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Raguindin PF, Cardona I, Muka T, Lambrinoudaki I, Gebhard C, Franco OH, Marques‐Vidal P, Glisic M. Does reproductive stage impact cardiovascular disease risk factors? Results from a population-based cohort in Lausanne (CoLaus study). Clin Endocrinol (Oxf) 2022; 97:568-580. [PMID: 35377481 PMCID: PMC9790265 DOI: 10.1111/cen.14730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 12/30/2022]
Abstract
CONTEXT Menopause has been associated with adverse cardiovascular disease (CVD) risk profile, yet it is unclear whether the changes in CVD risk factors differ by reproductive stage independently of underlying ageing trajectories. DESIGN The CoLaus study is a prospective population-based cohort study in Lausanne, Switzerland. PATIENTS We used data from women at baseline and follow-up (mean: 5.6 ± 0.5 years) from 2003 to 2012 who did not use hormone therapy. We classified women into (i) premenopausal, (ii) menopausal transition, (iii) early (≤5 years) and (iv) late (>5 years) postmenopausal by comparing their menstruation status at baseline and follow-up. MEASUREMENTS We measured fasting lipids, glucose and cardiovascular inflammatory markers. We used repeated measures (linear mixed models) for longitudinal analysis, using premenopausal women as a reference category. We adjusted analyses for age, medications and lifestyle factors. RESULTS We used the data from 1710 women aged 35-75 years. Longitudinal analysis showed that the changes in CVD risk factors were not different in the other three menopausal categories compared to premenopausal women. When age was used as a predictor variable and adjusted for menopause status, most CVD risk factors increased, while interleukin-6 and interleukin-1β decreased with advancing age. CONCLUSION The current study suggests that women have a worsening cardiovascular risk profile as they age, and although menopausal women may have higher levels of cardiovascular risk factors compared to premenopausal women at any given time, the 5-year changes in cardiovascular risk factors may not depend on the reproductive stage.
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Affiliation(s)
- Peter Francis Raguindin
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
- Swiss Paraplegic ResearchNottwilSwitzerland
- Graduate School for Health SciencesUniversity of BernBernSwitzerland
| | - Isabel Cardona
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
| | - Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, Medical School, Aretaieio HospitalNational and Kapodistrian University of AthensAthensGreece
| | - Catherine Gebhard
- Department of Nuclear MedicineUniversity Hospital ZurichZurichSwitzerland
| | - Oscar H. Franco
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
| | - Pedro Marques‐Vidal
- Department of Nuclear Medicine, Lausanne University Hospital (CHUV)University of LausanneLausanneSwitzerland
| | - Marija Glisic
- Institute of Social and Preventive Medicine (ISPM)University of BernBernSwitzerland
- Swiss Paraplegic ResearchNottwilSwitzerland
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Raeisi-Dehkordi H, Kummer S, Francis Raguindin P, Dejanovic G, Eylul Taneri P, Cardona I, Kastrati L, Minder B, Voortman T, Marques-Vidal P, Dhana K, Glisic M, Muka T. Risk Prediction Models of Natural Menopause Onset: A Systematic Review. J Clin Endocrinol Metab 2022; 107:2934-2944. [PMID: 35908226 DOI: 10.1210/clinem/dgac461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Predicting the onset of menopause is important for family planning and to ensure prompt intervention in women at risk of developing menopause-related diseases. OBJECTIVE We aimed to summarize risk prediction models of natural menopause onset and their performance. METHODS Five bibliographic databases were searched up to March 2022. We included prospective studies on perimenopausal women or women in menopausal transition that reported either a univariable or multivariable model for risk prediction of natural menopause onset. Two authors independently extracted data according to the CHARMS (critical appraisal and data extraction for systematic reviews of prediction modelling studies) checklist. Risk of bias was assessed using a prediction model risk of bias assessment tool (PROBAST). RESULTS Of 8132 references identified, we included 14 articles based on 8 unique studies comprising 9588 women (mainly Caucasian) and 3289 natural menopause events. All included studies used onset of natural menopause (ONM) as outcome, while 4 studies also predicted early ONM. Overall, there were 180 risk prediction models investigated, with age, anti-Müllerian hormone, and follicle-stimulating hormone being the most investigated predictors. Estimated C-statistic for the prediction models ranged from 0.62 to 0.95. Although all studies were rated at high risk of bias mainly due to the methodological concerns related to the statistical analysis, their applicability was satisfactory. CONCLUSION Predictive performance and generalizability of current prediction models on ONM is limited given that these models were generated from studies at high risk of bias and from specific populations/ethnicities. Although in certain settings such models may be useful, efforts to improve their performance are needed as use becomes more widespread.
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Affiliation(s)
- Hamidreza Raeisi-Dehkordi
- Institute of Social and Preventive Medicine (ISPM), University of Bern, 3012 Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, 3012 Bern, Switzerland
| | - Stefanie Kummer
- Institute of Social and Preventive Medicine (ISPM), University of Bern, 3012 Bern, Switzerland
| | - Peter Francis Raguindin
- Institute of Social and Preventive Medicine (ISPM), University of Bern, 3012 Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, 3012 Bern, Switzerland
- Swiss Paraplegic Research, 6207, Nottwil, Switzerland
| | - Gordana Dejanovic
- Institute of Social and Preventive Medicine (ISPM), University of Bern, 3012 Bern, Switzerland
| | - Petek Eylul Taneri
- School of Nursing and Midwifery, National University of Ireland, Galway H91 CF50, Ireland
- HRB-Trials Methodology Research Network, National University Of Ireland, Galway H91 CF50, Ireland
| | - Isabel Cardona
- Institute of Social and Preventive Medicine (ISPM), University of Bern, 3012 Bern, Switzerland
- Department of Obstetrics and Gynaecology, McGill University Health Center, McGill University, Montreal H4A 3J1, Canada
| | - Lum Kastrati
- Institute of Social and Preventive Medicine (ISPM), University of Bern, 3012 Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, 3012 Bern, Switzerland
| | - Beatrice Minder
- Public Health & Primary Care Library, University Library of Bern, University of Bern, 3012 Bern, Switzerland
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center, 3000 CA Rotterdam, the Netherlands
- Division of Human Nutrition and Health, Wageningen University & Research, 6708 PB Wageningen, the Netherlands
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne CH-1015, Switzerland
| | - Klodian Dhana
- Section on Nutrition and Nutritional Epidemiology, Department of Internal Medicine, Rush University, Chicago, IL 60612, USA
| | - Marija Glisic
- Institute of Social and Preventive Medicine (ISPM), University of Bern, 3012 Bern, Switzerland
- Swiss Paraplegic Research, 6207, Nottwil, Switzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM), University of Bern, 3012 Bern, Switzerland
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Raguindin PF, Cardona I, Muka T, Lambrinoudaki I, Gebhard C, Franco OH, Marques-Vidal P, Glisic M. Does transition through menopause affect cardiovascular disease risk factors? Results from a population-based cohort (CoLaus study). Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Menopause has been associated with adverse cardiovascular disease (CVD) risk profile, yet it is unclear whether the changes in CVD risk factors differ by reproductive stage independently of underlying aging trajectories. We examined whether reproductive stages are differently associated with changes in cardiovascular risk factors.
Methods
This is a prospective population-based cohort study. We used data from women at baseline and follow-up (mean 5.5 years). We classified women into (i) premenopausal, (ii) menopausal transition, (iii) early (≤5 years), and (iv) late (>5 years) postmenopausal by comparing their menstruation status at baseline and follow-up. In the cross-sectional analysis, we compared CVD risk factors at baseline across different reproductive stages using multivariable linear regression models. In the longitudinal analysis, we used multivariable linear mixed models. We used premenopausal women as a reference category and adjusted our analyses for age, medications, hormone replacement therapy, lifestyle, body mass index (BMI) at baseline and follow-up.
Results
We used the data from 2,558 women aged 35–75 years. At baseline, compared to premenopausal women, (i) transition and early postmenopausal groups had higher HDL, (ii) early- and late postmenopausal women had higher BMI, total cholesterol, adiponectin, and interleukin-6 levels, and (iii) all other women groups had higher diastolic blood pressure and glucose levels, while no differences were observed in the other CVD risk factors. At follow-up, women across the four reproductive categories showed an increase in BMI, total cholesterol, triglycerides, and fasting glucose compared to baseline. However, linear mixed models showed that, the changes in CVD risk factors were not significantly different in the other three menopausal categories compared to premenopausal women. When using age as a predictor variable and adjusting for menopause status, most of the CVD risk factors increased, while interleukin 6 and interleukin 1b decreased with advancing age. The estimates did not change when the analyses were restricted to women who did not report hormone therapy-use.
Conclusion
The current study suggests that women have a worsening of cardiovascular risk profile as they age, and although menopausal women may have higher levels of cardiovascular risk factors compared to premenopausal women at any given time, the five year changes in cardiovascular risk factors may not depend on menopausal status per se. More studies are still needed to disentangle the contribution of age and menopause in postmenopausal CVD risk, and other pathways not explored in this study.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): COLAUS was supported by a research grants from GlaxoSmithKline and the Swiss National Science Foundation and
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Affiliation(s)
- P F Raguindin
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - I Cardona
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - T Muka
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - I Lambrinoudaki
- National & Kapodistrian University of Athens Medical School, University of Athens, Athens, Greece
| | - C Gebhard
- University Hospital Zurich, Zurich, Switzerland
| | - O H Franco
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
| | - P Marques-Vidal
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - M Glisic
- Institute of Social and Preventive Medicine. University of Bern, Bern, Switzerland
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Baettig SJ, Parini A, Cardona I, Morand GB. Case series of coronavirus (SARS-CoV-2) in a military recruit school: clinical, sanitary and logistical implications. BMJ Mil Health 2021; 167:251-254. [PMID: 32303575 PMCID: PMC7306277 DOI: 10.1136/bmjmilitary-2020-001482] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 01/23/2023]
Abstract
INTRODUCTION A new coronavirus, called Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2), has emerged from China in late 2019 and has now caused a worldwide pandemic. The impact of COVID-19 has not been described so far in a military setting. We therefore report a case series of infected patients in a recruit school in Switzerland and the herein associated challenges. METHODS Retrospective review of COVID-19 cases among Swiss Armed Forces recruits in the early weeks of SARS-CoV-2 pandemic in the canton of Ticino, the southernmost canton of Switzerland. Positive cases were defined with two positive PCR testing for SARS-CoV-2 from nasopharyngeal swabs. Serological testing was performed with a commercially available kit according to manufacturers' instructions. RESULTS The first case was likely contaminated while skiing during weekend permission. He became symptomatic 4 days later, tested positive for SARS-CoV-2 and was put into isolation. He showed complete symptom resolution after 48 hours. Quarantine was ordered for all recruits with close contact in the past 2 days, a total of 55 persons out of 140 in the company. Seven out of nine recruits in one particular quarantine room became mildly symptomatic. SARS-CoV-2 PCR was positive in one of them. Seven days after initial diagnosis, the index patient and the other one from the quarantine retested positive for SARS-CoV-2, although they had been completely asymptomatic for over 96 hours. Serological testing revealed positive for both patients. All others showed negative IgM and IgG. CONCLUSIONS Young healthy recruits often showed a mild course of COVID-19 with rapid symptom decline but were persistent SARS-CoV-2 carriers. This illustrates how asymptomatic patients may be responsible for covert viral transmission. An early and prolonged establishment of isolation and quarantine for patients and close contacts is essential to slow down the spread of SARS-CoV-2, especially in the confined space of a military environment.
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Affiliation(s)
- Sascha J Baettig
- Department of Anaesthesiology, Kantonsspital Winterthur, Winterthur, Switzerland
- Military Medical Services, Swiss Armed Forces, Bern, Switzerland
| | - A Parini
- Military Medical Services, Swiss Armed Forces, Bern, Switzerland
| | - I Cardona
- Department of Gynaecology and Obstetrics, Spitalzentrum Biel, Biel, Switzerland
| | - G B Morand
- Military Medical Services, Swiss Armed Forces, Bern, Switzerland
- Department of Otorhinolaryngology - Head & Neck Surgery, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
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Morand GB, Ikenberg K, Vital DG, Cardona I, Moch H, Stoeckli SJ, Huber GF. Preoperative assessment of CD44‐mediated depth of invasion as predictor of occult metastases in early oral squamous cell carcinoma. Head Neck 2018; 41:950-958. [DOI: 10.1002/hed.25532] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 07/31/2018] [Accepted: 09/28/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Grégoire B. Morand
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Kristian Ikenberg
- Institute of Pathology and Molecular PathologyUniversity Hospital Zurich Zurich Switzerland
| | - Domenic G. Vital
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
| | - Isabel Cardona
- Department of Otolaryngology, Head and Neck SurgeryMcGill University Montreal Québec Canada
| | - Holger Moch
- Institute of Pathology and Molecular PathologyUniversity Hospital Zurich Zurich Switzerland
| | - Sandro J. Stoeckli
- Department of Otorhinolaryngology, Head and Neck SurgeryKantonsspital St. Gallen St. Gallen Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Zurich Zurich Switzerland
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6
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Font R, Espinas J, Layos L, Martinez Villacampa M, Capdevila J, Tobeña M, Pisa A, Pericay C, Lezcano C, Fort E, Cardona I, Berga N, Solà J, Borras J. Adherence to capecitabine in preoperative treatment of stage II and III rectal cancer: do we need to worry? Ann Oncol 2017; 28:831-835. [DOI: 10.1093/annonc/mdx006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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7
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Mosseri A, Cardona I, Blumenkrantz M, Daniel SJ. Histopathologic Effects of Onabotulinum Toxin A Treatment in Pediatric Submandibular Glands. Otolaryngol Head Neck Surg 2016; 156:368-370. [PMID: 27879418 DOI: 10.1177/0194599816679940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Onabotulinum toxin A (OBTXA) is an effective treatment for drooling. Our objective was to determine if there are histologic changes in the submandibular glands (SMGs) after repetitive OBTXA injections. The study included blinded histologic analysis and comparison of SMGs with ≥4 OBTXA injections versus controls who never received OBTXA. The number of acinar cells were counted, and the morphology of the cells was evaluated within each histologic sample of the SMGs. Thirty-one glands were analyzed (14 control, 17 cases). No physical differences were observed between the 2 acinar cell groups. There was no significant difference in the number acinar cells per surface area in the control group as compared with the OBTXA group (1.29 ± 0.13 vs 1.17 ± 0.11 cells/μm2, respectively). To conclude, no significant histologic findings were established in this first human study on SMGs post-OBTXA treatment.
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Affiliation(s)
- Ashley Mosseri
- 1 Department of Otolaryngology-Head and Neck Surgery, Montréal Children's Hospital, McGill University Health Center, Montréal, Canada
| | - Isabel Cardona
- 1 Department of Otolaryngology-Head and Neck Surgery, Montréal Children's Hospital, McGill University Health Center, Montréal, Canada
| | - Miriam Blumenkrantz
- 2 Department of Pathology, Montréal Children's Hospital, McGill University Health Center, Montréal, Canada
| | - Sam J Daniel
- 1 Department of Otolaryngology-Head and Neck Surgery, Montréal Children's Hospital, McGill University Health Center, Montréal, Canada
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8
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Cardona I, Ferretti E, Daboval T, Klaassen RJ, Dror Y. Case 1: A newborn with pancytopenia. Paediatr Child Health 2016; 21:9-11. [PMID: 26941551 DOI: 10.1093/pch/21.1.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Isabel Cardona
- Department of Otolaryngology Pediatrics - Head & Neck Surgery, McGill University Health Centre, Montreal Children's Hospital, Montreal, Quebec
| | | | | | - Robert J Klaassen
- Department of Pediatrics, Division of Oncology and Hematology, Children's Hospital of Eastern Ontario, Ottawa, Ontario
| | - Yigal Dror
- Department of Pediatrics, Division of Hematology Oncology, Marrow Failure and Myelodysplasia Program, The Hospital for Sick Children, Toronto, Ontario
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Ruiz-de-Adana MS, Dominguez-Lopez ME, Gonzalez-Molero I, Machado A, Martin V, Cardona I, de-la-Higuera M, Tapia MJ, Soriguer F, Anarte MT, Rojo-Martínez G. Comparison between a multiple daily insulin injection regimen (basal once-daily glargine plus mealtime lispro) and continuous subcutaneous insulin infusion (lispro) using continuous glucose monitoring in metabolically optimized type 1 diabetes patients: A randomized open-labelled parallel study. Med Clin (Barc) 2016; 146:239-46. [DOI: 10.1016/j.medcli.2015.09.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 08/25/2015] [Accepted: 09/03/2015] [Indexed: 10/22/2022]
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10
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Abstract
An improved method was used to determine chemical oxygen demand (COD) as a measure of organic content in water samples containing high chloride content. A contour plot of COD percent error in the Cl(-)-Cl(-):COD domain showed that COD errors increased with Cl(-):COD. Substantial errors (>10%) could occur in low Cl(-):COD regions (<300) for samples with low (<10 g/L) and high chloride concentrations (>25 g/L). Applying the method to flowback water samples resulted in COD concentrations ranging in 130 to 1060 mg/L, which were substantially lower than the previously reported values for flowback water samples from Marcellus Shale (228 to 21 900 mg/L). It is likely that overestimations of COD in the previous studies occurred as result of chloride interferences. Pretreatment with mercuric sulfate, and use of a low-strength digestion solution, and the contour plot to correct COD measurements are feasible steps to significantly improve the accuracy of COD measurements.
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Affiliation(s)
- Isabel Cardona
- Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV 26505, USA
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Cardona I, Saint‐Martin C, Daniel SJ. Effect of recurrent onabotulinum toxin a injection into the salivary glands: An ultrasound measurement. Laryngoscope 2015. [DOI: 10.1002/lary.25222] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Isabel Cardona
- Department of Otolaryngology–Head & Neck SurgeryMontreal Children's HospitalMcGill University Health CenterMontreal Quebec Canada
| | - Christine Saint‐Martin
- Department of Pediatric Medical ImagingMontreal Children's HospitalMcGill University Health CenterMontreal Quebec Canada
| | - Sam J. Daniel
- Department of Otolaryngology–Head & Neck SurgeryMontreal Children's HospitalMcGill University Health CenterMontreal Quebec Canada
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12
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Cardona I, Saint-Martin C, Daniel SJ. Salivary glands of healthy children versus sialorrhea children, is there an anatomical difference? An ultrasonographic biometry. Int J Pediatr Otorhinolaryngol 2015; 79:644-7. [PMID: 25765127 DOI: 10.1016/j.ijporl.2015.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 02/02/2015] [Accepted: 02/03/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES There is no literature about the average size of the salivary glands in the pediatric population with drooling (sialorrhea). Studies have shown that some pathologies affect the functionality of the salivary glands. We assessed via ultrasonography the sizes of the submandibular and parotid glands in 9 healthy children who were not suffering from local or systemic diseases that could affect the salivary glands. We also compared this group with a group of 9 patients with sialorrhea. METHODS Volunteers were matched based on age, gender, and BMI. Body weight did not differ more than 20% from ideal weight. The parotid and submandibular glands of 9 patients with sialorrhea without any previous treatment were measured via ultrasound and matched to a healthy control. Children with various causes for drooling were included (neurological disorders, neuromuscular disorders, lack of oral motor control). RESULTS Dimensions of the parotid glands in drooling and healthy patients were: surface area 2.96 cm(2) (SD ±0.90) and 2.81 cm(2) (SD ±0.54); in depth 1.68 cm (SD ±0.24) and 1.61 cm (SD ±0.27); in the axis longitudinal to the horizontal mandibular ramus 3.18 cm (±0.46) and 3.15 cm (SD ±0.45) in drooling and healthy groups respectively. The means of submandibular glands of drooling and healthy patients measured in surface area: 3.20 cm(2) (SD ±0.66) and 3.08 cm(2) (SD ±0.65); anterior-posterior length 1.55 cm (SD ±0.23) and 1.46 cm (SD ±0.23), medio-lateral length 3.07 cm (SD ±0.39) and 3.07 cm (SD ±0.32). There was no statistical significance in comparison with the healthy group control. CONCLUSION The parotid and submandibular salivary glands in the pediatric population do not differ in size in children with or without drooling. Measuring the glands at baseline and post treatment with botulinum toxin injections allows one to evaluate if there are changes in the gland related to the treatment.
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Affiliation(s)
- Isabel Cardona
- Department of Otolaryngology Head & Neck Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
| | - Christine Saint-Martin
- Department of Pediatric Imaging, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
| | - Sam J Daniel
- Department of Otolaryngology Head & Neck Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
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13
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Ibrahim FF, Cardona I, Smith MM, Daniel SJ. Onabotulinum toxin injection for parotid fistula treatment in a case of recurrent parotitis complicated with abscess formation. Int J Pediatr Otorhinolaryngol 2015; 79:766-8. [PMID: 25819498 DOI: 10.1016/j.ijporl.2015.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 02/28/2015] [Accepted: 03/02/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Farid F Ibrahim
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Isabel Cardona
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Mariana M Smith
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada
| | - Sam J Daniel
- Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada.
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14
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Daniel SJ, Cardona I. Cricothyroid Onabotulinum Toxin A Injection to Avert Tracheostomy in Bilateral Vocal Fold Paralysis. JAMA Otolaryngol Head Neck Surg 2014; 140:867-9. [DOI: 10.1001/jamaoto.2014.1515] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Sam J. Daniel
- Department of Otolaryngology–Head and Neck Surgery, Montreal Children’s Hospital, McGill University Health Center, Montreal, Quebec, Canada
| | - Isabel Cardona
- Department of Otolaryngology–Head and Neck Surgery, Montreal Children’s Hospital, McGill University Health Center, Montreal, Quebec, Canada
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Abstract
Objective Acute mastoiditis is an uncommon but challenging condition when it occurs in children with cochlear implant. The literature is scarce as to the management of this condition with regards to explantation. The objective of the study is to determine the need for explantation in patients with cochlear implants who suffer from acute mastoiditis. Data Sources Online medical databases—PubMed, Ovid Medline, Ovid Medline in process, Embase, Cochrane Library, CINAHL, Biosis, Google Scholar, and Scopus. Review Methods A systematic review of all publications addressing the treatment of mastoiditis in cochlear implant children prior to November 2013 was conducted. Data were collected from online medical databases—PubMed, Ovid Medline, Ovid Medline in process, Embase, Cochrane Library, CINAHL, Biosis, Google Scholar, and Scopus. The review was performed in 3 phases; an initial screening review of abstracts was performed, followed by a detailed review of full articles based on inclusion and exclusion criteria, and lastly a final review to extract data from selected articles. Results Twelve articles were found eligible for this systematic review including a total of 43 patients. Subperiosteal abscess was present in 14.3%. All patients received intravenous antibiotics as an initial treatment, and if needed, surgical intervention was performed. Only 1 patient required explantation (2.3%). Conclusion Prompt, aggressive medical and if needed surgical therapy can help in saving the implant and result in a favorable outcome.
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Affiliation(s)
- Faisal Zawawi
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
- Department of Otolaryngology–Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Isabel Cardona
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Olubunmi V. Akinpelu
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Sam J. Daniel
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
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Cardona I, Daniel SJ. 109: Cricothyroid Botulinum Toxin Injection to Avert Tracheostomy in Bilateral Vocal Cord Paralysis. Paediatr Child Health 2014. [DOI: 10.1093/pch/19.6.e35-107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Daniel SJ, Cardona I. Onabotulinum toxin A for the treatment of sialorrhea in familial dysautonomia. Int J Pediatr Otorhinolaryngol 2014; 78:879-81. [PMID: 24725647 DOI: 10.1016/j.ijporl.2014.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 02/05/2014] [Accepted: 02/05/2014] [Indexed: 11/30/2022]
Abstract
Familial dysautonomia is a rare disease affecting the nervous system. Symptoms include speech and movement problems, anterior sialorrhea (drooling) due to hypersalivation as a consequence of poor oropharyngeal coordination; dysphagia and aspiration pneumonia secondary to recurrent posterior sialorrhea. The treatment for sialorrhea in this population is very challenging. Traditional drugs carry a number of side-effects that are difficult to control in this disease. We report the first documented case series of 3 patients with this condition that successfully responded to Onabotulinum toxin A injection into their salivary glands. This is an innovative, safe method for drooling control in this population.
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Affiliation(s)
- Sam J Daniel
- Department of Otolaryngology Head & Neck Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
| | - Isabel Cardona
- Department of Otolaryngology Head & Neck Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
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González-Molero I, Domínguez-López M, Guerrero M, Carreira M, Caballero F, Rubio-Martín E, Linares F, Cardona I, Anarte MT, de Adana MSR, Soriguer F. Use of telemedicine in subjects with type 1 diabetes equipped with an insulin pump and real-time continuous glucose monitoring. J Telemed Telecare 2012; 18:328-32. [PMID: 22912487 DOI: 10.1258/jtt.2012.120103] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We evaluated a telemedicine system in patients with type 1 diabetes who had optimized treatment with an insulin pump and a real-time continuous glucose monitoring system. We conducted a prospective, one-year study of 15 subjects. Three medical visits took place: pre-baseline, baseline and at 6 months. Each month the subjects transmitted information from the glucose meter, glucose sensor and insulin pump. We adjusted the treatment and returned the information by email. We evaluated psychological and metabolic variables, including HbA(1c), hypoglycaemia, hyperglycaemia and glucose variability. At baseline the mean age of the subjects was 40 years and the mean duration of diabetes was 22 years. There was a significant reduction in HbA(1c) (7.50 to 6.97%) at 6 months, a significant increase in the number of self-monitoring blood glucose checks per day (5.2 to 6.2), and significant improvements in variability: MODD, mean of daily difference (67 to 53) and MAGE, mean amplitude of glycaemic excursions (136 to 102). There were significant improvements in quality of life (92 to 87), satisfaction with the treatment (34 to 32) and less fear of hypoglycaemia (36 to 32). Adult subjects with type 1 diabetes on treatment with a continuous insulin infusion system and a real time glucose sensor and who have acceptable metabolic control and optimized treatment can benefit from the addition of a telemetry system to their usual outpatient follow-up.
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Affiliation(s)
- Inmaculada González-Molero
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, sótano P1., Avda del Dr. Gálvez Ginachero s/n, 29009 Málaga, Spain.
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Soriguer F, García-Serrano S, García-Almeida JM, Garrido-Sánchez L, García-Arnés J, Tinahones FJ, Cardona I, Rivas-Marín J, Gallego-Perales JL, García-Fuentes E. Changes in the serum composition of free-fatty acids during an intravenous glucose tolerance test. Obesity (Silver Spring) 2009; 17:10-5. [PMID: 18948964 DOI: 10.1038/oby.2008.475] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recent studies suggest that measuring the free-fatty acids (FFA) during an intravenous glucose tolerance test (IVGTT) may provide information about the metabolic associations between serum FFA and carbohydrate and insulin metabolism. We evaluated the FFA profile during an IVGTT and determined whether this test changes the composition and concentration of FFA. An IVGTT was given to 38 severely obese persons before and 7 months after undergoing bariatric surgery and also to 12 healthy, nonobese persons. The concentration and composition of the FFA were studied at different times during the test. The concentration of FFA fell significantly faster during the IVGTT in the controls and in the severely obese persons with normal-fasting glucose (NFG) than in the severely obese persons with impaired-fasting glucose (IFG) or type 2 diabetes mellitus (T2DM) (P < 0.05). Significant differences were found in the time to minimum serum concentrations of FFA (control = NFG < IFG < T2DM) (P < 0.001). These variables improved after bariatric surgery in the three groups. The percentage of monounsaturated and n-6 polyunsaturated FFA in the control subjects and in the obese persons, both before and after surgery, decreased significantly during the IVGTT. In conclusion, during an IVGTT, severely obese persons with IFG or T2DM experienced a lower fall in the FFA than the severely obese persons with NFG and the controls, becoming normal after bariatric surgery.
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Affiliation(s)
- Federico Soriguer
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Málaga, Spain
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Garrido-Sánchez L, García-Almeida JM, García-Serrano S, Cardona I, García-Arnes J, Soriguer F, Tinahones FJ, García-Fuentes E. Improved carbohydrate metabolism after bariatric surgery raises antioxidized LDL antibody levels in morbidly obese patients. Diabetes Care 2008; 31:2258-64. [PMID: 18835956 PMCID: PMC2584174 DOI: 10.2337/dc08-0930] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Antioxidized LDL (anti-oxLDL) antibodies have recently been suggested to be protective against the development of diabetes. We measured the changes in anti-oxLDL antibody levels in the inverse situation of improvement in carbohydrate metabolism. RESEARCH DESIGN AND METHODS The study was undertaken in 73 morbidly obese individuals, 21 of whom had type 2 diabetes, before and 7 months after they underwent bariatric surgery and in 11 healthy, nonobese individuals. Measurements were made of the area under the curve of glucose (AUC(Glu)) by an intravenous glucose tolerance test and of oxidized LDL (oxLDL) and IgG and IgM anti-oxLDL antibodies. RESULTS The morbidly obese patients with diabetes had significantly higher levels of oxLDL compared with the morbidly obese patients with normal fasting glucose and the control subjects and significantly lower levels of IgM anti-oxLDL antibodies. An inverse correlation was found between the levels of oxLDL and IgM anti-oxLDL antibodies (r = -0.352, P = 0.012). Although the levels of IgG and IgM anti-oxLDL antibodies rose after surgery, this increase was only significant in the diabetic patients, who experienced an improvement in their metabolic profile. Different multiple linear regression models showed that the AUC(Glu) was the main factor explaining the behavior of the levels of oxLDL and anti-oxLDL antibodies. CONCLUSIONS We found a close association between carbohydrate metabolism and IgM anti-oxLDL antibodies, which were significantly reduced in the morbidly obese patients with diabetes. The improvement in carbohydrate metabolism after bariatric surgery led to a significant increase in the levels of IgG and IgM anti-oxLDL antibodies.
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Garcia-Fuentes E, Garrido-Sanchez L, Garcia-Almeida JM, Garcia-Arnes J, Gallego-Perales JL, Rivas-Marin J, Morcillo S, Cardona I, Soriguer F. Different effect of laparoscopic Roux-en-Y gastric bypass and open biliopancreatic diversion of Scopinaro on serum PYY and ghrelin levels. Obes Surg 2008; 18:1424-9. [PMID: 18542849 DOI: 10.1007/s11695-008-9560-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2007] [Accepted: 10/26/2007] [Indexed: 12/17/2022]
Abstract
BACKGROUND The impact of bariatric surgery on levels of peptide YY (PYY) and ghrelin is still under discussion. We undertook a simultaneous evaluation of the serum changes in PYY and ghrelin depending on the specific type of bariatric surgery. METHODS Total PYY and ghrelin were analyzed in 29 healthy persons and in morbidly obese persons undergoing open biliopancreatic diversion (BPD) of Scopinaro (n = 38) or laparoscopic Roux-en-Y gastric bypass (RYGB; n = 13). RESULTS RYGB resulted in a significantly greater loss of weight and body mass index than BPD. Both RYGB and BPD were associated with a significant increase in PYY, significantly greater for BDP (p = 0.001). Ghrelin rose significantly after RYGB (p = 0.022) but not after BPD. After surgery, PYY correlated positively with weight (r = 0.416, p = 0.009). Ghrelin did not correlate significantly with any of the variables studied. Analysis of variance showed that only the type of surgery contributed significantly to explain the variances in the PYY (p = 0.002) and ghrelin (p = 0.018). CONCLUSIONS BPD results in a greater increase in PYY and a lower weight loss than RYGB. However, only RYGB was associated with a significant increase in ghrelin. The differing weight loss according to the type of bariatric surgery does not seem to be explained by changes arising in PYY and ghrelin.
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Baum AE, Akula N, Cabanero M, Cardona I, Corona W, Klemens B, Schulze TG, Cichon S, Rietschel M, Nöthen MM, Georgi A, Schumacher J, Schwarz M, Abou Jamra R, Höfels S, Propping P, Satagopan J, Detera-Wadleigh SD, Hardy J, McMahon FJ. A genome-wide association study implicates diacylglycerol kinase eta (DGKH) and several other genes in the etiology of bipolar disorder. Mol Psychiatry 2008; 13:197-207. [PMID: 17486107 PMCID: PMC2527618 DOI: 10.1038/sj.mp.4002012] [Citation(s) in RCA: 490] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The genetic basis of bipolar disorder has long been thought to be complex, with the potential involvement of multiple genes, but methods to analyze populations with respect to this complexity have only recently become available. We have carried out a genome-wide association study of bipolar disorder by genotyping over 550,000 single-nucleotide polymorphisms (SNPs) in two independent case-control samples of European origin. The initial association screen was performed using pooled DNA, and selected SNPs were confirmed by individual genotyping. While DNA pooling reduces power to detect genetic associations, there is a substantial cost saving and gain in efficiency. A total of 88 SNPs, representing 80 different genes, met the prior criteria for replication in both samples. Effect sizes were modest: no single SNP of large effect was detected. Of 37 SNPs selected for individual genotyping, the strongest association signal was detected at a marker within the first intron of diacylglycerol kinase eta (DGKH; P=1.5 x 10(-8), experiment-wide P<0.01, OR=1.59). This gene encodes DGKH, a key protein in the lithium-sensitive phosphatidyl inositol pathway. This first genome-wide association study of bipolar disorder shows that several genes, each of modest effect, reproducibly influence disease risk. Bipolar disorder may be a polygenic disease.
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Affiliation(s)
- A E Baum
- Unit on the Genetic Basis of Mood and Anxiety Disorders, Mood and Anxiety Disorders Program, US Department of Health and Human Services, National Institute of Mental Health, NIH, Bethesda, MD 20892, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Morcillo S, Rojo-Martínez G, Cardona F, Almaraz MDLC, de Adana MDLSR, Esteva I, Cardona I, Soriguer F. Effect of the interaction between the fatty acid binding protein 2 gene Ala54Thr polymorphism and dietary fatty acids on peripheral insulin sensitivity: a cross-sectional study. Am J Clin Nutr 2007; 86:1232-7. [PMID: 17921407 DOI: 10.1093/ajcn/86.4.1232] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The intestinal fatty acid-binding protein (FABP2) is involved in the intracellular transport and metabolism of fatty acids and may affect insulin sensitivity and glucose metabolism. OBJECTIVE The objective was to study the effect of interaction between the Ala54Thr polymorphism of the FABP2 gene (FABP2) and the type of dietary cooking oil used on peripheral insulin sensitivity in a population from southern Spain. DESIGN The study was cross-sectional. Anthropometric measurements were obtained for 1226 persons aged 18-65 y selected randomly from the municipal census of Pizarra, Spain. An oral-glucose-tolerance test was given to 1020 of these persons. Insulin resistance was measured by homeostasis model assessment. Samples of the cooking oil being used were taken from the kitchens of a random subset of 538 persons. RESULTS Persons who consumed sunflower oil and who also had the Thr54 variant had higher insulin resistance than did those who consumed olive oil (P = 0.01). We detected an interaction between the Ala54Thr polymorphism and the type of oil consumed that accounted for the variance in insulin resistance (P = 0.02). CONCLUSIONS The effect of dietary fatty acids on the populational pattern of insulin resistance is not independent of the Ala54Thr polymorphism of FABP2. An interaction existed between this polymorphism and the intake of dietary fats in a population with a high intake of monounsaturated fatty acids.
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Affiliation(s)
- Sonsoles Morcillo
- Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya (Red de Diabetes y Metabolismo of the Instituto de Salud Carlos III, Madrid), Málaga, Spain.
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Tinahones FJ, Cardona F, Rojo-Martínez G, Almaraz MC, Cardona I, Vázquez-Mellado J, Garrido-Sánchez L, Collantes E, Soriguer F. Decreased levels of uric acid after oral glucose challenge is associated with triacylglycerol levels and degree of insulin resistance. Br J Nutr 2007; 99:44-8. [PMID: 17761018 DOI: 10.1017/s0007114507787470] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Hyperuricaemia is one of the components of metabolic syndrome. Both oxidative stress and hyperinsulinism are important variables in the genesis of this syndrome and have a close association with uric acid (UA). We evaluated the effect of an oral glucose challenge on UA concentrations. The study included 656 persons aged 18 to 65 years. Glycaemia, insulin, UA and plasma proteins were measured at baseline and 120 min after an oral glucose tolerance test (OGTT). The baseline sample also included measurements of total cholesterol, triacylglycerol (TAG) and HDL-cholesterol. Insulin resistance was calculated with the homeostasis model assessment. UA levels were significantly lower after the OGTT (281·93 (sd92·19)v. 267·48 (sd90·40) μmol/l;P < 0·0001). Subjects with a drop in UA concentrations >40·86 μmol/l (>75th percentile) had higher plasma TAG levels (P = 0·0001), baseline insulin (P = 0·02) and greater insulin resistance (P = 0·034). Women with a difference in plasma concentrations of UA above the 75th percentile had higher baseline insulin levels (P = 0·019), concentration of plasma TAG (P = 0·0001) and a greater insulin resistance index (P = 0·029), whereas the only significant difference in men was the level of TAG. Multiple regression analysis showed that the basal TAG levels, insulin at 120 min, glycaemia at 120 min and waist:hip ratio significantly predicted the variance in the UA difference (r20·077). Levels of UA were significantly lower after the OGTT and the individuals with the greatest decrease in UA levels are those who have greater insulin resistance and higher TAG levels.
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Affiliation(s)
- F J Tinahones
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario Virgen de la Victoria, Málaga and CIBER Fisiopatología de la obesidad y nutrición CB06/03 Instituto de Salud Carlos III, Málaga, Spain.
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Garcia-Almeida J, Cardona F, Rojo-Martinez R, Morcillo S, Cardona I, Esteva I, Murri M, Almaraz M, Soriguer F, Tinahones F. YI-823 URIC ACID PREDICTS DIABETES IN THE GENERAL POPULATION. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71833-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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García-Fuentes E, García-Almeida JM, García-Arnés J, Rivas-Marín J, Gallego-Perales JL, González-Jiménez B, Cardona I, García-Serrano S, Garriga MJ, Gonzalo M, de Adana MSR, Soriguer F. Morbidly obese individuals with impaired fasting glucose have a specific pattern of insulin secretion and sensitivity: effect of weight loss after bariatric surgery. Obes Surg 2006; 16:1179-88. [PMID: 16989702 DOI: 10.1381/096089206778392383] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Obesity is often associated with hyper-secrection of insulin. Impaired fasting glucose (IFG) has recently been redefined as a fasting plasma glucose of 5.6-6.9 mmol/L. The aim of this study was to determine whether changes in insulin secretion in morbidly obese persons also commence with normal serum glucose levels. METHODS 32 morbidly obese subjects were studied before and after bariatric surgery. Measurements were made of glucose tolerance (K(G)), insulin sensitivity (SI), first-phase insulin release and the disposition index (DI) from a frequently sampled intravenous glucose tolerance test. RESULT In morbidly obese subjects, the SI (P<0.01), DI (P<0.01) and first-phase insulin release (P<0.02) started changing with serum glucose levels considered to be normal (5.00-5.28 mmol/L). K(G) showed a clear slope according to the baseline glycemia status (P<0.05), and it was significantly related with the DI, both before (r=0.76, P<0.001) and after (r=0.57, P=0.002) surgery. Following surgery, all the variables significantly associated with insulin secretion and insulin sensitivity recovered significantly. The most significant changes occurred in morbidly obese individuals with IFG. CONCLUSIONS Morbidly obese subjects show slopes of insulin sensitivity and insulin secretion in accordance with their baseline serum glucose levels. The fall in first-phase insulin release begins when serum glucose values are considered normal. Morbidly obese persons with the IFG phenotype have a specific pattern of insulin sensitivity and insulin secretion. K(G) clearly discriminates the clinical phenotypes, depending on baseline serum glucose levels.
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