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Hyperuricaemia is one of the components of metabolic syndrome. Both oxidative stress and hyperinsulinism are important variables in the genesis of this syndrome and have a close association with uric acid (UA). We evaluated the effect of an oral glucose challenge on UA concentrations. The study included 656 persons aged 18 to 65 years. Glycaemia, insulin, UA and plasma proteins were measured at baseline and 120 min after an oral glucose tolerance test (OGTT). The baseline sample also included measurements of total cholesterol, triacylglycerol (TAG) and HDL-cholesterol. Insulin resistance was calculated with the homeostasis model assessment. UA levels were significantly lower after the OGTT (281·93 (sd 92·19) v. 267·48 (sd 90·40) μmol/l; P < 0·0001). Subjects with a drop in UA concentrations >40·86 μmol/l (>75th percentile) had higher plasma TAG levels (P = 0·0001), baseline insulin (P = 0·02) and greater insulin resistance (P = 0·034). Women with a difference in plasma concentrations of UA above the 75th percentile had higher baseline insulin levels (P = 0·019), concentration of plasma TAG (P = 0·0001) and a greater insulin resistance index (P = 0·029), whereas the only significant difference in men was the level of TAG. Multiple regression analysis showed that the basal TAG levels, insulin at 120 min, glycaemia at 120 min and waist:hip ratio significantly predicted the variance in the UA difference (r2 0·077). Levels of UA were significantly lower after the OGTT and the individuals with the greatest decrease in UA levels are those who have greater insulin resistance and higher TAG levels. [ABSTRACT FROM PUBLISHER]

Objective: To evaluate the demand for public health services in two gender identity disorder units (Andalusia and Catalonia) during the period of 2000-2009., Method: A descriptive and comparative study was made of the demand for health services, the demographic and clinical characteristics of the patients, and the sex reassignment surgeries performed., Results: A total of 828 subjects in Andalusia and 549 in Catalonia requested clinical assistance. In both communities, the percentages of cases diagnosed of transsexualism (88 vs 89.7%), the percentages excluded in the sex reassignment program (16.7 vs 15.3%), the male/female ratio (1.6:1 vs 2.1:1), and the mean age (28 vs 29 years) were similar. A total of 284 sex-reassignment surgeries were performed in Andalusia and 50 in Catalonia., Conclusions: The demand has been maintained in Andalusia and has increased in Catalonia in recent years. The basic demographic and clinical characteristics of transsexual patients were similar between both units and comparable to those of other countries., (Copyright © 2010 Elsevier España, S.L. All rights reserved.)

Objective: To find the frequency of amputations of lower limbs (ALL) with the aim of designing a programme to prevent ALL in people with diabetes mellitus (DM)., Design: Retrospective observation study., Setting: Population study in Malaga and its province., Patients: The clinical records of everyone with ALL in public or subsidized hospitals in the province of Malaga between January 1 1996 and December 31 1997 were reviewed. Traumatic or tumoural ALL were excluded. Cumulative incidence, relative risk (RR) of ALL and the mortality rate of people with DM were calculated., Results: 449 ALL took place during the period studied, 316 (70.3%) in people with DM and 133 (29.6%) in people not suffering DM. The incidence of ALL per 100,000 people and per year was 6.3 (CI: 4.7-7.8) in the population without DM and 136.1 (CI: 114.9-157.3) in people with DM. The RR of ALL was 21.6 (CI: 17.6-26.4) for the population with DM, with differences between men and women (16.8 vs. 36.1, respectively). Mean age of ALL was significantly greater (p < 0.05) for the population with DM (70.0 +/- 10.2 vs. 68.9 +/- 15.9 years old). Older ALL were more numerous in both women and men in the two groups studied. The mortality rate, complications and mean stay in hospital were greater in the population with DM., Conclusions: This study confirmed the greater risk of ALL run by people with DM. The incidence of ALL in this study was less than in countries of Northern Europe, the USA and Australia, but more than in any study published before in Spain.