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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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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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Aguayo A, Urrutia I, González-Frutos T, Martínez R, Martínez-Indart L, Castaño L, Gaztambide S. Prevalence of diabetes mellitus and impaired glucose metabolism in the adult population of the Basque Country, Spain. Diabet Med 2017; 34:662-666. [PMID: 27353285 DOI: 10.1111/dme.13181] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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] [Accepted: 06/27/2016] [Indexed: 01/13/2023]
Abstract
AIMS To assess the prevalence of diabetes mellitus and impaired glucose metabolism in the Basque Country and their relationship with cardiovascular risk factors. METHODS A population-based, cross-sectional, cluster sampling design study was carried out in an adult (≥18 years) Basque population. A total of 847 participants completed a questionnaire on personal and family medical history and lifestyle. Anthropometric variables and blood pressure were measured and biochemical analysis and an oral glucose tolerance test (75 g) were also performed. RESULTS The total prevalence of diabetes was 10.6% (95% CI 8.65-12.95). Among them 6.3% (95% CI 4.79-8.22) had previously been diagnosed and 4.3% (95% CI 3.04-5.92) were not aware that they had diabetes. Impaired glucose tolerance was present in 7.2% (95% CI 5.53-9.15) and impaired fasting glucose in 3.8% (95% CI 2.64-5.37) of the population. In total, 21.6% of the population had some type of glucose metabolism disturbance, with a higher rate among men (28.3 vs 16.3%; P<0.001) and with the rate increasing with age. Risk factors independently associated with the development of diabetes were: male sex [odds ratio 4.58 (95% CI 2.34-8.97)]; abdominal obesity [odds ratio 2.80 (95% CI 1.47-5.36)]; high triglyceride levels [odds ratio 2.46 (95% CI 1.26-4.81)]; hypertension [odds ratio 2.40 (95% CI 1.16-4.96)]; family history of diabetes [odds ratio 2.30 (95% CI 1.25-4.24)]; high LDL cholesterol levels [odds ratio 1.83 (95% CI 1.01-3.31)] and older age [odds ratio 1.08 (95% CI 1.05-1.10)]. CONCLUSIONS The prevalence of diabetes in the Basque Country was lower than in Spain and was independently associated with family history of diabetes and with cardiovascular risk factors such as abdominal obesity, hypertension, high LDL cholesterol levels and high triglyceride levels, which were also observed in those with prediabetes.
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Affiliation(s)
- A Aguayo
- BioCruces Research Institute, Cruces University Hospital, University of the Basque Country (UPV/EHU), Bizkaia, Spain
- CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), CIBERER (Spanish Biomedical Research Centre in Rare Diseases), Madrid, Spain
| | - I Urrutia
- BioCruces Research Institute, Cruces University Hospital, University of the Basque Country (UPV/EHU), Bizkaia, Spain
- CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), CIBERER (Spanish Biomedical Research Centre in Rare Diseases), Madrid, Spain
| | - T González-Frutos
- BioCruces Research Institute, Cruces University Hospital, University of the Basque Country (UPV/EHU), Bizkaia, Spain
- CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), CIBERER (Spanish Biomedical Research Centre in Rare Diseases), Madrid, Spain
| | - R Martínez
- BioCruces Research Institute, Cruces University Hospital, University of the Basque Country (UPV/EHU), Bizkaia, Spain
- CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), CIBERER (Spanish Biomedical Research Centre in Rare Diseases), Madrid, Spain
| | - L Martínez-Indart
- BioCruces Research Institute, Cruces University Hospital, University of the Basque Country (UPV/EHU), Bizkaia, Spain
| | - L Castaño
- BioCruces Research Institute, Cruces University Hospital, University of the Basque Country (UPV/EHU), Bizkaia, Spain
- CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), CIBERER (Spanish Biomedical Research Centre in Rare Diseases), Madrid, Spain
| | - S Gaztambide
- BioCruces Research Institute, Cruces University Hospital, University of the Basque Country (UPV/EHU), Bizkaia, Spain
- CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), CIBERER (Spanish Biomedical Research Centre in Rare Diseases), Madrid, Spain
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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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Gaztambide S, Vazquez F, Castaño L. Diagnosis and treatment of multiple endocrine neoplasia type 1 (MEN1). MINERVA ENDOCRINOL 2013; 38:17-28. [PMID: 23435440 DOI: pmid/23435440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Multiple endocrine neoplasia type 1 (MEN1; formerly known as Wermer syndrome) is a rare disorder characterized by the combined occurrence of two or more tumors involving parathyroid, pancreatic islets and anterior pituitary glands; some other tumors have also been described. In most cases it is inherited in an autosomic dominant manner but it may occur sporadically. The MEN1 gene (MEN1) is located on chromosome 11q13, it is composed of ten exons that encode a 610 amino acid protein called menin. Menin, with no homology to any other known protein, interacts with several different proteins and plays an important role in regulation of cell growth, cell cycle, genome stability and synapse plasticity. Familiar MEN1 has a high degree of penetrance with clinical or biochemical manifestations of the disease in 80% and 98%, respectively, by the fifth decade. Clinical manifestations are related to tumor localizations and their secretory products. Hyperparathyroidism is the most common feature of MEN1 (95% of patients), pancreatic islet tumors or pancreatic NET (neuroendocrine tumor) occur in 40-70% and pituitary tumors in 30-40% of MEN 1 patients. In addition, other tumors, such as adrenal cortical tumors, carcinoid tumors, lipomas, angiofibromas, colagenomas and meningiomas may be present. Occurrence of de novo mutations appear in 10% of all patients with MEN1. A correlation between genotype and phenotype has not been found and, even more, combinations of these tumors may be different in members of the same family. Untreated patients have a decreased life expectancy, with a 50% probability of death by the age of 50 years and the cause of death is mostly directly related to MEN1, being the most important causes malignant pancreatic neuroendocrine tumors (NET) and thymic carcinoids. Treatment for each type of endocrine tumor is generally similar as in non-MEN1 associated tumors, but results are less successful according to multiplicity of tumors, higher metastatic disease, larger and more aggressive tumors and more resistant to treatment. The prognosis might improve by preclinical tumor diagnosis and appropriated treatment.
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Affiliation(s)
- S Gaztambide
- Hospital Universitario Cruces - Ciberer-UPV-EHU, Barakaldo, Spain.
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6
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Muñoz Torres M, Jodar Gimeno E, Reyes Garcia R, Martínez Diaz Guerra G, Amado JA, Gaztambide S, Quesada Gómez JM. Results from a national survey on the management of primary hyperparathyroidism. J Endocrinol Invest 2012; 35:957-63. [PMID: 22183161 DOI: 10.3275/8184] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Management of primary hyperparathyroidism (PHPT) continues to be challenging. At the Third International Workshop on PHPT, recent data on this disease were reviewed and new clinical recommendations were developed. There are few data on the influence of new guidelines in clinical practice. AIM We designed an online survey that was sent to all Spanish hospital endocrinology services. METHODS The questionnaire included 28 questions about diagnosis and management of PHPT. Ninety-nine of 131 sites (76%), giving health coverage to 70% of Spanish population, completed the survey. RESULTS The reported incidence of PHPT was 9.95/100,000 person-years. Heighty percent of patients were asymptomatic. Each center performed a median (Q1, Q3) of 12 (6, 20) parathyroidectomies/year. The median (Q1, Q3) percentage of curative interventions (at first trial) was 90% (80, 95). The main reasons for not performing surgery were, by decreasing frequency: surgery contraindication, patient's refusal, loss of monitoring, limited surgery experience. Localization techniques were used in 83% of cases. The main criteria for parathyroidectomy in asymptomatic patients were Ca≥2.875 mmol/l (79%), Tscore ≤-2.5 SD at any site (91%), age <50 yr (80%) and glomerular filtration rate <60 ml/min/1.73 m 2 (82%). Minimally invasive surgery was performed in 42% of centers. Frequency of biochemistry and bone density determinations for non-surgically managed patients was in accordance with international guidelines. CONCLUSIONS The clinical practice of Spanish endocrinologists is consistent with the recommendations of the guidelines from the Third International Workshop for the management of PHPT.
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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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8
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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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9
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Bilbao JR, Calvo B, Aransay AM, Martin-Pagola A, Perez de Nanclares G, Aly TA, Rica I, Vitoria JC, Gaztambide S, Noble J, Fain PR, Awdeh ZL, Alper CA, Castaño L. Conserved extended haplotypes discriminate HLA-DR3-homozygous Basque patients with type 1 diabetes mellitus and celiac disease. Genes Immun 2006; 7:550-4. [PMID: 16929349 DOI: 10.1038/sj.gene.6364328] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The major susceptibility locus for type 1 diabetes mellitus (T1D) maps to the human lymphocyte antigen (HLA) class II region in the major histocompatibility complex on chromosome 6p21. In southern European populations, like the Basques, the greatest risk to T1D is associated with DR3 homo- and heterozygosity and is comparable to that of DR3/DR4, the highest risk genotype in northern European populations. Celiac disease (CD) is another DR3-associated autoimmune disorder showing certain overlap with T1D that has been explained by the involvement of common genetic determinants, a situation more frequent in DR3-rich populations, like the Basques. As both T1D- and CD-associated HLA alleles are part of conserved extended haplotypes (CEH), we compared DR3-homozygous T1D and CD patients to determine whether CEHs were equally distributed between both disorders or there was a differential contribution of different haplotypes. We observed a very pronounced distribution bias (P<10(-5)) of the two major DR3 CEHs, with DR3-B18 predominating in T1D and DR3-B8 in CD. Additionally, high-density single nucleotide polymorphism (SNP) analysis of the complete CEH [A*30-B*18-MICA*4-F1C30-DRB1*0301-DQB1*0201-DPB1*0202] revealed extraordinary conservation throughout the 4.9 Mbp analyzed supporting the existence of additional diabetogenic variants (other than HLA-DRB1*0301-DQB1*0201), conserved within the DR3-B18 CEH (but not in other DR3 haplotypes) that could explain its enhanced diabetogenicity.
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Affiliation(s)
- J R Bilbao
- Endocrinology and Diabetes Research Group, Hospital de Cruces, Barakaldo, Bizkaia, Spain
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10
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Unson CG, Siccion E, Gaztambide J, Gaztambide S, Mahoney Trella P, Prestwood K. Nonadherence and Osteoporosis Treatment Preferences of Older Women: A Qualitative Study. J Womens Health (Larchmt) 2003; 12:1037-45. [PMID: 14709192 DOI: 10.1089/154099903322643965] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Physicians must have an understanding of patients' medication beliefs in order to enhance medication adherence. To increase understanding, this study examined how beliefs about medication and four osteoporosis treatments influenced treatment selection and adherence. METHODS Six focus groups, three with 28 African Americans and one with 11 non-Hispanic white women, were conducted in English. Two groups with 16 Hispanics were conducted in Spanish. The convenience sample was recruited from senior centers and housing in lower socioeconomic geographic areas. The average age was 74.8 +/- 1.1 years. RESULTS Adherence was associated with recognition of the serious consequences of nonadherence, realization of the beneficial effects, and the belief that medicines are not harmful. Doubts about physicians' competence to prescribe appropriate drugs were also revealed. Women who thought they were unlikely to fracture or perceived fracture outcomes as not severe chose no treatment. If they identified a need, they weighed benefits against the attendant risks to find the best alternative among the affordable options. Price considerations eliminated raloxifene and alendronate. Consideration of side effects eliminated estrogen and raloxifene. Calcium was viewed as a low-cost, low-risk alternative. Those who could afford alendronate and who viewed its side effects as preventable preferred it. Benefit and risk assessments may have been biased by fear of cancer and thromboembolic events. CONCLUSIONS Women's beliefs about necessity of treatment, medication safety, cost of treatment, and treatment goals appear critical to osteoporosis treatment selection and adherence.
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Affiliation(s)
- C G Unson
- Claude Pepper Older Americans Independence Center, UConn Center on Aging, University of Connecticut Health Center, Farmington, Connecticut 06030-6147, USA.
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11
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Webb SM, Prieto L, Badia X, Albareda M, Catalá M, Gaztambide S, Lucas T, Páramo C, Picó A, Lucas A, Halperin I, Obiols G, Astorga R. Acromegaly Quality of Life Questionnaire (ACROQOL) a new health-related quality of life questionnaire for patients with acromegaly: development and psychometric properties. Clin Endocrinol (Oxf) 2002; 57:251-8. [PMID: 12153605 DOI: 10.1046/j.1365-2265.2002.01597.x] [Citation(s) in RCA: 128] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To develop a disease-specific questionnaire suitable to measure health-related quality of life (HRQOL) in acromegaly (ACROQOL). DESIGN, PATIENTS AND MEASUREMENTS For the development of the ACROQOL questionnaire different sources of information were used: First, a literature search was performed to identify relevant papers describing the impact of acromegaly in HRQOL. Second, 10 endocrinologists identified the main domains of impact on HRQOL in patients with acromegaly. Third, 10 in-depth, semistructured interviews were conducted in acromegalic patients to identify domains and items related to the self-perceived impact of acromegaly in patients' life. Qualitative analyses of the information were performed identifying domains and items to be included in the questionnaire. Those items considered ambiguous, complicated to read, double-barrelled, with jargon terms, too long, or negatively worded were excluded. Each remaining item was subsequently rated by the same panel of endocrinologists and experts in HRQOL evaluation, and assessed according to clarity of wording, frequency of occurrence and importance among patients with acromegaly. Analysis of internal consistency of the questionnaire was evaluated with a Cronbach's Alpha. A preliminary questionnaire was administered to 72 patients with acromegaly. Rasch analysis (dichotomous logistic response model) of the answers given by these patients allowed parameter estimates and model data fit indices to be computed and misfitting items deleted. Frequency of occurrence and degree of agreement with the statements were selected as response choices in a 5-point Likert type scale. RESULTS The following domains related to HRQOL in acromegaly were identified: physical and psychological functions, social, daily activities, symptoms, cognition, general health perception, sleep, sexual function, pain, energy and body image. An initial set of 204 expressions were identified from the initial transcripts of the patient interviews. After elimination of ambiguous or unclear expressions, 142 items remained drafted in question form. From the quantitative analysis of the item rank position within each of the three areas of clarity, frequency and importance, the 38-item questionnaire was produced, with satisfactory internal consistency (Cronbach's Alpha 0.94). Rasch analysis produced a further reduction to the final 22-item questionnaire (Cronbach's Alpha 0.91) containing two scales that evaluate physical (eight questions) and psychological aspects related to appearance and personal relations (seven items each). The evaluation of the item parameters confirmed the construct validity of the new instrument. The substantial reliability of the questionnaire suggested the sample was well targeted by the questionnaire. The initial Spanish version was translated into English and presented to five English-speaking Australian patients with acromegaly to assess and correct for comprehension, clarity, cultural relevance and suitable wording. CONCLUSIONS We present the ACROQOL questionnaire, developed and preliminarily validated to specifically assess HRQOL in patients with acromegaly.
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Affiliation(s)
- S M Webb
- Departments of Endocrinology, Hospital Sant Pau, Autonomous University, Barcelona, Spain.
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12
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Abstract
Although most pituitary neoplasms are benign, some grow rapidly, spreading to extrasellar tissues. Definition of these 'giant' pituitary adenomas (PAs) is not clear. In order to clarify this question, we studied all pituitary macroadenomas operated in our hospital during the last 20 years, differentiating those with diameter > or = 3 cm (n = 43) and attempting to identify their typical features and prognosis. The reason for consultation was local in 58.3% of giant PAs, hormonal in 22.9% and tumour recurrence in 16.7%. Surgery was performed via a trans-sphenoidal approach in 92.5% of cases and succeeded in completely removing the tumour in only 27% of cases. In conclusion, we found that giant PAs are not a special type but the extreme case in the gradient of invasiveness of tumours of adenohypophyseal origin. They are characterized by a higher frequency of neuro-ophthalmological symptoms and hormonal deficits, and poorer response to surgical treatment.
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Affiliation(s)
- J Garibi
- Department of Neurosurgery, Cruces Hospital, Bilbao, Spain.
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13
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Bernabeu I, Gaztambide S, Menéndez E, Webb S, García-Patterson A, Díaz M, Ferrer J, Biarnés J, Lecube A, Henrich G, Herschbach P, Blum W, MaríNk F. Características de la versión española del cuestionario de calidad de vida QLSM-H en sujetos adultos con deficiencia de hormona de crecimiento tratados con somatotropina. Estudio piloto. ACTA ACUST UNITED AC 2002. [DOI: 10.1016/s1575-0922(02)74440-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chanson P, Boerlin V, Ajzenberg C, Bachelot Y, Benito P, Bringer J, Caron P, Charbonnel B, Cortet C, Delemer B, Escobar-Jiménez F, Foubert L, Gaztambide S, Jockenhoevel F, Kuhn JM, Leclere J, Lorcy Y, Perlemuter L, Prestele H, Roger P, Rohmer V, Santen R, Sassolas G, Scherbaum WA, Schopohl J, Torres E, Varela C, Villamil F, Webb SM. Comparison of octreotide acetate LAR and lanreotide SR in patients with acromegaly. Clin Endocrinol (Oxf) 2000; 53:577-86. [PMID: 11106918 DOI: 10.1046/j.1365-2265.2000.01134.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE The most effective option for the medical treatment of patients with acromegaly is the use of somatostatin analogues. Long-acting depot formulations for intramuscular injection of two somatostatin analogues have recently become available: octreotide acetate LAR (Sandostatin LAR, Novartis Pharma AG) and lanreotide SR (Somatuline, Ipsen Biotech). We wished to compare efficacy of octreotide LAR and lanreotide SR in acromegalic patients. PATIENTS AND METHODS A group of 125 patients with acromegaly (67 females; mean age, 47 years; 59 patients had previous pituitary irradiation) from 26 medical centres in France, Spain and Germany were studied. Before the study, all patients had been treated with intramuscular injections of lanreotide SR (mean duration, 26 months) at a dose of 30 mg which was injected every 10 days in 64 and every 14 days in 61 patients, respectively. All patients were switched from lanreotide SR to intramuscular injections of 20 mg of octreotide LAR once monthly for three months. In order to obtain efficacy and safety data of lanreotide SR under study conditions, it was decided to randomly assign at day 1, in a 3 : 1 ratio, the time point of the treatment switch; 27 of the patients were randomly assigned to continue the lanreotide SR treatment for the first 3 months of the study (group A); they were on octreotide LAR 20 mg from month 4-6. The other 98 patients were assigned to be switched to treatment with octreotide LAR 20 mg at day 1 (group B). In group B patients, octreotide LAR treatment was continued until month 6, with an adjustment of the dose based on GH levels obtained at month 3. RESULTS The mean GH concentration decreased from 9.6 +/- 1.3 mU/l at the last evaluation on lanreotide SR to 6.8 +/- 1.0 mU/l after three injections of octreotide LAR (P < 0.001). The percentages of patients with mean GH values < or = 6.5 mU/l (2.5 microg/l) and < or = 2.6 mU/l (1.0 microg/l) at the last evaluation on lanreotide SR were 54% and 14%, and these values increased after 3 months treatment with octreotide LAR to 68% and 35% (P < 0.001), respectively. IGF-I levels were normal in 48% at the last evaluation on lanreotide SR and in 65% after 3 months on octreotide LAR (P < 0.001). Patients with pre-study pituitary irradiation had lower mean GH and IGF-I concentrations. But the effects of the treatment change did not differ between the irradiated and the nonirradiated patients. In general both drugs were well tolerated. CONCLUSION Octreotide LAR 20 mg administered once monthly was more effective than lanreotide SR 30 mg administered 2 or 3 times monthly in reducing GH and IGF-I in patients with acromegaly.
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Affiliation(s)
- P Chanson
- Novartis Pharma AG, Clinical Research and Development, Basel, Switzerland
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15
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Vázquez JA, Gaztambide S, Soto-Pedre E. [10-year prospective study on the incidence and risk factors for type 2 diabetes mellitus]. Med Clin (Barc) 2000; 115:534-9. [PMID: 11141379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND The aims of this study were to determine the incidence of diabetes mellitus type 2 and to define the associated risk factors. PATIENTS AND METHOD A 10-year prospective study was done over 584 people identified by screening of the Lejona (Vizcaya, Spain) adult population in 1985. Data on age, sex, body mass index, family history of diabetes mellitus and blood pressure were collected. Also an oral glucose tolerance test was done following the criteria recommended by the WHO. RESULTS Age-adjusted cumulative incidence per year was 8 per 1,000 persons. In a multivariate logistic regression analysis, impaired glucose tolerance was the major predictor of worsening to diabetes (relative risk 4.17; 95% confidence interval 1.80-9.63). Age and sex were also statistically significant predictors (p < 0.05), and family history of diabetes was almost significant (p = 0.057). Body mass index was not an independent and significant risk factor in this study. However, the rise in body mass index was larger in those who progressed to diabetes mellitus type 2 than in those who did not. CONCLUSIONS The incidence of diabetes mellitus type 2 found in Lejona was similar to that reported in other european countries. Subjects having impaired glucose tolerance as well as those with elevated blood glucose levels are at higher risk of worsening to diabetes mellitus type 2. Body mass index seems to play a precipitating role in the progression to diabetes mellitus type 2.
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Affiliation(s)
- J A Vázquez
- Servicio de Endocrinología. Hospital de Cruces. Baracaldo. Vizcaya.
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Pérez de Nanclares G, Castaño L, Gaztambide S, Bilbao JR, Pi J, González ML, Vázquez JA. Excess iron storage in patients with type 2 diabetes unrelated to primary hemochromatosis. N Engl J Med 2000; 343:891. [PMID: 11001697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Abstract
Medical treatment is the elective therapy for patients with gastrinoma when the tumor is not found at surgery or is unresectable or when there is a metastatic disease. H2-blockers and omeprazol are able to control gastric acid secretion and, in addition, somatostatin analogues decrease gastrin levels. A new long-acting and slow release formulation of a somatostatin analogue (lanreotide, SR-L) has been developed. We treated two patients suffering from gastrinoma, total gastrectomy and hepatic metastases with 30 mg intramuscular injections of SR-L every 15 and 10 days, respectively, for a seven-month period. After the treatment, gastrin levels decreased from 35,494 and 15,086 ng/l to 3,211 and 167 ng/l (92 and 98% below pre-treatment levels) in case 1 and 2 respectively, with a relief of symptoms and no side effects.
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Affiliation(s)
- S Gaztambide
- Department of Endocrinology, Universidad del País Vasco, Hospital de Cruces, Baracaldo, Spain
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Calvo B, Bilbao JR, Urrutia I, Eizaguirre J, Gaztambide S, Castaño L. Identification of a novel nonsense mutation and a missense substitution in the vasopressin-neurophysin II gene in two Spanish kindreds with familial neurohypophyseal diabetes insipidus. J Clin Endocrinol Metab 1998; 83:995-7. [PMID: 9580132 DOI: 10.1210/jcem.83.3.4658] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [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: 02/07/2023]
Abstract
Familial neurohypophyseal diabetes insipidus (FNDI) is an autosomal dominant disease caused by deficiency in the antidiuretic hormone arginine vasopressin (AVP) encoded by the AVP-neurophysin II (AVP-NPII) gene on chromosome 20p13. In this study, we analyzed two families with FNDI using direct automated fluorescent, solid phase, single-stranded DNA sequencing of PCR-amplified AVP-NPII DNA. In one of the families, affected individuals presented a novel nonsense mutation in exon 3 of the gene, consisting in a G to T transition at nucleotide 2101, which produces a stop signal in codon 82 (Glu) of NPII. The premature termination eliminates part of the C-terminal domain of NPII, including a cysteine residue in position 85, which could be involved in the correct folding of the prohormone. In the second family, a G279A substitution at position -1 of the signal peptide was observed in all affected individuals. This missense mutation, which replaces Ala with Thr, is frequent among FNDI patients and is thought to reduce the efficiency of cleavage by signal peptidases.
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Affiliation(s)
- B Calvo
- Department of Endocrinology, Hospital de Cruces, Barakaldo-Basque Country, Spain
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Piniés JA, Cairo G, Gaztambide S, Vazquez JA. Course and prognosis of 132 patients with diabetic non ketotic hyperosmolar state. Diabete Metab 1994; 20:43-8. [PMID: 8056135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
One hundred and thirty two episodes of diabetic non ketotic hyperosmolar states were studied after a prospective schedule of treatment was designed. The admission data, the prognostic factors and their outcome were analyzed. Initial high osmolarity, urea and sodium plasma levels and low plasma pH were related to the admission level of consciousness (p < 0.01). High glucose, osmolarity, urea and sodium plasma levels at entry were related to the admission level of dehydration (p < 0.01). In multivariate regression analysis, osmolarity was the most influential variable in both the level of consciousness and the admission level of dehydration (p < 0.0001). Twenty two patients died (16.9%). Septic shock was the most frequent cause of death (31%) and mortality was higher in patients with cardiovascular disease (acute myocardial infarction or stroke) as the precipitating factor for diabetic hyperosmolar state (p < 0.002). Older age, low blood pressure, low sodium, pH and bicarbonate plasma levels, and high urea plasma levels were related to mortality (p < 0.01). In multiple regression analysis, urea was the most influential mortality risk factor (p < 0.0118). Non survivors received higher doses of insulin than survivors (p < 0.01). All these data suggest that it is not the hyperosmolarity itself, but the hemodynamical state of the patients, which is the most influential factor on the prognosis of a diabetic hyperosmolar state.
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Affiliation(s)
- J A Piniés
- Endocrinology Unit, Hospital de Cruces, Baracaldo, Vizcaya, Spain
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Abstract
Although morbility and mortality in acromegaly are higher than in the general population, there have been very few previous epidemiological studies. This study tries to answer "why". Seventy-four patients affected by acromegaly in Vizcaya (Spain) between 1970 and 1989 were considered for an epidemiological study. The prevalence of known cases at the end of 1989 was 60 per million inhabitants. The average incidence of newly diagnosed cases was 3.1 per million people per year. Unexpectedly, acromegaly was more frequent in women (n = 48) than in men (n = 26), with a ratio of 1.8:1. Mean age at diagnosis was significantly higher in women (46.1 +/- 2.2 yr) than in men (39.5 +/- 2.2 yr) (p < 0.05) There was a positive correlation between age at diagnosis and the estimated duration of the disease (r = 0.56, p < 0.05) and a negative one between age and basal GH serum levels (r = -0.52 p < 0.002). The age at diagnosis was significantly higher in patients with invasive tumors (grade III and IV) than in those with enclosed tumors (grade I and II) (47.7 +/- 1.8 vs 40.1 +/- 3.3 p < 0.05). In general, mortality was higher than the expected for the control population (standardized mortality ratio, SMR = 3.2, 95% confidence interval. Cl = 1.55-5.93). However, mortality was higher in men (SMR = 7, 95% Cl = 2.81-14.4) but not in women (SMR = 1.4 95% Cl = 0.29-4.17).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J Etxabe
- Department of Endocrinology, Hospital de Cruces, Universidad del Paìs Vasco, Vizcaya, Spain
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Garcia-sanchez J, Gaztambide S, Vazquez JA. Hypoglycaemic coma in the puerperium as the first manifestation of an insulinoma. J OBSTET GYNAECOL 1993. [DOI: 10.3109/01443619309151824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Peñalva A, Gaztambide S, Vazquez JA, Dieguez C, Casanueva FF. Role of cholinergic muscarinic pathways on the free fatty acid inhibition of GH responses to GHRH in normal men. Clin Endocrinol (Oxf) 1990; 33:171-6. [PMID: 2225476 DOI: 10.1111/j.1365-2265.1990.tb00480.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [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] [Indexed: 12/30/2022]
Abstract
In order to explore the mechanisms by which free fatty acids (FFA) inhibit GH secretion, we studied the effect of the acetylcholinesterase inhibitor pyridostigmine (120 mg p.o.) on the FFA blockade of GH responses to the administration of GHRH (100 micrograms i.v.) in seven normal subjects. GHRH-induced GH secretion was significantly reduced following elevation of circulating FFA levels by lipid-heparin infusion and significantly potentiated by previous pyridostigmine treatment. Peak GH levels following combined administration of pyridostigmine plus lipid-heparin plus GHRH were significantly higher (P less than 0.01) than after GHRH alone and significantly lower than after pyridostigmine plus GHRH (P less than 0.01). In conclusion, central cholinergic activation by pyridostigmine, with the presumed reduction in somatostatin discharge, reversed the blocking effect of FFA on GHRH-stimulated GH release. Conversely, FFA were able to reduce even a maximal GH stimulation by pyridostigmine plus GHRH.
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Affiliation(s)
- A Peñalva
- Department of Medicine, Hospital General de Galicia, Spain
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Bahillo del Río MT, Burgos-Bretones J, Gaztambide S, Vázquez JA, Rivera-Pomar JM. [Clinico-pathologic correlation of muscular involvement in hypothyroid patients before and after treatment]. Med Clin (Barc) 1984; 83:697-701. [PMID: 6521525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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