Role of the rs10401670 variant in the resistin gene on the metabolic response after weight loss secondary to a high‐fat hypocaloric diet with a Mediterranean pattern

Producción CientíficaBackground:The single nucleotide polymorphism (SNP) (rs10401670) of theRETNgene has been associated with metabolic disorder in obese subjects andhas scarcely been evaluated after dietary interventions. The present studyaimed to analyse the effects of thers10401670 RETNgene polymorphismon metabolic changes secondary to weight loss and secondary to a high‐fathypocaloric diet with a Mediterranean dietary pattern.Methods:A Caucasian population comprising 284 obese patients withoutdiabetes mellitus was analysed. Before and after 3 months of a high‐fathypocaloric diet with a Mediterranean pattern, an anthropometric evaluation,an assessment of nutritional intake and a biochemical analysis were per-formed. A statistical analysis was conducted for the combinedCTandTTas agroup and for wild‐typeCCas a second group.Results:Decreases in weight, body mass index (BMI), fat mass, systolic bloodpressure and waist circumference were similar in both genotypes groups. InTallele carriers, insulin, homeostatic model assessment for insulin resistance(HOMA‐IR), triglycerides and C‐reactive protein levels were decreased.The decrease in these parameters was statistically significant for triglycerides(−22.3 ± 9.3 mg dl–1:p= 0.03), C‐reactive protein (−2.8 ± 0.5 mg dl–1:p= 0.03), insulin (−7.4 ± 2.9 mUI L–1:p= 0.03) and HOMA‐IR (−2.4 ± 1.0:p= 0.02). Leptin levels were decreased in both genotypes groups after thehypocaloric diet, as well as the anthropometric parameters BMI, weight, waistcircumference and fat mass. Resistin and adiponectin levels remained un-changed in both groups.Conclusions:In the present study, we have detected a significant associationbetween theTallele of this SNP and a better response of insulin resistance,triglycerides and C‐reactive protein compared to nonTallele carriers afterweight loss with a high‐fat hypocaloric diet and a Mediterranean diet

Relation of resistin levels with cardiovascular risk factors, insulin resistance and inflammation in naı¨ve diabetes obese patients

Producción CientíficaBackground: The aim of the present study was to explore the relationship of resistin levels with cardiovascular risk factors, insulin resistance and inflammation in naı¨ve diabetic patients. Subjects: A population of 66 naı¨ve diabetic patients with obesity was analyzed. A complete nutritional and biochemical evaluation was performed. Results: The mean age 56.9 11.6 years and the mean BMI was 37.8 6.3. Patients were divided in two groups by median resistin value (3.3 ng/ml), group I (patients with the low values, average value 2.5 0.5) and group II (patients with the high values, average value 4.8 1.8). Patients in the group I had lower waist circumference, total cholesterol, LDLcholesterol and C-reactive protein than patients in group II. Correlation analysis showed a significant correlation among resistin levels and the independent variables; BMI (r = 0.26; p < 0.05), waist circumference (r = 0.38; p < 0.05), fat mass (r = 0.28; p < 0.05), LDL-cholesterol (r = 0.3; p < 0.05), C-reactive protein (r = 0.28; p < 0.05). In the multivariate analysis, resistin concentration increase 0.024 ng/ml (CI 95%: 0.006–0.42) for each mg/dl of C-reactive protein. Conclusion: Circulating resistins are associated with C-reactive protein in an independent way in naı¨ve diabetic patients

Obesidad en España y Castilla y León: ¿qué nos dicen los estudios?

La obesidad, es la epidemia del siglo XXI, se define como un peso corporal desproporcionado para la altura con una acumulación excesiva de tejido adiposo que se acompaña habitualmente de una inflamación sistémica crónica leve. Para clasificar a los pacientes con obesidad se utiliza el índice de Quetelet o índice de masa corporal, que se obtiene dividiendo el peso del individuo en Kg entre la talla al cuadrado en metros (kg/m2). Un índice de masa corporal por encima de 30 kg/m2 se considera como obesidad. La obesidad está asociada con el desarrollo de diabetes mellitus tipo 2, enfermedades cardiovasculares, algunos tipos de cáncer y otras condiciones patológicas crónicas. La circunferencia de la cintura también es un marcador de riesgo, en obesidad. En el estudio ENPE, se demostró una prevalencia en la población española de sobrepeso de 39,3% y de obesidad de 21,6%. La prevalencia de sobrepeso en mujeres fue de 32,1% y de obesidad de 22,8%, en varones, por otra parte, la obesidad represento un 20,5% y el sobrepeso un 46,5 %. Recientemente, en Castilla y León, la Consejería de Sanidad ha publicado los resultados de un estudio de cohortes “Estudio de Riesgo Cardiovascular en Castilla y León; la evolución de los Factores de Riesgo cardiovascular 2004-2014”. La prevalencia de obesidad (IMC ≥30) en 2004 era en nuestra Comunidad Autónoma de 22,9%. En la reevaluación de la misma cohorte de pacientes, diez años más tarde, esa proporción ha aumentado hasta el 27,6%, casi 5 puntos porcentuales. Con respecto al total de la muestra de 2014, el 31,1% tenían normopeso, el 41,3% tenían sobrepeso y el 26,1% tenían un IMC entre 30 y 40 (obesidad) y un 1,6% presentaban un IMC>40.En conclusión, la obesidad se ha convertido en una pandemia a nivel mundial, situándose España en una zona intermedia de prevalencia, así como Castilla y León. EL índice de masa corporal, así como la circunferencia de la cintura son las herramientas más utilizadas a la hora de realizar los estudios de prevalencia de obesidad.Obesity, the epidemic of the 21st century (1), is defined as a disproportionate body weight for height with an excessive accumulation of adipose tissue that is usually accompanied by a mild chronic systemic inflammation. To classify patients with obesity, the Quetelet index or body mass index is used, which is obtained by dividing the weight of the individual in Kg by the square height in meters (kg/m2). A body mass index above 30 kg/m2 is considered as obesity. Obesity is associated with the development of type 2 diabetes mellitus, cardiovascular diseases, some types of cancer and other chronic pathological conditions. Waist circumference is a risk factor in obesity, too. In the ENPE study, a prevalence in the Spanish population of overweight of 39.3% and of obesity of 21.6% was demonstrated. The prevalence of overweight in women was 32.1% and obesity 22.8%, in men; on the other hand, obesity represented 20.5% and overweight 46.5%. Recently, Castilla y León Health System has published the results of a study of cohorts “Cardiovascular Risk Study in Castilla y León; the evolution of cardiovascular risk factors 2004-2014 “. The prevalence of obesity (BMI ≥30) in 2004 was 22.9% in our Autonomous Community. In the re-evaluation of the same cohort of patients, ten years later, that proportion has increased to 27.6%, almost 5 percentage points. With respect to the total sample of 2014, 31.1% had normal weight, 41.3% were overweight and 26.1% had a BMI between 30 and 40 (obesity) and a 1, 6% had a BMI> 40 In conclusion, obesity has become a pandemic worldwide, placing Spain in an intermediate zone of prevalence as well as Castilla y León. The body mass index, as well as the circumference of the waist are the most used tools when carrying out obesity prevalence studie

Accuracy of urea breath test performed immediately after emergency endoscopy in peptic ulcer bleeding

Producción CientíficaThe aim of this work is to investigate the accuracy of the urea breath test (UBT) performed immediately after emergency endoscopy in peptic ulcer bleeding (PUB). METHODS: Urea breath test was carried out right after emergency endoscopy in patients with PUB. The accuracy of this early UBT was compared to a delayed one after hospital discharge that was considered the gold standard. Clinical and epidemiological factors were analyzed in order to study their influence on the accuracy of the early UBT. RESULTS: Early UBT was collected without any complication and good acceptance from all the 74 patients included. In 53 of the patients (71.6%), a delayed UBT was obtained. Comparing concordance between the two tests we have calculated an accuracy of 83% for the early UBT. Sensibility and specificity were 86.36 and 66%, respectively, with a positive predictive value of 92.68% and negative predictive value of 50% (Kappa index = 0.468; p = 0.0005; CI: 95%). We found no influence of epidemiological factors, clinical presentation, drugs, times to gastroscopy, Forrest classification, endoscopic therapy, hemoglobin, and urea levels over the accuracy of early UBT. CONCLUSIONS: Urea breath test carried out right after emergency endoscopy in PUB is an effective, safe, and easy-to-perform procedure. The accuracy of the test is not modified by clinical or epidemiological factors, ulcer stage, or by the type of therapy applied. However, we have found a low negative predictive value for early UBT, so a delayed test is mandatory for all negative cases

Evaluation of cytokines as robust diagnostic biomarkers for COVID-19 detection

Producción CientíficaAntigen tests or polymerase chain reaction (PCR) amplification are currently COVID-19 diagnostic tools. However, developing complementary diagnosis tools is mandatory. Thus, we performed a plasma cytokine array in COVID-19 patients to identify novel diagnostic biomarkers. A discovery–validation study in two independent prospective cohorts was performed. The discovery cohort included 136 COVID-19 and non-COVID-19 patients recruited consecutively from 24 March to 11 April 2020. Forty-five cytokines’ quantification by the MAGPIX system (Luminex Corp., Austin, TX, USA) was performed in plasma samples. The validation cohort included 117 patients recruited consecutively from 15 to 25 April 2020 for validating results by ELISA. COVID-19 patients showed different levels of multiple cytokines compared to non-COVID-19 patients. A single chemokine, IP-10, accurately identified COVID-19 patients who required hospital admission (AUC: 0.962; 95%CI (0.933–0.992); p < 0.001)). The results were validated in an independent cohort by multivariable analysis (OR: 25.573; 95%CI (8.127–80.469); p < 0.001) and AUROC (AUC: 0.900; 95%CI (0.846–0.954); p < 0.001). Moreover, showing IP-10 plasma levels over 173.35 pg/mL identified COVID-19 with higher sensitivity (86.20%) than the first SARS-CoV-2 PCR. Our discover–validation study identified IP-10 as a robust biomarker in clinical practice for COVID-19 diagnosis at hospital. Therefore, IP-10 could be used as a complementary tool in clinical practice, especially in emergency departments.Instituto de Salud Carlos III (grant COV20/00491)Consejo Superior de Investigaciones científicas (grant CSIC-COV19-016/202020E155)Junta de Castilla y León (project COVID 07.04.467B04.74011.0)IBGM excellence programme (grant CLU-2029-02

Factores analíticos, antropométricos y dietéticos asociados al desarrollo de fibrosis en pacientes con enfermedad por hígado graso no alcohólico

RESUMEN Antecedentes: la esteatohepatitis no alcohólica (EHNA) mantenida en el tiempo puede conducir a estadios avanzados de enfermedad hepática y al desarrollo de hepatocarcinoma. Objetivos: evaluar los factores analíticos, antropométricos y dietéticos asociados a la presencia de fibrosis hepática, evento que más influye en supervivencia y evolución. Métodos: fueron estudiados setenta y seis pacientes diagnosticados de enfermedad por hígado graso no alcohólica mediante biopsia. Las biopsias fueron clasificadas según el NAS-score (Kleiner). Se obtuvieron parámetros analíticos, antropométricos y dietéticos y se calculó el índice no invasivo NAFLD Fibrosis Score (NFLD-FS). Se determinaron los niveles séricos de leptina, adiponectina, resistina y TNF-alfa. Resultados: cincuenta y seis pacientes eran hombres (73,7%), con una edad media de 44,5 ± 11,3 años (19-68). Pacientes con fibrosis en biopsia: 39 (51,3%) (F1-F2: 84,6%; F3-4: 15,4%). Univariante: 17 mujeres (85%) presentaban fibrosis, frente a 22 hombres (39%) (p = 0,000). Los pacientes con fibrosis avanzada tenían mayor edad, menor recuento de plaquetas, menor albúmina sérica, mayor resistencia a la insulina (homeostatic model assessment insulin resistance, HOMA-IR), menor ingesta de lípidos, mayor nivel de leptina sérica y valores más altos de NAFLD-FS. Este índice presenta para detectar fibrosis avanzada un valor predictivo negativo del 98% y un valor predictivo positivo del 60%. Variables asociadas de forma independiente a la presencia de fibrosis (regresión logística): sexo masculino (factor protector) (0,09, IC 95%, 0,01-0,7; p < 0,05) y HOMA-IR (1,7, IC 95% 1,03-2,79; p < 0,05). Conclusiones: el sexo y el HOMA-IR son los únicos factores independientes que se asociaron a la presencia de fibrosis hepática en biopsia. El NAFLD-FS es un buen marcador no invasivo para descartar la presencia de fibrosis avanzada