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Hypertension is associated with insulin resistance (IR), metabolic syndrome (MS), and arterial stiffness. Non-insulin-based IR indexes were developed as tools for metabolic screening. Here, we aimed to evaluate the novel non-insulin-based Metabolic Score for IR (METS-IR) index for the prediction of incident hypertension and arterial stiffness evaluated using pulse wave velocity (PWV) analysis, compared with other non-insulin-based IR indexes. We evaluated two populations, a cross-sectional evaluation of high-risk individuals (n = 305) with a wide range of metabolic comorbidities and dyslipidemia in whom PWV measurement was performed and a 3-year prospective cohort of normotensive individuals (N = 6850). We observed a positive correlation between METS-IR and PWV in the cross-sectional cohort, which was higher compared with other non-insulin-based fasting IR indexes; furthermore, PWV values >75th percentile were associated with the upper tercile of METS-IR values. In the prospective cohort, we observed an increased risk for incident hypertension for the upper METS-IR tercile (METS-IR ≥ 46.42; HR: 1.81, 95% CI: 1.41-2.34), adjusted for known cardiovascular risk factors, and observed that METS-IR had greater increases in the predictive capacity for hypertension along with SBP and the Framingham Hypertension Risk Prediction Model compared with other non-insulin-based IR indexes. Therefore, METS-IR is a novel non-insulin-based IR index which correlates with arterial stiffness and is a predictor of incident hypertension, complementary to previously validated risk prediction models., (©2019 Wiley Periodicals, Inc.)

Protein-coding genetic variants that strongly affect disease risk can yield relevant clues to disease pathogenesis. Here we report exome-sequencing analyses of 20,791 individuals with type 2 diabetes (T2D) and 24,440 non-diabetic control participants from 5 ancestries. We identify gene-level associations of rare variants (with minor allele frequencies of less than 0.5%) in 4 genes at exome-wide significance, including a series of more than 30 SLC30A8 alleles that conveys protection against T2D, and in 12 gene sets, including those corresponding to T2D drug targets (P = 6.1 × 10 -3 ) and candidate genes from knockout mice (P = 5.2 × 10 -3 ). Within our study, the strongest T2D gene-level signals for rare variants explain at most 25% of the heritability of the strongest common single-variant signals, and the gene-level effect sizes of the rare variants that we observed in established T2D drug targets will require 75,000-185,000 sequenced cases to achieve exome-wide significance. We propose a method to interpret these modest rare-variant associations and to incorporate these associations into future target or gene prioritization efforts.

Background: Type 2 diabetes mellitus (T2D) is a leading cause of morbidity and mortality in Mexico. Here, we aimed to report incidence rates (IR) of type 2 diabetes in middle-aged apparently-healthy Mexican adults, identify risk factors associated to ID and develop a predictive model for ID in a high-risk population., Methods: Prospective 3-year observational cohort, comprised of apparently-healthy adults from urban settings of central Mexico in whom demographic, anthropometric and biochemical data was collected. We evaluated risk factors for ID using Cox proportional hazard regression and developed predictive models for ID., Results: We included 7636 participants of whom 6144 completed follow-up. We observed 331 ID cases (IR: 21.9 per 1000 person-years, 95%CI 21.37-22.47). Risk factors for ID included family history of diabetes, age, abdominal obesity, waist-height ratio, impaired fasting glucose (IFG), HOMA2-IR and metabolic syndrome. Early-onset ID was also high (IR 14.77 per 1000 person-years, 95%CI 14.21-15.35), and risk factors included HOMA-IR and IFG. Our ID predictive model included age, hypertriglyceridemia, IFG, hypertension and abdominal obesity as predictors (D xy  = 0.487, c-statistic = 0.741) and had higher predictive accuracy compared to FINDRISC and Cambridge risk scores., Conclusions: ID in apparently healthy middle-aged Mexican adults is currently at an alarming rate. The constructed models can be implemented to predict diabetes risk and represent the largest prospective effort for the study metabolic diseases in Latin-American population.

The prevalence of obesity in Mexico is the highest in the world, with almost 70% of adults being classified as overweight or obese. The increased prevalence of obesity in Mexico, and globally, may be related to the changing food environment, providing increased access to highly palatable, but obesogenic, food products. One potential mechanism for this association is changing food perceptions, an area poorly studied in transitional countries. Thus, we conducted a study to determine the degree to which perception thresholds for four basic tastes are associated with anthropometric variables, hormone levels, and energy intake. Bitter and sweet taste had the lowest and highest thresholds, respectively, and women reported a greater sensitivity to these flavors compared to men. Overall, the perception thresholds to each flavor were not associated with energy intake or body mass index (BMI), while the perception threshold of aspartame was negatively associated with energy intake. Based on the results of our study, in a sample of Mexican adults, sensory taste response to basic flavors is not associated with energy intake or BMI., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

In a prospective study performed between January, 1989 to August, 1988, we evaluated the association between hyperprolactinemia and its clinical features. Of the 58 subjects included: 23 had hyperprolactinemia and 35 were controls. The most frequent clinical manifestations in hyperprolactinemic patients were galactorrhea (43.4%) and amenorrhea (17.3%) amenorrhea-galactorrhea syndrome was found in only 8.6% cases with hyperprolactinemia. We found a statistically significant correlation (R = 0.66, p less than 0.01) between serum prolactin levels and clinical symptoms in hyperprolactinemic patients.