University Hospital San Cecilio

Hospital de Órbigo, Spain

University Hospital San Cecilio

Hospital de Órbigo, Spain
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Martin-Rodriguez J.L.,University Hospital San Cecilio | Gonzalez-Cantero J.,University of Granada | Gonzalez-Cantero A.,Complejo Hospitalario Of Toledo | Arrebola J.P.,Complejo Hospitalario Universitario Of Granada | Gonzalez-Calvin J.L.,University of Granada
Medicine (United States) | Year: 2017

Recognition of the close relationship of nonalcoholic fatty liver disease (NAFLD) with diabetes mellitus 2, obesity, metabolic syndrome, and cardiovascular disease has stimulated growing interest in NAFLD as a public health problem. Serum alanine aminotransferase (ALT) has been proposed as a marker of NAFLD, but levels are within the range currently considered "normal" in a large proportion of NAFLD subjects. The aim of the study was to determine the diagnostic accuracy of serum ALT for identifying individuals with NAFLD, using 3-Tesla (T) magnetic resonance spectroscopy (1 H-MRS). A cross-sectional study was conducted in 129 healthy subjects. Liver triglyceride content was quantified by 1 H-MRS. NAFLD was defined as liver triglyceride content greater than 5.56%. Liver triglyceride content was >5.56% in 79 participants (NAFLD) and lower in the remaining 50 (normal). Serum ALT levels correlated positively with liver triglyceride content (r=0.58, P<.001), Homeostatic Model Assessment for Insulin Resistance (r=0.32, P<.01), and fasting insulin (r=0.31, P<.01), and inversely correlated with adiponectin (r=0.35, P<.01) and high-density lipoprotein cholesterol (r=0.32, P<.01). Regression analysis showed that serum ALT was the best predictor of NAFLD (P<.01). Optimal serum ALT cut-off to predict NAFLD was 23IU/L (area under receiver-operating characteristic curve: 0.93; sensitivity: 0.94; specificity: 0.72). This study shows that serum ALT is a sensitive and accurate biomarker of NAFLD if the "normal" ALT value is revised and established at a lower level. An ALT threshold of 23IU/L identified 94% of individuals with NAFLD in the present series, using 3-T 1 H-MRS for liver triglyceride quantification. Copyright © 2017 the Author(s).


Campos Pastor M.M.,University Hospital San Cecilio | Serrano Pardo M.D.,University Hospital San Cecilio | Fernandez Soto M.L.,University Hospital San Cecilio | Luna Del Castillo J.D.,University of Granada | Escobar-Jimenez F.,University Hospital San Cecilio
Annals of Nutrition and Metabolism | Year: 2012

Background/Aims: In adolescents, overweight and obesity are associated with an increased cardiovascular risk. The aim of this study was to determine the impact of a school-based nutritional education program (NEP) on lifestyle changes in Spanish adolescents. Methods: We selected 263 secondary school students (127 males) aged 12-16 years from Granada (Spain), who were followed up throughout 1 school year (2009-2010). At the beginning and end of the school year, data were gathered on the food consumption frequency, and anthropometric and biochemical profile. The NEP comprised a class on nutritional recommendations every 15 days, and administration of a daily breakfast of 275-350 kcal. Results: After the intervention, the prevalence of overweight and obesity decreased among both male and female students (p < 0.001) and there was also a global reduction in the prevalence of the metabolic syndrome (MS) from 32.2 to 19.7% (p < 0.001); in addition, body mass index was significantly decreased in normal weight, overweight and obesity groups (p = 0.001 and p = 0.02, respectively), and high-density-lipoprotein cholesterol and lean body mass was increased in all groups (p = 0.001). Conclusion: The NEP achieved a medium-term reduction in the prevalence of overweight and obesity and had a significant and positive effect on MS components in all groups. © 2012 S. Karger AG, Basel.


Munoz-Torres M.,Bone Metabolic Unit RETICEF | Reyes-Garcia R.,Bone Metabolic Unit RETICEF | Garcia-Martin A.,Bone Metabolic Unit RETICEF | Jimenez-Moleon J.J.,University of Granada | And 4 more authors.
Journal of Diabetes Investigation | Year: 2013

Aims/Introduction: Discordant results about the relationship between diabetes complications and the risk of fragility fractures have been reported. Our aims were to analyze the factors related to morphometric vertebral fractures (VFs) in patients with type 2 diabetes mellitus, and to explore the association between the presence of VFs and the main cardiovascular risk factors. Materials and Methods: We carried out a cross-sectional study including 123 patients with type 2 diabetes mellitus, and in 72 of these patients we recorded data about the risk factors for VFs and comorbidities of diabetes including diabetes-related microvascular disease and cardiovascular disease. Results: In the crude analysis, diabetic retinopathy (odds ratio [OR] 4.09, 95% confidence interval [CI] 1.01-12.5), ischemic heart disease (OR 5.02, 95% CI 1.1-9.7) and waist circumference (OR 1.06, 95% CI 1.006-1.114) were related to VFs. In the full model (adjusted for age, sex, body mass index), ischemic heart disease was the only determinant of VF (OR 3.33, CI 1.02-10.91, P = 0.047); whereas diabetic retinopathy did not reached significance (OR 2.27, CI 0.71-7.27, P = 0.16). Conclusions: In summary, ischemic heart disease is associated with an increased risk of VFs in type 2 diabetes mellitus. © 2013 Asian Association for the Study of Diabetes and Wiley Publishing Asia Pty Ltd.

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