Effects of the Mediterranean diet on the cardiovascular risk factors

Background: Eating habits have been modified, which together with a more sedentary lifestyle has contributed to a significant increase in cardiovascular risk factors and consequently in cardiovascular disease. It is believed that this epidemic could be reduced with a change to a healthier lifestyle and diet, such as the Mediterranean diet. Objetive: To demonstrate the benefit of the Mediterranean diet as a valid dietary pattern for the primary prevention of cardiovascular disease Methods: study of the articles found in bibliographic review of different databases through systematic technique Results: In interventions with Mediterranean diet, a global beneficial effect on blood pressure has been observed with significant reductions in systolic, diastolic or both depending on the study. There is also a positive effect on glucose levels, HbA1c and incidence of type 2 diabetes mellitus with a significant level of significance. Regarding the lipid profile, the results are more variable, although generally it is considered that there is a reduction of total cholesterol, triglycerides, concentration and oxidation of LDL and ApoB and an increase of HDL. Inflammatory markers such as CRP, IL6, IL8, TNF alpha, ICAM, P-selectin, are also reduced in several of the studies analyzed. Likewise, the Mediterranean diet has proven to be an useful tool in the reversal of the metabolic syndrome. Conclusions: After a few decades in which prevention and treatment of cardiovascular diseases focused on the use of low-fat diets, the Mediterranean diet is currently emerging as a healthier alternative since it has shown a greater reduction in blood pressure, glycaemia, lipid profile, markers of inflammation and endothelial damage

Bone mass disorders in patients treated with a replacement dose of levothyroxine.

Some thyroid diseases have been associated with osteoporosis due to the effect of thyroid hormones on bone resorption. On this basis, chronic treatment with thyroid hormones, especially suppressive doses, could lead to osteoporosis. Objective: To estimate the prevalence of osteoporosis in patients treated with thyroid hormone in a health center in the city of Albacete. Methods: Cross-sectional study, conducted in patients diagnosed with subclinical hypothyroidism in treatment with levothyroxine in the city of Albacete. Patients were selected by reviewing medical records and laboratory parameters. Physical examination and medical history data were collected. Subsequently they underwent a bone density test and completed a questionnaire. Results: 112 patients were included in the study, with female predominance (88.5%), mean age of 42.5 years and a tendency to be overweight (mean BMI of 25.67 kg/m2, 95% CI: 18,02-35,49) . The average TSH was 6.67 mU / ml (95% CI: 4.31 - 11.15) with normal free T4. Osteoporosis was only found in 14%, with osteopenia prevailing among those where some kind of bone loss was found. Paradoxically, there is a greater bone mass loss in patients with a higher BMI. Although the bone mass deficit has been significantly associated with sex and years of treatment with levothyroxine, it is not related to dose nor to hormone levels detected in blood. Conclusions: The characteristics of our population do not make it particularly susceptible to developing osteoporosis (premenopausal women, overweight, non-smokers) and cases that were found are not doses dependent, but rather time dependent, therefore there must be other factors contributing to this pathology

Alteraciones de masa ósea en pacientes con hipotiroidismo subclínico en tratamiento con Levotiroxina a dosis sustitutiva en un área urbana de Albacete (España).

Some thyroid diseases have been associated with osteoporosis due to the effect of thyroid hormones on bone resorption. On this basis, chronic treatment with thyroid hormones, especially suppressive doses, could lead to osteoporosis.Algunas enfermedades tiroideas se han asociado a osteoporosis por el efecto que las hormonas tiroideas tienen sobre la resorción ósea. Asumiendo lo anterior, el tratamiento crónico con hormonas tiroideas, sobre todo a dosis supresoras, podría conllevar osteoporosis.Objetivo: Estimar la prevalencia de osteoporosis en pacientes tratados con hormona tiroidea en un Centro de Salud de la ciudad de Albacete.Métodos: Estudio transversal, realizado en pacientes diagnosticados de hipotiroidismo subclínico en tratamiento con levotiroxina en la ciudad de Albacete. Se seleccionaron mediante revisión de historias clínicas y se recogieron parámetros analíticos, de exploración física y antecedentes personales. Posteriormente, se les realizó una densitometría y rellenaron un cuestionario. Resultados: Se obtuvieron 112 pacientes, con predominio femenino (88,5%),  edad media de 42,5 años y tendencia al sobrepeso (I.M.C. medio de 25,67 kg /m2, 95% IC: 18,02- 35,49). La TSH media fue de 6,67 µU/ml (95% IC: 4,31-11,15) con T4 libre normal. Sólo se halló osteoporosis en un 14%, prevaleciendo la osteopenia entre los que se halló algún tipo de pérdida ósea. Paradójicamente, existe mayor pérdida de masa ósea en pacientes con un IMC mayor. Aunque el déficit de masa ósea se ha relacionado significativamente con el sexo y años de tratamiento con levotiroxina, no está relacionado con la dosis, ni con los niveles de hormonas detectados en sangre.Conclusiones: Las características de nuestra población no la hacen especialmente susceptible de presentar osteoporosis (mujer perimenopaúsica, con  sobrepeso, no fumadora) y los casos hallados no son dosis, si no tiempo dependientes, por lo cual debe haber otros factores que contribuyan a la misma