Main Article Content

Authors

The prevalence of Prediabetes in Colombia is high, and despite being recognized and categorized in the main Medical Guidelines and included in the International Classification of Diseases in Colombia, knowledge and awareness of it is limited amongst healthcare professionals and in the community. Our expert group recommends that educational programs emphasize a global approach to risk which includes a recognition of the importance of prediabetes and its evaluation along with and other risk factors such as a family history of DM2, overweight and obesity, dislipidemia and hypertension. Studies conducted in Colombia demonstrate the value of the FINDRIS questionnaire as a tool to identify subjects at risk of prediabetes and DM2, and we recommend that it should be systematic applied throughout the country as part of government policy.Prediabetes progresses to DM2 at an annual rate of 10%, but it has also been shown that prediabetes is an independent risk factor for cardiovascular outcomes. On this basis, the Committee recommends that once prediabetes is detected and diagnosed, immediate management of the disease begins through lifestyle changes, with follow up assessments performed at 3 and 6 months. If the patient does not respond with a weight loss of at least 5% and if the HbA1C values ​​are not normalized, pharmacological management should be initiated with a metformin dose of 500 mg / day, increasing up to 1,500 - 1,700 mg / day, according to tolerance.

Patricio López-Jaramillo, -Clínica de Síndrome Metabólico, Prediabetes y Diabetes, Bucaramanga, Colombia -Fundación Oftalmológica de Santander (FOSCAL), Bucaramanga, Colombia

Director de Investigación, Desarrollo e Innovación Tecnológica, Clínica de Síndrome Metabólico, Prediabetes y Diabetes, Bucaramanga, Colombia

Carlos Calderón, -Federación Diabetológica Colombiana (FDC), Bogotá, Colombia -Fundación Santandereana de Diabetes (FUSANDE), Bucaramanga, Colombia.

-Federación Diabetológica Colombiana (FDC), Bogotá, Colombia

-Fundación Santandereana de Diabetes (FUSANDE), Bucaramanga, Colombia.

Jorge Castillo, - Sociedad Colombiana de Sarcopenia (SCS), Bogotá, Colombia. - Federación Diabetológica Colombiana (FDC), Bogota, Colombia.

- Presidente de la Sociedad Colombiana de Sarcopenia (SCS), Bogotá, Colombia.

- Vicepresidente de la Federación Diabetológica Colombiana (FDC), Bogota, Colombia.

Iván Darío Escobar, - Fundación Colombiana de Obesidad (FUNCOBES), Bogotá, Colombia. - Asociación Colombiana de Endocrinología (ACE), Bogota, Colombia

- Ex Presidente de la Fundación Colombiana de Obesidad (FUNCOBES), Bogotá, Colombia.

- Delegado de la Asociación Colombiana de Endocrinología (ACE), Bogota, Colombia

Enrique Melgarejo, -Sociedad Colombiana de Cardiología y Cirugía Cardiovascular (SCC), Bogotá, Colombia. -Colegio Panamericano del Endotelio (CPE), Bogotá, Colombia.

- Presidente de la Sociedad Colombiana de Cardiología y Cirugía Cardiovascular (SCC), Bogotá, Colombia.

-Presidente Honorario del Colegio Panamericano del Endotelio (CPE), Bogotá, Colombia.

Gustavo Adolfo Parra, -Asociación Colombiana de Medicina Interna (ACMI), Bogotá, Colombia. -Universidad Autonoma de Bucaramanga (UNAB), Bucaramanga, Colombia

- Presidente de la Asociación Colombiana de Medicina Interna (ACMI), Bogotá, Colombia.

-Universidad Autonoma de Bucaramanga (UNAB), Bucaramanga, Colombia

López-Jaramillo, P., Calderón, C., Castillo, J., Escobar, I. D., Melgarejo, E., & Parra, G. A. (2024). Prediabetes in Colombia: Expert Consensus. Colombia Medica, 48(4), 191–203. https://doi.org/10.25100/cm.v48i4.3662 (Original work published December 29, 2017)

American Diabetes Association Standars of medical care in diabetes. Diabetes Care. 2016;39:119–119.

López-Jaramillo P, Nieto-Martínez RE, Aure-Fariñez G, Mendivil CO, Lahsen RA, Silva-Filho RL. Identification and management of prediabetes results of the Latin America strategic prediabetes meeting. Rev Panam Salud Publica. 2017;41:e172 doi: 10.26633/RPSP.2017.172.

WHO . Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia. Geneva(Switzerland): World Health Organization; 2006.

International Diabetes Federation . Diabetes Atlas, 7th edition. Brussels(Belgium): International Diabetes Federation; 2015.

Instituto Colombiano de Bienestar Familiar . Encuesta Nacional de la Situación Nutricional en Colombia (ENSIN). Bogotá,, Colombia: Ministerio de Proteccion Social; 2010.https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/Base%20de%20datos%20ENSIN%20-%20Protocolo%20Ensin%202010.pdf

Clarke WL, Cox D, Gender-Frederick LA, Cater W, Pohl SL. Evaluating clinical accuracy of systems for self-monitoring of blood glucose. Diabetes Care. 1987;10:622–628.

Instituto Colombiano de Bienestar Familiar . Encuesta Nacional de la Situación Nutricional en Colombia (ENSIN) Bogotá, Colombia: Ministerio de Proteccion Social; 2005. https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/Ensin%202005.pdf

Camacho PA, Gomez-Arbelaez D, Molina DI, Sanchez G, Arcos E, Narvaez C. Social disparities explain differences in hypertension prevalence, detection and control in Colombia. J Hypertens. 2016;34:2344–2352.

Barengo NC, Tamayo DC, Tono T, Tuomilehto J. A Colombian diabetes risk score for detecting undiagnosed diabetes and impaired glucose regulation. Prim Care Diabetes. 2017;11:86–93.

Lopez-Jaramillo P, Sanchez G, Perez M, Calderon JE, Sotomayor A, Suarez M. Colombo-Ecuadorian study to determinate the prevalence of pre-diabetes in patients with a first acute myocardial infarction. J Diabetes. 2011;3(Suppl 1):73–73.

Rafael G, Gonzalez-Villalpando C, Lopez-Jaramillo P, Acosta T, López RR, R Nieto-Martínez. Prediabetes and Diabetes Prevention Initiatives in Latin America (LA) . In: Bergman M, editor. Global health perspectives in prediabetes and diabetes prevention. 1st Edition. Singapore: World Scientific Publishing Co; 2014. Chapter 20.

Lopez-Jaramillo P, Sanchez R, Diaz M, Cobos L, Bryce A, Parra-Carrillo JZ. Latin America consensus on hypertension in patients with diabetes type 2 and metabolic syndrome. J Hyperten. 2013;31:223–238.

Tseng E, Greer RC, O'Rourke P, Yeh HC, McGuire MM, Clark JM. Survey of primary care providers' knowledge of screening for, diagnosing and managing prediabetes. J Gen Intern Med. 2017;32:760–766.

Garay J, Camacho P, Cohen D, Calderon C, Parra-Zuluaga G, Lopez-Jaramillo P. Survey of knowledge for diagnosing and managing prediabetes in Latin-America. Diabetol Metab Syndr. 2017:Submitted–Submitted.

Ministerio de Salud y Protección Social . Codificación CIE10 para prediabetes. Ministerio de Salud y Protección Social; https://www.minsalud.gov.co/sites/rid/paginas/freesearchresults.aspx Repositorio Institucional Digital (RID)

Figueroa FN, Morales J, Melgarejo A, Forero J, Motoa G, León JA. Characterization of patients with pre-diabetes in first-level health care service institutions Cali, Colombia. Colomb Med (Cali) 2011;42:98–106.

Kabadi UM. Major pathophysiology in prediabetes and type 2 diabetes decreased insulin in lean and insulin resistance in obese. J Endocr Soc. 2017;1:742–750.

Dagenais GR, Gerstein HC, Zhang X, McQueen M, Lear S, Lopez-Jaramillo P. Variations in diabetes prevalence in low-, middle-,and high-income countries Results from the prospective urban and rural epidemiology study. Diabetes Care. 2016;39:780–787.

Diabetes Prevention Program Research Group Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. NEJM. 2002;346:393–404.

Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343–1350.

Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijay V. Indian Diabetes Prevention Programme The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1) Diabetologia. 2006;49:289–297.

Gomez-Arbelaez D, Alvarado-Jurado L, Ayala-Castillo M, Forero-Naranjo L, Camacho PA, Lopez-Jaramillo P. Evaluation of the Finnish Diabetes Risk Score to predict type 2 diabetes mellitus in a Colombian population A longitudinal observational study. World J Diabetes. 2015;6:1337–1344.

Departamento Administrativo Nacional de Estadísticas Proyecciones de población. 2005. [2016].http://www.dane.gov.co/index.php/estadisticas-por-tema/demografia-y-poblacion/proyecciones-de-poblacion.

CDC . National diabetes statistics report, 2017: estimates of diabetes and its burden in the United States. Atlanta (GA): U.S. Department of Health and Human Services; 2017. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf

Shen J, Kondal D, Rubinstein A, Irazola V, Gutierrez L, Miranda JJ. A Multiethnic Study of Pre-Diabetes and Diabetes in LMIC. Glob Heart. 2016;11:61–70.

Bamberg F, Hetterich H, Rospleszcz S, Lorbeer R, Auweter SD, Schlett CL. A Subclinical disease burden as assessed by whole-body MRI in subjects with prediabetes, subjects with diabetes, and normal control subjects from the general population The KORA-MRI Study. Diabetes. 2017;66:158–169.

Goldberg RB. Cytokine and Cytokine-like inflammation markers, endothelial dysfunction, and imbalanced coagulation in development of diabetes and its complications. J Clin Endocrinol Metab. 2009;94:3171–3182.

Davis TM, Chubb SA, Bruce DG, Davis WA. Metabolic memory and all-cause death in community-based patients with type 2 diabetes the Fremantle Diabetes Study. Diabetes Obes Metab. 2016;18:598–606.

Ranjit Unnikrishnan I, Anjana RM, Mohan V. Importance of controlling diabetes early--the concept of metabolic memory, legacy effect and the case for early insulinisation. J Assoc Physicians India. 2011;59:8–12.

Misra A, Bloomgarden Z. Metabolic memory evolving concepts. J Diabetes. 2017;doi:10–10. doi: 10.1111/1753-0407.12622.

Semenkovich CF. We know more than we can tell about diabetes and vascular disease The 2016 Edwin Bierman Award Lecture. Diabetes. 2017;66:1735–1741.

Garcia RG, Lopez-Jaramillo P. Cardiovascular prevention in high-risk patients with type 2 diabetes mellitus when to start it? Eur Hearth J. 2008;29:2058–2059.

Dluhy RG, McMahon GT. Intensive glycemic control in the ACCORD and ADVANCE trials. N Engl J Med. 2008;358:2630–2633.

Mannucci E, Monami M. Cardiovascular safety of incretin-based therapies in type 2 diabetes Systematic review of integrated analyses and randomized controlled trials. Adv Ther. 2017;34:1–40.

UK Prospective Diabetes Study Group Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) Lancet. 1998;352:854–865.

Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359:1577–1589.

Mah E, Bruno RS. Postprandial hyperglycemia on vascular endothelial function mechanisms and consequences. Nutr Res. 2012;32(10):727–740.

Fortier C, Sidibé A, Desjardins MP, Marquis K, De Serres SA, Mac-Way F. Aortic-brachial pulse wave velocity ratio A blood pressure-independent index of vascular aging. Hypertension. 2017;69:96–101.

Barton M, Husmann M, Meyer MR. Accelerated vascular aging as a paradigm for hypertensive vascular disease Prevention and therapy. Can J Cardiol. 2016;32:680–686.

Qiu M, Shen W, Song X, Ju L, Tong W, Wang H. Effects of prediabetes mellitus alone or plus hypertension on subsequent occurrence of cardiovascular disease and diabetes mellitus longitudinal study. Hypertension. 2015;65:525–530.

Bergmann A, Li J, Wang L, Schulze J, Bornstein SR, Schwarz PE. A simplified finnish diabetes risk score to predict type 2 diabetes risk and disease evolution in a German population. Horm Metab Res. 2007;39:677–682.

Schwarz PE, Li J, Reimann M, Schutte AE, Bergmann A, Hanefeld M. The Finnish Diabetes Risk Score is associated with insulin resistance and progression towards type 2 diabetes. J Clin Endocrinol Metab. 2009;94:920–926.

Gomez-Arbelaez D, Alvarado-Jurado L, Ayala-Castillo M, Forero-Naranjo L, Camacho PA, Lopez-Jaramillo P. Evaluation of the Finnish Diabetes Risk Score to predict type 2 diabetes mellitus in a Colombian population A longitudinal observational study. World J Diabetes. 2015;6:1337–1344.

Lopez-Lopez J, Garay J, Wandurraga E, Camacho P, Higuera-Escalante F, Cohen D, et al. Glycosylated hemoglobin does not improve the detection of prediabetes and type 2 diabetes mellitus in colombian adults: a cross-sectional study. Plos One. 2017Submited

Choi SH, Kim TH, Lim S, Park KS, Jang HC, Cho NH. Hemoglobin A1c as a diagnostic tool for diabetes screening and new-onset diabetes prediction a 6-year community-based prospective study. Diabetes Care. 2011;34:944–949.

Shibata K, Suzuki S, Sato J, Ohsawa I, Goto S, Iritani I. Diagnostic accuracy of glycohemoglobin A1c (HbA1c) for postprandial hyperglycemia was equivalent to that of fasting blood glucose. J Clin Epidemiol. 2005;58:1052–1057.

Bennett CM, Guo M, Dharmage SC. HbA(1c) as a screening tool for detection of Type 2 diabetes a systematic review. Diabet Med. 2007;24:333–343.

Cavagnolli G, Comerlato J, Comerlato C, Renz PB, Gross JL, Camargo JL. HbA(1c) measurement for the diagnosis of diabetes is it enough? Diabet Med. 2011;28:31–35.

Kumaravel B, Bachmann MO, Murray N, Dhatariya K, Fenech M, John WG. Use of haemoglobin A1c to detect impaired fasting glucose or Type 2 diabetes in a United Kingdom community based population. Diabetes Res Clin Pract. 2012;96:211–216.

Lee H, Oh JY, Sung YA, Kim DJ, Kim SH, Kim SG. Optimal hemoglobin A1C cutoff value for diagnosing type 2 diabetes mellitus in Korean adults. Diabetes Res Clin Pract. 2013;99:231–236.

Aschner P, Muñoz O, Giron D, Garcia O, Fernandez-Avila D, L Casas, et al. Clinical practice guideline for the prevention, early detection, diagnosis, management and follow up of type 2 diabetes mellitus in adults. Colomb Méd (Cali) 2016;47(2):109–130.

ALAD Guias Latinoamericanas de Diabetes. 2013. https://issuu.com/alad-diabetes/docs/guias_alad_2013

Rosas-Saucedo J, Enrique CA, Brito-Córdova G, García-Bruce H, Costa-Gil J, Lyra R, Rosas-Guzmán J. Consenso de Prediabetes Documento de Posición de la Asociación Latinoamericana de Diabetes (ALAD) Rev ALAD. 2017;7:184–202.

Garber AJ, Abrahamson MJ, Barzilay JI, Blonde L, Bloomgarden ZT, Bush MA. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensivew type 2 diabetes management algorithm - 2017 executive summary. Endocr Pract. 2017;23:207–238.

Rydén L, Grant PJ, Anker SD, Berne C, Cosentino F, Danchin N. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD) Eur Heart J. 2013;34:3035–3087.

Shaye K, Amir T, Shlomo S, Yechezkel S. Fasting glucose levels within the high normal range predict cardiovascular outcome. Am Heart J. 2012;164:111–116.

Eastwood SV, Tillin T, Sattar N, Forouhi NG, Hughes AD, Chaturvedi N. Associations Between Prediabetes, by Three Different Diagnostic Criteria, and Incident CVD Differ in South Asians and Europeans. Diabetes Care. 2015;38:2325–2332.

Huang Y, Cai X, Mai W, Li M, Hu Y. Association between prediabetes and risk of cardiovascular disease and all cause mortality systematic review and meta-analysis. BMJ. 2016;355:i5953–i5953.

Warren B, Pankow JS, Matsushita K, Punjabi NM, Daya NR, Grams M. Comparative prognostic performance of definitions of prediabetes a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study. Lancet Diabetes Endocrinol. 2017;5:34–42.

Cefalu WT. “Prediabetes”: Are There Problems With This Label? No, We Need Heightened Awareness of This Condition! Diabetes Care. 2016;39:1472–1477.

Selvin E, Steffes MW, Zhu H, Matsushita K, Wagenknecht L, Pankow J. Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. N Engl J Med. 2010;362:800–811.

Gomez-Arbelaez D, Sánchez-Vallejo G, Perez M, Garcia RG, Arguello JF, Peñaherrera E. Hiperglucemia se asocia a mayor número de desenlaces adversos en individuos latinoamericanos con infarto agudo de miocardio. Clin Investig Arterioscler. 2016;28:9–18.

Lopez-Jaramillo P, Velandia- Carrillo C, Gomez-Arbelaez D, Aldana-Campos M. Is the present cut-point to define type 2 diabetes appropiate in Latin-Americans. World J Diabetes. 2014;5:747–755.

Cellek S, Foxwell NA, Moncada S. Two phases of nitrergic neuropathy in streptozotocin-induced diabetic rats. Diabetes. 2003;52:2353–2362.

Cellek S, Qu W, Schmidt AM, Moncada S. Synergistic action of advanced glycation end products and endogenous nitric oxide leads to neuronal apoptosis in vitro a new insight into selective nitrergic neuropathy in diabetes. Diabetologia. 2004;47:331–339.

Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003;348:383–393.

Lonn EM, Bosch J, López-Jaramillo P, Zhu J, Liu L, Pais P. Blood-Pressure Lowering in intermediate-Risk Persons without Cardiovascular Disease. N Engl J Med. 2016;374:2009–2020.

Yusuf S, Bosch J, Dagenais G, Zhu J, Xavier D, Liu L. Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease. N Engl J Med. 2016;374:2021–2031.

Yusuf S, Lonn E, Pais P, López-Jaramillo P, Zhu J, Xavier D. Blood-pressure and cholesterol lowering in persons without cardiovascular disease. N Engl J Med. 2016;374:2032–2043.

Jyothirmayi GN, Soni BJ, Masurekar M, Lyons M, Regan TJ. Effects of Metformin on Collagen Glycation and Diastolic Dysfunction in Diabetic Myocardium. J Cardiovasc Pharmacol Ther. 1998;3:319–326.

Barry E, Roberts S, Oke J, Vijayaraghavan S, Normasenll R, Greenhalgh T. Efficacy and effectiveness of screen and treat policies in prevention of type 2 diabetes systematic review and meta-analysis of screening tests and interventions. BMJ. 2017;356:i6538–i6538.

Knowler WC, Fowler SE. Hamman RF et al 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374:1677–1686.

Diabetes Prevention Program Research Group Long-term Effects of Lifestyle Intervention or Metformin on Diabetes Development and Microvascular Complications over 15-year follow-up the DPP Outcomes Study. Lancet Diabetes Endocrinol. 2015;3:866–875.

Diabetes Prevention Program Research Group The 10-year cost-effectiveness of lifestyle intervention or metformin for diabetes prevention an intent-to-treat analysis of the DPP/DPPOS. Diabetes Care. 2012;35:723–730.

Lopez-Jaramillo P. Defining the research priorities to fight the burden of cardiovascular diseases in Latin America. J Hyperten. 2008;26:1886–1889.

Hostalek U, Gwilt M, Hildemann S. Therapeutic Use of Metformin in Prediabetes and Diabetes Prevention. Drugs. 2015;75:1071–1094.

Lopez-Jaramillo P, Lahera V, Lopez-Lopez J. Epidemic of cardiometabolic diseases A Latin American point of view. Ther Adv Cardiovas Dis. 2011;5:119–131.

Lopez-Jaramillo P, Rey JJ, Gomez-Arbelaez D, Rodriguez YA, Lopez-Lopez J. Combatir la epidemia de diabetes mellitus tipo 2 en Latinoamerica caracteristicas especiales que demandan acciones innovadoras. Clin Invest Arterioscl. 2011;23:90–99.

Lopez-Jaramillo P. Cardiometabolic diseases in Latin America the role of fetal programming in response to maternal malnutrition. Rev Esp Cardiol. 2009;62:670–676.

Lopez-Jaramillo P, Lopez-Lopez J. Fetal programming and cardiometabolic diseases the role of angiotensin II and inflammation. Clin Invest Arterioscl. 2010;22(Suppl 2):37–40.

Lopez-Jaramillo P, Garcia G, Camacho P. A, Herrera E, Castillo V Interrelationship between body mass index, C-reactive protein and blood pressure in a Hispanic pediatric population. Am J Hyperten. 2008;21:527–532.

Cohen DD, Gomez-Arbelaez D, Camacho PA, Pinzon S, Hormiga C, Trejos-Suarez J, Duperly J, Lopez-Jaramillo P. Low muscle strength is associated with metabolic risk factors in Colombian children The ACFIES study. Plos One. 2014;9(4):e93150 doi: 10.1371/journal.pone.0093150.

Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A, Jr, Orlandini A, et al. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet. 2015;18(386):266–273.

Lopez-Jaramillo P, Cohen DD, Gómez-Arbeláez D, Bosch J, Dyal L, Yusuf S, et al. for the ORIGIN Trial Investigators Association of handgrip strength to cardiovascular mortality in pre-diabetic and diabetic patients: A subanalysis of the ORIGIN trial. Int J Cardiol. 2014;172:458–461.

Leong DP, Teo KK. Rangarajan S Kutty VR.Lanas F.Hui C Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries a prospective urban rural epidemiologic (PURE) study. J Cachexia Sarcopenia Muscle. 2016;7(5):535–546Apr. doi: 10.1002/jcsm.12112.

Lopez-Lopez J, Lopez-Jaramillo P, Camacho PA, Gomez-Arbelaez D, Cohen DD. The link between fetal programming, inflammation, muscular strength, and blood pressure. Mediators Inflammation. 2015;2015

Barker DJ, Martyn CN. The maternal and fetal origins of cardiovascular disease. J Epidemiol Community Health. 1992;46:8–11.

Lopez-Jaramillo P, Gomez-Arbelaez D, Sotomayor-Rubio A, Mantilla-Garcia D, Lopez-Lopez J. Maternal undernutrition and cardiometabolic disease A Latin America Perspective. BMC Medicine. 2015;13:41–41.

López-Jaramillo P, Silva S. Y, Rodríguez-Salamanca N, Duran A, Mosquera W, Castillo V Are nutrition-induced epigenetic changes the link between socioeconomic pathology and cardiovascular diseases? Am J Ther. 15, 2008;15:362–372.

Perez M, Gonzales L, Olarte R, Rodriguez NJ, Tabares M, Salazar JP. Nonalcoholic fatty liver disease is associated with insulin resistance in a young Hispanic population. Prev Med. 2011;52:174–177.

Gomez-Arbelaez D, Lopez-Jaramillo P. Mechanisms of acute coronary syndromes. N Engl J Med. 2013;310:882–884.

Lopez-Jaramillo P, Gomez-Arbelaez D, Lopez-Lopez J, Lopez-Lopez C, Martinez-Ortega J, Gomez-Rodriguez A, et al. The role of leptin-adiponectin ratio in metabolic syndrome and diabetes. Horm Mol Biol Clin Invest. 2014;18(1):37–45. doi: 10.1515/hmbci-2013-0053.

Lopez-Jaramillo P. The role of adiponectin in cardiometabolic diseases effecs of nutritional interventions. J Nutr. 2016;146:422S–426S.

Lopez-Jaramillo P, Gonzalez-Gomez S, Vanstrahlen-Gonzales L, Zarate-Bernal D, DiStefano K, Camacho-Lopez P. The interaction between epigenetic, muscle, and cardiovascular diseases. Clinical Epigenetics. 2015;1:7–7.

Block T, El-Osta A. Epigenetic programming, early life nutrition and the risk of metabolic disease. Atherosclerosis. 2017;266:31–40..

Downloads

Download data is not yet available.
Received 2017-11-28
Accepted 2018-01-09
Published 2024-06-05