Reytor González, Claudia

Preferred name

Main Affiliation

Facultad de Ciencias de la Salud y Bienestar Humano

Ambato

Scopus Author ID

59139226400

Now showing 1 - 10 of 18

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Hot flashes: a potential marker of deterioration of health-related quality of life
(2026)
Juan E. Blümel
;
María S. Vallejo
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Peter Chedraui
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Eugenio Arteaga
;
Félix Ayala
Objective: Hot flashes are among the most common symptoms of the menopausal transition and have traditionally been considered benign and self-limiting. However, increasing evidence suggests that they may indicate broader neurovascular and inflammatory dysregulation linked to reproductive aging. The possible effect of hot flush severity on health-related quality of life (HRQoL) remains inadequately studied, particularly in Latin American populations. This study aimed to examine the association between hot flash severity and HRQoL in middle-aged women using validated tools and a large, multicenter sample. Method: A cross-sectional study was conducted between June 2024 and January 2025 in 30 healthcare centers across 12 Latin American countries. A total of 3523 women aged 40–60 years were assessed using the Menopause Rating Scale (MRS) to evaluate vasomotor symptoms and the Short Form-36 Health Survey (SF-36) to measure HRQoL. Multivariable logistic regression models were utilized to estimate the association between hot flush severity and low HRQoL, adjusting for sociodemographic, behavioral and clinical covariates. Results: Increasing severity of hot flushes was significantly associated with lower HRQoL scores across all SF-36 domains. In the logistic regression analysis, mild hot flushes (MRS item 1 score = 1) were associated with increased odds of impaired HRQoL (odds ratio [OR] 1.29; 95% confidence interval [CI]: 1.08–1.55), whereas very severe symptoms (MRS item 1 score = 4) demonstrated a substantially stronger association (OR 4.10; 95% CI: 2.93–5.74). Additional factors significantly associated with lower HRQoL included physical inactivity, the presence of comorbidities, obesity, current use of psychotropic medication, age ≥50 years and having two or more children. Conclusion: Hot flush severity is a strong and independent determinant of HRQoL in midlife women. These findings underscore the need for systematic assessment and targeted management of vasomotor symptoms in routine care, supporting the hypothesis that hot flashes may be a clinical marker of systemic aging. © 2026 International Menopause Society.
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Alcohol and Substance Use After Bariatric Surgery: Nutritional Risks and Clinical Implications in Long-Term Postoperative Care
(2026)
Martín Campuzano-Donoso
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Reytor González, Claudia
;
Gerardo Sarno
;
Martha Montalvan
;
Luigi Barrea
Metabolic and bariatric surgery (MBS) has evolved into a highly effective neurohormonal intervention for severe obesity; however, it introduces unique long-term vulnerabilities, particularly regarding alcohol (AUD) and substance use disorders (SUD). This review synthesizes the epidemiological, pharmacokinetic, and neurobiological drivers of postoperative substance misuse. Procedures like Roux-en-Y gastric bypass (RYGB) radically alter ethanol metabolism, eliminating first-pass metabolism and accelerating gastric emptying, while simultaneously recalibrating reward pathways, creating a “reward gap” that facilitates addiction transfer. These physiological shifts exacerbate critical micronutrient deficiencies (thiamine, B12, iron), increase the risk of post-bariatric hypoglycemia, and correlate with higher rates of liver cirrhosis and suicide. Furthermore, substance use is a primary driver of suboptimal weight loss trajectories and weight regain. Mitigation requires a lifelong, multidisciplinary framework involving preoperative risk stratification, validated screening (e.g., AUDIT-C), and targeted nutritional supplementation to safeguard the long-term metabolic and psychological benefits of MBS.
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Endometriosis as a Systemic and Complex Disease: Toward Phenotype-Based Classification and Personalized Therapy
(2026)
Simancas Racines, Daniel
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Emilia Jiménez-Flores
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Martha Montalvan
;
Raquel Horowitz
;
Valeria Araujo
Endometriosis is traditionally conceptualized as a pelvic lesion–centered disease; however, mounting evidence indicates it is a chronic, systemic, and multifactorial inflammatory disorder. This review examines the molecular dialog between ectopic endometrial tissue, the immune system, and peripheral organs, highlighting mechanisms that underlie disease chronicity, symptom variability, and therapeutic resistance. Ectopic endometrium exhibits distinct transcriptomic and epigenetic signatures, disrupted hormonal signaling, and a pro-inflammatory microenvironment characterized by inflammatory mediators, prostaglandins, and matrix metalloproteinases. Immune-endometrial crosstalk fosters immune evasion through altered cytokine profiles, extracellular vesicles, immune checkpoint molecules, and immunomodulatory microRNAs, enabling lesion persistence. Beyond the pelvis, systemic low-grade inflammation, circulating cytokines, and microRNAs reflect a molecular spillover that contributes to chronic pain, fatigue, hypothalamic–pituitary–adrenal axis dysregulation, and emerging gut–endometrium interactions. Furthermore, circulating biomarkers—including microRNAs, lncRNAs, extracellular vesicles, and proteomic signatures—offer potential for early diagnosis, patient stratification, and monitoring of therapeutic responses. Conventional hormonal therapies demonstrate limited efficacy, whereas novel molecular targets and delivery systems, including angiogenesis inhibitors, immune modulators, epigenetic regulators, and nanotherapeutics, show promise for precision intervention. A systems medicine framework, integrating multi-omics analyses and network-based approaches, supports reconceptualizing endometriosis as a systemic inflammatory condition with gynecologic manifestations. This perspective emphasizes the need for interdisciplinary collaboration to advance diagnostics, therapeutics, and individualized patient care, ultimately moving beyond a lesion-centered paradigm toward a molecularly informed, holistic understanding of endometriosis.
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Molecular Bases of Myopathies and Their Impact on Clinical Practice: Advances and Future Perspectives
(2026)
Martín Campuzano-Donoso
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Reytor González, Claudia
;
Melannie Toral-Noristz
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Yamilia González
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Simancas Racines, Daniel
Myopathies represent a highly heterogeneous group of primary muscle disorders, traditionally classified based on clinical presentation and histopathological findings. Recent breakthroughs in molecular genetics, immunology, and pathophysiology have revolutionized the understanding, diagnosis, and management of these conditions. Both inherited and acquired forms of myopathy, including structural, metabolic, inflammatory, endocrine, and mitochondrial subtypes, are now recognized to arise from diverse pathogenic mechanisms such as impaired calcium handling, mitochondrial dysfunction, chronic inflammation, altered metabolism, and defective muscle regeneration. The advent of next-generation sequencing technologies has enabled more precise diagnosis of genetic forms, while the discovery of novel molecular biomarkers and immunological signatures offers promising avenues for disease monitoring and stratification across the broader spectrum. Importantly, molecular and mechanistic insights have redefined clinical classifications, allowing for better prognostic predictions and patient-tailored therapeutic approaches. Innovative treatments, including gene therapy, antisense oligonucleotide therapies, immune-modulating agents, metabolic support strategies, and targeted pharmacological interventions, are progressively translating molecular knowledge into clinical applications. However, technical limitations, biological variability, and ethical considerations continue to pose significant challenges to the implementation of precision medicine in myopathies. In this narrative review, we comprehensively discuss the latest molecular findings, their integration into clinical practice, and the emerging therapeutic strategies based on these discoveries. We also highlight current limitations and propose future research directions aimed at bridging the gap between molecular insights and effective, equitable patient care.
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The Oral–Gut–Immune–Nutrition Axis in Rheumatoid Arthritis: Molecular Mechanisms and Therapeutic Implications
(2026)
Reytor González, Claudia
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Náthaly Mercedes Román-Galeano
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Lenin Saul Aules-Curicama
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Camila Doménica Cevallos-Villacis
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Erik González
Rheumatoid arthritis is a chronic systemic autoimmune disease that arises from complex interactions among genetic susceptibility, environmental factors, and immune dysregulation. Growing evidence indicates that microorganisms residing in the oral cavity and gastrointestinal tract, together with dietary factors, play a central role in shaping inflammatory and autoimmune responses in rheumatoid arthritis, forming an interconnected microbiome–immune–nutrition axis. Alterations in the composition and function of oral and intestinal microbial communities are associated with disruption of mucosal barrier integrity, activation of innate and adaptive immune pathways, increased differentiation of proinflammatory T lymphocyte subsets, and loss of immune tolerance that promotes autoantibody production. In addition, microbially derived metabolites, particularly short-chain fatty acids, provide a mechanistic link between microbial ecology, immune regulation, and bone metabolism. Diet represents a key upstream modulator of this axis. Dietary patterns rich in anti-inflammatory nutrients support microbial diversity and immunoregulatory metabolite production, whereas diets high in processed foods and saturated fats favor proinflammatory microbial profiles. Accumulating clinical evidence suggests that nutritional strategies and microbiome-targeted dietary interventions may reduce systemic inflammation and disease-related comorbidities when used alongside standard pharmacological treatments. Taken together, the microbiome–immune–nutrition axis represents a modifiable and clinically meaningful target in rheumatoid arthritis, emphasizing the need for interdisciplinary research and well-designed clinical trials to translate these insights into personalized approaches for disease management. The aim of this review is to integrate current mechanistic and clinical evidence on the interactions between the microbiome, immune system, and nutrition in rheumatoid arthritis, with a focus on their pathogenic relevance, therapeutic potential, and implications for personalized, diet-based interventions.
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Severity of menopausal symptoms is associated with lower work-related quality of life and job satisfaction in midlife Latin American women: REDLINC XIII
(2026)
María S. Vallejo
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Juan E. Blümel
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Peter Chedraui
;
Juan Matsumura-Kasano
;
Paolo Meza
Background: Female participation in the workforce has increased, particularly among women over 50; hence, the influence of menopause on occupational well-being requires greater attention. Although the epidemiology of climacteric symptoms has been well documented, their impact on job satisfaction and work-related quality of life remains underexplored, especially in low- and middle-income countries, and is virtually absent from large, multinational studies in Latin America. Objective: To evaluate the relationship between severe menopausal symptoms and occupational well-being among salaried, employed midlife women in Latin America. Methods: A cross-sectional study was conducted between June 2024 and January 2025 across 30 centres in 12 Latin American countries, with a total of 2035 employed women (aged 40 to 60 years). Menopausal symptoms were assessed with the Menopause Rating Scale, and occupational well-being domains were assessed using the Work-Related Quality of Life Scale and the Job Satisfaction Scale. Hierarchical multiple linear regression analyses were conducted to assess the contribution of menopausal symptom severity to occupational well-being. Results: Women with severe menopausal symptoms scored significantly lower across all domains of both the Job Satisfaction Scale and the Work-Related Quality of Life Scale. Hierarchical regression analyses showed that menopausal symptoms were the strongest predictors of job satisfaction (R2 = 0.133). Higher education, menopausal hormone therapy use, and physical activity were positive predictors, whereas number of children, comorbidities, psychotropic medication use, and higher body mass index were associated with lower job satisfaction. For work-related quality of life (R2 = 0.121), education, physical activity, and sexual activity were the main positive predictors, while psychological and severe menopausal symptoms were the strongest negative predictors. The final models explained 13.3% of the variance in job satisfaction and 18.7% in work-related quality of life. Conclusions: This study, one of the first large multinational analyses in Latin-American, shows that the severity of menopausal symptoms is negatively associated with occupational well-being. These findings highlight the necessity for workplace strategies and public policies that recognise menopause as a significant determinant of women's occupational well-being. © 2026 Elsevier B.V.
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Sleep disorders and menopausal symptoms: a Latin American perspective on postmenopausal health
(2025)
Eugenio E. Arteaga
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Juan E. Blümel
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María S. Vallejo
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Carlos Salinas
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Konstantinos Tserotas
Objective: This cross-sectional, observational study, conducted in nine Latin American countries, aimed to examine the association between hot flashes and insomnia, and whether the severity of vasomotor symptoms (VMS) correlates with sleep disturbances. Method: The study collected sociodemographic and clinical data, and evaluated the presence of sleep disorders using Jenkin’s Sleep Scale (JSS-4) and menopausal symptoms using the Menopause Rating Scale (MRS) questionnaire. Results: The study included 1185 postmenopausal women with average age 56.9 ± 5.7 years, body mass index (BMI) of 26.5 ± 5.2 kg/m² and 8.6 ± 6.4 years since menopause. Overall, 20.6% reported sleep disturbances. Compared to those without sleep problems, affected women had longer postmenopausal duration (12 ± 9.0 vs. 10.8 ± 7.8, p < 0.03), had higher BMI (27.9 ± 5.6 vs. 26.1 ± 5.0, p < 0.001), were more often smokers and homemakers, and had more comorbidities. They were also less likely to have a partner or have used menopausal hormone therapy. Sleep disturbances increased proportionally with VMS severity (p < 0.01). In multivariate analysis, sleep disorders were associated with VMS (odds ratio [OR] 4.47), psychotropic use (OR 1.84), obesity (OR 1.45) and comorbidities (OR 1.45). Conclusion: Women with VMS were more likely to experience sleep disorders and this effect was proportional to the magnitude of the hot flashes. The study also presents several factors associated with sleep disorders in postmenopausal women that should be considered to help prevent these disturbances. © 2025 International Menopause Society.
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Obesity, Bariatric Surgery, and Cancer Risk: Nutritional Perspectives and Long-Term Clinical Implications
(2026)
Reytor González, Claudia
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Gerardo Sarno
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Martha Montalvan
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Ludovica Verde
;
Giuseppe Annunziata
Obesity is recognized as a causal risk factor for the development of multiple cancers, with risk magnitude varying by tumor site, sex, life stage, and adipose tissue distribution. This narrative review synthesizes recent epidemiological evidence linking excess body fatness with cancer incidence and mortality and integrates the biological mechanisms that explain this association. Chronic low-grade inflammation, insulin resistance with compensatory hyperinsulinemia, dysregulation of adipose-derived hormones and sex steroids, impairment of anti-tumor immune responses, alterations in the gut microbiota, and remodeling of the tumor microenvironment collectively create conditions that favor tumor initiation and progression. Bariatric surgery is the most effective clinical intervention for achieving substantial and sustained weight loss in individuals with severe obesity, and growing evidence indicates that it is associated with a reduction in overall cancer risk and cancer-related mortality, particularly for malignancies strongly linked to obesity. However, the extent of this benefit differs by surgical technique and remains less consistent for colorectal cancer. Beyond metabolic improvements, bariatric surgery produces long-term changes in nutritional physiology that may also influence oncologic outcomes. Persistent deficiencies of micronutrients such as iron, folate, vitamin B12, vitamin D, and calcium can affect DNA synthesis, methylation, oxidative balance, and cellular repair. Altered protein and energy intake may contribute to loss of lean mass and reduced metabolic resilience, while changes in alcohol absorption and metabolism can increase systemic exposure to ethanol and its carcinogenic metabolites. In addition, bariatric surgery induces sustained remodeling of the gut microbiome and bile acid metabolism, which may further modulate tumorigenic signaling. Overall, the oncological impact of bariatric surgery reflects a balance between metabolic improvement and long-term nutritional management, underscoring the need for structured follow-up and targeted nutritional strategies to optimize cancer risk reduction.
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Dietary Diversity, Dietary Patterns, and Cardiometabolic Health in University Students: A Cross-Sectional Study
(2026)
Diana Fonseca-Pérez
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Ludwig Álvarez-Córdova
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Cecilia Arteaga-Pazmiño
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Víctor Sierra-Nieto
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Cagua Ordoñez, Jaen
Cardiometabolic risk is increasingly observed in young adults, particularly during university years, and is not limited to individuals with elevated body mass index. Emerging evidence highlights the presence of normal weight obesity—characterized by excess adiposity and unfavorable body composition despite normal BMI—which may confer early metabolic vulnerability. Dietary diversity is often promoted as a marker of dietary adequacy; however, its relationship with adiposity, body composition, and muscular health remains inconsistent, particularly in Latin American populations. Moreover, few studies have directly contrasted dietary diversity indicators with empirically derived dietary patterns in relation to cardiometabolic and functional outcomes. Objective: To examine the associations between dietary diversity, dietary patterns, and indicators of adiposity, muscular strength, and relative muscle mass in Ecuadorian university students. Methods: A cross-sectional study was conducted among 349 undergraduate students aged 18–26 years enrolled in health sciences programs in Ecuador. Dietary intake was assessed using a validated food frequency questionnaire. Dietary diversity was quantified using the Food and Agriculture Organization’s Individual Dietary Diversity Score, while dietary patterns were identified through principal component analysis followed by k-means clustering. Outcomes included excess body weight, relative muscle mass assessed by bioelectrical impedance analysis, and handgrip strength. Multivariable Poisson and linear regression models were fitted, adjusting for age, sex, academic program, physical activity level, and pre-existing conditions. Results: Despite their young age and low prevalence of diagnosed disease, approximately one-third of the participants exhibited markers of early cardiometabolic risk, including excess body weight and central adiposity. Higher dietary diversity was independently associated with a higher prevalence of excess body weight (adjusted prevalence ratio per one-unit increase in IDDS: 1.17; 95% CI: 1.06–1.30) and with greater relative muscle mass (adjusted β = 0.13; 95% CI: 0.05–0.22), whereas no association was observed with handgrip strength. In contrast, dietary patterns derived from multivariate analysis showed no significant associations with adiposity, muscular strength, or relative muscle mass after adjustment. Conclusions: In this young adult population, dietary diversity captured aspects of overall dietary exposure associated with both increased adiposity and greater lean mass, but not with muscular strength. Empirically derived dietary patterns demonstrated limited discriminatory capacity, likely reflecting dietary homogeneity within the cohort. These findings indicate that dietary diversity alone does not necessarily reflect diet quality and underscore the importance of interpreting diversity metrics alongside indicators of food quality, energy density, and body composition when evaluating early cardiometabolic risk in contemporary food environments.
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Association of menopausal symptoms on work performance in midlife Latin American women
(2026)
Konstantinos Tserotas
;
Juan E. Blümel
;
Peter Chedraui
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María S. Vallejo
;
Mónica Ñañez
OBJECTIVE: To explore the association between the severity of menopausal symptoms and work-related outcomes and performance. METHODS: This cross-sectional study involved 3,523 women aged 40-60 from 30 health care centres across 12 Latin American countries. The severity of menopausal symptoms was assessed with the Menopause Rating Scale (MRS). Work-related outcomes were surveyed, including absenteeism, medical visits, perceived reduced work performance, impact of menopause on work performance, and job loss. Comparisons employed suitable tests based on data distribution, and logistic regression was used to assess associations, adjusting for covariates such as menopausal symptoms, comorbidities, age, and education. RESULTS: Women with severe menopausal symptoms (total MRS score ≥14 points) were significantly older (51.1 ± 5.1 vs 49.7 ± 5.6y), had a higher body mass index (27.4 ± 4.8 vs 26.7 ± 4.6 kg/m 2 ), were postmenopausal in a higher proportion (69.9% vs 52.2%), had more comorbidities (42.8% vs 27.6%), higher smoking prevalence, and lower educational attainment. In addition, these women significantly reported more medical leaves (42.4% vs 29.5%), more medical visits (mean: 3.9 vs 2.5 visits), and a more significant perceived reduction of work performance (82.1% vs 56.7%). They also were more likely to believe that menopause significantly reduced their work capacity (67.0% vs 24.0%), had a higher prevalence of job dismissals (6.9% vs 2.0%), and more voluntary resignations or early retirements (8.1% vs 4.7%). Binary logistic regression determined that severe menopausal symptoms, subsequently adjusted for covariates, were primarily associated with more work absenteeism (aOR: 1.64; 95% CI: 1.41-1.90), more medical visits (aOR: 2.45; 95% CI: 1.97-3.05), decreased work performance (aOR: 3.13; CI 95%: 2.65-3.69), the perception of menopause negatively impacting their work performance (aOR: 5.84; 95% CI: 5.01-6.80), more job dismissals (aOR: 3.23; 95% CI: 2.21-4.72), and more voluntary resignations or early retirements (aOR: 1.44; 95% CI: 1.08-1.93). CONCLUSION: In this large sample of midlife Latin American women, severe menopausal symptoms were associated with reduced work capacity and adverse work-related outcomes. Copyright © 2025 by The Menopause Society.
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Reytor González, Claudia

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