Metabolic syndrome and Growth Differentiation Factor 15 in older adults

This is a pre-print of an article published in GeroScience. The final authenticated version is available online at: https://doi.org/10.1007/s11357-021-00370-wGrowth Differentiation Factor 15 (GDF-15) is a cytokine produced in response to tissue injury and inflammatory states that may capture distinct pathways between the risk factors aggregated within metabolic syndrome (MS) and the development of diabetes and cardiovascular disease. Objective: To study the association of MS and its components with GDF-15 among older adults, examining the roles of body fat distribution, glucose metabolism, and inflammation. Methods: Data were taken from the Seniors-ENRICA-2 study in Spain, which included 1938 non-institutionalized individuals aged ≥65 years free of diabetes and cardiovascular disease. MS was defined as the presence of ≥3 of the following components: high waist circumference, elevated fasting blood glucose levels, raised blood pressure, increased triglyceride levels; and low serum high-density lipoprotein (HDL) cholesterol. Statistical analyses were performed with linear regression models and adjusted for potential sociodemographic and lifestyle confounders. Results: MS was associated with higher GDF-15 levels (fully adjusted mean increase [95% confidence interval] = 9.34% [5.16,13.7]). The MS components showing the strongest associations were high waist circumference (6.74% [2.97,10.6]), elevated glucose levels (4.91% [0.77,9.23]), and low HDL-cholesterol (8.13% [3.51,13.0]). High waist-to-hip ratio (7.07% [2.63,11.7]), urine albumin (12.1% [2.57,22.5]), and C-reactive protein (10.4% [3.89,17.3]) were also associated with increased GDF-15. Conclusion: MS was associated with higher GDF-15 levels in older adults. Abdominal obesity, hyperglycemia -possibly linked to microvascular disease, as inferred from elevated urine albumin-, low HDL-cholesterol, and inflammation were the main drivers of this associationThis work was supported by the Instituto de Salud Carlos III, State Secretary of R+D+I and FEDER/FSE (FIS grants 18/287, 19/319); grant 2020/017 from the National Plan on Drug Addiction (Ministry of Health), and the MITOFUN project grant from the Fundación Francisco Soria Melguiz

The inflammatory potential of diet and pain incidence: a cohort study in older adults

This article has been accepted for publication in The Journals of Gerontology: Series A Published by Oxford University PressBackground: Pain is a highly prevalent and on-the-rise symptom with heavy associated healthcare and social burdens among older adults, yet evidence regarding its prevention is inadequate. The growing knowledge on how diet regulates inflammation may be utilized for pain prevention. Objective: To examine the association of 3-year changes in the inflammatory potential of diet (2008-2010 to 2012) with pain incidence over the subsequent 3 years (2012 to 2014-2015) among older adults. Methods: We used data from 820 individuals aged ≥60 years and free of pain in 2012, drawn from the Seniors-ENRICA cohort study in Spain. Food consumption was collected with a validated diet history, and the inflammatory potential of diet was estimated via the a priori empirical dietary inflammatory index (EDII) and the a posteriori dietary inflammatory index (DII). The frequency, severity (impact on daily activities), and number of locations of incident pain were combined into a scale that classified subjects as suffering from no pain, intermediate pain, and highest pain. The associations were summarized with relative risk ratios (RRR) and their 95% confidence interval (CI), estimated with multinomial logistic regression, and adjusted for potential sociodemographic, lifestyle, and morbidity confounders. Results: Shifting the diet towards a higher inflammatory potential was associated with a subsequent increased risk of intermediate pain [fully adjusted RRR (95% CI) per 1-point increment in the EDII=1.30 (1.03,1.65)] and highest pain [DII=1.14 (1.03,1.26)]. The three components of the pain scale followed similar trends, the most consistent one being with moderate-to-severe pain [EDII=1.26 (1.04,1.54); DII=1.12 (1.01,1.24)]. The association of increasing DII with highest incident pain was only apparent among the least physically active subjects [1.35 (1.17,1.56) vs 0.96 (0.83,1.10); p for interaction <0.001]. Conclusions: An increase in the inflammatory potential of diet was associated with higher pain incidence over the following years. Future studies in older adults should assess the efficacy of pain prevention interventions targeting the inflammatory potential of dietThe present study was supported by Instituto de Salud Carlos III, State Secretary of R+D+I and FEDER/FSE (FIS grants 16/1512, 18/287, and 19/319

The immunogenicity to the first anti-TNF therapy determines the outcome of switching to a second anti-TNF therapy in spondyloarthritis patients

Introduction: Anti-TNF drugs have proven to be effective against spondyloarthritis (SpA), although 30% of patients fail to respond or experience adverse events leading to treatment discontinuation. In rheumatoid arthritis, the presence of anti-drug antibodies (ADA) against the first TNF inhibitor influences the outcome after switching. Our aim was to assess whether the response to a second anti-TNF drug is related to the previous development of ADA to the first anti-TNF drug SpA patients. Methods: Forty-two SpA patients began a second anti-TNF drug after failing to respond to the first anti-TNF therapy. Clinical activity was assessed by the Ankylosing Spondylitis Disease Activity Score (ASDAS) at baseline (at the beginning of the first and second anti-TNF therapy) and at 6 months after switching. The drug and ADA levels were measured by ELISA before each administration. Results: All patients were treated with anti-TNF drugs and mainly due to inefficacy were switched to a second anti-TNF drug. Eleven of 42 (26.2%) developed ADA during the first biologic treatment. At baseline, no differences in ASDAS were found in patients with or without ADA to the first anti-TNF drug (3.52 ± 1.03 without ADA vs. 3.14 ± 0.95 with ADA, p = 0.399) and to the second anti-TNF drug (3.36 ± 0.94 without ADA vs. 3.09 ± 0.91 with ADA, p = 0.466). At 6 months after switching, patients with previous ADA had lower disease activity (1.62 ± 0.93 with ADA vs. 2.79 ± 1.01 without ADA, p = 0.002) and most patients without ADA had high disease activity state by the ASDAS (25 out of 31 (80.6%) without ADA vs. 3 out of 11 (27.3%) with ADA, p = 0.002). Conclusions: In SpA the failure to respond to the first anti-TNF drug due to the presence of ADA predicts a better clinical response to a second anti-TNF drug

Animal and vegetable protein intake and malnutrition in older adults: a multicohort study

Malnutrition is a global concern in older adults, as it negatively affects morbidity and mortality. While higher animal protein intake may help prevent and treat malnutrition, it might also increase the risk of chronic diseases and death. Conversely, vegetable protein intake might have a lower anabolic effect and not be as effective to improve nutritional status. We studied whether animal and vegetable protein intake are associated with changes in nutritional status in older adults. We used pooled data from two Spanish cohorts: the Seniors-ENRICA 1 and Seniors-ENRICA 2. Settings and participants: 2,965 community-dwelling adults aged 62–92 years. Measurements: Protein intake was estimated at baseline via an electronic, validated diet history. Nutritional status was assessed at baseline and after 2.6 years with the GLIM (Global Leadership Initiative on Malnutrition) phenotypic criteria: weight loss, low body mass index, and reduced muscle mass. The odds of improvements in nutritional status were assessed with logistic regression models, extensively adjusted for potential confounders. Higher animal and vegetable protein intake were associated with improvements in nutritional status [odds ratios (95% confidence intervals) per 0.25 g/kg/day were 1.15 (1.00, 1.32) and 1.77 (1.35, 2.32), respectively]. Cereal protein intake drove most of the latter association [2.07 (1.44, 2.98)]. Replacing 0.25 g/kg/day of total animal protein, meat, or fish protein (but not dairy or egg protein) with vegetable protein was associated with improvements in nutritional status [1.54 (1.13, 2.09), 1.70 (1.20, 2.41), and 1.77 (1.18, 2.64), respectively]. Higher animal and, especially, vegetable protein intake were associated with improvements in nutritional status in older adults. Replacing total animal protein, meat, or fish protein with vegetable protein may help improve malnutritionThis work was supported by FIS grants 19/319 and 22/1111 (funded by the Institute of Health Carlos III; the Secretary of R+D+I; and the European Regional Development Fund/European Social Fund); PLEC2022-009352 grant (funded by MCIN/AEI/10.13039/ 501100011033 and the European Union “NextGenerationEU/PRTR”); FACINGLCOVID-CM project (funded by Comunidad de Madrid and European Regional Development Fund “Funding REACT EU Program”). Adrián Carballo-Casla was supported by Universidad Autónoma de Madrid (FPI fellowship). The funding agencies had no role in study design, data collection and analysis, interpretation of results, manuscript preparation or the decision to submit this manuscript for publicatio

Estudio microbiológico de nuevas alternativas en el tratamiento de "stenotrophomonas maltophilia"

A partir de la década de los 80 comienzan a publicarse numerosos trabajos que comunican un aumento de la frecuencia de los aislamientos de S. maltophilia en muestras clínicas, así como la aparición de brotes epidémicos nosocomiales causados por este microorganismo. Estos hechos, junto a su característica resistencia intrínseca a la mayoría de los antimicrobianos, le han hecho adquirir importancia como patógeno nosocomial emergente. La situación ocasionada por Acinetobacter baumannii y otros microorganimos multirresistentes (la utilización, por tanto, de antibioterapia de amplio espectro) en nuestros hospitales estaría creando las condiciones ideales para la emergencia de Stenotrophomonas maltophilia. En relación con la sugerencia realizada por Hanes y cols. (180) , según la cual “los pacientes no mueren como consecuencia de una neumonía por S. maltophilia, sino por la falta de un tratamiento empírico adecuado frente al microorganismo”, el trabajo presentado en esta memoria trata de participar en la necesaria búsqueda de nuevas opciones terapéuticas para el tratamiento de colonizaciones/infecciones causadas por Stenotrophomonas maltophilia, dadas las limitadas opciones terapéuticas, los efectos secundarios producidos por los antimicrobianos que se emplean como terapia de elección y el aumento de cepas resistentes a los mismos en dichas colonizaciones/infecciones. El fin de este estudio es comprobar si nuevas combinaciones betalactámico-inhibidor de betalactamasas alcanzan, como mínimo, los resultados obtenidos con los actuales tratamientos de elección, ofreciendo menores tasas de resistencia y perfilándose, detal forma, como una opción terapéutica a tener en cuenta a la hora de tratar infecciones causadas por este patógeno

Baremación de una tarea de repetición de pseudopalabras para la evaluación del desarrollo léxico

It has been demonstrated that the ability to repeat non-words is a good marker of lexical development in a number of languages, including Spanish. In addition, the ability to repeat nonwords has been used as a good discriminator between typically developing children and children with language delays or other language difficulties. However, despite its potential usefulness for clinical and research purposes, there is no validated scale in Spanish. To address this situation, we present a scale based on a sample of 342 monolingual Spanish-speaking children aged from four to seven years. After data analysis, a scale was elaborated to provide populational references for colleagues working in educational, clinical and research fields. The results show a ceiling effect for six years olds, as well as for monomorphemic and bisyllabic items. Implications of these scores are discussed in the corresponding section.La habilidad para repetir pseudopalabras se ha mostrado como un buen marcador de desarrollo léxico en multitud de lenguas incluyendo el español. Además, permite discriminar en buena medida entre niños con desarrollo típico y niños con trastornos y retrasos del lenguaje. Sin embargo, pese a su potencial importancia para su uso clínico e investigador, en español no contamos con baremos para una lista de estímulos determinada. Con el objetivo salvar esta notable carencia, se realiza una tarea de repetición de pseudopalabras a una muestra total de 342 niños y niñas monolingües españoles de entre cuatro y siete años. Tras el análisis de los resultados se elaboró un baremo con el objeto de aportar referencias poblacionales a colegas que trabajan en las citadas áreas clínico-educativas y de investigación. Los resultados muestran un efecto techo de esta tarea a los 6 años, así como para los estímulos monomorfémicos y bisílabos. Las implicaciones de estos resultados y baremo obtenido son discutidas en el apartado correspondiente. Palabras clave: Baremación; Desarrollo léxico; Repetición de pseudopalaSección Deptal. de Investigación y Psicología en Educación (Psicología)Fac. de PsicologíaTRUEpu

Word and Nonword Repetition Abilities in Spanish Language: Longitudinal Evidence from Typically Developing and Late Talking Children

This longitudinal study examined the early word and nonword repetition abilities of monolingual Spanish speaking children. We explored the role that word status, word length, and time play in repetition performance of children with different vocabulary levels. We also examined the predictive value of vocabulary level in repetition abilities. Thirty-seven children participated in this study: 15 late talkers and 22 typically developing children. Families completed the Spanish version of the MacArthur Communicative Developmental Inventory (MCDI) at age 2; children performed a word and nonword repetition task at three different moments, with a temporal interval of 6 months between Time 1 and Time 2, and eight months between Time 2 and Time 3, periods during which linguistic development takes place. We found significant effects for word status, word length, vocabulary level and time: words are repeated better than nonwords; one syllable items are easier to repeat than two and three syllable ones; the performance of late talking children is lower compared to typically developing children throughout the study; and repetition abilities improve longitudinally. In addition, early vocabulary level predicts subsequent repetition abilities and early nonword repetition abilities predict future nonword repetition performance.Sección Deptal. de Investigación y Psicología en Educación (Psicología)Fac. de PsicologíaTRUEpu

Effects of grammatical category and morphology on fast mapping in typically developing and late talking toddlers

The purpose of this study was to examine early fast mapping abilities in late talkers (LT) and typically developing (TD) Spanish-speaking children by considering the effect of different variables on fast mapping (age, vocabulary level, grammatical category and number morphology). Thirty-eight Spanish-speaking children were assessed at three times (21 to 24 months at the beginning of the study). A group of LT was matched in age with a TD control group. They completed a fast mapping task with a disambiguation phase and an extension phase. Results show that vocabulary level and age interact with grammatical category and number morphology. TD children’s performance was significantly higher than LT children’s, but these differences decreased with age. Results suggest that the incorporation of new labels does not work automatically; some children may need repeated exposures to word–referent pairings. Longitudinal results suggest the importance of looking at the dynamics of lexical acquisition in addition to vocabulary size.Depto. de Investigación y Psicología en EducaciónFac. de PsicologíaTRUEpu

Prognostic significance of the p185 protein in colorectal cancer Significado pronóstico de la proteína p185 en cáncer colorrectal

The amplification and/or overexpression of the c-erbB-2/neu oncogene may play a role in tumor development and progression. The aim of this prospective study was to evaluate the prognostic value of p185 protein in colorectal cancer using immunohistochemical techniques. We analyzed 106 colorectal tumor tissue specimens from patients who had been operated on by the same surgeon and subjected to a median follow-up of 3 years. Thirty-three per cent of patients showed p185 overexpression related to an advanced stage of the disease. In patients with adenocarcinoma tumors of the colon without distant metastases, p185 detection was found to be of clinical prognostic relevance (p = 0.06).<br>La amplificación y/o sobre-expresión del oncogén c-erbB2/neu puede contribuir al desarrollo y progresión tumoral. El objetivo de este trabajo es el estudio del valor pronóstico de la proteína p185 mediante técnicas de inmunohistoquímica en el carcinoma colorrectal. Se trata de un estudio de cohortes prospectivo en 106 muestras de tejido tumoral colorrectal de pacientes intervenidos quirúrgicamente por un mismo cirujano y con una mediana de tiempo de seguimiento de 3 años. El 33% de los pacientes presenta sobre-expresión de p185, que se relaciona con estadios avanzados de la enfermedad. En los pacientes con tumores adenocarcinoma localizados en colon y sin metástasis a distancia, la determinación de p185 muestra valor pronóstico clínicamente relevante (p=0,06)