Las Rozas de Madrid, Spain
Las Rozas de Madrid, 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.


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).


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.


Gutierrez-Repiso C.,Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders | Gutierrez-Repiso C.,Hospital Regional Universitario | Soriguer F.,Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders | Soriguer F.,Hospital Regional Universitario | And 40 more authors.
Nutrition, Metabolism and Cardiovascular Diseases | Year: 2014

Background and aim: Prevalence rates of "metabolically healthy obese" (MHO) subjects vary depending on the criteria used. This study examined the prevalence and characteristics of MHO subjects and metabolically abnormal normal-weight subjects and compared the findings with the NHANES 1999-2004 study. The aims of the present study were, first, to determine the prevalence rates of MHO and MNHNO subjects using the same criteria as those of the National Health and Nutrition Examination Survey (NHANES) (1999-2004) study, and second to compare the prevalence and correlates of obese subjects who are resistant to the development of adiposity-associated cardiometabolic abnormalities (CA) and normal-weight individuals who display cardiometabolic risk factor clustering between the Spanish and the US populations. Methods and results: Di@bet.es study is a national, cross-sectional population-based survey of 5728 adults conducted in 2009-2010. Clinical, metabolic, sociodemographic, and anthropometric data and information about lifestyle habits, such as physical activity, smoking habit, alcohol intake and food consumption, were collected. Subjects were classified according to their body mass index (BMI) (normal-weight, <25 kg/m2; overweight, 25-29.9 kg/m2; and obese, >30 kg/m2). CA included elevated blood pressure; elevated levels of triglycerides, fasting glucose, and high-sensitivity C-reactive protein (hs-CRP); and elevated homeostasis model assessment of insulin resistance (HOMA-IR) value and low high-density lipoprotein cholesterol (HDL-c) level. Two phenotypes were defined: metabolically healthy phenotype (0-1 CA) and metabolically abnormal phenotype (≥2 CA). The prevalence of metabolically abnormal normal-weight phenotype was slightly lower in the Spanish population (6.5% vs. 8.1%). The prevalence of metabolically healthy overweight and MHO subjects was 20.9% and 7.0%, respectively, while in NHANES study it was 17.9% and 9.7%, respectively. Cigarette smoking was associated with CA in each phenotype, while moderate physical activity and moderate alcohol intake were associated with being metabolically healthy. Olive oil intake was negatively associated with the prevalence of CA. Conclusions: Smoking, physical activity level, and alcohol intake contribute to the explanation of the prevalence of CA in the Spanish population, as in the US population. However in Spain, olive oil intake contributes significantly to the explanation of the variance in the prevalence of CA. © 2014 Elsevier B.V.


Gutierrez-Repiso C.,Research Center Biomedica En Red Of Diabetes fermedades Metabolicas Asociadas Ciberdem | Gutierrez-Repiso C.,Hospital Universitario Carlos Haya | Rojo-Martinez G.,Research Center Biomedica En Red Of Diabetes fermedades Metabolicas Asociadas Ciberdem | Rojo-Martinez G.,Hospital Universitario Carlos Haya | And 44 more authors.
Clinical Science | Year: 2013

The present study was undertaken to examine the prevalence of urinary ACR (albumin/creatinine ratio) >30 mg/g and the associated clinical and environmental factors in a representative sample of the population of Spain. Di@bet.es study is a national, cross-sectional population-based survey conducted in 2009-2010. Clinical, metabolic, socio-demographic, anthropometric data and information about lifestyle habit were collected. Those subjects without KDM (known diabetes mellitus) were given an OGTT (oral glucose tolerance test). Albumin and creatinine were measured in a urinary sample and ACR was calculated. The population prevalence of ACR >30 mg/g was 7.65% (adjusted for sex and age). The prevalence of ACR >30 mg/g increased with age (P<0.001). Subjects with carbohydrate metabolism disorders had a greater prevalence of ACR >30 mg/g but after being adjusted for age, sex and hypertension, was significant only in those subjects with UKDM (unknown diabetes mellitus) {OR (odd ratio), 2.07 [95% CI (confidence interval), 1.38-3.09]; P<0.001] and KDM [OR, 3.55 (95% CI, 2.63-4.80); P<0.001]. Prevalence of ACR >30 mg/g was associated with hypertension [OR, 1.48 (95% CI, 1.12-1.95); P=0.001], HOMA-IR (homoeostasis model assessment of insulin resistance) [OR, 1.47 (95% CI, 1.13-1.92); P ≤0.01], metabolic syndrome [OR, 2.17 (95% CI, 1.72-2.72); P<0.001], smoking [OR, 1.40 (95% CI, 1.06-1.83); P≤0.05], physical activity [OR, 0.68 (95% CI, 0.54-0.88); P≤0.01] and consumption of fish [OR, 0.38 (95% CI, 0.18-0.78); P≤0.01]. This is the first study that reports the prevalence of ACR >30 mg/g in the Spanish population. The association between clinical variables and other potentially modifiable environmental variables contribute jointly, and sometimes interactively, to the explanation of prevalence of ACR >30 mg/g. Many of these risk factors are susceptible to intervention. © The Authors Journal compilation © 2013 Biochemical Society.


PubMed | Hospital del Mar Barcelona, Institute Salud Carlos III, Hospital Universitario Central Of Asturias, Autonomous University of Barcelona and 7 more.
Type: | Journal: Thyroid : official journal of the American Thyroid Association | Year: 2016

The aim of this study was to investigate the national prevalence of thyroid dysfunction in Spain, and its association with various clinical, environmental and demographic variables.The present report includes 4554 people (42.4% men) with a mean age of 50 years (range 18-93 years) participants in a national, cross-sectional, population-based survey conducted in 2009-10. Data gathered included clinical and demographic characteristics, physical examination and blood sampling. TSH, FT4, FT3 and TPOAb concentrations were analysed by electrochemiluminescence (E170, Roche Diagnostics). UI level measurements were made in an isolated urine sample.The prevalence of treated, untreated subclinical and untreated clinical hypothyroidism was 4.2% (CI95% 3.6-4.9%), 4.6% (CI95% 4.0-5.2%) and 0.3% (CI95% 0.1-0.5%) respectively. The prevalence of total hypothyroidism (including all fractions) was 9.1% (CI95% 8.2-10.0%). The prevalence of total hyperthyroidism was 0.8% (CI95% 0.6-1.1). 7.5% (CI95% 6.7-8.3%) of the population tested positive for TPOAbs (50 U/ml). In multivariate logistic regression models, TPOAbs were strongly associated with both hypothyroidism (p<0.001) and hyperthyroidism (p= 0.005), whereas high UI levels (>200 mcgr/g creatinine), were associated with hypothyroidism (p<0.001). The positive association between UI and hypothyroidism remained for both treated (p<0.001) and untreated (p<0.05) hypothyroidism whereas it was especially significant for non-autoimmune (TPOAbs negative) forms (p<0.001). At UI levels 200 mcgr/gr there was a positive correlation between UI and TSH levels (=0,152, p<0.001) and a negative correlation between UI and FT3 levels (=-0.134, p=0.001).According to our data, a large proportion of the Spanish population (10%) has some evidence of thyroid dysfunction. High TPOAb concentrations were associated with both hypo and hyperthyroidism whereas high UI concentrations were associated with hypothyroidism.


PubMed | University of Barcelona, Spanish Diabetes Society, Hospital Central Of Asturias, Hospital Universitario rlos Of Madrid and 13 more.
Type: Journal Article | Journal: Nutrition, metabolism, and cardiovascular diseases : NMCD | Year: 2014

Prevalence rates of metabolically healthy obese (MHO) subjects vary depending on the criteria used. This study examined the prevalence and characteristics of MHO subjects and metabolically abnormal normal-weight subjects and compared the findings with the NHANES 1999-2004 study. The aims of the present study were, first, to determine the prevalence rates of MHO and MNHNO subjects using the same criteria as those of the National Health and Nutrition Examination Survey (NHANES) (1999-2004) study, and second to compare the prevalence and correlates of obese subjects who are resistant to the development of adiposity-associated cardiometabolic abnormalities (CA) and normal-weight individuals who display cardiometabolic risk factor clustering between the Spanish and the US populations.Di@bet.es study is a national, cross-sectional population-based survey of 5728 adults conducted in 2009-2010. Clinical, metabolic, sociodemographic, and anthropometric data and information about lifestyle habits, such as physical activity, smoking habit, alcohol intake and food consumption, were collected. Subjects were classified according to their body mass index (BMI) (normal-weight, <25 kg/m(2); overweight, 25-29.9 kg/m(2); and obese, >30 kg/m(2)). CA included elevated blood pressure; elevated levels of triglycerides, fasting glucose, and high-sensitivity C-reactive protein (hs-CRP); and elevated homeostasis model assessment of insulin resistance (HOMA-IR) value and low high-density lipoprotein cholesterol (HDL-c) level. Two phenotypes were defined: metabolically healthy phenotype (0-1 CA) and metabolically abnormal phenotype (2 CA). The prevalence of metabolically abnormal normal-weight phenotype was slightly lower in the Spanish population (6.5% vs. 8.1%). The prevalence of metabolically healthy overweight and MHO subjects was 20.9% and 7.0%, respectively, while in NHANES study it was 17.9% and 9.7%, respectively. Cigarette smoking was associated with CA in each phenotype, while moderate physical activity and moderate alcohol intake were associated with being metabolically healthy. Olive oil intake was negatively associated with the prevalence of CA.Smoking, physical activity level, and alcohol intake contribute to the explanation of the prevalence of CA in the Spanish population, as in the US population. However in Spain, olive oil intake contributes significantly to the explanation of the variance in the prevalence of CA.


Franch J.,Institute Catala Of La Salut | Castell C.,Public Health Division | Goday A.,Hospital del Mar | Ribas-Barba L.,University of Barcelona | And 17 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.


Valdes S.,Research Center Biomedica En Red Of Diabetes fermedades Metabolicas Asociadas Ciberdem | Valdes S.,Hospital Universitario Carlos Haya | Maldonado-Araque C.,Research Center Biomedica En Red Of Diabetes fermedades Metabolicas Asociadas Ciberdem | Maldonado-Araque C.,Hospital Universitario Carlos Haya | And 45 more authors.
Obesity | Year: 2014

Objective: The aim of this study was to examine possible associations between ambient temperature and obesity in the Spanish population using an ecological focus. Methods: The Di@bet.es study is a national, cross-sectional, population-based survey of cardiometabolic risk factors and their association with lifestyle. Sample: 5,061 subjects in 100 clusters. Variables: Clinical, demographic and lifestyle survey, physical examination, and blood sampling. The mean annual temperature (°C) for each study site was collected from the Spanish National Meteorology Agency (1971-2000). Results: The prevalence rates of obesity in the different geographical areas divided according to mean annual temperature quartiles were 26.9% in quartile 1 (10.4-14.5°C), 30.5% in quartile 2 (14.5-15.5°C), 32% in quartile 3 (15.5-17.8°C), and 33.6% in quartile 4 (17.8-21.3°C) (P = 0.003). Logistic regression analyses including multiple socio-demographic (age, gender, educational level, marital status) and lifestyle (physical activity, Mediterranean diet score, smoking) variables showed that, as compared with quartile 1, the odd ratios for obesity were 1.20 (1.01-1.42), 1.35 (1.12-1.61), and 1.38 (1.14-1.67) in quartiles 2, 3, and 4, respectively (P = 0.001 for difference, P < 0.001 for trend). Conclusions: Our study reports an association between ambient temperature and obesity in the Spanish population controlled for known confounders. © 2014 The Obesity Society.

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