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OBJECTIVES: To determine the relationship between apolipoprotein E (APOE) epsilon4 and Alzheimer's disease (AD) in the Mexican Mestizo population, as well as its effects on the cognitive profile of AD and elderly Mestizos without dementia. DESIGN: Cross-sectional analysis of a cohort study. SETTING: Evaluations were conducted at the geriatrics clinic of an academic medical hospital in Mexico City. PARTICIPANTS: Forty-nine elderly subjects with AD and 141 controls selected from a representative sample of Mexican Mestizos aged 65 to 96 who participated in the Prevalence Survey of Dementia in the Mexico City Elderly Population cohort. MEASUREMENTS: All subjects underwent APOE genotypification and a comprehensive clinical and neuropsychological evaluation. RESULTS: There were no significant differences in epsilon3 and epsilon4 frequencies between the subjects with and without AD and a tendency toward higher epsilon4 and lower epsilon3 allele frequencies in subjects aged 75 and older. No association was found between APOE epsilon4 and the presence of AD. The age-, sex-, and education-adjusted risk for AD associated with at least one epsilon4 allele was 1.01 (95% confidence interval=0.45-2.23). Performance on a long-term visual memory test was significantly worse in APOE epsilon4 carriers than in APOE epsilon3 carriers only in the group with AD. CONCLUSION: APOE epsilon4 did not increase the risk for AD in this Mexican Mestizo elderly urban population sample, although the presence of this allele seems to modify its clinical expression. [ABSTRACT FROM AUTHOR]

Although ATP-binding cassette transporter A1 (ABCA1) is well known for its role in cholesterol efflux and HDL formation, it is expressed in various tissues, where it may have different functions. Because hypoalphalipoproteinemia is highly prevalent in Mexico, we screened the ABCA1 coding sequence in Mexican individuals with low and high HDL cholesterol levels to seek functional variants. A highly frequent nonsynonymous variant (R230C) was identified in low-HDL cholesterol but not in high-HDL cholesterol individuals (P = 0.00006). We thus assessed its frequency in the Mexican-Mestizo general population, seeking possible associations with several metabolic traits. R230C was screened in 429 Mexican Mestizos using Taqman assays, and it was found in 20.1% of these individuals. The variant was significantly associated not only with decreased HDL cholesterol and apolipoprotein A-I levels but also with obesity (odds ratio 2.527, P = 0.005), the metabolic syndrome (1.893, P = 0.0007), and type 2 diabetes (4.527, P = 0.003). All of these associations remained significant after adjusting for admixture (P = 0.011, P = 0.001, and P = 0.006, respectively). This is the first study reporting the association of an ABCA1 variant with obesity and obesity-related comorbidities as being epidemiologically relevant in the Mexican population. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical characteristics of the diabetic population that formed part of a population-based survey conducted in México.Research Design and Methods: In 2000, information was obtained from 42,886 subjects aged > or =20 years using a multistage sampling procedure. Standardized questionnaires were used. Anthropometric measurements, blood pressure, and capillary glucose concentrations were taken.Results: Type 2 diabetes was found in 3,597 subjects (age-adjusted prevalence 8.18%), of which 2,878 (80%) had previously been diagnosed. The average age of the diabetic participants was 55.2 +/- 13.5 years; 13% were <40 years of age. Nine percent had been diagnosed for >10 years. The average BMI was 29.2 +/- 5.7 kg/m(2); three-quarters of the cases had BMI >25 kg/m(2). The average waist circumference was 102 +/- 13.4 cm, and increased waist circumference was more common among women. Arterial hypertension was found in half of the cases and, of those on treatment, only one-third had a blood pressure <140/90 mmHg. Smoking was reported in 34% of the diabetic group, a higher rate than in the nondiabetic subjects. There was at least one modifiable coronary risk factor in 67.6% of the cases. Very few followed an exercise or dietary regimen and a small percentage used insulin.Conclusions: Diabetes affects a large proportion of Mexican adults (8.18%). This figure may be underestimated. The majority of the subjects had modifiable risk factors for the chronic complications of diabetes. Only a few achieved adequate blood pressure control and other treatment goals. [ABSTRACT FROM AUTHOR]

PURPOSE: The purpose of this study was to measure the level of diabetes knowledge in a representative group of Mexican individuals with diabetes and to identify the factors that influence it. METHODS: A validated questionnaire was administered to 570 outpatients, 11.2 % had Type 1 diabetes, 36.4 % had Type 2 diabetes treated with insulin, and 52.2 % had Type 2 diabetes treated with oral agents. Samples for HbA1c determination also were obtained. RESULTS: The percentage of correct answers in each section of the questionnaire was low. Type I patients had the highest scores, followed by the insulin-treated Type 2 patients; those with chronic complications also had high scores. Educational background, attendance at diabetes courses, age, and HbA1c concentration were the main predictors of knowledge. Attendance at courses was influenced by the severity of the disease. CONCLUSIONS: The amount of patient knowledge about diabetes-related issues was low in this representative Mexican population. The educational efforts were focused on those with the worst metabolic control and/or with diabetes complications. [ABSTRACT FROM AUTHOR]

We evaluated factors associated with fetal losses in patients with severe lupus in a nested case-control study. We assessed separately 73 pregnancies that occurred in 46 women from a cohort of 633 Systemic Lupus Erythematosus (SLE) patients. They had at least one preg nancy after SLE diagnosis, one or more of our severity criteria and all had taken immuno suppressive drugs. Included data were related to disease severity, anti-phospholipid syndrome (APS), anticardiolipin antibodies (a-CL ab), and drugs received during preg nancy. Cases were pregnancies with fetal wastage; controls were pregnancies with live-born children.The mean age at pregnancy was 26.6 ± 4.5 years. Cases had longer disease duration, 6.1 ± 3.5 years vs 4.5 ± 4.3 of controls (p = 0.02); higher prevalence of renal involvement, hemolysis and recurrent venous thrombosis (p < 0.05); they also tended to have a greater prevalence of a-CL ab, and previous fetal losses (p = 0.06). Cases used azathioprine more frequently than controls (p = 0.04). Univariate analysis showed an association of renal involvement, hemolytic anemia, azathioprine or cyclophosphamide prescription during pregnancy, previous fetal losses and APS with fetal wastage. Immunosuppressive drugs and the APS remained significant in the multivariate analysis (p = 0.05; F = 0.01). Factors related with fetal losses in women with severe SLE were: longer disease duration, ingestion of immunosuppressive drugs during pregnancy and any related manifestation of APS. We did not find macroscopic malformations in live-children of women that took azathioprine during pregnancy. [ABSTRACT FROM PUBLISHER]