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Corbatón-Anchuelo A, Martínez-Larrad MT, Gómez-Huelgas R. Professor Manuel Serrano Ríos (Málaga, 1935-Madrid, 2021): A shining example of the internal medicine physician-scientist. Rev Clin Esp 2021; 221:617-618. [PMID: 34565711 DOI: 10.1016/j.rceng.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 06/03/2021] [Indexed: 12/01/2022]
Affiliation(s)
- A Corbatón-Anchuelo
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain; Fundación de Investigación del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Grupo de Diabetes y Obesidad de la Sociedad Española de Medicina Interna (SEMI), Madrid, Spain.
| | - M T Martínez-Larrad
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| | - R Gómez-Huelgas
- Centro de Investigación Biomédica en Red de Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; Universidad de Málaga (UMA), Málaga, Spain; Grupo de Diabetes y Obesidad de la Sociedad Española de Medicina Interna (SEMI), Madrid, Spain
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Martínez F, Furió E, Fabiá MJ, Pérez AV, González-Albert V, Rojo-Martínez G, Martínez-Larrad MT, Mena-Martín FJ, Soriguer F, Serrano-Ríos M, Chaves FJ, Martín-Escudero JC, Redón J, García-Fuster MJ. Risk factors associated with retinal vein occlusion. Int J Clin Pract 2014; 68:871-81. [PMID: 24548738 DOI: 10.1111/ijcp.12390] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [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: 11/28/2022] Open
Abstract
AIMS Retinal vein occlusion (RVO) is the most frequent retinal vascular disease after diabetic retinopathy in which arterial risk factors are much more relevant than venous factors. The objective was to evaluate the role of risk factors in the development of the first episode of RVO. SUBJECTS AND METHODS One hundred patients with RVO [mean age 56 years, 42% females and mean body mass index (BMI) 27.5 kg/m(2)] were recruited consecutively from the outpatient clinic of a tertiary hospital in Valencia (Spain). All subjects underwent clinical assessment including anthropometric and blood pressure measurements and laboratory test including homocysteine, antiphospholipid antibodies (aPLAs) and thrombophilia studies. In half of the subjects, a carotid ultrasonography was performed. Three control populations matched by age, sex and BMI from different population-based studies were used to compare the levels and prevalence of arterial risk factors. One cohort of young patients with venous thromboembolic disease was used to compare the venous risk factors. RESULTS Blood pressure levels and the prevalence of hypertension were significantly higher in the RVO population when compared with those for the general populations. There was also a large proportion of undiagnosed hypertension within the RVO group. Moreover, carotid evaluation revealed that a large proportion of patients with RVO had evidence of subclinical organ damage. In addition, homocysteine levels and prevalence of aPLAs were similar to the results obtained in our cohort of venous thromboembolic disease. CONCLUSIONS The results indicate that hypertension is the key factor in the development of RVO, and that RVO can be the first manifestation of an undiagnosed hypertension. Furthermore, the majority of these patients had evidence of atherosclerotic disease. Among the venous factors, a thrombophilia study does not seem to be useful and only the prevalence of hyperhomocysteinaemia and aPLAs is higher than in the general population.
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Affiliation(s)
- F Martínez
- Internal Medicine Department, Fundación de Investigación del Hospital Clínico de Valencia- INCLIVA, Hospital Clínico Universitario, Universidad de Valencia, Valencia, Spain; "Centro de Investigación Biomédica en Red (CIBER) de Fisiopatología, Obesidad y Nutrición (CIBEROB)", Institute of Health Carlos III, Minister of Health, Madrid, Spain
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Rojo-Martínez G, Valdés S, Colomo N, Lucena MI, Gaztambide S, Gomis R, Casamitjana R, Carmena R, Catalá M, Martínez-Larrad MT, Serrano-Ríos M, Castaño L, Vendrell J, Girbés J, Franch J, Vázquez JA, Mora-Peces I, Urrutia I, Pascual-Manich G, Ortega E, Menéndez E, Delgado E, Bordiú E, Castell C, López-Alba A, Goday A, Calle A, Bosch-Comas A, Soriguer F. Use of drugs related to the treatment of diabetes mellitus and other cardiovascular risk factors in the Spanish population. The Di@bet.es study. ACTA ACUST UNITED AC 2014; 66:854-63. [PMID: 24773992 DOI: 10.1016/j.rec.2013.05.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 05/31/2013] [Indexed: 01/10/2023]
Abstract
INTRODUCTION AND OBJECTIVES To assess the patterns of use of 8 therapeutic drug groups for the treatment of diabetes mellitus and other cardiovascular risk factors, and to identify sociodemographic and health determinants of their use in the overall Spanish population. METHODS A representative sample of the Spanish population within the Di@bet.es study, a cross-sectional population-based survey, was included. STUDY VARIABLES sociodemographic, clinical, and lifestyle data; physical examination, and an oral glucose tolerance test in patients without known diabetes mellitus. Furthermore, patients were systematically queried about current medication use, and 8 pharmacotherapeutic groups were evaluated: lipid-lowering therapy, antihypertensives, oral hypoglycemic agents, insulin, thyroid hormone, uricosurics, psychoactive drugs, and nonsteroidal anti-inflammatory drugs. RESULTS Sixty-six percent of the Spanish population was taking at least one medication. Therapeutic drug use was associated with age, independently of the higher prevalence of diabetes mellitus, hypertension, or hyperlipidemia in older patients. Sex disparities were found in the use of lipid-lowering agents, allopurinol, levothyroxine, nonsteroidal anti-inflammatory drugs, and psychoactive drugs. Use of psychoactive drugs was related to education level, work status, physical activity, smoking, and alcohol consumption. Almost 30% of patients with diabetes mellitus were taking 6 or more medications daily. Diabetes mellitus was associated with greater use of antihypertensives, lipid-lowering agents, and nonsteroidal anti-inflammatory drugs. CONCLUSIONS Age and sex are the most important factors determining therapeutic drug use. Lifestyle patterns and sociocultural factors have an impact only on psychoactive drug use. Diabetes mellitus is associated with greater use of antihypertensives, lipid-lowering agents, and nonsteroidal anti-inflammatory drugs.
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Affiliation(s)
- Gemma Rojo-Martínez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Sergio Valdés
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Natalia Colomo
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - M Isabel Lucena
- Departamento de Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Facultad de Medicina, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Sonia Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Ramón Gomis
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Unidad de Endocrinología y Diabetes, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Roser Casamitjana
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Centro de Diagnóstico Biomédico, Hospital Clínic, Barcelona, Spain
| | - Rafael Carmena
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Departamento de Medicina y Endocrinología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Miguel Catalá
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Departamento de Medicina y Endocrinología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - María T Martínez-Larrad
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Manuel Serrano-Ríos
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Joan Vendrell
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitàries Pere Virgili, Tarragona, Spain
| | - Juan Girbés
- Unidad de Diabetes, Hospital Arnau de Vilanova, Valencia, Spain
| | - Josep Franch
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Atención Primaria, Unitat de Suport a la Recerca (IDIAP-Fundació Jordi Gol), Barcelona, Spain
| | - José A Vázquez
- Plan Nacional de Diabetes, Ministerio de Sanidad, Madrid, Spain
| | | | - Inés Urrutia
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Gemma Pascual-Manich
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Emilio Ortega
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Unidad de Endocrinología y Diabetes, Hospital Clínic, Barcelona, Spain
| | - Edelmiro Menéndez
- Departamento de Medicina-Endocrinología y Nutrición, Hospital Universitario Central de Asturias (HUCA), Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Elias Delgado
- Departamento de Medicina-Endocrinología y Nutrición, Hospital Universitario Central de Asturias (HUCA), Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Elena Bordiú
- Laboratorio de Endocrinología, Hospital Universitario San Carlos, Madrid, Spain
| | - Conxa Castell
- Departament de Salut Pública, Conselleria de Sanitat, Generalitat de Catalunya, Barcelona, Spain
| | | | - Alberto Goday
- Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, Spain
| | - Alfonso Calle
- Servicio de Endocrinología y Nutrición, Hospital Universitario San Carlos, Madrid, Spain
| | - Anna Bosch-Comas
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Federico Soriguer
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain.
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Rojo-Martínez G, Valdés S, Colomo N, Lucena MI, Gaztambide S, Gomis R, Casamitjana R, Carmena R, Catalá M, Martínez-Larrad MT, Serrano-Ríos M, Castaño L, Vendrell J, Girbés J, Franch J, Vázquez JA, Mora-Peces I, Urrutia I, Pascual-Manich G, Ortega E, Menéndez E, Delgado E, Bordiú E, Castell C, López-Alba A, Goday A, Calle A, Bosch-Comas A, Soriguer F. Consumo de fármacos relacionados con el tratamiento de la diabetes mellitus y otros factores de riesgo cardiovascular en la población española. Estudio Di@bet.es. Rev Esp Cardiol 2013. [DOI: 10.1016/j.recesp.2013.05.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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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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Martínez-Larrad MT, Lorenzo C, González-Villalpando C, Gabriel R, Haffner SM, Serrano-Ríos M. Associations between surrogate measures of insulin resistance and waist circumference, cardiovascular risk and the metabolic syndrome across Hispanic and non-Hispanic white populations. Diabet Med 2012; 29:1390-4. [PMID: 22681498 DOI: 10.1111/j.1464-5491.2012.03723.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS We evaluated the relations between surrogate indices of insulin resistance and waist circumference, metabolic syndrome and coronary heart disease risk across Hispanic and non-Hispanic white populations. METHODS The study was a cross-sectional analysis of participants without diabetes in the San Antonio Heart Study, Mexico City Diabetes Study and Spanish Insulin Resistance Study. We evaluated commonly used indices of insulin resistance, including homeostasis model assessment, McAuley's index, Gutt's insulin sensitivity index, Avignon's insulin sensitivity index and the Stumvoll index with and without demographics, the modified Matsuda index and the product of the triglycerides and glucose index. The metabolic syndrome was defined by American Heart Association/National Heart, Lung, and Blood Institute criteria and coronary heart disease risk by Framingham risk scores. RESULTS The Stumvoll index with demographics and the Avignon's insulin sensitivity index had the strongest correlations with waist circumference across populations. The triglycerides and glucose and McAuley's indices had the most robust correlations with Framingham risk score. The triglycerides and glucose index had the greatest ability to detect individuals with the metabolic syndrome and ≥ 10% coronary heart disease risk. Some indices display significant variability in the strength of the relationship with adiposity and coronary heart disease risk across populations. CONCLUSIONS There are significant differences between insulin resistance indices regarding the ability to detect the metabolic syndrome and coronary heart disease risk across populations. Studies may need to consider the index of insulin resistance that best suits the objectives.
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Affiliation(s)
- M T Martínez-Larrad
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain.
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González-Sánchez JL, Zabena CA, Martínez-Larrad MT, Fernández-Pérez C, Pérez-Barba M, Laakso M, Serrano-Ríos M. An SNP in the Adiponectin Gene Is Associated with Decreased Serum Adiponectin Levels and Risk for Impaired Glucose Tolerance. ACTA ACUST UNITED AC 2012; 13:807-12. [PMID: 15919831 DOI: 10.1038/oby.2005.91] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [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: 12/17/2022]
Abstract
Adiponectin is a plasma protein produced by the adipose tissue. Hypoadiponectinemia has been associated with insulin resistance and several components of the metabolic syndrome (MS): type 2 diabetes, obesity, and dyslipidemia. We investigated whether single nucleotide polymorphisms (SNPs) at positions 45 and 276 in the adiponectin gene were associated with features of the MS in 747 unrelated Spanish subjects. The G allele of SNP45 and the G/G genotype of SNP276 were associated with impaired glucose tolerance (p = 0.020 and 0.042, respectively). The G/G genotype for SNP276 was associated with lower serum adiponectin levels as compared with the G/T and T/T genotypes (G/G, 10.10 +/- 0.24 microg/mL; G/T, 10.98 +/- 0.32 microg/mL; T/T, 12.00 +/- 0.92 microg/mL; p = 0.015) even after adjustment for sex, age, BMI, waist-to-hip ratio, homeostasis model assessment index, and the degree of glucose tolerance (p = 0.040). We found a significant negative association of circulating adiponectin levels with waist-to-hip ratio (r = -0.42, p < 0.001), sagittal abdominal diameter (r = -0.24, p < 0.001), triglycerides (r = -0.32, p < 0.001), homeostasis model assessment index (r = -0.14, p = 0.001), and uric acid (r = -0.36, p < 0.001) and positive association with high-density lipoprotein-cholesterol (r = 0.41, p < 0.001). Our findings indicate that serum adiponectin levels are associated with several components of the MS. The SNP276 of the adiponectin gene may affect impaired glucose tolerance and hypoadiponectinemia.
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Lorenzo C, Serrano-Ríos M, Martínez-Larrad MT, Gabriel R, Williams K, Gómez-Gerique JA, Stern MP, Haffner SM. Central Adiposity Determines Prevalence Differences of the Metabolic Syndrome. ACTA ACUST UNITED AC 2012; 11:1480-7. [PMID: 14694212 DOI: 10.1038/oby.2003.198] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [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: 01/22/2023]
Abstract
OBJECTIVE To compare the expression of the metabolic syndrome in Spain and San Antonio, TX, two populations with major differences regarding their cardiovascular risk profile. RESEARCH METHODS AND PROCEDURES Cross-sectional analysis of population-based, epidemiological surveys using the metabolic syndrome definition of the National Cholesterol Education Program. In San Antonio, we limited our analysis to non-Hispanic whites because non-Hispanic whites are largely of European ancestry (n = 1339 in San Antonio and 2947 in Spain) RESULTS In men, increased central adiposity was more prevalent in San Antonio than in Spain (29.7 vs. 23.0%, p < 0.0001); in women, it was less prevalent in San Antonio than in Spain (40.2 vs. 66.4%, p < 0.0001). The metabolic syndrome followed that same pattern: more prevalent in men (28.9 vs. 20.8%, p = 0.019) and less in women from San Antonio (27.1 vs. 30.9%, p < 0.0001). In subjects with the metabolic syndrome, most women had increased central adiposity (92.6% in San Antonio and 97.5% in Spain), and most men had either increased central adiposity or blood pressure (99.2% in San Antonio and 95.0% in Spain). DISCUSSION Contrary to men, the metabolic syndrome is more prevalent in Spanish women than in women from San Antonio with differences that mirror differences in central adiposity. Central adiposity and blood pressure may be used to exclude the metabolic syndrome. Considering recent secular trends in obesity, we predict there will be an increase in the prevalence of the metabolic syndrome in both populations in the coming years.
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Affiliation(s)
- Carlos Lorenzo
- Department of Medicine, University of Texas Health Science Center, San Antonio, Texas 78284-7873, USA.
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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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Abstract
OBJECTIVE The metabolic syndrome (MS) is a cluster of cardiometabolic factors, which predisposes to diabetes and cardiovascular disease (CVD). Early detection of high-risk individuals for MS using accurate measures of insulin resistance (IR) could improve detection and prevention of CVD and diabetes. The aim of this study was to explore the ability of lipid accumulation product (LAP), compared with traditional measures of IR, to identify MS. DESIGN In total, 768 Spanish adults were recruited. MS was assessed using the revised criteria of National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) and International Diabetes Federation (IDF). Measures of IR such as homeostasis model assessment of IR and LAP, an index of lipid accumulation based on a combination of waist circumference and serum triglycerides, were calculated. Receiver operating characteristic analysis was performed in order to detect the parameter with the best predictive capability for MS. RESULTS The prevalence of MS-NCEP/ATP III and MS-IDF was 15.1 and 20.5% for men respectively, and 15.4 and 17.5% for women. LAP showed the highest diagnostic accuracy for MS-NCEP/ATP III (area under the curve 0.91 and 0.90 among males and females) and MS-IDF (0.88 for both males and females). This was confirmed by internal validation using 20 000 bootstrap samples. Among males and females, different LAP cut-off values exhibited high sensitivity (78-85%) and specificity (78-85%) for MS-NCEP/ATP III and MS-IDF identification with elevated efficiency (proportion of positives and negatives classified correctly by the test=78-85%). When the sample was stratified according to decades of life, LAP exhibited a slightly lower performance among women than men, especially for MS-IDF detection. CONCLUSIONS In non-diabetic adults LAP has a strong and reliable diagnostic accuracy for MS-IDF and, especially, MS-NCEP/ATP III among females and, in particular, among males from Spain.
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Affiliation(s)
- Mariano J Taverna
- Diabetes Genetics Section, Division of Genetics, Clinical Hospital of the University of Buenos Aires, Buenos Aires (C1120AAR), Argentina.
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Sáez ME, González-Pérez A, Martínez-Larrad MT, Gayán J, Real LM, Serrano-Ríos M, Ruiz A. WWOX gene is associated with HDL cholesterol and triglyceride levels. BMC Med Genet 2010; 11:148. [PMID: 20942981 PMCID: PMC2967537 DOI: 10.1186/1471-2350-11-148] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Accepted: 10/14/2010] [Indexed: 01/22/2023]
Abstract
Background Altered lipid profile, and in particular low HDL and high triglyceride (TG) plasma levels, are within the major determinants of cardiovascular diseases. The identification of quantitative trait loci (QTL) affecting these lipid levels is a relevant issue for predictive purposes. The WWOX gene has been recently associated with HDL levels. This gene is located at chromosome 16q23, a region previously linked to familial combined hyperlipidemia (FCHL) and HDL. Our objective is to perform a genetic association analysis at the WWOX gene region with HDL, TG and TG/HDL ratio. Methods A quantitative association analysis performed in 801 individuals selected from the Spanish general population. Results For HDL levels, two regions of intron 8 display clustering of positive signals (p < 0.05) but none of them was associated in the haplotypic analysis (0.07 ≤ p ≤ 0.165). For TG levels not only intron 8 but also a 27 kb region spanning from the promoter region to intron 4 are associated in this study. For the TG/HDL genetic association analysis, positive signals are coincident with those of the isolated traits. Interestingly, haplotypic analysis at the 5' region showed that variation in this region modified both HDL and TG levels, especially the latter (p = 0.003). Conclusions Our results suggest that WWOX is a QTL for both TG and HDL.
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Affiliation(s)
- María E Sáez
- Departamento de Genómica Estructural, Neocodex, 41092 Sevilla, Spain.
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Tellechea ML, Aranguren F, Martínez-Larrad MT, Serrano-Ríos M, Taverna MJ, Frechtel GD. Ability of lipid accumulation product to identify metabolic syndrome in healthy men from Buenos Aires. Diabetes Care 2009; 32:e85. [PMID: 19564464 DOI: 10.2337/dc08-2284] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Mariana L. Tellechea
- Department of Genetics and Molecular Biology, Laboratory of Molecular Biology, School of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Florencia Aranguren
- Division of Diabetology, Hospital “José de San Martín,” University of Buenos Aires, Buenos Aires, Argentina
| | | | - Manuel Serrano-Ríos
- Department of Internal Medicine II, Hospital Clínico San Carlos, Madrid, Spain
| | - Mariano J. Taverna
- Division of Diabetology, Hospital “José de San Martín,” University of Buenos Aires, Buenos Aires, Argentina
- Division of Genetics, Hospital “José de San Martín,” University of Buenos Aires, Buenos Aires, Argentina
- Humoral Immunity Institute “Prof. Ricardo A. Margni” (IDEHU), the National Research Council (CONICET) and School of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Gustavo D. Frechtel
- Department of Genetics and Molecular Biology, Laboratory of Molecular Biology, School of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
- Division of Genetics, Hospital “José de San Martín,” University of Buenos Aires, Buenos Aires, Argentina
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González-Sánchez JL, Zabena C, Martínez-Larrad MT, Martínez-Calatrava MJ, Pérez-Barba M, Serrano-Ríos M. Variant rs9939609 in the FTO gene is associated with obesity in an adult population from Spain. Clin Endocrinol (Oxf) 2009; 70:390-3. [PMID: 18616701 DOI: 10.1111/j.1365-2265.2008.03335.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [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: 11/27/2022]
Abstract
OBJECTIVE Recently independent studies, including genome-wide scans, have shown that variation in the fat mass and obesity associated gene (FTO) were significantly associated with obesity in populations of European origin. DESIGN AND METHODS In this study we examined the association between rs9939609 FTO variant and obesity related parameters in a population based-study of 732 unrelated individuals (46.9% males and 53.1% females; ages 35-74 years) from the province of Segovia in Central Spain (Castille). RESULTS The AA genotype was significantly more frequent in obese individuals (defined as body mass index >or= 30 kg/m(2), n = 207; 80 males and 127 females) than in non-obese (19.9%vs. 13.7%, P = 0.026). In addition to increased obesity, AA homozygous individuals had higher waist circumference than individuals with AT heterozygous and TT homozygous genotypes. The minor A-allele of rs9939609 was associated with an increased odds ratio (OR) for obesity [OR 1.51, 95% confidence interval (CI) 1.10-2.12] as compared to the TT genotype. This difference was also statistically significant even after the adjustment for sex and age (OR 1.46, 95% CI 1.02-2.07). CONCLUSIONS Our results support the association of FTO gene variants with obesity, including parameters of visceral (abdominal) obesity, in an adult general population from Spain. Overall we confirm the previously reported association studies between variants in FTO gene and the risk of obesity.
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González-Sánchez JL, Martínez-Larrad MT, Zabena C, Pérez-Barba M, Serrano-Ríos M. Association of variants of the TCF7L2 gene with increases in the risk of type 2 diabetes and the proinsulin:insulin ratio in the Spanish population. Diabetologia 2008; 51:1993-7. [PMID: 18712344 DOI: 10.1007/s00125-008-1129-2] [Citation(s) in RCA: 43] [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] [Received: 05/28/2008] [Accepted: 07/14/2008] [Indexed: 12/21/2022]
Abstract
AIMS/HYPOTHESIS The gene encoding transcription factor 7-like 2 (TCF7L2) has been related to type 2 diabetes in multiple ethnic groups. Here, we investigate whether three single nucleotide polymorphisms (SNPs) in the TCF7L2 gene are associated with an impaired proinsulin:insulin ratio. METHODS In this study we examined the associations between SNPs rs7901695, rs7903146 and rs12255372 in the TCF7L2 gene and metabolic variables affecting type 2 diabetes in a population-based study of 706 unrelated individuals (47% men and 53% women; aged 35-74 years) from the province of Segovia in central Spain (Castille), including 180 individuals with type 2 diabetes. RESULTS The minor allele frequency of rs7901695, rs7903146 and rs12255372 was significantly higher in diabetic patients compared with that in non-diabetic individuals. The T (minor) allele of the variant rs7903146 was significantly associated with a greater OR for type 2 diabetes adjusted for age, sex and BMI in logistic regression analysis: OR 1.29 (95% CI 1.06-1.57, p = 0.01). This risk allele was also associated with an increased proinsulin:insulin ratio after OGTT. Similar results were obtained for the other TCF7L2 SNPs. CONCLUSIONS/INTERPRETATION Our results provide further evidence supporting the belief that the TCF7L2 gene is a major determinant of type 2 diabetes risk in Spain, as in other southern European populations. The association with increased proinsulin:insulin ratio after an OGTT suggests that TCF7L2 might be involved in insulin synthesis and processing.
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Zabena C, González-Sánchez JL, Martínez-Larrad MT, Torres-García A, Alvarez-Fernández-Represa J, Corbatón-Anchuelo A, Pérez-Barba M, Serrano-Ríos M. The FTO obesity gene. Genotyping and gene expression analysis in morbidly obese patients. Obes Surg 2008; 19:87-95. [PMID: 18855084 DOI: 10.1007/s11695-008-9727-0] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2008] [Accepted: 09/19/2008] [Indexed: 12/28/2022]
Abstract
BACKGROUND Obesity has emerged as one of the most serious public health concerns in the twenty-first century. the fat mass and obesity associated gene (FTO) has been found to contribute to the risk of obesity in humans. Our aims in this study were to investigate the association of rs9939609 single nucleotide polymorphism (SNP) of the FTO gene with different obesity-related parameters, to assess the FTO gene expression in subcutaneous and visceral adipose tissues from morbidly obese and its correlations with other adipocytokine gene expressions. METHODS The association between the rs9939609 FTO gene variant and obesity related parameters in 75 obese/morbidly obese adult patients and 180 subjects with body mass index (BMI) < 30 kg/m(2) (control group) was examined. Gene expression analyses: subcutaneous adipose tissue samples were obtained from 52 morbidly obese and five subjects with BMI < 30 kg/m(2). Visceral adipose tissue was also obtained from 35 morbidly obese patients. Weight, height, BMI, SBP, DBP, fasting glucose, lipid profile, proinsulin, insulin, leptin, and adiponectin (RIA) of patients were also obtained. Insulin resistance by HOMA(IR). rs9939609 of FTO genotyping using allele discrimination in real-time PCR. Genomic study of RNA extraction of adipose tissue and real-time PCR (RT-PCR) of adipocytokines and a housekeeping gene were quantified using TaqMan probes. Relative quantification was calculated using the DeltaDelta Ct formula. RESULTS The minor-(A) allele frequency of rs9939609 FTO gene in the whole population was 0.39. A strong association between this A allele and obesity was found, even after age-sex adjustment (p = 0.013). We found higher levels of FTO mRNA in subcutaneous adipose tissue from morbidly obese than in the control group (p = 0.021). FTO gene expression was lower in visceral than in subcutaneous adipose depot. However, this finding did not reach the level of statistical significance. A negative correlation between subcutaneous FTO gene expression and serum triglyceride levels and a positive correlation with leptin, perilipin, and visfatin gene expressions was found. In the visceral adipose tissue, these positive correlations were statistically significant only for perilipin. CONCLUSIONS Our results show: (1) A strong association between rs9939609 SNP of the FTO gene variant and obesity in Spanish morbidly obese adult patients; (2) positive correlations between FTO mRNA and leptin, perilipin, and visfatin gene expressions in subcutaneous adipose tissue; (3) FTO and perilipin gene expressions were positively correlated in visceral fat depot. Overall these results may suggest a role of FTO in the regulation of lipolysis as well as in total body fat rather in fat distribution patterns.
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Affiliation(s)
- Carina Zabena
- Department of Internal Medicine II, Hospital Clínico San Carlos, CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Cea Bermúdez 66, 5 G., 28003, Madrid, Spain
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Sáez ME, González-Sánchez JL, Ramírez-Lorca R, Martínez-Larrad MT, Zabena C, González A, Morón FJ, Ruiz A, Serrano-Ríos M. The CAPN10 gene is associated with insulin resistance phenotypes in the Spanish population. PLoS One 2008; 3:e2953. [PMID: 18698425 PMCID: PMC2495037 DOI: 10.1371/journal.pone.0002953] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Accepted: 07/24/2008] [Indexed: 01/09/2023] Open
Abstract
Cardiovascular disease is the leading cause of morbidity and mortality in the industrialized world. Familial aggregation of cardiovascular risk factors is a frequent finding, but genetic factors affecting its presentation are still poorly understood. The calpain 10 gene (CAPN10) has been associated with type 2 diabetes (T2DM), a complex metabolic disorder with increased risk of cardiovascular disease. Moreover, the CAPN10 gene has been associated with the presence of metabolic syndrome (MS) in T2DM and in polycystic ovary syndrome (PCOS). In this work, we have analysed whether the polymorphisms UCSNP44, -43, -19 and -63 are related to several cardiovascular risk factors in the context of MS. Molecular analysis of CAPN10 gene was performed in 899 individuals randomly chosen from a cross-sectional population-based epidemiological survey. We have found that CAPN10 gene in our population is mainly associated with two indicators of the presence of insulin resistance: glucose levels two hours after a 75-g oral glucose tolerance test (OGTT) and HOMA values, although cholesterol levels and blood pressure values are also influenced by CAPN10 variants. In addition, the 1221/1121 haplogenotype is under-represented in individuals that fulfil the International Diabetes Federation (IDF) diagnostic criteria for MS. Our results suggest that CAPN10 gene is associated with insulin resistance phenotypes in the Spanish population.
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Affiliation(s)
- María E Sáez
- Neocodex, Departamento de Genómica Estructural, Seville, Spain.
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Sáez ME, Grilo A, Morón FJ, Manzano L, Martínez-Larrad MT, González-Pérez A, Serrano-Hernando J, Ruiz A, Ramírez-Lorca R, Serrano-Ríos M. Interaction between Calpain 5, Peroxisome proliferator-activated receptor-gamma and Peroxisome proliferator-activated receptor-delta genes: a polygenic approach to obesity. Cardiovasc Diabetol 2008; 7:23. [PMID: 18657264 PMCID: PMC2527300 DOI: 10.1186/1475-2840-7-23] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Accepted: 07/25/2008] [Indexed: 11/10/2022] Open
Abstract
Context Obesity is a multifactorial disorder, that is, a disease determined by the combined effect of genes and environment. In this context, polygenic approaches are needed. Objective To investigate the possibility of the existence of a crosstalk between the CALPAIN 10 homologue CALPAIN 5 and nuclear receptors of the peroxisome proliferator-activated receptors family. Design Cross-sectional, genetic association study and gene-gene interaction analysis. Subjects The study sample comprise 1953 individuals, 725 obese (defined as body mass index ≥ 30) and 1228 non obese subjects. Results In the monogenic analysis, only the peroxisome proliferator-activated receptor delta (PPARD) gene was associated with obesity (OR = 1.43 [1.04–1.97], p = 0.027). In addition, we have found a significant interaction between CAPN5 and PPARD genes (p = 0.038) that reduces the risk for obesity in a 55%. Conclusion Our results suggest that CAPN5 and PPARD gene products may also interact in vivo.
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Affiliation(s)
- María E Sáez
- Departamento de Genómica Estructural, Neocodex, C/.,Charles Darwin 6, Acc. A, 41092, Sevilla, Spain.
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González-Sánchez JL, Zabena C, Martínez-Larrad MT, Martínez-Calatrava MJ, Pérez-Barba M, Serrano-Ríos M. Association of ENPP1 (PC-1) K121Q polymorphism with obesity-related parameters in subjects with metabolic syndrome. Clin Endocrinol (Oxf) 2008; 68:724-9. [PMID: 17986276 DOI: 10.1111/j.1365-2265.2007.03103.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [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: 12/31/2022]
Abstract
BACKGROUND The metabolic syndrome (MS), a cluster of several metabolic disorders, is increasingly being recognized as a risk factor for cardiovascular disease. Ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1), originally described as a plasma cell allo-antigen and named plasma cell membrane glycoprotein (PC-1), is an inhibitor of insulin-induced activation of the insulin receptor. The single nucleotide polymorphism (SNP) K121Q in the ENPP1 gene has been studied in relation to obesity, insulin resistance and other features of MS in several populations with conflicting results. We therefore investigate the role of the K121Q SNP in the ENPP1 gene in MS in Caucasians from the province of Segovia in Central Spain (Castille). DESIGN AND METHODS We recruited 794 unrelated persons (46.5% males and 53.5% females), ages 35-74 years from a cross-sectional population-based epidemiological survey in the province of Segovia in Central Spain (Castille). Obesity-related anthropometric measurements included BMI, waist circumference, blood pressure and lipid profile. MS was defined by International Diabetes Federation (IDF) guidelines. K121Q PC-1 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS The 121Q allele was associated with an increased BMI and waist circumference among subjects fulfilling the criteria for MS. These differences remained statistically significant even after the adjustment for sex, age and degree of glucose tolerance (beta = 1.347, P = 0.017 and beta = 2.824, P = 0.046; for BMI and waist circumference, respectively). Moreover, among type 2 diabetic patients those carrying the 121Q allele had higher BMI and higher leptin levels than subjects carrying the K121K genotype. CONCLUSIONS Our results suggest that the ENPP1121Q allele might contribute to the genetic susceptibility to abdominal obesity among subjects with MS.
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Lorenzo C, Serrano-Ríos M, Martínez-Larrad MT, González-Villalpando C, González-Sánchez JL, Martínez-Calatrava MJ, Gabriel R, Haffner SM. Is waist circumference an essential component of the metabolic syndrome? Diabetes Care 2007; 30:2141-2. [PMID: 17519434 DOI: 10.2337/dc06-2627] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Carlos Lorenzo
- Department of Medicine, Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 78284-7873, USA.
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Lorenzo C, Serrano-Ríos M, Martínez-Larrad MT, Gonzalez-Villalpando C, Williams K, Gabriel R, Stern MP, Haffner SM. Which obesity index best explains prevalence differences in type 2 diabetes mellitus? Obesity (Silver Spring) 2007; 15:1294-301. [PMID: 17495206 DOI: 10.1038/oby.2007.151] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Obesity drives the diabetes epidemic. However, it is not known which obesity index best explains variations in type 2 diabetes mellitus prevalence across populations. RESEARCH METHODS AND PROCEDURES We analyzed three cross-sectional studies from San Antonio, TX, (Mexican-Americans and non-Hispanic whites, n = 2839), Mexico City (n = 2233), and Spain (n = 2161) (age range, 35 to 64 years). We used the area under the receiver operating characteristic curve (AUC) to assess performance for identifying diabetic subjects and logistic regression analysis to examine differences in diabetes prevalence. RESULTS AUCs for waist circumference and BMI were similar in white subjects, but the AUC for waist circumference was greater in Mexican-origin subjects (Mexican men, 0.594 vs. 0.549, p = 0.008; and women, 0.605 vs. 0.557, p = 0.002; Mexican-American men, 0.648 vs. 0.600, p < 0.001; and women, 0.744 vs. 0.693, p < 0.001). The AUC for waist-to-height ratio tended to be greater than that for waist circumference, but statistical significance was demonstrated only in Mexican women (0.628 vs. 0.613, p = 0.044), Mexican-American women (0.774 vs. 0.758, p < 0.001), and Spanish women (0.734 vs. 0.715, p = 0.039). No obesity index was consistently superior to the others for explaining differences in diabetes prevalence among populations. CONCLUSIONS In white and Mexican-origin men, waist circumference may be the preferred marker for identifying diabetic subjects on account of its simplicity; in women, waist-to-height ratio may be better. Differences in diabetes prevalence among these populations cannot be attributed to a single measure of obesity.
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Affiliation(s)
- Carlos Lorenzo
- Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284-7873, USA.
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Martínez-Calatrava MJ, González-Sánchez JL, Zabena C, Martínez-Larrad MT, Luque-Otero M, Serrano-Ríos M. Is the plasminogen activator inhibitor-1 gene a candidate gene predisposing to hypertension? Results from a population-based study in Spain. J Hypertens 2007; 25:773-7. [PMID: 17351368 DOI: 10.1097/hjh.0b013e32803cae09] [Citation(s) in RCA: 11] [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: 11/25/2022]
Abstract
BACKGROUND Studies in humans and mice suggest that plasminogen activator inhibitor-1 (PAI-1) might be a candidate gene for arterial hypertension. Our aims were to analyse whether the functional 4G/5G PAI-1 polymorphism represents a risk marker for the development of arterial hypertension regardless of hypertension-related metabolic variables. METHODS Eight hundred and fifteen unrelated individuals (387 men, age 35-74 years) from a cross-sectional, population-based, epidemiological survey in the province of Segovia (Spain) were studied. Anthropometric/biochemical parameters--body mass index, waist circumference, diastolic and systolic blood pressures, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, fasting glucose, insulin, C-reactive protein, and PAI-1 levels--were analysed. The 4G/5G PAI-1 genotypes were established by restriction fragment length polymorphism. Insulin resistance was estimated by the homeostasis model assessment. Tobacco consumption data were obtained using a standard questionnaire. RESULTS The 4G/4G PAI-1 genotype was significantly associated with a high prevalence of arterial hypertension. This association remained statistically significant even after adjustment for hypertension-related metabolic variables in our population (adjusted odds ratio, 1.858; 95% confidence interval, 1.135-3.018; P = 0.013). CONCLUSION Our results show that the 4G/4G PAI-1 genotype appears to be associated with an elevated relative risk of developing arterial hypertension, regardless of PAI-1 levels and other hypertension-related factors, in a representative sample of the Spanish population.
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Affiliation(s)
- María J Martínez-Calatrava
- Department of Internal Medicine, Hospital Universitario Clínico San Carlos, Universidad Complutense de Madrid, Spain
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Sáez ME, Martínez-Larrad MT, Ramírez-Lorca R, González-Sánchez JL, Zabena C, Martinez-Calatrava MJ, González A, Morón FJ, Ruiz A, Serrano-Ríos M. Calpain-5 gene variants are associated with diastolic blood pressure and cholesterol levels. BMC Med Genet 2007; 8:1. [PMID: 17227582 PMCID: PMC1783645 DOI: 10.1186/1471-2350-8-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2006] [Accepted: 01/16/2007] [Indexed: 11/16/2022]
Abstract
Background Genes implicated in common complex disorders such as obesity, type 2 diabetes mellitus (T2DM) or cardiovascular diseases are not disease specific, since clinically related disorders also share genetic components. Cysteine protease Calpain 10 (CAPN10) has been associated with T2DM, hypertension, hypercholesterolemia, increased body mass index (BMI) and polycystic ovary syndrome (PCOS), a reproductive disorder of women in which isunlin resistance seems to play a pathogenic role. The calpain 5 gene (CAPN5) encodes a protein homologue of CAPN10. CAPN5 has been previously associated with PCOS by our group. In this new study, we have analysed the association of four CAPN5 gene variants(rs948976A>G, rs4945140G>A, rs2233546C>T and rs2233549G>A) with several cardiovascular risk factors related to metabolic syndrome in general population. Methods Anthropometric measurements, blood pressure, insulin, glucose and lipid profiles were determined in 606 individuals randomly chosen from a cross-sectional population-based epidemiological survey in the province of Segovia in Central Spain (Castille), recruited to investigate the prevalence of anthropometric and physiological parameters related to obesity and other components of the metabolic syndrome. Genotypes at the four polymorphic loci in CAPN5 gene were detected by polymerase chain reaction (PCR). Results Genotype association analysis was significant for BMI (p ≤ 0.041), diastolic blood pressure (p = 0.015) and HDL-cholesterol levels (p = 0.025). Different CAPN5 haplotypes were also associated with diastolic blood pressure (DBP) (0.0005 ≤ p ≤ 0.006) and total cholesterol levels (0.001 ≤ p ≤ 0.029). In addition, the AACA haplotype, over-represented in obese individuals, is also more frequent in individuals with metabolic syndrome defined by ATPIII criteria (p = 0.029). Conclusion As its homologue CAPN10, CAPN5 seems to influence traits related to increased risk for cardiovascular diseases. Our results also may suggest CAPN5 as a candidate gene for metabolic syndrome.
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Affiliation(s)
- María E Sáez
- Departamento de Genómica Estructural. Neocodex. Sevilla, Spain
| | | | | | | | - Carina Zabena
- Departamento de Medicina Interna II. Hospital Clínico San Carlos. Madrid, Spain
| | | | - Alejandro González
- Unidad de reproducción y genética humana. Centro Avanzado de Fertilidad (CAF). Jerez de la Frontera, Cádiz, Spain
| | | | - Agustín Ruiz
- Departamento de Genómica Estructural. Neocodex. Sevilla, Spain
| | - Manuel Serrano-Ríos
- Departamento de Medicina Interna II. Hospital Clínico San Carlos. Madrid, Spain
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Martínez-Calatrava MJ, Martínez-Larrad MT, Zabena C, González-Sánchez JL, Fernández-Pérez C, Serrano-Ríos M. The 4G/4G PAI-1 genotype is associated with elevated plasma PAI-1 levels regardless of variables of the metabolic syndrome and smoking status. A population-based study in Spanish population. Diabetes Obes Metab 2007; 9:134-5. [PMID: 17199731 DOI: 10.1111/j.1463-1326.2006.00584.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Reported data about the effect of the 4G/5G PAI-1 polymorphism on plasma PAI-1 levels are controversial. This study was designed to determine the relative effect of the 4G/5G PAI-1 polymorphism on high plasma PAI-1 levels after adjustment for metabolic syndrome - related variables, and to test if this effect is modified by the smoking status. Six hundred and thirty one unrelated subjects (292 men; 35-74 years), from a cross-sectional population-based epidemiological survey in the province of Segovia (Spain) were studied. The higher frequency of high PAI-1 levels was found in 4G/4G subjects (5G/5G 19.4%, 4G/5G 21.6%, 4G/4G 33.7%, p = 0.003). A multiple regression model, adjusted for gender, age, BMI, waist circumference, triglycerides, HDL-cholesterol, HOMA IR and leptin, showed this adjOR: 4G/4G vs 5G/5G: 2.22, p = 0.008. When smoking status - 4G/5G PAI-1 interaction was included as an independent variable these results were not modified. Our results indicate that the 4G/4G PAI-1 genotype might be strongly associated with high PAI-1 levels regardless of metabolic syndrome-related variables and smoking status.
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González-Sánchez JL, Martínez-Larrad MT, Sáez ME, Zabena C, Martínez-Calatrava MJ, Serrano-Ríos M. Endothelial Nitric Oxide Synthase Haplotypes Are Associated with Features of Metabolic Syndrome. Clin Chem 2007; 53:91-7. [PMID: 17110473 DOI: 10.1373/clinchem.2006.075176] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Abstract
Background: The metabolic syndrome, a cluster of several metabolic disorders, is increasingly being recognized as a risk factor for cardiovascular disease. Endothelium-derived nitric oxide facilitates skeletal muscle glucose uptake, and data from animal models indicate that endothelial nitric oxide synthase (eNOS) gene–null mice present with a phenotype of insulin resistance, hypertension, and hypertriglyceridemia, much like that observed in humans with metabolic syndrome. We used haplotype tagging single nucleotide polymorphisms (htSNPs) to investigate the role of genetic variation in the eNOS gene (NOS3) in metabolic syndrome in humans.
Methods: We recruited 738 unrelated persons from a cross-sectional population-based epidemiological survey in the province of Segovia in Central Spain (Castille). Metabolic syndrome was defined according to the recently modified National Cholesterol Education Program Adult Treatment Panel III guidelines.
Results: Haplotype analysis showed a statistically significant association between some NOS3 gene variants and features of metabolic syndrome. Relative to the most common haplotype, 121, the haplotype 212 was associated with an increased odds ratio (OR) for metabolic syndrome [OR = 1.81, 95% confidence interval (CI) 1.15–2.84], and for decreased HDL-cholesterol concentrations (OR 1.52, 95% CI 1.01–2.29), and with increased mean values for the homeostasis model assessment of insulin resistance (P = 0.043), and triglycerides (P = 0.026).
Conclusions: Our results suggest that genetic variation at the eNOS locus is associated with features of metabolic syndrome, and might represent a new genetic susceptibility component for insulin resistance, hypertriglyceridemia, and low HDL-cholesterol concentrations.
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Lorenzo C, Serrano-Ríos M, Martínez-Larrad MT, González-Sánchez JL, Seclén S, Villena A, Gonzalez-Villalpando C, Williams K, Haffner SM. Geographic variations of the International Diabetes Federation and the National Cholesterol Education Program-Adult Treatment Panel III definitions of the metabolic syndrome in nondiabetic subjects. Diabetes Care 2006; 29:685-91. [PMID: 16505527 DOI: 10.2337/diacare.29.03.06.dc05-1796] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We have carried out international comparisons of the metabolic syndrome using the International Diabetes Federation (IDF) and National Cholesterol Education Program-Adult Treatment Panel III (ATP III) definitions. This analysis could help to discern the applicability of these definitions across populations. RESEARCH DESIGN AND METHODS Nondiabetic subjects aged 35-64 years were eligible for analysis in population-based studies from San Antonio (Mexican Americans and non-Hispanic whites, n = 2,473), Mexico City (n = 1,990), Spain (n = 2,540), and Peru (n = 346). Kappa statistics examined the agreement between metabolic syndrome definitions. RESULTS Because of the lower cutoff points for elevated waist circumference, the IDF definition of the metabolic syndrome generated greater prevalence estimates than the ATP III definition. Prevalence difference between definitions was more significant in Mexican-origin and Peruvian men than in Europid men from San Antonio and Spain because the IDF definition required ethnic group-specific cutoff points for elevated waist circumference. ATP III and IDF definitions disagreed in the classification of 13-29% of men and 3-7% of women. In men, agreement between these definitions was 0.54 in Peru, 0.43 in Mexico City, 0.62 in San Antonio Mexican Americans, 0.69 in San Antonio non-Hispanic whites, and 0.64 in Spain. In women, agreement between definitions was 0.87, 0.89, 0.86, 0.87, and 0.93, respectively. CONCLUSIONS The IDF definition of the metabolic syndrome generates greater prevalence estimates than the ATP III definition. Agreement between ATP III and IDF definitions was lower for men than for women in all populations and was relatively poor in men from Mexico City.
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Affiliation(s)
- Carlos Lorenzo
- Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284-7873, USA.
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González-Sánchez JL, Martínez-Calatrava MJ, Martínez-Larrad MT, Zabena C, Fernández-Pérez C, Laakso M, Serrano-Ríos M. Interaction of the -308G/A promoter polymorphism of the tumor necrosis factor-alpha gene with single-nucleotide polymorphism 45 of the adiponectin gene: effect on serum adiponectin concentrations in a Spanish population. Clin Chem 2005; 52:97-103. [PMID: 16254197 DOI: 10.1373/clinchem.2005.049452] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND We investigated whether interactions of the -308G/A polymorphism in the promoter region of the tumor necrosis factor-alpha (TNF-alpha) gene with single-nucleotide polymorphisms (SNPs) 45 and 276 of the adiponectin gene are associated with circulating adiponectin and soluble TNF-alpha receptor 2 (sTNFR2) concentrations in a Spanish population. METHODS We performed anthropometric and physiologic measurements in 809 unrelated participants recruited with a simple random sampling approach from respondents to a cross-sectional population-based epidemiologic survey in the province of Segovia in central Spain (Castille). RESULTS The 2-h postload glucose and serum insulin concentrations were higher in -308A allele carriers than in -308G/G individuals homozygous for the TNF-alpha gene. Plasma concentrations of sTNFR2 were positively correlated with body mass index, waist-to-hip ratio, and sagittal abdominal diameter among individuals with type 2 diabetes. Individuals with type 2 diabetes and the -308A allele had higher sTNFR2 and lower adiponectin concentrations than -308G homozygotes. Moreover, individuals carrying both the TNF-alpha -308A allele and the G allele of SNP 45 in the adiponectin gene had the highest prevalence of impaired glucose tolerance (adjusted odds ratio, 1.26; 95% confidence interval, 1.01-1.56; P = 0.038) and had lower adiponectin concentrations (beta = -0.090; P = 0.005) than individuals without these genotypes. CONCLUSIONS Our findings are the first to indicate that a higher incidence of impaired glucose tolerance and low circulating adiponectin concentration may be associated with interaction between the -308G/A promoter polymorphism of the TNF-alpha gene and SNP 45 in the adiponectin gene.
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