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Petermann-Rocha F, Apolinar E, Nazar G, Diaz-Toro F, Celis A, Deo S, Ferrari G, O'Donovan G. Associations of diabesity with all-cause and cardiovascular disease mortality: Findings from the Mexico City Prospective Study. Diabetes Obes Metab 2024; 26:2199-2208. [PMID: 38439662 DOI: 10.1111/dom.15528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 03/06/2024]
Abstract
AIM To investigate the joint associations of diabetes and obesity with all-cause and cardiovascular disease (CVD) mortality in the Mexico City Prospective Study. MATERIALS AND METHODS In total, 154 128 participants (67.2% women) were included in this prospective analysis. Diabetes was self-reported, while body mass index was used to calculate obesity. Using diabetes and obesity classifications, six groups were created: (a) normal (no diabetes and normal weight); (b) normal weight and diabetes; (c) overweight but not diabetes (overweight); (d) overweight and diabetes (prediabesity); (e) obesity but not diabetes (obesity); and (f) obesity and diabetes (diabesity). Associations between these categories and outcomes were investigated using Cox proportional hazard models adjusted for confounder factors. RESULTS During 18.3 years of follow-up, 27 197 (17.6%) participants died (28.5% because of CV causes). In the maximally adjusted model, participants those with the highest risk {hazard ratio (HR): 2.37 [95% confidence interval (CI): 2.24-2.51]}, followed by those with diabesity [HR: 2.04 (95% CI: 1.94-2.15)]. Similar trends of associations were observed for CVD mortality. The highest CV mortality risk was observed in individuals with diabesity [HR: 1.80 (95% CI: 1.63-1.99)], followed by normal weight and diabetic individuals [HR: 1.78 (95% CI: 1.60-1.98)]. CONCLUSION This large prospective study identified that diabetes was the main driver of all-cause and CVD mortality in all the categories studied, with diabesity being the riskiest. Given the high prevalence of both conditions in Mexico, our results reinforce the importance of initiating prevention strategies from an early age.
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Affiliation(s)
- Fanny Petermann-Rocha
- Centro de Investigación Biomédica, Facultad de Medicina, Universidad Diego Portales, Santiago, Chile
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Evelia Apolinar
- Unidad de Metabolismo y Nutrición, Departamento de Investigación, Hospital Regional de Alta Especialidad del Bajío, Secretaría de Salud, León, Mexico
| | - Gabriela Nazar
- Departamento de Psicología, Universidad de Concepción, Concepción, Chile
- Centro de Vida Saludable, Universidad de Concepción, Concepción, Chile
| | - Felipe Diaz-Toro
- Facultad de Enfermeria, Universidad Andrés Bello, Santiago, Chile
| | - Andrés Celis
- Facultad de Odontología, Universidad de los Andes, Santiago, Chile
| | - Salil Deo
- Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA
- Case School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago, Chile
| | - Gary O'Donovan
- Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
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Espinosa-Montero J, Monterrubio-Flores E, Aguilar-Tamayo M, Macías-Morales N, Sanchez-Dominguez M, Campos-Nonato I. Indicators of Dietary Behavior and Physical Activity Change Associated with Metabolic Control of Obesity, Hypertension, and Type 2 Diabetes Mellitus in Mexican Adults: National Nutrition and Health Survey in Mexico, 2016. Metab Syndr Relat Disord 2024. [PMID: 38683637 DOI: 10.1089/met.2023.0264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
Introduction: Obesity (OB), type 2 diabetes mellitus (T2D), and hypertension (HTN) are health issues in Mexico linked to unhealthy behaviors. This study investigates the relationship between behavior change indicators and metabolic control in Mexican adults with OB, T2D, and HTN. Methods: We used data from the 2016 National Health and Nutrition Survey Midway (ENSANUT MC-2016), representing ∼59.5 million Mexican adults aged 20-59 with these conditions. We assessed behavior change indicators, including stages of change, self-efficacy, and perceptions of benefits and barriers. In addition, we conducted descriptive analyses and used statistical tests, such as Pearson's chi-squared test and logistic regression models, adjusted for multiple variables. Results: We found that adults in the action and maintenance stages of physical activity (PA) were four times more likely to have adequate HTN control than those in the precontemplation stage. Self-efficacy for PA was related to better control in T2D and HTN. Self-efficacy for reducing the consumption of sugary beverages was positively associated with control in OB and T2D. No significant association was observed with self-efficacy for consuming fruits and vegetables. Conclusion: Behavior-change indicators are significantly linked to metabolic control in adults with HTN. These results support the importance of these indicators in managing chronic diseases such as HTN and their potential use in public health strategies.
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Affiliation(s)
- Juan Espinosa-Montero
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Eric Monterrubio-Flores
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Manuel Aguilar-Tamayo
- Institute of Education Sciences, Autonomous University of the State of Morelos, Mexico City, Mexico
| | - Nayeli Macías-Morales
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
| | - Mario Sanchez-Dominguez
- Health Equity Research Department, Center for Research in Health Systems, National Institute of Public Health, México City, Mexico
| | - Ismael Campos-Nonato
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
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Perichart-Perera O, Reyes-Muñoz E, Borboa-Olivares H, Rodríguez-Cano AM, Solis Paredes JM, Hernández-Hernández L, Rodríguez-Hernández C, González-Ludlow I, Suárez-Rico BV, Sánchez-Martínez M, Torres-Herrera U, Canul-Euan AA, Tolentino-Dolores M, Espejel-Nuñez A, Estrada-Gutierrez G. Optimizing perinatal wellbeing in pregnancy with obesity: a clinical trial with a multi-component nutrition intervention for prevention of gestational diabetes and infant growth and neurodevelopment impairment. Front Med (Lausanne) 2024; 11:1339428. [PMID: 38681052 PMCID: PMC11045894 DOI: 10.3389/fmed.2024.1339428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/18/2024] [Indexed: 05/01/2024] Open
Abstract
Pregnancy complicated by obesity represents an increased risk of unfavorable perinatal outcomes such as gestational diabetes mellitus (GDM), hypertensive disorders in pregnancy, preterm birth, and impaired fetal growth, among others. Obesity is associated with deficiencies of micronutrients, and pregnant women with obesity may have higher needs. The intrauterine environment in pregnancies complicated with obesity is characterized by inflammation and oxidative stress, where maternal nutrition and metabolic status have significant influence and are critical in maternal health and in fetal programming of health in the offspring later in life. Comprehensive lifestyle interventions, including intensive nutrition care, are associated with a lower risk of adverse perinatal outcomes. Routine supplementation during pregnancy includes folic acid and iron; other nutrient supplementation is recommended for high-risk women or women in low-middle income countries. This study is an open label randomized clinical trial of parallel groups (UMIN Clinical Trials Registry: UMIN000052753, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000060194) to evaluate the effect of an intensive nutrition therapy and nutrient supplementation intervention (folic acid, iron, vitamin D, omega 3 fatty acids, myo-inositol and micronutrients) in pregnant women with obesity on the prevention of GDM, other perinatal outcomes, maternal and newborn nutritional status, and infant growth, adiposity, and neurodevelopment compared to usual care. Given the absence of established nutritional guidelines for managing obesity during pregnancy, there is a pressing need to develop and implement new nutritional programs to enhance perinatal outcomes.
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Affiliation(s)
- Otilia Perichart-Perera
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Enrique Reyes-Muñoz
- Gynecological and Perinatal Endocrinology Coordination, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Hector Borboa-Olivares
- Community Interventions Research Branch, Instituto Nacional de Perinatología, Mexico City, Mexico
| | | | - Juan Mario Solis Paredes
- Department of Research in Reproductive and Perinatal Health, Instituto Nacional de Perinatología, Mexico City, Mexico
| | | | | | - Isabel González-Ludlow
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City, Mexico
| | | | | | | | | | | | - Aurora Espejel-Nuñez
- Department of Immunobiochemistry, Instituto Nacional de Perinatología, Mexico City, Mexico
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Meaney E, Pérez-Robles E, Ortiz-Flores M, Perez-Ishiwara G, Meaney A, Munguía L, Roman G, Nájera N, Ceballos G. Overweight, Obesity, and Age Are the Main Determinants of Cardiovascular Risk Aggregation in the Current Mexican Population: The FRIMEX III Study. J Clin Med 2024; 13:2248. [PMID: 38673521 PMCID: PMC11051286 DOI: 10.3390/jcm13082248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/09/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Background: The Mexican population exhibits several cardiovascular risk factors (CVRF) including high blood pressure (HBP), dysglycemia, dyslipidemia, overweight, and obesity. This study is an extensive observation of the most important CVFRs in six of the most populated cities in Mexico. Methods: In a cohort of 297,370 participants (54% female, mean age 43 ± 12.6 years), anthropometric (body mass index (BMI)), metabolic (glycemia and total cholesterol (TC)), and blood pressure (BP) data were obtained. Results: From age 40, 40% and 30% of the cohort's participants were overweight or obese, respectively. HBP was found in 27% of participants. However, only 8% of all hypertensive patients were controlled. Fifty percent of the subjects 50 years and older were hypercholesterolemic. Glycemia had a constant linear relation with age. BMI had a linear correlation with SBP, glycemia, and TC, with elevated coefficients in all cases and genders. The β1 coefficient for BMI was more significant in all equations than the other β, indicating that it greatly influences the other CVRFs. Conclusions: TC, glycemia, and SBP, the most critical atherogenic factors, are directly related to BMI.
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Affiliation(s)
- Eduardo Meaney
- Laboratorio de Investigación Cardiometabólica Integral, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico (E.P.-R.); (M.O.-F.)
| | - Enrique Pérez-Robles
- Laboratorio de Investigación Cardiometabólica Integral, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico (E.P.-R.); (M.O.-F.)
| | - Miguel Ortiz-Flores
- Laboratorio de Investigación Cardiometabólica Integral, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico (E.P.-R.); (M.O.-F.)
| | - Guillermo Perez-Ishiwara
- Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Mexico City 07320, Mexico;
| | - Alejandra Meaney
- Cardiovascular Unit, Hospital Regional “1° de Octubre”, Instituto de Seguridad Social y Servicios para los Trabajadores del Estado, Mexico City 07760, Mexico
| | - Levy Munguía
- Dirección Normativa de Salud, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Mexico City 06030, Mexico
| | - Gisele Roman
- Coalición por el Corazón de México, Mexico City 01090, Mexico
| | - Nayelli Nájera
- Laboratorio de Investigación Cardiometabólica Integral, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico (E.P.-R.); (M.O.-F.)
| | - Guillermo Ceballos
- Laboratorio de Investigación Cardiometabólica Integral, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico (E.P.-R.); (M.O.-F.)
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Ferreira SRG, Macotela Y, Velloso LA, Mori MA. Determinants of obesity in Latin America. Nat Metab 2024; 6:409-432. [PMID: 38438626 DOI: 10.1038/s42255-024-00977-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 01/04/2024] [Indexed: 03/06/2024]
Abstract
Obesity rates are increasing almost everywhere in the world, although the pace and timing for this increase differ when populations from developed and developing countries are compared. The sharp and more recent increase in obesity rates in many Latin American countries is an example of that and results from regional characteristics that emerge from interactions between multiple factors. Aware of the complexity of enumerating these factors, we highlight eight main determinants (the physical environment, food exposure, economic and political interest, social inequity, limited access to scientific knowledge, culture, contextual behaviour and genetics) and discuss how they impact obesity rates in Latin American countries. We propose that initiatives aimed at understanding obesity and hampering obesity growth in Latin America should involve multidisciplinary, global approaches that consider these determinants to build more effective public policy and strategies, accounting for regional differences and disease complexity at the individual and systemic levels.
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Affiliation(s)
| | - Yazmín Macotela
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, UNAM Campus-Juriquilla, Querétaro, Mexico
| | - Licio A Velloso
- Obesity and Comorbidities Research Center, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil
| | - Marcelo A Mori
- Institute of Biology, Universidade Estadual de Campinas, Campinas, Brazil.
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Nájera N, Ortíz-Flores M, Pérez-Durán J, Reyes-Muñoz E, Romo-Yañez J, Ortiz-Luna G, Villarreal F, Meaney E, Ceballos G, Montoya-Estrada A. Improving Cardiovascular Risk in Postmenopausal Women with an (-)-Epicatechin-Based Nutraceutical: A Randomly Assigned, Double-Blind vs. Placebo, Proof-of-Concept Trial. J Clin Med 2023; 13:195. [PMID: 38202201 PMCID: PMC10779966 DOI: 10.3390/jcm13010195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/24/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Age-adjusted rates of cardiovascular disease (CVD) are higher in men than in women. CVD risk-factor outcomes are underrecognized, underestimated, and undertreated in women because the clinical expressions in women differ from those of men. There are no universally accepted recommendations on what to do in women when the values of fasting glucose, blood pressure, and lipids are only slightly altered or at borderline values. We reported the positive effects on CVD risk markers using cacao by-products, showing that alternative approaches can be used to prevent cardiovascular disease in women. The objective was to evaluate the changes in lipoprotein subfractions induced by three months of treatment with an epicatechin-enriched cacao supplement. METHODS A double-blind, placebo-controlled proof-of-concept study was developed to evaluate the effects of 3 months of treatment with an (-)-epicatechin-enriched cacao supplement on lipoprotein subfractions. RESULTS The usual screening workshop for postmenopausal women could be insufficient and misleading. Assessing the effect of a (-)-epicatechin-enriched cacao supplement employing a lipoprotein subfractionation profile analysis suggests a decrease in cardiovascular risk. CONCLUSIONS A simple, low-cost, safe (-)-epicatechin-enriched cacao supplement product can improve the cardiovascular risk in postmenopausal women.
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Affiliation(s)
- Nayelli Nájera
- Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (N.N.); (M.O.-F.)
| | - Miguel Ortíz-Flores
- Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (N.N.); (M.O.-F.)
| | - Javier Pérez-Durán
- Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (N.N.); (M.O.-F.)
- Reproductive and Perinatal Health Research Department, National Institute of Perinatology, Ministry of Health, Mexico City 11000, Mexico
| | - Enrique Reyes-Muñoz
- Coordination of Gynecological and Perinatal Endocrinology, National Institute of Perinatology, Ministry of Health, Mexico City 11000, Mexico; (E.R.-M.)
| | - José Romo-Yañez
- Coordination of Gynecological and Perinatal Endocrinology, National Institute of Perinatology, Ministry of Health, Mexico City 11000, Mexico; (E.R.-M.)
| | - Guillermo Ortiz-Luna
- Peri and Postmenopause Clinic, National Institute of Perinatology, Ministry of Health, Mexico City 11000, Mexico
| | - Francisco Villarreal
- School of Medicine, University of California San Diego, San Diego, CA 92093, USA;
| | - Eduardo Meaney
- Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (N.N.); (M.O.-F.)
| | - Guillermo Ceballos
- Sección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (N.N.); (M.O.-F.)
| | - Araceli Montoya-Estrada
- Coordination of Gynecological and Perinatal Endocrinology, National Institute of Perinatology, Ministry of Health, Mexico City 11000, Mexico; (E.R.-M.)
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Islas-Garduño AL, Romero-Cerecero O, Jiménez-Aparicio AR, Tortoriello J, Montiel-Ruiz RM, González-Cortazar M, Zamilpa A. Pharmacological and Chemical Analysis of Bauhinia divaricata L. Using an In Vitro Antiadipogenic Model. Plants (Basel) 2023; 12:3799. [PMID: 38005696 PMCID: PMC10674420 DOI: 10.3390/plants12223799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023]
Abstract
Obesity is characterized by an excessive and abnormal accumulation of fat. According to the 2022 National Health and Nutrition Survey, in Mexico, the prevalence of overweight and obesity-diagnosed if one's body mass index (BMI) was ≥25 kg/m2-in adults was 75.2%. A strong association between the amount of visceral fat and diseases such as diabetes mellitus type II has been recognized. Species of the Bauhinia genus have lipid-lowering and antidiabetic properties. The aim of this work was to evaluate the lipolytic and antiadipogenic activity of Bauhinia divaricata L. in 3T3-L1 cells and to identify the major compounds in the bioactive treatments. The extraction of aerial parts allowed us to obtain hexanic (BdHex), ethyl acetate (BdEAc), and hydroalcoholic (BdHA) extracts. Lipid levels were measured in 3T3-L1 cells differentiated into adipocytes. Our evaluation of cell viability identified an IC50 > 1000 μg/mL in all the extracts, and our evaluation of the antiadipogenic activity indicated that there was a significant reduction (p < 0.001) in the accumulation of lipids with hydroalcoholic (60%) and ethyl acetate (75%) extracts of B. divaricate compared with metformin at 30 mM (65%). The major compounds identified in these extracts were as follows: triacetin (1), 2,3-dihydroxypropyl acetate (2), (3E)-2-methyl-4-(1,3,3-trimethyl-7-oxabicyclo[4.1.0]hept-2-yl)-3-buten-2-ol (3), 2,5-dihydroxyphenylacetic acid (4), (3R)-3-hydroxydodecanoic acid (5), kaempferol-3-O-rhamnoside (6), and quercetin 3-O-rhamnoside (7). Some of these naturally occurring compounds have been related to the anti-obesity effects of other medicinal plants; therefore, these compounds isolated from B. divaricata could be responsible for inhibiting the differentiation process from preadipocytes to mature adipocytes.
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Affiliation(s)
- Ana Laura Islas-Garduño
- Centro de Desarrollo de Productos Bióticos, Instituto Politécnico Nacional, Yautepec 62739, Mexico;
- Centro de Investigación Biomédica del Sur, Instituto Mexicano del Seguro Social, Xochitepec 62790, Mexico; (O.R.-C.); (J.T.); (R.M.M.-R.); (M.G.-C.)
| | - Ofelia Romero-Cerecero
- Centro de Investigación Biomédica del Sur, Instituto Mexicano del Seguro Social, Xochitepec 62790, Mexico; (O.R.-C.); (J.T.); (R.M.M.-R.); (M.G.-C.)
| | | | - Jaime Tortoriello
- Centro de Investigación Biomédica del Sur, Instituto Mexicano del Seguro Social, Xochitepec 62790, Mexico; (O.R.-C.); (J.T.); (R.M.M.-R.); (M.G.-C.)
| | - Rosa Mariana Montiel-Ruiz
- Centro de Investigación Biomédica del Sur, Instituto Mexicano del Seguro Social, Xochitepec 62790, Mexico; (O.R.-C.); (J.T.); (R.M.M.-R.); (M.G.-C.)
| | - Manases González-Cortazar
- Centro de Investigación Biomédica del Sur, Instituto Mexicano del Seguro Social, Xochitepec 62790, Mexico; (O.R.-C.); (J.T.); (R.M.M.-R.); (M.G.-C.)
| | - Alejandro Zamilpa
- Centro de Investigación Biomédica del Sur, Instituto Mexicano del Seguro Social, Xochitepec 62790, Mexico; (O.R.-C.); (J.T.); (R.M.M.-R.); (M.G.-C.)
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8
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Domínguez-Ramírez L, Sosa-Jurado F, Díaz-Sampayo G, Solis-Tejeda I, Rodríguez-Pérez F, Pelayo R, Santos-López G, Cortes-Hernandez P. Age and Comorbidities as Risk Factors for Severe COVID-19 in Mexico, before, during and after Massive Vaccination. Vaccines (Basel) 2023; 11:1676. [PMID: 38006008 PMCID: PMC10674414 DOI: 10.3390/vaccines11111676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/26/2023] Open
Abstract
During 2020-2023, Mexico had a large COVID-19 emergency with >331,000 adult deaths and one of the highest excess mortalities worldwide. Age at COVID-19 death has been lower in Mexico than in high-income countries, presumably because of the young demographics and high prevalence of chronic metabolic diseases in young and middle-aged adults. SARS-CoV-2 vaccination covered 85% of adults with at least one dose and 50% with booster(s) up to April 2022. No new vaccination efforts or updated boosters were introduced until October 2023; thus, we explored the public health impact of massive SARS-CoV-2 vaccination against ancestral strains and asked whether their real-world protection has persisted through time. We compared three periods with respect to vaccine roll-outs: before, during and after vaccine introduction in a national retrospective cohort of >7.5 million COVID-19 cases. The main findings were that after vaccination, COVID-19 mortality decreased, age at COVID-19 death increased by 5-10 years, both in populations with and without comorbidities; obesity stopped being a significant risk factor for COVID-19 death and protection against severe disease persisted for a year after boosters, including at ages 60-79 and 80+. Middle-aged adults had the highest protection from vaccines/hybrid immunity and they more than halved their proportions in COVID-19 deaths.
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Affiliation(s)
- Lenin Domínguez-Ramírez
- Population Health and Metadynamics Lab, Centro de Investigacion Biomedica de Oriente, Instituto Mexicano del Seguro Social Atlixco, Atlixco 74360, Puebla, Mexico; (L.D.-R.); (G.D.-S.)
| | - Francisca Sosa-Jurado
- Virology Lab, Centro de Investigacion Biomedica de Oriente, Instituto Mexicano del Seguro Social, Atlixco 74360, Puebla, Mexico; (F.S.-J.); (G.S.-L.)
| | - Guadalupe Díaz-Sampayo
- Population Health and Metadynamics Lab, Centro de Investigacion Biomedica de Oriente, Instituto Mexicano del Seguro Social Atlixco, Atlixco 74360, Puebla, Mexico; (L.D.-R.); (G.D.-S.)
| | - Itzel Solis-Tejeda
- Population Health and Metadynamics Lab, Centro de Investigacion Biomedica de Oriente, Instituto Mexicano del Seguro Social Atlixco, Atlixco 74360, Puebla, Mexico; (L.D.-R.); (G.D.-S.)
| | - Francisco Rodríguez-Pérez
- Population Health and Metadynamics Lab, Centro de Investigacion Biomedica de Oriente, Instituto Mexicano del Seguro Social Atlixco, Atlixco 74360, Puebla, Mexico; (L.D.-R.); (G.D.-S.)
| | - Rosana Pelayo
- Oncoimmunology and Cytomics Lab, Centro de Investigacion Biomedica de Oriente, Instituto Mexicano del Seguro Social, Atlixco 74360, Puebla, Mexico;
- Unidad de Educación e Investigación, Instituto Mexicano del Seguro Social, Dirección de Prestaciones Médicas, Mexico City 06725, Mexico
| | - Gerardo Santos-López
- Virology Lab, Centro de Investigacion Biomedica de Oriente, Instituto Mexicano del Seguro Social, Atlixco 74360, Puebla, Mexico; (F.S.-J.); (G.S.-L.)
| | - Paulina Cortes-Hernandez
- Population Health and Metadynamics Lab, Centro de Investigacion Biomedica de Oriente, Instituto Mexicano del Seguro Social Atlixco, Atlixco 74360, Puebla, Mexico; (L.D.-R.); (G.D.-S.)
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9
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Pérez-Beltrán YE, González-Becerra K, Rivera-Iñiguez I, Martínez-López E, Ramos-Lopez O, Alcaraz-Mejía M, Rodríguez-Echevarría R, Sáyago-Ayerdi SG, Mendivil EJ. A Nutrigenetic Strategy for Reducing Blood Lipids and Low-Grade Inflammation in Adults with Obesity and Overweight. Nutrients 2023; 15:4324. [PMID: 37892400 PMCID: PMC10609523 DOI: 10.3390/nu15204324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023] Open
Abstract
The pathogenesis of obesity and dyslipidemia involves genetic factors, such as polymorphisms related to lipid metabolism alterations predisposing their development. This study aimed to evaluate the effect of a nutrigenetic intervention on the blood lipid levels, body composition, and inflammation markers of adults with obesity and overweight. Eleven genetic variants associated with dyslipidemias in Mexicans were selected, and specific nutrigenetic recommendations for these polymorphisms were found. One hundred and one adults were recruited and assigned to follow either a standard or nutrigenetic diet for eight weeks. Anthropometric, biochemical, body composition, and inflammation markers were evaluated through standardized methods. Weighted genetic risk scores (wGRSs) were computed using the study polymorphisms. After intervention, both diets significantly decreased the anthropometric parameters and body composition (p < 0.05). Only the nutrigenetic diet group showed significant reductions in VLDL-c (p = 0.001), triglycerides (p = 0.002), TG:HDL (p = 0.002), IL-6 (p = 0.002), and TNF-α (p = 0.04). wGRSs had a high impact on the ΔTGs and ΔVLDL-c of both groups (standard diet: ΔTGs: Adj R2 = 0.69, p = 0.03; ΔVLDL-c: Adj R2 = 0.71, p = 0.02; nutrigenetic diet: ΔTGs: Adj R2 = 0.49, p = 0.03 and ΔVLDL-c: R2 = 0.29, p = 0.04). This nutrigenetic intervention improved lipid abnormalities in patients with excessive body weight. Hence, nutrigenetic strategies could be coadjuvant tools and enhance the standard dietary treatment for cardiometabolic diseases.
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Affiliation(s)
- Yolanda E. Pérez-Beltrán
- Laboratorio Integral de Investigación en Alimentos, Tecnológico Nacional de México/Instituto Tecnológico de Tepic, Tepic 63175, Nayarit, Mexico;
| | - Karina González-Becerra
- Departamento de Ciencias Médicas y de la Vida, Centro Universitario de la Ciénega, Instituto de Investigación en Genética Molecular, Universidad de Guadalajara, Ocotlán 47820, Jalisco, Mexico;
| | - Ingrid Rivera-Iñiguez
- Department of Pediatrics, University of California, UCSD Center for Healthy Eating and Activity Research (CHEAR), San Diego, CA 92037, USA;
| | - Erika Martínez-López
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Departamento de Biología Molecular y Genómica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (E.M.-L.); (R.R.-E.)
| | - Omar Ramos-Lopez
- Facultad de Medicina y Psicología, Universidad Autónoma de Baja California, Tijuana 22390, Baja California, Mexico;
| | - Mildreth Alcaraz-Mejía
- Departamento de Electrónica, Sistemas e Informática, ITESO, Unioversidad Jesuita de Guadalajara, Tlaquepaque 45604, Jalisco, Mexico;
| | - Roberto Rodríguez-Echevarría
- Instituto de Nutrigenética y Nutrigenómica Traslacional, Departamento de Biología Molecular y Genómica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico; (E.M.-L.); (R.R.-E.)
| | - Sonia G. Sáyago-Ayerdi
- Laboratorio Integral de Investigación en Alimentos, Tecnológico Nacional de México/Instituto Tecnológico de Tepic, Tepic 63175, Nayarit, Mexico;
| | - Edgar J. Mendivil
- Departamento de Salud, Universidad Iberoamericana, Ciudad de Mexico 01219, Mexico
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10
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Mendoza-Cano O, Trujillo X, Ríos-Silva M, Lugo-Radillo A, Benites-Godínez V, Bricio-Barrios JA, Cuevas-Arellano HB, Ríos-Bracamontes EF, Serrano-Moreno W, Cárdenas Y, Murillo-Zamora E. Association between Vaccination Status for COVID-19 and the Risk of Severe Symptoms during the Endemic Phase of the Disease. Vaccines (Basel) 2023; 11:1512. [PMID: 37896916 PMCID: PMC10610663 DOI: 10.3390/vaccines11101512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/15/2023] [Accepted: 09/19/2023] [Indexed: 10/29/2023] Open
Abstract
The global health emergency caused by COVID-19 concluded in May 2023, marking the beginning of an endemic phase. This study aimed to evaluate the association between vaccination status and other patient characteristics and the risk of severe disease during this new endemic period. A nationwide cohort study was conducted in Mexico, where we analyzed data from 646 adults who had received positive confirmation of COVID-19 through PCR testing from May to August 2023. The overall risk of severe symptoms in the study sample was 5.3%. The average time elapsed from the last vaccine shot to symptom onset was over six months in all the immunized groups (1, 2 or 3 vaccine doses). Compared to unvaccinated patients, those with three vaccine doses showed an elevated risk of severe symptoms. Advancing age and various chronic comorbidities (specifically cardiovascular, kidney, and obstructive pulmonary conditions) were associated with a heightened risk of severe COVID-19 manifestations. These findings underscore the ongoing seriousness of COVID-19, even in an endemic phase, underscoring the urgent need for tailored interventions aimed at high-risk patients.
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Affiliation(s)
- Oliver Mendoza-Cano
- Facultad de Ingeniería Civil, Universidad de Colima, km. 9 Carretera Colima-Coquimatlán, Coquimatlán 28400, Mexico
- Centro de Estudios e Investigación en Biocultura, Agroecología, Ambiente y Salud Colima, Ex-Hacienda Nogueras S/N, Nogueras 28450, Mexico
| | - Xóchitl Trujillo
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Av. 25 de Julio 965, Colima 28045, Mexico
| | - Mónica Ríos-Silva
- CONAHCyT—Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Av. 25 de Julio 965, Colima 28045, Mexico
| | - Agustin Lugo-Radillo
- CONAHCyT—Faculty of Medicine and Surgery, Universidad Autónoma Benito Juárez de Oaxaca, Ex Hacienda Aguilera S/N, Carr. a San Felipe del Agua, Oaxaca 68020, Mexico
| | - Verónica Benites-Godínez
- Coordinación de Educación en Salud, Instituto Mexicano del Seguro Social, Calzada del Ejercito Nacional 14, Tepic 63169, Mexico
- Unidad Académica de Medicina, Universidad Autónoma de Nayarit, Ciudad de la Cultura Amado Nervo, Tepic 63155, Mexico
| | | | | | - Eder Fernando Ríos-Bracamontes
- Departamento de Medicina Interna, Hospital General de Zona No. 1, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Villa de Álvarez 28984, Mexico
| | - Walter Serrano-Moreno
- Facultad de Medicina, Universidad de Colima, Av. Universidad 333, Colima 28040, Mexico
| | - Yolitzy Cárdenas
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Av. 25 de Julio 965, Colima 28045, Mexico
| | - Efrén Murillo-Zamora
- Unidad de Investigación en Epidemiología Clínica, Instituto Mexicano del Seguro Social, Av. Lapislázuli 250, Villa de Álvarez 28984, Mexico
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11
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Martínez-Marroquín Y, Meaney A, Samaniego-Méndez V, Nájera N, Ceballos G, Fernández-Barros C, Meaney E. The TG/HDL-c Lipid Ratio as a Cardiovascular Risk Marker in a Mexican Urban Middle-Class Population: Do We Need a Risk Score Tailored for Mexicans? J Clin Med 2023; 12:6005. [PMID: 37762944 PMCID: PMC10531773 DOI: 10.3390/jcm12186005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/28/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION Risk scores are essential in primary prevention to detect high-risk patients. The most common scores exclude hypertriglyceridemia and abdominal obesity in their risk assessment. We examined the triglyceride/HDL-cholesterol (TG/HDL-c) ratio as a cardiovascular (CV) risk marker in a middle-class urban Mexican population sample. AIM Our aim was to test the concept of a scoring system reflecting Mexican population characteristics. METHODS A total of 2602 healthy adults from the Lindavista primary prevention program were considered, evaluating gender, age, blood pressure, smoking, body mass index, waist circumference, lipid profile, and fasting glucose. According to the abnormality, a score from -3 to +3 was assigned. RESULTS The summation of eleven variables yielded the Lindavista score (LS), which was calibrated versus the TG/HDL ratio and ACC ASCVD Risk Estimator Plus score to determine its correlation with risk categories. The TG/HDL-c ratio had a linear correlation with LS and high-risk ACC ASCVD categories. CONCLUSIONS Compared with LS and TG/HDL-c, the ACC ASCVD system underestimates the high-risk category. The high prevalence of obesity and lipid triad in the Mexican population requires a scale that considers those traits. The TG/HDL-c ratio is a practical, easy, and economical instrument to categorize risk in Mexicans.
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Affiliation(s)
| | - Alejandra Meaney
- Cardiovascular Unit, Hospital Regional “1° de Octubre”, ISSSTE, Lindavista, Mexico City 07760, Mexico
| | - Virginia Samaniego-Méndez
- Cardiovascular Unit, Hospital Regional “1° de Octubre”, ISSSTE, Lindavista, Mexico City 07760, Mexico
| | - Nayelli Nájera
- Laboratorio de Investigación Cardiometabólica Integral, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (N.N.); (G.C.)
| | - Guillermo Ceballos
- Laboratorio de Investigación Cardiometabólica Integral, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (N.N.); (G.C.)
| | | | - Eduardo Meaney
- Laboratorio de Investigación Cardiometabólica Integral, Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (N.N.); (G.C.)
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