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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. Source


Ortega E.,Research Center Biomedica En Red Of Diabetes fermedades Metabolicas Asociadas | Franch J.,Institute Catala Of La Salut | Castell C.,Autonomous Government of Catalonia | 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. Source


Soriguer F.,Research Center Biomedica En Red Of Diabetes | Soriguer F.,Hospital Universitario Carlos Haya | Goday A.,Hospital Del Mar | Bosch-Comas A.,Research Center Biomedica En Red Of Diabetes | And 40 more authors.
Diabetologia | Year: 2012

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. © 2011 The Author(s). Source


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. Source


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 55 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. Source

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