MAFLD and glomerular hyperfiltration in subjects with normoglycemia, prediabetes and type 2 diabetes: A cross-sectional population study

BACKGROUND

Metabolic dysfunction-associated fatty liver disease (MAFLD, 2020 diagnostic criteria) and glomerular hyperfiltration share common risk factors, including obesity, insulin resistance, impaired glucose tolerance, diabetes, dyslipidemia, and hypertension.

AIMS

To assess the prevalence of MAFLD and its association with glomerular hyperfiltration and age-related worsening of kidney function in subjects with normoglycemia, prediabetes and type 2 diabetes mellitus (T2DM).

METHODS

We analysed data recorded during occupational health visits of 125,070 Spanish civil servants aged 18-65 years with a de-indexed glomerular filtration rate (GFR) estimated with the chronic-kidney-disease-epidemiological (CKD-EPI) equation (estimated glomerular filtration rate [eGFR]) ≥60 mL/min. Subjects were categorised according to fasting plasma glucose levels <100 mg/dL (normoglycemia), ≥100 and ≤ 125 mg/dL (prediabetes), or ≥126 mg/dL and/or antidiabetic treatment (T2DM). The association between MAFLD and glomerular hyperfiltration, defined as a de-indexed eGFR above the age- and gender-specific 95th percentile, was assessed by multivariable logistic regression.

RESULTS

In the whole study group, MAFLD prevalence averaged 19.3%. The prevalence progressively increased from 14.7% to 33.2% and to 48.9% in subjects with normoglycemia, prediabetes and T2DM, respectively (p < 0.001 for trend). Adjusted odds ratio (95% CI) for the association between MAFLD and hyperfiltration was 9.06 (8.53-9.62) in the study group considered as a whole, and 8.60 (8.03-9.21), 9.52 (8.11-11.18) and 8.31 (6.70-10.30) in subjects with normoglycemia, prediabetes and T2DM considered separately. In stratified analyses, MAFLD amplified age-dependent eGFR decline in all groups (p < 0.001).

CONCLUSIONS

MAFLD prevalence increases across the glycaemic spectrum. MAFLD is significantly associated with hyperfiltration and amplifies the age-related eGFR decline.

Development of a three-dimensional printed model from a digital impression of a real patient for aesthetic dentistry undergraduate teaching

INTRODUCTION

The acquisition of skills and manual dexterity in aesthetic dentistry in undergraduate teaching requires preclinical practices with simulation that should approximate real clinical situations.

OBJECTIVE

We will present a digital procedure for the creation of three-dimensional (3D) resin models adapted to the practices of the Aesthetic Dentistry course.

MATERIAL AND METHOD

Stereolithography or Standard Tesellation Language (STL) files of a real patient were previously obtained with a 3-shape intraoral scanner. Using the Exocad computer programme for dental prosthesis design, various modifications were made, such as incisor rotation, surface alterations imitating dysplasias or erosions, the creation of diastemas, or even changes in tooth size. The virtual model was printed in resin for use by students. Once the practices were finished, the students and the teachers evaluated the use of the 3D printed models.

RESULTS

The result is the typodont model, in which seven laboratory sessions took place: 1-Restoration of conoid tooth morphology, 2-Cervical abrasion/ erosion restoration, 3-Direct Composite Veneer, 4-Aesthetic correction in a tooth with rotation, 5-Diastem closure, 6-Occlusal abrasions/ erosion, and 7-Maryland bridge. 90.48% of the students evaluated the designed 3D model as the best method for laboratory practice compared to other methods, obtaining a general assessment of 8.3 out of 10.

CONCLUSION

The method used has provided a reproducible standard analog model for direct aesthetic dental restoration practice, with a good assessment by students and teachers.

The Effect of a Program to Improve Adherence to the Mediterranean Diet on Cardiometabolic Parameters in 7034 Spanish Workers

BACKGROUND

Cardiovascular and metabolic diseases include a large group of pathologies and constitute one of the most serious chronic health problems facing the 21st century, with high rates of morbidity and mortality worldwide. Unhealthy diets influence the development of these pathologies. The Mediterranean diet can be an important part in the treatment of these diseases. The objective of this study was to assess the effect of a program that aims to increase adherence to the Mediterranean diet on the improvement of different cardiometabolic risk parameters.

METHODS

A prospective intervention study was carried out on 7034 Spanish workers. Prior to the intervention, 22 cardiometabolic risk scales were evaluated. Participants in this study were informed both orally and in writing of the characteristics and benefits of the Mediterranean diet and were given the website of the Ministry of Health, Consumption and Social Welfare of Spain, which provides advice on nutrition. Adherence to the Mediterranean diet was reinforced by sending a monthly SMS to their mobile phones. After six months of follow-up, the 22 risk scales were re-evaluated to assess changes. Means and standard deviations were calculated using Student's t test to analyse quantitative variables. Prevalence was calculated using the Chi-square test when the variables were qualitative.

RESULTS

All the cardiometabolic risk scales studied decreased after implementing a program to improve and enhance adherence to the Mediterranean diet. The number of losses in the sample was very low, standing at 4.31%.

CONCLUSIONS

The Mediterranean diet is effective in reducing all cardiovascular risk scales evaluated. The mean values and prevalence of high values of the different cardiometabolic risk scales analysed led to lower values after the implementation of the program to increase adherence to the Mediterranean diet. We observed a significant positive difference in metabolic age in both sexes. We have obtained a significant improvement in the insulin resistance index, especially in the SPISE-IR index, data that we have not found in previous publications. Easy access to the Internet and new information and communication technologies facilitate adherence to a diet and can reduce the number of losses.

Influence of Sociodemographic Variables and Healthy Habits on the Values of Insulin Resistance Indicators in 386,924 Spanish Workers

BACKGROUND

Insulin resistance (IR) is an alteration of the action of insulin in cells, which do not respond adequately to this action, leading to an increase in blood glucose levels. IR produces a very diverse clinical picture and increases the cardiometabolic risk of the population that suffers from it. Among the factors that influence IR are genetics, unhealthy lifestyle habits, overweight, and obesity. The objective of this work was to determine how different sociodemographic variables and healthy habits influence the values of different scales that assess the risk of presenting IR in a group of Spanish workers.

METHODS

An observational, cross-sectional, descriptive study was carried out in 386,924 workers from different Spanish regions. Different sociodemographic variables and lifestyle habits were studied (age, social class, educational level, smoking, Mediterranean diet, physical exercise) along with their association with four scales to evaluate the risk of insulin resistance (TyG index, TyG-BMI, METS-IR, TG/HDL-c). To analyse the quantitative variables, Student's t test was used, while the Chi-squared test was used for the qualitative variables. A multinomial logistic regression analysis was performed, calculating the odds ratio with its 95% confidence intervals. The accepted level of statistical significance was set at p < 0.05.

RESULTS

In the multivariate analysis, all variables, except educational level, increased the risk of presenting high values on the IR risk scales, especially a sedentary lifestyle and low adherence to the Mediterranean diet.

CONCLUSIONS

Our results demonstrate an association between the practice of regular physical exercise and a reduction in the risk of IR; a strong role of the Mediterranean diet as a protective factor for IR; an association between aging and increased IR, which has also been suggested in other studies; and, finally, a relationship between a low socioeconomic level and an increase in IR.

Relationship between Abdominal Volume Index and Body Adiposity Index and Scales of Insulin Resistance and Metabolic Syndrome

Introduction, objectives: Obesity is a global health problem with a great negative impact on health. Among the pathologies caused by obesity are insulin resistance and metabolic syndrome, which constitute an increasingly common health problem in both developed and developing countries. The aim of this study was to examine the relationship between two scales that assess obesity-based on hip circumference-and metabolic syndrome (MetS) and insulin resistance risk scales as predictors of these alterations.

MATERIALS, METHODS

A descriptive, cross-sectional study was carried out on 193,462 workers from different Spanish regions and work groups between January 2019 and September 2021. Abdominal volume index (AVI) and body adiposity index (BAI) were evaluated to assess obesity and its association with insulin resistance using three risk scales (TyG index, Triglycerides/HDL, and METS-IR), while their association with metabolic syndrome was determined using the NCEP ATP III, IDF, and JIS models.

RESULTS

The results of the ROC curves to determine the predictive value of BAI and AVI in relation to the three criteria evaluated to calculate MetS in all instances presented a higher area under the curve (AUC) for AVI. The high values of AVI stand out for predicting MetS when applying the IDF criteria. The cut-off point in women was 13.70 with a Youden index of 0.802, whereas in men, the cut-off point was set at 17.59 with a Youden index of 0.672. Regarding the relationship of BAI and AVI with insulin resistance risk scales for both sexes, the AUC only revealed high values when using the METS-IR formula for both AVI and BAI. The AVI cut-off points to predict high values of insulin resistance risk scales in women were established at 13.12 with a Youden index of 0.722. In men, the cut-off point was 17.59, with a Youden index of 0.626. The BAI cut-off points in women were set at 33.88 with a Youden index of 0.748. In men, the cut-off point was 27.91, with a Youden index of 0.598.

CONCLUSIONS

AVI demonstrated its value as a predictor of metabolic syndrome while exclusively applying the IDF criteria. AVI and BAI demonstrated their value as predictors of high values of insulin resistance risk scales only in the case of METS-IR. This predictive value is also higher in women.

Determination of the Level of Cardiovascular Risk in 172,282 Spanish Working Women

Introduction, objectives: Although cardiovascular events have been traditionally associated mainly with men, some data reflect an increase in women, which may even exceed their male counterparts, constituting the leading cause of death in working women in Spain. The objective of this present study was to analyze the level of cardiovascular risk in Spanish working women by assessing the influence of age, type of work, and tobacco consumption.

MATERIAL, METHODS

A descriptive cross-sectional study was carried out in 172,282 working women from different Spanish geographical areas and from different companies between January 2018 and June 2020. A range of variables and risk factors were assessed and various cardiovascular risk scales were used to analyze the data.

RESULTS

An increase in cardiovascular risk was observed in the least qualified work groups, mainly corresponding to blue-collar workers, when using the SCORE or REGICOR risk equation. The prevalence of altered values for all the parameters analyzed (overweight and obesity, hypertension, dyslipidemia, diabetes, fatty liver, hepatic fibrosis, atherogenic indexes, and cardiovascular risk scales) was higher among blue-collar women. Age was the only factor that influenced all the cardiovascular risk scales studied, increasing risk when comparing the group of women aged 50 years and older with the others.

CONCLUSIONS

Aging and belonging to the blue-collar job category meant worse results in the cardiovascular risk scales and in all the parameters analyzed. This is in line with numerous studies that argue that age and zip code are more influential than genetic code.

MAFLD and Glomerular Hyperfiltration in Subjects with Prediabetes, Visceral Obesity and "Preserved" Kidney Function:A Cross-Sectional Study

AIMS

To investigate the prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) in prediabetes, visceral obesity, and preserved kidney function, and explore whether MAFLD is associated with hyperfiltration.

METHODS

We analyzed data from 6697 Spanish civil servants, aged 18-65 years, with fasting plasma glucose ≥100 and ≤125 mg/dL (prediabetes, ADA), waist circumference ≥94 cm in men and ≥80 cm in women (visceral obesity, IDF) and de-indexed estimated glomerular filtration rate (eGFR) ≥60 mL/min, collected during occupational health visits. The association between MAFLD and hyperfiltration (eGFR >age- and sex-specific 95^th percentile) was tested by multivariable logistic regression analyses.

RESULTS

Overall, 4213 patients (62.9%) had MAFLD, and 330 (4.9%) were hyperfiltering. MAFLD was more frequent in hyperfiltering than in non-hyperfiltering subjects (86.4% vs 61.7%, P<0.001). BMI, waist circumference, systolic, diastolic, mean arterial pressure, and prevalence of hypertension were higher in hyperfiltering than in non-hyperfiltering subjects (P<0.05). MAFLD was independently associated with hyperfiltration, even after adjusting for common confounders [OR (95% CI): 3.36 (2.33-4.84), P<0.001]. In stratified analyses MAFLD potentiated age-related eGFR decline vs. non-MAFLD (P<0.001).

CONCLUSIONS

More than half of subjects with prediabetes, visceral obesity and eGFR ≥60 ml/min presented MAFLD that was associated with hyperfiltration and potentiated the age-related eGFR decline.

Determination of cardiovascular risk in Spanish veterinarians using different scaling methods

Introduction

Cardiovascular diseases are responsible for a significant morbimortality rate around the world. Due to the characteristics of their work, health care professionals, including veterinarians, are more prone to present this type of pathology.

Objectives

To determine the level of cardiovascular risk using different scales in a group of veterinarians.

Methods

A descriptive and cross-sectional study of 610 Spanish veterinarians was conducted to assess cardiovascular risk scores, including 14 overweight and obesity scales, six fatty liver scales, six cardiovascular risk scales, four atherogenic indices, and three metabolic syndrome scales.

Results

The prevalence of obesity among women was 7.95%, and 17.53% among men. Hypertension was present in 15.23% of women and 24.68% of men. Dyslipidemia affected 45% of women and 58.64% of men. The prevalence of metabolic syndrome according to the International Diabetes Federation criteria was slightly over 10% while 10.90% of women and 14.93% of men showed moderate to high values on the Registre Gironí del Cor scale.

Conclusions

There is a moderate to high level of cardiovascular risk among veterinarians in this group.

Influence of Educational Level and Healthy Habits on the Prevalence of Diabesity in a Spanish Working Population

Background: Diabesity is a growing problem internationally. Taking into account the importance of physical activity and diet in its prevention and treatment, the objective of this study was to delve into the impact of healthy habits on diabesity. Methods: A descriptive, cross-sectional study was carried out in 386,924 Spanish adult workers. Obesity was determined according to eleven different formulas. Life habits were also valued; sociodemographic variables; and educational level; as well as analytical and clinical variables such as blood pressure and blood glucose levels. The association between the different variables was performed using the chi-square and the Student’s t-tests when the samples were independent. A multivariate analysis was performed using the multinomial logistic regression test by calculating the odds ratio and a 95% confidence interval. The Hosmer–Lemeshow goodness-of-fit test was also performed. Results: The overall prevalence of diabesity ranged between 0.3% (95% CI 0.3–0.4) when obesity was assessed according to the abdominal volume index and 8.3% (95% CI 8.2–8.4) when evaluated according to the CUN-BAE (Clínica Universitaria de Navarra Body Adiposity Estimator) formula. The prevalence of diabesity was also higher in workers with a non-heart-healthy diet and in those who did not exercise regularly. Conclusions: The most disadvantaged socioeconomic classes are those with the highest prevalence of diabesity. It is important to prioritise prevention in populations and communities with the most unfavourable social and environmental conditions to reduce the burden of diabesity.

Relationship between Atherogenic Dyslipidaemia and Lipid Triad with Different Scales of Overweight and Obesity in 418,343 Spanish Workers

Obesity induces alterations in lipid biochemistry, evolving toward dyslipidaemia atherogenesis, a critical factor in the development of cardiovascular events. Two relevant forms of lipid abnormalities are atherogenic dyslipidaemia (AD) and lipid triad (LT), which involve alterations in triglyceride levels, HDL-c, and LDL-c. The aim of this study was to assess the linkage of atherogenic AD and LT with different scales of overweight and obesity. We carried out a cross-sectional study including 418,343 Spanish adult workers, recruited from workplace health assessments. Atherogenic dyslipidaemia was defined as triglyceride levels ≥ 150 mg/dL, HDL values < 40 mg/dL in men and <45 mg/dL in women, and normal LDL. Additionally, if LDL levels were >160 mg/dL, LT was considered. Subjects affected by AD and LT in the study exhibited significantly higher mean values than those without AD and LT in all overweight, obesity, and body fat related scales studied. VAI (visceral adiposity index) was the strongest predictor of AD (AUC = 0.934, 95% CI: 0.933 to 0.936) and LT (AUC = 0.926, 95% CI: 0.923 to 0.928). Atherogenic dyslipidaemia and LT positively correlate with different scales of overweight and obesity. Further studies should aim to identify other contributory factors. Our obtained data might be useful in laying the groundwork for future works on AD and LT.

MO446: The Prevalence of Mafld in Subjects With Normoglycaemia, Prediabetes and Type 2 Diabetes Without Evidence of Chronic Kidney Disease and its Association With Glomerular Hyperfiltration

BACKGROUND AND AIMS

Whereas metabolic dysfunction-associated fatty liver disease (MAFLD) reflects multisystem disorders [1], many aspects of the association between MAFLD and extra-hepatic diseases are the issues to study. Glomerular hyperfiltration (GHF) is an early manifestation of kidney damage in diabetic patients and predicts its further progression. Recently it was reported that an initial increase of plasma glucose in subjects with prediabetes is an independent risk for incident GHF [2]. However, it remains unknown whether GHF could also occur in subjects with normoglycaemia and whether it is associated with MAFLD.

The study aimed to compare the prevalence of MAFLD in subjects with normoglycaemia, prediabetes and type 2 diabetes mellitus without evidence of chronic kidney disease (CKD) and then explore its association with GHF in the study groups.

METHOD

A cohort of 125 070 people aged 18–65 years, without CKD [(estimated glomerular filtration rate (eGFR) ≥60 mL/min], belonging to a large Spanish database of routine occupational health visits (January 2008–December 2010), has been explored. Subjects were divided into three groups according to their fasting plasma glucose (FPG) levels—subjects with normoglycaemia (FPG &lt; 100 mg/dL), prediabetes (FPG ≥ 100–≤125 mg/dL) and type 2 diabetes mellitus (FPG ≥ 126 mg/d or use of antidiabetic drugs), according to the American Diabetes Association criteria. The presence of MAFLD was defined according to the new criteria of an international expert consensus statement [1]. Liver steatosis was determined by the validated Fatty liver index (FLI) with a cut-off value of ≥ 60 [3]. eGFR was calculated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation [4], deindexed for body surface area (BSA) to avoid underestimation in patients with obesity [5]. Hyperfiltration was defined as an eGFR above the age- and gender-specific 95th percentile. The association between MAFLD and GHF was evaluated by multivariable logistic regression.

RESULTS

The overall prevalence of subjects with MAFLD was 19.3% (n = 24 112) and it significantly increased from 14.7% (n = 14 809) to 33.2% (n = 5697) and 48,9% (n = 3606), in subjects with normoglycaemia, prediabetes and diabetes, respectively (Table 1), (P &lt; 0.001 between all paired groups). By definition, the overall presence of hyperfiltration was 5% (n = 6249) and it significantly increased from 4.5% (n = 4553) to 5.7% (n = 978) and 9.7% (n = 718) in subjects with normoglycaemia, prediabetes and diabetes, respectively (P &lt; 0.001 between all paired groups). In multivariable logistic regressions, along with age, gender, overweight, obesity (common risk factors in the three groups), the presence of MAFLD was independently associated with GHF, ​after adjusting for the following confounding variables—age, gender, overweight, obesity, FPG, mean arterial pressure, triglycerides, gamma-glutamyl transferase, presence of arterial hypertension, drug therapy and smoking status: adjusted odds ratio (OR), 1.96; 95% confidence interval (CI), 1.78–2.15, P &lt; 0.001; adjusted OR, 2.83; 95% CI, 2.31–3.47, P &lt; 0.001 and adjusted OR, 2.05; 95% CI, 1.58–2.66, P &lt; 0.001 for the subjects with normoglycaemia, prediabetes and diabetes, respectively (Table 2).

CONCLUSION

The increase of FPG levels in subjects with normoglycaemia, prediabetes and diabetes is accompanied by an increase of the prevalence of MAFLD, which in turn, raises a possible independent early risk marker of GHF in the three study groups, together with other metabolic risk factors. Timely identifying subjects with MAFLD might be helpful to early setup calorie restriction and lifestyle modification strategies. Longitudinal studies are needed to investigate whether and to which extent MAFLD is associated with an increased risk of a future kidney function decline among subjects with normoglycaemia and prediabetes.

FC003: Association Between Metabolic Dysfunction-Associated Fatty Liver Disease and Hyperfiltration In Subjects with Prediabetes and Abdominal Obesity Without Evidence of Chronic Kidney Disease

BACKGROUND AND AIMS

The newly defined metabolic dysfunction-associated fatty liver disease (MAFLD) [1] is a multifactorial state that could influence multiple extra-hepatic diseases. Glomerular hyperfiltration (GHF) is an important early determinant of diabetic kidney disease onset and progression in a subgroup of patients, and recently it was reported that prediabetes stage is an independent risk for incident GHF [2]. Currently, no data are available on the association between MAFLD and GHF. The aim of the study was to determine the prevalence of MAFLD and whether and to which extent it is associated with GHF in prediabetic subjects with abdominal obesity and without evidence of chronic kidney disease (CKD).

METHOD

Data from a total of 6697 civil servants, aged 18–65 years, with prediabetes (fasting plasma glucose ≥100 ≤ 125 mg/dL, American Diabetes Association criteria), abdominal obesity (waist circumference ≥94 cm for men and ≥80 cm for women, International Diabetes Federation criteria) and an estimated glomerular filtration rate (eGFR) ≥60 mL/min, belonging to a large Spanish database of routine occupational health visits (January 2008–December 2010), were included in the analyses. The presence of MAFLD was defined according to the criteria of an international expert consensus statement [1]. Liver steatosis, the first component of MAFLD, was determined by the validated fatty liver index (FLI) with a cut-off value of ≥603. An eGFR was calculated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation [4], deindexed for body surface area (BSA) to avoid underestimation in patients with obesity [5]. Hyperfiltration was defined as an eGFR above the age- and gender-specific 95th percentile. The association between MAFLD and GHF was evaluated by multivariable logistic regression.

RESULTS

Overall, the prevalence of subjects with MAFLD was 62.9% (n = 4213). Hyperfiltering subjects (n = 330, 4.9%), as compared with non-hyperfiltering subjects, had a higher prevalence of MAFLD (86.4% versus 61.7%, P &lt; .001), higher BMI, waist circumference for both genders, systolic blood pressure, diastolic blood pressure and mean arterial pressure (MAP), higher prevalence of arterial hypertension, lower total cholesterol and serum creatinine (P &lt; .05 for all comparisons) (Table 1). In multivariable logistic regression, the presence of MAFLD was independently associated with GHF after adjusting for age, gender, obesity, MAP and smoking status (adjusted OR 3.36, 95% CI 2.33–4.84; P &lt; .001) (Table 2). Receiving operator characteristic curve analysis confirmed the predictive power of MAFLD (area under the curve of 0.623, 95% CI 0.60–0.65; P &lt; .001).

CONCLUSION

Prediabetic subjects with abdominal obesity are characterized by an increased prevalence of MAFLD that emerges as a possible early risk marker of GHF. This could help general practitioners to timely identify patients at high risk and to start weight loss with appropriate calorie restriction and lifestyle modification strategies. Longitudinal studies are needed to investigate whether MAFLD in prediabetes is associated with a later decline in eGFR.

Differences in cardiovascular risk levels between cleaning staff and hotel housekeepers

Background and objective

Cardiovascular diseases are the leading cause of morbidity and mortality worldwide, with a greater incidence in the most disadvantaged social classes. In this study, we aimed to evaluate the level of cardiovascular risk in cleaning workers.

Methods

This was a descriptive, cross‐sectional study in 46.632 cleaning workers (40.169 women and 6.463 men). Thirty‐one different scales related to cardiovascular risk were studied (14 assessing overweight and obesity, 5 determining the risk of nonalcoholic fatty liver disease, 5 scales of cardiovascular risk, 4 atherogenic indices, and 3 scales of metabolic syndrome, among others). The results obtained were divided between personnel who perform their cleaning tasks in the hotel and catering industry and those in other sectors.

Results

The prevalence of obesity and arterial hypertension in cleaning workers was over 20% in both sexes. A similar amount was observed in moderate or high values on the REGICOR (Registre GIroní del COR) scale. More than 15% presented metabolic syndrome according to the NCEP ATPIII (National Cholesterol Education Program‐Adult Treatment Program III) criteria, while over 10% of women and 20% of men had a high risk of nonalcoholic fatty liver disease assessed with the fatty liver index.

Conclusion

Cardiovascular risk is higher, in both sexes, in the group of cleaning workers who work in companies other than hotels.

Determination of Cardiovascular Risk in 56,262 Spanish Construction Workers: Cardiovascular Risk in Construction Workers

OBJECTIVE

To evaluate different cardiovascular risk scales in construction workers.

METHODS

A descriptive, cross-sectional study was carried out in 56,262 Spanish construction workers. Scales of obesity and fatty liver, metabolic syndrome, atherogenic indices, and cardiovascular risk scales, among others, were assessed.

RESULTS

In women, 19.6% were obese, 18.2% hypertensive, 12.6% had metabolic syndrome, 12% were at high risk of non-alcoholic fatty liver disease, and 4.3% were at moderate or high risk on the SCORE scale. In men, 20.1% were obese, 30.1% hypertensive, 17.5% had metabolic syndrome, and 27.6% had high or moderate risk on the SCORE scale.

CONCLUSIONS

Knowing the cardiovascular risk of a large number of construction workers by means of a large number of scales may be of great interest to occupational health professionals, as it may enable them to establish prevention strategies.

Alcohol consumption in Spanish mental health patients vs. working population

Introducción. El consumo de alcohol tiene una elevada prevalencia en la sociedad y su consumo crónico es uno de los principales factores relacionados con el estado de salud de los individuos, junto a otros aspectos concernientes al estilo de vida. Debido a su importancia, este tema ha sido objeto tradicional de estudio desde diferentes perspectivas epidemiológicas y en diversos colectivos poblacionales.Objetivo. Realizar una comparativa de patrones de consumo y variables relacionadas en dos colectivos diferenciados: pacientes de unidades de salud mental y trabajadores en general.Materiales y métodos. Estudio transversal realizado en una población de 1 180 trabajadores del sector servicios de la administración pública y 304 pacientes de una unidad de salud mental. Se analizaron variables sociodemográficas y laborales y el patrón de consumo de alcohol.Resultados. Existen diferencias en ambos colectivos en cuanto al número de consumidores, cantidad de consumo y tipo de bebidas consumidas, diferencias que desaparecen en parte cuando se comparan colectivos de trabajadores de ambas muestras poblacionales.Conclusiones. Las diferencias en el patrón de consumo de ambas poblaciones orientan hacia actuaciones preventivo-asistenciales distintas en ambos grupos y hacia una necesidad de implementar actuaciones coordinadas entre todos los afectados mediante programas específicos.

Relationship between blood glucose levels and cardiovascular risk in the Spanish Mediterranean population

BACKGROUND/AIM

Diabetes is associated with an increased prevalence of cardiovascular disease. Impaired fasting glucose (IFG) is an intermediate clinical situation between normal glucose levels and type 2 diabetes. The aim of this study is to determine how fasting glucose concentrations affect different cardiovascular risk scales.

MATERIALS AND METHODS

A descriptive study was conducted with 59,041 Mediterranean Spanish workers. IFG was determined using the American Diabetes Association (ADA) and the World Health Organization (WHO) criteria. Different indicators of cardiovascular risk were analyzed: body mass index, waist circumference, waist-to-height ratio, blood pressure, lipid parameters, atherogenic indices, metabolic syndrome, and various scales of cardiovascular risk such as REGICOR, DORICA, SCORE, Heart Age, and Vascular Age.

RESULTS

All cardiovascular scales showed statistically significant differences between the IFG group and the normal glucose group. In all cases, values were worse in the IFG group; furthermore, men exhibited more unfavorable levels of cardiovascular risk factors than women. Higher odds ratio values were present in employees with metabolic syndrome according to ATP III criteria (9.42, 95% CI: 8.56-10.37 using WHO criteria and 9.25, 95% CI: 8.67-9.87 using ADA criteria).Conclusions: IFG increases cardiovascular risk whether using classical scales (REGICOR, SCORE, and metabolic syndrome) or other less studied scales (atherogenic indices, Heart Age, and Vascular Age).

[FINDRISC Test: Relationship between cardiovascular risk parameters and scales in Spanish Mediterranean population]

BACKGROUND

The Finnish Diabetes Risk Score (FINDRISC) questionnaire has been used to assess the risk of type 2 diabetes and metabolic syndrome. The objetive was to assess the relationship between different scales related to cardiovascular risk and FINDRISC questionnaire.

METHODS

Values of different anthropometric and clinical parameters (body mass index, waist circumference, waist to height ratio, blood pressure), analytical parameters (lipid profile, blood glucose) and scales related to cardiovascular risk (atherogenic index, metabolic syndrome, REGICOR, SCORE, heart age and vascular age) were determined on the basis of the value of the FINDRISC questionnaire.

RESULTS

All analyzed parameters related to cardiovascular risk were getting worse at the same time that the value of the FINDRISC questionnaire increased.

CONCLUSIONS

There is a close relationship between FINDRISC questionnaire values and those obtained in the different parameters by which cardiovascular risk was measured directly or indirectly.

[Prevalence of impaired fasting glucose in a working population of Spanish Mediterranean area: influence of sociodemographic variables and healthy habits]

INTRODUCTION

The impaired fasting glucose (IFG) is an intermediate clinical situation between normal glucose and type 2 diabetes, it is known that 25% of people with IFG progress to type 2 diabetes.

METHODS

Descriptive study in 60,798 Spanish workers. The IFG was determined using the American Diabetes Association (ADA) criteria: 100-125 mg/dl and the World Health Organization (WHO) criteria: 110-125 mg/dl. The influence of sociodemographic variables (age, sex, social class, studies class) and healthy habits (tobacco, alcohol consumption, physical activity, feeding) were evaluated in the IFG prevalence.

RESULTS

The IFG prevalence was 3.3% (1.8% in women and 4.5% in men) using the WHO criteria and 11.8% (7% in women and 15.4% in men) using the ADA criteria. The IFG is more common in men and increases with age. People with low socioeconomic status (social classes IV and V, blue collar and primary studies) and poor health habits (smokers, heavy alcohol consumption and low physical activity) have a higher prevalence.

CONCLUSIONS

The sociodemographic variables and the healthy habits, except consumption of fruits and vegetables, influence the prevalence of IFG.

Infección por virus del Ébola. Corta historia, larga repercusión

La Infección por Virus Ébola constituye en el momento actual una preocupación creciente en el mundo, aunque su historia se remonta a 1967, con brotes posteriores en 1979, 1980 y 1987, todos ellos en trabajadores por contacto en zonas afectadas. La preocupación de la Comunidad Científica por este tema, puede verse parcialmente reflejada en las publicaciones que recoge MEDLINE, en la base de datos PUBMED y en las que tomando como palabra clave en el buscador (Ebola virus) aparecen 2.151 publicaciones, 984 de las cuales corresponden a los últimos 5 años (45,7%) y 527 de estas publicaciones (el 53,5%) a los años 2014-2015. La primera publicación que consta es de 1977, sin autor listado ni abstract de referencia, y la más reciente de enero del presente año 2015. Todo ello habla de un problema globalizado y que preocupa a la comunidad científica internacional. Se realiza en este trabajo una revisión de algunos de los estudios publicados en esta materia, considerados de interés y comentados por los autores.

[Occupational disability in epilepsy. The assessment criteria]

Epilepsy is a chronic disease cursing with recurrent and paroxysmal crises due to anomalies in the electrical activity of brain, and is controllable in most of the patients by using antiepileptic drugs, in single or combination therapy. Probably one of the most complex aspects of epilepsy is the assessment of disability for work of the affected person. For this purpose, multiple factors need to be taken into account for homogeneous decision-making, and according to criteria of approval and within the principle of equity inherent in the granting of Social Security disability benefits. This requires the cooperation of all professionals involved in the different specialties, with reports using common criteria and taking into account the disease itself, as well as the effects of the prescribed treatments, the effects of which can contribute to the limitations in the performance of certain professions of risk.

[No traumatic labor accident risk in diabetic patient. View from the Spanish legislation]

The Spanish legislation includes the concept of industrial accidents and industrial damage since 1900, although since then in our country some legislative changes have been made, reaching the current Occupational Risk Prevention Law (ORPL) of 1995 and the legislation emanating from it. This is a controversial concept, if we talk about nontraumatic labor injury that carries consequences in the workplace, civil, criminal and contentious administrative disputes, and economic gains. It differs from others in both in qualifying risk and their benefits; the concept also exists in the other European Union countries and in different Spanish-American countries. Therefore the objective of the paper is to discuss the concept of traumatic industrial accident and non-traumatic labor injury in Spain from the point of view of our law and to establish future benchmarks with professionals of other countries around us for enabling collaboration and joint improvement of the safety and about the health of workers.