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Cleto Alvarez-Aguilar

Publications and source records attributed to Cleto Alvarez-Aguilar.

5 recordsLinked to original sources

[Insulin sensitivity and beta cell function in different glucose tolerance status].

The objective of this work was to investigate the insulin sensitivity (SI) and the beta cell function (BCF) in different glucose tolerance statuses in a comparative cross-sectional study. Eighty-four patients with different glucose tolerance statues were classified as normoglicemic-control group (NC) patients without family history of type 2 diabetes (DM2) or hypertension (HTN); normoglicemic-patients with familiar history of DM2 or HTN (FPDM2); patients with glucose intolerance (IGT group) and patients with diagnostic of DM2 <10 years (DM2 group). In each patient was obtained a clinical history and an oral glucose tolerance test (75 g) was performed. Glucose (GOD-PAP) and insulin (RIA) were quantified. Insulin Sensitivity (IS) (Whole Body Insulin Sensitivity Index), Insulin resistance (IR) (HOMA) and BCF (insulinogenic index) were evaluated. The statistical analysis was realized in SPSS v. 10.0. It was found that glucose was similar among NC, FPDM2 and IGT groups. Insulin was higher in the FPDM2 (26.71 +/- 22.25 microU/mL), and IGT (34.10 +/- 34.98 microU/mL) in comparison with NC (22.83 +/- 21.26 microU/mL) (p < 0.01). IS was different among NC and IGT group (0.74 +/- 0.43 to 0.29 +/- 0.18, p < 0.05) and among IGT and DM2 (0.29 +/- 0.18 to 0.86 +/- 0.55, p < 0.001). BCF was different among the DM2 and NC (0.051 +/- 0.05 to 1.28 +/- 1.99 microU.mL/mg.dL, p < 0.05), DM2 and FPDM2 group (0.051 +/- 0.05 to 1.23 +/- 1.51 microU.mL/mg.dL, p < 0.01), DM2 and IGT (0.051 +/- 0.05 to 2.64 +/- 2.22 microU.mL/mg.dL, p < 0.001). SI was inversely related to corporal weight and IMC (r = -0.38, p = 0.001 and r = -0.33, p = 0.004, respectively). BCF was related to age (r = -0.27, p = 0.016), the area under curve of glucose (r = -0.30, p = 0.010) and body weight (r = 0.34, p = 0.002). In conclusion, the decrease of glucose tolerance was associated with the lowering of Insulin Sensitivity (IS). The beta cell function (FCB) was lower in the diabetic patients group in comparison with the TGA and FPDM2 groups. These measurements need to be included in patients with high risk for early identification and changes in life style to protect the normal functioning of beta cell and to prevent the onset of IGT or DM2.

Age Factors↗

Prevalence of chronic kidney disease in an urban Mexican population.

BACKGROUND: The present study was primarily designed to assess the prevalence of chronic kidney disease in a Mexican urban population residing in Mexico and to evaluate certain biologic and socioeconomic conditions as risk factors for the development of renal disease. METHODS: A population-based cross-sectional survey was conducted, which included 3564 patients of either gender aged >18 years, who were randomly selected from lists of patients assigned to primary care facilities in the city of Morelia. A questionnaire about personal current health status, kidney disease, diabetes, hypertension, or heart disease in close relatives, anthropometric and blood pressure measurements, and blood and urine samples to measure glucose, blood urea nitrogen, and creatinine was obtained for each patient. Creatinine clearance (Ccr) was calculated by the Cockcroft-Gault formula. Patients were classified in 1 of the 5 Ccr categories established by the Kidney Disease Outcomes Quality Initiative guidelines. RESULTS: The prevalence rate of Ccr < 15 mL/min was 1142 per million population, and that of Ccr <60 mL/min 80,788 per million population. Alcohol and tobacco consumption, female gender, age >65 years, educational level < primary school, and income < US $4.00/day were significantly associated with reduced Ccr. CONCLUSION: Chronic kidney disease prevalence in this population is similar to that seen in industrialized countries. If these figures are similar to those of the entire Mexican population, only l out of 4 patients requiring renal replacement therapy in the country currently has access to it.

Adult↗

Bromocriptine induces regression of left ventricular hypertrophy in peritoneal dialysis patients.

Left ventricular hypertrophy (LVH) prevalence is very high in end stage renal disease (ESRD). It's a predictor of cardiac death in peritoneal dialysis patients. Noradrenalin, Angiotensin II and aldosterone are involved incardiac hypertrophy. Dopamine, acting at DA2 receptors inhibits norephinephrin release, antagonizes aldosterone and down-regulates AT1 receptor numbers, suggesting that DA2 agonists, like bromocriptine (BEC) could regress LVH. The objective of this study was to evaluate the changes in left ventricular mass in patients with ESRD in continuous ambulatory peritoneal dialysis (CAPD), by adding BEC to the treatment. An open clinical trial was conducted. Twenty patients were enrolled. Five formed the control group. Fifteen patients in the experimental group received BEC 2.5 mg three times daily over three months. M mode echocardiography and prolactin plasma levels were measured at the beginning and at the end of the study. The statistical analysis was performed using Student t test. The echocardiography reports showed a 24.4% decreased in left ventricular mass index (LVMI); the interventricular septum decreased 11.3%, the ejection fraction was not modified. The control group showed no difference. BEC-mediated decreases in left-ventricular mass in LVH patients on dialysis suggest that Dopaminergic agonists could be useful in caring for patients with ESRD and LVH.

Adult↗

[Hyperleptinemia as a risk factor in obesity-related hypertension].

BACKGROUND AND OBJECTIVE: Obesity is a risk factor for high blood pressure (HBP). However, the mechanism has not been dilucidated yet. High concentrations of leptin (LEP) contributing to an increased blood pressure in obese patients via increase in the activity of the sympathetic nervous system. We explored the physiopathologic role of hyperleptinemia in HBP with regard to obesity. SUBJECTS AND METHOD: Prospective and comparative study. Between February 2001 and December 2002, we studied 499 subjects, 255 with HBP and 244 without hypertension. The relationship between weight, LEP, insulin, and serum lipids with blood pressure was assessed. RESULTS: Patients with HBP versus patients without HBP had a higher body mass index (30.4 +/- 3.9 to 25.5 +/- 1.7 kg/m2) (p < 0.01), higher serum concentrations of: creatinine (0.99 +/- 0.16 to 0.88 +/- 0.16 mg/dl), total cholesterol (219.5 +/- 50.4 to 190.6 +/- 40.0 mg/dl), cLDL (126.9 +/- 52.2 to 108.3 +/- 53.3 mg/dl), triglycerides (221.1 +/- 123.8 to 164.5 +/- 86.5 mg/dl), LEP (14.9 +/- 8.4 to 6.7 +/- 3.5 ng/ml) and insulin (24.2 +/- 6.5 to 16.8 +/- 4.7 mU/ml) (p < 0.01). In the univariate and multivariate analysis, obesity, dyslipidemia, hyperleptinemia and hyperinsulinemia were independent risk factors for HBP (p < 0.01). CONCLUSIONS: We suggest that hyperleptinemia has a direct role in the physiopathologic mechanism of obesity-associated HBP, and it could be considered as an independent risk factor for HBP and cardiovascular disease.

Blood Chemical Analysis↗