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Gutiérrez-Repiso C, Soriguer F, Rojo-Martínez G, García-Fuentes E, Valdés S, Goday A, Calle-Pascual A, López-Alba A, Castell C, Menéndez E, Bordiú E, Delgado E, Ortega E, Pascual-Manich G, Urrutia I, Mora-Peces I, Vendrell J, Vázquez JA, Franch J, Girbés J, Castaño L, Serrano-Ríos M, Martínez-Larrad MT, Catalá M, Carmena R, Gomis R, Casamitjana R, Gaztambide S. Variable patterns of obesity and cardiometabolic phenotypes and their association with lifestyle factors in the Di@bet.es study. Nutr Metab Cardiovasc Dis 2014; 24:947-955. [PMID: 24984822 DOI: 10.1016/j.numecd.2014.04.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 04/29/2014] [Accepted: 04/30/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIM Prevalence rates of "metabolically healthy obese" (MHO) subjects vary depending on the criteria used. This study examined the prevalence and characteristics of MHO subjects and metabolically abnormal normal-weight subjects and compared the findings with the NHANES 1999-2004 study. The aims of the present study were, first, to determine the prevalence rates of MHO and MNHNO subjects using the same criteria as those of the National Health and Nutrition Examination Survey (NHANES) (1999-2004) study, and second to compare the prevalence and correlates of obese subjects who are resistant to the development of adiposity-associated cardiometabolic abnormalities (CA) and normal-weight individuals who display cardiometabolic risk factor clustering between the Spanish and the US populations. METHODS AND RESULTS Di@bet.es study is a national, cross-sectional population-based survey of 5728 adults conducted in 2009-2010. Clinical, metabolic, sociodemographic, and anthropometric data and information about lifestyle habits, such as physical activity, smoking habit, alcohol intake and food consumption, were collected. Subjects were classified according to their body mass index (BMI) (normal-weight, <25 kg/m(2); overweight, 25-29.9 kg/m(2); and obese, >30 kg/m(2)). CA included elevated blood pressure; elevated levels of triglycerides, fasting glucose, and high-sensitivity C-reactive protein (hs-CRP); and elevated homeostasis model assessment of insulin resistance (HOMA-IR) value and low high-density lipoprotein cholesterol (HDL-c) level. Two phenotypes were defined: metabolically healthy phenotype (0-1 CA) and metabolically abnormal phenotype (≥2 CA). The prevalence of metabolically abnormal normal-weight phenotype was slightly lower in the Spanish population (6.5% vs. 8.1%). The prevalence of metabolically healthy overweight and MHO subjects was 20.9% and 7.0%, respectively, while in NHANES study it was 17.9% and 9.7%, respectively. Cigarette smoking was associated with CA in each phenotype, while moderate physical activity and moderate alcohol intake were associated with being metabolically healthy. Olive oil intake was negatively associated with the prevalence of CA. CONCLUSIONS Smoking, physical activity level, and alcohol intake contribute to the explanation of the prevalence of CA in the Spanish population, as in the US population. However in Spain, olive oil intake contributes significantly to the explanation of the variance in the prevalence of CA.
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Affiliation(s)
- Carolina Gutiérrez-Repiso
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
| | - Federico Soriguer
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Gemma Rojo-Martínez
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Eduardo García-Fuentes
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Sergio Valdés
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; UGCI de Endocrinología y Nutrición, Hospital Regional Universitario, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Albert Goday
- Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain
| | - Alfonso Calle-Pascual
- Department of Endocrinology and Nutrition, Hospital Universitario S. Carlos de Madrid, Madrid, Spain
| | | | - Conxa Castell
- Public Health Division, Department of Health, Autonomous Government of Catalonia, Barcelona, Spain
| | - Edelmiro Menéndez
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, Oviedo, Spain
| | - Elena Bordiú
- Laboratorio de Endocrinología, Hospital Universitario San Carlos de Madrid, Madrid, Spain
| | - Elías Delgado
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, Oviedo, Spain
| | - Emilio Ortega
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Endocrinology and Diabetes Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), Universitat de Barcelona (UB), Barcelona, Spain
| | - Gemma Pascual-Manich
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain
| | - Inés Urrutia
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Spain
| | | | - Joan Vendrell
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain
| | | | - Josep Franch
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP - Fundació Jordi Gol), Barcelona, Spain
| | - Juan Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Spain
| | - Luis Castaño
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Spain
| | - Manuel Serrano-Ríos
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Lipids and Diabetes Laboratory, Instituto de Investigación Sanitaria del Hospital Clínico S. Carlos (IdISSC), Madrid, Spain
| | - María Teresa Martínez-Larrad
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Lipids and Diabetes Laboratory, Instituto de Investigación Sanitaria del Hospital Clínico S. Carlos (IdISSC), Madrid, Spain
| | - Miguel Catalá
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Department of Medicine and Endocrinology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Rafael Carmena
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Department of Medicine and Endocrinology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Ramón Gomis
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Endocrinology and Diabetes Unit, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), Universitat de Barcelona (UB), Barcelona, Spain
| | - Roser Casamitjana
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Biomedic Diagnostic Centre University Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sonia Gaztambide
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Spain; Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Spain
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Type 2 diabetes mellitus and other cardiovascular risk factors are no more common during menopause: longitudinal study. Menopause 2009; 16:817-21. [PMID: 19387417 DOI: 10.1097/gme.0b013e31819d4113] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to undertake a prospective study of the changes in certain risk factors for cardiovascular disease occurring during menopause. METHODS A longitudinal cohort study of 475 women was followed up for 6 years (Pizarra Study). The final menstrual period was defined after at least 6 months of amenorrhea. The women were classified into three groups: group 1, no menopause at either the first or second study; group 2, no menopause at the first study but menopause at the second study (6 y later); and group 3, menopause at the first study (and also at the second). The following are the main outcome measures used: age; body mass index; waist circumference; waist-to-hip ratio; skinfold thickness; arm circumference; intake of macronutrients (quantitative questionnaire); systolic and diastolic blood pressures; cholesterol, triglycerides; high-density lipoprotein cholesterol; uric acid; homeostasis model assessment of insulin resistance; and the prevalence of obesity, hypertension, type 2 diabetes mellitus, impaired glucose tolerance, and impaired fasting glucose. RESULTS None of the cardiovascular risk factors studied changed during the passage from premenopause to postmenopause, independently of age or physical activity. CONCLUSIONS Menopause is a biological condition of the human species, for which has recently received attempts at medicalization that were not always justified. If menopause is not accompanied by any other cardiovascular risk factor independently of age, the stigma of menopause being considered a risk factor should cease. Although the results have the strength of a prospective study, the sample size forced us to consider these findings as preliminary.
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Soriguer F, Rojo-Martínez G, Almaraz MC, Esteva I, Ruiz de Adana MS, Morcillo S, Valdés S, García-Fuentes E, García-Escobar E, Cardona I, Gomez-Zumaquero JM, Olveira-Fuster G. Incidence of type 2 diabetes in southern Spain (Pizarra Study). Eur J Clin Invest 2008; 38:126-33. [PMID: 18226046 DOI: 10.1111/j.1365-2362.2007.01910.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Few European studies have used an oral glucose tolerance test (OGTT) to examine the incidence of type 2 diabetes. We determined the incidence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes in a population from southern Spain. MATERIAL AND METHODS A population-based cohort study was undertaken in Pizarra, Spain. Baseline data were recorded on age, sex, weight, height, waist and hip circumferences, and diabetes status for 1051 persons, of whom 910 were free of type 2 diabetes (at-risk sample). Of these, 714 completed the 6-year follow-up study. Body mass index, waist-to-hip ratio and weight increase since baseline were calculated. The homeostasis model assessment equations were used to estimate the indices of insulin resistance and beta-cell function. Each person received an OGTT at baseline and after 6 years. RESULTS Type 2 diabetes developed in 81 people for a total of 4253 person-years, representing an incidence of 19.1 cases per 1000 person-years (95% confidence interval, 15.3-23.6). Age and the presence of obesity, central obesity and carbohydrate metabolism disorders [IFG (cut off = 100 mg dL(-1), capillary blood glucose level), IGT or both] at baseline were significant markers for the onset of type 2 diabetes during follow-up. After adjusting for these variables, multivariate analysis showed weight increase, waist-to-hip ratio and the indices of insulin resistance and beta-cell function were significantly associated with the risk for type 2 diabetes. CONCLUSIONS The incidence of type 2 diabetes in a population from southern Spain is high. It is probably associated with the high prevalence of obesity and weight increase in this population.
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Affiliation(s)
- F Soriguer
- Hospital Universitario Carlos Haya (REDIMET RD06/0015/0008), Malaga, Spain
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de Moraes C, Camargo EA, Antunes E, de Nucci G, Zanesco A. Reactivity of mesenteric and aortic rings from trained rats fed with high caloric diet. Comp Biochem Physiol A Mol Integr Physiol 2006; 147:788-792. [PMID: 17140833 DOI: 10.1016/j.cbpa.2006.10.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2006] [Revised: 10/09/2006] [Accepted: 10/15/2006] [Indexed: 11/19/2022]
Abstract
A strong association between the benefits of physical exercise on the cardiovascular disease with an improvement of the endothelium-derived relaxing factor production has been consistently shown. The purpose of this study was to evaluate the effect of exercise training associated with high caloric diet in the reactivity of rat mesenteric and aortic rings. Experimental protocol consisted of 4 weeks of high caloric diet consumption previous to 4 weeks of run training (1.2 km/h, 0% grade, in sessions of 60 min, 5 days/week). Concentrations of triglycerides, glucose, insulin and nitrite/nitrate levels were measured and atherogenic index was calculated. Concentration-response curves to acetylcholine (10 nM-100 microM), sodium nitroprusside (100 pM-100 nM) and phenylephrine (1 nM-3 microM) were obtained. Exercise training reduced body mass (6%) and triglyceride levels (about 54%), without changes in glucose and insulin concentrations. An improvement of endothelium-dependent relaxation responses to acetylcholine in mesenteric and aortic rings was observed in trained group. No changes were seen for sodium nitroprusside and phenylephrine. In conclusion, our study is the first to show clearly that run training promotes an improvement of the endothelium-dependent relaxing response in aorta and mesenteric rings from rats fed with high caloric diet and that is associated with increase of NO production.
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Affiliation(s)
| | | | - Edson Antunes
- Department of Pharmacology, UNICAMP, Campinas (SP), Brazil
| | | | - Angelina Zanesco
- Department of Physical Education, UNESP, Rio Claro (SP), Brazil.
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Soriguer F, Morcillo S, Cardona F, Rojo-Martínez G, de la Cruz Almaráz M, Ruiz de Adana MDLS, Olveira G, Tinahones F, Esteva I. Pro12Ala polymorphism of the PPARG2 gene is associated with type 2 diabetes mellitus and peripheral insulin sensitivity in a population with a high intake of oleic acid. J Nutr 2006; 136:2325-30. [PMID: 16920849 DOI: 10.1093/jn/136.9.2325] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Activation of the PPAR gamma 2 gene (PPARG2) improves the action of insulin and its lipid metabolism. We examined the association between Pro12Ala polymorphism of PPARG2, type 2 diabetes mellitus (DM2), and peripheral insulin sensitivity in a population with a high intake of oleic acid. A cross-sectional, population-based study was undertaken in Pizarra, a small town in the province of Malaga in southern Spain. A total of 538 subjects, aged 18-65 y, were selected randomly from the municipal census. All subjects underwent a clinical, anthropometrical, and biochemical evaluation, including an oral glucose tolerance test and Pro12Ala polymorphism of PPARG2. Insulin resistance was measured by homeostasis model assessment. Those subjects with the Ala-12 allele had an odds ratio for impaired fasting glucose of 0.55, for impaired glucose tolerance of 0.59, and for DM2 of 0.30. The intake of monounsaturated fatty acids (MUFA) contributed to the variance of the homeostasis model assessment insulin resistance index (HOMA IR) (P = 0.04), with a 2-way interaction between the Ala-12 allele of PPARG2 and the intake of MUFA (P = 0.005). The results suggest the existence of an interaction between Pro12Ala polymorphism of PPARG2 and dietary MUFA, such that obese people with the Ala-12 allele have higher HOMA IR values, especially if their intake of MUFA is low.
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Affiliation(s)
- Federico Soriguer
- Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya (Fundación IMABIS), Malaga, Spain
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