Objective: To investigate the role of the Pro12Ala peroxisome proliferator-activated receptor (PPAR) g-2 polymorphism in the susceptibility to the insulin resistance syndrome and its metabolic complications in a population-based nationwide multicenter study in Spain. Design: 464 unrelated adults (45.3% men and 54.7% women) aged between 35 and 64 years were randomly chosen from a nationwide population-based survey of obesity and related conditions including insulin resistance and cardiovascular risk factors. Methods: Anthropometric determinations included: body mass index (BMI), waist-to-hip ratio, sagittal abdominal diameter; biochemical determinations included: fasting plasma glucose concentration and concentration 2 h after an oral glucose tolerance test (OGTT), total cholesterol, high and low density lipoprotein-cholesterol, triglycerides, leptin and insulin. Systolic and diastolic blood pressure were also measured. Genotyping of the PPARg-2 Pro12Ala polymorphism was determined by polymerase chain reaction and single strand conformation polymorphism analysis. Results: The Ala12 allele frequency was higher in obese men than in lean men (0.15 vs 0.08, P ¼ 0:03). Men carriers of the Ala12 allele had a higher BMI than non-carriers (38.9% vs 21.3%; adjusted odds ratio 2.36, 95% confidence interval 1.10 -5.05, P ¼ 0:03). However, despite higher BMI obese men carriers of the Ala12 allele had lower sagittal abdominal diameter than Pro12 homozygotes ð24:1^3:2 vs 26:3^2:5 cm; P ¼ 0:01Þ: The Ala12 allele was associated with lower total triglycerides levels in the overall population and it was also associated with lower fasting insulin levels and a higher insulin sensitivity by homeostasis model assessment (HOMA) in women. Conclusions: Our results suggest that the Pro12Ala polymorphism of the PPARg-2 gene promotes peripheral deposition of adipose tissue and increased insulin sensitivity for a given BMI. The results in women might be due to their different adipose tissue distribution.

In this Mestizo Peruvian population, prevalence of the MS is relatively low as compared to other ethnic groups; the higher prevalence in females is likely due to a higher prevalence of abdominal obesity. Overall, abdominal obesity and hypertriglyceridemia were the predominant combination of metabolic disorders in individuals fulfilling criteria for the diagnosis of the MS.

Objetivo: Conocer la prevalencia del síndrome metabólico en la población adulta del Perú. Materiales y Métodos: Se estudió 4091 personas mayores de 20 años. El 50,4% correspondió al género femenino y 49,6% al masculino. Estas personas fueron elegidas sobre la base de un muestreo por conglomerado trietápico, que representa el nivel nacional y los siguientes ámbitos: Lima metropolitana, resto de la costa, sierra urbana, sierra rural y selva. A todos se les tomó el peso, la talla, la circunferencia de la cintura, la presión arterial, y se les dosó triglicéridos, colesterol HDL y glucosa. Para el diagnóstico del síndrome metabólico se utilizó el criterio del National Cholesterol Education Program ATP III (Adult Treatment Panel). Resultados: La prevalencia nacional del síndrome metabólico fue 16,8%. Lima metropolitana (20,7%) y el resto de la costa (21,5%) fueron los únicos ámbitos que estuvieron por encima de la prevalencia nacional. La sierra rural es la que presentó los valores más bajos, con 11,1%. El género femenino (26,4%) superó ampliamente al masculino (7,2%). El síndrome metabólico fue más prevalente en las personas con obesidad que en las que tenían sobrepeso. A mayor edad, mayor presencia del síndrome metabólico. Conforme se incrementó la circunferencia de la cintura, las otras variables lo hicieron de la misma manera. Conclusiones: En el país, 2 680 000 personas presentaron el síndrome metabólico, lo que significa que una gran cantidad de personas se encuentra en riesgo de su salud por las diversas alteraciones que le pueden ocurrir. Conociendo que la principal causa de este problema es el sobrepeso y la obesidad, hay que realizar estrategias que permitan combatir lo mencionado. Estas estrategias son ampliamente conocidas: tener una alimentación saludable y realizar una actividad física.

Our results suggest that the glutamic acid 27 allele of the beta2-adrenoceptor may be a risk factor in men but not in women for the accumulation of visceral fat and for its association with the development of type 2 diabetes mellitus.

Endothelium-derived nitric oxide (NO) facilitates skeletal muscle glucose uptake. Energy expenditure induces the endothelial NO synthase (eNOS) gene, providing a mechanism for insulin-independent glucose disposal. The object was to test 1) the association of genetic variation in eNOS, as assessed by haplotype-tagging single nucleotide polymorphisms (htSNPs) with type 2 diabetes, and 2) the interaction between eNOS haplotypes and total energy expenditure on glucose intolerance. Using multivariate models, we tested associations between eNOS htSNPs and diabetes (n ‫؍‬ 461 and 474 case and control subjects, respectively) and glucose intolerance (two cohorts of n ‫؍‬ 706 and 738 U.K. and Spanish Caucasians, respectively), and we tested eNOS ؋ total energy expenditure interactions on glucose intolerance. An overall association between eNOS haplotype and diabetes was observed (P ‫؍‬ 0.004). Relative to the most common haplotype (111), two haplotypes (121 and 212) tended to increase diabetes risk (OR 1.22, 95% CI 0.96 -1.55), and one (122) was associated with decreased risk (0.58, 0.39 -0.86). In the cohort studies, no association was observed between haplotypes and 2-h glucose (P > 0.10). However, we observed a significant total energy expenditure-haplotype interaction (P ‫؍‬ 0.007). Genetic variation at the eNOS locus is associated with diabetes, which may be attributable to an enhanced effect of total energy expenditure on glucose disposal in individuals with specific eNOS haplotypes. Gene-environment interactions such as this may help explain why replication of genetic association frequently fails. Diabetes 54:2795-2801, 2005