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Valdés S, Doulatram-Gamgaram V, Maldonado-Araque C, García-Escobar E, García-Serrano S, Oualla-Bachiri W, García-Vivanco M, Garrido JL, Gil V, Martín-Llorente F, Calle-Pascual A, Castaño L, Delgado E, Menéndez E, Franch-Nadal J, Gaztambide S, Girbés J, Chaves FJ, Galán-García JL, Aguilera-Venegas G, Vallvé JC, Amigó N, Guardiola M, Ribalta J, Rojo-Martínez G. Association between exposure to air pollution and blood lipids in the general population of Spain. Eur J Clin Invest 2024; 54:e14101. [PMID: 37795744 DOI: 10.1111/eci.14101] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/13/2023] [Accepted: 09/23/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND AND AIMS We aimed to assess the associations of exposure to air pollutants and standard and advanced lipoprotein measures, in a nationwide sample representative of the adult population of Spain. METHODS We included 4647 adults (>18 years), participants in the national, cross-sectional, population-based di@bet.es study, conducted in 2008-2010. Standard lipid measurements were analysed on an Architect C8000 Analyzer (Abbott Laboratories SA). Lipoprotein analysis was made by an advanced 1 H-NMR lipoprotein test (Liposcale®). Participants were assigned air pollution concentrations for particulate matter <10 μm (PM10 ), <2.5 μm (PM2.5 ) and nitrogen dioxide (NO2 ), corresponding to the health examination year, obtained by modelling combined with measurements taken at air quality stations (CHIMERE chemistry-transport model). RESULTS In multivariate linear regression models, each IQR increase in PM10 , PM2.5 and NO2 was associated with 3.3%, 3.3% and 3% lower levels of HDL-c and 1.3%, 1.4% and 1.1% lower HDL particle (HDL-p) concentrations (p < .001 for all associations). In multivariate logistic regression, there was a significant association between PM10 , PM2.5 and NO2 concentrations and the odds of presenting low HDL-c (<40 mg/dL), low HDL-p ( CONCLUSIONS Our study shows an association between the exposure to air pollutants and blood lipids in the general population of Spain, suggesting a link to atherosclerosis.
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Affiliation(s)
- Sergio Valdés
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Viyey Doulatram-Gamgaram
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
| | - Cristina Maldonado-Araque
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Eva García-Escobar
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Sara García-Serrano
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Wasima Oualla-Bachiri
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta García-Vivanco
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) - División de Contaminación Atmosférica, Madrid, Spain
| | - Juan Luis Garrido
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) - División de Contaminación Atmosférica, Madrid, Spain
| | - Victoria Gil
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) - División de Contaminación Atmosférica, Madrid, Spain
| | - Fernando Martín-Llorente
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) - División de Contaminación Atmosférica, Madrid, Spain
| | - Alfonso Calle-Pascual
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition and Instituto de Investigación Sanitaria University Hospital S. Carlos (IdISSC), Department Medicine II, Universidad Complutense (UCM), Madrid, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Cruces, BioCruces, UPV/EHU, Barakaldo, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Elías Delgado
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Edelmiro Menéndez
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Josep Franch-Nadal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP - Fundació Jordi Gol), Barcelona, Spain
| | - Sonia Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Cruces - BioCruces Bizkaia - UPV-EHU, Baracaldo, Barcelona, Spain
| | - Joan Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Spain
| | - F Javier Chaves
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Genomic Studies and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia - INCLIVA, Valencia, Spain
| | | | | | - Joan Carles Vallvé
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Rovira i Virgili University, IISPV, Reus, Spain
| | - Núria Amigó
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Metabolomics Platform, Universitat Rovira i Virgili, IISRV, Reus, Spain
- Biosfer Teslab, Reus, Spain
| | - Montse Guardiola
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Rovira i Virgili University, IISPV, Reus, Spain
| | - Josep Ribalta
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Research Unit on Lipids and Atherosclerosis, Sant Joan University Hospital, Rovira i Virgili University, IISPV, Reus, Spain
| | - Gemma Rojo-Martínez
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
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Valdés S, Doulatram-Gamgaram V, Maldonado-Araque C, Lago-Sampedro A, García-Escobar E, García-Serrano S, García-Vivanco M, Garrido Juan L, Theobald MR, Gil V, Martín-Llorente F, Ocon P, Calle-Pascual A, Castaño L, Delgado E, Menendez E, Franch-Nadal J, Gaztambide S, Girbés J, Chaves FJ, Galán-García JL, Aguilera-Venegas G, Gutierrez-Repiso C, Fernández-García JC, Colomo N, Soriguer F, García-Fuentes E, Rojo-Martínez G. Ambient air pollution and thyroid function in Spanish adults. A nationwide population-based study (Di@bet.es study). Environ Health 2022; 21:76. [PMID: 35978396 PMCID: PMC9387071 DOI: 10.1186/s12940-022-00889-1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Recent reports have suggested that air pollution may impact thyroid function, although the evidence is still scarce and inconclusive. In this study we evaluated the association of exposure to air pollutants to thyroid function parameters in a nationwide sample representative of the adult population of Spain. METHODS The Di@bet.es study is a national, cross-sectional, population-based survey which was conducted in 2008-2010 using a random cluster sampling of the Spanish population. The present analyses included 3859 individuals, without a previous thyroid disease diagnosis, and with negative thyroid peroxidase antibodies (TPO Abs) and thyroid-stimulating hormone (TSH) levels of 0.1-20 mIU/L. Participants were assigned air pollution concentrations for particulate matter <2.5μm (PM2.5) and Nitrogen Dioxide (NO2), corresponding to the health examination year, obtained by means of modeling combined with measurements taken at air quality stations (CHIMERE chemistry-transport model). TSH, free thyroxine (FT4), free triiodothyronine (FT3) and TPO Abs concentrations were analyzed using an electrochemiluminescence immunoassay (Modular Analytics E170 Roche). RESULTS In multivariate linear regression models, there was a highly significant negative correlation between PM2.5 concentrations and both FT4 (p<0.001), and FT3 levels (p<0.001). In multivariate logistic regression, there was a significant association between PM2.5 concentrations and the odds of presenting high TSH [OR 1.24 (1.01-1.52) p=0.043], lower FT4 [OR 1.25 (1.02-1.54) p=0.032] and low FT3 levels [1.48 (1.19-1.84) p=<0.001] per each IQR increase in PM2.5 (4.86 μg/m3). There was no association between NO2 concentrations and thyroid hormone levels. No significant heterogeneity was seen in the results between groups of men, pre-menopausal and post-menopausal women. CONCLUSIONS Exposures to PM2.5 in the general population were associated with mild alterations in thyroid function.
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Affiliation(s)
- Sergio Valdés
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Viyey Doulatram-Gamgaram
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
| | - Cristina Maldonado-Araque
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Lago-Sampedro
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Eva García-Escobar
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Sara García-Serrano
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta García-Vivanco
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) - División de Contaminación Atmosférica, Madrid, Spain
| | - Luis Garrido Juan
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) - División de Contaminación Atmosférica, Madrid, Spain
| | - Mark Richard Theobald
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) - División de Contaminación Atmosférica, Madrid, Spain
| | - Victoria Gil
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) - División de Contaminación Atmosférica, Madrid, Spain
| | - Fernando Martín-Llorente
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) - División de Contaminación Atmosférica, Madrid, Spain
| | - Pilar Ocon
- UGC de Laboratorio (Bioquímica), Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Alfonso Calle-Pascual
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition and Instituto de Investigación, Department Medicine II, Sanitaria University Hospital S. Carlos (IdISSC), Universidad Complutense (UCM), Madrid, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Cruces, UPV/EHU, BioCrucesBarakaldo, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Elías Delgado
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias / University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Edelmiro Menendez
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias / University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Josep Franch-Nadal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- EAP Raval Sud, Institut Català de la Salut, Unitat de Suport a la Recerca (IDIAP - Fundació Jordi Gol), Red GEDAPS, Primary Care, Barcelona, Spain
| | - Sonia Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- EAP Raval Sud, Institut Català de la Salut, Unitat de Suport a la Recerca (IDIAP - Fundació Jordi Gol), Red GEDAPS, Primary Care, Barcelona, Spain
| | - Joan Girbés
- Genomic Studies and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia - INCLIVA, Valencia, Spain
| | - F Javier Chaves
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Genomic Studies and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia - INCLIVA, Valencia, Spain
| | | | | | - Carolina Gutierrez-Repiso
- UGC de Endocrinología y Nutrición. Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - José Carlos Fernández-García
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
| | - Natalia Colomo
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Eduardo García-Fuentes
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga, Spain
- CIBER Enfermedades Hepáticas y Digestivas - CIBEREHD, Instituto de Salud Carlos III, Málaga, Spain
| | - Gemma Rojo-Martínez
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
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García-Escobar E, Valdés S, Soriguer F, Vendrell J, Urrutia-Etxebarria IM, Maldonado-Araque C, Ortega E, Ocón P, Montanya E, Menéndez E, Lago-Sampedro A, González-Frutos T, Gomis R, Goday A, García-Serrano S, Galán-García JL, Castell C, Bordiú E, Badía R, Aguilera-Venegas G, Girbés J, Gaztambide S, Delgado E, Chaves FJ, Castaño L, Calle-Pascual A, Rojo-Martínez G, Franch-Nadal J. Fatty liver index as a predictor for type 2 diabetes in subjects with normoglycemia in a nationwide cohort study. Sci Rep 2021; 11:16453. [PMID: 34385479 PMCID: PMC8361016 DOI: 10.1038/s41598-021-95546-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/20/2021] [Indexed: 01/21/2023] Open
Abstract
Our aim was to evaluate whether fatty liver index (FLI) is associated with the risk of type 2 diabetes (T2DM) development within the Spanish adult population and according to their prediabetes status; additionally, to examine its incremental predictive value regarding traditional risk factors. A total of 2260 subjects (Prediabetes: 641 subjects, normoglycemia: 1619 subjects) from the Di@bet.es cohort study were studied. Socio-demographic, anthropometric, clinical data and survey on habits were recorded. An oral glucose tolerance test was performed and fasting determinations of glucose, lipids and insulin were made. FLI was calculated and classified into three categories: Low (< 30), intermediate (30–60) and high (> 60). In total, 143 people developed diabetes at follow-up. The presence of a high FLI category was in all cases a significant independent risk factor for the development of diabetes. The inclusion of FLI categories in prediction models based on different conventional T2DM risk factors significantly increase the prediction power of the models when all the population was considered. According to our results, FLI might be considered an early indicator of T2DM development even under normoglycemic condition. The data also suggest that FLI could provide additional information for the prediction of T2DM in models based on conventional risk factors.
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Affiliation(s)
- E García-Escobar
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain. .,Endocrinology and Nutrition Department, Biomedical Research Institute of Malaga (IBIMA), Regional University Hospital of Malaga, Málaga, Spain.
| | - S Valdés
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Endocrinology and Nutrition Department, Biomedical Research Institute of Malaga (IBIMA), Regional University Hospital of Malaga, Málaga, Spain
| | - F Soriguer
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Endocrinology and Nutrition Department, Biomedical Research Institute of Malaga (IBIMA), Regional University Hospital of Malaga, Málaga, Spain
| | - J Vendrell
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Rovira i Virgili University; Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain
| | - I M Urrutia-Etxebarria
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Cruces University Hospital, BioCruces Bizkaia, UPV/EHU, Endo-ERN, Barakaldo, Spain.,Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain
| | - C Maldonado-Araque
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Endocrinology and Nutrition Department, Biomedical Research Institute of Malaga (IBIMA), Regional University Hospital of Malaga, Málaga, Spain
| | - E Ortega
- Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute - IDIBAPS, Hospital Clínic of Barcelona, Barcelona, Spain.,Spanish Biomedical Research Network in Physiopathology of Obesity and Nutrition (CIBEROBN), Barcelona, Spain
| | - P Ocón
- General Laboratory, Regional University Hospital of Malaga, Málaga, Spain
| | - E Montanya
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Bellvitge University Hospital, Barcelona, Spain
| | - E Menéndez
- Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain.,Department of Endocrinology and Nutrition, Central University Hospital of Asturias/University of Oviedo, Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
| | - A Lago-Sampedro
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Endocrinology and Nutrition Department, Biomedical Research Institute of Malaga (IBIMA), Regional University Hospital of Malaga, Málaga, Spain
| | - T González-Frutos
- Cruces University Hospital, BioCruces Bizkaia, UPV/EHU, Endo-ERN, Barakaldo, Spain
| | - R Gomis
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute - IDIBAPS, Hospital Clínic of Barcelona, Barcelona, Spain
| | - A Goday
- Spanish Biomedical Research Network in Physiopathology of Obesity and Nutrition (CIBEROBN), Barcelona, Spain.,Endocrinology and Nutrition Department, Hospital del Mar/Medicine Departament, Univeristat Autonoma de Barcelona, Barcelona, Spain
| | - S García-Serrano
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Endocrinology and Nutrition Department, Biomedical Research Institute of Malaga (IBIMA), Regional University Hospital of Malaga, Málaga, Spain
| | - J L Galán-García
- Department of Applied Mathematics, Malaga University, Málaga, Spain
| | - C Castell
- Department of Health, Public Health Agency of Catalonia, Barcelona, Spain
| | - E Bordiú
- Department of Endocrinology and Nutrition, San Carlos University Hospital of Madrid, Madrid, Spain
| | - R Badía
- Endocrinology and Nutrition Department, Biomedical Research Institute of Malaga (IBIMA), Regional University Hospital of Malaga, Málaga, Spain
| | | | - J Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Spain
| | - S Gaztambide
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Cruces University Hospital, BioCruces Bizkaia, UPV/EHU, Endo-ERN, Barakaldo, Spain.,Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain
| | - E Delgado
- Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain.,Department of Endocrinology and Nutrition, Central University Hospital of Asturias/University of Oviedo, Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
| | - F J Chaves
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Genomic and Genetic Diagnosis Unit, Research Foundation of Valencia University Clinical Hospital-INCLIVA, Valencia, Spain
| | - L Castaño
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Cruces University Hospital, BioCruces Bizkaia, UPV/EHU, Endo-ERN, Barakaldo, Spain.,Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain
| | - A Calle-Pascual
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Department of Endocrinology and Nutrition, San Carlos University Hospital of Madrid, Madrid, Spain
| | - G Rojo-Martínez
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain. .,Endocrinology and Nutrition Department, Biomedical Research Institute of Malaga (IBIMA), Regional University Hospital of Malaga, Málaga, Spain.
| | - J Franch-Nadal
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,EAP Raval Sud, Catalan Institute of Health, GEDAPS Network, Primary Care, Research Support Unit (IDIAP - Jordi Gol Foundation), Barcelona, Spain
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Maldonado-Araque C, Valdés S, Badía-Guillén R, Lago-Sampedro A, Colomo N, Garcia-Fuentes E, Gutierrez-Repiso C, Goday A, Calle-Pascual A, Castaño L, Castell C, Delgado E, Menendez E, Franch-Nadal J, Gaztambide S, Girbés J, Chaves FJ, Soriguer F, Rojo-Martínez G. Iodine Deficiency and Mortality in Spanish Adults: Di@bet.es Study. Thyroid 2021; 31:106-114. [PMID: 32781944 PMCID: PMC7840306 DOI: 10.1089/thy.2020.0131] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Longitudinal data assessing the impact of iodine deficiency (ID) on mortality are scarce. We aimed to study the association between the state of iodine nutrition and the risk of total and cause-specific mortality in a representative sample of the Spanish adult population. Methods: We performed a longitudinal observational study to estimate mortality risk according to urinary iodine (UI) concentrations using a sample of 4370 subjects >18 years representative of the Spanish adult population participating in the nationwide study Di@bet.es (2008-2010). We used Cox regression to assess the association between UI at the start of the study (<50, 50-99, 100-199, 200-299, and ≥300 μg/L) and mortality during follow-up (National death registry-end of follow-up December 2016) in raw models, and adjusted for possible confounding variables: age, sex, educational level, hypertension, diabetes, obesity, chronic kidney disease, smoking, hypercholesterolemia, thyroid dysfunction, diagnosis of cardiovascular disease or cancer, area of residence, physical activity, adherence to Mediterranean diet, dairy and iodinated salt intake. Results: A total of 254 deaths were recorded during an average follow-up period of 7.3 years. The causes of death were cardiovascular 71 (28%); cancer 85 (33.5%); and other causes 98 (38.5%). Compared with the reference category with adequate iodine nutrition (UI 100-300 μg/L), the hazard ratios (HRs) of all-cause mortality in the category with UI ≥300 μg/L were 1.04 (95% confidence interval [CI 0.54-1.98]); however, in the categories with 50-99 UI and <50 μg/L, the HRs were 1.29 [CI 0.97-1.70] and 1.71 [1.18-2.48], respectively (p for trend 0.004). Multivariate adjustment did not significantly modify the results. Conclusions: Our data indicate an excess mortality in individuals with moderate-severe ID adjusted for other possible confounding factors.
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Affiliation(s)
- Cristina Maldonado-Araque
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergio Valdés
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Address correspondence to: Sergio Valdés, MD, PhD, Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, IBIMA, Plaza del Hospital Civil s/n, Malaga 29009, Spain
| | - Rocío Badía-Guillén
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
| | - Ana Lago-Sampedro
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Natalia Colomo
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Eduardo Garcia-Fuentes
- UGC de Aparato Digestivo, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
| | - Carolina Gutierrez-Repiso
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen de la Victoria, Instituto de Investigagión Biomedica de Málaga-IBIMA, Málaga, Spain
| | - Albert Goday
- Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain
| | - Alfonso Calle-Pascual
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario S. Carlos de Madrid, Madrid, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Cruces, BioCruces Bizkaia, UPV/EHU, Barakaldo, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Conxa Castell
- Department of Health, Public Health Agency of Catalonia, Barcelona, Spain
| | - Elías Delgado
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Edelmiro Menendez
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Josep Franch-Nadal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP—Fundació Jordi Gol), Barcelona, Spain
| | - Sonia Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Cruces, BioCruces Bizkaia, UPV/EHU, Barakaldo, Spain
| | - Joan Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Spain
| | - Francisco Javier Chaves
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Genomic Studies and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia-INCLIVA, Valencia, Spain
| | - Federico Soriguer
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Rojo-Martínez
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomedica de Málaga-IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
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5
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Rojo-Martínez G, Valdés S, Soriguer F, Vendrell J, Urrutia I, Pérez V, Ortega E, Ocón P, Montanya E, Menéndez E, Lago-Sampedro A, González-Frutos T, Gomis R, Goday A, García-Serrano S, García-Escobar E, Galán-García JL, Castell C, Badía-Guillén R, Aguilera-Venegas G, Girbés J, Gaztambide S, Franch-Nadal J, Delgado E, Chaves FJ, Castaño L, Calle-Pascual A. Incidence of diabetes mellitus in Spain as results of the nation-wide cohort di@bet.es study. Sci Rep 2020; 10:2765. [PMID: 32066839 PMCID: PMC7026031 DOI: 10.1038/s41598-020-59643-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 01/28/2020] [Indexed: 12/22/2022] Open
Abstract
Our aim was to determine the incidence of type 2 diabetes mellitus in a nation-wide population based cohort from Spain (di@bet.es study). The target was the Spanish population. In total 5072 people older than 18 years,were randomly selected from all over Spain). Socio-demographic and clinical data, survey on habits (physical activity and food consumption) and weight, height, waist, hip and blood pressure were recorder. A fasting blood draw and an oral glucose tolerance test were performed. Determinations of serum glucose were made. In the follow-up the same variables were collected and HbA1c was determined. A total of 2408 subjects participated in the follow-up. In total, 154 people developed diabetes (6.4% cumulative incidence in 7.5 years of follow-up). The incidence of diabetes adjusted for the structure of age and sex of the Spanish population was 11.6 cases/1000 person-years (IC95% = 11.1–12.1). The incidence of known diabetes was 3.7 cases/1000 person-years (IC95% = 2.8–4.6). The main risk factors for developing diabetes were the presence of prediabetes in cross-sectional study, age, male sex, obesity, central obesity, increase in weight, and family history of diabetes. This work provides data about population-based incidence rates of diabetes and associated risk factors in a nation-wide cohort of Spanish population.
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Affiliation(s)
- G Rojo-Martínez
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain. .,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain.
| | - S Valdés
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - F Soriguer
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - J Vendrell
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Department of Endocrinology and Nutrition, University Hospital Joan XXIII, Pere Virgili Institute (IISPV), Rovira I Virgili University, Tarragona, Spain
| | - I Urrutia
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Cruces University Hospital, Biocruces Bizkaia Health Research Institute, UPV/EHU, Barakaldo, Spain.,Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain
| | - V Pérez
- General Laboratory. Regional University Hospital of Malaga, Malaga, Spain
| | - E Ortega
- Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute - IDIBAPS, Hospital Clínic of Barcelona, Barcelona, Spain.,Spanish Biomedical Research Network in physiopathology of obesity and Nutrition (CIBEROBN), Barcelona, Spain
| | - P Ocón
- General Laboratory. Regional University Hospital of Malaga, Malaga, Spain
| | - E Montanya
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Bellvitge University Hospital, Barcelona, Spain
| | - E Menéndez
- Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain.,Department of Endocrinology and Nutrition, Central University Hospital of Asturias/University of Oviedo, Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
| | - A Lago-Sampedro
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - T González-Frutos
- Cruces University Hospital, Biocruces Bizkaia Health Research Institute, UPV/EHU, Barakaldo, Spain
| | - R Gomis
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute - IDIBAPS, Hospital Clínic of Barcelona, Barcelona, Spain
| | - A Goday
- Spanish Biomedical Research Network in physiopathology of obesity and Nutrition (CIBEROBN), Barcelona, Spain.,Department of Endocrinology and Nutrition, Hospital del Mar, IMIM. Universitat Autònoma, Barcelona, Spain
| | - S García-Serrano
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - E García-Escobar
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | - J L Galán-García
- Department of Applied Mathematics, Malaga University, Malaga, Spain
| | - C Castell
- Department of Health, Public Health Agency of Catalonia, Barcelona, Spain
| | - R Badía-Guillén
- Biomedical Research Institute of Malaga (IBIMA), Endocrinology and Nutrition Department, Regional University Hospital of Malaga, Malaga, Spain
| | | | - J Girbés
- Diabetes Unit, Hospital Arnau of Vilanova, Valencia, Spain
| | - S Gaztambide
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain.,Department of Endocrinology and Nutrition, Cruces University Hospital, Biocruces Bizkaia Health Research Institute, UPV/EHU, Barakaldo, Spain
| | - J Franch-Nadal
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,EAP Raval Sud, Catalan Institute of Health, GEDAPS Network, Primary Care, Research support unit (IDIAP - Jordi Gol Foundation), Barcelona, Spain
| | - E Delgado
- Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain.,Department of Endocrinology and Nutrition, Central University Hospital of Asturias/University of Oviedo, Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
| | - F J Chaves
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Genomic and Genetic Diagnosis Unit, Research Foundation of Valencia University Clinical Hospital-INCLIVA, Valencia, Spain
| | - L Castaño
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Cruces University Hospital, Biocruces Bizkaia Health Research Institute, UPV/EHU, Barakaldo, Spain.,Spanish Biomedical Research Network in Rare Diseases (CIBERER), Madrid, Spain
| | - A Calle-Pascual
- Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain.,Department of Endocrinology and Nutrition, University Hospital S. Carlos of Madrid, Madrid, Spain
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6
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Valdés S, Doulatram-Gamgaram V, Lago A, García Torres F, Badía-Guillén R, Olveira G, Goday A, Calle-Pascual A, Castaño L, Castell C, Delgado E, Menendez E, Franch-Nadal J, Gaztambide S, Girbés J, Gomis R, Ortega E, Galán-García JL, Aguilera-Venegas G, Soriguer F, Rojo-Martínez G. Ambient temperature and prevalence of diabetes and insulin resistance in the Spanish population: Di@bet.es study. Eur J Endocrinol 2019; 180:273-280. [PMID: 30840583 DOI: 10.1530/eje-18-0818] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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] [Received: 10/09/2018] [Accepted: 03/05/2019] [Indexed: 01/14/2023]
Abstract
Objective The activity of brown adipose tissue is sensitive to changes in ambient temperature. A lower exposure to cold could result in an increased risk of developing diabetes at population level, although this factor has not yet been sufficiently studied. Design We studied 5072 subjects, participants in a national, cross-sectional population-based study representative of the Spanish adult population (Di@bet.es study). All subjects underwent a clinical, demographic and lifestyle survey, a physical examination and blood sampling (75 g oral glucose tolerance test). Insulin resistance was estimated with the homeostasis model assessment (HOMA-IR). The mean annual temperature (°C) in each individual municipality was collected from the Spanish National Meteorology Agency. Results Linear regression analysis showed a significant positive association between mean annual temperature and fasting plasma glucose (β: 0.087, P < 0.001), 2 h plasma glucose (β: 0.049, P = 0.008) and HOMA-IR (β: 0.046, P = 0.008) in multivariate adjusted models. Logistic regression analyses controlled by multiple socio-demographic variables, lifestyle, adiposity (BMI) and geographical elevation showed increasing odds ratios for prediabetes (WHO 1999), ORs 1, 1.26 (0.95-1.66), 1.08 (0.81-1.44) and 1.37 (1.01-1.85) P for trend = 0.086, diabetes (WHO 1999) ORs 1, 1.05 (0.79-1.39), 1.20 (0.91-1.59) and 1.39 (1.02-1.90) P = 0.037, and insulin resistance (HOMA-IR ≥75th percentile of the non-diabetic population): ORs 1, 1.03 (0.82-1.30), 1.22 (0.96-1.55), 1.26 (0.98-1.63) (P for trend = 0.046) as the mean annual temperature (into quartiles) rose. Conclusions Our study reports an association between ambient temperature and the prevalence of dysglycemia and insulin resistance in Spanish adults, consistent with the hypothesis that a lower exposure to cold could be associated with a higher risk of metabolic derangements.
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Affiliation(s)
- Sergio Valdés
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Viyey Doulatram-Gamgaram
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, IBIMA, Málaga, Spain
| | - Ana Lago
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Rocío Badía-Guillén
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, IBIMA, Málaga, Spain
| | - Gabriel Olveira
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Albert Goday
- Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain
| | - Alfonso Calle-Pascual
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario S. Carlos de Madrid, Madrid, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Cruces, BioCruces Bizkaia, UPV/EHU, Barakaldo, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Conxa Castell
- Department of Health, Public Health Agency of Catalonia, Barcelona, Spain
| | - Elías Delgado
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Edelmiro Menendez
- Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Josep Franch-Nadal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP - Fundació Jordi Gol), Barcelona, Spain
| | - Sonia Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Cruces -BioCruces Bizkaia - UPV-EHU, Baracaldo, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Joan Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Spain
| | - Ramón Gomis
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Emilio Ortega
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Federico Soriguer
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Rojo-Martínez
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga/Universidad de Málaga, IBIMA, Málaga, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
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7
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Maldonado-Araque C, Valdés S, Lago-Sampedro A, Lillo-Muñoz JA, Garcia-Fuentes E, Perez-Valero V, Gutierrez-Repiso C, Goday A, Urrutia I, Peláez L, Calle-Pascual A, Castaño L, Castell C, Delgado E, Menendez E, Franch-Nadal J, Gaztambide S, Girbés J, Ortega E, Vendrell J, Chacón MR, Chaves FJ, Soriguer F, Rojo-Martínez G. Iron deficiency is associated with Hypothyroxinemia and Hypotriiodothyroninemia in the Spanish general adult population: Di@bet.es study. Sci Rep 2018; 8:6571. [PMID: 29700318 PMCID: PMC5919900 DOI: 10.1038/s41598-018-24352-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 03/23/2018] [Indexed: 01/08/2023] Open
Abstract
Previous studies have suggested that iron deficiency (ID) may impair thyroid hormone metabolism, however replication in wide samples of the general adult population has not been performed. We studied 3846 individuals free of thyroid disease, participants in a national, cross sectional, population based study representative of the Spanish adult population. Thyroid stimulating hormone (TSH), free thyroxin (FT4) and free triiodothyronine (FT3) were analyzed by electrochemiluminescence (E170, Roche Diagnostics). Serum ferritin was analyzed by immunochemiluminescence (Architect I2000, Abbott Laboratories). As ferritin levels decreased (>100, 30–100, 15–30, <15 µg/L) the adjusted mean concentrations of FT4 (p < 0.001) and FT3 (p < 0.001) descended, whereas TSH levels remained unchanged (p = 0.451). In multivariate logistic regression models adjusted for age, sex, UI, BMI and smoking status, subjects with ferritin levels <30 µg/L were more likely to present hypothyroxinemia (FT4 < 12.0 pmol/L p5): OR 1.5 [1.1–2.2] p = 0.024, and hypotriiodothyroninemia (FT3 < 3.9 pmol/L p5): OR 1.8 [1.3–2.6] p = 0.001 than the reference category with ferritin ≥30 µg/L. There was no significant heterogeneity of the results between men, pre-menopausal and post-menopausal women or according to the iodine nutrition status. Our results confirm an association between ID and hypothyroxinemia and hypotriiodothyroninemia in the general adult population without changes in TSH.
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Affiliation(s)
- Cristina Maldonado-Araque
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Sergio Valdés
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain. .,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Ana Lago-Sampedro
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Eduardo Garcia-Fuentes
- UGC de Aparato Digestivo. Hospital Universitario Virgen de la Victoria, IBIMA, Málaga, Spain.,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Vidal Perez-Valero
- UGC de Laboratorio (Bioquímica). Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Carolina Gutierrez-Repiso
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain.,UGC de Endocrinología y Nutrición. Hospital Universitario Virgen de la Victoria. IBIMA, Málaga, Spain
| | - Albert Goday
- Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain
| | - Ines Urrutia
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain.,Hospital Universitario Cruces, BioCruces, UPV/EHU, Barakaldo, Spain
| | - Laura Peláez
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Alfonso Calle-Pascual
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Endocrinology and Nutrition, Hospital Universitario S. Carlos de Madrid, Madrid, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain.,Hospital Universitario Cruces, BioCruces, UPV/EHU, Barakaldo, Spain
| | - Contxa Castell
- Public Health Agency of Catalonia, Department of Health, Barcelona, Spain
| | - Elias Delgado
- Endocrinology and Nutrition Service, Hospital Universitario Central de Asturias, Oviedo, Spain.,Department of Medicine, University of Oviedo, Hospital Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Edelmiro Menendez
- Endocrinology and Nutrition Service, Hospital Universitario Central de Asturias, Oviedo, Spain.,Department of Medicine, University of Oviedo, Hospital Central de Asturias, Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Josep Franch-Nadal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain.,EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP - Fundació Jordi Gol), Barcelona, Spain
| | - Sonia Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Endocrinology and Nutrition, Hospital Universitario Cruces - UPV-EHU, Baracaldo, Barcelona, Spain
| | - Joan Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Spain
| | - Emilio Ortega
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Joan Vendrell
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain
| | | | - Felipe J Chaves
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain.,Genomic Studies and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia-INCLIVA, Valencia, Spain
| | - Federico Soriguer
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Rojo-Martínez
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
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8
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Valdés S, Maldonado-Araque C, Lago-Sampedro A, Lillo-Muñoz JA, Garcia-Fuentes E, Perez-Valero V, Gutiérrez-Repiso C, Garcia-Escobar E, Goday A, Urrutia I, Peláez L, Calle-Pascual A, Bordiú E, Castaño L, Castell C, Delgado E, Menéndez E, Franch-Nadal J, Gaztambide S, Girbés J, Ortega E, Vendrell J, Chacón MR, Javier Chaves F, Soriguer F, Rojo-Martínez G. Reference values for TSH may be inadequate to define hypothyroidism in persons with morbid obesity: Di@bet.es study. Obesity (Silver Spring) 2017; 25:788-793. [PMID: 28276648 DOI: 10.1002/oby.21796] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [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] [Received: 10/27/2016] [Revised: 12/22/2016] [Accepted: 01/12/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To analyze the reference range of thyroid-stimulating hormone (TSH) in different BMI categories and its impact on the classification of hypothyroidism. METHODS The study included 3,928 individuals free of thyroid disease (without previous thyroid disease, no interfering medications, TSH <10 µUI/mL and thyroid peroxidase antibodies [TPO Abs] <50 IU/mL) who participated in a national, cross-sectional, population-based study and were representative of the adult population of Spain. Data gathered included clinical and demographic characteristics, physical examination, and blood and urine sampling. TSH, free thyroxine, free triiodothyronine, and TPO Ab were analyzed by electrochemiluminescence (E170, Roche Diagnostics, Basel, Switzerland). RESULTS The reference range (p2.5-97.5) for TSH was estimated as 0.6 to 4.8 µUI/mL in the underweight category (BMI<20 kg/m2 ), 0.6 to 5.5 µUI/mL in the normal-weight category (BMI 20-24.9 kg/m2 ), 0.6 to 5.5 µUI/mL in the overweight category (BMI 25-29.9 kg/m2 ), 0.5 to 5.9 µUI/mL in the obesity category (BMI 30-39.9 kg/m2 ), and 0.7 to 7.5 µUI/mL in the morbid obesity category (BMI ≥40). By using the reference criteria for the normal-weight population, the prevalence of high TSH levels increased threefold in the morbid obesity category (P < 0.01). CONCLUSIONS Persons with morbid obesity might be inappropriately classified if the standard ranges of normality of TSH for the normal-weight population are applied to them.
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Affiliation(s)
- Sergio Valdés
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Cristina Maldonado-Araque
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Ana Lago-Sampedro
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | | | - Eduardo Garcia-Fuentes
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Vidal Perez-Valero
- UGC de Laboratorio (Bioquímica), Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Carolina Gutiérrez-Repiso
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Eva Garcia-Escobar
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Albert Goday
- Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain
| | - Inés Urrutia
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Cruces, BioCruces, UPV/EHU, Barakaldo, Spain
| | - Laura Peláez
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Alfonso Calle-Pascual
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario S. Carlos de Madrid, Spain
| | - Elena Bordiú
- Laboratorio de Bioquímica, Hospital Universitario S. Carlos de Madrid, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Cruces, BioCruces, UPV/EHU, Barakaldo, Spain
| | - Conxa Castell
- Public Health Agency, Department of Health, Autonomous Government of Catalonia, Barcelona, Spain
| | - Elias Delgado
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, Oviedo, Spain
| | - Edelmiro Menéndez
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, Oviedo, Spain
| | - Josep Franch-Nadal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP - Fundació Jordi Gol), Barcelona, Spain
| | - Sonia Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Cruces - UPV-EHU, Baracaldo, Spain
| | - Joan Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Spain
| | - Emilio Ortega
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Spain
| | - Joan Vendrell
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain
| | - Matilde R Chacón
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain
| | - F Javier Chaves
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Genotyping and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia-INCLIVA, Valencia, Spain
| | - Federico Soriguer
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
| | - Gemma Rojo-Martínez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain
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9
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Valdés S, Maldonado-Araque C, Lago-Sampedro A, Lillo JA, Garcia-Fuentes E, Perez-Valero V, Gutierrez-Repiso C, Ocon-Sanchez P, Goday A, Urrutia I, Peláez L, Calle-Pascual A, Bordiú E, Castaño L, Castell C, Delgado E, Menendez E, Franch J, Gaztambide S, Girbés J, Ortega E, Lopez-Alba A, Chaves FJ, Vendrell J, Chacón MR, Soriguer F, Rojo-Martínez G. Population-Based National Prevalence of Thyroid Dysfunction in Spain and Associated Factors: Di@bet.es Study. Thyroid 2017; 27:156-166. [PMID: 27835928 DOI: 10.1089/thy.2016.0353] [Citation(s) in RCA: 40] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The aim of this study was to investigate the national prevalence of thyroid dysfunction in Spain and its association with various clinical, environmental, and demographic variables. METHODS The study included 4554 subjects (42.4% men) with a mean age of 50 years (range 18-93 years), who were participants in a national, cross-sectional, population-based survey conducted in 2009-2010. Data gathered included clinical and demographic characteristics, physical examination, and blood sampling. Thyrotropin, free thyroxine, free triiodothyronine, and thyroid peroxidase antibody (TPOAb) concentrations were analyzed by electrochemiluminescence. Urinary iodine (UI) levels were measured in an isolated urine sample. RESULTS The prevalence of treated hypothyroidism, untreated subclinical hypothyroidism, and untreated clinical hypothyroidism was 4.2% [confidence interval (CI) 3.6-4.9%], 4.6% [CI 4.0-5.2%], and 0.3% [CI 0.1-0.5%], respectively. The prevalence of total hypothyroidism (including all fractions) was 9.1% [CI 8.2-10.0%]. The prevalence of total hyperthyroidism was 0.8% [CI 0.6-1.1]. A total of 7.5% [CI 6.7-8.3%] of the population tested positive for TPOAbs (≥50 IU/mL). In multivariate logistic regression models, TPOAbs were strongly associated with both hypothyroidism (p < 0.001) and hyperthyroidism (p = 0.005), whereas high UI levels (>200 μg/g creatinine) were associated with hypothyroidism (p < 0.001). The positive association between UI and hypothyroidism remained for both treated (p < 0.001) and untreated (p < 0.05) hypothyroidism, whereas it was especially significant for non-autoimmune (TPOAbs negative) forms (p < 0.001). At UI levels ≥200 μg/g, there was a positive correlation between UI and thyrotropin levels (β = 0.152, p < 0.001) and a negative correlation between UI and free triiodothyronine levels (β = -0.134, p = 0.001). CONCLUSION According to the data, a large proportion (10%) of the Spanish population has some evidence of thyroid dysfunction. High TPOAb concentrations were associated with both hypo- and hyperthyroidism, whereas high UI concentrations were associated with hypothyroidism.
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Affiliation(s)
- Sergio Valdés
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Cristina Maldonado-Araque
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Ana Lago-Sampedro
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - J Antonio Lillo
- 3 UGC de Laboratorio (Bioquímica), Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Eduardo Garcia-Fuentes
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- 4 CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III , Madrid, Spain
| | - Vidal Perez-Valero
- 3 UGC de Laboratorio (Bioquímica), Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Carolina Gutierrez-Repiso
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Pilar Ocon-Sanchez
- 3 UGC de Laboratorio (Bioquímica), Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Albert Goday
- 5 Department of Endocrinology and Nutrition, Hospital del Mar , Barcelona, Spain
| | - Ines Urrutia
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 6 Research Unit, Hospital Universitario Cruces-UPV-EHU , Baracaldo, Spain
| | - Laura Peláez
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Alfonso Calle-Pascual
- 7 Department of Endocrinology and Nutrition, Hospital Universitario S. Carlos de Madrid , Madrid, Spain
| | - Elena Bordiú
- 8 Laboratorio de Bioquímica, Hospital Universitario S. Carlos de Madrid , Madrid, Spain
| | - Luis Castaño
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 6 Research Unit, Hospital Universitario Cruces-UPV-EHU , Baracaldo, Spain
| | - Conxa Castell
- 9 Public Health Agency, Department of Health, Autonomous Government of Catalonia , Barcelona, Spain
| | - Elias Delgado
- 10 Department of Endocrinology and Nutrition, Hospital Central de Asturias , Oviedo, Spain
| | - Edelmiro Menendez
- 10 Department of Endocrinology and Nutrition, Hospital Central de Asturias , Oviedo, Spain
| | - Josep Franch
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 11 EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP-Fundació Jordi Gol) , Barcelona, Spain
| | - Sonia Gaztambide
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 12 Department of Endocrinology and Nutrition, Hospital Universitario Cruces-UPV-EHU , Baracaldo, Spain
| | - Joan Girbés
- 13 Diabetes Unit, Hospital Arnau de Vilanova , Valencia, Spain
| | - Emilio Ortega
- 4 CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III , Madrid, Spain
- 14 Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS); Hospital Clínic de Barcelona , Barcelona, Spain
| | - Alfonso Lopez-Alba
- 15 Department of Endocrinology and Nutrition, Fundación Hospital de Jove , Gijón, Spain
| | - Felipe J Chaves
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 16 Genotyping and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia-INCLIVA , Valencia, Spain
| | - Joan Vendrell
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 17 Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII , Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain
| | - Matilde R Chacón
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 17 Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII , Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain
| | - Federico Soriguer
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Gemma Rojo-Martínez
- 1 Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid, Spain
- 2 Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga , Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
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Mata-Cases M, Artola S, Escalada J, Ezkurra-Loyola P, Ferrer-García J, Fornos J, Girbés J, Rica I. [Consensus on the detection and management of prediabetes. Consensus and Clinical Guidelines Working Group of the Spanish Diabetes Society]. Aten Primaria 2015; 47:456-68. [PMID: 25735589 PMCID: PMC6983698 DOI: 10.1016/j.aprim.2014.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 10/27/2014] [Accepted: 12/04/2014] [Indexed: 01/09/2023] Open
Abstract
En España, según datos del estudio Di@bet.es, un 13,8% de la población adulta padece diabetes y un 14,8% algún tipo de prediabetes (intolerancia a la glucosa, glucemia basal alterada o ambas). Puesto que la detección precoz de la prediabetes puede facilitar la puesta en marcha de medidas terapéuticas que eviten su progresión a diabetes, consideramos que las estrategias de prevención en las consultas de atención primaria y especializada deberían consensuarse. La detección de diabetes y prediabetes mediante un cuestionario específico (test de FINDRISC) y/o la determinación de la glucemia basal en pacientes de riesgo permiten detectar los pacientes con riesgo de desarrollar la enfermedad y es necesario considerar cómo debe ser su manejo clínico. La intervención sobre los estilos de vida puede reducir la progresión a diabetes o hacer retroceder un estado prediabético a la normalidad y es una intervención coste-efectiva. Algunos fármacos, como la metformina, también se han mostrado eficaces en reducir la progresión a diabetes aunque no son superiores a las intervenciones no farmacológicas. Finalmente, aunque no hay pruebas sólidas que apoyen la eficacia del cribado en términos de morbimortalidad, sí que se ha observado una mejora de los factores de riesgo cardiovascular. El Grupo de Trabajo de Consensos y Guías Clínicas de la Sociedad Española de Diabetes, ha elaborado unas recomendaciones que han sido consensuadas con la Sociedad Española de Endocrinología y Nutrición, la Sociedad Española de Endocrinología Pediátrica, la Sociedad Española de Farmacia Comunitaria, la Sociedad Española de Medicina Familiar y Comunitaria, la Sociedad Española de Médicos Generales, la Sociedad Española de Médicos de Atención Primaria, la Sociedad Española de Medicina Interna y la Asociación de Enfermería Comunitaria y la Red de Grupos de Estudio de la Diabetes en Atención Primaria.
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11
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Mata-Cases M, Artola S, Escalada J, Ezkurra-Loyola P, Ferrer-García J, Fornos J, Girbés J, Rica I. Consenso sobre la detección y el manejo de la prediabetes. Grupo de Trabajo de Consensos y Guías Clínicas de la Sociedad Española de Diabetes. Rev Clin Esp 2015; 215:117-29. [DOI: 10.1016/j.rce.2014.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 10/22/2014] [Accepted: 10/26/2014] [Indexed: 02/08/2023]
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12
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Ortega E, Franch J, Castell C, Goday A, Ribas-Barba L, Soriguer F, Vendrell J, Casamitjana R, Bosch-Comas A, Bordiú E, Calle-Pascual A, Carmena R, Castaño L, Catalá M, Delgado E, Gaztambide S, Girbés J, López-Alba A, Martínez-Larrad MT, Menéndez E, Mora-Peces I, Pascual-Manich G, Rojo-Martínez G, Serrano-Rios M, Urrutía I, Valdés S, Vázquez JA, Gomis R. Mediterranean diet adherence in individuals with prediabetes and unknown diabetes: the Di@bet.es Study. Ann Nutr Metab 2013; 62:339-46. [PMID: 23838479 DOI: 10.1159/000346553] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 12/16/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS Mediterranean diet (MedDiet) is causally related to diabetes and is a dietary pattern recommended to individuals with diabetes. We investigated MedDiet adherence in individuals with prediabetes and unknown (PREDM/UKDM) or known diabetes (KDM) compared to those with normal glucose metabolism (NORMAL). METHODS This was a national, population-based, cross-sectional, cluster-sampling study. MedDiet adherence was scored (MedScore, mean ± SD 24 ± 5) using a qualitative food frequency questionnaire. Logistic regression was used to examine the association between MedScore and PREDM/UKDM or KDM versus control subjects. RESULTS We evaluated 5,076 individuals. Mean age was 50 years, 57% were female, 826 (582/244) were PREDM/UKDM, 478 were KDM and 3,772 were NORMAL. Mean age increased across MedScore tertiles (46, 51 and 56 years, p < 0.0001). Higher age-adjusted adherence to MedDiet (5-unit increment in the MedScore) was associated with lower and nondifferent odds (OR, 95% CI) of prevalent PREDM/UKDM (0.88, 0.81-0.96, p = 0.001) and KDM (0.97, 0.87-1.07, p = 0.279), respectively, compared to individuals in the NORMAL group. CONCLUSIONS In a representative sample of the whole Spanish population, MedDiet adherence is independently associated with PREDM/UKDM. Therapeutic intervention may be, in part, responsible for the lack of differences in adherence observed between the KDM and NORMAL groups. However, reverse causation bias cannot be ruled out in cross-sectional studies.
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Affiliation(s)
- E Ortega
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain.
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13
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Soriguer F, Goday A, Bosch-Comas A, Bordiú E, Calle-Pascual A, Carmena R, Casamitjana R, Castaño L, Castell C, Catalá M, Delgado E, Franch J, Gaztambide S, Girbés J, Gomis R, Gutiérrez G, López-Alba A, Martínez-Larrad MT, Menéndez E, Mora-Peces I, Ortega E, Pascual-Manich G, Rojo-Martínez G, Serrano-Rios M, Valdés S, Vázquez JA, Vendrell J. Prevalence of diabetes mellitus and impaired glucose regulation in Spain: the Di@bet.es Study. Diabetologia 2012; 55:88-93. [PMID: 21987347 PMCID: PMC3228950 DOI: 10.1007/s00125-011-2336-9] [Citation(s) in RCA: 623] [Impact Index Per Article: 51.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Accepted: 09/19/2011] [Indexed: 11/01/2022]
Abstract
AIMS/HYPOTHESIS The Di@bet.es Study is the first national study in Spain to examine the prevalence of diabetes and impaired glucose regulation. METHODS A population-based, cross-sectional, cluster sampling study was carried out, with target population being the entire Spanish population. Five thousand and seventy-two participants in 100 clusters (health centres or the equivalent in each region) were randomly selected with a probability proportional to population size. Participation rate was 55.8%. Study variables were a clinical and demographic structured survey, lifestyle survey, physical examination (weight, height, BMI, waist and hip circumference, blood pressure) and OGTT (75 g). RESULTS Almost 30% of the study population had some carbohydrate disturbance. The overall prevalence of diabetes mellitus adjusted for age and sex was 13.8% (95% CI 12.8, 14.7%), of which about half had unknown diabetes: 6.0% (95% CI 5.4, 6.7%). The age- and sex-adjusted prevalence rates of isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT) and combined IFG-IGT were 3.4% (95% CI 2.9, 4.0%), 9.2% (95% CI 8.2, 10.2%) and 2.2% (95% CI 1.7, 2.7%), respectively. The prevalence of diabetes and impaired glucose regulation increased significantly with age (p < 0.0001), and was higher in men than in women (p < 0.001). CONCLUSIONS/INTERPRETATION The Di@bet.es Study shows, for the first time, the prevalence rates of diabetes and impaired glucose regulation in a representative sample of the Spanish population.
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Affiliation(s)
- F Soriguer
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain.
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14
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Marcuello C, Calle-Pascual AL, Fuentes M, Runkle I, Soriguer F, Goday A, Bosch-Comas A, Bordiú E, Carmena R, Casamitjana R, Castaño L, Castell C, Catalá M, Delgado E, Franch J, Gaztambide S, Girbés J, Gomis R, Gutiérrez G, López-Alba A, Martínez-Larrad MT, Menéndez E, Mora-Peces I, Ortega E, Pascual-Manich G, Rojo-Martínez G, Serrano-Rios M, Valdés S, Vázquez JA, Vendrell J. Evaluation of Health-Related Quality of Life according to Carbohydrate Metabolism Status: A Spanish Population-Based Study (Di@bet.es Study). Int J Endocrinol 2012; 2012:872305. [PMID: 22848215 PMCID: PMC3405659 DOI: 10.1155/2012/872305] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 05/07/2012] [Accepted: 05/22/2012] [Indexed: 11/17/2022] Open
Abstract
Objective. To evaluate the association between diabetes mellitus and health-related quality of life (HRQOL) controlled for several sociodemographic and anthropometric variables, in a representative sample of the Spanish population. Methods. A population-based, cross-sectional, and cluster sampling study, with the entire Spanish population as the target population. Five thousand and forty-seven participants (2162/2885 men/women) answered the HRQOL short form 12-questionnaire (SF-12). The physical (PCS-12) and the mental component summary (MCS-12) scores were assessed. Subjects were divided into four groups according to carbohydrate metabolism status: normal, prediabetes, unknown diabetes (UNKDM), and known diabetes (KDM). Logistic regression analyses were conducted. Results. Mean PCS-12/MCS-12 values were 50.9 ± 8.5/ 47.6 ± 10.2, respectively. Men had higher scores than women in both PCS-12 (51.8 ± 7.2 versus 50.3 ± 9.2; P < 0.001) and MCS-12 (50.2 ± 8.5 versus 45.5 ± 10.8; P < 0.001). Increasing age and obesity were associated with a poorer PCS-12 score. In women lower PCS-12 and MCS-12 scores were associated with a higher level of glucose metabolism abnormality (prediabetes and diabetes), (P < 0.0001 for trend), but only the PCS-12 score was associated with altered glucose levels in men (P < 0.001 for trend). The Odds Ratio adjusted for age, body mass index (BMI) and educational level, for a PCS-12 score below the median was 1.62 (CI 95%: 1.2-2.19; P < 0.002) for men with KDM and 1.75 for women with KDM (CI 95%: 1.26-2.43; P < 0.001), respectively. Conclusion. Current study indicates that increasing levels of altered carbohydrate metabolism are accompanied by a trend towards decreasing quality of life, mainly in women, in a representative sample of Spanish population.
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Affiliation(s)
- C. Marcuello
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos de Madrid, Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - A. L. Calle-Pascual
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos de Madrid, Profesor Martín Lagos s/n, 28040 Madrid, Spain
- *A. L. Calle-Pascual:
| | - M. Fuentes
- Preventive Medicine Service, Hospital Clínico San Carlos de Madrid, Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - I. Runkle
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos de Madrid, Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - F. Soriguer
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario Carlos Haya Málaga, Málaga, Spain
| | - A. Goday
- Department of Endocrinology and Nutrition, Hospital del Mar, 08003 Barcelona, Spain
| | - A. Bosch-Comas
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - E. Bordiú
- Laboratorio de Endocrinología, Hospital Clínico San Carlos de Madrid, 28040 Madrid, Spain
| | - R. Carmena
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Department of Medicine and Endocrinology, Hospital Clínico Universitario de Valencia, 40010 Valencia, Spain
| | - R. Casamitjana
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Biomedic Diagnostic Centre, Hospital Clínic de Barcelona, 08007 Barcelona, Spain
| | - L. Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Barakaldo, Spain
| | - C. Castell
- Public Health Division, Department of Health, Autonomous Government of Catalonia, Barcelona, Spain
| | - M. Catalá
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Department of Medicine and Endocrinology, Hospital Clínico Universitario de Valencia, 40010 Valencia, Spain
| | - E. Delgado
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, 33006 Oviedo, Spain
| | - J. Franch
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP—Fundació Jordi Gol), Barcelona, Spain
| | - S. Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Barakaldo, Spain
| | - J. Girbés
- Diabetes Unit, Hospital Arnau de Vilanova, 46015 Valencia, Spain
| | - R. Gomis
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Endocrinology and Diabetes Unit, Hospital Clínic de Barcelona, Universitat de Barcelona (UB), 08007 Barcelona, Spain
| | - G. Gutiérrez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Diabetes Research Group, Hospital Universitario de Cruces, UPV-EHU, Barakaldo, Spain
| | | | - M. T. Martínez-Larrad
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Lipids and Diabetes Laboratory, Hospital Clínico San Carlos de Madrid, Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - E. Menéndez
- Department of Endocrinology and Nutrition, Hospital Central de Asturias, 33006 Oviedo, Spain
| | | | - E. Ortega
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Endocrinology and Diabetes Unit, Hospital Clínic de Barcelona, Universitat de Barcelona (UB), 08007 Barcelona, Spain
| | - G. Pascual-Manich
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - G. Rojo-Martínez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario Carlos Haya Málaga, Málaga, Spain
| | - M. Serrano-Rios
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Lipids and Diabetes Laboratory, Hospital Clínico San Carlos de Madrid, Profesor Martín Lagos s/n, 28040 Madrid, Spain
| | - S. Valdés
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario Carlos Haya Málaga, Málaga, Spain
| | - J. A. Vázquez
- Diabetes National Plan, Ministry of Health, Madrid, Spain
| | - J. Vendrell
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
- Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain
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15
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González-Clemente JM, Piniés JA, Calle-Pascual A, Saavedra A, Sánchez C, Bellido D, Martín-Folgueras T, Moraga I, Recasens A, Girbés J, Sánchez-Zamorano MA, Mauricio D. Cardiovascular risk factor management is poorer in diabetic patients with undiagnosed peripheral arterial disease than in those with known coronary heart disease or cerebrovascular disease. Results of a nationwide study in tertiary diabetes centres. Diabet Med 2008; 25:427-34. [PMID: 18341592 DOI: 10.1111/j.1464-5491.2008.02402.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [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: 12/25/2022]
Abstract
AIMS To assess whether patients with Type 2 diabetes mellitus and unrecognized peripheral arterial disease (PAD), detected by the ankle-brachial index (ABI), have poorer cardiovascular risk factor management (CVRFs) and receive fewer medications than patients previously diagnosed with coronary heart disease (CHD) or cerebrovascular disease (CVD). METHODS In 31 diabetes centres throughout Spain, 1303 patients with Type 2 diabetes mellitus were screened for PAD using the ABI. Patient history of CHD and CVD and treatment and control of CVRFs were recorded. RESULTS Forty-one patients had an ABI > 1.30 and were excluded, leaving 1262 patients (age 65.3 +/- 7.7 years) for the study. Of those screened, 790 patients had a normal ABI (ABI > 0.9) and no known history of CHD or CVD (no CHD/CVD/PAD group), 194 had unrecognized PAD (ABI < or = 0.9) with no known history of CHD or CVD (undiagnosed PAD group) and 278 had a known history of CHD and/or CVD (CHD/CVD group). The undiagnosed PAD group had higher low-density lipoprotein (LDL) cholesterol (2.9 +/- 0.83 vs. 2.4 +/- 0.84 mmol/l; P < 0.001) and systolic blood pressure (150 +/- 20 vs. 145 +/- 21 mmHg; P < 0.001) compared with the CHD/CVD group. They were less likely to take statins (56.9 vs. 71.6%; P < 0.001), anti-hypertensive agents (75.9 vs. 90.1%, P = 0.001), and anti-platelet agents (aspirin, 28.7 vs. 57.2%; P < 0.001; clopidogrel, 5.6 vs. 20.9%; P < 0.001) and more likely to smoke (21.0 vs. 9.2%; P < 0.001). Higher LDL in the undiagnosed PAD group was associated with the underutilization of statins. CONCLUSIONS Measurement of ABI detected a significant number of patients with PAD, who did not have CHD or CVD, but whose CVRFs were under treated and poorly controlled compared with subjects with CHD and/or CVD.
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Carreño M, Girbés J, Malluguiza R, Serrano S, Matias-Guiu X, Tudela J, Alfayate R, Lagarda H. [Usefulness of RET proto-oncogene in the diagnosis of hereditary-type medullary carcinoma of the thyroid. Correlation with surgical findings]. Acta Otorrinolaringol Esp 2001; 52:57-63. [PMID: 11269881 DOI: 10.1016/s0001-6519(01)78178-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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: 11/15/2022]
Abstract
In about 25% of cases medullary thyroid carcinoma (MTC) is hereditary. In this group is possible to detect germline point mutations of the RET proto-oncogene in about 95% of the studied cases. The purpose of the present paper is to confirm the value of the RET in the screening of the hereditary MTC. We studied 43 subjects at risk for a Multiple Endocrine Neoplasia Type 2A Syndrome. RET analysis was positive for MEN 2A in 22 subjects. Fifteen of the 22 have undergone a total thyroidectomy at our facility. Histopathological study of the surgical specimens confirmed the presence of a MTC in all the cases. According with our experience. RET analysis is a 100% sensitive and specific method of hereditary MTC screening, and we think it has obvious advantages over the calcitonin tests in technical, economic and ethic aspects.
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Affiliation(s)
- M Carreño
- Servicio de Otorrinolaringología, Hospital General de Elda.
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17
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Alonso E, Girbés J, García-España A, Rubio V. Changes in urea cycle-related metabolites in the mouse after combined administration of valproic acid and an amino acid load. Arch Biochem Biophys 1989; 272:267-73. [PMID: 2502068 DOI: 10.1016/0003-9861(89)90219-1] [Citation(s) in RCA: 21] [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: 01/01/2023]
Abstract
Increased blood ammonia was induced in fasting mice by ip administration of 200 mg/kg Na-valproate followed 1 h later by 13 and 4 mmol/kg alanine and ornithine, respectively. When valproate was not used blood or liver ammonia was not increased, but increases were observed in liver glutamate (5-fold), glutamine (2-fold), aspartate (5-fold), acetylglutamate (15-fold), citrulline (35-fold), argininosuccinate (11-fold), arginine (11-fold), and urea (3-fold). The level of carbamoyl phosphate (less than 2 nmol/g) was, by far, the lowest of all urea cycle intermediates. The large increase in citrulline indicates that argininosuccinate synthesis was limiting, and that the increase in acetylglutamate induced a considerable activation of carbamoyl phosphate synthetase, which agrees with theoretical expectations, irrespective of the actual KD value for acetylglutamate. Pretreatment with valproate resulted in lower hepatic levels of glutamate, glutamine, aspartate, acetyl-CoA, and acetylglutamate. At the level found of acetylglutamate the activation of carbamoyl phosphate synthetase would be expected to be similar to that without valproate. Indeed, the levels of citrulline were similar with or without valproate. Argininosuccinate, arginine, and urea levels exhibited little if any change. Although the model used may not replicate exactly the situation in patients, from our results it appears that changes in citrullinogenesis or in other steps of the urea cycle do not account for the increase in blood ammonia induced by valproate, and it is proposed that valproate may alter glutamine metabolism.
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Affiliation(s)
- E Alonso
- Laboratory of Cell Chemistry, Instituto de Investigaciones Citológicas de la Caja de Ahorros de Valencia (Centro asociado del CSIC), Spain
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