Erectile Dysfunction Associated with Cardiovascular Risk Factors

Objectives: (1) Determine erectile dysfunction (ED) prevalence in patients with cardiovascular risk factors (CVRF). (2) Assess ED incidence in relation to the extent of controlling CVRF. Methodology: Patients: Enrolled participants came to the health centres in the study area. In accordance with the incidence of diseases with cardiovascular risks (CVR) in the Basic Health Regions of the study area, sample size was calculated with a 95% confidence interval and an alpha error of 0.005, resulting in a sample of 210 people, of which 30 could not complete the study for various reasons (change of address, death, refused to complete questionnaire, etc.). A full awareness and diffusion campaign was organized with talks and leaflets. Letters: A standard letter was given to patients which explained the importance of sexual health, offering them an appointment with a DUE (Diploma in Nursing) survey taker. The questionnaire was devised by the research group and was given by a fully trained DUE survey taker. Previously, contact was made with all the health centres, physicians and nursing staff to give them information on ED and CVRF and to inform them about the work to be done in their health region. Those patients who did not come to the appointment were telephoned to insist on the importance of attending and completing the questionnaire. Variables analysis: We analysed age, level of education, civil status, height, weight and body mass index (BMI), SBP, DBP, smoking habit, number cigarettes/day, year smoking began, ex‐smoker, year smoking stopped, alcohol consumption, grams alcohol/week, as well as consumption of other drugs, frequency and type. Blood test: glucose, haemoglobin glycated haemoglobin, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, artherogenic index, creatinine, urea, GOT, GPT, gamma‐GT and PSA. Urine test: micro‐albuminuria, proteinuria and creatinine clearance. ECG: Diabetes diagnosed at least 1 year ago and prescribed drugs to treat it. High blood pressure diagnosed at least 1 year ago and prescribed drugs to treat it. Dyslipidaemia (hypercholesterolaemia) diagnosed at least 1 year ago and prescribed drugs to treat it. Concomitant diseases of at least 1 year and drugs (up to 3) SHIM questionnaire and ED according to SHIM. Statistical analysis: an observational, descriptive, analytical, cross‐sectional study. Qualitative variables are presented as exact values and a percentage; quantitative variables as the mean and standard deviation (SD). A means comparison was done with the Student’s t‐test for independent groups, or the Mann‐Whitney U test if normality conditions (using the Kolmogorov‐Smirnoff or Shapiro‐Wilks test) were not fulfilled. The chi‐squared test was used for qualitative variables. Results: Of the 210 selected people, 179 completed the questionnaire (85.2%). The mean age was 64.5 ± 11.6 years. When analysing all the study variables in relation to the main variable, presence or absence of ED, age played an important role in ED appearing as ED incidence rises with age. Blood pressure had no significant relationship with the studied variable, and the same hold for BMI and its subdivision into normal weight and obesity. As regards toxic habits, neither cigarette smoking nor alcohol consumption influenced the presence of ED. The same hold for the sociological‐type variables (civil states, level of education). Regarding the biochemical variables from blood tests, a significant relationship with the atherogenic index and its recoded variable at high and low atherogenic risk (p < 0.04) was noted. In the glycaemic profile, a glycaemia mean of 126 mg/dl was obtained in the ED presence group, which is the cut‐off point proposed by ADA117 (American Diabetes Association) to consider a subject diabetic. Likewise, glycated haemoglobin presented figures in the two groups can be considered an alternation of a practically diabetic glucose metabolism. In our study, the presence of diabetic disease, high blood pressure (HBP) and dyslipidaemia showed no significant relationship with ED presence for each disease. However, in the combination of these diseases, a statistically significant relationship was seen when CVR increases, according to the Framinghan tables. Neither did each disease’s duration show a significant relationship with ED presence nor significant differences for the drugs used to treat the three pathologies were found. The coronary risk calculated according to the Framinghan tables indicated a statistically significant result, as did excessive risk (the difference between the coronary risk and the average assigned per age) for ED presence. The LISAT 8 test suggested that ED affected health‐associated quality of life and was statistically significant in two items of sex life and economic situation and was borderline statistically significant in the general life and working life items. Conclusions: There is a high ED prevalence in patients with high CVR. When ED improves, the better CVRFs are controlled. These patients’ pluripathology implies aggressive polymedication which doctors must consider as it increases the risk of ED

Nonalcoholic steatohepatitis and cardiovascular risk factors in primary care

Varias circunstancias motivan el creciente interés por la esteatosis hepática no alcohólica (EHNA): la elevada prevalencia de la enfermedad en el mundo occidental, su capacidad de progresión a formas histológicas más agresivas y su asociación con enfermedades que incrementan el riesgo cardiovascular. Objetivo: analizar la relación de la esteatosis hepática no alcohólica con los factores de riesgo cardiovascular en pacientes con criterios de síndrome metabólico. Método: fue realizado un estudio descriptivo transversal con una muestra de 100 pacientes, con 2 o más factores de riesgo cardiovascular, con nula o baja ingesta de alcohol, que acudían a consulta de atención primaria. A los seleccionados se les solicitó analítica completa e interconsulta para ecografía de abdomen completo. Se evaluó si tenían esteatosis hepática; en caso de ser afirmativo, se estratificaba en 3 grados. Se recogieron las siguientes variables tanto cualitativas (sexo, antecedentes personales y familiares de diabetes, hipertensión arterial, dislipidemia, entre otros) y cuantitativas (edad, peso, talla, índice de masa corporal, tratamiento farmacológico, cifras de distintos parámetros analíticos, cifras de tensión arterial y perímetro abdominal). Resultados: participaron 100 pacientes, 56% de los cuales eran mujeres, con una edad media de 61,84 DE ± 9,5 años. Del total de sujetos del estudio, el 23 % no tenía esteatosis hepática no alcohólica; un 29% tenía esteatosis hepática leve; otro 29%, esteatosis hepática moderada; y el 19% restante, esteatosis hepática severa. En los hombres, el 82% presentó esteatosis hepática. De las mujeres, el 28,57% no presentó hígado graso. Un 22% tenía sobrepeso y un 38% de los pacientes eran obesos. Solo un 22% y un 18% tenían alteradas las cifras tensionales sistólica y diastólica, respectivamente. El 60% tenía una glucemia basal alterada. En cuanto a los parámetros lipídicos, el 36% tenía hipertrigliceridemia; el 41%, hipercolesterolemia, con un 65% de colesterol LDL alto y un 16% de colesterol HDL bajo. El 83% de los pacientes tenía 2 o más criterios de síndrome metabólico. Conclusiones: hay una estrecha relación entre la aparición de esteatosis hepática no alcohólica y los factores de riesgo cardiovascular en pacientes con síndrome metabólico, por lo que se recomienda que, ante la aparición de estos, se analice el hígadoSeveral factors motivate the growing interest in this disease. They include the high prevalence of the disease in the Western world, its ability to progress to more aggressive histological forms, and its association with diseases that increase cardiovascular risk. Objective: The objective of this study was to analyze the relationship of nonalcoholic steatohepatitis (NASH) with cardiovascular risk factors in patients with criteria for metabolic syndrome. Method: This is a descriptive cross-sectional study of 100 patients who had two or more cardiovascular risk factors, who did not consume alcohol or consumed only small amounts of alcohol, and who came to the primary care clinic. The patients selected underwent complete analyses including abdominal ultrasound. They were evaluated for hepatic steatosis, and, if they tested positive, it was stratified into three degrees. Among the qualitative variables used were sex, personal and family history of diabetes, hypertension, dyslipidemia, and the quantitative variables included age, weight, height, body mass index, pharmacological treatment, numbers of different analytical parameters, blood pressure and abdominal perimeter. Results: There were 100 patients, 56% of whom were women. Patients’ mean age was 61.84 SD ± 9.5 years. Of the total number of subjects in the study, 23% did not have NASH, 29% had mild hepatic steatosis, 29% had moderate hepatic steatosis and 19% had severe hepatic steatosis. Of the men in the study, 82% had hepatic steatosis. Of the women, 28.57% did not have fatty livers. 22% were overweight and 38% obese. Only 22% had altered the systolic blood pressure and and 18% had altered diastolic blood pressure. 60% had altered basal glycemia. 36% had hypertriglyceremia, 41% had hypercholesterolemia including 65% with high LDL cholesterol and 16% with low HDL cholesterol. 83% of the patients had two or more criteria for metabolic syndrome.Conclusions: There is a close relationship between the occurrence of NASH and cardiovascular risk factors in patients with metabolic syndrome, and it is advisable that the liver be analyzedEstudio financiado en parte por la Comisión de Investigación de la Gerencia Integrada de Albacet

Longitudinal changes in adherence to the portfolio and DASH dietary patterns and cardiometabolic risk factors in the PREDIMED-Plus study

[Background & aims]: The Portfolio and Dietary Approaches to Stop Hypertension (DASH) diets have been shown to lower cardiometabolic risk factors in randomized controlled trials (RCTs). However, the Portfolio diet has only been assessed in RCTs of hyperlipidemic patients. Therefore, to assess the Portfolio diet in a population with metabolic syndrome (MetS), we conducted a longitudinal analysis of one-year data of changes in the Portfolio and DASH diet scores and their association with cardiometabolic risk factors in Prevención con Dieta Mediterránea (PREDIMED)-Plus trial. [Methods]: PREDIMED-Plus is an ongoing clinical trial (Trial registration: ISRCTN89898) conducted in Spain that includes 6874 older participants (mean age 65 y, 48% women) with overweight/obesity fulfilling at least three criteria for MetS. Data for this analysis were collected at baseline, six months and one year. Adherence to the Portfolio and DASH diet scores were derived from a validated 143-item food frequency questionnaire. We used linear mixed models to examine the associations of 1-SD increase and quartile changes in the diet scores with concomitant changes in cardiometabolic risk factors. [Results]: After adjusting for several potential confounders, a 1-SD increase in the Portfolio diet score was significantly associated with lower HbA1c (β [95% CI]: −0.02% [−0.02, −0.01], P < 0.001), fasting glucose (−0.47 mg/dL [−0.83, −0.11], P = 0.01), triglycerides (−1.29 mg/dL [−2.31, −0.28], P = 0.01), waist circumference (WC) (−0.51 cm [−0.59, −0.43], P < 0.001), and body mass index (BMI) (−0.17 kg/m2 [−0.19, −0.15], P < 0.001). A 1-SD increase in the DASH diet score was significantly associated with lower HbA1c (−0.03% [−0.04, −0.02], P < 0.001), glucose (−0.84 mg/dL [−1.18, −0.51], P < 0.001), triglycerides (−3.38 mg/dL [−4.37, −2.38], P < 0.001), non-HDL-cholesterol (−0.47 mg/dL [−0.91, −0.04], P = 0.03), WC (−0.69 cm [−0.76, −0.60 cm], P < 0.001), BMI (−0.25 kg/m2 [−0.28, −0.26 kg/m2], P < 0.001), systolic blood pressure (−0.57 mmHg [−0.81, −0.32 mmHg], P < 0.001), diastolic blood pressure (−0.15 mmHg [−0.29, −0.01 mmHg], P = 0.03), and with higher HDL-cholesterol (0.21 mg/dL [0.09, 0.34 mg/dL, P = 0.001]). Similar associations were seen when both diet scores were assessed as quartiles, comparing extreme categories of adherence. [Conclusions]: Among older adults at high cardiovascular risk with MetS, greater adherence to the Portfolio and DASH diets showed significant favourable prospective associations with several clinically relevant cardiometabolic risk factors. Both diets are likely beneficial for cardiometabolic risk reduction.The PREDIMED-Plus trial was supported by the Spanish government's official funding agency for biomedical research, ISCIII, through the Fondo de Investigación para la Salud (FIS) and co-funded by European Union ERDF/ESF, “A way to make Europe”/“Investing in your future” (five coordinated FIS projects led by JS-S and JVid, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183,PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, and PI19/01332), the Special Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to JS-S, the European Research Council (Advanced Research Grant 2014–2019, 340918) to MÁM-G, the Recercaixa Grant to JS-S (2013ACUP00194), grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, and PI0137/2018), a grant from the Generalitat Valenciana (PROMETEO/2017/017), a SEMERGEN grant, and funds from the European Regional Development Fund (CB06/03). This research was also partially funded by EU-H2020 Grant (EAT2BENICE/H2020-SFS-2016-2; Ref 728018). Study resulting from the SLT006/17/00246 grant, funded by the Department of Health of the Generalitat de Catalunya by the call “Acció instrumental de programes de recerca orientats en l'àmbit de la recerca i la innovació en salut”. We thank CERCA Programme/Generalitat de Catalunya for institutional support. This work is partially supported by ICREA under the ICREA Academia programme. IP-G receives a grant from the Spanish Ministry of Education, Culture and Sports (FPU 17/01925). MRBL was supported by “Miguel Servet Type I” program (CP15/00028) from the ISCIII-Madrid (Spain), cofinanced by the Fondo Europeo de Desarrollo Regional-FEDER. AJG was supported by the Nora Martin Fellowship in Nutritional Sciences, the Banting & Best Diabetes Centre Tamarack Graduate Award in Diabetes Research, the Peterborough K.M. Hunter Charitable Foundation Graduate Award and an Ontario Graduate Scholarship. PH-A was supported by a postdoctoral fellowship (Juan de la Cierva-Formación), FJCI-2017–32205, funded by the Ministry of Science and Innovation. RE group has been supported by the ‘Ajut 2017-2021 SGR 1717 from the Generalitat de Catalunya. DJAJ was funded by the Government of Canada through the Canada Research Chair Endowment. JK was supported by the ‘FOLIUM’ programme within the FUTURMed project from the Fundación Instituto de Investigación Sanitaria Illes Balears (financed by 2017 annual plan of the sustainable tourism tax and at 50% with charge to the ESF Operational Program 2014–2020 of the Balearic Islands). JLS was funded by a Diabetes Canada Clinician Scientist Award

Factores Influyentes en la aparición de Disfunción Eréctil

Objectives: Determine erectile dysfunction (ED) prevalence in patients with cardiovascular risk factors (CVRF). Assess ED incidence in relation to the extent of controlling CVRF.Methodology: An observational, descriptive, analytical, cross-sectional study. Resulting in a sample of 210 people, of which 31 could not complete the study for various reasons (change of address, death, refused to complete questionnaire, etc.).Variables analysis.We analysed: Age, Level of education, Civil status, Height, Weight and Body mass index (BMI), SBP, DBP, Smoking habit, No. cigarettes/day, year smoking began, ex-smoker, year smoking stopped, Alcohol consumption, grams alcohol/week. Consumption ofother drugs, frequency and type. Blood test: glucose, haemoglobin glycated haemoglobin, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, artherogenic index, creatinine, urea, GOT, GPT, gamma-GT and PSA. Urine test: microalbuminuria, proteinuria and creatinine clearance. ECG. Diabetes diagnosed at least one year ago and prescribed drugs to treat it. High blood pressure diagnosed at least one year ago and prescribed drugs to treat it. Dyslipidaemia (hypercholesterolaemia) diagnosed at least one year ago and prescribed drugs to treat it. Concomitant diseases of at least one year and drugs (up to 3) .Results: Of the 210 selected people, 179 completed the questionnaire (85.2%). The mean age was 64.5 ± 11.6 years. When analysing all the study variables in relation to the main variable, presence or absence of ED, age is seen to play an importantrole in ED appearing as ED incidence rises with age. Blood pressure had no significant relationship with the studied variable, and the same can be said of BMI and its subdivision into normal weight and obesity. As regards toxic habits, neither cigarette smoking nor alcohol consumption influenced the presence of ED. The same may be said of the sociological-type variables (civil states, level of education).  Regarding the biochemical variables from blood tests, a significant relationship with the atherogenic index and its recoded variable at high and low atherogenic risk (p< 0.04) was noted. In the glycaemic profile, a glycaemia mean of 126 mg/dl was obtained in the ED presence group, which is the cut-off point proposed by ADA (American Diabetes Association) to consider a subject diabetic. Likewise, glycated haemoglobin presented figures in the 2 groups that can be considered an alternation of a practically diabetic glucose metabolism.In our study, the presence of diabetic diseases, HBP (high blood pressure) and dyslipidaemia showed no significant relationship with ED presence for each disease.Conclusions: In our study of cardiovascular risk factors such as hypertension, diabetes mellitus, or hypercholesterolemia show no relation to the appearance of erectile dysfunction. Objetivos: Determinar la prevalencia de disfunción erectil (DE) en pacientes con factores de riesgo cardiovascular (FRCV).Método: Estudio observacional, descriptivo, transversal analítico. 210 pacientes, de las cuales 31 no pudieron completar el estudio y fueron excluidosSe analizaron: Edad. Nivel de estudios. Estado civil. Talla, Peso e índice de masa corporal (IMC). TAS Y TAD. Consumo de tabaco, número de cigarrillos/día, año comienzo, exfumador, año retirada. Consumo de alcohol, gramos/semana de alcohol. Consumo deotras drogas, frecuencia de consumo y tipo. Bioquímica hemática: Marcadores hepáticos y PSA. Bioquímica urinaria. Electrocardiograma (ECG). Diabetes, fármacos prescritos, existencia o no de hipertensión arterial, dislipemia y enfermedades concomitantes.(hasta 3).Resultados: 179 pacientes completaron el estudio. (85,2%).La edad media, 64,5 ± 11,6 años. Al analizar todas las variables del estudio con respecto a la variable principal de presencia o ausencia de disfunción eréctil, se observa que la edad juega un papelimportante. No mostraron relación significativa con la DE presión arterial, el índice de masa corporal y su subdivisión en dos rangos de normopeso y obesidad, ni el consumo de cigarrillos ni el consumo de alcohol, el estado civil ni el nivel de estudios.En la presencia de las enfermedades diabetes, HTA y dislipemia no se encontró relación significativa con respecto a la presencia de DE. Se puede observar relación estadísticamente significativa en la asociación de estas enfermedades un aumento del riesgocardiovascular. La duración de cada enfermedad, los fármacos utilizados para el tratamiento de estas tres patologías ni las enfermedades asociadas mostraron diferencias significativas. (p< 0,46).Conclusión: Factores de riesgo cardiovascular como hipertensión arterial, diabetes mellitus o hipercolesterolemia no muestran relación con la aparición de disfunción eréctil

Análisis de la relación entre Diabetes Mellitus tipo 2 y la obesidad con los factores de riesgo cardiovascular

"Diabesity" is a booming concept that refers to individuals with type 2 diabetes mellitus and obesity. Both concepts are closely related.A search of Web Of Science was carried out to carry out a bibliographic review with the aim of establishing the relationship between obesity, type 2 diabetes mellitus and cardiovascular risk factors.Adipose tissue is an endocrine gland capable of secreting hormones, cytokines, and vasoactive substances. In obese individuals, this adipose tissue is dysfunctional, secreting certain adipokines such as leptin and adiponectin in an unusual way. So much so, that in obese individuals undergoing bariatric surgery, the adiponectin / leptin ratio has been reversed. Furthermore, in an obesogenic environment, adipose tissue displays a proinflammatory phenotype, which helps perpetuate the process of insulin resistance and the consequent development of prediabetes and type 2 diabetes mellitus.It is important to determine new therapeutic targets for diabesity, such as the GPS2 transcription factor, which shows a decrease in its levels in obese subjects, which predisposes to a pro-diabetic phenotype.Mi-483-5p has recently been shown to be expressed in relevant tissues of diabetes and cardiovascular disease, which predicts its potential as a blood biomarker for these diseases.In conclusion, this review aims to emphasize the importance of controlling cardiovascular risk factors, such as obesity, to prevent the subsequent development of a disease closely related to it, such as type 2 diabetes.La “diabesidad” es un concepto en auge que hace referencia a los individuos con diabetes mellitus tipo 2 y obesidad. Ambos conceptos se encuentran íntimamente relacionados.Se ha llevado a cabo una búsqueda en Web Of Science para realizar una revisión bibliográfica con el objetivo de establecer la relación existente entre la obesidad, la diabetes mellitus tipo 2 y los factores de riesgo cardiovascular.El tejido adiposo es una glándula endocrina capaz de secretar hormonas, citoquinas y sustancias vasoactivas. En los individuos obesos, este tejido adiposo se muestra disfuncional, secretando de forma inusual ciertas adipocinas como la leptina y adiponectina. Tanto es así, que en individuos obesos sometidos a una cirugía bariátrica se ha visto como la relación adiponectina/leptina se invierte. Además, en un ambiente obesogénico, el tejido adiposo muestra un fenotipo proinflamatorio, que ayuda a perpetuar el proceso de resistencia a la insulina y el consiguiente desarrollo de prediabetes y diabetes mellitus tipo 2.Es importante determinar nuevas dianas terapéuticas para la diabesidad, como el factor de transcripción GPS2, que muestra una disminución de sus niveles en sujetos obesos, lo cual predispone a un fenotipo pro-diabético.Recientemente se ha demostrado que mi-483-5p se expresa en tejidos relevantes de diabetes y enfermedad cardiovascular, lo cual predice su potencial como biomarcador en sangre de dichas enfermedades.En conclusión, esta revisión pretende recalcar la importancia de controlar los factores de riesgo cardiovascular, como la obesidad, para impedir el desarrollo posterior de una enfermedad estrechamente ligada a ésta como es la diabetes tipo 2.

Alteration of liver parameters in non-alcoholic fatty liver disease in patients with metabolic síndrome

The interest of non-alcoholic fatty liver disease (NAFLD) is growing due to several reasons: high prevalence of the disease in the Western World, its capability to progress towards more aggressive histological forms and its association with diseases that increase cardiovascular risk. Objective: To analyze the alteration of liver parameters in NAFLD in patients with metabolic syndrome. Methods: A transverse, descriptive study of 100 patients with two or more cardiovascular risk factors was conducted. All patients signed informed consent. Patients selected were among those attending our Medical Office of Primary Attention and who had very little or no alcoholic consumption. A complete battery of analysis was performed including total abdominal ultrasound. Steatosis was evaluated and, if determined positive, patients were stratified in three degrees. The following determinations were collected: sex, personal and familial history of diabetes, arterial hypertension, dyslipidemia, age, weight, BMI, present pharmacological treatment, analytical parameters, blood pressure and abdominal perimeter. Results: 100 patients were included in the study, 56 (56%) women and 44 (44%) men, with an average age of 61,84 + 9,5 years 23% of all patients did not have NAFLD; 29% had mild NAFLD, 29% had moderate NAFLD and 19% had severe NAFLD. 82% of men presented NAFLD. 29% of women did not nave NAFLD. 22% were overweight and 38% were obese. Blood pressure was altered in 22% of men and 18% of women. 60% had altered fasting blood glucose. 36% had hypertriglyceridemia, 41% hypercholesterolemia with 65% high LDL cholesterol and 16% of low HDL cholesterol. 83% of patients had two or more criteria of metabolic syndrome. Average transaminases were: ALT 24.98 u/i; AST 32.19 u/i; GGT 55,65 u/i; ALT/AST ratio: 0.77. Lactate dehydrogenase 255.30 u/L. Alkaline phosphatase 82.80 u/L and bilirubin 0.78 mg/dL Conclusions: We did not find correlation between liver steatosis and alteration of liver parameters in our study

Alteración de los parámetros hepáticos en la esteatosis hepática no alcohólica de pacientes con síndrome metabólico

The interest of non-alcoholic fatty liver disease (NAFLD) is growing due to several reasons: high prevalence of the disease in the Western World, its capability to progress towards more aggressive histological forms and its association with diseases that increase cardiovascular risk. Objective: To analyze the alteration of liver parameters in NAFLD in patients with metabolic syndrome. Methods: A transverse, descriptive study of 100 patients with two or more cardiovascular risk factors was conducted. All patients signed informed consent. Patients selected were among those attending our Medical Office of Primary Attention and who had very little or no alcoholic consumption. A complete battery of analysis was performed including total abdominal ultrasound. Steatosis was evaluated and, if determined positive, patients were stratified in three degrees. The following determinations were collected: sex, personal and familial history of diabetes, arterial hypertension, dyslipidemia, age, weight, BMI, present pharmacological treatment, analytical parameters, blood pressure and abdominal perimeter. Results: 100 patients were included in the study, 56 (56%) women and 44 (44%) men, with an average age of 61,84 + 9,5 years 23% of all patients did not have NAFLD; 29% had mild NAFLD, 29% had moderate NAFLD and 19% had severe NAFLD. 82% of men presented NAFLD. 29% of women did not nave NAFLD. 22% were overweight and 38% were obese. Blood pressure was altered in 22% of men and 18% of women. 60% had altered fasting blood glucose. 36% had hypertriglyceridemia, 41% hypercholesterolemia with 65% high LDL cholesterol and 16% of low HDL cholesterol. 83% of patients had two or more criteria of metabolic syndrome. Average transaminases were: ALT 24.98 u/i; AST 32.19 u/i; GGT 55,65 u/i; ALT/AST ratio: 0.77. Lactate dehydrogenase 255.30 u/L. Alkaline phosphatase 82.80 u/L and bilirubin 0.78 mg/dL Conclusions: We did not find correlation between liver steatosis and alteration of liver parameters in our study.Varias circunstancias motivan el creciente interés por esta enfermedad: elevada prevalencia de la enfermedad en el mundo occidental, y su capacidad de progresión a formas histológicas más agresivas y su asociación con enfermedades que incrementan el riesgo cardiovascular. Objetivo: Analizar la alteración de los parámetros hepáticos en la Esteatosis hepatica no alcohólica de pacientes con síndrome metabólico. Método: Se realiza un estudio descriptivo transversal con una muestra de 100 pacientes, con 2 ó más factores de riesgo cardiovascular, con nula o baja ingesta de alcohol, que acudían a consulta de Atención Primaria. A los seleccionados se les solicitaba analítica completa, y se les citaba en consulta para ecografía de abdomen completo. Se evaluaba si tenían esteatosis hepática Y, en caso afirmativo, se estratificaba en 3 grados. Se recogen las siguientes variables tanto cualitativas (sexo, antecedentes personales y familiares de Diabetes, Hipertensión Arterial, dislipemia, etc.) como cuantitativas (edad, peso, talla, índice de masa corporal, tratamiento farmacológico, cifras de distintos parámetros analíticos, cifras de tensión arterial y perímetro abdominal). Resultados: Han participado 100 pacientes, 56% mujeres, con una edad media de 61,84 DE +/- 9,5 años. Del total de sujetos del estudio, el 23 % no tenían Esteatosis Hepática No Alcohólica, 29% tenían esteatosis hepática leve, 29 % esteatosis hepática moderada y 19% esteatosis hepática severa. En los hombres, el 82 % presentaba esteatosis hepática. De las mujeres, el 28,57% no presentaban hígado graso. Un 22% tenían sobrepeso y eran obesos un 38%. Sólo un 22% y un 18% tenían alteradas las cifras tensionales sistólica y diastólica respectivamente. El 60% tienen una glucemia basal alterada. En cuanto a los parámetros lipídicos 36% tienen hipertrigliceremia, 41% hipercolesterolemia con un 65% de Colesterol LDL alto y 16% Colesterol HDL bajo. El 83% de los pacientes tienen dos o mas criterios de síndrome metabólico. Las media de transaminasas ALT: 24,98 u/i AST: 32,19 u/i GGT: 55,65 u/i . Cociente ALT/AST: 0.77. Lactato deshidrogenasa 255,30 u/L. Fosfatasa alcalina 82.80 u/L y Bilirrubina 0,78 mg/dL Conclusiones: En nuestro estudio no existe correlación entre el grado esteatosis hepática y la alteración de los parámetros hepáticos

Efecto de una intervención motivacional de Obesidad sobre factores de riesgo cardiovascular.

Objective: To determine the effect on cardiovascular risk factors in a group of motivational intervention by nurses trained by an expertpsychologist, complementarily to the usual procedure.Methods: Multicenter intervention in overweight and obese patients randomized clinical trial. Randomization of intervention by BasicHealth Zones (ZBS).Two groups located in separated different centers, one receiving motivational intervention in group (study group)and the other routine monitoring (control group) were established. Variables: Sociodemographic, results: percentage of patientsreducing 5% of weight, assessment of cardiovascular risk factors and analytical data.Results: 696 patients were evaluated; 377 control and 319 of the study group. Weight diminished in both groups in each visit. Meanpercent weight reduction remained at 1% in the control group and 2.5% in the intervention group (p-value = 0.009). 55.8% of patientsreduced their weight in the control group and 65.5% in the study group (p-value = 0.0391). 18.1% of patients in the control groupreduced more than 5% of weight; this percentage increased to 26.9% in the intervention group being statistically significant (p-value = 0.0304). No significant differences (5% vs. 8%) were detected at 2 years in the case of the 10% target. It was found after two years that BMI was reduced an average 0.9 kg / m2 in the control group and 2.4 kg / m2 in the study group (p-value = 0.0237). A significant evolution in triglycerides reduction and systolic blood pressure was detected. However there was no statistically significant reduction in blood sugar, diastolic blood pressure and other lipid parameters (total cholesterol, HDL and LDL-cholesterol).Objetivo: Determinar el efecto sobre los factores de riesgo cardiovascular de una intervención de motivación en grupo, por profesionales de enfermería entrenados por psicólogo experto, complementariamente a la intervención habitual.Métodos: Ensayo clínico aleatorio multicéntrico de intervención en pacientes con sobrepeso y obesidad. Asignación aleatoria de la intervención por Zonas Básicas de Salud (ZBS). Se establecen dos grupos situados en centros diferentes separados, uno de los cuales recibirá la intervención de motivación en grupo (grupo de estudio) y el otro el seguimiento habitual (grupo control). Variables: Sociodemográficas, de resultados: porcentaje de pacientes que reducen un 5 % de su peso, valoración de factores de riesgo cardiovascular y datos analíticos.Resultados: Se evaluaron 696 pacientes; 377 grupo control y 319 del de estudio. En ambos grupos el peso descendía en cada una de las visitas. La reducción porcentual media del peso se situó en el 1% para el grupo control y del 2,5% en el grupo intervención (pvalor =0,009). El 55,8% de los pacientes redujeron el peso en el grupo control y el 65,5% del grupo de estudio (p-valor =0,0391). El 18,1% de los pacientes del grupo control redujeron más del 5% del peso, en el grupo intervención este porcentaje aumentó hasta el 26.9%; estadísticamente significativo (p-valor = 0,0304). En el caso del objetivo del 10% no se detectaron diferencias significativas a los 2 años (5% vs. 8%). Se detectó que a los dos años el IMC en el grupo control se redujo una media 0,9 kg/m2 y 2,4 kg/ m2 en el grupo de estudio (p-valor = 0,0237). Se detectó una evolución significativa en la reducción de Trigliceridos y presión arterial sistólica. Sin embargo no hubo reducción estadísticamente significativa en la Glucemia, en la presión arterial diastólica y en los otros parámetros lipídicos (Colesterol Total, HDL-Colesterol y LDL-Colesterol)

Effect of a motivational intervention of obesity upon cardiovascular risk factors

Objective: To determine the effect on cardiovascular risk factors in a group of motivational intervention by nurses trained by an expert psychologist, complementarily to the usual procedure. Methods: Multicenter intervention in overweight and obese patients randomized clinical trial. Randomization of intervention by Basic Health Zones (ZBS).Two groups located in separated different centers, one receiving motivational intervention in group (study group) and the other routine monitoring (control group) were established. Variables: Sociodemographic, results: percentage of patients reducing 5% of weight, assessment of cardiovascular risk factors and analytical data. Results: 696 patients were evaluated; 377 control and 319 of the study group. Weight diminished in both groups in each visit. Mean percent weight reduction remained at 1% in the control group and 2.5% in the intervention group (p-value = 0.009). 55.8% of patients reduced their weight in the control group and 65.5% in the study group (p-value = 0.0391). 18.1% of patients in the control group reduced more than 5% of weight; this percentage increased to 26.9% in the intervention group being statistically significant (p-value = 0.0304). No significant differences (5% vs. 8%) were detected at 2 years in the case of the 10% target. It was found after two years that BMI was reduced an average 0.9 kg / m2 in the control group and 2.4 kg / m2 in the study group (p-value = 0.0237). A significant evolution in triglycerides reduction and systolic blood pressure was detected. However there was no statistically significant reduction in blood sugar, diastolic blood pressure and other lipid parameters (total cholesterol, HDL and LDL-cholesterol)

Porcieda

Este Proyecto plantea varios tipos de objetivos, a saber: objetivos educativos, objetivos del BUP, objetivos de la ESO, objetivos didácticos de la actividad y obetivos de formación y perfeccionamiento del profesorado. Los objetivos educativos consisten en: Obtener y seleccionar información utilizando las fuentes en las que habitualmente se encuentra disponible, tratarla de forma autónoma y crítica, con una finalidad previamente establecida y transmitirla a los demás de manera organizada e inteligible. Elaborar estrategias de identificación y solución de problemas. Formarse una imagen ajustada de si mismo, de sus características y posibilidades. Relacionarse con otras personas y participar en actividades de grupo con actitudes solidarias y tolerantes. Conocer las creencias, actitudes y valores que rigen el funcionamiento del medio físico. Conocer y valorar el desarrollo científico y tecnológico. Conocer y valorar el patrimonio cultural y contribuir activamente a su conservación y mejora. Las áreas que abarca el Proyecto son Ciencias de la Naturaleza, Ciencias Sociales, Educación Física, Educación Plástica y Visual, Lengua Española y Literatura, Matemáticas, Música y Tecnología. En este proyecto se va a hacer una aproximación a las costumbres y formas de vida del valle de Liébana (Cantabria) y en concreto al pueblo de Porcieda, en el que la emigración lo ha dejado sin gente.Gobierno de Cantabria. Consejería de Educación y JuventudCantabriaES