantes-Huerta M.,Mexican Social Security Institute | And 6 more authors.
Annals of Hepatology | Year: 2010

Objective. To determine the clinical characteristics of NAFLD in asymptomatic obese women. Methods. A total of 457 asymptomatic obese women were enrolled in a cross-sectional study and allocated into groups with and without NAFLD. Irrespective of ALT levels, diagnosis of NAFLD was established by ultrasonographic findings; irrespective of fibrosis, NASH was defined by hepatic histological changes. Results. One hundred ninety five (42.7%) women had elevated ALT levels. Diagnosis of NAFLD was established in 228 (49.9%) women; among women with NAFLD, 34 (14.9%) have ALT levels within the normal range. On the other hand, based on the healthy range for ALT levels (19 Ul/L), 336 (73.5%) women had elevated ALT, but only 2 (0.9%) women with NAFLD exhibited ALT levels within normal healthy values. Furthermore, 93 (41%) women who had AST/ALT levels * 1 underwent liver biopsy; of these, 90 (96.8%) had diagnosis of NASH and 3 (3.2%) of hepatic cirrhosis. Women with NAFLD were more obese and have higher fasting plasma glucose, triglycerides, ALT, and AST levels than obese women without NAFLD. Seventy six (16.6%) women had diagnosis of diabetes; of these 47 (61.8) in the NAFLD group. Conclusions. Results of this study support the statement that women with NAFLD have an adverse metabolic profile. Furthermore, our results show that hyperglycemia, hypertriglyceridemia and markers of liver injury such as AST/ALT > 1 may be useful for early recognition of NAFLD.


Rodriguez-Moran M.,Mexican Social Security Institute | Rodriguez-Moran M.,Research Group on Diabetes and Chronic Illnesses | Guerrero-Romero F.,Mexican Social Security Institute | Guerrero-Romero F.,Research Group on Diabetes and Chronic Illnesses | And 8 more authors.
Diabetes and Vascular Disease Research | Year: 2013

We evaluate the relationship between different lipoproteins and atherogenic indices with pre-hypertension in 297 obese and 942 non-obese children with Tanner stage 1 enrolled in a multicentre, community-based cross-sectional study. Height, weight, fasting glucose and insulin levels, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), non-HDL-c, LDL/HDL-c, triglycerides/cholesterol and total cholesterol/HDL-c ratios were measured. Mean age was 8.4 ± 1.2 years; pre-hypertension was identified in 104 (8.4%) participants, 46 (15.5%) obese and 58 (6.1%) non-obese children. The pre-hypertensive non-obese children show a high proportion of family history of hypertension (41.6 and 24.7%, p = 0.002) and elevation of insulin at a relatively low body mass index. The triglycerides:HDL-c ratio, but not other lipoproteins or atherogenic indices, was associated with pre-hypertension in obese (1.15, 95% confidence intervals 1.06-1.26) and non-obese children (1.38 95% confidence intervals 1.22-1.57). The triglycerides:HDL-c ratio is related to pre-hypertension in children; the family history of hypertension seems to be a risk factor in developing pre-hypertension. © 2012 The Author(s).


Simental-Mendia L.E.,Mexican Social Security Institute | Simental-Mendia L.E.,Research Group on Diabetes and Chronic Illnesses | Rodriguez-Moran M.,Mexican Social Security Institute | Rodriguez-Moran M.,Research Group on Diabetes and Chronic Illnesses | And 2 more authors.
Endocrine Research | Year: 2015

Aim of the study: The objective of this study was to determine if hypertriglyceridemia is associated with isolated impaired glucose tolerance in subjects without insulin resistance. Materials and methods: A total of 365 apparently healthy individuals aged 20-65 years were enrolled in a population-based cross-sectional study. Subjects were allocated into the groups with and without hypertriglyceridemia. Age, gender, body mass index, and waist circumference were matched criteria. Individuals with impaired fasting glucose, impaired fasting glucose+impaired glucose tolerance, diabetes, homeostasis model assessment of insulin resistance index ≥2.5, and/or chronic illnesses such as renal disease or malignancy were excluded. Hypertriglyceridemia was defined by triglycerides levels ≥150mg/dL. Impaired glucose tolerance was defined by plasma glucose concentration 2-h post-load glucose ≥140mg/dL <200mg/dL. Subjects with impaired glucose tolerance were required to have fasting plasma glucose levels <100mg/dL. Logistic regression analysis was used to compute the odds ratio between hypertriglyceridemia (independent variable) and impaired glucose tolerance (dependent variable). Results: A total of 132 and 233 subjects were allocated into the groups with and without hypertriglyceridemia, respectively. The frequency of impaired glucose tolerance was 13.6% and 5.6% in the individuals with and without hypertriglyceridemia, p=0.01. The logistic regression analysis adjusted by gender, blood pressure, and high-density lipoprotein cholesterol showed that hypertriglyceridemia is significantly associated with impaired glucose tolerance (OR 2.34; 95% CI: 1.02-5.32, p=0.04). Conclusion: Results of this study indicate that hypertriglyceridemia is independently associated with isolated impaired glucose tolerance in subjects without insulin resistance. © 2015 Informa Healthcare USA, Inc.


Rodriguez-Hernandez H.,Mexican Social Security Institute | Rodriguez-Hernandez H.,Research Group on diabetes and Chronic Illnesses | Cervantes-Huerta M.,Mexican Social Security Institute | Cervantes-Huerta M.,Research Group on diabetes and Chronic Illnesses | And 4 more authors.
Magnesium Research | Year: 2010

To evaluate the effect of oral supplementation with magnesium chloride on the systemic and hepatic inflammation, 38 non-hypertensive obese women aged 30 to 65 years were allocated into groups with and without hypo- magnesemia. Hypomagnesemic women drank 50 mL of 5% solution of MgCl2 equivalent to 450 mg of elemental magnesium. Low-carbohydrate diets and physical activity were indicated for women in both groups. Chronic diarrhea, alcohol intake, use of diuretics, previous oral magnesium supplementation, hepatic disease, and renal damage were exclusion criteria. Hypomagnesemia is defined by serum magnesium concentrations ≤ 1.8 mg/dL, hepatic inflammation by serum alanine aminotransferase (ALT) levels ≥ 40 U/L, and systemic inflam- mation by serum high-sensitivity C reactive protein (hs-CRP) concentration ≥3 mg/L. At baseline (p=0.06) and final of follow-up (p=0.80), there were no significant differences by body mass index between the groups in the study. In the same way, at baseline ALT (48.1 ± 25.5 and 34.6 ± 24.1 U/L, p = 0.14) and hs-CRP (9.4 ± 6.0 and 7.9 ± 5.9 mg/dL, p = 0.47) levels were similar in the supplemented and non-supplemented women. In the magnesium group, ALT (24.3 ± 10.3 and 34.8 ± 13.6 U/L, p = 0.02) levels, but not hs-CRP (5.2 ± 1.9 and 8.0 ± 5.6 mg/L, p = 0.08) reached significantly lower levels, in the fourth month of treatment, than in women in the control group. The adjusted odds ratios between the improvement in serum magnesium and reduction in ALT and hs-CRP levels were 0.56 (95% CI: 0.3-0.9) and 0.93 (95% CI: 0.6-29.9), respectively. Results of this study show that in hypomagnesemic obese women, oral supplementation with magnesium chloride reduces plasma ALT levels; hs-CRP levels only show a reduction trend.


Rodriguez-Moran M.,Mexican Social Security Institute at Durango | Rodriguez-Moran M.,Research Group on Diabetes and Chronic Illnesses | Aradillas-Garcia C.,Autonomous University of San Luis Potosi | Simental-Mendia L.E.,Mexican Social Security Institute at Durango | And 6 more authors.
American Journal of Hypertension | Year: 2010

Background: To determine the relationship between family history of hypertension (FHH) and cardiovascular risk factors (CVRF) in healthy prepubertal children. Methods: Design: Cross-sectional, population-based study. Setting: Elementary schools from San Luis Potosi and Durango, cities in middle and northern Mexico. Participants: A total of 358 randomly enrolled, healthy boys and girls aged 6-10 years in Tanner stage 1, with and without FHH. Outcome measures: Odds ratio (OR) that estimates the relationship between FHH and CVRF. Results: FHH was identified in 72 (20.1%) children; 212 (59.2%) children had at least one CVRF, where low high-density lipoprotein (HDL)-cholesterol (36.3%), elevated waist circumference (WC) (29.3%), and hypertriglyceridemia (28.8%) were the most frequent; high-blood pressure (HBP) and hyperglycemia were recognized in 10 (3.3%) and 1 (0.3%) children. Metabolic syndrome and hyperinsulinemia were identified in 36 (10.0%) and 48 (13.4%) children. In all subjects, hyperinsulinemia (OR 2.0; 95% confidence interval (CI) 1.2-8.4), but not other CVRF was significantly associated with FHH. Subsequent analysis stratified by WC showed that FHH was not associated with CVRF in children with elevated WC. Among children with nonelevated WC, FHH in the maternal branch, but not in the paternal branch, was associated with hyperinsulinemia (OR 1.5; 95% CI 1.1-5.5), HBP (OR 4.0; 95% CI 1.3-30.1), hypertriglyceridemia (OR 1.6; 95% CI 1.1-7.2), and low HDL-cholesterol (OR 1.3; 95% CI 1.1-3.0).Conclusion Results: show that FHH in the maternal branch is associated with CVRF in children with nonelevated WC. © 2010 American Journal of Hypertension, Ltd.


Aradillas-Garcia C.,Autonomous University of San Luis Potosi | Rodriguez-Moran M.,Mexican Social Security Institute | Rodriguez-Moran M.,Research Group on Diabetes and Chronic Illnesses | Garay-Sevilla M.E.,University of Guanajuato | And 4 more authors.
European Journal of Endocrinology | Year: 2012

Objective: Several cutoff points of the homeostasis model assessment of insulin resistance (HOMA-IR; varying from 2.5 to 4.0) have been suggested for diagnosing IR in youth. In this study, we determined the distribution of the HOMA-IR in Mexican children and adolescents. Design and methods: A total of 6132 children and adolescents from San Luis Potosi, León, Queretaro, and Durango, which are cities in central and northern Mexico, were enrolled in a population-based cross-sectional study. Eligible participants were apparently healthy children and adolescents aged 6-18 years. Pregnancy and the presence of chronic illnesses were exclusion criteria. Results: A total of 3701 (60.3%) girls and 2431 (39.7%) boys were included in this study. In the overall population, the mean body mass index, insulin levels, and fasting glucose levels were 21.8 ± 1.3 kg/m 2, 7.1 ± 3.2 μU/ml, and 86.2 ± 10.0 mg/dl respectively. The concentrations of insulin and fasting glucose gradually increased from 6 to 12 years of age, whereas the concentrations tended to plateau in the 13- to 18-year-old population. The absolute mean of the HOMA-IR was 2.89 ± 0.7. The HOMA-IR gradually increased with age and reached a plateau at 13 years of age. Conclusions: Because the insulin concentrations, glucose levels, and HOMA-IR exhibited a gradual increase with age that was not related to obesity, our results suggested that the evaluation of IR in children should be based on percentiles of the HOMA-IR rather than a dichotomous value derived from a single cutoff point. © 2012 European Society of Endocrinology.

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