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Garcia-Etxebarria K, Gayoso L, Arzallus T, Montalvo I, Lizasoain J, Izagirre A, Ezkurra A, D’Amato M, Etxeberria U, Bujanda L. A 1 year course of starch- and sucrose-reduced diet used by irritable bowel syndrome patients with diarrhoea and the effect of genetic variants. Front Nutr 2023; 10:1268538. [PMID: 37955017 PMCID: PMC10639127 DOI: 10.3389/fnut.2023.1268538] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
Background Irritable bowel syndrome is a heterogeneous syndrome and it is difficult to find an effective treatment. Previously, a starch- and sucrose-reduced diet (SSRD) demonstrated promising short-term outcomes. It was proposed that genetic variants in the sucrose-isomaltase gene might influence this success. Our aim in this work was to extend the follow-up study to 1 year and to analyse the effect of the genetic variants of genes involved in starch and sucrose metabolism. Methods IBS-SSS questionnaire, IBS-QoL questionnaire and questionnaires about adherence, difficulty and food assessment were sent to 34 patients after 6 months and 1 year after the end of the dietary intervention. In addition, 11 genes involved in sucrose and starch metabolism were sequenced. Results Twenty-three participants responded to the 6 months follow-up and 16 to the 1 year follow-up. IBS-SSS total value increased 59.71% in the 6 months follow-up compared with the end of the intervention (p = 0.0018), and 55.39% in the 1 year follow-up (p = 0.0166); while IBS-QoL score decreased 24.09% (p = 0.0002) and 18.07% (p = 0.0022), respectively. The adherence decreased by 29.11% (p = 4.8 × 10-5) and 27.21% (p = 0.0054), respectively. In addition, carriers of pathogenic variants on the SI gene showed a slightly better performance than non-carriers. Finally, the participants showed less satisfaction over time with 18 allowed foods in the diet. Conclusion Over time the SSRD is difficult to follow and the genotype might affect the performance of the diet. Since this diet could be a promising therapeutic option, a larger cohort needs to be analysed to validate the results and to compare it with other diets.
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Affiliation(s)
- Koldo Garcia-Etxebarria
- Biodonostia, Gastrointestinal Genetics Group, Donostia-San Sebastián, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - Lucía Gayoso
- Technology Center in Gastronomy, Basque Culinary Center, BCC Innovation, Donostia-San Sebastián, Spain
- Basque Culinary Center, Faculty of Gastronomic Sciences, Mondragon Unibertsitatea, Donostia-San Sebastián, Spain
| | - Teresa Arzallus
- Biodonostia, Gastrointestinal Diseases Group, Universidad del País Vasco (UPV/EHU), Donostia-San Sebastián, Spain
| | - Isabel Montalvo
- Biodonostia, Gastrointestinal Diseases Group, Universidad del País Vasco (UPV/EHU), Donostia-San Sebastián, Spain
| | - Jacobo Lizasoain
- Biodonostia, Gastrointestinal Diseases Group, Universidad del País Vasco (UPV/EHU), Donostia-San Sebastián, Spain
| | - Arantzazu Izagirre
- Biodonostia, Gastrointestinal Diseases Group, Universidad del País Vasco (UPV/EHU), Donostia-San Sebastián, Spain
| | - Ander Ezkurra
- Biodonostia, Gastrointestinal Diseases Group, Universidad del País Vasco (UPV/EHU), Donostia-San Sebastián, Spain
| | - Mauro D’Amato
- Gastrointestinal Genetics Lab, CIC bioGUNE, Basque Research and Technology Alliance, Bilbao, Spain
- Ikerbasque, Basque Foundation for Sciences, Bilbao, Spain
- Department of Medicine and Surgery, LUM University, Bari, Italy
| | - Usune Etxeberria
- Technology Center in Gastronomy, Basque Culinary Center, BCC Innovation, Donostia-San Sebastián, Spain
- Basque Culinary Center, Faculty of Gastronomic Sciences, Mondragon Unibertsitatea, Donostia-San Sebastián, Spain
| | - Luis Bujanda
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
- Biodonostia, Gastrointestinal Diseases Group, Universidad del País Vasco (UPV/EHU), Donostia-San Sebastián, Spain
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Gayoso L, Garcia-Etxebarria K, Arzallus T, Montalvo I, Lizasoain J, D’Amato M, Etxeberria U, Bujanda L. The effect of starch- and sucrose-reduced diet accompanied by nutritional and culinary recommendations on the symptoms of irritable bowel syndrome patients with diarrhoea. Therap Adv Gastroenterol 2023; 16:17562848231156682. [PMID: 37153501 PMCID: PMC10155021 DOI: 10.1177/17562848231156682] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 01/25/2023] [Indexed: 05/09/2023] Open
Abstract
Background Irritable bowel syndrome (IBS) is a common gastrointestinal condition which entails a high burden in the quality of life (QoL) of patients. Nutritional interventions have been proposed to alleviate symptoms, since still no effective treatments exist for IBS. Objectives Our aim is to analyse the feasibility of the use of starch- and sucrose-reduced diet (SSRD). Design In this study, we used a SSRD accompanied by nutritional and culinary recommendations to measure the effects in IBS patients with diarrhoea. Methods In all, 34 participants completed a 4-week nutritional intervention based on SSRD. Symptoms, QoL and dietary habits were assessed by several questionnaires that were completed at the beginning, daily, after 2 weeks, at the end, and after 2 months. Results 85.29% of the participants reached the primary endpoint [reduction of 50 points or more in IBS-symptom severity scale (SSS)], and 58.82% the secondary endpoint (reduction of 50% or more in IBS-SSS). The relief of symptoms and improvement of the QoL were significant after 2 weeks of intervention, at the end and after 2 months. Dietary habits were consistent with the diet and high adherence was achieved. Conclusions SSRD and individualized nutritional and culinary guidance improved symptoms and QoL of IBS patients with diarrhoea, with a high adherence.
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Affiliation(s)
- Lucia Gayoso
- Technology Center in Gastronomy, Basque
Culinary Center, BCC Innovation, Donostia-San Sebastián, Spain
- Basque Culinary Center, Faculty of Gastronomic
Sciences, Mondragon Unibertsitatea, Donostia-San Sebastián, Spain
| | - Koldo Garcia-Etxebarria
- Gastrointestinal Genetics Group, Biodonostia,
Dr Beguiristain S/N, San Sebastian 20014, Spain
- Centro de Investigación Biomédica en Red de
Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, 08036,
Spain
| | - Teresa Arzallus
- Gastrointestinal Diseases Group, Universidad
del País Vasco (UPV/EHU), Biodonostia, San Sebastián, Spain
| | - Isabel Montalvo
- Gastrointestinal Diseases Group, Universidad
del País Vasco (UPV/EHU), Biodonostia, San Sebastián, Spain
| | - Jacobo Lizasoain
- Gastrointestinal Diseases Group, Universidad
del País Vasco (UPV/EHU), Biodonostia, San Sebastián, Spain
| | - Mauro D’Amato
- Gastrointestinal Genetics Lab, Basque Research
and Technology Alliance, CIC bioGUNE, Derio, Spain
- Ikerbasque, Basque Foundation for Sciences,
Bilbao, Spain
- Department of Medicine and Surgery, LUM
University, Casamassima, Italy
| | - Usune Etxeberria
- Technology Center in Gastronomy, Basque
Culinary Center, BCC Innovation, Donostia-San Sebastián, Spain
- Basque Culinary Center, Faculty of Gastronomic
Sciences, Mondragon Unibertsitatea, Donostia-San Sebastián, Spain
| | - Luis Bujanda
- Centro de Investigación Biomédica en Red de
Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
- Gastrointestinal Diseases Group, Universidad
del País Vasco (UPV/EHU), Biodonostia, San Sebastián, Spain
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Rodríguez‐Lago I, Aguirre U, Ramírez de la Piscina P, Muñagorri A, Zapata E, Higuera R, Montalvo I, Iriarte A, Fernández‐Calderón M, Arreba P, Carrascosa J, Cabriada JL, Barreiro‐de Acosta M. Subclinical bowel inflammation increases healthcare resources utilization and steroid use before diagnosis of inflammatory bowel disease. United European Gastroenterol J 2022; 11:9-18. [PMID: 36547009 PMCID: PMC9892483 DOI: 10.1002/ueg2.12352] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Previous data support that the inflammatory process underlying ulcerative colitis (UC) and Crohn's disease (CD) can start years before the diagnosis. The aim of this study was to determine if patients with an incidental diagnosis of UC or CD demonstrate an increase in healthcare utilization in the years preceding the symptomatic onset of the disease. METHODS We performed a multicenter, retrospective, hospital-based, case-control study. Patients with an incidental diagnosis of UC or CD during the colorectal cancer screening program at 9 hospitals were included. Cases were matched 1:3 and compared separately with two control populations: one including healthy non-IBD subjects adjusted by gender, age, and date, excluding those with visits to Gastroenterology; and a second control cohort of UC/CD patients with symptomatic onset. RESULTS A total of 124 patients with preclinical inflammatory bowel disease (IBD) were included (87 UC, 30 CD, 7 IBD unclassified; median age 56 years). Patients with preclinical IBD showed an increase in the number of visits to Primary Care up to 3 and 5 years before diagnosis (aIRR 1.59, 95% CI [1.37-1.86], p = 0.001; aIRR 1.43, 95% CI [1.24-1.67], p = 0.01) and more frequent use of steroids (aOR 2.84, 95% CI [1.21-6.69], p = 0.03; aOR 2.25, 95% CI [1.06-4.79], p = 0.04) compared to matched non-IBD healthy controls, respectively. In contrast, patients with a symptomatic onset visited Primary Care less frequently, but they had an increase in the number of visits to Emergency Department, specialist care, sick-leaves, CT/ultrasound examinations, and use of antibiotics or systemic steroids. CONCLUSIONS There is an increased need for medical assistance and use of systemic steroids during the presymptomatic phase of IBD. These results will help in establishing new tools for early identification of IBD in the future.
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Affiliation(s)
- Iago Rodríguez‐Lago
- Gastroenterology DepartmentHospital Universitario de GaldakaoBiocruces Bizkaia Health Research InstituteDeusto UniversityGaldakaoSpain
| | - Urko Aguirre
- Research UnitHospital Universitario de GaldakaoGaldakaoSpain,Research Network on Chronic Disease (REDISSEC)Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS)GaldakaoSpain,Deusto UniversityGaldakaoSpain
| | | | - Ana Muñagorri
- Gastroenterology DepartmentHospital Universitario DonostiaDonostiaSpain
| | - Eva Zapata
- Gastroenterology DepartmentHospital de MendaroMendaroSpain
| | - Rebeca Higuera
- Gastroenterology DepartmentHospital de UrdulizUrdulizSpain
| | | | - Ainara Iriarte
- Gastroenterology DepartmentHospital de BidasoaHondarribiaSpain
| | | | - Paz Arreba
- Gastroenterology DepartmentHospital Universitario de BasurtoBilbaoSpain
| | - Juan Carrascosa
- Gastroenterology DepartmentHospital de ZumárragaZumárragaSpain
| | - José Luis Cabriada
- Gastroenterology DepartmentHospital Universitario de GaldakaoBiocruces Bizkaia Health Research InstituteDeusto UniversityGaldakaoSpain
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Rodríguez-Lago I, Ramírez C, Merino O, Azagra I, Maiz A, Zapata E, Higuera R, Montalvo I, Fernández-Calderón M, Arreba P, Carrascosa J, Iriarte A, Muñoz-Navas M, Cabriada JL, Barreiro-de Acosta M. Early microscopic findings in preclinical inflammatory bowel disease. Dig Liver Dis 2020; 52:1467-1472. [PMID: 32601034 DOI: 10.1016/j.dld.2020.05.052] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/28/2020] [Accepted: 05/31/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The immune response involved in the pathogenesis of Inflammatory Bowel Disease (IBD) may be present years before the diagnosis, but the characteristics of the disease during the preclinical period have been scarcely investigated. AIM To describe the microscopic findings of preclinical IBD and its relationship with the natural history of the disease. METHODS Medical records from all patients with an incidental diagnosis of IBD during a screening colonoscopy were included in this multicentric and retrospective study. We assessed 15 histologic items in the biopsy samples at diagnosis, and the Geboes score was calculated in patients with Ulcerative Colitis (UC). The main outcome was the development of gastrointestinal symptoms during follow-up. RESULTS We included 110 patients (79 UC, 24 Crohn's Disease (CD) and 7 with unclassified disease). In UC the most common histologic findings were acute or chronic inflammatory infiltrate and crypt epithelial polymorphs, while in CD we observed acute or chronic neutrophilic infiltrate and epithelial irregularity. Granuloma were only observed in 4% of CD patients. Crypt distortion and the infiltration of neutrophils in the epithelium were associated with a higher risk of developing symptomatic disease. CONCLUSIONS Preclinical IBD shows specific microscopic findings and they are associated with the progression to symptomatic disease.
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Affiliation(s)
- Iago Rodríguez-Lago
- Gastroenterology Department, Hospital de Galdakao, Barrio Labeaga, 48960 Galdakao (Vizcaya), Spain; Biocruces Bizkaia Health Research Institute, Plaza de Cruces, 48903 Barakaldo (Vizcaya), Spain.
| | - Cynthia Ramírez
- Gastroenterology Department, Hospital de Galdakao, Barrio Labeaga, 48960 Galdakao (Vizcaya), Spain
| | - Olga Merino
- Gastroenterology Department, Hospital Universitario de Cruces, Plaza de Cruces, 48903, Baracaldo (Vizcaya), Spain
| | - Irene Azagra
- Gastroenterology Department, Hospital Universitario Araba, Calle Jose Atxotegi, 01009 Vitoria-Gasteiz (Álava), Spain
| | - Ainara Maiz
- Gastroenterology Department, Hospital Donostia, Begiristain Doktorea Pasealekua 109, 20014 Donostia (Guipúzcoa), Spain
| | - Eva Zapata
- Gastroenterology Department, Hospital de Mendaro, Mendarozabal Kalea, 20850 Mendaro (Guipúzcoa), Spain
| | - Rebeca Higuera
- Gastroenterology Department, Hospital San Eloy, Av. A. Miranda, 5, 48902 Baracaldo (Vizcaya), Spain
| | - Isabel Montalvo
- Gastroenterology Department, Hospital Onkologikoa, Begiristain Doktorea Pasealekua 121, 20014 Donostia (Guipúzcoa), Spain
| | - María Fernández-Calderón
- Gastroenterology Department, Hospital de Mondragón, Nafarroa Hiribidea 16, 20500 Mondragón (Guipúzcoa), Spain
| | - Paz Arreba
- Gastroenterology Department, Hospital de Basurto, Montevideo Etorbidea 18, 48013 Bilbao (Vizcaya), Spain
| | - Juan Carrascosa
- Gastroenterology Department, Hospital de Zumárraga, Barrio Argixao, 20700 Zumárraga (Guipúzcoa), Spain
| | - Ainara Iriarte
- Gastroenterology Department, Hospital de Bidasoa, Barrio Mendelu, 20280 Hondarribia (Guipúzcoa), Spain
| | - Miguel Muñoz-Navas
- Gastroenterology Department, Clínica Universidad de Navarra, Av. de Pío XII 36, 31008 Pamplona (Navarra), Spain
| | - José Luis Cabriada
- Gastroenterology Department, Hospital de Galdakao, Barrio Labeaga, 48960 Galdakao (Vizcaya), Spain; Biocruces Bizkaia Health Research Institute, Plaza de Cruces, 48903 Barakaldo (Vizcaya), Spain
| | - Manuel Barreiro-de Acosta
- Gastroenterology Department, Hospital Clínico Universitario de Santiago de Compostela, Rúa Choupana, 15706 Santiago de Compostela (Galicia), Spain
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Vaamonde-Lorenzo M, Elorriaga K, Montalvo I, Bujanda L. Colonic mucosal Schwann cell hamartoma. J Dig Dis 2020; 21:475-477. [PMID: 32378790 DOI: 10.1111/1751-2980.12874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/17/2020] [Accepted: 05/04/2020] [Indexed: 12/11/2022]
Affiliation(s)
| | - Kepa Elorriaga
- Department of Anatomic Pathology, Onkologikoa Foundation, San Sebastián, Spain
| | - Isabel Montalvo
- Digestive Endoscopy Unit, Onkologikoa Foundation, San Sebastián, Spain
| | - Luis Bujanda
- Department of Gastroenterology, University Hospital Donostia, San Sebastián, Spain
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Rodríguez-Lago I, Merino O, Azagra I, Maiz A, Zapata E, Higuera R, Montalvo I, Fernández-Calderón M, Arreba P, Carrascosa J, Iriarte A, Portillo I, Aguirre U, Barreiro-de Acosta M, Muñoz-Navas M, Cabriada JL. Characteristics and Progression of Preclinical Inflammatory Bowel Disease. Clin Gastroenterol Hepatol 2018; 16:1459-1466. [PMID: 29133254 DOI: 10.1016/j.cgh.2017.11.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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] [Received: 06/22/2017] [Revised: 10/19/2017] [Accepted: 11/04/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Inflammatory bowel disease (IBD) is a chronic disease usually diagnosed after the appearance of gastrointestinal symptoms. Little is known about IBD progression during its early and even preclinical phases. We aimed to determine the number of new incidental diagnoses of IBD in an older population, and evaluate disease progression from its early stages. METHODS We performed a retrospective analysis of 31,005 colonoscopies performed during colorectal cancer screening of patients with positive results from fecal immunochemical tests, at 11 centers in the Basque Country (Spain) from 2009 through 2014. We collected clinical and laboratory data from all asymptomatic individuals suspected to have IBD during screening colonoscopies, with histologic confirmation. RESULTS Colonoscopy screening led to 79 new diagnoses of ulcerative colitis, 24 of Crohn's disease, and 7 of unclassified colitis (average patient age, 57 y; interquartile range, 52-62 y; 57% male). Eleven patients had symptoms before colonoscopy and were excluded from the analysis. Among those patients who were asymptomatic at diagnosis, 36% developed symptoms after a follow-up period of 25 months (interquartile range, 10.5-42 mo), mostly rectal bleeding and diarrhea. Treatment was prescribed for 81 patients (88%), and 2 cases required surgery. CONCLUSIONS We analyzed data from a large cohort of patients with IBD diagnosed at early or even preclinical stages, from an older population. New incidental diagnoses of IBD were made in 0.35% of individuals undergoing a population-based screening colonoscopy-most were classified as ulcerative colitis. Approximately one third of patients developed symptoms during the follow-up period.
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Affiliation(s)
- Iago Rodríguez-Lago
- Gastroenterology Department, Hospital de Galdakao, Galdakao, Vizcaya, Spain.
| | - Olga Merino
- Gastroenterology Department, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain
| | - Irene Azagra
- Gastroenterology Department, Hospital Universitario de Álava, Álava, Spain
| | - Ainara Maiz
- Gastroenterology Department, Hospital Donostia, Donosti, Guipúzcoa, Spain
| | - Eva Zapata
- Gastroenterology Department, Hospital de Mendaro, Guipúzcoa, Spain
| | - Rebeca Higuera
- Gastroenterology Department, Hospital de San Eloy, Baracaldo, Vizcaya, Spain
| | - Isabel Montalvo
- Gastroenterology Department, Hospital Onkologikoa, Donosti, Guipúzcoa, Spain
| | | | - Paz Arreba
- Gastroenterology Department, Hospital de Basurto, Bilbao, Vizcaya, Spain
| | - Juan Carrascosa
- Gastroenterology Department, Hospital de Zumárraga, Zumárraga, Guipúzcoa, Spain
| | - Ainara Iriarte
- Gastroenterology Department, Hospital de Bidasoa, Hondarribia, Guipúzcoa, Spain
| | - Isabel Portillo
- Colorectal Cancer Screening Programme, The Basque Health Service, Spain
| | - Urko Aguirre
- Research Unit, Health Services Research on Chronic Patients Network, Hospital de Galdakao, Galdakao, Vizcaya, Spain
| | - Manuel Barreiro-de Acosta
- Gastroenterology Department, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Galicia, Spain
| | - Miguel Muñoz-Navas
- Gastroenterology Department, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - José Luis Cabriada
- Gastroenterology Department, Hospital de Galdakao, Galdakao, Vizcaya, Spain
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Labad J, Barbero JD, Gutiérrez-Zotes A, Montalvo I, Creus M, Cabezas Á, Solé M, Algora MJ, Garcia-Parés G, Vilella E. Free thyroxine levels are associated with cognitive changes in individuals with a first episode of psychosis: A prospective 1-year follow-up study. Schizophr Res 2016; 171:182-6. [PMID: 26805411 DOI: 10.1016/j.schres.2016.01.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/19/2015] [Accepted: 01/12/2016] [Indexed: 10/22/2022]
Abstract
The results of previous cross-sectional studies suggest that free thyroxine (FT4) levels are associated with cognitive abilities (particularly attention/vigilance) during the early stages of psychosis. We aimed to explore whether hypothalamic-pituitary-thyroid hormones predict cognitive changes in a 1-year longitudinal study following first episodes of psychosis (FEP). We studied 36 FEP patients and a control group of 50 healthy subjects (HS). Plasma levels of thyroid-stimulating hormone (TSH) and FT4 were measured. Cognitive assessment was performed with the MATRICS Cognitive Consensus Cognitive Battery (MCCB). FEP patients were assessed twice (baseline and after 1year), whereas HS were assessed only once. We compared cognitive changes at 1year between three groups based on baseline FT4 levels: 1) lowest quartile (Q1, FT4<1.16ng/dL); 2) medium quartiles (Q2-Q3, FT4 1.16-1.54ng/dL); and 3) highest quartile (Q4, FT4>1.54ng/dL). No differences in TSH or FT4 levels were found between HS and FEP patients. All participants had FT4 levels within the normal range. HS outperformed FEP patients in all cognitive tasks. In relation to the relationship between FT4 levels and cognitive changes, a U-shaped pattern was observed: FEP patients from the middle quartiles (Q2-Q3) improved in attention/vigilance, whereas both extreme quartiles (Q1 and Q4) showed a worsening in this cognitive domain over time. Patients with lower FT4 (Q1) showed poorer baseline attention; therefore, lower baseline FT4 levels predicted a poorer prognosis in terms of attention performance. Our study suggests that baseline FT4 levels are associated with changes in attention and vigilance performance over one year in FEP patients.
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Affiliation(s)
- J Labad
- Department of Psychiatry, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain.
| | - J D Barbero
- Department of Psychiatry, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - A Gutiérrez-Zotes
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - I Montalvo
- Department of Psychiatry, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | - M Creus
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Á Cabezas
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - M Solé
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - M J Algora
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - G Garcia-Parés
- Department of Psychiatry, Hospital Nostra Senyora de Meritxell, Servei Andorrà d'Atenció Sanitària, Andorra
| | - E Vilella
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
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Castells A, Bessa X, Quintero E, Bujanda L, Cubiella J, Salas D, Lanas Á, Carballo F, Morillas JD, Hernández C, Jover R, Montalvo I, Arenas J, Cosme Á, Hernández V, Iglesias B, Castro I, Cid L, Sala T, Ponce M, Andrés M, Teruel G, Peris A, Roncales MP, González-Rubio F, Seoane-Urgorri A, Grau J, Serradesanferm A, Pellisé M, Ono A, Cruzado J, Pérez-Riquelme F, Alonso-Abreu I, Carrillo-Palau M, de la Vega-Prieto M, Iglesias R, Amador J, Blanco JM, Sastre R, Ferrándiz J, González-Hernández MJ, Andreu M. Risk of Advanced Proximal Neoplasms According to Distal Colorectal Findings: Comparison of Sigmoidoscopy-Based Strategies. J Natl Cancer Inst 2013; 105:878-886. [DOI: 10.1093/jnci/djt117] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Quintero E, Castells A, Bujanda L, Cubiella J, Salas D, Lanas Á, Andreu M, Carballo F, Morillas JD, Hernández C, Jover R, Montalvo I, Arenas J, Laredo E, Hernández V, Iglesias F, Cid E, Zubizarreta R, Sala T, Ponce M, Andrés M, Teruel G, Peris A, Roncales MP, Polo-Tomás M, Bessa X, Ferrer-Armengou O, Grau J, Serradesanferm A, Ono A, Cruzado J, Pérez-Riquelme F, Alonso-Abreu I, de la Vega-Prieto M, Reyes-Melian JM, Cacho G, Díaz-Tasende J, Herreros-de-Tejada A, Poves C, Santander C, González-Navarro A. Colonoscopy versus fecal immunochemical testing in colorectal-cancer screening. N Engl J Med 2012; 366:697-706. [PMID: 22356323 DOI: 10.1056/nejmoa1108895] [Citation(s) in RCA: 583] [Impact Index Per Article: 48.6] [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: 12/12/2022]
Abstract
BACKGROUND Colonoscopy and fecal immunochemical testing (FIT) are accepted strategies for colorectal-cancer screening in the average-risk population. METHODS In this randomized, controlled trial involving asymptomatic adults 50 to 69 years of age, we compared one-time colonoscopy in 26,703 subjects with FIT every 2 years in 26,599 subjects. The primary outcome was the rate of death from colorectal cancer at 10 years. This interim report describes rates of participation, diagnostic findings, and occurrence of major complications at completion of the baseline screening. Study outcomes were analyzed in both intention-to-screen and as-screened populations. RESULTS The rate of participation was higher in the FIT group than in the colonoscopy group (34.2% vs. 24.6%, P<0.001). Colorectal cancer was found in 30 subjects (0.1%) in the colonoscopy group and 33 subjects (0.1%) in the FIT group (odds ratio, 0.99; 95% confidence interval [CI], 0.61 to 1.64; P=0.99). Advanced adenomas were detected in 514 subjects (1.9%) in the colonoscopy group and 231 subjects (0.9%) in the FIT group (odds ratio, 2.30; 95% CI, 1.97 to 2.69; P<0.001), and nonadvanced adenomas were detected in 1109 subjects (4.2%) in the colonoscopy group and 119 subjects (0.4%) in the FIT group (odds ratio, 9.80; 95% CI, 8.10 to 11.85; P<0.001). CONCLUSIONS Subjects in the FIT group were more likely to participate in screening than were those in the colonoscopy group. On the baseline screening examination, the numbers of subjects in whom colorectal cancer was detected were similar in the two study groups, but more adenomas were identified in the colonoscopy group. (Funded by Instituto de Salud Carlos III and others; ClinicalTrials.gov number, NCT00906997.).
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Affiliation(s)
- Enrique Quintero
- Department of Gastroenterology, Hospital Universitario de Canarias, Tenerife, Spain.
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10
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Cosme Jiménez A, Ojeda Pérez E, Neira F, Vaquero Pérez M, Bujanda Fernández de Piérola L, Montalvo I, Muro Carral N. [Tonsillar hypertrophy and mesenteric adenopathies as the main manifestations in a patient with Whipple's disease]. Gastroenterol Hepatol 2007; 30:395-8. [PMID: 17692197 DOI: 10.1157/13108813] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Whipple's disease is an infrequent chronic infection caused by Tropheryma whipplei, identified in 1992. Intestinal, articular, central nervous system and cardiac involvement is common. The presence of abdominal adenopathies, especially mesenteric adenopathies, without peripheral adenopathies or gastrointestinal, articular, neurological or cardiac symptoms is rare. We present the case of a male patient with tonsillar hypertrophy, mesenteric adenopathies, fever and constitutional syndrome, leading to suspicion of lymphoma. Biopsy findings of the lingual tonsil and mesenteric adenopathies were compatible with Whipple's disease. The diagnosis was confirmed by blood polymerase chain reaction.
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Affiliation(s)
- Angel Cosme Jiménez
- Servicio de Aparato Digestivo. Hospital Donostia. San Sebastián. Guipúzcoa. España.
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11
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Cosme A, Montalvo I, Sánchez J, Ojeda E, Torrado J, Zapata E, Bujanda L, Gutiérrez A, Arenas I. Glucogenosis tipo III asociada a carcinoma hepatocelular. Gastroenterología y Hepatología 2005; 28:622-5. [PMID: 16373012 DOI: 10.1016/s0210-5705(05)71526-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Type III glycogen storage disease is a hereditary disorder with autosomal recessive transmission. It is characterized by accumulation of abnormal glycogen in the liver and, in 80% of patients, in muscle. The liver can also show fibrosis and sometimes cirrhosis. Until 2000, 9 cases of cirrhosis had been published, 3 of which showed associated hepatocarcinoma. We present the case of a 31-year-old woman, diagnosed in childhood with type III glycogen storage disease, who 30 years after onset developed a hepatocellular carcinoma with portal thrombosis in the context of advanced cirrhosis. This is the first case to be reported in the Spanish literature of type III glycogen storage disease associated with hepatocellular carcinoma.
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Affiliation(s)
- A Cosme
- Servicio de Aparato Digestivo, Hospital Infantil La Paz, Madrid, Spain
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12
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Hernández-Infante M, Sousa V, Montalvo I, Tena E. Impact of microwave heating on hemagglutinins, trypsin inhibitors and protein quality of selected legume seeds. Plant Foods Hum Nutr 1998; 52:199-208. [PMID: 9950081 DOI: 10.1023/a:1008033610737] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Selected legume seeds (dry and soaked) including faba beans, peas, chickpeas, soybeans, lentils and common beans containing 8 and 25% moisture, respectively, were subjected to microwave heating, and to a conventional cooking method to determine the heating effect on toxic compounds and protein quality. Trypsin inhibitors, hemagglutinins and available lysine were analyzed, and laboratory rats were used to determine digestibility and protein efficiency ratio (PER). Results indicated that microwaving destroyed trypsin inhibitors to a similar degree to that observed in beans cooked using the conventional method without affecting PER for raw seeds with low antinutrients content (faba beans, peas, chickpeas and lentils). Microwave-heated soaked soybeans had a higher amount of destroyed trypsin inhibitors, along with a higher PER, compared with microwave-heated dry soybeans. Microwave heating of common beans failed to destroy hemagglutinins and trypsin inhibitors, and consequently their digestibility and PER values were poor. Finally it was concluded that microwave heating constitutes an adequate method for destroying hemagglutinins and trypsin inhibitors without affecting protein quality of most legume seeds, except for common beans that despite of this process retained the antinutritional substances.
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Affiliation(s)
- M Hernández-Infante
- Unidad de Investigación Médica en Nutrición, Coordinación de los Servicios de Investigación, Instituto Mexicano del Seguro Social, México DF
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13
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López P, Castiella A, Montalvo I, Bujanda L, Alzate LF, Gil I, Arenas JI. Treatment of achalasia with botulinum toxin. Rev Esp Enferm Dig 1997; 89:367-74. [PMID: 9190142 DOI: pmid/9190142] [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: 02/08/2023]
Abstract
UNLABELLED We studied the efficacy of local injections of botulinum toxin in the treatment of patients with achalasia. Four patients diagnosed of achalasia using manometric, radiologic and endoscopic criteria, were treated with botulinum toxin (80 U) injected directly into lower esophageal sphincter (LES), via a sclerotherapy injector. Response to treatment was assessed by changes in symptom scores and LES pressure. All determinations were repeated after 10, 30, 90, 120 and 180 days of treatment. The patients improved after the initial injection. This improvement was accompanied by improved relaxation of the LES. Two patients relapsed after 30 and 65 days and the other two patients remained symptom-free 5 months after treatment. CONCLUSION Botulinum toxin is probably a safe and effective alternative for the treatment of achalasia and should be considered in patients in whom pneumatic dilation has failed or who are poor surgical candidates. Long-term evaluation of the safety and efficacy of botulinum toxin in the treatment of achalasia is required.
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Affiliation(s)
- P López
- Service of Digestive Diseases, Ntra. Sra. de Aránzazu Hospital, San Sebastián, Spain
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14
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Cilla G, García-Bengoechea M, Perez-Trallero E, Montalvo I, Vicente D, Arenas JI. Genotyping of hepatitis C virus isolates from Basque Country, Spain. Epidemiol Infect 1996; 117:533-6. [PMID: 8972680 PMCID: PMC2271634 DOI: 10.1017/s0950268800059227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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: 02/03/2023] Open
Abstract
The genotype of HCV was determined in 161 chronic HCV-infected patients. The patients were classified into three groups on the basis of the origin of the HCV infection: 50 patients had a history of intravenous drug use (IVDU) but no HIV infection; 41 patients had received blood transfusions, and 70 patients had no known exposure. The distribution of HCV genotypes was associated with the origin of infection and age of patients: genotype 1b was predominant among patients who had received blood transfusions and those without evidence of parenteral exposure (84.6% and 67.7%, respectively), whereas genotype 3a was present in 65.3% of IVDUs. Patients with genotype 1b were older than those with genotypes 1a or 3a: 50.3 +/- 12 vs. 34.1 +/- 9.9 and 31 +/- 5.4 years, respectively. These findings suggest that the pattern of HCV genotypes in our region is changing and that genotype 1b may be substituted by 3a as the dominant genotype in the future.
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Affiliation(s)
- G Cilla
- Microbiology Service and Infectious Epidemiology Unit, Hospital Nuestra Señora de Aránzazu, San Sebastián, Spain
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15
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Cosme A, Bujanda L, Torrado J, Berdejo L, Ojeda E, Castiella A, Montalvo I, Gil I. [Primary melanoma of the esophagus. 2 new cases]. Rev Esp Enferm Dig 1996; 88:705-8. [PMID: 8983311 DOI: pmid/8983311] [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: 02/08/2023]
Abstract
Primary melanoma of the esophagus is rare. Until 1990, eight cases had been reported in Spain. We report two patients, 50 and 61-year-old men. Melanomas were located in the distal esophagus and were polypoid (5-6 cm), pediculated and pigmented. Endoscopic biopsy was diagnostic in both cases. Fontana staining technique and monoclonal HMB-45 and S-100 antibodies were used. A revision of clinical characteristics, treatment and survival of the patients with primary melanoma of the esophagus in our country is made.
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Affiliation(s)
- A Cosme
- Servicio de Digestivo, Hospital Nuestra Señora de Aránzazu, San Sebastián
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16
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Hernández M, Montalvo I, Sousa V, Sotelo A. The protein efficiency ratios of 30:70 mixtures of animal:vegetable protein are similar or higher than those of the animal foods alone. J Nutr 1996; 126:574-81. [PMID: 8632233 DOI: 10.1093/jn/126.2.574] [Citation(s) in RCA: 17] [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: 02/01/2023] Open
Abstract
Animal foods in general are considered to be foods with high protein qualities, although their qualities are not always similar because of differences in essential amino acids. The purpose of this study was to compare the protein quality of different animal foods and of their mixtures with vegetable foods, mainly cereals, at the 30:70 animal:vegetable protein proportion with experiments performed under the same conditions. The animal foods were eggs, beef, pork, barbecued lamb, chicken, ham, sausage and milk powder. The vegetable foods used in the mixtures were rice, lime-treated corn flour, wheat flour and cooked black beans. The protein concentrations in the raw and cooked materials were analyzed. The protein efficiency ratios (PER) and digestibilities were determined in Fisher 344 weanling rats. Based on the corrected PER, the foods with the best protein quality were egg (3.24), sirloin beef (3.16), lamb (3.11) and chicken breast (3.07), which were significantly different (P < 0.05) from milk powder (2.88) and beef liver and beef round (2.81 and 2.70, respectively). The ham (2.63) and the pork loin (2.57) had a similar protein quality to that of casein (2.50). The lowest protein quality was found in sausages (2.14). In most of the mixtures of animal and vegetable protein (30:70), the PER was similar to or higher than that of the animal food alone. Beans were the vegetable food that showed the lowest response to the addition of animal food. The conclusion of the study is that some 30:70 mixtures of animal:vegetable protein, such as chicken, beef round and pork with cereals could be utilized for regular meals because of their high PER and low cost.
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Affiliation(s)
- M Hernández
- Instituto Mexicano del Seguro Social. Unidad de Investigación en Nutrición, Centro Médico Siglo XXI, México, D.F
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17
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Hern Andez M, Sotelo A, Montalvo I, Ledezma H. Comparative quality evaluation of two commercial products and experimental diets for laboratory rats. Contemp Top Lab Anim Sci 1994; 33:76-80. [PMID: 16466200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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Gonzales-garza MT, Montalvo I, Sotelo A. Cytotoxic effects of gossypol and vitamin E on human and rat lymphocytes and spermatozoa. Nutr Rep Int 1985; 32:559-64. [PMID: 12340733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The cytotoxicity of vitamin E, gossypol, and mixture of both was determined in lymphocytes and spermatozoa using different concentrations of the substances. The cellular viability was assessed by means of the trypan blue exclusion test at 0, 60, and 120 minutes. Spermatozoa exhibited a higher sensitivity to these compounds, which was proportional to the length of exposure and the dose.
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Herrera J, Montalvo I, González Garza MT, Sotelo A, Gómez S, Bermúdez JA. Modifications in the testis steroidogenic pathways in rats fed with cottonseed flour. Arch Androl 1984; 12:53-8. [PMID: 6236762 DOI: 10.3109/01485018409161149] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Suppression of the testicular T production by effect of the CSF has been previously reported. Changes in the testicular content of intermediates and precursors of T biosynthesis were determined in rats fed during 28 days with diets containing 25,35 and 50% of CSF and compared with a defated cottonseed flour diet group and a control Purina-chow diet group. Also described were modifications during a six wk post CSF diet period. The results showed a diminution in pregnenolone and progesterone testicular content to a third and a half of the control values (21.5 and 19.3 pg/mg of protein respectively). Other compounds in the delta 5 pathway, 17 hidroxypregnenolone and dehydroepiandrosterone were undetectable since the 35% CSF diet, the 17 hidroxyprogesterone diminished to undetectable values only with the maximal (50%) CSF content diet. During the post CSF diet period all the steroids showed a tendency toward the control values. The 25% CSF content diet group reached the initial contents; other groups presented different recovery degrees. The most affected was the 50% diet group with a direct effect of the CSF on the testicular androgen steroidogenesis affecting both the delta 4 and the delta 5 pathways.
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Herrera J, Montalvo I, González-Garza MT, Sotelo A, Bermúdez JA. Cottonseed flour effects on androgen testicular content and serum levels in rats. Arch Androl 1983; 11:161-5. [PMID: 6688944 DOI: 10.3109/01485018308987476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Natural gossypol present in the whole cottonseed flour (CSF) has clear antifertility properties, decreasing the number and motility of spermatozoa. In this study the endocrine function of the testes was evaluated, measuring by specific radioimmunoassays the testicular content and the serum levels of androstenedione (A), testosterone (T), and 5 alpha-dihydrotestosterone in male rats fed with different and nontoxic concentrations of CSF along with Purina chow for 4 weeks, followed by 6 weeks of a recovery period. The testicular content of A, T, and DHT decreased 63%, 90%, and 38%, respectively, in comparison with their control. The serum levels of the three androgens diminished as follows: A 74%, T 95%, and DHT 60%. All the steroids measured in the recovery period showed a tendency towards the control values in both testicular content and serum. The most affected steroid was testosterone, which, after the recovery period, did not reach the control values. A also decreased, suggesting a blockade in testicular steroidogenesis caused by the initial diet.
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21
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Sotelo A, Montalvo I, de la Luz Crail M, González-Garza MT. Infertility in male rats induced by diets containing whole cottonseed flour. J Nutr 1982; 112:2052-7. [PMID: 6897076 DOI: 10.1093/jn/112.11.2052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
It has recently been shown that gossypol, a component of the cottonseed, has clear antifertility properties. The present study was planned to determine whether diets containing cottonseed in different proportions and in nontoxic amounts, could produce infertility in male rats. Diets were formulated with different concentrations of whole cottonseed flour and stock diet (Purina Chow). After 4 weeks of feeding these diets, the male rats were mated with virgin female rats in order to test male fertility rate. Thereafter, the male rats went into a recovery period during which they were fed stock diet for 6 weeks and were again mated after 3 and 6 weeks on this diet. The results show that: 1) infertility was produced by cottonseed flour diets even with a low concentration of gossypol (defatted cottonseed flour); 2) this effect was reversible at least after 6 weeks of gossypol-containing diets, even in the groups fed diets with a high gossypol concentration. The gossypol present in the diets decreases the number and motility of spermatozoa, even when present in concentrations below its toxic level, which may have an important deleterious effect on animal reproduction, since cottonseed is frequently used in the preparation of balanced diets mainly for animal consumption.
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