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Iriarte-Campo V, de Burgos-Lunar C, Mostaza J, Lahoz C, Cárdenas-Valladolid J, Gómez-Campelo P, Taulero-Escalera B, San-Andrés-Rebollo FJ, Rodriguez-Artalejo F, Salinero-Fort MA. Incidence of T2DM and the role of baseline glycaemic status as a determinant in a metropolitan population in northern Madrid (Spain). Diabetes Res Clin Pract 2024; 209:111119. [PMID: 38307139 DOI: 10.1016/j.diabres.2024.111119] [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: 09/19/2023] [Revised: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 02/04/2024]
Abstract
AIM To estimate the incidence of T2DM and assess the effect of pre-T2DM (isolated impaired fasting glucose [iIFG], isolated impaired glucose tolerance [iIGT] or both) on progress to T2DM in the adult population of Madrid. METHODS Population-based cohort comprising 1,219 participants (560 normoglycaemic and 659 preT2DM [418 iIFG, 70 iIGT or 171 IFG-IGT]). T2DM was defined based on fasting plasma glucose or HbA1c or use of glucose-lowering medication. We used a Cox model with normoglycaemia as reference category. RESULTS During 7.26 years of follow-up, the unadjusted incidence of T2DM was 11.21 per 1000 person-years (95 %CI, 9.09-13.68) for the whole population, 5.60 (3.55-8.41) for normoglycaemic participants and 16.28 (12.78-20.43) for pre-T2DM participants. After controlling for potential confounding factors, the baseline glycaemic status was associated with higher primary effect on developing T2DM was iIGT (HR = 3.96 [95 %CI, 1.93-8.10]) and IFG-IGT (3.42 [1.92-6.08]). The HR for iIFG was 1.67 (0.96-2.90). Obesity, as secondary effect, was strongly significantly associated (HR = 2.50 [1.30-4.86]). CONCLUSIONS Our incidence of T2DM is consistent with that reported elsewhere in Spain. While baseline iIGT and IFG-IGT behaved a primary effect for progression to T2DM, iIFG showed a trend in this direction.
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Affiliation(s)
- V Iriarte-Campo
- Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP), Madrid, Spain; Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community - Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain
| | - C de Burgos-Lunar
- Department of Preventive Medicine, San Carlos Clinical University Hospital, Madrid, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
| | - J Mostaza
- Lipid and Vascular Risk Unit, Department of Internal Medicine, Hospital Carlos III, Madrid, Spain
| | - C Lahoz
- Lipid and Vascular Risk Unit, Department of Internal Medicine, Hospital Carlos III, Madrid, Spain
| | - J Cárdenas-Valladolid
- Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community - Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain; Alfonso X El Sabio University, Madrid, Spain
| | - P Gómez-Campelo
- Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community - Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain; La Paz University Hospital Biomedical Research Foundation, Madrid, Spain
| | - B Taulero-Escalera
- Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP), Madrid, Spain; Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community - Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain
| | - F J San-Andrés-Rebollo
- Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community - Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain; Centro de Salud Las Calesas, Madrid, Spain
| | - F Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain; CIBERESP, Madrid, Spain; IMDEA-Food, CEI UAM+CSIC Madrid, Spain
| | - M A Salinero-Fort
- Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP), Madrid, Spain; Frailty, Multimorbidity Patterns and Mortality in the Elderly Population Residing in the Community - Hospital La Paz Institute for Health Research IdiPAZ, Madrid, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain.
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2
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Urrutia I, Martín-Nieto A, Martínez R, Casanovas-Marsal JO, Aguayo A, Del Olmo J, Arana E, Fernandez-Rubio E, Castaño L, Gaztambide S. Incidence of diabetes mellitus and associated risk factors in the adult population of the Basque country, Spain. Sci Rep 2021; 11:3016. [PMID: 33542348 PMCID: PMC7862431 DOI: 10.1038/s41598-021-82548-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 01/15/2021] [Indexed: 01/14/2023] Open
Abstract
The aim of this study was to estimate the incidence of diabetes mellitus in the Basque Country and the risk factors involved in the disease by reassessing an adult population after 7 years of follow-up. In the previous prevalence study, 847 people older than 18 years were randomly selected from all over the Basque Country and were invited to answer a medical questionnaire, followed by a physical examination and an oral glucose tolerance test. In the reassessment, the same variables were collected and the resulting cohort comprised 517 individuals of whom 43 had diabetes at baseline. The cumulative incidence of diabetes was 4.64% in 7 years and the raw incidence rate was 6.56 cases/1000 person-years (95%CI: 4.11-9.93). Among the incident cases, 59% were undiagnosed. The most strongly associated markers by univariate analyses were age > 60 years, dyslipidaemia, prediabetes and insulin resistance. We also found association with hypertension, obesity, family history of diabetes and low education level. Multivariate analysis adjusted for age and sex showed that a set of risk factors assessed together (dyslipidaemia, waist-to-hip-ratio and family history of diabetes) had great predictive value (AUC-ROC = 0.899, 95%CI: 0.846-0.953, p = 0.942), which suggests the need for early intervention before the onset of prediabetes.
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Affiliation(s)
- Inés Urrutia
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain
- CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), CIBERER (Spanish Biomedical Research Centre in Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain
| | - Alicia Martín-Nieto
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain
- Endocrinology and Nutrition Department, Cruces University Hospital, Osakidetza, Bilbao, Bizkaia, Spain
| | - Rosa Martínez
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain
- CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), CIBERER (Spanish Biomedical Research Centre in Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain
| | - J Oriol Casanovas-Marsal
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain
| | - Anibal Aguayo
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain
- CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), CIBERER (Spanish Biomedical Research Centre in Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Del Olmo
- Clinical Chemistry Laboratory, Cruces University Hospital, Osakidetza, Bilbao, Bizkaia, Spain
| | - Eunate Arana
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain
| | - Elsa Fernandez-Rubio
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain
- Endocrinology and Nutrition Department, Cruces University Hospital, Osakidetza, Bilbao, Bizkaia, Spain
| | - Luis Castaño
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain.
- CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), CIBERER (Spanish Biomedical Research Centre in Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain.
| | - Sonia Gaztambide
- Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain.
- CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), CIBERER (Spanish Biomedical Research Centre in Rare Diseases), Instituto de Salud Carlos III, Madrid, Spain.
- Endocrinology and Nutrition Department, Cruces University Hospital, Osakidetza, Bilbao, Bizkaia, Spain.
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3
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Bennasar-Veny M, Fresneda S, López-González A, Busquets-Cortés C, Aguiló A, Yañez AM. Lifestyle and Progression to Type 2 Diabetes in a Cohort of Workers with Prediabetes. Nutrients 2020; 12:nu12051538. [PMID: 32466178 PMCID: PMC7284825 DOI: 10.3390/nu12051538] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/19/2020] [Accepted: 05/21/2020] [Indexed: 02/06/2023] Open
Abstract
Background: People with prediabetes have an increased risk of developing type 2 diabetes (T2D). Few studies have evaluated the influence of lifestyle factors on the risk of progression to diabetes and reversion to normoglycemia. The aim of this study was to determine the incidence of T2D in a large cohort of workers with prediabetes, and to evaluate the influence of sociodemographic, clinical, metabolic, and lifestyle factors that affect the persistence of prediabetes and the progression to T2D. Methods: A cohort study of 27,844 adult workers (aged 20 to 65 years) from Spain who had prediabetes based on an occupational medical examination from 2012 to 2013. Prediabetes was defined as fasting plasma glucose (FPG) between 100 and 125 mg/dL. At the baseline evaluation, sociodemographic, anthropometric, metabolic, and lifestyle data were collected. At the 5-year follow-up, incident T2D was defined as an FPG of at least 126 mg/dL or initiation of an antidiabetic medication. Results: Among 235,995 initially screened workers, the prevalence of T2D was 14.19% (95% confidence interval (CI) 14.05 to 14.33) and the prevalence of prediabetes was 11.85% (95% CI 11.71 to 11.99). Follow-up data were available for 23,293 individuals with prediabetes. Among them, 36.08% (95% CI 35.46 to 36.70) returned to normoglycemia, 40.92% (95% CI 40.29 to 41.55) had persistent prediabetes, and 23.00% (95% CI 22.46 to 23.54) progressed to T2D. The risk for persistence of prediabetes and for progression to T2D increased with age, body mass index (BMI), triglyceride level, and less than 150 min/week of physical activity. An HbA1c level of 6% or greater was the strongest individual predictor of progression to T2D. Conclusions: Physical activity, diet, smoking, and BMI are modifiable factors that are associated with the persistence of prediabetes and the progression to T2D. The workplace is a feasible setting for the early detection of prediabetes and the promotion of lifestyles that can prevent progression to T2D.
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Affiliation(s)
- Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears, Spain;
| | - Sergio Fresneda
- Department of Nursing and Physiotherapy, Balearic Islands University, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears, Spain;
- Correspondence: ; Tel.: +0034-971172367; Fax: +0034-971173190
| | - Arturo López-González
- Prevention of Occupational Risks in Health Services, Balearic Islands Health Service, C/Reina Esclaramunda, 9, 07003 Palma, Illes Balears, Spain;
- Escuela Universitaria ADEMA, C/ Gremi de Passamaners, 11, 07009 Palma, Illes Balears, Spain;
| | - Carla Busquets-Cortés
- Escuela Universitaria ADEMA, C/ Gremi de Passamaners, 11, 07009 Palma, Illes Balears, Spain;
- Research Group on Evidence, lifestyles and Health Research, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears, Spain; (A.A.); (A.M.Y.)
| | - Antoni Aguiló
- Research Group on Evidence, lifestyles and Health Research, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears, Spain; (A.A.); (A.M.Y.)
| | - Aina M. Yañez
- Research Group on Evidence, lifestyles and Health Research, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears, Spain; (A.A.); (A.M.Y.)
- Research Group on Global Health & Human Development, Balearic Islands University, Instituto de Investigación Sanitaria Illes Balears, Cra. de Valldemossa, Km 7,5, 07122 Palma, Illes Balears, Spain
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4
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Lee PN, Coombs KJ. Systematic review with meta-analysis of the epidemiological evidence relating smoking to type 2 diabetes. World J Meta-Anal 2020; 8:119-152. [DOI: 10.13105/wjma.v8.i2.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/02/2020] [Accepted: 04/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Evidence relating tobacco smoking to type 2 diabetes has accumulated rapidly in the last few years, rendering earlier reviews considerably incomplete.
AIM To review and meta-analyse evidence from prospective studies of the relationship between smoking and the onset of type 2 diabetes.
METHODS Prospective studies were selected if the population was free of type 2 diabetes at baseline and evidence was available relating smoking to onset of the disease. Papers were identified from previous reviews, searches on Medline and Embase and reference lists. Data were extracted on a range of study characteristics and relative risks (RRs) were extracted comparing current, ever or former smokers with never smokers, and current smokers with non-current smokers, as well as by amount currently smoked and duration of quitting. Fixed- and random-effects estimates summarized RRs for each index of smoking overall and by various subdivisions of the data: Sex; continent; publication year; method of diagnosis; nature of the baseline population (inclusion/exclusion of pre-diabetes); number of adjustment factors; cohort size; number of type 2 diabetes cases; age; length of follow-up; definition of smoking; and whether or not various factors were adjusted for. Tests of heterogeneity and publication bias were also conducted.
RESULTS The literature searches identified 157 relevant publications providing results from 145 studies. Fifty-three studies were conducted in Asia and 53 in Europe, with 32 in North America, and seven elsewhere. Twenty-four were in males, 10 in females and the rest in both sexes. Fifteen diagnosed type 2 diabetes from self-report by the individuals, 79 on medical records, and 51 on both. Studies varied widely in size of the cohort, number of cases, length of follow-up, and age. Overall, random-effects estimates of the RR were 1.33 [95% confidence interval (CI): 1.28-1.38] for current vs never smoking, 1.28 (95%CI: 1.24-1.32) for current vs non-smoking, 1.13 (95%CI: 1.11-1.16) for former vs never smoking, and 1.25 (95%CI: 1.21-1.28) for ever vs never smoking based on, respectively, 99, 156, 100 and 100 individual risk estimates. Risk estimates were generally elevated in each subdivision of the data by the various factors considered (exceptions being where numbers of estimates in the subsets were very low), though there was significant (P < 0.05) evidence of variation by level for some factors. Dose-response analysis showed a clear trend of increasing risk with increasing amount smoked by current smokers and of decreasing risk with increasing time quit. There was limited evidence of publication bias.
CONCLUSION The analyses confirmed earlier reports of a modest dose-related association of current smoking and a weaker dose-related association of former smoking with type 2 diabetes risk.
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Affiliation(s)
- Peter N Lee
- Department of Statistics, P.N. Lee Statistics and Computing Ltd., Sutton SM2 5DA, Surrey, United Kingdom
| | - Katharine J Coombs
- Department of Statistics, P.N. Lee Statistics and Computing Ltd., Sutton SM2 5DA, Surrey, United Kingdom
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5
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Congdon P. A diabetes risk index for small areas in England. Health Place 2020; 63:102340. [PMID: 32543429 DOI: 10.1016/j.healthplace.2020.102340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 03/26/2020] [Accepted: 04/06/2020] [Indexed: 01/03/2023]
Abstract
UK and international studies point to significant area variation in diabetes risk, and summary indices of diabetic risk are potentially of value in effective targeting of health interventions and healthcare resources. This paper aims to develop a summary measure of the diabetic risk environment which can act as an index for targeting health care resources. The diabetes risk index is for 6791 English small areas (which provide entire coverage of England) and has advantages in incorporating evidence from both diabetes outcomes and area risk factors, and in including spatial correlation in its construction. The analysis underlying the risk index shows that area socio-economic status, social fragmentation and south Asian ethnic concentration are all positive risk factors for diabetes risk. However, urban-rural and regional differences in risk intersect with these socio-demographic influences.
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Affiliation(s)
- Peter Congdon
- School of Geography, Queen Mary University of London, Mile End Rd, London, E1 4NS, UK.
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6
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Rojo-Martínez G, Valdés S, Soriguer F, Vendrell J, Urrutia I, Pérez V, Ortega E, Ocón P, Montanya E, Menéndez E, Lago-Sampedro A, González-Frutos T, Gomis R, Goday A, García-Serrano S, García-Escobar E, Galán-García JL, Castell C, Badía-Guillén R, Aguilera-Venegas G, Girbés J, Gaztambide S, Franch-Nadal J, Delgado E, Chaves FJ, Castaño L, Calle-Pascual A. Incidence of diabetes mellitus in Spain as results of the nation-wide cohort di@bet.es study. Sci Rep 2020; 10:2765. [PMID: 32066839 PMCID: PMC7026031 DOI: 10.1038/s41598-020-59643-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 01/28/2020] [Indexed: 12/22/2022] Open
Abstract
Our aim was to determine the incidence of type 2 diabetes mellitus in a nation-wide population based cohort from Spain (di@bet.es study). The target was the Spanish population. In total 5072 people older than 18 years,were randomly selected from all over Spain). Socio-demographic and clinical data, survey on habits (physical activity and food consumption) and weight, height, waist, hip and blood pressure were recorder. A fasting blood draw and an oral glucose tolerance test were performed. Determinations of serum glucose were made. In the follow-up the same variables were collected and HbA1c was determined. A total of 2408 subjects participated in the follow-up. In total, 154 people developed diabetes (6.4% cumulative incidence in 7.5 years of follow-up). The incidence of diabetes adjusted for the structure of age and sex of the Spanish population was 11.6 cases/1000 person-years (IC95% = 11.1–12.1). The incidence of known diabetes was 3.7 cases/1000 person-years (IC95% = 2.8–4.6). The main risk factors for developing diabetes were the presence of prediabetes in cross-sectional study, age, male sex, obesity, central obesity, increase in weight, and family history of diabetes. This work provides data about population-based incidence rates of diabetes and associated risk factors in a nation-wide cohort of Spanish population.
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Affiliation(s)
- G Rojo-Martínez
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain. .,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain.
| | - S Valdés
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - F Soriguer
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - J Vendrell
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Department of Endocrinology and Nutrition, University Hospital Joan XXIII, Pere Virgili Institute (IISPV), Rovira I Virgili University, Tarragona, Spain
| | - I Urrutia
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Cruces University Hospital, Biocruces Bizkaia Health Research Institute, UPV/EHU, Barakaldo, Spain.,Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain
| | - V Pérez
- General Laboratory. Regional University Hospital of Malaga, Malaga, Spain
| | - E Ortega
- Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute - IDIBAPS, Hospital Clínic of Barcelona, Barcelona, Spain.,Spanish Biomedical Research Network in physiopathology of obesity and Nutrition (CIBEROBN), Barcelona, Spain
| | - P Ocón
- General Laboratory. Regional University Hospital of Malaga, Malaga, Spain
| | - E Montanya
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Bellvitge University Hospital, Barcelona, Spain
| | - E Menéndez
- Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain.,Department of Endocrinology and Nutrition, Central University Hospital of Asturias/University of Oviedo, Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
| | - A Lago-Sampedro
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - T González-Frutos
- Cruces University Hospital, Biocruces Bizkaia Health Research Institute, UPV/EHU, Barakaldo, Spain
| | - R Gomis
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute - IDIBAPS, Hospital Clínic of Barcelona, Barcelona, Spain
| | - A Goday
- Spanish Biomedical Research Network in physiopathology of obesity and Nutrition (CIBEROBN), Barcelona, Spain.,Department of Endocrinology and Nutrition, Hospital del Mar, IMIM. Universitat Autònoma, Barcelona, Spain
| | - S García-Serrano
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - E García-Escobar
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - J L Galán-García
- Department of Applied Mathematics, Malaga University, Malaga, Spain
| | - C Castell
- Department of Health, Public Health Agency of Catalonia, Barcelona, Spain
| | - R Badía-Guillén
- Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | | | - J Girbés
- Diabetes Unit, Hospital Arnau of Vilanova, Valencia, Spain
| | - S Gaztambide
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain.,Department of Endocrinology and Nutrition, Cruces University Hospital, Biocruces Bizkaia Health Research Institute, UPV/EHU, Barakaldo, Spain
| | - J Franch-Nadal
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,EAP Raval Sud, Catalan Institute of Health, GEDAPS Network, Primary Care, Research support unit (IDIAP - Jordi Gol Foundation), Barcelona, Spain
| | - E Delgado
- Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain.,Department of Endocrinology and Nutrition, Central University Hospital of Asturias/University of Oviedo, Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
| | - F J Chaves
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Genomic and Genetic Diagnosis Unit, Research Foundation of Valencia University Clinical Hospital-INCLIVA, Valencia, Spain
| | - L Castaño
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Cruces University Hospital, Biocruces Bizkaia Health Research Institute, UPV/EHU, Barakaldo, Spain.,Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain
| | - A Calle-Pascual
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Department of Endocrinology and Nutrition, University Hospital S. Carlos of Madrid, Madrid, Spain
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