20 results on '"J.J. Cabré"'
Search Results
2. Evaluación de la validez de las funciones SCORE de bajo riesgo y calibrada para población española en las cohortes FRESCO
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Albert Francès, María José Medrano, Josep Basora, Fernando Rigo, Eva Ardanaz, Roberto Elosua, Irene R. Dégano, José Lapetra, José Miguel Baena-Díez, Guillem Frontera, Miquel Quesada, Manel García-Lareo, María Jesús Guembe, Rafael Ramos, Antonio Segura, Eduardo Mayoral, Conchi Moreno-Iribas, Isaac Subirana, María José Tormo-Díaz, Agustín Gómez de la Cámara, J.J. Cabré, Alejandro Marín-Ibañez, Paulino González-Diego, Conxa Castell, Diana Gavrila, María Grau, José Antonio Gutiérrez-Fuentes, Joan Sala, Joan Vila, Jaume Marrugat, and José María García
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03 medical and health sciences ,0302 clinical medicine ,business.industry ,Medicine ,030212 general & internal medicine ,030204 cardiovascular system & hematology ,Cardiology and Cardiovascular Medicine ,business ,Humanities - Abstract
Resumen Introduccion y objetivos Estudiar la validez de la funcion SCORE original de bajo riesgo sin y con colesterol unido a lipoproteinas de alta densidad y SCORE calibrada en poblacion espanola. Metodos Analisis agrupado con datos individuales de 12 estudios de cohorte de base poblacional. Se incluyo a 30.919 participantes de 40-64 anos sin enfermedades cardiovasculares en el momento del reclutamiento, que se siguieron durante 10 anos para la mortalidad cardiovascular contemplada en el proyecto SCORE. La validez de las funciones se analizo mediante el area bajo la curva ROC (discriminacion) y el test de Hosmer-Lemeshow (calibracion), respectivamente. Resultados Se dispuso de 286.105 personas/ano. La mortalidad a 10 anos por causas cardiovasculares fue del 0,6%. La razon de casos esperados/observados fue de 9,1, 6,5 y 9,1 en varones y de 3,3, 1,3 y 1,9 en mujeres con las funciones SCORE original de bajo riesgo sin y con colesterol unido a lipoproteinas de alta densidad y SCORE calibrada, respectivamente; diferencias estadisticamente significativas con el test de calibracion de Hosmer-Lemeshow entre la mortalidad predicha con SCORE y la observada (p Conclusiones Todas las versiones de las funciones SCORE disponibles en Espana sobreestiman significativamente la mortalidad cardiovascular observada en la poblacion espanola. A pesar de la aceptable capacidad de discriminacion, la prediccion del numero de acontecimientos cardiovasculares mortales (calibracion) fue significativamente imprecisa.
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- 2018
3. Interaction between cardiovascular risk factors and body mass index and 10-year incidence of cardiovascular disease, cancer death, and overall mortality
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Miquel Quesada, Fernando Rigo, Fresco Investigators, Jesús Berjón, José Miguel Baena-Díez, Manel García-Lareo, María Grau, María Barroso, Aurelio Barricarte, David Lora-Pablos, Diana Gavrila, Rafel Ramos, Guillem Frontera, Agustín Gómez de la Cámara, Eduardo Mayoral, María Jesús Guembe, Alejandro Marín-Ibañez, Antonio Segura, José María García, María José Tormo-Díaz, Albert Goday, Josep Basora, José Lapetra, María José Medrano, Jaume Marrugat, J.J. Cabré, and Conchi Moreno-Iribas
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Adult ,Male ,medicine.medical_specialty ,Epidemiology ,Disease ,030204 cardiovascular system & hematology ,Overweight ,Body Mass Index ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Cor -- Malalties ,Risk Factors ,Neoplasms ,Cause of Death ,Internal medicine ,Mortalitat ,medicine ,Humans ,Longitudinal Studies ,Obesity ,030212 general & internal medicine ,Mortality ,Càncer ,Epidemiologia ,Body mass index ,Aged ,Tumors ,Cause of death ,Malalties cardiovasculars ,business.industry ,Incidence ,Hazard ratio ,Public Health, Environmental and Occupational Health ,Cancer ,Middle Aged ,Cardiovascular disease ,medicine.disease ,Cardiovascular diseases ,Cardiovascular Diseases ,Spain ,Obesitat ,Female ,medicine.symptom ,business - Abstract
The effect of above-normal body mass index (BMI) on health outcomes is controversial because it is difficult to distinguish from the effect due to BMI-associated cardiovascular risk factors. The objective was to analyze the impact on 10-year incidence of cardiovascular disease, cancer deaths and overall mortality of the interaction between cardiovascular risk factors and BMI. We conducted a pooled analysis of individual data from 12 Spanish population cohorts with 10-year follow-up. Participants had no previous history of cardiovascular diseases and were 35-79years old at basal examination. Body mass index was measured at baseline being the outcome measures ten-year cardiovascular disease, cancer and overall mortality. Multivariable analyses were adjusted for potential confounders, considering the significant interactions with cardiovascular risk factors. We included 54,446 individuals (46.5% with overweight and 27.8% with obesity). After considering the significant interactions, the 10-year risk of cardiovascular disease was significantly increased in women with overweight and obesity [Hazard Ratio=2.34 (95% confidence interval: 1.19-4.61) and 5.65 (1.54-20.73), respectively]. Overweight and obesity significantly increased the risk of cancer death in women [3.98 (1.53-10.37) and 11.61 (1.93-69.72)]. Finally, obese men had an increased risk of cancer death and overall mortality [1.62 (1.03-2.54) and 1.34 (1.01-1.76), respectively]. In conclusion, overweight and obesity significantly increased the risk of cancer death and of fatal and non-fatal cardiovascular disease in women; whereas obese men had a significantly higher risk of death for all causes and for cancer. Cardiovascular risk factors may act as effect modifiers in these associations.
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- 2018
4. 1489-P: Ten-Year Follow-Up of Diabetes Incidence in the DE-PLAN (Diabetes in Europe—Prevention Using Lifestyle, Physical Activity, and Nutritional Intervention) Project in Catalonia
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J.J. Cabré, Francisco Barrio, Francesc Xavier Cos, Santiago Mestre, Bernardo Costa, Conxa Castell, Anna Martinez, and Jaana Lindström
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Relative risk reduction ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Incidence (epidemiology) ,Physical activity ,Type 2 diabetes ,medicine.disease ,Discontinuation ,Internal medicine ,Diabetes mellitus ,Intervention (counseling) ,Internal Medicine ,medicine ,Prediabetes ,business - Abstract
To assess the long-term effectiveness of a pragmatic public healthcare strategy to prevent type 2 diabetes within primary care setting. In the extended follow-up of the DEPLANCAT project, we explored whether the originally-achieved risk reduction remains after discontinuation of active lifestyle intervention. Middle-aged men (n=184) and women (n=368) with Finnish Diabetes Risk Score (FINDRISC)>14 and/or prediabetes (WHO rules for fasting or 2-h glucose) were allocated not randomly but sequentially to standard care control (CG) or intensive lifestyle intervention (IG) group. After a median of 4.2 y of active intervention, participants who were still free of diabetes were further followed-up without any additional specific intervention for a median of 5.8 y (median total follow-up of 10.01 y) via computerized health-care records or direct personal contact with invitation to 2h-glucose retest. The primary outcome was the development of diabetes. During the active intervention, diabetes was diagnosed in 124 participants (22.5%): 63 (28.8%) in the CG and 61 (18.3%) in the IG. After 10 y, 27 people (4.9%) had died. Among the remaining 401 individuals, 34 diabetes diagnoses were traced using the health-care records. Additionally, among the 191 people (47.6%) who agreed to blood re-test (66 in the CG and 125 in the IG) 16 new cases were found. During the post-intervention follow-up the total number of new cases of diabetes was 16 in the CG and 34 in the IG. The absolute incidences of diabetes during the overall follow-up were 6.1 (95% CI 5.2-6.9) and 5.1 (4.4-5.8) per 100 person-years, respectively (p=0.019 log-rank). The corresponding HR was 0.59 (0.43-0.81) with a relative risk reduction of 16.6%. The NNT to prevent one case of diabetes was 10. Intensive lifestyle intervention in a primary care setting substantially reduces diabetes incidence among high-risk individuals. Risk reduction can persist for at least 10 years. Disclosure F. Barrio: None. B. Costa: None. F. Cos: None. J. Cabre: None. A. Martinez: None. S. Mestre: None. C. Castell: None. J. Lindstrom: None. Funding Institute of Health Carlos III, Spanish Ministry of Health and the European Regional Development Fund (PI14/00122, PI14/00124); La Marató de TV3 Foundation (73-201609.10); Spanish Diabetes Society; Department of Health, Generalitat de Catalunya; Pla Estratègic de Recerca i Innovació en Salut (SLT002/16/00045, SLT002/16/00154, SLT002/16/00093)
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- 2019
5. Legume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study
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Miguel Fiol, Patricia Guillem-Saiz, Leticia Miró-Moriano, Josep A. Tur, N. Ibarrola, A.I. Castellote-Bargalló, J. Boj, Estefanía Toledo, Ana Jover, V. Extremera-Urabayen, E. Manzano, I. González-Monje, Juan Carlos Martínez-González, María P. Portillo, O. Portolés, C. Simón, Olga Castañer, B. Sanjulián, S. Sánchez-Navarro, R. González, Rosa M. Lamuela-Raventós, R. Pedret, N. Tort, J. Pérez-Cabrera, J. García, J. Portu-Zapirain, Carolina Ortega-Azorín, Dolors Montañes, Helmut Schröder, Guillermo Frontera, Mònica Bulló, Lluis Serra-Majem, J.M. Santos-Lozano, F. Trias, Nuria Rosique-Esteban, P. Martínez, C. Iglesias, Magí Farré, J.M. Lozano-Rodriguez, Valentina Ruiz-Gutiérrez, Luis Forga, L.T. Casañas-Quintana, I. Sarasa, C. de Juan, R. Benítez Pont, Javier Díez-Espino, L. Parra, M. Ginard, Josep Basora, Luis V. García, Rosa Casas, Fernando Arós, L. Quinzavos, A. Larrauri, A. Guarner, Ramon Estruch, A.M. Alonso-Gómez, Aleix Sala-Vila, E. Montero Romero, Cinta Valls-Pedret, F. Bestard, Jesús Berjón, Y. García, José Manuel Santos-Lozano, Emili Corbella, J. Clos, Christopher Papandreou, E. Maestre, R.E. Sosa-Also, J. Altirriba, M. Bianchi Alba, José I. González, Eva M. Asensio, Paula Carrasco, J. Vila, J.A. García Pastor, J. Medina-Ponce, Jordi Salas-Salvadó, L. Mellado, Amelia Marti, Estíbaliz Goñi, Joan Fernández-Ballart, Ana García-Arellano, Pilar Roura, Albert Salas-Huetos, A. Loma-Osorio, E. Jurado-Ruiz, Casandra Riera, Pilar Buil-Cosiales, Ana Galera, J. Gil Zarzosa, Miquel Fiol, Fabiola Márquez, Alfredo García-Layana, Maria Luisa García, B.V. Díaz-González, M.A. Pages, Enrique Gómez-Gracia, D. Godoy, F. Paris, T. del Hierro, F. Cortés-Ugalde, Ernest Vinyoles, J. Marrugat, V. Velasco García, Olga Portolés, F. Sarmiento de la Fe, Roberto Elosua, F.J. García-Corte, J. Timiraus-Fernández, Ana Pérez-Heras, P. Baby, M. Aldamiz-Echevarría, Montse Cofán, Y. Corchado, J. Villanueva-Telleria, T. Sagredo-Arce, C. Valero-Barceló, M.C. Belló, J. Frigola, J.J. Cabré, B. Churio-Beraza, Montserrat Fitó, P. Román, A. Proenza, M.C. López Sabater, P. Iglesias, J.M. Baena, M.T. Martín, Javier Rekondo, S. Vaquero-Diaz, G. Mestres, Nancy Babio, J. Diez-Espino, M. Liroz, M. García-Valdueza, J. Gállego, J.M. Castillo Anzalas, M.V. Gueto Rubio, L. Coll, S. Tello, Manuel Moñino, Anna Tresserra-Rimbau, Susana Munuera, J. Sánchez Perona, Guillermo T. Sáez, Gemma Flores, J. Amat, J. Benavent, M. Sorlí, Manuel Ortega-Calvo, A. Altés, Dolores Corella, Inmaculada Bautista-Castaño, Jacqueline Álvarez-Pérez, Marisa Guillén, Rafel M. Prieto, Ángel M. Alonso-Gómez, A. Ramos, Daniel Muñoz-Aguayo, M.A. Rovira, E. de la Cruz, Manuel Serrano-Martínez, A. Urtasun-Samper, R. Osma, R. de la Torre, J. Basells, N. Berrade, Jaime Algorta, R. Segarra, I. Duaso, Emilio Ros, C. Domínguez-Espinaco, J.A. Munar, A. Brau, M.I. Santamaría, A. Medina-Renom, Mercè Serra-Mir, Jesús Vizcaíno, J. de Diego Salas, M. Amorós, Z. Vázquez, Ana María Castro, E. Sanz, M. García-García, F. Fiol, F.J. Giménez, Itziar Salaverria, M. Vivó, Elena H. Martinez-Lapiscina, C. Viñas, J. García Roselló, A. Baca Osorio, A. Carratalá-Calvo, Francesc Francés, Julia Wärnberg, C. Arroyo-Azpa, Rebeca Fernández-Carrión, E.M. Díaz-Benítez, O. Coltell, Miguel Ruiz-Canela, M.D. Vigata-López, F. Martin, M.S. Sánchez, L. Mengual, Mónica Doménech, V. Pascual, Nerea Becerra-Tomás, Ricardo Gómez-Huelgas, Xavier Corbella, M.C. Yuste, E. Vargas López, Carmen Saiz, J.J. Sánchez Luque, I. Pla, S. Francisco, F. Aros, Marta Guasch-Ferré, Almudena Sánchez-Villegas, A. Isach, Ariadna Rovira, Marta Fanlo-Maresma, Carmen Cabezas, Dora Romaguera, L. Garcia-Pérez, M. Oller, M.T. Bonet, M. Mata, Sonia Eguaras, Ana Sánchez-Tainta, M. Llauradó, J. Costa-Vizcaino, Laura Quiles, Paola Quifer-Rada, C. Molina, N. Molina, M.T. Arceiz Campo, Cristina Ruano-Rodríguez, J.M. Verdú, Rocío Barragán, and Andrés Díaz-López
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0301 basic medicine ,Gerontology ,Blood Glucose ,Male ,Lentils ,Mediterranean diet ,PREDIMED-study ,030209 endocrinology & metabolism ,Context (language use) ,Type 2 diabetes ,Critical Care and Intensive Care Medicine ,Lower risk ,Diet, Mediterranean ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Diabetes mellitus ,medicine ,Humans ,Prospective Studies ,Glycemic ,Adiposity ,Aged ,Proportional Hazards Models ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Fabaceae ,Middle Aged ,medicine.disease ,Legumes ,Diet ,Glycemic index ,Quartile ,Diabetes Mellitus, Type 2 ,Glycemic Index ,Female ,business ,Demography ,Follow-Up Studies - Abstract
Background & aims: Legumes, a low-energy, nutrient-dense and low glycemic index food, have shown beneficial effects on glycemic control and adiposity. As such, legumes are widely recommended in diabetic diets, even though there is little evidence that their consumption protects against type 2 diabetes. Therefore the aim of the present study was to examine the associations between consumption of total legumes and specific subtypes, and type 2 diabetes risk. We also investigated the effect of theoretically substituting legumes for other protein- or carbohydrate-rich foods. Methods: Prospective assessment of 3349 participants in the PREvención con DIeta MEDiterránea (PREDIMED) study without type 2 diabetes at baseline. Dietary information was assessed at baseline and yearly during follow-up. We used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for type-2 diabetes incidence according to quartiles of cumulative average consumption of total legumes, lentils, chickpeas, dry beans and fresh peas. Results: During a median follow-up of 4.3 years, 266 new cases of type 2 diabetes occurred. Individuals in the highest quartile of total legume and lentil consumption had a lower risk of diabetes than those in the lowest quartile (HR: 0.65; 95% CI: 0.43, 0.96; P-trend = 0.04; and HR: 0.67; 95% CI: 0.46–0.98; P-trend = 0.05, respectively). A borderline significant association was also observed for chickpeas consumption (HR 0.68; 95% CI: 0.46, 1.00; P-trend = 0.06). Substitutions of half a serving/day of legumes for similar servings of eggs, bread, rice or baked potato was associated with lower risk of diabetes incidence. Conclusions: A frequent consumption of legumes, particularly lentils, in the context of a Mediterranean diet, may provide benefits on type 2 diabetes prevention in older adults at high cardiovascular risk. Trial registration: The trial is registered at http://www.controlled-trials.com (ISRCTN35739639). Registration date: 5th October 2005., The authors disclose no conflict of interest related with the article. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN) is an initiative of the Instituto de Salud Carlos III (ISCIII) of Spain which is supported by FEDER funds (CB06/03). Supported by the official funding agency for biomedical research of the Spanish government, ISCIII, through grants provided to research networks specifically developed for the trial (RTIC G03/140 and RD 06/0045) through CIBEROBN, and by grants from Centro Nacional de Investigaciones Cardiovasculares (CNIC 06/2007), Fondo de Investigación Sanitaria–FondoEuropeo de Desarrollo Regional (PI04–2239, PI05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, and PI11/02505; PI13/00462), Ministerio de Ciencia e Innovación (AGL-2009–13906-C02 and AGL2010–22319-C03), Fundación Mapfre 2010, Consejería de Salud de la Junta de Andalucía (PI0105/2007), Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana (ACOMP06109, GVA-COMP2010–181, GVACOMP2011–151, CS2010-AP-111, and CS2011-AP-042), and the Navarra Regional Government (27/2011). The Fundación Patrimonio Comunal Olivarero and Hojiblanca SA (Málaga, Spain), California Walnut Commission (Sacramento, CA), Borges SA (Reus, Spain), and Morella Nuts SA (Reus, Spain) donated the olive oil, walnuts, almonds, and hazelnuts, respectively, used in the study. None of the funding sources played a role in the design, collection, analysis or interpretation of the data or in the decision to submit the manuscript for publication. Acknowledgements: The authors thank all the participants for their collaboration, all the PREDIMED personnel for their assistance and all the personnel of affiliated primary care centers for making the study possible. CIBEROBN is an initiative of ISCIII, Spain.
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- 2018
6. Derivation and validation of a set of 10-year cardiovascular risk predictive functions in Spain: The FRESCO Study
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José Lapetra, María José Medrano, María Jesús Guembe, Josep Basora, Eva Ardanaz Aicua, Conchi Moreno-Iribas, Fernando Rigo, Guiem Frontera, Roberto Elosua, José Gutiérrez, Joan Sala, Antonio Segura, Eduardo Mayoral, María Grau, Paulino González Diego, Diana Gavrila, Agustín Gómez de la Cámara, Isaac Subirana, María José Tormo Díaz, Miquel Quesada, José Miguel Baena-Díez, Ralph B. D'Agostino, J.J. Cabré, Joan Vila, Jaume Marrugat, José María García, Rafel Ramos, Alejandro Marín-Ibañez, and Manuel García-Lareo
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Adult ,Male ,medicine.medical_specialty ,Epidemiology ,Population ,Kaplan-Meier Estimate ,Risk Assessment ,Cohort Studies ,chemistry.chemical_compound ,Sex Factors ,Risk Factors ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Registries ,cardiovascular diseases ,Derivation ,Mortality ,education ,Stroke ,Aged ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Cholesterol ,Cholesterol, HDL ,Public Health, Environmental and Occupational Health ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Survival Analysis ,Blood pressure ,chemistry ,Cardiovascular Diseases ,Spain ,Cardiology ,Female ,business ,Lipid profile ,Risk Reduction Behavior ,Body mass index ,Follow-Up Studies - Abstract
Objective To derive and validate a set of functions to predict coronary heart disease (CHD) and stroke, and validate the Framingham-REGICOR function. Method Pooled analysis of 11 population-based Spanish cohorts (1992–2005) with 50,408 eligible participants. Baseline smoking, diabetes, systolic blood pressure (SBP), lipid profile, and body mass index were recorded. A ten-year follow-up included re-examinations/telephone contact and cross-linkage with mortality registries. For each sex, two models were fitted for CHD, stroke, and both end-points combined: model A was adjusted for age, smoking, and body mass index and model B for age, smoking, diabetes, SBP, total and HDL cholesterol, and for hypertension treatment by SBP, and age by smoking and by SBP interactions. Results The 9.3-year median follow-up accumulated 2973 cardiovascular events. The C-statistic improved from model A to model B for CHD (0.66 to 0.71 for men; 0.70 to 0.74 for women) and the combined CHD-stroke end-points (0.68 to 0.71; 0.72 to 0.75, respectively), but not for stroke alone. Framingham-REGICOR had similar C-statistics but overestimated CHD risk. Conclusions The new functions accurately estimate 10-year stroke and CHD risk in the adult population of a typical southern European country. The Framingham-REGICOR function provided similar CHD prediction but overestimated risk.
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- 2014
7. Lifestyle interventions for diabetes mellitus type 2 prevention
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Oriol Solà-Morales, J.J. Cabré, Bernardo Costa, Ramon Sagarra, Francisco Barrio, Predice, and el Grupo de Investigación De-Plan-Cat
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medicine.medical_specialty ,business.industry ,Cost effectiveness ,General Medicine ,Type 2 diabetes ,medicine.disease ,Impaired fasting glucose ,Surgery ,Impaired glucose tolerance ,Quality of life ,Internal medicine ,Diabetes mellitus ,medicine ,Prediabetes ,Prospective cohort study ,business - Abstract
Background and aims Transferring the results from clinical trials on type 2 diabetes prevention is the objective of the Diabetes in Europe-Prevention using Lifestyle, Physical Activity and Nutritional intervention (DE-PLAN) project in Catalonia, whose cost-effectiveness analysis is now presented. Patients and methods A prospective cohort study was performed in primary care involving individuals without diagnosed diabetes aged 45–75 years (n = 2054) screened using the questionnaire Finnish Diabetes Risk Score (FINDRISC) and a subsequent oral glucose tolerance test. Where feasible, high-risk individuals who were identified (n = 552) were allocated sequentially to standard care (n = 219), a group-based (n = 230) or an individual-level (n = 103) intensive (structured programme of 6 h using specific teaching techniques) lifestyle intervention (n = 333). The primary outcome was the development of diabetes (WHO). We evaluated the cost of resources used with comparison of standard care and the intervention groups in terms of effectiveness and quality of life (15D questionnaire). Results After 4.2-year median follow-up, the cumulative incidences were 18.3% (14.3–22.9%) in the intensive intervention group and 28.8% (22.9–35.3%) in the standard care group (36.5% relative-risk-reduction). The corresponding 4-year HR was 0.64 (0.47–0.87; P
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- 2014
8. Validity Assessment of Low-risk SCORE Function and SCORE Function Calibrated to the Spanish Population in the FRESCO Cohorts
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Guillem Frontera, María José Medrano, María Jesús Guembe, María José Tormo-Díaz, Alejandro Marín-Ibañez, José María García, Albert Francès, Rafael Ramos, Agustín Gómez de la Cámara, Roberto Elosua, Paulino González-Diego, Antonio Segura, Irene R. Dégano, Joan Vila, José Antonio Gutiérrez-Fuentes, Isaac Subirana, José Miguel Baena-Díez, Conxa Castell, Conchi Moreno-Iribas, Fernando Rigo, Joan Sala, Eduardo Mayoral, María Grau, Eva Ardanaz, José Lapetra, Manel García-Lareo, Diana Gavrila, J.J. Cabré, Josep Basora, Jaume Marrugat, and Miquel Quesada
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Adult ,Score ,Coronary Disease ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Humans ,030212 general & internal medicine ,Sex Distribution ,Stroke ,Cardiovascular mortality ,Aged ,Validity assessment ,Framingham Risk Score ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Test (assessment) ,Spanish population ,Cardiovascular Diseases ,Spain ,business ,Cohort study ,Demography - Abstract
Introduction and objectives To assess the validity of the original low-risk SCORE function without and with high-density lipoprotein cholesterol and SCORE calibrated to the Spanish population. Methods Pooled analysis with individual data from 12 Spanish population-based cohort studies. We included 30 919 individuals aged 40 to 64 years with no history of cardiovascular disease at baseline, who were followed up for 10 years for the causes of death included in the SCORE project. The validity of the risk functions was analyzed with the area under the ROC curve (discrimination) and the Hosmer-Lemeshow test (calibration), respectively. Results Follow-up comprised 286 105 persons/y. Ten-year cardiovascular mortality was 0.6%. The ratio between estimated/observed cases ranged from 9.1, 6.5, and 9.1 in men and 3.3, 1.3, and 1.9 in women with original low-risk SCORE risk function without and with high-density lipoprotein cholesterol and calibrated SCORE, respectively; differences were statistically significant with the Hosmer-Lemeshow test between predicted and observed mortality with SCORE (P < .001 in both sexes and with all functions). The area under the ROC curve with the original SCORE was 0.68 in men and 0.69 in women. Conclusions All versions of the SCORE functions available in Spain significantly overestimate the cardiovascular mortality observed in the Spanish population. Despite the acceptable discrimination capacity, prediction of the number of fatal cardiovascular events (calibration) was significantly inaccurate.
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- 2016
9. Delaying progression to type 2 diabetes among high-risk Spanish individuals is feasible in real-life primary healthcare settings using intensive lifestyle intervention
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J.J. Cabré, Josep Basora, Jordi Salas-Salvadó, Bernardo Costa, Claustre Sole, Bonaventura Bolíbar, J. Tuomilehto, Jaana Lindström, Francisco Barrio, Oriol Solà-Morales, Josep Ll. Piñol, Conxa Castell, Xavier Cos, Alimentació, Nutrició, Creixement i Salut Mental, Departament de Bioquímica i Biotecnologia, and Universitat Rovira i Virgili
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Male ,Risk ,Gerontology ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Population ,Primary health care ,MEDLINE ,Type 2 diabetes ,Primary care ,Bioquímica i biotecnologia ,White People ,Estils de vida -- Aspectes sanitaris ,Diabetes mellitus ,Lifestyle intervention ,Internal Medicine ,medicine ,Humans ,Diabetes prevention ,education ,Aged ,FINDRISC ,Bioquímica y tecnología ,education.field_of_study ,Primary Health Care ,business.industry ,Incidence ,Incidence (epidemiology) ,lifestyle intervention ,Middle Aged ,medicine.disease ,Atenció primària -- Mètodes ,Diabetis -- Prevenció ,Biochemistry and technology ,Diabetes Mellitus, Type 2 ,Spain ,Disease Progression ,Physical therapy ,Female ,0012-186X ,business ,Risk Reduction Behavior - Abstract
To assess the feasibility and effectiveness of an active real-life primary care lifestyle intervention in preventing type 2 diabetes within a high-risk Mediterranean population.A prospective cohort study was performed in the setting of Spanish primary care. White-European individuals without diabetes aged 45-75 years (n = 2,054) were screened using the Finnish Diabetes Risk Score (FINDRISC) and a subsequent 2 h OGTT. Where feasible, high-risk individuals who were identified were allocated sequentially to standard care, a group-based or an individual level intervention (intensive reinforced DE-PLAN [Diabetes in Europe-Prevention using Lifestyle, Physical Activity and Nutritional] intervention). The primary outcome was the development of diabetes according to WHO criteria. Analyses after 4-year follow-up were performed based on the intention-to-treat principle with comparison of standard care and the combined intervention groups.The standard care (n = 219) and intensive intervention (n = 333) groups were comparable in age (62.0/62.2 years), sex (64.4/68.2% women), BMI (31.3/31.2 kg/m(2)), FINDRISC score (16.2/15.8 points), fasting (5.3/5.2 mmol/l), 2 h plasma glucose (7.1/6.9 mmol/l) and self-reported interest to make lifestyle changes at baseline. Diabetes was diagnosed in 124 individuals: 63 (28.8%) in the standard care group and 61 (18.3%) in the intensive intervention group. During a 4.2-year median follow-up, the incidences of diabetes were 7.2 and 4.6 cases per 100 person-years, respectively (36.5% relative risk reduction, p0.005). The number of participants needed to be treated by intensive intervention for 4 years to reduce one case of diabetes was 9.5.Intensive lifestyle intervention is feasible in a primary care setting and substantially reduces diabetes incidence among high-risk individuals.ClinicalTrial.gov NCT01519505.Commission of the European Communities, Institute of Health Carlos III, Spanish Ministry of Health and Department of Health, Generalitat de Catalunya.
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- 2012
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10. Shifting from glucose diagnostic criteria to the new HbA1c criteria would have a profound impact on prevalence of diabetes among a high-risk Spanish population
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Bonaventura Bolíbar, Bernardo Costa, Jaana Lindström, J. Tuomilehto, Francisco Barrio, J.J. Cabré, Conxa Castell, Noël C. Barengo, Josep Lluís Piñol, Claustre Sole, and Francesc Xavier Cos
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medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Population ,030209 endocrinology & metabolism ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Impaired glucose tolerance ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,education ,Glucose tolerance test ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Impaired fasting glucose ,3. Good health ,Spanish population ,business ,Body mass index - Abstract
Diabet. Med. 28, 1234–1237 (2011) Abstract Aim To investigate changes in the prevalence of diabetes and pre-diabetes by shifting from 2-h plasma glucose and/or fasting plasma glucose diagnostic criteria to the proposed new HbA1c-based criteria when applied to a Mediterranean population detected to have a high risk of Type 2 diabetes. Methods Individuals without diabetes aged 45–75 years (n = 2287) were screened using the Finnish Diabetes Risk Score questionnaire, a 2-h oral glucose tolerance test plus HbA1c test. Prevalence and degree of diagnostic overlap between three sets of criteria (2-h plasma glucose, fasting plasma glucose and HbA1c) and three diagnostic categories (normal, pre-diabetes and diabetes) were calculated. Results Defining diabetes by a single HbA1c measurement resulted in a dramatic decrease in prevalence (1.3%), particularly in comparison with diabetes defined by 2-h plasma glucose (8.6%), but was also significant with regard to fasting plasma glucose (2.8%). A total of 201 screened subjects (8.8%) were classified as having diabetes and 1023 (44.7%) as having pre-diabetes based on at least one of these criteria; among these, the presence of all three criteria simultaneously classified only 21 and 110 individuals respectively, about ten percent of each group. The single overlap index between subjects diagnosed as having diabetes by 2-h plasma glucose/fasting plasma glucose vs. HbA1c was 13.9/28%. Similarly, the single overlap index regarding pre-diabetes was 19.2/27.1%. Conclusions A shift from the glucose-based diagnosis to the HbA1c-based diagnosis for diabetes will reduce diabetes prevalence with a low overall or single degree of overlap between diagnostic categories in this high-risk Spanish population.
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- 2011
11. Effects of one serving of mixed nuts on serum lipids, insulin resistance and inflammatory markers in patients with the metabolic syndrome
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J.J. Cabré-Vila, Patricia Casas-Agustench, Jordi Salas-Salvadó, Emilio Ros, Patricia López-Uriarte, and Mònica Bulló
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Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Medicine (miscellaneous) ,Blood lipids ,Insulin resistance ,Internal medicine ,medicine ,Humans ,Insulin ,Nuts ,Resting energy expenditure ,Obesity ,Adiposity ,Inflammation ,Metabolic Syndrome ,chemistry.chemical_classification ,Analysis of Variance ,Nutrition and Dietetics ,medicine.diagnostic_test ,Interleukin-6 ,business.industry ,food and beverages ,Cholesterol, LDL ,Middle Aged ,medicine.disease ,Diet ,Endocrinology ,chemistry ,Saturated fatty acid ,Linear Models ,Female ,Insulin Resistance ,Metabolic syndrome ,Energy Metabolism ,Cardiology and Cardiovascular Medicine ,business ,Lipid profile ,Biomarkers ,Polyunsaturated fatty acid - Abstract
Background and aims: Knowledge of the effect of nut consumption on metabolic syndrome (MetS) components is limited. We assessed the effects of nut intake on adiposity, serum lipids, insulin resistance, and inflammatory biomarkers in patients with MetS. Methods and results: In a randomized, parallel-group, 12-week feeding trial, 50 patients with MetS were given recommendations for a healthy diet with or without supplementation with 30 g/day of raw nuts (15 g walnuts, 7.5 g almonds and 7.5 g hazelnuts) (Nut and Control diet groups, respectively). Adiposity measures, serum lipids, insulin, Homeostasis Model Assess- ment (HOMA), interleukin-6 (IL-6) and other inflammatory biomarkers, and 48-h fecal fat were determined basally and at study's completion. Moderate weight loss, decreased adiposity, and lower blood pressure occurred similarly after both diets. The Control, but not the Nut diet, was associated with significant (P
- Published
- 2011
12. Relevance of casual undetected hyperglycemia among high-risk individuals for developing diabetes
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Cruz María Fuentes, Bernardo Costa, J.J. Cabré, Josep Lluís Piñol, and Jesús Vizcaíno
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Adult ,Male ,medicine.medical_specialty ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Carbohydrate metabolism ,Impaired glucose tolerance ,Endocrinology ,Risk Factors ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Humans ,Glucose tolerance test ,Plasma glucose ,medicine.diagnostic_test ,business.industry ,Continuous glucose monitoring ,nutritional and metabolic diseases ,General Medicine ,Glucose Tolerance Test ,Middle Aged ,medicine.disease ,Impaired fasting glucose ,Cross-Sectional Studies ,Diabetes Mellitus, Type 2 ,Pre diabetes ,Hyperglycemia ,Female ,business - Abstract
To assess the relevance of unrecognized hyperglycemia among high-risk subjects for developing diabetes a cross-sectional study was carried out. Subjects aged 40–75 years with (high-risk group) and without (control group) history of impaired glucose metabolism underwent a 2 h-oral glucose tolerance test (OGTT). All individuals with diabetes diagnostic criteria and all controls with glucose abnormalities at OGTT were excluded. An individualized 48-h continuous glucose monitoring (CGM) calibrated by fasting plasma glucose was performed. The microdialysis-based biosensor recordings were computerized in order to identify continuous glucose profiles. Of the 121 monitored subjects, 104 were finally analyzed (56.7% female, 57.8 years, BMI = 29.2, A1C = 4.9%, HOMA index = 2.5). Glucose profiles corresponded to 31 controls (29.8%), 32 high-risk individuals with normal OGTT (30.8%) and 41 (39.4%) with hyperglycemia at OGTT. The recordings defined as hyperglycemia (fasting ≥6.1 mmol/l, non-fasting ≥7.8 mmol/l) appeared during an average of 1.4 h, 4.9 h and 7.6 h (3.9%, 13.9% and 19% of the CGM time), respectively. The highest percentage of impaired CGM registers corresponded to the fasting period. Nevertheless, the longest duration corresponded to the non-fasting period. The CGM evidenced a relevant degree of casual undetected hyperglycaemia among high-risk individuals.
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- 2007
13. La escala de Framingham sobrevalora el riesgo cerebrovascular de la diabetes y el síndrome metabólico en la población española
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Josep Lluís Piñol, J. Bladé, Bernardo Costa, Josep Basora, F. Martin, and J.J. Cabré
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Síndrome metabólico ,medicine.medical_specialty ,Enfermedad cerebrovascular ,Riesgo cerebrovascular ,Stroke risk ,Comentario Editorial ,Risk Factors ,Humans ,Medicine ,Prospective Studies ,cardiovascular diseases ,Gynecology ,Metabolic Syndrome ,Medicine(all) ,business.industry ,Diabetes ,Síndrome X ,General Medicine ,Originales ,X-Syndrome ,Stroke ,Diabetes Mellitus, Type 2 ,Spain ,business ,Family Practice - Abstract
ObjetivoEstimar el riesgo de accidente cerebrovascular (ACV) de la diabetes, en el contexto del síndrome metabólico (SM) o fuera de él, según los criterios de la Organización Mundial de la Salud (OMS) y del National Cholesterol Education Program (NCEP).DiseñoEstudio multicéntrico y prospective de cohortes.EmplazamientoAtención primaria de salud.ParticipantesSujetos de 55-85 años libres de ACV incluidos desde 1998 en una muestra poblacional aleatoria y representativa para el seguimiento del SM en Reus (Tarragona).Mediciones principalesEl riesgo de ACV se estimó con la escala de Framingham aplicando un algoritmo informático de cálculo automático y un diseño factorial por diagnósticos (diabetes y/o SM). Se comparó el riesgo teórico con la incidencia real de acontecimientos cerebrovasculares (1998-2003).ResultadosEntre 728 sujetos (412 mujeres; edad media de 66 años; índice de masa corporal = 29), 457 (62,8%) no tenían diabetes ni SM, 93 (12,8%) con SM no tenían diabetes, 72 (9,9%) con diabetes no tenían SM y 106 (14,5%) presentaban ambas enfermedades (según criterios de la OMS). Según el NCEP, estas proporciones fueron del 60,7; el 14,8; el 7,8 y el 16,7%. El riesgo de ACV medio a 10 años para los 4 grupos (OMS/NCEP) fue: 8,4/9,1; 10,8/10,5; 18/17,3 y 18,8/19,1%, respectivamente. La incidencia acumulada de acontecimientos cerebrovasculares fue del 2,8; 1,4; 5,4 y 3,8% (OMS) y 2,5; 2,8; 3,5 y 5,8% (NCEP).ConclusionesEl riesgo de ACV calculado mediante la fórmula de Framingham es muy elevado en sujetos con diabetes, con independencia de su integración en el SM. Es muy probable que la escala también sobredimensione este riesgo en la población española.ObjectiveTo estimate stroke risk for diabetes, isolated or associated to metabolic syndrome (MS) according WHO and National Cholesterol Education Program (NCEP)criteria.DesignMulticentre and prospective cohort study.SettingPrimary health care.ParticipantsSubjects between 55-85 years-old without any evidence of stroke, included from 1998 in a random population sample for MS follow-up during routine practice in Reus (Tarragona, Spain).Main measurementsStroke risk was achieved using Framingham function by means of a computerized algorithm using a diagnostic factorial design (diabetes and/or MS). Theoretical stroke risk and cumulated incidence of stroke events (1998-2003) were compared.ResultsAmong 728 subjects (412 women, mean age =66 years old, body mass index =29 kg/m2), 457 (62.8%) did not have diabetes, nor MS, 93 (12.8%) had MS without diabetes, 72 (9.9%) diabetes without MS, and 106 (14.5%) presented both conditions (WHO rules). According NCEP criteria were 60.7%, 14.8%, 7.8%, and 16.7%, respectively. Ten-year estimated stroke risk accounted for (WHO/NCEP) 8.4/9.1%, 10.8/10.5%, 18/17.3%, and 18.8/19.1%. Cumulated incidence for stroke events were: 2.8%, 1.4%, 5.4%, and 3.8% (WHO), and 2.5%, 2.8%, 3.5%, and 5.8%, respectively (NCEP).ConclusionsStroke risk scores were extremely increased among diabetic subjects irrespective to MS diagnose. The Framingham function probably overestimates stroke risk among Spanish individuals.
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- 2005
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14. El proyecto RECORD (Registro Continuo de la Glucemia en Sujetos de Alto Riesgo para la Diabetes Tipo 2). Diseño y aplicación en atención primaria de salud
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Josep Basora, Bernardo Costa, J Vizcaíno, el Grupo Record, Josep Lluís Piñol, J.J. Cabré, and F. Martin
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Medicine(all) ,Intolerancia a la glucosa ,business.industry ,Diabetes ,Impaired glucose tolerance ,General Medicine ,Impaired fasting glucose ,Glucemia basal alterada ,Continuous blood glucose monitoring ,Medicine ,Registro continuo de la glucemia ,Family Practice ,business ,Prediabetes ,Humanities - Abstract
ObjetivoEvaluar si una nueva técnica, el registro continuo de la glucemia (RCG), es viable y útil para contrastar el diagnóstico y predecir la evolución durante la prediabetes tipo 2.DiseñoObservacional, multicéntrico, transversal (fase 1); posteriormente, longitudinal de seguimiento de cohortes (fase 2).EmplazamientoAtención primaria de salud (5 centros).ParticipantesSerá incluido un grupo de 84 sujetos de alto riesgo libres de diabetes si una prueba actual de tolerancia oral a la glucosa (PTOG) descarta la enfermedad. Se efectuará un primer RCG mediante un biosensor calibrado por la glucemia plasmática, obteniendo un perfil glucémico continuo. Se establecen 2 cohortes de seguimiento diferenciando los sujetos con PTOG normal (n=42) de aquellos con hiperglucemia prediabética (n=42). A los 12 y 24 meses, se reclasificará el diagnóstico mediante sobrecarga oral seguida de un nuevo registro.Mediciones principalesDatos demográficos, clínicos (incluidos componentes del síndrome metabólico), analíticos básicos y avanzados (marcadores de inflamación, insulinemia, péptido C). Análisis informático del RCG comparando sus períodos (basal, pre-posprandial, nocturno) y el área bajo la curva del perfil continuo con el diagnóstico convencional revisando su concordancia temporal. Estudio de su influencia sobre la incidencia de diabetes o la regresión a la normalidad glucémica. Evaluación de la satisfacción del usuario con el RCG mediante cuestionario estructurado tipo Likert.DiscusiónEl proyecto es un contrapunto diagnóstico evolutivo entre PTOG estándar y RCG, más fisiológico y basado en un criterio infrautilizado, la glucemia al azar. Una técnica aún no evaluada en atención primaria puede aportar datos de indudable interés científico para el estudio de la prediabetes tipo 2.ObjectiveTo evaluate the accuracy of continuous blood glucose monitoring (CBGM) in order to asses diagnostic procedures and predict glycaemic status in type 2 prediabetes.DesignObservational, multicenter, cross-sectional (phase 1) plus longitudinal, cohort follow-up study (phase 2).SettingFive primary health-care centers.InterventionsA total of 84 high-risk subjects will be included after a non-diabetic oral glucose tolerance test (OGTT). A first CBGM using a subcutaneous microdialysis glucose sensor technique in order to obtain a continuous profile will be carried out. Two different cohorts, subjects with normal OGTT (n=42) and individuals with prediabetic hyperglycemia (n=42) will be established. Diagnoses will be revised at 12 and 24 month follow-up by means of an OGTT together with a new monitoring.Main measurementDemographical, clinical (including metabolic syndrome items), basic, and advanced analyses (inflammation emergent markers, insulinemia, C-peptide). CBGM computerized analysis comparing fasting, preprandial, postprandial, nocturnal period, and area under the curve of continuous profile with regular diagnoses, taking into account temporary concordance. Relationship of CBGM parameters with normal glucose tolerance or diabetes incidence. Evaluation of day-to-day quality of life of CBGM users by means of an standardized Likert questionnaire.DiscussionThis study seeks to demonstrate the effectiveness and feasibility of CBGM, more physiological than OGTT and based on an underestimated random blood glucose diagnostic criterion. This innovative system may provide interesting scientific data in the field of type 2 prediabetes.
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- 2005
15. Síndrome metabólico y enfermedad cardiovascular en población diabética asistida en Atención Primaria
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F. Martín Luján, R. Solà Alberich, J.J. Cabré Vila, J.L. Piñol Moreso, J. Basora Gallisà, and B. Costa Pinel
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Internal Medicine ,Cardiology and Cardiovascular Medicine - Abstract
Introduccion Estimar la prevalencia del sindrome metabolico (SM) y de enfermedad cardiovascular asociada en poblacion diabetica asistida en Atencion Primaria en comparacion con la poblacion libre de diabetes. Diseno y ambito Diseno y ambito: estudio observacional, transversal y multicentrico (10 centros) en Atencion Primaria. Mediciones e intervenciones: muestreo sistematico entre los sujetos de 15 a 74 anos atendidos durante el ano 2001 (error ?: 0,05; precision: 1%; prevalencia de diabetes: 6%-7%). Se registraron datos demograficos y antropometricos (edad, sexo e indice de masa corporal), factores de riesgo y episodios confirmados de enfermedad cardiovascular en cualquiera de sus formas. Se determino presion arterial, glucemia basal, glucohemoglobina A1c, perfil lipidico (colesterol total, c-HDL, c-LDL y trigliceridos) y microalbuminuria, calculando el riesgo cardiovascular teorico mediante la ecuacion de Framingham. Resultados Se revisaron datos de 2.222 sujetos (1.181 mujeres; 53,2 %) con 49,8±18,4 anos de edad media, 702 (31,6%) con hipertension, 499 (22,4 %) con dislipidemia, 453 (20,4%) fumadores activos y 235 (10,6 %) con diabetes mellitus. Entre estos ultimos, 154 (65,5 %) presentaron criterios de SM (criterios OMS), con un riesgo cardiovascular promedio de 20,2± 7,8 frente a 7,0 ± 7,0 de la poblacion sin diabetes ni SM (p Discusion En poblacion asistida en Atencion Primaria la prevalencia del SM asociado a la diabetes es muy elevada, comportando un incremento significativo tanto del riesgo como de la enfermedad cardiovascular.
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- 2004
16. Síndrome metabólico, resistencia a la insulina y diabetes. ¿Qué se oculta bajo la punta del iceberg?
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J.J. Cabré, F. Martin, and Bernardo Costa
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Síndrome metabólico ,Metabolic Syndrome ,Medicine(all) ,Gynecology ,Clinical Trials as Topic ,medicine.medical_specialty ,business.industry ,Intolerancia a la glucose ,Diabetes ,General Medicine ,Resistencia a la insulina ,medicine.disease ,Formacin continuada ,Insulin resistance ,Diabetes Mellitus, Type 2 ,Diabetes mellitus ,Tiazolidindionas ,Humans ,Medicine ,Insulin Resistance ,Family Practice ,business - Published
- 2003
17. Registro continuo de glucosa en sujetos con alto riesgo de diabetes tipo 2
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Cruz María Fuentes, Bernardo Costa, Jesús Vizcaíno, Josep Lluís Piñol, Joan Boj, and J.J. Cabré
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Gynecology ,medicine.medical_specialty ,business.industry ,Continuous glucose monitoring ,medicine ,General Medicine ,Impaired fasting glucose ,medicine.disease ,business - Abstract
Fundamento y objetivo: Evidenciar la hiperglucemia inadvertida en sujetos con alto riesgo de diabetes tipo 2. Sujetos y metodo: Estudio transversal multicentrico en atencion primaria. Se selecciono a sujetos de 40-75 anos con antecedentes de hiperglucemia no diabetica a los que se cribo mediante una prueba de tolerancia oral a la glucosa (PTOG), excluyendo a aquellos con criterios de diabetes segun la Organizacion Mundial de la Salud. Se desarrollo un registro continuo de la glucosa (RGC) individualizado y ambulatorio de 48 h mediante un biosensor subcutaneo (GlucoDay®) calibrado por la glucemia plasmatica. Se informatizo la actividad del biosensor para evidenciar posibles registros de hiperglucemia. Resultados: Se efectuo el RCG a 50 de 64 sujetos seleccionados, de los que 30 eran mujeres. El indice de masa corporal medio fue de 30,9 kg/m2; la hemoglobina glucosilada del 5,3%, y el indice HOMA de 2,8, descartando 9 perfiles completos (18%) por problemas tecnicos. Se evaluaron 41 RCG (82%) pertenecientes a 17 sujetos con PTOG normal (41,5%) y a 24 (58,5%) con PTOG alterada. Por termino medio, se obtuvieron registros de hiperglucemia (basal e 6,1 mmol/l o no basal e 7,8 mmol/l) durante 5,8 h, un 17,2% del tiempo total de registro efectivo (33,8 h). La hiperglucemia en el intervalo de diabetes (basal e 7 mmol/l o no basal e 11,1 mmol/l) concurrio durante el 3,6% del tiempo (1,2 h) y el 3,3% (1,1 h), respectivamente. Conclusiones: El RCG evidencio indices altos de hiperglucemia no reconocida en sujetos de riesgo. Este hallazgo indica que medir la glucemia en cualquier momento del dia incrementaria la deteccion de anomalias glucidicas.
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- 2006
18. Metabolic Syndrome as a Cardiovascular Disease Risk Factor: Patients Evaluated in Primary Care
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Irene Pascual, Yolanda Ortega, Joan L Frigola, Marta Baldrich, Angel Donado-Mazarrón, Judit Saumell, Josep Lluís Piñol, Ana Urbaneja, Isabel Sánchez-Oro, Vanesa Revuelta, Josep M Hernández, Bernardo Costa, Jesús Vizcaíno, Josep Basora, Jordi Daniel, Rosa Solà, Jordi Blade, J.J. Cabré, Josep M de Magriñà, Dolors Montañes, Ramon Sagarra, Maria Teresa García-Vidal, Josep L Llor, F. Martin, Josep M Sabaté, Francisco Barrio, and Teresa Basora
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Male ,medicine.medical_specialty ,Population ,Blood Pressure ,Sampling Studies ,Body Mass Index ,Cohort Studies ,Risk Factors ,Internal medicine ,Prevalence ,Humans ,Medicine ,education ,Triglycerides ,Aged ,Metabolic Syndrome ,education.field_of_study ,Framingham Risk Score ,Primary Health Care ,business.industry ,lcsh:Public aspects of medicine ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Odds ratio ,Middle Aged ,medicine.disease ,Cholesterol ,Logistic Models ,Cardiovascular Diseases ,Spain ,Relative risk ,Cohort ,Physical therapy ,Female ,Metabolic syndrome ,business ,Body mass index ,Research Article ,Cohort study - Abstract
To estimate the prevalence of metabolic syndrome (MS) in a population receiving attention in primary care centers (PCC) we selected a random cohort of ostensibly normal subjects from the registers of 5 basic-health area (BHA) PCC. Diagnosis of MS was with the WHO, NCEP and IDF criteria. Variables recorded were: socio-demographic data, CVD risk factors including lipids, obesity, diabetes, blood pressure and smoking habit and a glucose tolerance test outcome. Of the 720 individuals selected (age 60.3 ± 11.5 years), 431 were female, 352 hypertensive, 142 diabetic, 233 pre-diabetic, 285 obese, 209 dyslipemic and 106 smokers. CVD risk according to the Framingham and REGICOR calculation was 13.8 ± 10% and 8.8 ± 9.8%, respectively. Using the WHO, NCEP and IDF criteria, MS was diagnosed in 166, 210 and 252 subjects, respectively and the relative risk of CVD complications in MS subjects was 2.56. Logistic regression analysis indicated that the MS components (WHO set), the MS components (IDF set) and the female gender had an increased odds ratio for CVD of 3.48 (95CI%: 2.26–5.37), 2.28 (95%CI: 1.84–4.90) and 2.26 (95%CI: 1.48–3.47), respectively. We conclude that MS and concomitant CVD risk is high in ostensibly normal population attending primary care clinics, and this would necessarily impinge on resource allocation in primary care.
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- 2008
19. Evolution of parameters following instigation of insulin analogue treatment on diabetic patients in primary healthcare
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B. Fernández, L. Dudasu, D. Montañés, C. De Bonet, M. Maestro, M. Carrillo, C. Chancho, J.L. Frigola, J.J. Cabré, R. Sagarra, and J. Vizcaíno
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medicine.medical_specialty ,Nutrition and Dietetics ,Insulin Analogue ,business.industry ,Endocrinology, Diabetes and Metabolism ,Diabetes mellitus ,Internal Medicine ,medicine ,Primary health care ,Family Practice ,medicine.disease ,Intensive care medicine ,business - Published
- 2013
20. Improvement of screening of diabetic retinopathy in primary care with the non-mydriatic camera circuit programme
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F. García-Moya, I. Méndez, R. Ballester, P. Romero, R. Sagarra, J.J. Cabré, and L. Dudasu
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Pediatrics ,medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Endocrinology, Diabetes and Metabolism ,Primary care ,Diabetic retinopathy ,medicine.disease ,Ophthalmology ,Diabetes mellitus ,Internal Medicine ,medicine ,Family Practice ,business - Published
- 2013
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