Santa Cruz de Tenerife, Spain
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Rojo-Martinez G.,Institute Salud Carlos III | Rojo-Martinez G.,Hospital Universitario Carlos Haya | Soriguer F.,Institute Salud Carlos III | Soriguer F.,Hospital Universitario Carlos Haya | And 40 more authors.
European Journal of Clinical Investigation | Year: 2013

Background: Although high-sensitivity C-reactive protein (hs-CRP) is currently used as a risk marker of cardiovascular disease, it has been suggested that genetic, clinical, biochemical or environmental factors could modify hs-CRP levels. The aim of this study was to investigate sources of interindividual hs-CRP variability in the Spanish population. Materials and methods: A representative sample of the Spanish population within the di@bet.es study was used. Study variables included a clinical and demographic structured survey, a lifestyle survey, a physical examination, plasmatic hs-CRP and other biochemical parameters. Results: Median and interquartile range of plasma hs-CRP values were 1·73±2·75mg/dL. Thirty per cent of the study population had hs-CRP levels above 3mg/dL and 38% from 1 to 3mg/dL. Body mass index was the strongest factor associated with moderate and high hs-CRP levels. Age, sex, waist-to-hip ratio, weight increase, plasma lipid levels, glucose metabolism (HOMA-IR and abnormal glucose regulation categories), pharmacological treatment (lipid-lowering agents, psychotropic drugs and levothyroxine), smoking, physical activity, different dietary patterns, quality of life and educational level were all significantly associated with hs-CRP levels. Interactions were observed between variables. These interactions modulated the effect of previously described factors on hs-CRP. Conclusions: Thirty per cent of the Spanish population have hs-CRP levels considered to represent a cardiovascular risk. Different clinical, anthropometric, biochemical and environmental variables modulate hs-CRP levels. In addition, multiple interactions between variables complicate the interpretation of hs-CRP values. © 2012 Stichting European Society for Clinical Investigation Journal Foundation.


Fuentes M.,Hospital Clinico San Carlos Of Madrid | Rojo-Martinez G.,Research Center Biomedica En Red Of Diabetes fermedades Metabolicas Asociadas | Rojo-Martinez G.,Hospital Universitario Carlos Haya | Soriguer F.,Research Center Biomedica En Red Of Diabetes fermedades Metabolicas Asociadas | And 41 more authors.
Acta Diabetologica | Year: 2013

The aim of the study is to assess the prevalence of metabolic syndrome (MetS) in Spain using specific cutoff points for waist circumference (WC) (>94.5 cm for men and >89.5 cm for women) and evaluating the influence of several socio-demographic and economic factors. Data on MetS were obtained from a national study of 4,727 subjects from 18 to 90 years of age, conducted in Spain between 2009 and 2010 (The di@bet.es study). MetS was defined applying the new Harmonized definition (evaluating the use of abdominal obesity (AO) as a obligatory criterion for MetS or not) as well as with other widely used criteria. Results were then compared with data from previous studies. Multiple logistic regression models were used to evaluate the influence of different social factors. The age-standardized MetS prevalence was 38.37 % (CI 35.74-40.99) in men and 29.62 % (CI 27.56-31.69) in women, when AO was required as a diagnostic criterion; 42.13 % (CI 39.37-44.89) and 32.31 % (CI 30.15-34.47) in men and women, respectively, if AO was not considered mandatory. Prevalence of MetS increased with age (p < 0.001 for trend). Women with a lower educational level were more likely to have MetS (OR 4.4; 95 % CI: 2.84-6.7) as compared with those with a higher educational level. Subjects with MetS had a worse physical quality of life. The combination of AO, hypertension and carbohydrate alterations was the most common MetS' pattern. A high prevalence of MetS was detected in the Spanish population especially in men, the elderly and women with a low educational level. © 2013 Springer-Verlag Italia.


Ortega E.,Hospital Clinic | Franch J.,Institute Catala Of La Salut | Castell C.,Public Health Division | Goday A.,Hospital del Mar | And 33 more authors.
Annals of Nutrition and Metabolism | Year: 2013

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. Copyright © 2013 S. Karger AG, Basel.


Soriguer F.,Research Center Biomedica En Red Of Diabetes fermedades Metabolicas Asociadas | Soriguer F.,Hospital Universitario Carlos Haya | Rojo-Martinez G.,Research Center Biomedica En Red Of Diabetes fermedades Metabolicas Asociadas | Rojo-Martinez G.,Hospital Universitario Carlos Haya | And 43 more authors.
European Journal of Clinical Nutrition | Year: 2013

Background: Despite the marked increase in cardiovascular risk factors in Spain in recent years, the prevalence and incidence of cardiovascular diseases have not risen as expected. Our objective is to examine the association between consumption of olive oil and the presence of cardiometabolic risk factors in the context of a large study representative of the Spanish population. Subjects and methods: A population-based, cross-sectional, cluster sampling study was conducted. The target population was the whole Spanish population. A total of 4572 individuals aged ≥18 years in 100 clusters (health centers) were randomly selected with a probability proportional to population size. The main outcome measures were clinical and demographic structured survey, lifestyle survey, physical examination (weight, height, body mass index, waist, hip and blood pressure) and oral glucose tolerance test (OGTT) (75 g). Results: Around 90% of the Spanish population use olive oil, at least for dressing, and slightly fewer for cooking or frying. The preference for olive oil is related to age, educational level, alcohol intake, body mass index and serum glucose, insulin and lipids. People who consume olive oil (vs sunflower oil) had a lower risk of obesity (odds ratio (OR)=0.62 (95% confidence interval (CI)=0.41-0.93, P=0.02)), impaired glucose regulation (OR=0.49 (95% CI=0.28-0.86, P=0.04)), hypertriglyceridemia (OR=0.53 (95% CI=0.33-0.84, P=0.03)) and low HDL cholesterol levels (OR=0.40 (95% CI=0.26-0.59, P=0.0001)). Conclusions: The results show that consumption of olive oil has a beneficial effect on different cardiovascular risk factors, particularly in the presence of obesity, impaired glucose tolerance or a sedentary lifestyle. © 2013 Macmillan Publishers Limited.


Soriguer F.,CIBERDEM | Soriguer F.,University of Malaga | Soriguer F.,CIBER ISCIII | Garcia-Fuentes E.,University of Malaga | And 46 more authors.
Clinical Nutrition | Year: 2012

Background & aims: To date no nation-wide study has yet been undertaken in Spain to estimate the iodine deficiency. The aim was to evaluate iodine intake and its conditioning factors in a representative sample of the whole adult population. Methods: The Di@bet.es Study is a national, cross-sectional, population-based survey conducted in 2009-2010 in Spain. Results: The median urinary iodine (UI) was 117.2. μg/L. Iodized salt (IS) was consumed by 43.9% of the population. The median UI in those who consumed IS and in those who did not consume IS was 131.1 and 110.8. μg/L respectively (p<0.0001). The likelihood of having UI levels above 100. μg/L was significantly associated with the intake of IS (OR = 1.47) and milk at least once a day (OR = 1.22). Within each individual autonomous communities, the median UI levels in those who consumed IS correlated significantly with the median levels of those who did not consume IS (r=0.76, p=0.001). Conclusions: Though strictly speaking, Spain should be considered within the category of a country having an adequate iodine intake, the current value is too close to the cut point and does not guarantee that those groups with a greater need for iodine will have the required intake of iodine. © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.


Marcuello C.,Hospital Clinico San Carlos Of Madrid | Calle-Pascual A.L.,Hospital Clinico San Carlos Of Madrid | Fuentes M.,Preventive Medicine Service Hospital | Runkle I.,Hospital Clinico San Carlos Of Madrid | And 25 more authors.
International Journal of Endocrinology | Year: 2012

Objective. To evaluate the association between diabetes mellitus and health-related quality of life (HRQOL) controlled for several sociodemographic and anthropometric variables, in a representative sample of the Spanish population. Methods. A population-based, cross-sectional, and cluster sampling study, with the entire Spanish population as the target population. Five thousand and forty-seven participants (2162/2885 men/women) answered the HRQOL short form 12-questionnaire (SF-12). The physical (PCS-12) and the mental component summary (MCS-12) scores were assessed. Subjects were divided into four groups according to carbohydrate metabolism status: normal, prediabetes, unknown diabetes (UNKDM), and known diabetes (KDM). Logistic regression analyses were conducted. Results. Mean PCS-12/MCS-12 values were 50.9 ± 8.5 / 47.6 ± 10.2, respectively. Men had higher scores than women in both PCS-12 (51.8 ± 7.2 versus 50.3 ± 9.2; P < 0.001) and MCS-12 (50.2 ± 8.5 versus 45.5 ± 10.8; P < 0.001). Increasing age and obesity were associated with a poorer PCS-12 score. In women lower PCS-12 and MCS-12 scores were associated with a higher level of glucose metabolism abnormality (prediabetes and diabetes), (P < 0.0001 for trend), but only the PCS-12 score was associated with altered glucose levels in men (P < 0.001 for trend). The Odds Ratio adjusted for age, body mass index (BMI) and educational level, for a PCS-12 score below the median was 1.62 (CI 95: 1.22.19; P < 0.002) for men with KDM and 1.75 for women with KDM (CI 95: 1.262.43; P < 0.001), respectively. Conclusion. Current study indicates that increasing levels of altered carbohydrate metabolism are accompanied by a trend towards decreasing quality of life, mainly in women, in a representative sample of Spanish population. © Copyright © 2012 C. Marcuello et al.


Brugnara L.,Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders | Brugnara L.,Hospital Clinic Of Barcelona | Murillo S.,Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders | Murillo S.,Hospital Clinic Of Barcelona | And 42 more authors.
PLoS ONE | Year: 2016

Low physical activity (PA), or sedentary lifestyle, is associated with the development of several chronic diseases. We aimed to investigate current prevalence of sedentariness and its association with diabetes and other cardiovascular risk factors. PA was evaluated in a populationbased, cross-sectional, randomly sampled study conducted in 2009-2010 in Spain. International Physical Activity Questionnaire (SF-IPAQ) was used to assess PA. 4991 individuals (median age 50 years, 57% women) were studied. Prevalence of sedentariness was 32.3% for men and 39% for women (p < 0.0001). Sex differences were particularly notable (age∗sex interaction, p = 0.0024) at early and older ages. Sedentary individuals had higher BMI (28 vs. 27 kg/m2) and obesity prevalence (37 vs. 26%). Low PA was present in 44, 43, and 38% of individuals with known diabetes (KDM), prediabetes/unknown-diabetes (PREDM/UKDM), and normal glucose regulation (p = 0.0014), respectively. No difference between KDM and PREDM/UKDM (p = 0.72) was found. Variables independently associated (p < 0.05) with sedentariness were age, sex, BMI, central obesity, Mediterranean diet adherence, smoking habit, HDL-cholesterol, triglycerides and dyslipidemia. Low PA is on the rise in Spain, especially among women. Sedentariness is associated with several cardiovascular risk factors and may be responsible for the increasing prevalence of obesity and diabetes in this country. © 2016 Brugnara et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Martinez-Hervas S.,Hospital Clinico Universitario Of Valencia | Martinez-Hervas S.,Institute Investigacion Sanitaria HCUV INCLIVA | Martinez-Hervas S.,University of Valencia | Martinez-Hervas S.,CIBER ISCIII | And 56 more authors.
Clinica e Investigacion en Arteriosclerosis | Year: 2014

Introduction: Dyslipidemia is a significant contributor to the elevated CVD risk observed in type 2 diabetes mellitus. We assessed the prevalence of dyslipidemia and its association with glucose metabolism status in a representative sample of the adult population in Spain and the percentage of subjects at guideline-recommended LDL-C goals. Material and methods: The di@bet.es study is a national, cross-sectional population-based survey of 5728 adults. Results: A total of 4776 subjects were studied. Dyslipidemia was diagnosed in 56.8% of subjects; only 13.2% of subjects were treated with lipid lowering drugs. Lipid abnormalities were found in 56.8% of Spanish adults: 23.3% with high LDL-C, 21.5% high TG, 35.8% high non-HDL-C, and 17.2% low HDL-C. Most normal subjects showed an LDL-C. ≤ 3.36. mmol/l. Pre-diabetics presented similar proportion when considering a goal of 3.36. mmol/l, but only 35% of them reached an LDL-C goal. ≤ 2.6. mmol/l. Finally, 45.3% of diabetics had an LDL-C. ≤ 2.6. mmol/l, and only 11.3% achieved an LDL-C. ≤ 1.8. mmol/l. Conclusions: Our study demonstrates a high prevalence of dyslipidemia in the adult Spanish population, and a low use of lipid-lowering drugs. Moreover, the number of subjects achieving their corresponding LDL-C goal is small, particularly in subjects at high cardiovascular risk, such as diabetics. © 2013 Sociedad Española de Arteriosclerosis.

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