Los edulcorantes y su vínculo con la obesidad

Obesity is a public health problem in most countries with industrialised lifestyles. Sweeteners are substances used to impart sweetness and flavour to foods. Their use is increasingly common in all regions of the world for weight control. However, their impact and efficacy is still unclear. As substances with a high level of sweetness, they invite consumption, which is not considered harmful, as long as it is done within the appropriate ranges. However, over-consumption can lead to metabolic disorders, especially when consuming those with a high caloric content such as sucrose or fructose. Despite this, the long-term effects of many artificial and natural sweeteners and which are best for managing obesity and other disorders such as type 2 diabetes remain unclear. Due to the great interest in sweeteners and their effect on body weight and their association with chronic degenerative diseases, this work aimed to describe and classify the most common sweeteners marketed today, as well as to explore the state of the art of the association between sweetener consumption and its influence on health, especially on obesity.La obesidad es un problema de salud pública en la mayoría de los países con estilos de vida industrializados. Los edulcorantes son sustancias que se utilizan para brindar dulzor y sabor a los alimentos. Su uso es cada vez más habitual en todas las regiones del mundo para el control del peso, sin embargo, su impacto y eficacia no está aún del todo claras. Al ser sustancias con un nivel de dulzor elevado invitan a ser consumidos, lo cual no se considera dañino, siempre y cuando se lo haga dentro de los rangos adecuados. Sin embargo, el abuso en su consumo puede ocasionar desórdenes metabólicos, especialmente al consumir aquellos con alto contenido calórico como la sacarosa o fructosa.  A pesar de esto, aún no se establece con claridad cuáles serían los efectos a largo plazo de muchos edulcorantes artificiales y naturales, ni cuáles de éstos serían los mejores para el manejo de la obesidad y otros trastornos como la diabetes tipo 2. Debido al gran interés que despiertan los edulcorantes y su posible efecto sobre el peso corporal y su asociación con enfermedades crónico degenerativas, el objetivo de este trabajo fue describir y clasificar los edulcorantes que se comercializan con mas frecuencia en la actualidad, asi como explorar el estado del arte de la asociación entre el consumo de bebidas edulcorantes y su influencia en la salud, en especial sobre la obesidad

Osteoartritis y obesidad: papel de la leptina en la articulación de la rodilla

Osteoarthritis is a disease that is increasingly present in the population due to the pandemic of obesity, formerly attributed exclusively to obesity by weight load as the only factor that injured the joints, especially weight-bearing joints, This concept has been confirmed by research and evidence that weight gain alone is not an exclusive etiological factor, since the study of adipose tissue and its endocrine action, such as the production of leptin, has demonstrated its participation in the destruction of weight-bearing and non-weight-bearing joint structures.La osteoartritis es una enfermedad que cada vez más está presente en la población debido a la pandemia de la obesidad, antiguamente se atribuía exclusivamente a la obesidad por  la carga de peso como el único factor que lesionaba a las articulaciones, especialmente a las que soportan peso, concepto que con las investigaciones y evidencias confirman que el incremento ponderal, por sí solo, no es un factor etiológico exclusivo, ya que mediante el estudio del tejido adiposo y su acción endocrina, como la producción de leptina, ha demostrado su participación en la destrucción de las estructuras articulares que soportan o no peso

Alteraciones moleculares en el individuo metabólicamente obeso con peso normal

According to their "metabolic behaviour" people with and without obesity can be classified into several metabolic phenotypes: the metabolically healthy obese individual (MHO), the metabolically unhealthy obese individual (MUO), the metabolically obese lean individual (MONW), the sarcopenic obese individual (SO) and the metabolically healthy normal-weight individual (MHNW). MOWN refers to individuals whose body mass index (BMI) is in the normal range (normal weight) but who present with metabolic disturbances such as dysglycaemia, dyslipidaemia and hypertension. The determinant causes of this phenotype are still a matter of debate, but alterations in body fat distribution, early infiltration of immune cells with monocytes to M1 macrophages polarisation, reduced gluteal-femoral adipose tissue and decreased lean mass have been cited. In clinical practice, it is essential to assess BMI and lean and fat mass distribution by anthropometric and bio-impedance techniques to establish the real risk of developing cardio-metabolic disease in people with normal weight. Según su “comportamiento metabólico” las personas con y sin obesidad pueden clasificarse en varios fenotipos metabólicos: el individuo obeso metabólicamente sano (MHO), el individuo obeso metabólicamente enfermo (MUO), el individuo delgado metabólicamente obeso (MONW), el individuo con obesidad sarcopénica (SO) y el individuo delgado metabólicamente sano (MHLI). El acrónimo MOWN se refiere a personas que según el índice de masa corporal (IMC) se encuentran en el rango de la normalidad (persona con peso normal) pero que se presenta con alteraciones metabólicas como la disglicemia, dislipidemia e hipertensión arterial. Las causas determinantes de este fenotipo aún son materia de debate, pero se han citado alteraciones en la distribución de la grasa corporal, infiltración precoz de células inmunitarias con polarización de monocitos a macrófagos M1, menor cantidad de tejido adiposo glúteo-femoral, disminución de la masa magra. En la práctica clínica es importante valorar no sólo el IMC sino la distribución de la masa magra y grasa mediante técnicas antropométricas y bio-impedanciometría que podrían ser de valor al momento de establecer el riesgo real de desarrollar enfermedad cardio-metabólica en personas con peso normal. &nbsp

Punto de corte de la circunferencia abdominal: una descripción general

Introduction: Obesity is currently considered as a "pandemic" because it is a health challenge both in developed and developing countries, reducing life expectancy by up to 20 years. Abdominal circumference (AC) serves for the diagnosis and prognosis of associations with chronic non-communicable diseases. Objective: To provide an overview of the cut- off point for AC. Methods: A literature review was performed; the sources of information were Medline, Scopus, Embase, Pubmed, ScienceDirect and Springer Link in Spanish and English, between 2016 and 2021. Results: With the bibliography collected, it can be determined that this anthropometric value reflects clinical usefulness for prognosis and diagnosis. The study showed there is a discrepancy regarding the reference point of the AC between WHO, ATPIII and ALAD. Conclusion: The impact of this review lies in the urgent search for a cut-off point for AC to provide a reference for health personnel in each countryIntroducción: La obesidad, considerada actualmente una “pandemia”, es un desafío para la salud tanto en países desarrollados como en vías de desarrollo, reduciendo la esperanza de vida hasta en 20 años. La circunferencia abdominal (CA) sirve para el diagnóstico y pronóstico de asociaciones con enfermedades crónicas no transmisibles. Objetivo: Proporcionar una visión general del punto de corte para la CA. Métodos: Revisión de la literatura; las fuentes de información fueron Medline, Scopus, Embase, Pubmed, ScienceDirect y Springer Link en español e inglés, entre 2016 y 2021. Resultados: Con la bibliografía recolectada se puede determinar que este valor antropométrico refleja utilidad clínica para el pronóstico y diagnóstico. Mostrando que existe una discrepancia en cuanto al punto de referencia de la CA entre la OMS, ATPIII y ALAD. Conclusión: El impacto de esta radica en la búsqueda urgente de un punto de corte de AC que sirva de referencia para el personal de salud de cada país

Factores asociados a microalbuminuria y enfermedad renal crónica en pacientes diabéticos que acuden al Hospital Básico de Paute, Ecuador

Objective: To determine the associated factor to microalbuminuria and Chronic Kidney Disease (CKD) in diabetic patients of the Hospital Basico de Paute, Ecuador. Materials and methods: This was a descriptive and cross-sectional study in patients with type 2 diabetes mellitus of the Hospital Básico de Paute diabetes club during the period January to August 2018, a questionnaire validated by 2 experts in diabetes mellitus was used, the following data was reported: personal, anthropometric, microalbuminuria levels and glomerular filtration rate. Results: Out of the 80 patients evaluated, 73.8% (n=59) were female, microalbuminuria was present in 20% (n=16) of the cases and the majority of subjects were in stage 2 of CKD when applying the MDRD-4 formula. The main factor associated with microalbuminuria was occupation, with a lower frequency in patients with household activities (70 years of age increased as the Glomerular Filtration Rate decreased (Stage 1: 6.7% vs. Stage 3: 53.8%). Conclusion: The patients of the Hospital Basico de Paute diabetes club, Ecuador have a prevalence of microalbuminuria similar to previous reports, especially Latin America, with a classification of CKD in the first stages. Being the laboral status the main factor associated to microalbuminuria and the age related to the stage of CKD

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele