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Mallorquí A, Oliveira C, Rios J, Isla-Pera MP, Gil-Badenes J, Amoretti S, Bernardo M, Vieta E, Parellada E, Garriga M, García-Rizo C. Nurse-led lifestyle intervention in a cohort of schizophrenia patients treated with clozapine. Arch Psychiatr Nurs 2023; 46:51-57. [PMID: 37813503 DOI: 10.1016/j.apnu.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 06/06/2023] [Accepted: 06/18/2023] [Indexed: 10/17/2023]
Abstract
Patients diagnosed with schizophrenia are characterized by early mortality compared to the general population. The main cause of this premature death reflects medical complications linked to metabolic syndrome (MetS). The use of antipsychotics such as clozapine is associated with weight gain and metabolic disturbances in certain predisposed individuals. Non-pharmacological interventions for weight control have become a key element for secondary prevention in the health of patients diagnosed with schizophrenia. Here, we aim to evaluate the physical health effects of a nurse-led non-pharmacological intervention program in patients with a diagnosis of schizophrenia treated with clozapine. Thirty-one outpatients from the outpatient clinical facility of Hospital Clinic in Barcelona, Spain diagnosed with schizophrenia and other psychotic disorders receiving clozapine treatment were enrolled in a prospective interventional study, comprising an 8-week group program of therapeutic education in a healthy lifestyle. MetS factors, physical activity, diet, and lifestyle were evaluated at baseline, post-intervention (8 weeks), and 3 months after the program. Weight, body mass index, high-density lipoprotein cholesterol, and diet patterns displayed significant differences post-intervention and after 3 months, while only waist, hip perimeter, and lifestyle improved post-intervention. Our results suggest the effectiveness of the lifestyle intervention in patients under clozapine treatment despite its long-time differential effect. Strategies to prevent weight gain and metabolic decline will help prevent premature cardiometabolic disease in this vulnerable population.
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Affiliation(s)
- Andrea Mallorquí
- Neurosciences Institute, Hospital Clinic of Barcelona, Barcelona, Spain; Jaume I University, Castellón, Spain.
| | | | - Jose Rios
- Medical Statistics Core Facility, Hospital Clinic Barcelona, Barcelona, Spain; Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maria Pilar Isla-Pera
- Public Health, Mental Health and Maternal Department, Universitat de Barcelona, Campus de Bellvitge, L'Hospitalet del Llobregat, Barcelona, Spain
| | - Joaquin Gil-Badenes
- Barcelona Clinic Schizophrenia Unit (BCSU), Neurosciences Institute, Hospital Clinic Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Silvia Amoretti
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit (BCSU), Neurosciences Institute, Hospital Clinic Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Neurosciences Institute, Hospital Clinic Barcelona, Barcelona, Spain; University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Eduard Parellada
- Barcelona Clinic Schizophrenia Unit (BCSU), Neurosciences Institute, Hospital Clinic Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Marina Garriga
- Bipolar and Depressive Disorders Unit, Neurosciences Institute, Hospital Clinic Barcelona, Barcelona, Spain; University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | - Clemente García-Rizo
- Barcelona Clinic Schizophrenia Unit (BCSU), Neurosciences Institute, Hospital Clinic Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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Melero V, Arnoriaga M, Barabash A, Valerio J, Del Valle L, Martin O'Connor R, de Miguel MP, Diaz JA, Familiar C, Moraga I, Duran A, Cuesta M, Torrejon MJ, Martinez-Novillo M, Moreno M, Romera G, Runkle I, Pazos M, Rubio MA, Matia-Martín P, Calle-Pascual AL. An Early Mediterranean-Based Nutritional Intervention during Pregnancy Reduces Metabolic Syndrome and Glucose Dysregulation Rates at 3 Years Postpartum. Nutrients 2023; 15:3252. [PMID: 37513670 PMCID: PMC10383706 DOI: 10.3390/nu15143252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
A Mediterranean diet (MedDiet)-based intervention reduces the rate of immediate postpartum maternal metabolic disorders. Whether these effects persist long-term remains to be determined. A total of 2526 normoglycemic women were randomized before the 12th gestational week (GW). IG women followed a MedDiet with extra virgin olive oil (EVOO) (>40 mL/day) and a handful of nuts daily, whereas CG women had to restrict all kinds of dietary fat. At 3 months postpartum, a motivational lifestyle interview was held. The endpoint of the study evaluated the rate of abnormal glucose regulation (AGR) and metabolic syndrome (MetS) at 3 years postpartum in women of the San Carlos cohort. A total of 369/625 (59%) CG women and 1031/1603 (64.3%) IG women were finally analyzed. At 3 months and 3 years postdelivery, the IG women showed higher adherence to the MedDiet, which was associated with lower values of body mass index (BMI) and lipid and glycemic profiles. Body weight change and waist circumference were lower in the IG women. After applying multiple regression analysis, the ORs (95%CI) resulted in AGR (3.18 (2.48-4.08); p < 0.001)/MetS (3.79 (1.81-7.95); p = 0.001) for women with GDM and higher OR for development of MetS in CG women (3.73 (1.77-7.87); p = 0.001). A MedDiet-based intervention early in pregnancy demonstrated persistent beneficial effects on AGR and MetS rates at 3 years postpartum.
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Affiliation(s)
- Verónica Melero
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Maria Arnoriaga
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Ana Barabash
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Laura Del Valle
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Rocio Martin O'Connor
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Maria Paz de Miguel
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Jose Angel Diaz
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Inmaculada Moraga
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Alejandra Duran
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Martín Cuesta
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - María José Torrejon
- Clinical Laboratory Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Mercedes Martinez-Novillo
- Clinical Laboratory Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Maria Moreno
- Clinical Laboratory Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Gisela Romera
- Clinical Laboratory Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Mario Pazos
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
| | - Miguel A Rubio
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Pilar Matia-Martín
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Alfonso Luis Calle-Pascual
- Endocrinology and Nutrition Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
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Espigares-Tribo G, Ensenyat A. Assessing an educational booklet for promotion of healthy lifestyles in sedentary adults with cardiometabolic risk factors. PATIENT EDUCATION AND COUNSELING 2021; 104:201-206. [PMID: 32595028 DOI: 10.1016/j.pec.2020.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 06/06/2020] [Accepted: 06/06/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES 1) To evaluate and improve the suitability and readability of an educational booklet designed for use in an intervention aimed at promoting healthy lifestyles as a way to manage cardiometabolic risk factors in adults with low levels of physical activity and 2) to check its acceptability to real end users. METHODS A 7-phase methodology was used. The evaluation committee (9 experts, 6 potential end users) scored the booklet using the Suitability Assessment of Materials (SAM) and health education material (HEM) questionnaires on two occasions (original and revised version). Acceptability was also assessed by 75 real end users after a lifestyle intervention. RESULTS The SAM and HEM scores of the revised booklet were respectively 10% (SD = 9%) and 10% (SD = 7%) higher than the original booklet scores. The revised version attained "superior" scoring in all questionnaires: SAM, 87% (SD = 8%); HEM, 3.5 (SD = 0.4) out of 4; Acceptability, 3.7 (SD = 0.4) out of 4. CONCLUSIONS The suitability and readability of an educational booklet-to promote a healthy lifestyle-were improved following a systematic peer-review evaluation prior to its use in an intervention. PRACTICE IMPLICATIONS Improving the suitability and readability of educational resources can have a positive impact on patient knowledge and awareness, and hence on intervention effectiveness.
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Affiliation(s)
- Gemma Espigares-Tribo
- National Institute of Physical Education of Catalonia (INEFC), Campus Lleida, Catalonia, Spain
| | - Assumpta Ensenyat
- National Institute of Physical Education of Catalonia (INEFC), Campus Lleida, Catalonia, Spain; Complex systems and sport research group, Spain.
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Cuesta M, Fuentes M, Rubio M, Bordiu E, Barabash A, Garcia de la Torre N, Rojo-Martinez G, Valdes S, Soriguer F, Vendrell JJ, Urrutia IM, Ortega E, Montanya E, Menendez E, Lago-Sampedro A, Gomis R, Goday A, Castell C, Badia-Guillen R, Girbés J, Gaztambide S, Franch-Nadal J, Delgado Álvarez E, Chaves FJ, Castano L, Calle-Pascual AL. Incidence and regression of metabolic syndrome in a representative sample of the Spanish population: results of the cohort di@bet.es study. BMJ Open Diabetes Res Care 2020; 8:8/1/e001715. [PMID: 33051280 PMCID: PMC7554469 DOI: 10.1136/bmjdrc-2020-001715] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/22/2020] [Accepted: 08/19/2020] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Metabolic syndrome (MetS) is an important predictor of cardiovascular mortality. Identification of occurrence and regression trends of MetS could permit elaboration of preventive strategies with new targets. The objective of this study was to analyze the occurrence and regression rates of MetS and its associated factors in the representative cohort of Spain of the di@bet.es study. RESEARCH DESIGN AND METHODS The di@bet.es study is a prospective cohort where 5072 people representative of the Spanish population over 18 years of age were randomly selected between 2009 and 2010. Follow-up was a median of 7.5 (IQR 7.2-7.9) years, with 2408 (47%) participating subjects. A total of 1881 (78%) subjects had all the pertinent data available and were included in this study. RESULTS Of the 1146 subjects without baseline criteria for MetS, 294 (25.7%) developed MetS during follow-up, while of the 735 patients with prior MetS, 148 (20.1%) presented regression. Adjusted MetS incidence per 1000 person-years was 38 (95% CI 32 to 44), while regression incidence was 36 (95% CI 31 to 41). Regression rate was independently higher than incidence rate in the following: women, subjects aged 18-45, university-degree holders, patients without central obesity, without hypertension, as well as those with body mass index of <25 kg/m2. Lower progression and higher regression rates were observed with an adapted 14-point Mediterranean Diet adherence screener questionnaire score of >11 in both groups and with >500 and>2000 MET-min/week of physical activity, respectively. CONCLUSIONS This study provides MetS incidence and regression rates, and identifies the target population for intervention strategies in Spain and possibly in other countries.
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Affiliation(s)
- Martín Cuesta
- Endocrinologia y Nutricion, Hospital Clínico San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Manuel Fuentes
- Peventive Medicine Department, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Miguel Rubio
- Endocrinologia y Nutricion, Hospital Clínico San Carlos, Madrid, Spain
| | - Elena Bordiu
- Endocrinologia y Nutricion, Hospital Clínico San Carlos, Madrid, Spain
- Departamento de Medicina II, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana Barabash
- Endocrinologia y Nutricion, Hospital Clínico San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Nuria Garcia de la Torre
- Endocrinologia y Nutricion, Hospital Clínico San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Gemma Rojo-Martinez
- Endocrinology and Nutrition Department, Hospital Universitario Carlos Haya, Malaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Malaga, Spain
| | - Sergio Valdes
- Endocrinology and Nutrition Department, Hospital Universitario Carlos Haya, Malaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Malaga, Spain
| | - Federico Soriguer
- Endocrinology and Nutrition Department, Hospital Universitario Carlos Haya, Malaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Malaga, Spain
| | - Joan Josep Vendrell
- Endocrinology, University Hospital Joan XXIII, Tarragona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Tarragona, Spain
| | - Ines Maria Urrutia
- Endocrinology and Diabetes Research Group,UPV/EHU, Endo-ERN (ID number 739527), BioCruces Health Research Institute, Barakaldo, Bizkaia, Spain
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spanish Biomedical Research Network in Rare Diseases (CIBERER), Barakaldo, Spain
| | - Emilio Ortega
- Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute - IDIBAPS, Barcelona, Spain
- Spanish Biomedical Research Network in Physiopathology of Obesity and Nutrition (CIBEROBN), Barcelona, Spain
| | - Eduard Montanya
- Hospital Universitario Bellvitge IDIBELL, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barceloma, Spain
| | - Eldelmiro Menendez
- Department of Endocrinology and Nutrition, Department of Medicine,University of Oviedo, Health Research Institute of the Principality of Asturias (ISPA), Central University Hospital of Asturias, Oviedo, Asturias, Spain
- Spanish Biomedical Research Network in Rare Diseases (CIBERER), Oviedo, Asturias, Spain
| | - Ana Lago-Sampedro
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Malaga, Spain
- Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Hospital Universitario Carlos Haya, Malaga, Spain
| | - Ramón Gomis
- Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute - IDIBAPS, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barceloma, Spain
| | - Albert Goday
- Spanish Biomedical Research Network in Physiopathology of Obesity and Nutrition (CIBEROBN), Barcelona, Spain
- Department of Medicine, Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain
| | - Conxa Castell
- Department of Health, Public Health Agency of Catalonia, Barcelona, Catalunya, Spain
| | - Rocio Badia-Guillen
- Endocrinology and Nutrition Department, Hospital Universitario Carlos Haya, Malaga, Spain
| | - Juan Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Valenciana, Spain
| | - Sonia Gaztambide
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spanish Biomedical Research Network in Rare Diseases (CIBERER), Barakaldo, Spain
- Department of Endocrinology, UPV/EHU, Endo-ERN (ID number 739527), Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
| | - Josep Franch-Nadal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barceloma, Spain
- Research Support Unit (IDIAP - Jordi Gol Foundation), EAP Raval Sud, Catalan Institute of Health, GEDAPS Network, Primary Care, Barcelona, Spain
| | - Elías Delgado Álvarez
- Spanish Biomedical Research Network in Rare Diseases (CIBERER), Oviedo, Asturias, Spain
- Department of Endocrinology and Nutrition, Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Felipe Javier Chaves
- Genetic Diagnosis and Genotyping Unit, Fundacion Investigacion Clinico de Valencia-INCLIVA; CIBERDEM, Valencia, Valenciana, Spain
| | - Luis Castano
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spanish Biomedical Research Network in Rare Diseases (CIBERER), Barakaldo, Spain
- Endocrine Research Laboratory, Biocruces Bizkaia Health Research Institute, UPV/EHU, Endo-ERN (ID number 739527), Hospital de Cruces, Barcaldo,Vizcaya, Spain
| | - Alfonso L Calle-Pascual
- Endocrinologia y Nutricion, Hospital Clínico San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
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Semisupervised Physical Exercise and Lifestyle Counseling in Cardiometabolic Risk Management in Sedentary Adults: Controlled Randomized Trial (BELLUGAT). J Phys Act Health 2020; 17:744-755. [PMID: 32531762 DOI: 10.1123/jpah.2019-0409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 03/17/2020] [Accepted: 04/27/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the feasibility and effectiveness of a high-intensity semisupervised exercise program alongside lifestyle counseling as an intervention for managing cardiometabolic risk in sedentary adults. METHODS A 40-week 3-arm randomized controlled clinical trial (16-wk intervention and 24-wk follow-up) was used. Seventy-five sedentary adults (34-55 y) with at least 1 cardiometabolic risk factor were randomized into one of the following arms: (1) aerobic interval training (AIT) plus lifestyle counseling (n = 25), (2) low- to moderate-intensity continuous training plus lifestyle counseling (traditional continuous training, TCT) (n = 27), or (3) lifestyle counseling alone (COU) (n = 23). Metabolic syndrome severity scores, accelerometer-based physical activity, and self-reported dietary habits were assessed at baseline, after the intervention, and at follow-up. RESULTS AIT was well accepted with high enjoyment scores. All groups showed similar improvements in metabolic syndrome severity scores (standardized effect size = 0.46) and dietary habits (standardized effect size = 0.30). Moderate to vigorous physical activity increased in all study groups, with the number of responders higher in AIT and TCT groups (50%) than in COU group (21%). Both AIT and TCT had a greater impact on sedentary behavior than COU (63.5% vs 30.4% responders). CONCLUSIONS AIT appears to be a feasible and effective strategy in sedentary individuals with cardiometabolic risk factors. AIT could be included in intervention programs tackling unhealthy lifestyles.
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Assaf-Balut C, Garcia de la Torre N, Durán A, Bordiu E, Del Valle L, Familiar C, Valerio J, Jimenez I, Herraiz MA, Izquierdo N, Runkle I, de Miguel MP, Montañez C, Barabash A, Cuesta M, Rubio MA, Calle-Pascual AL. An Early, Universal Mediterranean Diet-Based Intervention in Pregnancy Reduces Cardiovascular Risk Factors in the "Fourth Trimester". J Clin Med 2019; 8:jcm8091499. [PMID: 31546914 PMCID: PMC6780735 DOI: 10.3390/jcm8091499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/10/2019] [Accepted: 09/16/2019] [Indexed: 01/15/2023] Open
Abstract
An early antenatal dietary intervention could play an important role in the prevention of metabolic diseases postpartum. The aim of this study is to evaluate whether an early, specific dietary intervention reduces women’s cardiovascular risk in the “fourth trimester”. This prospective cohort study compares 1675 women from the standard-care group (ScG/n = 676), who received standard-care dietary guidelines, with the intervention group (IG/n = 999), who received Mediterranean diet (MedDiet)-based dietary guidelines, supplemented with extra-virgin olive oil and nuts. Cardiovascular risk was determined by the presence of metabolic syndrome (MetS) and insulin resistance syndrome (IrS) (HOMA-IR 3.5) at 12–14 weeks postpartum. MetS was less frequent in the IG (11.3 vs. 19.3%, p < 0.05). The intervention was associated with a reduction in the relative risk of having MetS: 0.74 (95% CI, 0.60–0.90), but not in the risk of IrS. When analyzing the presence of having one or more components of the MetS, the IG had significantly higher rates of having 0 components and lower rates of having ≥1 (p-trend = 0.029). An early MedDiet-based nutritional intervention in pregnancy is associated with reductions in postpartum rates of MetS.
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Affiliation(s)
- Carla Assaf-Balut
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Nuria Garcia de la Torre
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain.
| | - Alejandra Durán
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Elena Bordiu
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Laura Del Valle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Johanna Valerio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Inés Jimenez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Miguel Angel Herraiz
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Nuria Izquierdo
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
- Gynecology and Obstetrics Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - María Paz de Miguel
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Carmen Montañez
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
| | - Ana Barabash
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain.
| | - Martín Cuesta
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain.
| | - Miguel Angel Rubio
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | - Alfonso Luis Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
- Facultad de Medicina, Medicina II Department, Universidad Complutense de Madrid, 28040 Madrid, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain.
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Reynoso-Villalpando GL, Sevillano-Collantes C, Valle Y, Moreno-Ruiz I, Padilla-Gutiérrez JR, Del Cañizo-Gómez FJ. ApoB/ApoA1 ratio and non-HDL-cholesterol/HDL-cholesterol ratio are associated to metabolic syndrome in patients with type 2 diabetes mellitus subjects and to ischemic cardiomyopathy in diabetic women. ACTA ACUST UNITED AC 2019; 66:502-511. [PMID: 31182348 DOI: 10.1016/j.endinu.2019.03.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 03/13/2019] [Accepted: 03/20/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND AIM Presence of metabolic syndrome (MS) in patients with type 2 diabetes mellitus (T2DM) involves an increased risk of cardiovascular disease and death. Markers such as ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios have been used to predict this risk with conflicting results. The study objective was to establish the relationship between the apoB/apoA1 and non-HDL-cholesterol/HDL-cholesterol ratios and MS in T2DM patients from a Madrid (Spain) district. PATIENTS AND METHODS One hundred patients with T2DM who attended University Hospital Infanta Leonor (Vallecas, Madrid, Spain) between January 2014 and June 2017 were enrolled. A blood sample was taken every 6 months from all patients to measure the different lipid parameters and to calculate ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios. A Mann-Whitney's U test to compare means and a Spearman's correlation test for correlations between variables were used, and a multivariate regression analysis was performed to determine the association between MS and the ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios. Values of p<0.05 were considered significant. RESULTS Associations were found between MS and ApoA1 (R2=0.164, p=0.028), ApoB/ApoA1 (R2=0.187, p=0.001), and non-HDL-cholesterol/HDL-cholesterol (R2= 0.269, p=0.0001) ratios and, in women with MS, between ApoB/ApoA1 ratio and ischemic cardiomyopathy (IC) (R2=0.160, p=0.032). Associations remained after adjusting for comorbidities and risk factors. CONCLUSIONS In the T2DM patients studied, MS was independently associated to ApoA1 and the ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios. Both ratios were better predictors of MS in T2DM subjects that its components alone. The ApoB/ApoA1 ratio could be used as a cardiovascular risk marker in women with MS.
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Affiliation(s)
- Gabriela Lizet Reynoso-Villalpando
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), Edificio Q, Primer piso, Colonia Independencia, Guadalajara, Mexico; Doctorado en Genética Humana, Centro Universitario de Ciencias de la Salud, Guadalajara, Mexico
| | - Cristina Sevillano-Collantes
- Sección de Endocrinología y Nutrición, Hospital Universitario Infanta Leonor, Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Yeminia Valle
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), Edificio Q, Primer piso, Colonia Independencia, Guadalajara, Mexico
| | - Inmaculada Moreno-Ruiz
- Sección de Endocrinología y Nutrición, Hospital Universitario Infanta Leonor, Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Jorge Ramón Padilla-Gutiérrez
- Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdG), Edificio Q, Primer piso, Colonia Independencia, Guadalajara, Mexico
| | - Francisco Javier Del Cañizo-Gómez
- Sección de Endocrinología y Nutrición, Hospital Universitario Infanta Leonor, Facultad de Medicina, Universidad Complutense, Madrid, Spain.
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8
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Norte A, Alonso C, Martínez-Sanz JM, Gutierrez-Hervas A, Sospedra I. Nutritional Status and Cardiometabolic Risk Factors in Institutionalized Adults with Cerebral Palsy. ACTA ACUST UNITED AC 2019; 55:medicina55050157. [PMID: 31108986 PMCID: PMC6572289 DOI: 10.3390/medicina55050157] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/02/2019] [Accepted: 05/15/2019] [Indexed: 01/10/2023]
Abstract
Background and Objectives: Cerebral palsy (CP) is a set of permanent disorders that limit physical activity and increase the risk of developing other diseases, such as metabolic syndrome (MS). Adequate nutrition can contribute to the prevention of associated symptoms. The main objective of this study is to evaluate the nutritional status and the prevalence of cardiometabolic risk factors in adults with CP and Gross Motor Function Classification System (GMFCS) levels between IV and V. Materials and Methods: A sample of 41 adults with CP and GMFCS levels from IV to V were studied. The variables used in the study were age, sex, weight, height, mean age, and GMFCS level range. To evaluate nutritional status, body mass index and the Mini Nutritional Assessment (MNA), a nutritional screening tool, were used. To assess cardiometabolic risk, data on obesity, central obesity, blood pressure, fasting plasma glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were collected. Results: More than 80% of the population studied was malnourished or at risk of malnutrition, according to the MNA tool classification ranges, and around 35% of the studied population was within the underweight range. Regarding cardiometabolic risk factors, only one adult with CP was diagnosed with MS. Conclusions: The studied population of adults with CP and GMFCS levels between IV and V is not a population at risk of MS; however, the high prevalence of malnutrition, as well as some of the most prevalent cardiovascular risk factors, should be taken into consideration.
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Affiliation(s)
- Aurora Norte
- Nursing Department, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain.
- Research Group on Food and Nutrition (ALINUT), University of Alicante, 03690 Alicante, Spain.
| | - Coral Alonso
- Nursing Department, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain.
| | - José Miguel Martínez-Sanz
- Nursing Department, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain.
- Research Group on Food and Nutrition (ALINUT), University of Alicante, 03690 Alicante, Spain.
| | - Ana Gutierrez-Hervas
- Nursing Department, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain.
| | - Isabel Sospedra
- Nursing Department, Faculty of Health Science, University of Alicante, 03690 Alicante, Spain.
- Research Group on Food and Nutrition (ALINUT), University of Alicante, 03690 Alicante, Spain.
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9
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Samblas M, Milagro FI, Martínez A. DNA methylation markers in obesity, metabolic syndrome, and weight loss. Epigenetics 2019; 14:421-444. [PMID: 30915894 DOI: 10.1080/15592294.2019.1595297] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The fact that not all individuals exposed to the same environmental risk factors develop obesity supports the hypothesis of the existence of underlying genetic and epigenetic elements. There is suggestive evidence that environmental stimuli, such as dietary pattern, particularly during pregnancy and early life, but also in adult life, can induce changes in DNA methylation predisposing to obesity and related comorbidities. In this context, the DNA methylation marks of each individual have emerged not only as a promising tool for the prediction, screening, diagnosis, and prognosis of obesity and metabolic syndrome features, but also for the improvement of weight loss therapies in the context of precision nutrition. The main objectives in this field are to understand the mechanisms involved in transgenerational epigenetic inheritance, and featuring the nutritional and lifestyle factors implicated in the epigenetic modifications. Likewise, DNA methylation modulation caused by diet and environment may be a target for newer therapeutic strategies concerning the prevention and treatment of metabolic diseases.
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Affiliation(s)
- Mirian Samblas
- a Department of Nutrition, Food Science and Physiology; Centre for Nutrition Research , University of Navarra , Pamplona , Spain
| | - Fermín I Milagro
- a Department of Nutrition, Food Science and Physiology; Centre for Nutrition Research , University of Navarra , Pamplona , Spain.,b CIBERobn, CIBER Fisiopatología de la Obesidad y Nutrición , Instituto de Salud Carlos III. Madrid , Spain.,c IdiSNA, Instituto de Investigación Sanitaria de Navarra (IdiSNA) , Pamplona , Spain
| | - Alfredo Martínez
- a Department of Nutrition, Food Science and Physiology; Centre for Nutrition Research , University of Navarra , Pamplona , Spain.,b CIBERobn, CIBER Fisiopatología de la Obesidad y Nutrición , Instituto de Salud Carlos III. Madrid , Spain.,c IdiSNA, Instituto de Investigación Sanitaria de Navarra (IdiSNA) , Pamplona , Spain.,d IMDEA, Research Institute on Food & Health Sciences , Madrid , Spain
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10
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Raposo L, Severo M, Santos AC. Adiposity cut-off points for cardiovascular disease and diabetes risk in the Portuguese population: The PORMETS study. PLoS One 2018; 13:e0191641. [PMID: 29377924 PMCID: PMC5788377 DOI: 10.1371/journal.pone.0191641] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 01/09/2018] [Indexed: 11/18/2022] Open
Abstract
Objectives The contribution of adiposity to cardiovascular and diabetes risk justifies the inclusion of an adiposity measure, usually waist circumference, in the definition of metabolic syndrome. However, waist circumference thresholds differ across populations. Our aim was to assess which adiposity measure performs the best in identifying the metabolic syndrome in a sample of Portuguese participants and to estimate cut-off values for these measures. Methods Data were obtained from a cross-sectional study (PORMETS study) conducted in Portugal between 2007 and 2009. A representative sample of non-institutionalized adults, comprising 3,956 participants, aged 18 years and older, was evaluated. A structured questionnaire was administered, collecting information on personal medical history, socio-demographics and behavioral characteristics. Anthropometrics, blood pressure and venous blood samples were also obtained. Metabolic syndrome was defined according to the Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology recommended criteria. Elevated cardiometabolic risk was considered when two or more of the four criteria of metabolic syndrome were present, excluding the waist circumference component. A receiver operating characteristic curve was used to estimate cut-off points. Results This study found that waist-to-height ratio, waist circumference and body adiposity index performed better than other adiposity measures, such as body mass index. The estimated cut-off points for waist-to-height ratio, waist circumference and body adiposity index in women and men were 0.564 / 89 cm / 27.4 and 0.571 / 93.5 cm / 25.5, respectively. Conclusion As waist circumference is currently used as the adiposity measure in the definition of metabolic syndrome and as no relevant differences were observed between this measure and waist-to-height ratio, it is likely that no modification to the metabolic syndrome definition needs to be proposed. Moreover, this study also confirmed the applicability of European cut-off points in the Portuguese population.
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Affiliation(s)
- Luís Raposo
- Insulin Resistance Study Group of the Portuguese Society of Endocrinology, Diabetes and Metabolism, Lisboa, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- * E-mail:
| | - Milton Severo
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Ana Cristina Santos
- Insulin Resistance Study Group of the Portuguese Society of Endocrinology, Diabetes and Metabolism, Lisboa, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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11
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Guo H, Gao X, Ma R, Liu J, Ding Y, Zhang M, Zhang J, Mu L, He J, Yan Y, Ma J, Guo S, Wei S. Prevalence of Metabolic Syndrome and its Associated Factors among Multi-ethnic Adults in Rural Areas in Xinjiang, China. Sci Rep 2017; 7:17643. [PMID: 29247195 PMCID: PMC5732195 DOI: 10.1038/s41598-017-17870-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 12/01/2017] [Indexed: 11/09/2022] Open
Abstract
Metabolic syndrome (MetS) has become a global public health problem affecting all nations and races. Few studies on the epidemic of metabolic syndrome (MetS) examined multi-ethnic adults in rural areas in Xinjiang, China. We thus investigated the prevalence and risk factors of MetS there. A cross-sectional study was performed in a representative sample of 15020 rural multi-ethnic adults from 2009 to 2010. Four widely used criteria (ATPIII\IDF\JIS\CDS) were used to measure the prevalence of MetS. Multiple logistic regression analysis was used to explore the risk factors of MetS. The age-adjusted prevalence of MetS was 14.43%, 21.33%, 26.50%, and 19.89% based on the ATP III, IDF, JIS and CDS criterion, respectively. The prevalence of MetS was higher in women and increased with age. According to JIS criterion, the prevalence of components in MetS was 57.75% for abdominal obesity, 44.05% for elevated blood pressure, 40.98% for reduced HDL-cholesterol, 23.33% for elevated triglycerides, 18.95% for raised fasting plasma glucose. Lower consumption of vegetables, milk, and higher consumption of red meat were associated with higher likelihood of having MetS. The prevalence of MetS in Xinjiang rural multi-ethnic adults was high. Diet factors were associated with the prevalence of MetS.
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Affiliation(s)
- Heng Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University 109 Chandlee Lab, University Park, PA, 16801, USA
| | - Rulin Ma
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Jiaming Liu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Yusong Ding
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Mei Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Jingyu Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Lati Mu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Jia He
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Yizhong Yan
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Jiaolong Ma
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China
| | - Shuxia Guo
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, 832000, China.
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
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12
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Cinza Sanjurjo S, Llisterri Caro JL, Segura Fragoso A, Prieto Díaz MÁ, Escobar Cervantes C, Barquilla García A, Rodríguez Padial L, Pallarés Carratalá V, Vidal Pérez R, Miravet Jiménez S, Rodríguez Roca GC, Badimón JJ, in representation of the IBERICAN S. Characteristics of the Metabolic Syndrome in the Patients of IBERICAN Study (Identification of the Spanish Population at Cardiovascular and Renal Risk). Metab Syndr Relat Disord 2017. [DOI: 10.1089/met.2017.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - Antonio Segura Fragoso
- Instituto de Ciencias de la Salud de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | | | | | | | | | | | - Rafael Vidal Pérez
- Servicio de Cardiología, Hospital Universitario Lucus Augusti, Lugo, Spain
| | | | | | - Juan Jose Badimón
- Atherothrombosis Research Unit, Cardiovascular Institute, Mount Sinai School of Medicine, New York, New York
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13
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Vallecillo G, Robles MJ, Torrens M, Samos P, Roquer A, Martires PK, Sanvisens A, Muga R, Pedro-Botet J. Metabolic syndrome among individuals with heroin use disorders on methadone therapy: Prevalence, characteristics, and related factors. Subst Abus 2017; 39:46-51. [DOI: 10.1080/08897077.2017.1363122] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Gabriel Vallecillo
- Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - María José Robles
- Department of Geriatric Medicine, Hospital del Mar, Barcelona, Spain
| | - Marta Torrens
- Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Pilar Samos
- Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Barcelona, Spain
| | - Albert Roquer
- Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Paula K. Martires
- Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Barcelona, Spain
| | - Arantza Sanvisens
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Roberto Muga
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
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14
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An approach to screening for Cushing's syndrome in non-specialized health care settings. ACTA ACUST UNITED AC 2017; 64:407-408. [PMID: 28895535 DOI: 10.1016/j.endinu.2017.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 04/23/2017] [Indexed: 11/23/2022]
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15
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Assaf-Balut C, García de la Torre N, Rubio MA, Bordiú E, Calle-Pascual AL. Change in postpartum insulin resistance syndrome in women with prior GDM identified by Carpenter-Coustan and IADPSG criteria. ACTA ACUST UNITED AC 2017; 64:400-403. [PMID: 28968222 DOI: 10.1016/j.endinu.2017.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 04/24/2017] [Accepted: 04/29/2017] [Indexed: 12/30/2022]
Affiliation(s)
- Carla Assaf-Balut
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Nuria García de la Torre
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Miguel A Rubio
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Elena Bordiú
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Alfonso L Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain; Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain.
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16
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Ensenyat A, Espigares-Tribo G, Machado L, Verdejo FJ, Rodriguez-Arregui R, Serrano J, Miret M, Galindo G, Blanco A, Marsal JR, Sarriegui S, Sinfreu-Bergues X, Serra-Paya N. Metabolic risk management, physical exercise and lifestyle counselling in low-active adults: controlled randomized trial (BELLUGAT). BMC Public Health 2017; 17:257. [PMID: 28292282 PMCID: PMC5351047 DOI: 10.1186/s12889-017-4144-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 02/23/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The primary aim of this study is to evaluate the effectiveness of different doses (intensity) of supervised exercise training - concomitant with lifestyle counselling - as a primary care intervention tool for the management of metabolic syndrome risk factors in low-active adults with one or more such factors (programme name in Catalan: Bellugat de CAP a peus). METHODS/DESIGN Three-arm, randomized controlled clinical trial implemented in the primary care setting, with a duration of 40 weeks (16 weeks intervention and 24-week follow-up). Adults aged 30 to 55 years with metabolic risk factors will be randomized into three intervention groups: 1) aerobic interval training (16 supervised training lessons) plus a healthy lifestyle counselling programme (6 group and 3 individual meetings); 2) low-to-moderate intensity continuous training (16 supervised training lessons) plus the same counselling programme; or 3) the counselling- programme without any supervised physical exercise. The main output variables assessed will be risk factors for metabolic syndrome (waist circumference, blood pressure, and levels of plasma triglycerides, high-density lipoproteins and glucose), systemic inflammation, cardiorespiratory fitness, physical activity and sedentary behaviour, dietary habits, health-related quality of life, self-efficacy and empowerment. Economic factors will also be analysed in order to determine the cost-effectiveness of the programme. These variables will be assessed three times during the study: at baseline, at the end of the intervention, and at follow-up. We estimate to recruit 35 participants per group. DISCUSSION The results of this study will provide insight into the immediate and medium-term effects on metabolic risk and lifestyle of a combined approach involving aerobic interval training and a multidisciplinary behavioural intervention. If effective, the proposed intervention would provide both researchers and practitioners in this field with a platform on which to develop similar intervention programmes for tackling the repercussions of an unhealthy lifestyle. TRIAL REGISTRATION Clinical trials.gov. NTC02832453 . Registered 6 July 2016 (retrospectively registered).
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Affiliation(s)
- Assumpta Ensenyat
- Institut Nacional d'Educacio Fisica de Catalunya - Campus Lleida, Lleida, Catalonia, Spain.
| | - Gemma Espigares-Tribo
- Institut Nacional d'Educacio Fisica de Catalunya - Campus Lleida, Lleida, Catalonia, Spain
| | - Leonardo Machado
- Institut Nacional d'Educacio Fisica de Catalunya - Campus Lleida, Lleida, Catalonia, Spain
| | - Francisco José Verdejo
- Institut Nacional d'Educacio Fisica de Catalunya - Campus Lleida, Lleida, Catalonia, Spain
| | - Rosa Rodriguez-Arregui
- Institut Nacional d'Educacio Fisica de Catalunya - Campus Lleida, Lleida, Catalonia, Spain
| | - José Serrano
- Institut Nacional d'Educacio Fisica de Catalunya - Campus Lleida, Lleida, Catalonia, Spain
| | - Marta Miret
- Institut Nacional d'Educacio Fisica de Catalunya - Campus Lleida, Lleida, Catalonia, Spain
| | - Gisela Galindo
- Institut Nacional d'Educacio Fisica de Catalunya - Campus Lleida, Lleida, Catalonia, Spain
| | - Alfonso Blanco
- Institut Nacional d'Educacio Fisica de Catalunya - Campus Lleida, Lleida, Catalonia, Spain
| | - Josep-Ramon Marsal
- Institut Nacional d'Educacio Fisica de Catalunya - Campus Lleida, Lleida, Catalonia, Spain
| | - Susana Sarriegui
- Institut Nacional d'Educacio Fisica de Catalunya - Campus Lleida, Lleida, Catalonia, Spain
| | - Xenia Sinfreu-Bergues
- Institut Nacional d'Educacio Fisica de Catalunya - Campus Lleida, Lleida, Catalonia, Spain
| | - Noemi Serra-Paya
- Institut Nacional d'Educacio Fisica de Catalunya - Campus Lleida, Lleida, Catalonia, Spain
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17
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Vayá A, Rivera L, Hernández-Mijares A, Bautista D, Solá E, Romagnoli M, Alis R, Laiz B. Association of metabolic syndrome and its components with hyperuricemia in a Mediterranean population. Clin Hemorheol Microcirc 2016; 60:327-34. [PMID: 25261431 DOI: 10.3233/ch-141887] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Several studies have found an association between hyperuricemia and metabolic syndrome (MS), although there are discrepancies as to which MS components play a pivotal role in this association. We aimed to investigate the association between serum uric acid (SUA) levels and MS in a Mediterranean population (eastern Spain). We performed a case-control study of 71 patients with MS and 122 healthy controls. MS was defined according to the revised National Cholesterol Education Program Adult Treatment Panel III modified criteria. Hyperuricemia was defined as SUA levels >6.55 mg/dL. We determined biochemical, lipidic and inflammatory parameters along with uric acid. Patients with MS showed a higher risk of hyperuricemia than those without MS (OR: 2.87 95% CI: 1.48- 5.55; p = 0.002). In turn, the unadjusted logistic regression analysis showed that hyperuricemia is associated with a higher risk of presenting all the MS components, except hypertension; i.e., hypertriglyceridemia, low HDL-cholesterol, abdominal obesity and glucose intolerance were predictors for hyperuricemia (OR: 3.15, 95% CI: 1.61- 6.15, p = 0.001; OR: 4.07, 95% CI: 1.77- 9.33, p = 0.001; OR: 2.81, 95% CI: 1.41- 5.58, p = 0.003 and OR: 2.82, 95% CI: 1.46- 5.45, p = 0.002 respectively). The adjusted logistic regression analysis revealed that only low HDL-cholesterol and glucose intolerance were independent predictors for hyperuricemia (OR: 2.71, 95% CI 1.06- 6.97, p = 0.038; OR: 2.14, 95% CI 1.01- 4.56, p = 0.049, respectively). In our geographical area, the patients with MS showed a nearly 3-fold risk of hyperuricemia than those without. Among all the MS components, low-HDL-cholesterol and high glucose independently increased more than twice the risk of hyperuricemia, and are the pivotal components involved in hyperuricemia.
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Affiliation(s)
- Amparo Vayá
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
| | - Leonor Rivera
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
| | | | - Daniel Bautista
- Epidemiology Service, Dr. Peset University Hospital, Valencia, Spain
| | - Eva Solá
- Endocrinology Service, Dr. Peset University Hospital, Valencia, Spain
| | - Marco Romagnoli
- Department of Physical Education and Sports, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain.,Research Universitary Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain
| | - Rafael Alis
- Research Universitary Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain.,Faculty of Medicine, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain
| | - Begoña Laiz
- Hemorheology and Haemostasis Unit, Service of Clinical Pathology, La Fe University Hospital, Valencia, Spain
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18
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Guo SX, Zhang XH, Zhang JY, He J, Yan YZ, Ma JL, Ma RL, Guo H, Mu LT, Li SG, Niu Q, Rui DS, Zhang M, Liu JM, Wang K, Xu SZ, Gao X, Ding YS. Visceral Adiposity and Anthropometric Indicators as Screening Tools of Metabolic Syndrome among Low Income Rural Adults in Xinjiang. Sci Rep 2016; 6:36091. [PMID: 27782221 PMCID: PMC5080571 DOI: 10.1038/srep36091] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 10/10/2016] [Indexed: 02/07/2023] Open
Abstract
Most previous studies on metabolic syndrome (MetS) examined urban and high income settings. We thus investigated the prevalence of MetS among a multi-ethnic population living in a low income rural area and explored the use of visceral adiposity and anthropometric indicators to identify men and women with MetS. We recruited 10,029 individuals of nomadic Kazakhs, rural Uyghur and Han residents in Xinjiang, China. MetS was defined by the Joint Interim Statement criteria. The receiver operating characteristic curve (ROC) was used to compare the area under the ROC curve (AUC) of each index. The age-adjusted prevalence of MetS was 21.8%. The visceral adiposity index (VAI), lipid accumulation product (LAP), body adiposity index (BAI) and the waist-to-height ratio (WHtR) were significantly associated with MetS, independent of ethnic, age, and other covariates. The AUC of VAI, LAP and WHtR were all greater than 0.7, and the LAP was the index that most accurately identified MetS status in men (AUC = 0.853) and women (AUC = 0.817), with the optimal cut-offs of 34.7 and 27.3, respectively. In conclusion, the prevalence of MetS in low income rural adults of Xinjiang was high and the LAP was an effective indicator for the screening of MetS.
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Affiliation(s)
- Shu-Xia Guo
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China.,Department of Pathology and Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Xiang-Hui Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Jing-Yu Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Jia He
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Yi-Zhong Yan
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Jiao-Long Ma
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Ru-Lin Ma
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Heng Guo
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - La-Ti Mu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Shu-Gang Li
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Qiang Niu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Dong-Sheng Rui
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Mei Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Jia-Ming Liu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Kui Wang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Shang-Zhi Xu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
| | - Xiang Gao
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China.,Department of Nutritional Sciences, The Pennsylvania State University 109 Chandlee Lab, University Park, PA 16801, USA
| | - Yu-Song Ding
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang 832000, China
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19
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Assaf-Balut C, Bordiú E, Del Valle L, Lara M, Duran A, Rubio MA, Familiar C, Herraiz MA, Izquierdo N, Pérez N, Torrejón MJ, Montañez C, Runkle I, Calle-Pascual AL. The impact of switching to the one-step method for GDM diagnosis on the rates of postpartum screening attendance and glucose disorder in women with prior GDM. The San Carlos Gestational Study. J Diabetes Complications 2016; 30:1360-4. [PMID: 27210051 DOI: 10.1016/j.jdiacomp.2016.04.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 04/05/2016] [Accepted: 04/30/2016] [Indexed: 12/16/2022]
Abstract
AIMS To compare rates of FPG-HbA1C-based postpartum-glucose disorder (PGD) of women with prior gestational diabetes mellitus (GDM) by Carpenter-Coustan criteria (CCc) versus International Association of Diabetes and Pregnancy Study Groups criteria (IADPSGc). METHODS 1620 women with GDM were divided into CCc group (2007-March 2012, n=915), and IADPSGc group (April 2012-2013, n=705). Pregravid (PG) body weight (BW) and body mass index (BMI) and postdelivery (PD) BW, BMI, waist circumference (WC), HOMA-insulin resistance (HOMA-IR), HbA1c, glucose and lipid profile were analysed. PGD definition: HbA1c ≥5.7% and/or FPG ≥5.6mmol/l. RESULTS Postpartum screening attendance rates (PSAr) were similar in both groups, CCc: 791 (86.5%) and IADPSGc: 570 (81%) as in PGD rates (PGDr), CCc: 233 (29.5%) and IADPSGc: 184 (32.3%). Both cohorts had similar PG-BMI, WC and PD-BMI. Both CCc and IADPSGc women had a significantly higher probability of having PGD when PG-BMI ≥25Kg/m(2) (CCc: OR: 1.55; IC 95% 1.06-2.26; p=0.016), (IADPSGc: OR: 1.42; IC 95% 1.03-2.38; p=0.046) as well as when WC ≥89.5cm, and age ≥34years, and in CCc women when PD-WG >0Kg, all adjusted by ethnicity and parity. CONCLUSIONS Changing GDM diagnostic methodology did not affect PSAr and PGDr, in spite of screening more women. Thus, using IADPSGc allowed the identification of a larger number of women with PGD.
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Affiliation(s)
- Carla Assaf-Balut
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain; Facultad de Medicina.Departamento de Medicina 2, Universidad Complutense de Madrid, Hospital Clínico San Carlos-IdISSC, Madrid, Spain
| | - Elena Bordiú
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain; Facultad de Medicina.Departamento de Medicina 2, Universidad Complutense de Madrid, Hospital Clínico San Carlos-IdISSC, Madrid, Spain
| | - Laura Del Valle
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain
| | - Miriam Lara
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain
| | - Alejandra Duran
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain; Facultad de Medicina.Departamento de Medicina 2, Universidad Complutense de Madrid, Hospital Clínico San Carlos-IdISSC, Madrid, Spain
| | - Miguel A Rubio
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain; Facultad de Medicina.Departamento de Medicina 2, Universidad Complutense de Madrid, Hospital Clínico San Carlos-IdISSC, Madrid, Spain
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain
| | - Miguel A Herraiz
- Gynecology and Obstetrician Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain
| | - Nuria Izquierdo
- Gynecology and Obstetrician Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain
| | - Noelia Pérez
- Gynecology and Obstetrician Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain
| | - María J Torrejón
- Clinical Laboratory Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain
| | - Carmen Montañez
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain; Facultad de Medicina.Departamento de Medicina 2, Universidad Complutense de Madrid, Hospital Clínico San Carlos-IdISSC, Madrid, Spain
| | - Alfonso L Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos-IdISSC, Madrid, Spain; Facultad de Medicina.Departamento de Medicina 2, Universidad Complutense de Madrid, Hospital Clínico San Carlos-IdISSC, Madrid, Spain.
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20
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Martínez-Larrad MT, Corbatón-Anchuelo A, Fernández-Pérez C, Lazcano-Redondo Y, Escobar-Jiménez F, Serrano-Ríos M. Metabolic syndrome, glucose tolerance categories and the cardiovascular risk in Spanish population. Diabetes Res Clin Pract 2016; 114:23-31. [PMID: 27103365 DOI: 10.1016/j.diabres.2016.02.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 12/28/2015] [Accepted: 02/08/2016] [Indexed: 12/12/2022]
Abstract
We examined the prevalence of metabolic syndrome (MetS), glucose tolerance categories and risk factors of cardiovascular-disease (CVD) in the general Spanish population. We studied 3844 randomly sampled subjects (46% males) aged 35-74 years. Glucose tolerance categories were defined according to the 2003 ADA and MetS according to the Harmonized Consensus Criteria with waist circumference (WC) cut-off-points previously reported in Spanish population (≥94.5/≥89.5cm for males/females). The prevalences of normoglycemia (NG), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG and IGT considered together (IFG/IGT), and diabetes mellitus (DM) were 67.6/16.6/5.0/3.3, and 7.5%, respectively. The overall prevalence of MetS was 31.2%. In subjects with NG, IFG, IGT, IFG/IGT, and DM the MetS prevalence's were 16.3/57.1/31.5/66.1, and 74.4% (p<0.001), respectively. MetS was more common in males, older subjects, smokers, and/or individuals with obesity, IFG, IFG/IGT, DM, or insulin resistance (HOMA-IR ≥3.8). MetS was less prevalent in individuals with low alcohol intake and/or high education level. Regarding the risk level of CVD estimated by Framingham and SCORE risk charts, IGT had higher estimated CVD-risk than IFG and IFG/IGT. The presence of MetS increases the risk 4.85 times by Framingham and 2.43 times by SCORE. Prevalence of prediabetes (IFG/IGT) and MetS were 25% and 31.2% respectively. Prevalence of MetS has not changed in the past decade in Spanish females, but has slightly increased in males. We found that subjects with IGT showed a higher risk of CVD than IFG and IFG/IGT according to the Framingham and SCORE. MetS increased the CVD-risk previously estimated by Framingham and SCORE.
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Affiliation(s)
- María Teresa Martínez-Larrad
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Arturo Corbatón-Anchuelo
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Cristina Fernández-Pérez
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Yera Lazcano-Redondo
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | | | - Manuel Serrano-Ríos
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
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21
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García Díaz E, Guagnozzi D, Gutiérrez V, Mendoza C, Maza C, Larrañaga Y, Perdomo D, Godoy T, Taleb G. Effect of incretin therapies compared to pioglitazone and gliclazide in non-alcoholic fatty liver disease in diabetic patients not controlled on metformin alone: An observational, pilot study. ACTA ACUST UNITED AC 2016; 63:194-201. [PMID: 26976710 DOI: 10.1016/j.endonu.2016.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 12/31/2015] [Accepted: 01/04/2016] [Indexed: 02/07/2023]
Abstract
AIM To compare the effect of different hypoglycemic drugs on laboratory and ultrasonographic markers of non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes not controlled on metformin alone. METHODS Prospective study of diabetic patients treated with metformin in combination with gliclazide, pioglitazone, sitagliptin, exenatide, or liraglutide. NAFLD was assessed by abdominal ultrasound and NAFLD fibrosis score was calculated at baseline and 6 months. RESULTS Fifty-eight patients completed 6 months of follow-up: 15 received gliclazide, 13 pioglitazone, 15 sitagliptin, 7 exenatide, and 8 liraglutide. NAFLD affected 57.8% of patients at baseline, and its ultrasonographic course varied depending on changes in weight (P=.009) and waist circumference (P=.012). The proportions of patients who experienced ultrasonographic improvement in the different treatment groups were: 33.3% with gliclazide, 37.5% with pioglitazone, 45.5% with sitagliptin, 80% with exenatide, and 33% with liraglutide (P=.28). CONCLUSIONS Qualitative ultrasonographic NAFLD improvement in diabetic patients treated with metformin in combination with other hypoglycemic drugs is associated to change over time in weight and waist circumference. Long-term clinical trials are needed to assess whether incretin therapies result in better liver outcomes than other hypoglycemic therapies.
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Affiliation(s)
- Eduardo García Díaz
- Unidad de Endocrinología, Hospital Dr. José Molina Orosa, Lanzarote, Canarias, España.
| | - Danila Guagnozzi
- Unidad de Gastroenterología, Hospital Vall d'Hebron, Barcelona, España
| | - Verónica Gutiérrez
- Unidad de Atención Primaria, Gerencia de Servicios Sanitarios de Lanzarote, Lanzarote, Canarias, España
| | - Carmen Mendoza
- Unidad de Atención Primaria, Gerencia de Servicios Sanitarios de Lanzarote, Lanzarote, Canarias, España
| | - Cristina Maza
- Unidad de Atención Primaria, Gerencia de Servicios Sanitarios de Lanzarote, Lanzarote, Canarias, España
| | - Yulene Larrañaga
- Unidad de Atención Primaria, Gerencia de Servicios Sanitarios de Lanzarote, Lanzarote, Canarias, España
| | - Dolores Perdomo
- Unidad de Atención Primaria, Gerencia de Servicios Sanitarios de Lanzarote, Lanzarote, Canarias, España
| | - Teresa Godoy
- Unidad de Atención Primaria, Gerencia de Servicios Sanitarios de Lanzarote, Lanzarote, Canarias, España
| | - Ghalli Taleb
- Unidad de Atención Primaria, Gerencia de Servicios Sanitarios de Lanzarote, Lanzarote, Canarias, España
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22
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Guo H, Liu J, Zhang J, Ma R, Ding Y, Zhang M, He J, Xu S, Li S, Yan Y, Mu L, Rui D, Niu Q, Guo S. The Prevalence of Metabolic Syndrome Using Three Different Diagnostic Criteria among Low Earning Nomadic Kazakhs in the Far Northwest of China: New Cut-Off Points of Waist Circumference to Diagnose MetS and Its Implications. PLoS One 2016; 11:e0148976. [PMID: 26901035 PMCID: PMC4763161 DOI: 10.1371/journal.pone.0148976] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 01/26/2016] [Indexed: 12/04/2022] Open
Abstract
Background Although the epidemic of metabolic syndrome (MetS) has aroused wide public concern, most studies on MetS tend to examine urban and high income settings, and few studies cover nomadic areas and low earning populations. This research aims to investigate the prevalence of MetS and explore the cut-off point of waist circumference in a nomadic minority typical of low income populations in the remote northwest region of China. Methods A cross-sectional study was performed in a representative sample of 3900 Kazakh adults aged 18–84 years from 2009–2010. Three widely used criteria (ATP III\IDF\JIS) were employed to estimate the prevalence of MetS in Kazakhs to compare them with other populations. Receiver operator characteristic (ROC) curve analysis was used to explore the optimal cut-off values of waist circumference. Results The age-adjusted prevalence of MetS was 13.8%, 20.9%, and 24.8% based on the ATP III, IDF, and JIS criteria, respectively. The prevalence of MetS was higher in women and increased with age. Except for reduced HDL-cholesterol, the risk of other components of MetS increased with waist circumference enlargement. The cut-off point of waist circumference in screening at least two other components of MetS was 88 cm in men (Sensitivity = 61.1%, Specificity = 62.1%, ROC Curve Distance = 0.54) and 83 cm in women (Sensitivity = 60.0%, Specificity = 59.6%, ROC Curve Distance = 0.57). Conclusion The prevalence of MetS in Kazakhs is higher than the national level of China and falls in between the Euro-American and Asia levels, as their cut-off points of waist circumference differ from that recommended for Chinese. We suggest a cost-effective strategy to screen for MetS and prevent cardiovascular disease using new cut-off points of waist circumference in low earning nomadic Kazakhs.
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Affiliation(s)
- Heng Guo
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Jiaming Liu
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Jingyu Zhang
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Rulin Ma
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Yusong Ding
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Mei Zhang
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Jia He
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Shangzhi Xu
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Shugang Li
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Yizhong Yan
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Lati Mu
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Dongsheng Rui
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Qiang Niu
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
| | - Shuxia Guo
- Department of Preventive Medicine, School of Medicine, Shihezi University, Shihezi, Xinjiang, 832000, China
- * E-mail:
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23
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Assaf-Balut C, Familiar C, García de la Torre N, Rubio MA, Bordiú E, del Valle L, Lara M, Ruiz T, Ortolá A, Crespo I, Duran A, Herraiz MA, Izquierdo N, Perez N, Torrejon MJ, Runkle I, Montañez C, Calle-Pascual AL. Gestational diabetes mellitus treatment reduces obesity-induced adverse pregnancy and neonatal outcomes: the St. Carlos gestational study. BMJ Open Diabetes Res Care 2016; 4:e000314. [PMID: 28074143 PMCID: PMC5220275 DOI: 10.1136/bmjdrc-2016-000314] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 09/23/2016] [Accepted: 10/19/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Obesity and gestational diabetes mellitus (GDM) increase the morbidity of the mother and newborn, which could increase further should they coexist. We aimed to determine the risk of adverse pregnancy and neonatal outcomes associated with excess weight (EW), and within this group identify potential differences between those with and without GDM. METHODS We carried out a post-hoc analysis of the St. Carlos Gestational Study which included 3312 pregnant women, arranged in 3 groups: normal-weight women (NWw) (2398/72.4%), overweight women (OWw) (649/19.6%) and obese women (OBw) (265/8%). OWw and OBw were grouped as EW women (EWw). We analyzed variables related to adverse pregnancy and neonatal outcomes. RESULTS The relative risk (95% CI) for GDM was 1.82 (1.47 to 2.25; p<0.0001) for OWw, and 3.26 (2.45 to 4.35; p<0.0001) in OBw. Univariate analysis showed associations of EW to higher rates of prematurity, birth weight >90th centile, newborns admitted to neonatal intensive care unit (NICU), instrumental delivery and cesarean delivery (all p<0.005). Multivariate analysis, adjusted for parity and ethnicity, showed that EW increased the risk of prematurity, admission to NICU, cesarean and instrumental delivery, especially in EWw without GDM. NWw with GDM had a significantly lower risk of admission to NICU and cesarean delivery, compared with NWw without GDM. CONCLUSIONS EW is detrimental for pregnancy and neonatal outcomes, and treatment of GDM contributes to lowering the risk in EWw and NWw. Applying the same lifestyle changes to all pregnant women, independent of their weight or GDM condition, could improve these outcomes.
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Affiliation(s)
- Carla Assaf-Balut
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Miguel A Rubio
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid,Madrid, Spain
| | - Elena Bordiú
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid,Madrid, Spain
| | - Laura del Valle
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Miriam Lara
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Teresa Ruiz
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Ana Ortolá
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Irene Crespo
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Alejandra Duran
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid,Madrid, Spain
| | - Miguel A Herraiz
- Facultad de Medicina, Universidad Complutense de Madrid,Madrid, Spain
- Gynecology and Obstetrics Department, Madrid, Spain
| | - Nuria Izquierdo
- Facultad de Medicina, Universidad Complutense de Madrid,Madrid, Spain
- Gynecology and Obstetrics Department, Madrid, Spain
| | - Noelia Perez
- Facultad de Medicina, Universidad Complutense de Madrid,Madrid, Spain
- Gynecology and Obstetrics Department, Madrid, Spain
| | - Maria J Torrejon
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
- Clinical Laboratory Department, Madrid, Spain
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid,Madrid, Spain
| | - Carmen Montañez
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
| | - Alfonso L Calle-Pascual
- Endocrinology and Nutrition Department, Hospital Clínico San Carlos, Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid,Madrid, Spain
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Duran A, Sáenz S, Torrejón MJ, Bordiú E, Del Valle L, Galindo M, Perez N, Herraiz MA, Izquierdo N, Rubio MA, Runkle I, Pérez-Ferre N, Cusihuallpa I, Jiménez S, García de la Torre N, Fernández MD, Montañez C, Familiar C, Calle-Pascual AL. Introduction of IADPSG criteria for the screening and diagnosis of gestational diabetes mellitus results in improved pregnancy outcomes at a lower cost in a large cohort of pregnant women: the St. Carlos Gestational Diabetes Study. Diabetes Care 2014; 37:2442-50. [PMID: 24947793 DOI: 10.2337/dc14-0179] [Citation(s) in RCA: 222] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The use of the new International Association of the Diabetes and Pregnancy Study Groups criteria (IADPSGC) for the diagnosis of gestational diabetes mellitus (GDM) results in an increased prevalence of GDM. Whether their introduction improves pregnancy outcomes has yet to be established. We sought to evaluate the cost-effectiveness of one-step IADPSGC for screening and diagnosis of GDM compared with traditional two-step Carpenter-Coustan (CC) criteria. RESEARCH DESIGN AND METHODS GDM risk factors and pregnancy and newborn outcomes were prospectively assessed in 1,750 pregnant women from April 2011 to March 2012 using CC and in 1,526 pregnant women from April 2012 to March 2013 using IADPSGC between 24 and 28 weeks of gestation. Both groups received the same treatment and follow-up regimes. RESULTS The use of IADPSGC resulted in an important increase in GDM rate (35.5% vs. 10.6%) and an improvement in pregnancy outcomes, with a decrease in the rate of gestational hypertension (4.1 to 3.5%: -14.6%, P < 0.021), prematurity (6.4 to 5.7%: -10.9%, P < 0.039), cesarean section (25.4 to 19.7%: -23.9%, P < 0.002), small for gestational age (7.7 to 7.1%: -6.5%, P < 0.042), large for gestational age (4.6 to 3.7%: -20%, P < 0.004), Apgar 1-min score <7 (3.8 to 3.5%: -9%, P < 0.015), and admission to neonatal intensive care unit (8.2 to 6.2%: -24.4%, P < 0.001). Estimated cost savings was of €14,358.06 per 100 women evaluated using IADPSGC versus the group diagnosed using CC. CONCLUSIONS The application of the new IADPSGC was associated with a 3.5-fold increase in GDM prevalence in our study population, as well as significant improvements in pregnancy outcomes, and was cost-effective. Our results support their adoption.
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Affiliation(s)
- Alejandra Duran
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Sofía Sáenz
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - María J Torrejón
- Clinical Laboratory Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Elena Bordiú
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Laura Del Valle
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Mercedes Galindo
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Noelia Perez
- Gynecology and Obstetrician Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Miguel A Herraiz
- Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain Gynecology and Obstetrician Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Nuria Izquierdo
- Gynecology and Obstetrician Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Miguel A Rubio
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Isabelle Runkle
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Natalia Pérez-Ferre
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Idalia Cusihuallpa
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Sandra Jiménez
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | | | - María D Fernández
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Carmen Montañez
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Cristina Familiar
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Alfonso L Calle-Pascual
- Endocrinology and Nutrition Department, Universidad Complutense de Madrid, Madrid, Spain Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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Jing F, Mao Y, Guo J, Zhang Z, Li Y, Ye Z, Ding Y, Wang J, Jin M, Chen K. The value of Apolipoprotein B/Apolipoprotein A1 ratio for metabolic syndrome diagnosis in a Chinese population: a cross-sectional study. Lipids Health Dis 2014; 13:81. [PMID: 24886173 PMCID: PMC4041140 DOI: 10.1186/1476-511x-13-81] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 04/30/2014] [Indexed: 12/18/2022] Open
Abstract
Background The apoB/apoA1 ratio has been reported to be associated with the metabolic syndrome (MetS), and it may be a more convenient biomarker in MetS predicting. However, whether apoB/apoA1 ratio is a better indicator of metabolic syndrome than other biomarkers and what is the optimal cut-off value of apoB/apoA1 ratio as an indicator of metabolic syndrome in Chinese population remain unknown. Thus, we carried out the current study to assess the predictive value of apoB/apoA1 ratio and determine the optimal cut-off value of apoB/apoA1 ratio for diagnosing MetS in a Chinese population. Method We selected 1,855 subjects with MetS and 6,265 individuals without MetS based on the inclusion and exclusion criteria from the China Health Nutrition Survey (CHNS) in 2009. MetS was identified based on the diagnostic criteria of International Diabetes Federation (2005). Logistic regression was used to estimate the association between the apoB/apoA1 ratio and risk of MetS, and receiver operating characteristics (ROC) curve analysis was performed to test the predictive value of apoB/apoA1 ratio and calculate the appropriate cut-off value. Results Compared with the lowest quartile of apoB/apoA1 ratio, subjects in the fourth quartile had a higher risk of MetS in both men [odds ratio (OR) = 2.64, 95% confidence interval (CI) =1.82-3.83] and women (OR = 5.18, 95% CI = 3.87-6.92) after adjustment for potential confounders. The optimal cut-off value of apoB/apoA1 ratio for MetS detection was 0.85 in men and 0.80 in women. Comparisons of ROC curves indicated that apoB/apoA1 ratio was better than traditional biomarkers in predicting MetS. Conclusion Our results suggest that, apoB/apoA1 ratio has a promising predictive effectiveness in detection of MetS. An apoB/apoA1 ratio higher than 0.85 in men and 0.80 in women may be a promising and convenient marker of MetS.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Kun Chen
- Department of Epidemiology and Biostatistics, Zhejiang University School of Public Health, Hangzhou, Zhejiang, China.
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Guallar-Castillón P, Pérez RF, López García E, León-Muñoz LM, Aguilera MT, Graciani A, Gutiérrez-Fisac JL, Banegas JR, Rodríguez-Artalejo F. Magnitude and management of metabolic syndrome in Spain in 2008-2010: the ENRICA study. ACTA ACUST UNITED AC 2014; 67:367-73. [PMID: 24774729 DOI: 10.1016/j.rec.2013.08.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 08/09/2013] [Indexed: 10/25/2022]
Abstract
INTRODUCTION AND OBJECTIVES Few studies in Spain have reported the distribution of metabolic syndrome using the harmonized definition and that of premorbid metabolic syndrome, which consists of metabolic syndrome without diabetes mellitus or cardiovascular disease. Moreover, their regional distributions and clinical management are unknown. The present study examined the distributions and clinical management of both syndromes in Spain. METHODS This cross-sectional study was performed from 2008 to 2010 in 11 149 representative individuals of the Spanish population aged 18 years or older. Data were obtained through standardized physical examination, and analytical measurements were done in a central laboratory. RESULTS The prevalences (95% confidence interval) of metabolic syndrome and premorbid metabolic syndrome were 22.7% (21.7%-23.7%) and 16.9% (16.0%-17.8%), respectively. The frequency of both syndromes increased with age and was higher in men than in women up to 65 years; above this age, the frequency was higher in women. The communities of the south of Spain and the Balearic and Canary islands had the highest prevalence of both syndromes, in some regions reaching double that of the community with the lowest prevalence. About one third of patients with premorbid metabolic syndrome reported that they had not received health recommendations to improve their lifestyles; of those that did receive advice, adherence was low, particularly for reducing weight (31.9%) and salt intake (38.3%). CONCLUSIONS The prevalence of metabolic syndrome is high in Spain and considerable geographical differences exist in its distribution. There is substantial room for improvement in the clinical management of premorbid metabolic syndrome.
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Affiliation(s)
- Pilar Guallar-Castillón
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Raúl Francisco Pérez
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Esther López García
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Luz M León-Muñoz
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | | | - Auxiliadora Graciani
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Juan Luis Gutiérrez-Fisac
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - José R Banegas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.
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