Dra. Troncoso-Pantoja, Claudia

Background: Genetic variants within the FTO gene have been associated with increased adiposity and metabolic markers; however, there is limited evidence regarding the association of FTO gene variants with physical activity-related variables. The authors aimed to investigate the association of the rs17817449 single-nucleotide polymorphism of FTO with physical activity, sedentary time, and cardiorespiratory fitness in Chilean adults. Methods: A total of 409 participants from the GENADIO study were included and genotyped for the rs17817449 single-nucleotide polymorphism of FTO in this cross-sectional study. Physical activity and sedentary time were measured with ActiGraph accelerometers. Cardiorespiratory fitness was assessed using the Chester step test. The associations were assessed by using multivariate regression analyses. Results: No associations were found for FTO variant with physical activity levels and cardiorespiratory fitness. The risk allele (G) of the FTO was found to be associated with sedentary time in the minimally adjusted model (β = 19.7 min/d; 95% confidence interval, 4.0 to 35.5, per each copy of the risk allele; P = .006), but the association was no longer significant when body mass index was included as a confounder (P = .211). Conclusion: The rs17817449 single-nucleotide polymorphism of the FTO gene was not associated with the level of physical activity, cardiorespiratory fitness, and sedentary behaviors in Chilean adults.

Objective: The aim of this study was to identify which anthropometric measurement (body mass index [BMI], waist circumference [WC], or waist-to-height ratio [WHtR]) is a better predictor of type 2 diabetes and hypertension in the Chilean population. Methods: The study included 13 044 participants (59.7% women) from the Chilean National Health Surveys conducted in 2003, 2009-2010, and 2016-2017. BMI, WC, and WHtR were the anthropometric measurements evaluated. Hypertension was defined as systolic blood pressure ≥140 mm Hg and diastolic blood pressure -90 mm Hg or on medication for hypertension. Diabetes was defined as fasting glucose -7 mmol/L or on medication for diabetes. The receiver operating characteristics (ROC) curve and the area under curve (AUC) were computed to derive the specificity and sensitivity using a bootstrapping approach. Results: Compared with BMI and WC, WHtR was the anthropometric measurement with the highest AUC curve in both sexes for hypertension (AUC for women: 0.70; 95% confidence interval [CI], 0.67-0.73; AUC for men: 0.71; 95% CI, 0.69-0.74) and diabetes (AUC for women: 0.71; 95% CI, 0.66-0.77; AUC for men: 0.71; 95% CI, 0.67-0.76). The sex-specific cutoff points of WHtR to predict hypertension were 0.59 and 0.55 for women and men, respectively. Those used to predict diabetes were 0.60 and 0.58 for women and men, respectively. Conclusion: WHtR was a better predictor of hypertension and diabetes than BMI and WC in Chile. The definition of cutoff points specific for the Chilean population could be implemented in future screening programs aiming to identify high-risk individuals.

El envejecimiento será una de las transformaciones sociales más importantes del siglo XXI en todo el mundo. En los últimos 40 años, Chile ha triplicado su población adulta mayor. Como resultado, para el 2050 el país tendrá la mayor proporción de adultos mayores en América Latina. Este notable crecimiento refuerza la necesidad de identificar su situación actual y revisar qué está haciendo la sociedad para mantener a las personas mayores como miembros activos. En este contexto, esta revisión narrativa tuvo como objetivo describir el perfil sociodemográfico, epidemiológico y sociocultural de los adultos mayores chilenos. Además, se identificaron programas y políticas públicas enfocadas a la mejora de su calidad de vida.

Objective: To investigate the association between a lifestyle score and all-cause mortality in the Chilean population. Design: Prospective study. Settings: The score was based on seven modifiable behaviours: salt intake, fruit and vegetable intake, alcohol consumption, sleep duration, smoking, physical activity and sedentary behaviours. 1-point was assigned for each healthy recommendation. Points were summed to create an unweighted score from 0 (less healthy) to 7 (healthiest). According to their score, participants were then classified into: less healthy (0–2 points), moderately healthy (3–4 points) and the healthiest (5–7 points). Associations between the categories of lifestyle score and all-cause mortality were investigated using Cox proportional hazard models adjusted for confounders. Nonlinear associations were also investigated. Participants: 2706 participants from the Chilean National Health Survey 2009–2010. Results: After a median follow-up of 10·9 years, 286 (10·6 %) participants died. In the maximally adjusted model, and compared with the healthiest participants, those less healthy had 2·55 (95 % CI 1·75, 3·71) times higher mortality risk due to any cause. Similar trends were identified for the moderately healthy group. Moreover, there was a significant trend towards increasing the mortality risk when increasing unhealthy behaviours (hazard ratio model 3: 1·61 (95 % CI 1·34, 1·94)). There was no evidence of nonlinearity between the lifestyle score and all-cause mortality. Conclusion: Individuals in the less healthy lifestyle category had higher mortality risk than the healthiest group. Therefore, public health strategies should be implemented to promote adherence to a healthy lifestyle across the Chilean population.

Background: Healthy lifestyles are associated with a better metabolic and cardiovascular health profile. Aim: To investigate the association between a lifestyle score and cardiovascular risk in Chilean adults. Material and Methods: A healthy lifestyle score was derived for 2,774 participants in the Chilean National Health Survey 2009-2010 and based on seven modifiable behaviors (salt intake, fruit and vegetable intake, alcohol consumption, sleep duration, smoking, physical activity and sedentary behaviors). A high score represented a healthier lifestyle whereas a low score represents an unhealthy lifestyle. The association between the lifestyle score and cardiovascular risk factors (obesity, hypertension, diabetes, dyslipidemia and metabolic syndrome), was explored using logistic regression models. Results: One quartile increment in the healthy lifestyle score was associated with a lower risk for obesity (Odds ratio (OR): 0.82 [95% confidence intervals (CI): 0.75 to 0.90], p < 0.01), central obesity (OR: 0.88 [95% CI: 0.81 to 0.96], p < 0.01), diabetes (OR: 0.84 [95% CI: 0.75 to 0.95], p < 0.04) and dyslipidemia (OR: 0.90 [95% CI: 0.83 to 0.98], p = 0.01). These results were independent of major confounding factors. Conclusions: The adherence to a healthy lifestyle is associated with lower cardiovascular risk.

Chile es uno de los países de Latinoamérica que exhibe un mayor envejecimiento poblacional, por lo que es necesario visualizar distintas herramientas que direccionen estilos de vida saludables en esta etapa de la trayectoria vital. Las Guías Alimentarias Basadas en Alimentos (GABA) entregan recomendaciones que permiten mejorar la calidad de vida de personas mayores. Por lo anterior, el objetivo del estudio fue determinar el nivel de cumplimiento de recomendaciones de las GABA y su asociación con variables antropométricas, metabólicas y de estilos de vida en 1.789 personas mayores de 60 años que participaron en la Encuesta Nacional de Salud 2016-2017. Se realizó un estudio descriptivo de corte transversal, en donde los participantes se subdividieron en cuatro grupos según cumplimiento de las GABA: no cumple, cumple con 1, 2 o a lo menos 3 recomendaciones de consumo de legumbres, frutas y verduras, lácteos, agua y pescado. Como resultado, el 43,8% de las personas mayores que participaron no cumplieron ninguna de las recomendaciones GABA evaluadas; estos últimos, realizaban menos actividad física y presentaban, además, una mayor probabilidad de pasar más tiempo sentados (p-tendencia: <0,001). Como conclusión, se destaca que cerca del 50% de las personas mayores en Chile no adhieren a las recomendaciones de las GABA, lo que podría repercutir en implicaciones en la salud y bienestar de la población mayor.

Objective: To study the association of SLC16A11 gene variants with obesity and metabolic markers in nondiabetic Chilean adults. Materials and methods: This cross-sectional study included 263 nondiabetic adults. The genotype of the rs75493593 polymorphism of SLC16A11 gene was performed by real-time PCR. It’s association with adiposity markers (body weight, BMI, waist circumference and fat mass percentage), metabolic markers (glucose, insulin, HOMAIR, leptin, total cholesterol, LDLc, HDLc, triglycerides, ALT, GGT and hsCRP) and blood pressure was analyzed by linear regression. Results: The minor allele (T) of the SLC16A11 gene (rs75493593) has a frequency of 29.7% among Chileans. Risk genotypes (GT and TT) were associated with a significant 1.49 mU/l increase in plasmatic insulin for each copy of the minor allele (95% CI: 0.12, 2.87, p < 0.05). This association remained significant after adjusting for socio-demographic variables, physical activity and smoking (1.36 mU/l, 95% CI: 0.16, 2.58 p < 0.05), but was lost when BMI was included as a confounding factor. Higher BMI was also significantly associated with polymorphic genotypes in SLC16A11, independent of sociodemographic variables. Conclusion: The minor allele of the SLC16A11 gene (T) is highly prevalent among Chileans and is associated with increased insulin and BMI in nondiabetic individuals. These findings suggest that the genetic variant in SLC16A11 is not only associated with type 2 diabetes as previously shown in Mexicans, but is also related to early metabolic alterations in healthy subjects that may lead to type 2 diabetes.

Depressive disorders are recognized as one of the most common mental health conditions across different age groups. However, the risk factors associated with depression among older people from low-and middle-income countries remains unclear. This study aims to identify socio-demographic, health and psychosocial-related factors associated with depression in Chilean older adults. A cross-sectional study was carried out in a representative sample of 1,765 adults aged ≥60 years participants from the Chilean National Health Survey 2016–2017. Depression was assessed with the Composite International Diagnostic Interview (CIDI-SF). Associations between the exposure variables and depression were investigated using Poisson regression analyses. The main findings indicated that women showed higher likelihood of depression than men (Prevalence Ratio (PR) = 2.6 [95% CI: 1.40; 4.89]). An increased likelihood of depression was found in older adults with chronic pain, multimorbidity (≥2 diseases), previous diagnose of depression, high perception of stress, financial stress, and difficulties for social participation. In women, higher likelihood of depression was found for those with the frailty phenotype (PR:8.53 [95% CI: 1.68; 43.32]), rheumatoid arthritis (PR:2.41 [95% CI: 1.34; 4.34]), insomnia (PR:2.99 [95% CI: 1.74; 5.12]) and low self-rated well-being (PR:4.94 [95% CI: 2.26; 10.79]). Men who were divorced (PR:7.10 [95% CI: 1.44; 34.90]) or widowed (PR:10.83 [95% CI: 3.71; 31.58]), obese (PR:5.08 [95% CI: 1.48; 17.42) and who had asthma (PR: 7.60 [95% CI: 2.31; 24.99]) were associated with higher odds of depression. The current findings may have clinical implications for the early identification of older adults more susceptible to depression and also suggest the need to implement cultural and age-sensitive strategies to promote mental health in late life.

Introduction: The average life expectancy, as well as the prevalence of Type 2 diabetes (T2D), is increasing worldwide. Population-based studies have demonstrated that the duration of T2D has been associated with cognitive impairment. However, despite the high prevalence of T2D and cognitive impairment in Chile, the association between years with T2D and suspicion of cognitive impairment has not yet been investigated. The objective of this study was to investigate the association between duration of T2D and suspicion of cognitive impairment in Chilean older adults. Material and Methods: 1,040 older adults aged ≥60 years from the Chilean National Health Survey (2009-2010) were included. Suspicion of cognitive impairment was assessed by the abbreviated Mini-Mental State Examination (MMSE). The number of years with T2D was self-reported and categorised into four groups. Poisson Regression analysis was used to assess the association between altered MMSE and the number of years with DM2, adjusted by potential confounders including socio-demographic, lifestyle, adiposity and health-related factors. Results: When the analyses were adjusted for socio-demographic factors, people who had T2D for 15 to 24 and ≥25 years had 2.2-times (95%CI: 1.07; 3.33) and 5.8-times (95%CI: 3.81; 11.0) higher relative risk (RR) of cognitive impairment, compared to those without T2D. When the analyses were additionally adjusted for lifestyle and health-related covariates, the RR for cognitive impairment was 1.76-times (95%CI: 1.02; 2.50) and 4.54-times (95%CI: 2.70; 6.38) higher for those who had T2D for 14-24 years and ≥25 years, respectively. Conclusions: Number of years with T2D was associated with suspicion of cognitive impairment. A longer duration of T2D was associated with a higher likelihood of cognitive impairment in the Chilean older population, independently of confounder factors included in the study.

Background: Walking pace is a well-known indicator of physical capability, but it is also a strong predictor of type 2 diabetes (T2D). However, there is a lack of evidence on the association between walking pace and T2D, specifically, within developing countries such as Chile. Aim: To investigate the association between self-reported walking pace and T2D in the Chilean adult population. Methods: 5520 Chilean participants (aged 15 to 90 years, 52.1% women) from the Chilean National Health Survey 2016–2017 were included in this cross-sectional study. Both walking pace (slow, average, and brisk) and diabetes data were collected through self-reported methods. Fasting blood glucose (reported in mg/dl) and glycosylated haemoglobin A (HbA1c) scores were determined via blood exams. Results: In the unadjusted model, and compared to people who reported a slow walking pace, those with average and brisk walking pace had lower blood glucose levels (β = −7.74 mg/dL (95% CI: −11.08 to −4.40) and β = −11.05 mg/dL (95% CI: −14.36 to −7.75), respectively) and lower HbA1c (β = −0.34% (95% CI: −0.57 to −0.11) and β= −0.72% (95% CI: −0.94 to −0.49)), respectively. After adjusting for sociodemographic, Body Mass Index and lifestyle factors, the association between glycaemia and HbA1c remained only for brisk walkers. Both the average and brisk walker categories had lower odds of T2D (OR: 0.59 (95% CI: 0.41 to 0.84) and (OR 0.48 (95% CI: 0.30 to 0.79), respectively). Conclusion: Brisk walkers were associated with lower blood glucose and HbA1c levels. Moreover, average to brisk walking pace also showed a lower risk for T2D.