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High-expression 5-HTT genotypes may render women more vulnerable to depressive symptoms after childbirth.

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The prevalence of lipid abnormalities revealed in a survey done in 417 Mexican cities is described. Information was obtained on 15,607 subjects, aged 20 to 69 years. In this report, only samples obtained after a 9-to 12-h fast were included (2,256 cases: 953 men and 1,303 women). The population is representative of Mexican urban adults. Mean lipid concentrations were: cholesterol, 4.80 mmol/l; triglycerides, 2.39 mmol/l; HDL cholesterol, 1.00 mmol/l; and LDL cholesterol, 3.06 mmol/l. The most prevalent abnormality was HDL cholesterol below 0.9 mmol/l (46.2% for men and 28.7% for women). Hypertriglyceridemia ( Ͼ 2.26 mmol/l) was the second most prevalent abnormality (24.3%). Severe hypertriglyceridemia ( Ͼ 11.2 mmol/l) was observed in 0.42% of the population. Increased LDL cholesterol ( у 4.21 mmol/l) was observed in 11.2% of the sample. Half of the hypertriglyceridemic subjects had a mixed dyslipidemia or low HDL cholesterol. More than 50% of the low HDL cholesterol cases were not related to hypertriglyceridemia. Insulin resistance was found in 59% of them.In conclusion, the prevalence of hypoalphalipoproteinemia and other forms of dyslipidemia in Mexican adults is very high and it is among the highest previously reported worldwide. -Aguilar-Salinas, C. A

Results from a population-based survey O ur objective was to evaluate the diagnostic proficiency of the World Health Organization (WHO) and the National Cholesterol Education Program (NCEP)-III definitions (1,2) for the metabolic syndrome in a Mexican nationwide, population-based survey. Details of the sampling procedures have been previously described (3). The population was composed of 2,158 men and women aged 20 -69 years sampled after a 9-to 12-h fasting period. For the WHO criteria, insulin resistance was diagnosed if a nondiabetic case had fasting insulin concentrations Ն126 pmol/l (21 U/ml) (Ͼ75th percentile in Mexican adults). The ageadjusted prevalence was 13.61% for the WHO criteria (n ϭ 268) and 26.6% for the NCEP-III definition (n ϭ 574). After excluding patients with diabetes, the prevalence was 9.2 and 21.4%, respectively. The agreement between the definitions was assessed in 1,969 subjects; 189 cases were eliminated due to the lack of a urine sample.The number of abnormal cases was lower using the WHO criteria. Only 237 of the 545 subjects (43.4%) who fulfilled the NCEP criteria were diagnosed as affected using the WHO definition. Just 16 of 253 cases (6.3%) detected by the WHO definition did not fulfill the NCEP definition. The agreement between the criteria was moderate ( ϭ 0.507). On the other hand, the subjects diagnosed using the WHO recommendations had a worse profile than the cases detected by the NCEP-III definition only-they had a higher BMI and higher non-HDL cholesterol, triglyceride, and glucose concentrations. The demonstration of insulin resistance among the nondiabetic population caused the lack of agreement in 202 of the 242 cases that fulfilled the NCEP definition but failed the WHO criteria. Other reasons for disparity were the higher thresholds used by the WHO criteria; these differences explained the lack of agreement in 66 of the 152 cases with diabetes.In conclusion, the prevalence of the metabolic syndrome is influenced by the selection of the diagnostic criteria. The WHO criteria identified a lower number of cases than the NCEP-III definition. These differences were explained mainly by the inclusion of abnormally high insulin concentrations as a diagnostic criterion. However, the presence of insulin resistance may help to identify patients more severely affected (4). We had previously assessed the effect of complete blockade of the renin-angiotensin system (RAS) in patients with advanced diabetic nephropathy (type 2 diabetes) and severe proteinuria (2). To do so, we studied 10 patients on prior treatment with ACE inhibitors at recommended doses, to which 50 mg/day of Losartan was added. CARLOS A. AGUILAR-SALINASAfter 3 months of the combined therapy, urinary protein excretion decreased from a mean of 6.9 (95% CI 4.3-9.6) to 5.8 g/24 h (3-8.6) (P ϭ 0.025) and, with the exception of two patients, was reduced in all cases. The proteinuria/ urinary creatinine ratio also decreased from 7.6 (4.2-11.05) to 6.0 g/g (3.2-8.7) (P ϭ 0.02). In one patient in which proteinuria did not ...