Aportes trasnacionales de la Epigenética a la Prevención de la DM2

A diferencia de la poca información útil para la práctica clínica obtenida de los estudios de genómica para predecir e identificar individuos en riesgo de presentar DM2 (84,85), el aparecimiento de marcadores epigenéticos como los patrones de metilación en promotores genéticos específicos, si pueden ser útiles en la identificación de sujetos y poblaciones con aumentada sensibilidad a presentar DM2 en la vida adulta a causa de factores adversos en la nutrición intrauterina (86).

La identificación de estas poblaciones o individuos, puede ser de gran utilidad para el desarrollo de programas preventivos de DM2, ya sea a través de modificaciones en los estilos de vida o a través de intervenciones nutricionales o farmacológicas activas (87-89). Las consecuencias fenotípicas y epigenéticas del retardo de crecimiento intrauterino en el desarrollo pancreático y el riesgo de presentar DM2 en la vida adulta, podría ser revertidas por intervenciones farmacológicas que modifiquen las alteraciones epigenéticas, así por ejemplo, con medicamentos de uso oncológico como el inhibidor de la deacetilasa de histonas (89).

En conclusión el proceso de transición de individuos nacidos de madres mal nutridas con bajo peso y que en la vida adulta se exponen en hábitos de vida que le conducen a obesidad abdominal, parece ser el determinante de la epidemia de diabetes que se presenta actualmente en los países latinoamericanos.

La comprensión de estos procesos a través de investigaciones epidemiológicas, clínicas y básicas, debe ser una prioridad en nuestra región, y de cuyos resultados dependerán la implementación de programas preventivos eficaces y eficientes que tomen en consideren las diferencias regionales dependientes de mecanismos epigenéticos.

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