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Soriguer F.,Hospital Universitario Carlos Haya | Soriguer F.,CIBERDEM CB07 08 0019 of the Institute Salud Carlos III | Soriguer F.,CIBER ISCIII | Rubio-Martin E.,Hospital Universitario Carlos Haya | And 20 more authors.
European Journal of Clinical Investigation | Year: 2012

Aim To evaluate the association between serum levels of testosterone, sex hormone-binding globulin (SHBG) and calculated bioavailable testosterone (bioT), and the risk of type 2 diabetes mellitus (T2D) in a prospective cohort from southern Spain (Pizarra study). Research design and methods The study was performed in the Pizarra Cohort Study, a prospective study started in 1995 with a follow-up of 11years. Anthropometric and metabolic variables were measured at baseline and at 6 and 11years of follow-up. Total testosterone (TT), SHBG and calculated bioT were determined at the 6-year follow-up. Results The levels of TT and bioT in men were negatively associated with the risk of obesity, T2D and the metabolic syndrome. In women, the levels of TT and bioT were associated positively with the risk of insulin resistance. The levels of SHBG were associated negatively with the risk of T2D, obesity and insulin resistance in both men and women. For all groups, the association was higher at the 11-year follow-up. Conclusions Low levels of testosterone and SHBG increase the risk of T2D in men, and high levels of testosterone increase the risk of insulin resistance in women. The association between TT levels and the risk of T2D is not completely independent of other variables, such as exposure time, adiposity, insulin resistance or SHBG levels. This study also shows that the different responses between men and women are probably because of the protective effect of SHBG, levels of which are higher in women than in men. © 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation.

Soriguer F.,Hospital Regional Universitario Carlos Haya | Soriguer F.,CIBER ISCIII | Garcia-Escobar E.,Hospital Regional Universitario Carlos Haya | Garcia-Escobar E.,CIBER ISCIII | And 7 more authors.
Medical Hypotheses | Year: 2013

The Spanish paradox is a phenomenon observed in Spain and some other Mediterranean countries by which the cardiovascular morbidity and mortality levels are dissociated from their cardiovascular risk factors. The Mediterranean diet has been proposed as the main reason for this dissociation, but dietary changes themselves are not enough to explain this situation. It has been recently discovered that Stearoil-CoA desaturase (SCD) is involved in the dissociation between a favourable atherogenic metabolic profile and the risk for arteriosclerosis. We propose a hypothesis that attempts to clarify the Spanish paradox. This hypothesis contemplates the essential role of dietary olive oil and its interaction with different SCD genetic patterns. Confirmation of this hypothesis could provide the basis for the design of clinical and preventive strategies against cardiovascular morbidity and mortality, as well as certain metabolic risk factors. © 2012 Elsevier Ltd.

Colomo N.,Hospital Universitario Carlos Haya | Colomo N.,CIBERDEM CB07 08 0019 of the Institute Salud Carlos III | Linares F.,Hospital Universitario Carlos Haya | Linares F.,CIBERDEM CB07 08 0019 of the Institute Salud Carlos III | And 16 more authors.
European Journal of Clinical Investigation | Year: 2013

Background Aims: (i) To evaluate glucometabolic status of patients without known diabetes hospitalized due to coronary artery disease (CAD), (ii) to assess markers of systemic inflammation determined during admission and to evaluate their relationship with glucometabolic status and (iii) to analyse usefulness of HbA1c determined during admission in patients with CAD to detect abnormal glucose regulation (AGR). Materials & methods: We studied 440 patients with CAD admitted to the cardiology ward. Patients were grouped in four groups during admission according to clinical data, fasting plasma glucose and HbA1c: diabetes, HbA1c > 5.9%, stress hyperglycaemia (SH) and normal. In 199 subjects without known diabetes, an oral glucose tolerance test (OGTT) was performed 3 months after discharge, and they were reclassified according to WHO 1998 criteria. Biochemical and inflammatory markers were measured. Results: The OGTT showed that 27.4% of subjects without known diabetes at admission had diabetes, 11.2% had impaired fasting glucose + impaired glucose tolerance, 33.5% impaired glucose tolerance, 3.6% impaired fasting glucose, and 24.4% normal glucose metabolism. Odds ratio for having diabetes 3 months after discharge in HbA1c > 5.9% group was 5.91 (P < 0.0001) and in SH group was 1.82 (P = 0.38). The best HbA1c cut-off point to predict AGR was 5.85%. HbA1c levels during admission were highly predictive of having AGR (AUC ROC 0.76 [95% CI 0.67-0.84]). Conclusion: We reported a high prevalence of AGR in subjects with CAD. Stress hyperglycaemia in patients with CAD was not associated with an increased risk of diabetes 3 months later. HbA1c in patients hospitalized with CAD was a useful tool to detect AGR. © 2013 Stichting European Society for Clinical Investigation Journal Foundation.

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