Universidade Federal de Ouro Preto

The interaction between genetic polymorphisms and environmental factors increases the risk of developing a diabetic phenotype which is associated with systemic arterial hypertension (SAH) and cardiovascular diseases. Variants in the T-cell factor 7-like 2 (TCF7L2) gene have been associated with type 2 diabetes mellitus (T2DM). To investigate the association of the rs.11196205 polymorphism of the TCF7L2 gene with biochemical and anthropometric parameters and cardiovascular risk indices in Brazilian patients with SAH and T2DM.

The polymorphism was identified by qPCR in 664 samples from four groups: Control (CG-without diabetes or hypertension), diabetic (DG-normotensive), hypertensive (HG-without diabetes) and hypertensive diabetic (HDG), using the TaqMan® system. Biochemical dosages were taken for the lipid profile: triglycerides (TG), total cholesterol, HDL, LDL, and uric acid. Anthropometric measurements were taken for body mass index (BMI), visceral fat index and cardiovascular risk calculations, including the atherogenic index of plasma (AIP), visceral adiposity index (VAI), triglyceride-glucose (TyG) index and uric acid/HDL-c ratio (UA/HDL). Bivariate logistic regression was used to identify variables associated with SAH and T2DM. Subsequent categorical variables were analyzed using multinomial logistic regression.

The GG genotype of the rs.11196205 variant of the TCF7L2 gene was associated with an increased risk of hypertension and diabetic hypertension. Patients in the GHD group with the GG genotype showed worsening BMI parameters and TyG index values.

The GG genotype of the rs.11196205 variant of the TCF7L2 gene acts as a cardiovascular risk genotype in patients with diabetic hypertension.

The association of genetic variants and environmental factors contribute to increased susceptibility to arterial hypertension (AH). Polymorphisms of the angiotensin-converting enzyme (ACE) gene have been identified as a genetic risk factor related to blood pressure (BP) levels and liver function, since they influence the renin-angiotensin-aldosterone system (RAAS).

To evaluate the influence of the rs4344 polymorphism of the ACE gene on AH and biochemical parameters of liver function (ALT, AST, GGT and ALP) in normotensive and hypertensive patients.

The identification of the polymorphism was performed by qPCR, using the TaqMan^® system, in 811 individuals (484 normotensive and 327 hypertensive) and biochemical dosages (AST, ALT, GGT and ALP) were performed by UV/Vis spectrophotometry. A univariate logistic regression model was used to identify factors associated with hypertension and Pearson's chi-square test to assess allele frequency between groups. A multivariate logistic regression model was used to correct confounding factors and assess the association of the variant with hypertension. Data normality was assessed using the Shapiro-Wilk test. Continuous nonparametric variables were expressed as median and interquartile range and analyzed using the Mann-Whitney test and parametric data were expressed as mean and standard deviation and analyzed by unpaired Student's t test. The rs4344 variant was not linked to hypertension in the individuals examined. However, concerning liver function marker enzymes, the G allele was associated with increased levels of GGT and ALT in hypertensive patients.

Our findings indicated that the rs4344 variant of the ACE gene is linked to impaired liver function in hypertensive individuals.

This is an Evaluability Assessment (EA) of the Specialized Care for Vulnerable Populations (SEAS) and Specialized Reference Centers for People Experiencing Homelessness (Centro POP) in Belo Horizonte, Brazil. These are social protection services for people in vulnerable situations who use the streets for housing and/or survival. The Thurston and Ramaliu model was employed with the construction of theoretical and logical models and SWOT matrix, using the analysis of legal frameworks, technical documents, on-site visits, and discussion groups with local managers. Questions were developed to compose questionnaires validated using the Delphi technique. This validation enhanced the evaluative questions, increasing the analytical power of the tools. Significant lessons were identified regarding the object of investigation and the use of the EA. Regarding the object, the findings highlight how challenging it is to offer services tailored to this population, necessitating intensive intra- and intersectoral efforts. Conversely, significant potentials for the operation of these services were elucidated. Regarding the use of the EA, three key lessons stand out: i) EA supports the implementation of participatory evaluation, ii) employing various tools and data collection methods paves the way for applying multiple evaluation approaches, and iii) there are diverse stakeholders interested in the results of an EA. The feasibility of conducting a more extensive systematic evaluation was confirmed, making this EA a pioneering effort for services aimed at the people experiencing homelessness within the field of social assistance.