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
;
Peter Chedraui
;
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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Natural Products Targeting Key Molecular Hallmarks in Gastric Cancer: Focus on Apoptosis, Inflammation, and Chemoresistance
(2026)
Simancas Racines, Daniel
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Cagua Ordoñez, Jaen
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Angamarca Iguago, Jaime
;
Parise Vasco, Juan Marcos
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Reytor González, Claudia
Natural products have emerged as promising multi-target agents for addressing the complex biology of gastric cancer, a malignancy characterized by marked molecular heterogeneity, late clinical presentation, and frequent resistance to systemic therapies. This narrative synthesis integrates primarily preclinical evidence, with emerging clinical data, on how naturally derived compounds modulate three central molecular processes that drive gastric tumor progression and therapeutic failure: evasion of programmed cell death, persistent tumor-promoting inflammation, and chemoresistance. Compounds such as curcumin, resveratrol, berberine, ginsenosides, quercetin, and epigallocatechin gallate restore apoptotic competence by shifting the balance between pro-survival and pro-death proteins, destabilizing mitochondrial membranes, promoting cytochrome c release, and activating caspase-dependent pathways. These agents also exert potent anti-inflammatory effects by inhibiting nuclear factor kappa B and signal transducer and activator of transcription signaling, suppressing pro-inflammatory cytokine production, reducing cyclooxygenase activity, and modulating the tumor microenvironment through changes in immune cell behavior. In parallel, multiple natural compounds function as chemo-sensitizers by inhibiting drug efflux transporters, reversing epithelial–mesenchymal transition, attenuating cancer stem cell-associated traits, and suppressing pro-survival signaling pathways that sustain resistance. Collectively, these mechanistic actions highlight the capacity of natural products to simultaneously target interconnected hallmarks of gastric cancer biology. Ongoing advances in formulation strategies may help overcome pharmacokinetic limitations; however, rigorous biomarker-guided studies and well-designed clinical trials remain essential to define the translational relevance of these compounds.
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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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Single vs. Dual Agonist Pharmacotherapy for Managing Insufficient Weight Loss and Weight Regain Following Metabolic and Bariatric Surgery: A Comparative Review
(2026)
Reytor González, Claudia
;
Martín Campuzano-Donoso
;
Gerardo Sarno
;
Martha Montalvan
;
Raquel Horowitz
Weight management after metabolic and bariatric surgery remains a persistent clinical challenge, particularly when patients experience insufficient weight loss or progressive weight regain following the postoperative nadir. In recent years, pharmacological therapies targeting gut-derived hormones have reshaped the therapeutic approach, offering nonsurgical strategies that directly influence appetite regulation, satiety, and energy balance. Single agonists acting on the glucagon-like peptide one receptor have demonstrated meaningful reductions in body weight among postoperative patients, while dual agonists that target both the glucagon-like peptide one receptor and the glucose-dependent insulinotropic polypeptide receptor have shown even greater weight reduction in early studies, suggesting enhanced therapeutic potential. These benefits, however, must be interpreted within the unique anatomical, nutritional, and behavioral context of individuals who have undergone metabolic and bariatric procedures, as they are inherently at higher risk for micronutrient deficiencies, gastrointestinal intolerance, and maladaptive eating patterns. Successful treatment requires a balanced integration of pharmacotherapy, individualized nutritional guidance, psychological support, and a patient-centered model of long-term care. Although emerging evidence is promising, dedicated clinical trials are still needed to directly compare the efficacy, safety, and sustainability of single versus dual agonist therapies in postoperative populations. Furthermore, culturally sensitive dietary strategies and shared decision-making processes are essential to enhance adherence, optimize long-term outcomes, and ensure equitable access to treatment. Ultimately, these therapies represent a significant advance in addressing postoperative weight challenges, but their full potential will rely on comprehensive, multidisciplinary frameworks that support both biological and behavioral aspects of chronic weight management.
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The Oral–Gut–Immune–Nutrition Axis in Rheumatoid Arthritis: Molecular Mechanisms and Therapeutic Implications
(2026)
Reytor González, Claudia
;
Náthaly Mercedes Román-Galeano
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Lenin Saul Aules-Curicama
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Camila Doménica Cevallos-Villacis
;
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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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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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
;
Juan E. Blümel
;
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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Bioactive Natural Compounds in Triple-Negative Breast Cancer: Molecular Targets and Therapeutic Perspectives
(2026)
Emilia Jiménez-Flores
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Reytor González, Claudia
;
Dolores Jima Gavilanes
;
Cesar Carrillo
;
Raquel Horowitz
Triple-negative breast cancer represents one of the most aggressive and therapeutically challenging subtypes of breast malignancies, characterized by marked biological heterogeneity, rapid progression, and limited targeted treatment options. Conventional therapies are frequently constrained by drug resistance, systemic toxicity, and high rates of recurrence. In this context, natural products have gained increasing attention as multifunctional agents capable of modulating several hallmarks of triple-negative breast cancer. Bioactive compounds, including polyphenols, terpenoids, alkaloids, and marine-derived molecules, exhibit pleiotropic antitumor effects by interfering with key oncogenic pathways. Importantly, these compounds have demonstrated the ability to counteract major mechanisms of therapeutic resistance, modulate the tumor immune microenvironment, and enhance the efficacy of standard chemotherapy and immunotherapy. Advances in drug delivery strategies, such as nanoparticle-based systems and tumor-targeted formulations, together with patient-specific molecular profiling, further expand the potential of these agents within personalized treatment approaches. This narrative review critically examines the role of natural compounds in targeting the hallmarks of triple-negative breast cancer and their potential synergistic use to improve therapeutic efficacy while reducing treatment-related toxicity. Overall, the integration of natural product-based strategies into precision oncology frameworks may offer more effective, less toxic, and individualized therapeutic options for this aggressive breast cancer subtype.
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Dietary Diversity, Dietary Patterns, and Cardiometabolic Health in University Students: A Cross-Sectional Study
(2026)
Diana Fonseca-Pérez
;
Ludwig Álvarez-Córdova
;
Cecilia Arteaga-Pazmiño
;
Víctor Sierra-Nieto
;
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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Reytor González, Claudia

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