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Ortega Martínez de Victoria E, Pané Vila A, Jiménez Pineda A. Obesity in Spain: an open book that must be read. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024:S1885-5857(24)00155-5. [PMID: 38750932 DOI: 10.1016/j.rec.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 03/07/2024] [Indexed: 05/26/2024]
Affiliation(s)
- Emilio Ortega Martínez de Victoria
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain; Servicio de Endocrinología y Nutrición, Hospital Clínic de Barcelona, Spain; Fundació Clínic per la Recerca Biomèdica - Institut d'Investigacions Biomèdiques August Pi Sunyer (FCRB-IDIBAPS), Barcelona, Spain.
| | - Adriana Pané Vila
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain; Servicio de Endocrinología y Nutrición, Hospital Clínic de Barcelona, Spain; Fundació Clínic per la Recerca Biomèdica - Institut d'Investigacions Biomèdiques August Pi Sunyer (FCRB-IDIBAPS), Barcelona, Spain
| | - Amanda Jiménez Pineda
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain; Servicio de Endocrinología y Nutrición, Hospital Clínic de Barcelona, Spain; Fundació Clínic per la Recerca Biomèdica - Institut d'Investigacions Biomèdiques August Pi Sunyer (FCRB-IDIBAPS), Barcelona, Spain
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2
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Sacramento-Pacheco J, Sánchez-Gómez MB, Gómez-Salgado J, Novo-Muñoz MM, Duarte-Clíments G. Prevalence of Cardiovascular Risk Factors in Spain: A Systematic Review. J Clin Med 2023; 12:6944. [PMID: 37959409 PMCID: PMC10650307 DOI: 10.3390/jcm12216944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
Cardiovascular diseases are the leading cause of death in Spain, according to data from the National Institute of Statistics, with the lack of control of cardiovascular risk factors (CVRF) being the main contributing factor. The CVRFs of greatest clinical interest are high blood pressure (HBP), smoking, diabetes mellitus (DM2), overweight, obesity, hypercholesterolaemia, and sedentary lifestyle. The main objective of this review was to compare the prevalence of the different CVRFs according to population-based studies carried out in Spain. For this, a systematic review based on publications assessing CVRFs in the adult population and estimating their national prevalence was conducted. Pubmed and Dialnet databases were consulted, and the selected articles were analysed using the Critical Appraisal Skills Programme Español (CASPe) tool for cohort studies and the Berra et al. tool for cross-sectional studies. A total of 33 studies were obtained from the autonomous regions of Andalusia, the Canary Islands, Castilla-Leon, Castilla-La Mancha, Catalonia, Extremadura, the Balearic Islands, Madrid, Murcia, and Navarra. In all the population-based studies, there was a greater representation of women in the sample. The most prevalent CVRFs differed across the studies according to the autonomous region targeted, with dyslipidaemia, sedentary lifestyle, high blood pressure, hypercholesterolaemia, overweight, and obesity standing out. Numerous differences exist between the studies included in this review, such as the age range, the CVRFs analysed and their prevalence, and remarkable aspects such as the over-representation of the female sex in all cases. It can be concluded that, based on the presented results, the prevalence of CVRFs in Spain varies according to the autonomous region, the sex of the individual, and the studied age range.
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Affiliation(s)
- Jennifer Sacramento-Pacheco
- Nuestra Señora de Candelaria Nursing University School, University of La Laguna, 38010 San Cristóbal de La Laguna, Spain
- Europa Sur Educational Centre (CESUR Tenerife), 38006 Santa Cruz de Tenerife, Spain
| | - María Begoña Sánchez-Gómez
- Cátedra de Enfermería, Universidad de La Laguna, 38200 San Cristóbal de La Laguna, Spain
- Cieza Este Health Centre, Area IX, Servicio Murciano de Salud, 30530 Murcia, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21071 Huelva, Spain
- Safety and Health Postgraduate Program, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
| | - María Mercedes Novo-Muñoz
- Department of Nursing, Faculty of Health Sciences, University of La Laguna, 38200 San Cristóbal de La Laguna, Spain
| | - Gonzalo Duarte-Clíments
- Cátedra de Enfermería, Universidad de La Laguna, 38200 San Cristóbal de La Laguna, Spain
- Case Management, Area IX, Servicio Murciano de Salud, 30530 Murcia, Spain
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3
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Llamas-Saez C, Saez-Vaquero T, Jiménez-García R, López-de-Andrés A, Carabantes-Alarcón D, Zamorano-León JJ, Cuadrado-Corrales N, Pérez-Farinos N, Wärnberg J. Cross Sectional and Case-Control Study to Assess Time Trend, Gender Differences and Factors Associated with Physical Activity among Adults with Diabetes: Analysis of the European Health Interview Surveys for Spain (2014 & 2020). J Clin Med 2023; 12:jcm12062443. [PMID: 36983443 PMCID: PMC10057052 DOI: 10.3390/jcm12062443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
(1) Background: We aim to assess the time trend from 2014 to 2020 in the prevalence of physical activity (PA), identify gender differences and sociodemographic and health-related factors associated with PA among people with diabetes, and compare PA between people with and without diabetes. (2) Methods: We conducted a cross-sectional and a case-control study using as data source the European Health Interview Surveys for Spain (EHISS) conducted in years 2014 and 2020. The presence of diabetes and PA were self-reported. Covariates included socio-demographic characteristics, health-related variables, and lifestyles. To compare people with and without diabetes, we matched individuals by age and sex. (3) Results: The number of participants aged ≥18 years with self-reported diabetes were 1852 and 1889 in the EHISS2014 and EHISS2020, respectively. The proportion of people with diabetes that had a medium or high frequency of PA improved from 48.3% in 2014 to 52.6% in 2020 (p = 0.009), with 68.5% in 2014 and 77.7% in 2020 being engaged in two or more days of PA (p < 0.001). Males with diabetes reported more PA than females with diabetes in both surveys. After matching by age and gender, participants with diabetes showed significantly lower engagement in PA than those without diabetes. Among adults with diabetes, multivariable logistic regression showed confirmation that PA improved significantly from 2014 to 2020 and that male sex, higher educational level, and better self-rated health were variables associated to more PA. However, self-reported comorbidities, smoking, or BMI > 30 were associated to less PA. (4) Conclusions: The time trend of PA among Spanish adults with diabetes is favorable but insufficient. The prevalence of PA in this diabetes population is low and does not reach the levels of the general population. Gender differences were found with significantly more PA among males with diabetes. Our result could help to improve the design and implementation of public health strategies to improve PA among people with diabetes.
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Affiliation(s)
- Carlos Llamas-Saez
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | | | - Rodrigo Jiménez-García
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Ana López-de-Andrés
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - David Carabantes-Alarcón
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - José J Zamorano-León
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Natividad Cuadrado-Corrales
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Napoleón Pérez-Farinos
- Epi-PHAAN Research Group, School of Medicine, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain
| | - Julia Wärnberg
- Epi-PHAAN Research Group, School of Health Sciences, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain
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4
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Mayoral E, Ravé R, Rodriguez de Vera P, Rojo-Martinez G, Olveira G, Aguilar-Diosdado M, León-Justel A, Martinez-Brocca MA. Temporal trends in hospitalizations due to diabetes complications during COVID-19 pandemic in Andalusia, Spain. BMJ Open Diabetes Res Care 2022; 10:10/2/e002623. [PMID: 35351686 PMCID: PMC8965863 DOI: 10.1136/bmjdrc-2021-002623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 03/06/2022] [Indexed: 11/03/2022] Open
Affiliation(s)
- Eduardo Mayoral
- Plan Integral de Diabetes de Andalucía, D.G. de Salud Pública y Ordenación Farmacéutica, Consejería de Salud y Familias, Sevilla, Spain
| | - Reyes Ravé
- Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Pablo Rodriguez de Vera
- Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Gemma Rojo-Martinez
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomédica de Málaga. CIBERDEM, CIBER de Diabetes y Enfermedades Metabólicas asociadas, Málaga, Spain
| | - Gabriel Olveira
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomédica de Málaga. CIBERDEM, CIBER de Diabetes y Enfermedades Metabólicas asociadas, Málaga, Spain
| | | | - Antonio León-Justel
- Servicio de Bioquímica Clínica, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Maria Asuncion Martinez-Brocca
- Plan Integral de Diabetes de Andalucía, D.G. de Salud Pública y Ordenación Farmacéutica, Consejería de Salud y Familias, Sevilla, Spain
- Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen Macarena, Sevilla, Spain
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5
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Domínguez-Mayoral A, Sánchez-Gómez J, Guerrero P, Ferrer M, Gutiérrez C, Aguilar M, Fouz-Rosón N, Benítez JM, Pérez-Sánchez S, Gamero-García MÁ, De Torres-Chacón R, Barragán-Prieto A, Algaba P, Ruiz-Bayo L, Montaner J. High prevalence of obstructive sleep apnea syndrome in Spain's Stroke Belt. J Int Med Res 2021; 49:3000605211053090. [PMID: 34719990 PMCID: PMC8562644 DOI: 10.1177/03000605211053090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objective Spain’s so-called Stroke Belt is an area with high prevalence of vascular disease. We aimed to determine the prevalence of undetected obstructive sleep apnea–hypopnea syndrome (OSAHS) among patients with acute ischemic stroke (AIS) in southern Spain. Methods We conducted a cross-sectional study at the Virgen Macarena University Hospital Stroke Unit during 2018 to 2019. We included patients <72 hours after AIS with a neuroimaging lesion and performed sleep tests. Results Seventy-two patients were included. The median participant age was 72 years. Mean body mass index was 27.07 kg/m2, and 40.28% were daily alcohol drinkers. Hypertension, atrial fibrillation, ischemic cardiomyopathy, and previous stroke were detected in 63.9%, 11.1%, 15.3%, and 17.6% of patients, respectively. Polygraphy was feasible in 91.38% of patients. The prevalence of OSAHS was 84.72% (apnea–hypopnea index ≥5). Patients with moderate and severe OSAHS were more likely to be obese and to have a larger neck circumference and facial palsy. The diagnostic criteria of central sleep apnea syndrome were met in only 1.38% of patients. Conclusions The high prevalence of OSAHS found in the Spanish Stroke Belt justifies further investigation and development of a screening program as a strategy to identify patients with undetected OSAHS.
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Affiliation(s)
- Ana Domínguez-Mayoral
- Stroke Unit, Neurology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain.,Neurovascular Research Laboratory, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | - Jesús Sánchez-Gómez
- Pneumology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain
| | - Patricia Guerrero
- Pneumology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain
| | - Marta Ferrer
- Pneumology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain
| | - Carmen Gutiérrez
- Neurophysiology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain
| | - María Aguilar
- Neurophysiology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain
| | - Natalia Fouz-Rosón
- Pneumology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain
| | - José María Benítez
- Pneumology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain
| | - Soledad Pérez-Sánchez
- Stroke Unit, Neurology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain.,Neurovascular Research Laboratory, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | - Miguel Ángel Gamero-García
- Stroke Unit, Neurology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain.,Neurovascular Research Laboratory, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | - Reyes De Torres-Chacón
- Stroke Unit, Neurology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain.,Neurovascular Research Laboratory, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | - Ana Barragán-Prieto
- Stroke Unit, Neurology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain.,Neurovascular Research Laboratory, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | - Pilar Algaba
- Neurovascular Research Laboratory, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
| | - Lidia Ruiz-Bayo
- Stroke Unit, Neurology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain
| | - Joan Montaner
- Stroke Unit, Neurology Department, 16582Virgen Macarena University Hospital, 16582Virgen Macarena University Hospital, Seville, Spain.,Neurovascular Research Laboratory, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain
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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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Montero E, Matesanz P, Nobili A, Luis Herrera-Pombo J, Sanz M, Guerrero A, Bujaldón A, Herrera D. Screening of undiagnosed hyperglycaemia in the dental setting: The DiabetRisk study. A field trial. J Clin Periodontol 2020; 48:378-388. [PMID: 33263197 DOI: 10.1111/jcpe.13408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 10/05/2020] [Accepted: 11/22/2020] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the efficacy of different screening protocols for undiagnosed hyperglycaemia in a Research Network of Dental Clinics coordinated by the Spanish Society of Periodontology (SEPA). MATERIAL AND METHODS A total of 1143 patients were included in the study. Participants filled a questionnaire considering diabetes risk factors (FINDRISC) and received a periodontal screening examination. Patients with a slightly elevated score according to the Findrisc (≥7), received a point-of-care HbA1c and were eventually referred to their physician for confirmatory diagnosis. Receiver Operating Characteristic (ROC) curves were used to assess the performance of various predictive models with confirmed hyperglycaemia as outcome. RESULTS From this population, 97 (8.5%) were finally diagnosed of diabetes (n = 28; 2.5%) or prediabetes (n = 69; 6.0%). When only including the results from the FINDRISC questionnaire, the model reported an area under the curve (AUC) of 0.866 (95% confidence interval - CI [0.833; 0.900]). This model significantly improved when a basic periodontal examination (EPB Code; AUC = 0.876; 95% CI [0.845: 0.906]; p = .042) or a point-of-care HbA1c were added (AUC = 0.961; 95% CI [0.941; 0.980]; p < .001). CONCLUSIONS The tested protocol, combining the FINDRISC questionnaire and a point-of-care HbA1c, showed to be feasible when carried out in a dental clinic setting and was efficient to identify subjects with undiagnosed diabetes or prediabetes.
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Affiliation(s)
- Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.,Working Group "Diabetes and Periodontal Diseases" of the Spanish Society of Diabetes (SED) and the Spanish Society of Periodontology (SEPA), Madrid, Spain
| | - Paula Matesanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.,Fundación SEPA de Periodoncia e Implantes Dentales and Spanish Society of Periodontology (SEPA), Madrid, Spain
| | - Antonio Nobili
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - José Luis Herrera-Pombo
- Working Group "Diabetes and Periodontal Diseases" of the Spanish Society of Diabetes (SED) and the Spanish Society of Periodontology (SEPA), Madrid, Spain.,Endocrinology and Nutrition Department, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.,Fundación SEPA de Periodoncia e Implantes Dentales and Spanish Society of Periodontology (SEPA), Madrid, Spain
| | - Adrián Guerrero
- Fundación SEPA de Periodoncia e Implantes Dentales and Spanish Society of Periodontology (SEPA), Madrid, Spain
| | - Antonio Bujaldón
- Fundación SEPA de Periodoncia e Implantes Dentales and Spanish Society of Periodontology (SEPA), Madrid, Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.,Working Group "Diabetes and Periodontal Diseases" of the Spanish Society of Diabetes (SED) and the Spanish Society of Periodontology (SEPA), Madrid, Spain.,Fundación SEPA de Periodoncia e Implantes Dentales and Spanish Society of Periodontology (SEPA), Madrid, Spain
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8
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Sánchez Torralvo FJ, Vázquez Pedreño L, Gonzalo Marín M, Tapia MJ, Lima F, García Fuentes E, García P, Moreno Ruiz J, Rodríguez Cañete A, Valdés S, Olveira G. Endoscopic intragastric injection of botulinum toxin A in obese patients on bariatric surgery waiting lists: A randomised double-blind study (IntraTox study). Clin Nutr 2020; 40:1834-1842. [PMID: 33092901 DOI: 10.1016/j.clnu.2020.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/15/2020] [Accepted: 10/02/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND & AIMS Several studies have evaluated the effect of intragastric injection of botulinum toxin A to treat obesity, achieving mixed results. Our objective is to determine the effect of intragastric botulinum toxin A on weight loss, satiety, biomarkers, and quality of life of obese patients prior bariatric surgery. METHODS Design: single-centre, randomised, double-blind, placebo-controlled clinical trial in 52 obese patients on bariatric surgery waiting lists. Two-arm parallel: the treatment group was administered intragastric botulinum toxin A by endoscopy, whereas the control group was administered physiological saline solution. Weight loss was evaluated at weeks 2, 4, 8, 16, and 24, as well as changes in body composition, satiety (Visual analogue scale (VAS) and GCSI questionnaire), quality of life (GIQLI questionnaire), and biomarkers of satiety and appetite. RESULTS Weight loss at weeks 2, 4, 8, 16, and 24 after the endoscopy, with respect to the basal visit, was 0.6 ± 2 kg, 0.4 ± 2.7 kg, 0.4 ± 3.1 kg, 0.2 ± 4.5 kg, and 0.6 ± 4.3 kg for the control group vs 1.9 ± 2.1 kg, 2 ± 2.6 kg, 2.8 ± 4.1 kg, 3.5 ± 5.3 kg, and 4.5 ± 7 kg for the treatment group, respectively, being differences between groups significant at all times (p = 0.016, 0.031, 0.014, 0.021, and 0.023, respectively). Treatment group patients obtained a significantly higher score for GIQLI questionnaire compared with baseline (104.4 ± 13.9 points vs 97.7 ± 15.6 points; p = 0.024), showing a significant improvement in the section of subjective physical capacity. No significant differences were found regarding perception of satiety, or biomarkers of satiety and appetite. CONCLUSIONS Intragastric injection of botulinum toxin A is an effective and safe procedure to achieve a moderate weight loss and improve quality of life. Registered under clinicaltrialsregister.eu Identifier EudraCT number 2015-004391-29 https://www.clinicaltrialsregister.eu/ctr-search/trial/2015-004391-29/ES.
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Affiliation(s)
- Francisco José Sánchez Torralvo
- UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N, 29009, Málaga, Spain; Universidad de Málaga, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain.
| | - Luis Vázquez Pedreño
- UGC Aparato Digestivo, Unidad de Endoscopias. Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Montserrat Gonzalo Marín
- UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N, 29009, Málaga, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
| | - María José Tapia
- UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N, 29009, Málaga, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
| | - Fuensanta Lima
- UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N, 29009, Málaga, Spain
| | - Eduardo García Fuentes
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
| | - Pilar García
- UGC Aparato Digestivo, Unidad de Endoscopias. Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Javier Moreno Ruiz
- UGC Cirugía General y Digestiva, Hospital Regional Universitario de Málaga, Málaga, Spain
| | | | - Sergio Valdés
- UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N, 29009, Málaga, Spain; Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
| | - Gabriel Olveira
- UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N, 29009, Málaga, Spain; Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
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Rodriguez-Acuña R, Mayoral E, Aguilar-Diosdado M, Rave R, Oyarzabal B, Lama C, Carriazo A, Martinez-Brocca MA. Andalusian program for early detection of diabetic retinopathy: implementation and 15-year follow-up of a population-based screening program in Andalusia, Southern Spain. BMJ Open Diabetes Res Care 2020; 8:8/1/e001622. [PMID: 33020135 PMCID: PMC7536837 DOI: 10.1136/bmjdrc-2020-001622] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/13/2020] [Accepted: 07/23/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Diabetic retinopathy (DR) is a preventable cause of vision loss and blindness worldwide. We aim at analyzing the impact of a population-based screening program of DR using retinal photography with remote reading in terms of population coverage, diagnosis of asymptomatic DR and impact on visual disability, in the region of Andalusia, Spain, in the period 2005-2019. RESEARCH DESIGN AND METHODS Descriptive study. Sociodemographic and clinical features included in the Andalusian program for early detection of diabetic retinopathy (APDR) were analyzed. Population coverage, annual incidence of DR, and DR severity gradation were analyzed. Estimated data on prevalence and incidence of legal blindness due to DR were included. RESULTS 407 762 patients with at least one successful DR examination during the study period were included. Most of the performed retinographies (784 584, 84.3%) were 'non-pathological.' Asymptomatic DR was detected in 52 748 (5.9%) retinographies, most of them (94.2%) being classified as 'mild to moderate non-proliferative DR.' DR was detected in 44 815 patients, while sight-threatening DR (STDR) in 6256 patients; cumulative incidence of DR was 11.0% and STDR was 1.5%, as DR and STDR was detected in 44 815 and 6256 patients, respectively. Annual incidence risk per patient recruitment year progressively decreased from 22.0% by January 2005 to 3.2% by June 2019. CONCLUSIONS Implementation of a long-term population-based screening program for early detection of DR is technically feasible and clinically viable. Thus, after 15 years of existence, the program has enabled the screening of the vast majority of the target population allowing the optimization of healthcare resources and the identification of asymptomatic DR.
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Affiliation(s)
| | - Eduardo Mayoral
- Comprehensive Healthcare Plan for Diabetes, Regional Ministry of Health and Families of Andalusia, Government of Andalusia, Seville, Spain
| | - Manuel Aguilar-Diosdado
- Endocrinology and Nutrition, Hospital Puerta del Mar, Cadiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cadiz, Spain
| | - Reyes Rave
- Endocrinology and Nutrition, Virgen Macarena University Hospital, Seville, Spain
| | | | - Carmen Lama
- Regional Ministry of Health and Families of Andalusia, Government of Andalusia, Seville, Spain
| | - Ana Carriazo
- Regional Ministry of Health and Families of Andalusia, Government of Andalusia, Seville, Spain
| | - Maria Asuncion Martinez-Brocca
- Comprehensive Healthcare Plan for Diabetes, Regional Ministry of Health and Families of Andalusia, Government of Andalusia, Seville, Spain
- Endocrinology and Nutrition, Virgen Macarena University Hospital, Seville, Spain
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10
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Díaz-Cerezo S, Romera I, Sicras-Mainar A, López-Simarro F, Dilla T, Artime E, Reviriego J. Resource use and costs in patients with poorly controlled type 2 diabetes mellitus and obesity in routine clinical practice in Spain. Curr Med Res Opin 2020; 36:1449-1456. [PMID: 32643441 DOI: 10.1080/03007995.2020.1793749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare healthcare resource use (HRU) and annual costs in type 2 diabetes mellitus (T2DM) patients with poor glycaemic control and obesity versus good glycaemic control without obesity. METHODS Observational retrospective study based on the analysis of electronic medical records from the BIG-PAC database, with one year of follow-up. T2DM patients aged ≥30 years who requested medical care during 2013 were included. Annual HRU and costs per patient were compared between a reference group (HbA1c ≥ 8%, BMI ≥30 kg/m2, receiving ≥2 oral antidiabetic drugs [OADs]) and a control group (HbA1c < 7% and BMI <30 kg/m2). Direct and indirect costs (lost productivity) were analysed. Cost comparisons across groups were made using the analysis of covariance (ANCOVA) for each cost component, with age, sex, time from diagnosis, Charlson comorbidity index, OAD number and sex by group interaction as covariates. RESULTS During the follow-up, patients in the reference group (N = 2709) had a greater HRU than those in the control group (N = 5266), especially in the number of primary care (PC) visits (11.8 vs. 9.8; 95%CI: 11.5-12.1 vs. 9.6-10.0) and days of hospitalization (1.1 vs 0.6; 95%CI: 1.0-1.2 vs. 0.5-0.7). The main components of the total cost were hospital admissions (24.5%), productivity losses (16.3%), complementary tests (14.4%), PC visits (14.2%) and medication (13.6%) in the reference group and medication (19.6%), hospital admissions (18.7%) and PC visits (18.2%) in the control group. The corrected mean annual cost per patient was higher in the reference than in the control group: €1804 vs. €1309; p < .001. CONCLUSIONS Poor glycaemic control and obesity in T2DM patients were associated with increased HRU and costs in routine clinical practice.
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Affiliation(s)
| | - Irene Romera
- Medical Department, Lilly S.A, Alcobendas, Madrid, Spain
| | | | | | - Tatiana Dilla
- Medical Department, Lilly S.A, Alcobendas, Madrid, Spain
| | - Esther Artime
- Medical Department, Lilly S.A, Alcobendas, Madrid, Spain
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11
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Martín-Peláez S, Fito M, Castaner O. Mediterranean Diet Effects on Type 2 Diabetes Prevention, Disease Progression, and Related Mechanisms. A Review. Nutrients 2020; 12:nu12082236. [PMID: 32726990 PMCID: PMC7468821 DOI: 10.3390/nu12082236] [Citation(s) in RCA: 128] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 02/06/2023] Open
Abstract
The search for a quality diet has grown over the past decade. Diet is considered one of the pillars for the prevention and progression of several diseases, among them: diabetes. Type 2 diabetes (T2D) is an epidemic of western countries that increases the vulnerability of other diseases, such as cardiovascular and cancer. T2D is associated with lifestyle and diet. The traditional Mediterranean diet has proven its benefits over several cardiovascular risk factors, and specifically on diabetes. This review compiles recent published evidence on the effects of the Mediterranean diet on the incidence and progression of type 2 diabetes (T2D) and its relation with several other cardiovascular healthy diets. We will also focus on how the Mediterranean diet could play a role in T2D-related mechanisms, such as anti-inflammatory or antioxidant compounds, glucagon-like peptide agonist compounds, and changes in gut microbiota. Each component of the Mediterranean diet could be involved in processes related to diabetes homeostasis, many of them sharing common physio-pathological pathways. The importance of this diet within the set of habits of a healthy lifestyle must be emphasized.
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Affiliation(s)
- Sandra Martín-Peláez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18071 Granada, Spain
| | - Montse Fito
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute [IMIM], 08003 Barcelona, Spain;
- Consorcio CIBER, M.P. Fisiopatologia de la Obesidad y Nutrición [CIBERObn], Instituto de Salud Carlos III [ISCIII], 28029 Madrid, Spain
| | - Olga Castaner
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute [IMIM], 08003 Barcelona, Spain;
- Consorcio CIBER, M.P. Fisiopatologia de la Obesidad y Nutrición [CIBERObn], Instituto de Salud Carlos III [ISCIII], 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-933-160-720; Fax: +34-933-160-796
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12
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Toms R, Feng X, Mayne DJ, Bonney A. Role of Area-Level Access to Primary Care on the Geographic Variation of Cardiometabolic Risk Factor Distribution: A Multilevel Analysis of the Adult Residents in the Illawarra-Shoalhaven Region of NSW, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4297. [PMID: 32560149 PMCID: PMC7344656 DOI: 10.3390/ijerph17124297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/13/2020] [Accepted: 06/14/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Access to primary care is important for the identification, control and management of cardiometabolic risk factors (CMRFs). This study investigated whether differences in geographic access to primary care explained area-level variation in CMRFs. METHODS Multilevel logistic regression models were used to derive the association between area-level access to primary care and seven discrete CMRFs after adjusting for individual and area-level co-variates. Two-step floating catchment area method was used to calculate the geographic access to primary care for the small areas within the study region. RESULTS Geographic access to primary care was inversely associated with low high density lipoprotein (OR 0.94, CI 0.91-0.96) and obesity (OR 0.91, CI 0.88-0.93), after adjusting for age, sex and area-level disadvantage. The intra-cluster correlation coefficient (ICCs) of all the fully adjusted models ranged between 0.4-1.8%, indicating low general contextual effects of the areas on CMRF distribution. The area-level variation in CMRFs explained by primary care access was ≤10.5%. CONCLUSION The findings of the study support proportionate universal interventions for the prevention and control of CMRFs, rather than any area specific interventions based on their primary care access, as the contextual influence of areas on all the analysed CMRFs were found to be minimal. The findings also call for future research that includes other aspects of primary care access, such as road-network access, financial affordability and individual-level acceptance of the services in order to gain an overall picture of the area-level contributing role of primary care on CMRFs in the study region.
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Affiliation(s)
- Renin Toms
- School of Medicine, University of Wollongong, Wollongong NSW 2522, Australia; (D.J.M.); (A.B.)
- Illawarra Health and Medical Research Institute, Wollongong NSW 2522, Australia;
| | - Xiaoqi Feng
- Illawarra Health and Medical Research Institute, Wollongong NSW 2522, Australia;
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong NSW 2500, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney NSW 2033, Australia
| | - Darren J Mayne
- School of Medicine, University of Wollongong, Wollongong NSW 2522, Australia; (D.J.M.); (A.B.)
- Illawarra Health and Medical Research Institute, Wollongong NSW 2522, Australia;
- Illawarra Shoalhaven Local Health District, Public Health Unit, Warrawong NSW 2502, Australia
- School of Public Health, The University of Sydney, Sydney NSW 2006, Australia
| | - Andrew Bonney
- School of Medicine, University of Wollongong, Wollongong NSW 2522, Australia; (D.J.M.); (A.B.)
- Illawarra Health and Medical Research Institute, Wollongong NSW 2522, Australia;
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Ramón-Arbués E, Martínez-Abadía B, Granada-López JM, Echániz-Serrano E, Huércanos-Esparza I, Antón-Solanas I. Association between adherence to the Mediterranean diet and the prevalence of cardiovascular risk factors. Rev Lat Am Enfermagem 2020; 28:e3295. [PMID: 32520245 PMCID: PMC7282722 DOI: 10.1590/1518-8345.3904.3295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 03/12/2020] [Indexed: 12/15/2022] Open
Abstract
Objective: to determine the prevalence of cardiovascular risk factors in a cohort of
workers and to quantify its association with compliance with the
Mediterranean diet follow-up. Method: a cross-sectional descriptive study was carried out on a cohort of 23,729
workers. Clinical data from annual medical examinations and the
Mediterranean Diet Adherence Screener were used to assess adherence to the
Mediterranean diet. Results: 51.3% of the participants showed good adherence to the Mediterranean diet.
The multivariate analysis showed an inverse and significant association
between the follow-up of the Mediterranean diet and the prevalence of
abdominal obesity (Odds Ratio = 0.64, 95% CI 0.56; 0.73), dyslipidemia (Odds
Ratio = 0.55, 95% CI 0.42; 0.73), and metabolic syndrome (Odds Ratio = 0.76,
95% CI 0.67; 0.86). Conclusions: our results suggest that the Mediterranean diet is potentially effective in
promoting cardiovascular health. Implementing the interventions promoting
the Mediterranean diet in the working population seems justified.
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Affiliation(s)
- Enrique Ramón-Arbués
- Universidad San Jorge, Facultad de Ciencias de la Salud, Zaragoza, Esp, Espanha.,Grupo de Investigación Tranfercult (Exp. H27-20D), Zaragoza, Esp, Spain
| | | | - José Manuel Granada-López
- Universidad de Zaragoza, Facultad de Ciencias de la Salud, Zaragoza, Esp, Espanha.,Grupo de Investigación Tranfercult (Exp. H27-20D), Zaragoza, Esp, Spain
| | - Emmanuel Echániz-Serrano
- Universidad de Zaragoza, Facultad de Ciencias de la Salud, Zaragoza, Esp, Espanha.,Grupo de Investigación Tranfercult (Exp. H27-20D), Zaragoza, Esp, Spain
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Aller R, Sigüenza R, Pina M, Laserna C, Antolín B, Burgueño B, Durà M, Izaola O, Primo D, de Luis DA. Insulin resistance is related with liver fibrosis in type 2 diabetic patients with non-alcoholic fatty liver disease proven biopsy and Mediterranean diet pattern as a protective factor. Endocrine 2020; 68:557-563. [PMID: 32239453 DOI: 10.1007/s12020-020-02268-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/12/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS The prevalence of the non-alcoholic fatty liver disease (NAFLD) in developed countries is up to 30% of the general population, and 50% of patients present type 2 diabetes mellitus (DM2). Fibrosis is the most important prognostic factor in NAFLD. The aim of this study was to search evidence for an early diagnosis of liver fibrosis in subjects with DM2 and to evaluate potential risk and protective factors. METHODS This study was conducted among 160 diabetic patients with NAFLD proven biopsy. Anthropometric assessments, laboratory test, liver histological features and follow-up of a Mediterranean diet were evaluated. RESULTS Diabetic patients with liver fibrosis showed a greater number of positive metabolic criteria than diabetic patients without liver fibrosis. Patients with hepatic fibrosis have a lower score on the PREDIMED test (9.0 (2.4) vs. 6.2 (2.3); p < 0.05). Diabetic patients with liver fibrosis showed higher glucose levels (delta: 10.1 (4.5) mg/dl), fasting insulin levels (delta: 3.1 (1.5) UI/L), HOMA-IR (delta: 2.1 (0.3) units) and HbA1c (delta: 0.6 (0.2)%). Non-invasive tests showed a higher score (non-alcoholic fatty liver disease fibrosis score and fibrosis-4) in liver fibrosis subjects than no liver fibrosis subjects. A logistic regression analysis adjusted by age, gender, HbA1c and body mass index showed independent significant direct association between liver fibrosis and homeostatic model assessment of insulin resistance as indicator of insulin resistance (odds ratio (OR) = 1.53: 95% confidence interval (CI): 1.1-2.2; p = 0.026) and inverse association with PREDIMED score as an indicator of adherence to Mediterranean diet (OR = 0.6; 95% CI: 0.4-0.8; p = 0.01). CONCLUSION In patients with DM2, insulin resistance is an independent risk factor associated with liver fibrosis, and the adherence of a Mediterranean diet is a protective factor associated with absence of liver fibrosis.
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Affiliation(s)
- Rocío Aller
- Center of Investigation of Endocrinology and Nutrition, Medicine School and University of Valladolid, 47130, Valladolid, Spain
- Department of Digestive Hospital Clinico, University of Valladolid, Valladolid, Spain
| | - Rebeca Sigüenza
- Department of Radiology Hospital Clinico, University of Valladolid, Valladolid, Spain
| | - María Pina
- Department of Radiology Hospital Clinico, University of Valladolid, Valladolid, Spain
| | - Cristina Laserna
- Center of Investigation of Endocrinology and Nutrition, Medicine School and University of Valladolid, 47130, Valladolid, Spain
| | - Beatriz Antolín
- Department of Digestive Hospital Clinico, University of Valladolid, Valladolid, Spain
| | - Beatriz Burgueño
- Department of Digestive Hospital Clinico, University of Valladolid, Valladolid, Spain
| | - Miguel Durà
- Department of Digestive Hospital Clinico, University of Valladolid, Valladolid, Spain
| | - Olatz Izaola
- Center of Investigation of Endocrinology and Nutrition, Medicine School and University of Valladolid, 47130, Valladolid, Spain
- Department of Endocrinology and Nutricion Hospital Clinico, University of Valladolid, Valladolid, Spain
| | - David Primo
- Center of Investigation of Endocrinology and Nutrition, Medicine School and University of Valladolid, 47130, Valladolid, Spain
- Department of Endocrinology and Nutricion Hospital Clinico, University of Valladolid, Valladolid, Spain
| | - Daniel Antonio de Luis
- Center of Investigation of Endocrinology and Nutrition, Medicine School and University of Valladolid, 47130, Valladolid, Spain.
- Department of Endocrinology and Nutricion Hospital Clinico, University of Valladolid, Valladolid, Spain.
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15
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Gómez García MC, Millaruelo Trillo JM, Avila Lachica L, Cos-Claramunt FX, Franch-Nadal J, Cortés Gil X. [ESCRYTO study. Diabetes without cardiovascular disease and level of control]. Semergen 2020; 46:261-269. [PMID: 31874786 DOI: 10.1016/j.semerg.2019.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/17/2019] [Accepted: 11/20/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Diabetes is a significant risk factor for the development of cardiovascular disease, which is the main cause of death. The purpose of this study was to determine the level of glycaemic control in patients with type 2 diabetes without cardiovascular disease in Spain. The data used includes the most recent determination of glycosylated haemoglobin, as well as the pattern of antidiabetic treatment, the incidence of episodes of severe hypoglycaemia in the last 6 months, and the level of control of cardiovascular risk factors, and gender. PATIENTS AND METHODS A national, multicentre, and cross-sectional epidemiological study in which 800 doctors associated with the GDPS network participated. RESULTS Of the total of 1,059 patients, 57% male, with a mean age of 62.7 years in men vs. 65.2 in women (P<.001). The mean onset of diabetes was 9.4±7.5 years. The mean HbA1C was 7.0% in men vs. 7.1% in women (P=.039), with the control objective of <7% being observed in 47.2%. There were 65% patients on treatment with metformin, and 62.4% on DPP-4 inhibitors, and basal insulin: 14.2%. Incidence of severe hypoglycemias in the last 6 months was 1.9%. The women had worse glycaemic control, total cholesterol, LDL cholesterol, abdominal obesity, and glomerular filtration levels. CONCLUSIONS The glycaemic control is worse in women even if adjusted for age and time of onset of diabetes (P=.043), and for the number of hypoglycaemic agents (P=.015). The level of control is also worse in women for dyslipidaemia, abdominal obesity, and glomerular filtration. A preventive strategy promoted from Primary care on healthy lifestyles and controlling all vascular risk factors is essential.
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Affiliation(s)
| | | | - L Avila Lachica
- Consultorio Almachar, Unidad de Gestión Clínica Vélez-Norte, Almachar, Málaga, España
| | - F X Cos-Claramunt
- CAP Sant Martí, Atenció Primària, Institut Catalá de la Salut, Barcelona, España
| | - J Franch-Nadal
- Centro de Salud de Raval Sud, Barcelona, España; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, España
| | - X Cortés Gil
- Departamento Médico, Almirall S.A., Barcelona, España
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16
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Castillejos MC, Martín-Pérez C, García-Ruiz A, Mayoral-Cleries F, Moreno-Küstner B. Recording of cardiovascular risk factors by general practitioners in patients with schizophrenia. Ann Gen Psychiatry 2020; 19:34. [PMID: 32467716 PMCID: PMC7236925 DOI: 10.1186/s12991-020-00284-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 05/10/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Patients with schizophrenia and related disorders (SRD) are more predisposed to having cardiovascular risk factors (CVRFs) compared to the general population due to a combination of lifestyle factors and exposure to antipsychotic medications. We aimed to analyse the documentation practices of CVRFs by general practitioners (GPs) and its associations with patient variables in a sample of persons with SRD. METHODS An observational, cross-sectional study was conducted in 13 primary care centres (PCCs) in Malaga (Spain). The population comprised all patients with SRD who were in contact with a GP residing in the study area. The number of CVRFs (type 2 diabetes mellitus, hypertension, hypercholesterolaemia, obesity and smoking) recorded by GPs were analysed by considering patients' demographic and clinical variables and use of primary care services. We performed descriptive, bivariate and multivariate regression analyses. RESULTS A total of 494 patients were included; CVRFs were not recorded in 59.7% of the patients. One CVRF was recorded in 42.1% of patients and two or more CVRFs were recorded in 16.1% of patients. Older age, living in an urban area and a higher number of visits to the GP were associated with a higher number of CVRFs recorded. CONCLUSION The main finding in this study is that both patients' demographic variables as well as use of primary care services were found to be related to the documentation of CVRFs in patients with SRD by GPs.
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Affiliation(s)
- Mª Carmen Castillejos
- 1Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology Andalusian Group of Psychosocial Research (GAP), University of Malaga, Campus Teatinos, 29071 Malaga, Spain
| | - Carlos Martín-Pérez
- 2North East Granada Sanitary District, Clinical Management Unit at Marquesado, Andalusian Health Service, Carretera los Pozos, 18518 Alquife, Granada Spain
| | - Antonio García-Ruiz
- 3Department of Health Economics and the Rational Drug Use of Medicines. Faculty of Medicine, University of Malaga, Campus Teatinos, 29071 Malaga, Spain
| | - Fermín Mayoral-Cleries
- 4Clinical Management Unit of Mental Health of the Regional Hospital of Malaga. Andalusian Health Service, Biomedical Research Institute of Malaga (IBIMA), Plaza del Hospital, 29009 Malaga, Spain
| | - Berta Moreno-Küstner
- 5Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology. Andalusian Group of Psychosocial Research (GAP). Biomedical Research Institute of Malaga (IBIMA), University of Malaga, Campus Teatinos, 29071 Malaga, Spain
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17
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Antihyperlipidemic and Antioxidant Effects of Averrhoa Carambola Extract in High-Fat Diet-Fed Rats. Biomedicines 2019; 7:biomedicines7030072. [PMID: 31527433 PMCID: PMC6784245 DOI: 10.3390/biomedicines7030072] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 09/12/2019] [Accepted: 09/14/2019] [Indexed: 01/24/2023] Open
Abstract
The present study explored the antihyperlipidemic potential of a standardized methanolic extract of Averrhoa carambola (A. carambola) leaf (MEACL) in high-fat diet (HFD)-fed rats. The standardized MEACL was orally administered at different doses (250, 500, and 1000 mg/kg) to HFD-induced hyperlipidemic rats for five weeks. Serum lipid profile, body weight changes, body mass index (BMI), daily food intake, relative organ weight, and histology of the liver were evaluated. In addition, the effect of MEACL on HMG-CoA reductase and pancreatic lipase activities as well as hepatic and fecal lipids was demonstrated. MEACL supplementation reduced serum lipids in HFD-fed rats in a dose-dependent manner. Histopathological scores revealed that 1000 mg/kg MEACL restored the damage to liver tissue in hyperlipidemic rats. MEACL decreased the body mass index (BMI), atherogenic index, and hepatic cholesterol and triglycerides and increased fecal cholesterol and bile acids in HFD-fed rats. Also, MEACL ameliorated lipid peroxidation and improved antioxidant defenses in the liver of HFD-fed rats. Furthermore, HMG-CoA reductase and lipase were suppressed by MEACL. In conclusion, this study shows the potential effect of MEACL to ameliorate hyperlipidemia and oxidative stress in HFD-fed rats. It prevented hepatic lipid accumulation and exerted an inhibitory effect on HMG-CoA reductase and lipase.
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Prevalencia de obesidad y comorbilidad cardiovascular asociada en los pacientes incluidos en el estudio IBERICAN (Identificación de la poBlación Española de RIesgo CArdiovascular y reNal). Semergen 2019; 45:311-322. [DOI: 10.1016/j.semerg.2018.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 11/05/2018] [Accepted: 11/09/2018] [Indexed: 01/24/2023]
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Analysis of cerebrovascular disease mortality trends in Andalusia (1980–2014). NEUROLOGÍA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.nrleng.2018.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Lago-Sampedro A, García-Escobar E, Rubio-Martín E, Pascual-Aguirre N, Valdés S, Soriguer F, Goday A, Calle-Pascual A, Castell C, Menéndez E, Delgado E, Bordiú E, Castaño L, Franch-Nadal J, Girbés J, Chaves FJ, Gaztambide S, Rojo-Martínez G, Olveira G. Dairy Product Consumption and Metabolic Diseases in the Di@bet.es Study. Nutrients 2019; 11:nu11020262. [PMID: 30682848 PMCID: PMC6412325 DOI: 10.3390/nu11020262] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/14/2019] [Accepted: 01/21/2019] [Indexed: 02/07/2023] Open
Abstract
To date it is not clear what the role of dairy products is in metabolic diseases like diabetes, obesity, and hypertension. Therefore, the aim of this study is to test the association between dairy product consumption and those pathologies. A cross-sectional study was conducted with 5081 adults included in the di@bet.es study, from 100 health centers around Spain. Food frequency questionnaires were carried out concerning consumption habits, which included dairy product consumption. Logistic regression models were used for the association analyses between the variables controlling confounding variables. Women had a higher consumption of milk, cheese, or yogurt than men (p < 0.0001), but men consumed more sugar dairy products (p < 0.001). People who live in the North of Spain consume more dairy products than those who live in the East. Dairy product consumption was inversely associated with the presence of hypertension regardless of age, sex, geographical region, and body mass index (BMI) (Odds Ratio (OR) 0.743; p = 0.022). The presence of obesity was inversely associated with dairy consumption regardless of age, sex, and geographical region (OR 0.61; p < 0.001). Milk consumption was not associated with diabetes. Our results show that consuming dairy products is associated with a better metabolic profile in the Spanish population.
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Affiliation(s)
- Ana Lago-Sampedro
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain.
- UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain.
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas -CIBERDEM-), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- UGC Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain.
| | - Eva García-Escobar
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain.
- UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain.
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas -CIBERDEM-), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Elehazara Rubio-Martín
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain.
- UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain.
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas -CIBERDEM-), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Nuria Pascual-Aguirre
- UGCI de Prevención, Promoción y Vigilancia de la Salud, Complejo Hospitalario Universitario Granada, 18016 Granada, Spain.
| | - Sergio Valdés
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain.
- UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain.
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas -CIBERDEM-), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Federico Soriguer
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain.
- UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain.
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas -CIBERDEM-), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Albert Goday
- Department of Endocrinology and Nutrition, Hospital del Mar, 08003 Barcelona, Spain.
| | - Alfonso Calle-Pascual
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas -CIBERDEM-), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Department of Endocrinology and Nutrition, Hospital Universitario S. Carlos de Madrid, 28040 Madrid, Spain.
| | - Conxa Castell
- Public Health Division, Department of Health, Autonomous Government of Catalonia, 08023 Barcelona, Spain.
| | - Edelmiro Menéndez
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, 33011 Oviedo, Spain.
| | - Elías Delgado
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, 33011 Oviedo, Spain.
| | - Elena Bordiú
- Laboratorio de Endocrinología, Hospital Universitario San Carlos de Madrid, 28040 Madrid, Spain.
| | - Luis Castaño
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas -CIBERDEM-), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, 48903 Baracaldo, Spain.
| | - Josep Franch-Nadal
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas -CIBERDEM-), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP e Fundació Jordi Gol), 08001 Barcelona, Spain.
| | - Juan Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, 46015 Valencia, Spain.
| | - Felipe Javier Chaves
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas -CIBERDEM-), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Genotyping and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia-INCLIVA, 46010 Valencia, Spain.
| | - Sonia Gaztambide
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas -CIBERDEM-), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, 48903 Baracaldo, Spain.
| | - Gemma Rojo-Martínez
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain.
- UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain.
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas -CIBERDEM-), Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Gabriel Olveira
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain.
- UGC Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain.
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas -CIBERDEM-), Instituto de Salud Carlos III, 28029 Madrid, Spain.
- UGC Endocrinología y Nutrición, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, 29010 Málaga, Spain.
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Sacramento-Pacheco J, Duarte-Clíments G, Gómez-Salgado J, Romero-Martín M, Sánchez-Gómez MB. Cardiovascular risk assessment tools: A scoping review. Aust Crit Care 2019; 32:540-559. [PMID: 30661867 DOI: 10.1016/j.aucc.2018.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 09/27/2018] [Accepted: 09/29/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The objective of this review was to describe cardiovascular risk (CVR) assessment methods and to identify evidence-based practice recommendations when dealing with population at risk of developing cardiovascular diseases. REVIEW METHODS AND DATA SOURCES A literature review following the Arksey and O'Malley scoping review methodology was conducted. By using appropriate key terms, literature searches were conducted in PubMed, SciELO, Cochrane Library, Dialnet, ENFISPO, Medigraphic, ScienceDirect, Cuiden, and Lilacs databases. A complementary search on websites related to the area of interest was conducted. Articles published in English or Spanish in peer-review journals between 2010 and 2017. Critical appraisal for methodological quality was conducted. Data was extracted using ad-hoc tables and qualitatively synthesized. RESULTS After eliminating duplicates, 55325 records remained, and 1432 records were selected for screening. Out of these, 88 full-text articles were selected for eligibility criteria, and finally, 67 studies were selected for this review, and 25 studies were selected for evidence synthesis. In total, 23 CVR assessment tools have been identified, pioneered by the Framingham study. Qualitative findings were grouped into four thematic areas: assessment tools and scores, CVR indicators, comparative models, and evidence-based recommendations. CONCLUSIONS It is necessary to adapt the instruments to the epidemiological reality of the population. The most appropriate way to estimate CVR is to choose the assessment tool that best suits individual conditions, accompanied by a comprehensive assessment of the patient. More research is required to determine a single, adequate, and reliable tool.
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Affiliation(s)
- Jennifer Sacramento-Pacheco
- Polyclinic Centre of Canarias, Santa Cruz de Tenerife, Calle Alfonso Trujillo, s/n (Edificio Temait III), 38300, La Orotava, Santa Cruz de Tenerife, Spain.
| | - Gonzalo Duarte-Clíments
- Multiprofessional Teaching Unit of Family and Community Care, Canary Islands Health Service, Santa Cruz de Tenerife, Hospital Universitario Ntra. Sra. de Candelaria, Ctra. del Rosario, 145, 38010 Santa Cruz de Tenerife, Spain.
| | - Juan Gómez-Salgado
- University of Huelva, Department of Nursing, Facultad de Enfermería, Campus del Carmen, Avda. Tres de Marzo s/n, 21071, Huelva, Spain; Espíritu Santo University, Guayaquil, Ecuador.
| | - Macarena Romero-Martín
- Red Cross Nursing University Center, University of Sevilla, Avda Cruz Roja s/n. Dpdo, 41009, Sevilla, Spain.
| | - María Begoña Sánchez-Gómez
- University School of Nursing Nuestra Señora de Candelaria, University of La Laguna, Hospital Universitario Ntra. Sra. De Candelaria, Ctra. del Rosario, 145, 38010, Santa Cruz de Tenerife, Spain.
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Geographic and area-level socioeconomic variation in cardiometabolic risk factor distribution: a systematic review of the literature. Int J Health Geogr 2019; 18:1. [PMID: 30621786 PMCID: PMC6323718 DOI: 10.1186/s12942-018-0165-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/31/2018] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION A growing number of publications report variation in the distribution of cardiometabolic risk factors (CMRFs) at different geographic scales. A review of these variations may help inform policy and health service organisation. AIM To review studies reporting variation in the geographic distribution of CMRFs and its association with various proxy measures of area-level socioeconomic disadvantage (ASED) among the adult ( ≥ 18 years) population across the world. METHODS A systematic search for published articles was conducted in four databases (MEDLINE (Ovid), PubMed, Scopus and Web of Science) considering the interdisciplinary nature of the review question. Population-based cross-sectional and cohort studies on geographic variations of one or more biological proxies of CMRFs with/without an analysed contextual association with ASED were included. Two independent reviewers screened the studies and PRISMA guidelines were followed in the study selection and reporting. RESULT A total of 265 studies were retrieved and screened, resulting in 24 eligible studies. The review revealed reports of variation in the distribution of CMRFs, at varying geographic scales, in multiple countries. In addition, consistent associations between ASED and higher prevalence of CMRFs were demonstrated. The reports were mainly from industrialised nations and small area geographic units were frequently used. CONCLUSION Geographic variation in cardiometabolic risk exists across multiple spatial scales and is positively associated with ASED. This association is independent of individual-level factors and provides an imperative for area-based approaches to informing policy and health service organisation. The study protocol is registered in International prospective register of systematic reviews (Register No: CRD42018115294) PROSPERO 2018.
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Evolución de la prevalencia de la diabetes mellitus en España (1999-2014). ENDOCRINOL DIAB NUTR 2018; 65:515-523. [DOI: 10.1016/j.endinu.2018.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 04/23/2018] [Accepted: 06/05/2018] [Indexed: 01/12/2023]
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Rodríguez-Roca GC, Segura-Fragoso A, Villarín-Castro A, Alonso-Moreno FJ, Rodríguez-Padial L, Rodríguez-García ML, Fernández-Conde JA, Rojas-Martelo GA, Menchén-Herreros A, Escobar-Cervantes C, Fernández-Martín J, Artigao-Rodenas LM, Carbayo-Herencia JA, Hernández-Moreno J. [Characteristics and cardiovascular events in a general population included in the RICARTO (RIesgo CARdiovascular TOledo) study: Data from the first 1,500 individuals included in the study]. Semergen 2017; 44:180-191. [PMID: 28869129 DOI: 10.1016/j.semerg.2017.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/17/2017] [Accepted: 07/04/2017] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The aim of this study was to assess cardiovascular risk (CVR) by investigating the prevalence of CVR factors (CVRF), target organ damage (TOD), and cardiovascular disease (CVD) in general population of the health area of Toledo, Spain. MATERIAL AND METHODS Epidemiological and observational study that analysed a sample from the general population aged 18years or older, randomly selected from a database of health cards stratified by age and gender. Clinical history, physical examination, and complementary tests were performed. Total blood and serum samples were frozen at -85°C to evaluate genetic studies in the future. Standard statistical analysis was performed. CVR was assessed by the SCORE scale calibrated for the Spanish population, and the Framingham Heart Study scale. RESULTS A total of 1,500 individuals (mean age 49.1±15.8years, 55.6% women) were included. Prevalences: dyslipidaemia 56.9% (95% confidence interval [95% CI]: 54.3-59.4), hypertension 33.0% (95%CI: 30.6-35.4), diabetes mellitus 8.6% (95%CI: 7.17-10.1), smoking 24.2% (95%CI; 122.0-26.4), obesity 25.3% (95%CI; 23.1-27.5), and sedentary life-style 39.4% (95%CI; 36.9-41.8). No CVRF was reported in 21.1% of cases, and 18.6% had 3-5 CVRF. TOD: electrocardiographic left ventricular hypertrophy, 4.3%, peripheral artery disease, 10.1% (Doppler ultrasound), and 15.3% (oscillometric device), microalbuminuria, 4.3%, sub-clinical renal disease, 3.2%, and nephropathy in 3.8% (CKD-EPI). At least one CVD was reported in 9.2% of cases. A low CVR (SCORE) was present in 44.6% of individuals. CONCLUSIONS Dyslipidaemia was found in 60% of individuals, 40% had a sedentary life-style, 30% with hypertension, 20% smoked, 20% obesity, and almost 10% with diabetes. More than a half of individuals have a moderate-high-very high risk. The prevalence of TOD and CVD are significant.
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Affiliation(s)
- G C Rodríguez-Roca
- Investigador Principal y Director del Proyecto RICARTO, Centro de Salud de La Puebla de Montalbán, La Puebla de Montalbán, Toledo, España.
| | - A Segura-Fragoso
- Instituto de Ciencias de la Salud de Castilla-La Mancha, Consejería de Sanidad, Talavera de la Reina, Toledo, España
| | - A Villarín-Castro
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria, Gerencia de Atención Primaria de Toledo, Toledo, España
| | | | - L Rodríguez-Padial
- Servicio de Cardiología, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - M L Rodríguez-García
- Enfermera del Estudio RICARTO, Gerencia de Atención Primaria de Toledo, Toledo, España
| | - J A Fernández-Conde
- Unidad Administrativa, Gerencia de Atención Primaria de Toledo, Toledo, España
| | - G A Rojas-Martelo
- Médico Interno Residente de Medicina Familiar y Comunitaria, Hospital Ramón y Cajal, Madrid, España
| | - A Menchén-Herreros
- Laboratorio de Análisis Clínicos, Hospital Virgen de la Salud, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | | | - J Fernández-Martín
- Servicio de Investigación e Innovación, Consejería de Sanidad, Junta de Comunidades de Castilla-La Mancha, Toledo, España
| | - L M Artigao-Rodenas
- Centro de Salud Zona III, Grupo de Enfermedades Vasculares de Albacete (GEVA), Albacete, España
| | - J A Carbayo-Herencia
- Grupo de Enfermedades Vasculares de Albacete (GEVA), Unidad de Lípidos, Hospital Quirónsalud de Albacete; Profesor de las Universidades Miguel Hernández de Alicante y Católica de San Antonio de Murcia, y del Centro Universitario de la Defensa de San Javier de Murcia, Albacete, España
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Cardiovascular risk factors in patients with spondyloarthritis from Northern European and Mediterranean countries: An ancillary study of the ASAS-COMOSPA project. Joint Bone Spine 2017; 85:447-453. [PMID: 28754402 DOI: 10.1016/j.jbspin.2017.07.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 07/12/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The objectives of this study were: (1) to compare the prevalence of cardiovascular disease and cardiovascular risk factors among different phenotypes of spondyloarthritis (SpA); (2) to assess the differences in cardiovascular disease and cardiovascular risk factors between two geographical areas, i.e. Northern Europe vs. Mediterranean region; (3) to identify potential predictive factors for high Framingham Risk Score regarding disease features in SpA and geographical area. METHODS Ancillary analysis of the international, multicentric, observational, cross-sectional ASAS-COMOSPA study. Cardiovascular disease and cardiovascular risk factors were compared depending on SpA phenotype and geographical regions. Potential factors associated with higher cardiovascular risk (i.e. Framingham Risk Score) were determined by a multiple logistic regression. RESULTS The most frequent cardiovascular risk factor and cardiovascular disease were smoking (31.2%) and ischemic heart disease (3.2%), respectively. Regarding SpA phenotype, axial SpA patients showed significantly lower prevalence (P<0.05) of hypertension (19.2% vs. 33.8% vs. 26.6% for axial, peripheral and mixed phenotypes, respectively), type 2 diabetes mellitus (4.3% vs. 8.5% vs. 7.4%), dyslipidemia (13.9% vs. 28.4% vs. 15.2%) and ischemic heart disease (2.4% vs. 7.0% vs. 3.2%). Regarding geographical area, a higher frequency of hypertension (34.7% vs. 19.4%,), dyslipidemia (19.3% vs. 14.4%), obesity (29.3% vs. 20.7%) and ischemic heart disease (6.2% vs. 1.8%) was observed for Northern Europe vs. Mediterranean Region, respectively. CONCLUSIONS Our results suggest that SpA phenotype and geographical area are associated with the prevalence of cardiovascular risk factors and the cardiovascular risk itself, observed in patients in the ASAS-COMOSPA cohort.
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Barranco RJ, Gomez-Peralta F, Abreu C, Delgado-Rodriguez M, Moreno-Carazo A, Romero F, de la Cal MA, Barranco JM, Pasquel FJ, Umpierrez GE. Incidence, recurrence and cost of hyperglycaemic crises requiring emergency treatment in Andalusia, Spain. Diabet Med 2017; 34:966-972. [PMID: 28326628 DOI: 10.1111/dme.13355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2017] [Indexed: 12/27/2022]
Abstract
AIMS Hyperglycaemic crises (diabetic ketoacidosis and hyperosmolar hyperglycaemic state) are medical emergencies in people with diabetes. We aimed to determine their incidence, recurrence and economic impact. METHODS An observational study of hyperglycaemic crises cases using the database maintained by the out-of-hospital emergency service, the Healthcare Emergency Public Service (EPES) during 2012. The EPES provides emergency medical services to the total population of Andalusia, Spain (8.5 million inhabitants) and records data on the incidence, resource utilization and cost of out-of-hospital medical care. Direct costs were estimated using public prices for health services updated to 2012. RESULTS Among 1 137 738 emergency calls requesting medical assistance, 3157 were diagnosed with hyperglycaemic crises by an emergency coordinator, representing 2.9 cases per 1000 persons with diabetes [95% confidence intervals (CI) 2.8 to 3.0]. The incidence of diabetic ketoacidosis was 2.5 cases per 1000 persons with diabetes (95% CI 2.4 to 2.6) and the incidence of hyperosmolar hyperglycaemic state was 0.4 cases per 1000 persons with diabetes (95% CI 0.4 to 0.5). In total, 17.7% (n = 440) of people had one or more hyperglycaemic crisis. The estimated total direct cost was €4 662 151, with a mean direct cost per episode of €1476.8 ± 217.8. CONCLUSIONS Hyperglycaemic crises require high resource utilization of emergency medical services and have a significant economic impact on the health system.
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Affiliation(s)
- R J Barranco
- Andalusian Healthcare Emergency Public Service, Neurotraumatologic Hospital
- Department Health Sciences, University of Jaén, Jaén
| | - F Gomez-Peralta
- Endocrinology and Nutrition Unit, Segovia General Hospital, Segovia
| | - C Abreu
- Endocrinology and Nutrition Unit, Segovia General Hospital, Segovia
| | - M Delgado-Rodriguez
- Division of Preventive Medicine and Public Health, University of Jaén, Jaén
- Center for Biomedical Research in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Madrid
| | - A Moreno-Carazo
- Endocrinology and Nutrition Unit, City of Jaén Hospital Complex, Jaén
| | - F Romero
- Andalusian Healthcare Emergency Public Service, Neurotraumatologic Hospital
| | - M A de la Cal
- Andalusian Healthcare Emergency Public Service, Los Morales Hospital, Córdoba
| | - J M Barranco
- Department of Business Management, Insulcloud S.L., Madrid, Spain
| | - F J Pasquel
- Department of Medicine, Emory University School of Medicine, Atlanta, USA
| | - G E Umpierrez
- Department of Medicine, Emory University School of Medicine, Atlanta, USA
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Castillo-Sánchez M, Fàbregas-Escurriola M, Bergè-Baquero D, Fernández-SanMartín M, Goday-Arno A. Screening of cardiovascular risk factors in patients with schizophrenia and patients treated with antipsychotic drugs: are we equally exhaustive as with the general population? Clin Exp Hypertens 2017; 39:441-447. [PMID: 28590147 DOI: 10.1080/10641963.2016.1267200] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Many studies have previously shown increased cardiovascular risk factors related to schizophrenia independently from the use of antipsychotic drugs. However, a poorer effort in clinical detection and management of cardiovascular risk in patients with severe mental illness could also explain these results. To test this hypothesis, we analyzed the differences in screening and incidence of cardiovascular risk factors between schizophrenia, non-schizophrenic patients on treatment with antipsychotic drugs (NS-TAD) and the general population. Data from adult subjects assessed by high-quality register general practitioners from 2006 to 2011 were extracted from the Catalonian SIDIAP database. The schizophrenia, NS-TAD, and control groups were compared in terms of measurements and incidence of diabetes, dyslipidemia, obesity, hypertension, and smoking. A total of 4911 patients in the schizophrenia group, 4157 in NS-TAD group, and 98644 in the control group were included. Schizophrenia patients were screened for dyslipidemia and diabetes more frequently than the control group, while for obesity or hypertension, they were screened equal to controls. Also, as compared to the control group, the NS-TAD group was more frequently screened for obesity with no differences in dyslipidemia and diabetes and less frequently for hypertension. Smoking was less frequently screened in both study groups. The incidence of all risk factors studied in both study groups was higher than or equal to the control group, except for hypertension, which had lower incidence. The lack of screening of risk factors does not appear decisive in the increased cardiovascular risk of patients diagnosed with schizophrenia seen in primary care. Studies evaluating the possible under diagnosis of the risk factors are required. ABBREVIATIONS Schizophrenia (SZ); Treatment with antipsychotic drugs (TAD); Cardiovascular risk factor/s (CVRF); Without schizophrenia but on therapy with antipsychotic drugs (NS-TAD); Defined Daily Dose (DDD).
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Affiliation(s)
- Miguel Castillo-Sánchez
- a Departamento de Medicina , Universitat Autònoma de Barcelona , Cerdanyola del Vallès, Barcelona, Spain.,b Médico de familia , CS Cox /Callosa de Segura , Alicante , Spain.,c Institut Universitari d'Investigaciò en Atenciò Primaria (IDIAP) Jordi Gol , Barcelona , Spain
| | | | - Daniel Bergè-Baquero
- e Hospital del Mar Medical Research Institute (IMIM) , Barcelona , Spain.,f CIBERSAM (Centro de Investigación Biomédica en Red , Salud Mental), Madrid, Spain
| | - MªIsabel Fernández-SanMartín
- c Institut Universitari d'Investigaciò en Atenciò Primaria (IDIAP) Jordi Gol , Barcelona , Spain.,g Técnica de Salud ICS, Unitat Docent AFiC , Barcelona , Spain
| | - Albert Goday-Arno
- a Departamento de Medicina , Universitat Autònoma de Barcelona , Cerdanyola del Vallès, Barcelona, Spain.,h Servicio de Endocrinología y Nutrición, Hospital del Mar , Barcelona , Spain.,i CIBER Obn, Centro de Investigaciones Biomedicas en obesidad y nutrición Parc de Salut Mar , Barcelona , Spain
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López-Sepúlveda R, García Lirola MÁ, Espínola García E, Jurado Martínez JM, Martín Sances S, Anaya Ordóñez S, Cabeza Barrera J. Antidiabetic medications use trends in an Andalusian region from 2001 to 2014. Prim Care Diabetes 2017; 11:254-264. [PMID: 28126469 DOI: 10.1016/j.pcd.2017.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 12/20/2016] [Accepted: 01/04/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE There is a widening range of antidiabetic medications available; however changes in consumption patterns remain poorly documented. The aim of this study is to analyze the evolution of consumption of antidiabetic medications during the period 2001-2014 in an Andalusian region. METHODS All antidiabetic medicines on the market were selected for analysis. Consumption data were obtained for the 15-year period and were expressed in defined daily doses (DDD) per 1000 inhabitants per day (DHD). RESULTS During the study period consumption of insulins grew only a 2.2%, from 17.9 DHD to 18.3 DHD, while oral agents increased a 27.6%, from 41.3 DHD to 52.7 DHD. Consumption of sulfonylureas was gradually reduced from 30.1 DHD to 16.4 DHD but metformin (alone) usage increased from 4.3 DHD to 23.7 DHD, and was the most consumed agent in 2014. A rise in consumption of dipeptidyl peptidase-4 inhibitors and "other hypoglycemic agents" was also noticed. Overall expenditure in antidiabetic medications increased notably from 4.5 in 2001 to 14.4 million euros in 2014. CONCLUSION We highlight the market uptake of antidiabetic drugs commercialized during the last decade; despite further exploration is needed to clarify the cost-benefit ratio of these new antidiabetic medicines.
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Affiliation(s)
- Rocío López-Sepúlveda
- Unidad Gestión Clínica de Farmacia Provincial de Granada, Distrito Sanitario Granada Metropolitano, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada, Spain
| | - María Ángeles García Lirola
- Unidad Gestión Clínica de Farmacia Provincial de Granada, Distrito Sanitario Granada Metropolitano, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada, Spain.
| | - Esther Espínola García
- Unidad Gestión Clínica de Farmacia Provincial de Granada, Distrito Sanitario Granada Metropolitano, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada, Spain
| | - Jose María Jurado Martínez
- Unidad Gestión Clínica de Farmacia Provincial de Granada, Distrito Sanitario Granada Metropolitano, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada, Spain
| | - Salvadora Martín Sances
- Unidad Gestión Clínica de Farmacia Provincial de Granada, Distrito Sanitario Granada Metropolitano, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada, Spain
| | - Sonia Anaya Ordóñez
- Unidad Gestión Clínica de Farmacia Provincial de Granada, Distrito Sanitario Granada Metropolitano, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada, Spain
| | - José Cabeza Barrera
- Unidad de Gestión Clínica de Farmacia Provincial de Granada, Complejo Hospitalario de Granada, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada, Spain
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Cayuela A, Cayuela L, Rodríguez-Domínguez S, González A, Moniche F. Analysis of cerebrovascular disease mortality trends in Andalusia (1980-2014). Neurologia 2017; 34:309-317. [PMID: 28318728 DOI: 10.1016/j.nrl.2016.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 12/14/2016] [Accepted: 12/23/2016] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION In recent decades, mortality rates for cerebrovascular diseases (CVD) have decreased significantly in many countries. This study analyses recent tendencies in CVD mortality rates in Andalusia (1980-2014) to identify any changes in previously observed sex and age trends. PATIENTS AND METHODS CVD mortality and population data were obtained from Spain's National Statistics Institute database. We calculated age-specific and age-standardised mortality rates using the direct method (European standard population). Joinpoint regression analysis was used to estimate the annual percentage change in rates and identify significant changes in mortality trends. We also estimated rate ratios between Andalusia and Spain. RESULTS Standardised rates for both males and females showed 3 periods in joinpoint regression analysis: an initial period of significant decline (1980-1997), a period of rate stabilisation (1997-2003), and another period of significant decline (2003-2014). CONCLUSIONS Between 1997 and 2003, age-standardised rates stabilised in Andalusia but continued to decrease in Spain as a whole. This increased in the gap between CVD mortality rates in Andalusia and Spain for both sexes and most age groups.
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Affiliation(s)
- A Cayuela
- Unidad de Gestión Clínica de Salud Pública, Prevención y Promoción de la Salud, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, España.
| | - L Cayuela
- Facultad de Medicina, Universidad de Sevilla, Sevilla, España
| | - S Rodríguez-Domínguez
- Unidad de Gestión Clínica Pino Montano A, Distrito Sanitario Sevilla, Sevilla, España
| | - A González
- Servicio de Neurorradiología Intervencionista, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - F Moniche
- Unidad de Ictus, Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, España
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Enfermedad cardiovascular y producto interior bruto en España: análisis de correlación por comunidades autónomas. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.07.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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31
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Dalama B, Mesa J. Nuevos hipoglucemiantes orales y riesgo cardiovascular. Cruzando la frontera metabólica. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.07.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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32
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Cardiovascular Disease and Gross Domestic Product in Spain: Correlation Analysis by Autonomous Communities. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2016; 70:210-212. [PMID: 27769792 DOI: 10.1016/j.rec.2016.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 07/22/2016] [Indexed: 11/22/2022]
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33
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Dalama B, Mesa J. New Oral Hypoglycemic Agents and Cardiovascular Risk. Crossing the Metabolic Border. ACTA ACUST UNITED AC 2016; 69:1088-1097. [PMID: 27687335 DOI: 10.1016/j.rec.2016.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/05/2016] [Indexed: 12/19/2022]
Abstract
Sodium-glucose cotransporter 2 inhibitors are a novel pharmacological class of oral hypoglycemic agents that lower glucose levels by increasing renal glucose excretion in an insulin-independent manner. However, this seemingly simple mechanism has more complex indirect metabolic effects. The results of randomized clinical trials have shown that these inhibitors effectively lower blood glucose and glycated hemoglobin levels without increasing the risk of hypoglycemia and, at the same time, also reduce bodyweight and systolic blood pressure. In this review, we describe the mechanism of action, efficacy, and safety of currently marketed drugs, as well as other risk factors besides glucose that can potentially be modulated positively. Recent data on empagliflozin showing a significant cardiovascular benefit have compelled us to update knowledge of this new therapeutic class for the treatment of type 2 diabetes.
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Affiliation(s)
- Belén Dalama
- Servicio de Endocrinología y Nutrición, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
| | - Jordi Mesa
- Servicio de Endocrinología y Nutrición, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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[Baseline characteristics and clinical management of the first 3,000 patients enrolled in the IBERICAN study (Identification of the Spanish population at cardiovascular and renal risk)]. Semergen 2016; 43:493-500. [PMID: 27567214 DOI: 10.1016/j.semerg.2016.07.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 07/04/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To determine the prevalence and incidence of cardiovascular risk factors in Spain, as well as cardiovascular events, in Spanish adult population attended in primary care. METHODOLOGY IBERICAN is a longitudinal, observational, multicenter study in which patients aged 18 to 85years attended in primary care health center in Spain are being included. The obtained cohort will be followed annually for at least 5years. The estimated final sample is 7,000 patients. The baseline characteristics of the second cut (n=3,042) are presented. RESULTS The mean age of the subjects included is 57.9±14.6 years, and 55.5% are women. 54.9% live in urban habitat, and 57.3% have primary education. 50.3% had dyslipidemia, 47.4% hypertension, 29.7% physical inactivity, 28.2% abdominal obesity and 19% diabetes mellitus. The degree of control of hypertension, dyslipidemia and type2 diabetes was 58.5%, 25.8% and 75.9%. 28.2% have criteria for metabolic syndrome. 15.6% of patients had previous cardiovascular disease. 7.8% have a history of coronary heart disease, a glomerular filtration rate <60ml/min (CKD-EPI) 8.4%, microalbuminuria 9.6%, atrial fibrillation 5.5%, stroke 4.6%, and heart failure 2.9%. CONCLUSIONS Although the population treated in primary care is relatively young, the high prevalence of risk factors, their poor control and the existence of previous cardiovascular disease will determine the impact on the prognosis of the cohort.
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Ferreira-González I, Abu-Assi E, Arias MA, Gallego P, Sánchez-Recalde Á, Avanzas P, Bayes-Genis A, de Isla LP, Sanchis J. REVISTA ESPAÑOLA DE CARDIOLOGÍA. Estado actual y perspectiva futura. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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36
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Ferreira-González I, Abu-Assi E, Arias MA, Gallego P, Sánchez-Recalde Á, Avanzas P, Bayes-Genis A, de Isla LP, Sanchis J. Revista Española de Cardiología: Current Position and Future Directions. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2016; 69:327-336. [PMID: 26927537 DOI: 10.1016/j.rec.2016.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 06/05/2023]
Affiliation(s)
| | | | | | | | | | - Pablo Avanzas
- Former Associate Editor, Revista Española de Cardiología
| | | | | | - Juan Sanchis
- Former Editor-in-Chief, Revista Española de Cardiología
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Barranco RJ, Gomez-Peralta F, Abreu C, Delgado M, Palomares R, Romero F, Morales C, de la Cal MA, Garcia-Almeida JM, Pasquel F, Umpierrez GE. Incidence and care-related costs of severe hypoglycaemia requiring emergency treatment in Andalusia (Spain): the PAUEPAD project. Diabet Med 2015; 32:1520-6. [PMID: 26118472 PMCID: PMC4755037 DOI: 10.1111/dme.12843] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2015] [Indexed: 12/31/2022]
Abstract
AIMS Hypoglycaemia is a serious medical emergency. The need for emergency medical service care and the costs of hypoglycaemic emergencies are not completely known. METHODS This was a retrospective observational study using Public Company for Health Emergencies (EPES) data for hypoglycaemia in 2012. The EPES provides emergency medical services to the entire population of Andalusia, Spain (8.5 million people). Data on event type, onsite treatments, emergency room visits or hospitalization were collected. Medical costs were estimated using the public rates for healthcare services. RESULTS From a total of 1 137 738 emergency calls that requested medical assistance, 8683 had a primary diagnosis of hypoglycaemia (10.34 per 10 000 person-years). The incidence of severe hypoglycaemic episodes requiring emergency treatment in the estimated population with diabetes was 80 episodes per 10 000 person-years. A total of 7479 episodes (86%) required an emergency team to visit the patient's residence. The majority of cases (64%) were addressed in the residence, although 1784 (21%) cases were transferred to hospital. A total of 5564 events (65%) involved patients aged > 65 years. Overall mortality was 0.32% (28 cases). The total annual cost of attending a hypoglycaemic episode was €6 093 507, leading to an estimated mean direct cost per episode of €702 ± 565. Episodes that required hospital treatment accounted for 49% of the total costs. CONCLUSIONS Hypoglycaemia is a common medical emergency that is associated with high emergency medical service utilization, resulting in a significant economic impact on the health system.
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Affiliation(s)
- R J Barranco
- Public Company for Health Emergencies of Andalucıa (EPES), Sevilla, Spain
- Department Health Sciences, University of Jaen, Segovia, Spain
| | - F Gomez-Peralta
- Endocrinology and Nutrition Unit, Segovia General Hospital, Segovia, Spain
| | - C Abreu
- Endocrinology and Nutrition Unit, Segovia General Hospital, Segovia, Spain
| | - M Delgado
- Division of Preventive Medicine and Public Health, Department Health Sciences, University of Jaen, Jaen, Spain
- Center for Biomedical Research in Epidemiology and Public Health (CIBERESP), ISCIII, Ministry of Health, Madrid, Spain
| | - R Palomares
- Endocrinology and Nutrition Unit, Reina Sofia Hospital, Cordoba, Spain
| | - F Romero
- Public Company for Health Emergencies of Andalucıa (EPES), Sevilla, Spain
| | - C Morales
- Endocrinology and Nutrition Unit, Virgen Macarena Hospital, Sevilla, Spain
| | - M A de la Cal
- Public Company for Health Emergencies of Andalucıa (EPES), Sevilla, Spain
| | - J M Garcia-Almeida
- Endocrinology and Clinical Nutrition Unit, Virgen de la Victoria Hospital, Malaga, Spain
| | - F Pasquel
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - G E Umpierrez
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
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Ortega Becerra M, Muros JJ, Palomares Cuadros J, Martín Sánchez J, Cepero González M. Influence of BMI on self-esteem of children aged 12–14 years. An Pediatr (Barc) 2015. [DOI: 10.1016/j.anpede.2014.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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39
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Ortega Becerra M, Muros J, Palomares Cuadros J, Martín Sánchez J, Cepero González M. Influencia del índice de masa corporal en la autoestima de niños y niñas de 12-14 años. An Pediatr (Barc) 2015; 83:311-7. [DOI: 10.1016/j.anpedi.2014.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 11/11/2014] [Accepted: 11/17/2014] [Indexed: 11/28/2022] Open
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Impacto de la cirugía bariátrica a medio plazo en la estructura y la función del corazón. Rev Esp Cardiol (Engl Ed) 2015. [DOI: 10.1016/j.recesp.2015.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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41
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García Iglesias A, Lozano Alonso J, Álamo Sanz R, Vega Alonso T. Evolución de los factores de riesgo cardiovascular entre 2004 y 2009 en la cohorte del estudio del Riesgo de Enfermedad Cardiovascular en Castilla y León (RECCyL). ANGIOLOGIA 2015. [DOI: 10.1016/j.angio.2014.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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42
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Mid-term Impact of Bariatric Surgery on Cardiac Structure and Function. ACTA ACUST UNITED AC 2015; 68:723-4. [PMID: 26094603 DOI: 10.1016/j.rec.2015.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 03/04/2015] [Indexed: 11/20/2022]
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Galve E, Cordero A, Bertomeu-Martínez V, Fácila L, Mazón P, Alegría E, Fernández de Bobadilla J, García-Porrero E, Martínez-Sellés M, González-Juanatey JR. Update in cardiology: vascular risk and cardiac rehabilitation. ACTA ACUST UNITED AC 2015; 68:136-43. [PMID: 25583549 DOI: 10.1016/j.rec.2014.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 10/02/2014] [Indexed: 01/03/2023]
Abstract
As in other fields, understanding of vascular risk and rehabilitation is constantly improving. The present review of recent epidemiological update shows how far we are from achieving good risk factor control: in diet and nutrition, where unhealthy and excessive societal consumption is clearly increasing the prevalence of obesity; in exercise, where it is difficult to find a balance between benefit and risk, despite systemization efforts; in smoking, where developments center on programs and policies, with the electronic cigarette seeming more like a problem than a solution; in lipids, where the transatlantic debate between guidelines is becoming a paradigm of the divergence of views in this extensively studied area; in hypertension, where a nonpharmacological alternative (renal denervation) has been undermined by the SYMPLICITY HTN-3 setback, forcing a deep reassessment; in diabetes mellitus, where the new dipeptidyl peptidase-4 and sodium-glucose cotransporter type 2 inhibitors and glucagon like peptide 1 analogues have contributed much new information and a glimpse of the future of diabetes treatment, and in cardiac rehabilitation, which continues to benefit from new information and communication technologies and where clinical benefit is not hindered by advanced diseases, such as heart failure. Our summary concludes with the update in elderly patients, whose treatment criteria are extrapolated from those of younger patients, with the present review clearly indicating that should not be the case.
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Affiliation(s)
- Enrique Galve
- Servicio de Cardiología, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
| | - Alberto Cordero
- Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
| | - Vicente Bertomeu-Martínez
- Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
| | - Lorenzo Fácila
- Servicio de Cardiología, Consorcio Hospital General de Valencia, Valencia, Spain
| | - Pilar Mazón
- Servicio de Cardiología, Hospital Universitario Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Eduardo Alegría
- Servicio de Cardiología, Policlínica Gipuzkoa, San Sebastián, Guipúzcoa, Spain
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Escobar C, Divisón J, Seguí Díaz M. Incidencia de obesidad infantil en Estados Unidos. Semergen 2014; 40:220-1. [DOI: 10.1016/j.semerg.2014.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 03/31/2014] [Indexed: 11/28/2022]
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