Clinical significance of HIV-1 coreceptor usage

The identification of phenotypically distinct HIV-1 variants with different prevalence during the progression of the disease has been one of the earliest discoveries in HIV-1 biology, but its relevance to AIDS pathogenesis remains only partially understood. The physiological basis for the phenotypic variability of HIV-1 was elucidated with the discovery of distinct coreceptors employed by the virus to infect susceptible cells. The role of the viral phenotype in the variable clinical course and treatment outcome of HIV-1 infection has been extensively investigated over the past two decades. In this review, we summarize the major findings on the clinical significance of the HIV-1 coreceptor usage

Sex differences in risk factors for cardiovascular disease: the PERU MIGRANT study.

INTRODUCTION: Although men and women have similar risk factors for cardiovascular disease, many social behaviors in developing countries differ by sex. Rural-to-urban migrants have different cardiovascular risk profiles than rural or urban dwellers. The objective of this study was to evaluate the sex differences with specific cardiovascular risk factors in rural-to-urban migrants. METHODS AND RESULTS: We used the rural-to-urban migrant group of the PERU MIGRANT cross-sectional study to investigate the sex differences in specific cardiovascular risk factors: obesity, hypertension, metabolic syndrome, as well as exposures of socioeconomic status, acculturation surrogates and behavioral characteristics. Logistic regression analysis was used to characterize strength of association between sex and our outcomes adjusting for potential confounders. The sample of migrants was 589 (mean age 46.5 years) and 52.4% were female. In the adjusted models, women were more likely to be obese (OR=5.97; 95%CI: 3.21-11) and have metabolic syndrome (OR=2.22; 95%CI: 1.39-3.55) than men, explaining the greatest variability for obesity and metabolic syndrome but not for hypertension. CONCLUSIONS: Our results suggest that interventions for CVD in Peru should be sex-specific and address the unique health needs of migrant populations living in urban shantytowns since the risk factors for obesity and metabolic syndrome differ between males and females

Chronic hypoxia increases insulin-stimulated glucose uptake in mouse soleus muscle

People living at high altitude appear to have lower blood glucose levels and decreased incidence of diabetes. Faster glucose uptake and increased insulin sensitivity are likely explanations for these findings: skeletal muscle is the largest glucose sink in the body, and its adaptation to the hypoxia of altitude may influence glucose uptake and insulin sensitivity. This study tested the hypothesis that chronic normobaric hypoxia increases insulin-stimulated glucose uptake in soleus muscles and decreases plasma glucose levels. Adult male C57BL/6J mice were kept in normoxia [fraction of inspired O2 = 21% (Control)] or normobaric hypoxia [fraction of inspired O2 = 10% (Hypoxia)] for 4 wk. Then blood glucose and insulin levels, in vitro muscle glucose uptake, and indexes of insulin signaling were measured. Chronic hypoxia lowered blood glucose and plasma insulin [glucose: 14.3 ± 0.65 mM in Control vs. 9.9 ± 0.83 mM in Hypoxia (P < 0.001); insulin: 1.2 ± 0.2 ng/ml in Control vs. 0.7 ± 0.1 ng/ml in Hypoxia (P < 0.05)] and increased insulin sensitivity determined by homeostatic model assessment 2 [21.5 ± 3.8 in Control vs. 39.3 ± 5.7 in Hypoxia (P < 0.03)]. There was no significant difference in basal glucose uptake in vitro in soleus muscle (1.59 ± 0.24 and 1.71 ± 0.15 μmol·g−1·h−1 in Control and Hypoxia, respectively). However, insulin-stimulated glucose uptake was 30% higher in the soleus after 4 wk of hypoxia than Control (6.24 ± 0.23 vs. 4.87 ± 0.37 μmol·g−1·h−1, P < 0.02). Muscle glycogen content was not significantly different between the two groups. Levels of glucose transporters 4 and 1, phosphoinositide 3-kinase, glycogen synthase kinase 3, protein kinase B/Akt, and AMP-activated protein kinase were not affected by chronic hypoxia. Akt phosphorylation following insulin stimulation in soleus muscle was significantly (25%) higher in Hypoxia than Control (P < 0.05). Neither glycogen synthase kinase 3 nor AMP-activated protein kinase phosphorylation changed after 4 wk of hypoxia. These results demonstrate that the adaptation of skeletal muscles to chronic hypoxia includes increased insulin-stimulated glucose uptake

Diabetes mellitus insulino dependiente en población de costa, sierra y selva del Perú

La presente investigación describe la epidemiología de la diabetes mellitus insulinodependiente (Tipo I) en la población peruana, a través de 3 registros que tomaron como estudio al grupo etáreo menor de 15 años de la provincia de Lima, Cuzco y San Martín queen conjunto representan el 28% de la población peruana menor de 15 años. La fuente primaria de datos fueron los casos ocurridos en 25 hospitales entre 1980-1988, siendo los criterios de selección: haber sido diagnosticado de diabetes (OMS), haber tenido menos de 15 años de edad al diagnóstico, estar en insulino terapia y ser residente de su ciudad. El número de casos encontrados fueron 55, de los cuales 22 tuvieron menos de 15 años en 1988, con una prevalencia de 0.94/100,000 y una incidencia anual de 0.6/100.000. La fuente secundaria de datos fue la Asociación Peruana de Diabetes con 90% de validación de los casos registrados. La baja tasa de prevalencia e incidencia de diabetes mellitas insulina-dependientes (tipo-I) encontradas en la población peruana y comparadas con las de poblaciones caucásicas de Europa y USA, sugieren muy poca predisposición de nuestra raza mestiza para adquirir esta enfermedad