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Background: Metabolic syndrome (MetS) worsens quality of life and increases mortality. Dissatisfaction with weight in patients with MetS may modify the effect of lifestyle interventions to achieve changes in health-related behaviors. Objective: To assess 1-year changes in cardiovascular risk scores, self-perceived general health and health-related behaviors according to observed changes in desired weight loss during the first year of intervention in a large cardiovascular prevention trial. Design: Prospective analysis of the PREDIMED-PLUS trial, including 5,499 adults (55-75 years old) with overweight or obesity at baseline. Methods: The desired weight loss was the difference between ideal and measured weight. Tertiles of change in desired weight loss (1 year vs. baseline) were defined by the following cut-off points: >= 0.0 kg (T1, n = 1,638); 0.0 to -4.0 kg (T2, n = 1,903), European Research Council (ERC) European Commission 20132018 340918, Spanish government, ISCIII, through the Fondo de Investigacion para la Salud (FIS) - European Regional Development Fund 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, Especial Action Project entitled: Implementacion y evaluacion de una intervencion intensive sobre la actividad fisica Cohorte PREDIMED-Plus grant, Recercaixa Grant 2013ACUP00194, Junta de Andalucia PI0458/2013 PS0358/2016 PI0137/2018, Center for Forestry Research & Experimentation (CIEF), European Commission PROMETEO/2017/017 European Cooperation in Science and Technology (COST) European Commission CA16112, Balearic Islands Health Research Institute (IDISBA), European Commission CIBEROBN CB06/03 CB12/03 European Commission European Commission Joint Research Centre EAT2BENICE_H2020_SFS2016, Fundacio La Marato TV3 201630.10, Fernando Tarongi Bauza Grant, 'Spanish government, ISCIII, through the Fondo de Investigacion para la Salud (FIS) - European Regional Development Fund' 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, the Spanish government, ISCIII, through the Fondo de Investigacion para la Salud (FIS) - European Regional Development Fund 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 PI19/01226, "Spanish government, ISCIII, through the Fondo de Investigacion para la Salud (FIS) - European Regional Development Fund" PI19/00781 PI19/01560 PI19/01332 PI20/01802 PI20/00138 PI20/01532 PI20/00456 PI20/00339 PI20/00557 PI20/00886 PI20/01158

Therapeutic hypothermia is a treatment used for patients who have suffered cardiores piratory arrest and remain conscious after the recovery of spontaneous circulation. However, its effectiveness is controversial. The objective of this systematic review is to summarize the scientific evidence available about the effect of therapeutic hypothermia on neurological status and survival in this type of patients. Methodology: A primary search in CINAHL, CUIDEN, Pubmed, Web of Science, and Scopus databases was carried out. Randomized clinical trials (RCT) published from 2016 to 2020 were selected. Results: 17 studies were selected for inclusion and most relevant data were extracted. Methodological quality was assessed by the RoB tool. Conclusions: Although therapeutic hypothermia is a safe technique with few adverse and manageable effects, it has not shown to improve survival rate and neurological status of adult nor pediatric patients. It is possible that its positive effect on neuroprotection could be achieved only by preventing hyperthermia although further investigation is needed. Yes

La presente tesis doctoral pretende dar respuesta a los siguientes objetivos: 1. Analizar la evolución de los factores determinantes del síndrome metabólico y la DM2, el RCV así como los valores séricos de OCi al inicio del estudio, a los seis y a los doce meses de seguimiento. 2. Analizar la relación entre los factores determinantes del SM y la DM2 y el RCV y los niveles séricos de OCi según la pérdida de peso, la adherencia a la dieta mediterránea y el nivel de actividad física en la población de estudio. 3. Determinar la influencia de la dieta mediterránea y la práctica de ejercicio sobre los parámetros óseos determinados por Absorciometría dual de rayos X (DXA) y la puntuación de Trabecular bone score (TBS) en un subgrupo de mujeres de la cohorte y analizar su relación con los niveles de OCi y los parámetros del RCV. Conclusiones: Este estudio confirma la relación entre la adherencia a la dieta mediterránea y el ejercicio físico con la reducción del riesgo cardiovascular y la mejora del perfil cardiometabólico, lo cual contribuye a la reversión del síndrome metabólico. La determinación de los niveles de OCi podría convertirse en una herramienta útil para una correcta estratificación de la población con SM en cuanto a RCV, especialmente en aquellos sujetos libres de DM2. Además podría representar una estrategia preventiva para caracterizar aquellos sujetos a mayor riesgo y poder establecer las intervenciones oportunas. La OCi se postula además como estimador del riesgo de desarrollar DM2 en la población con SM. Estos hallazgos abren nuevas líneas de investigación dirigidas a evaluar el rol que desempeña esta proteína ósea como biomarcador cardiovascular y como intervención terapéutica. Así mismo el uso de un score cardiovascular global y homogéneo como el CV-ZS podría ser una herramienta muy útil en la práctica clínica y en futuros estudios longitudinales. This doctoral thesis aims were: 1. To analyze the evolution of the cardiometabolic profile, CVR and serum ucOC levels at baseline and after six and twelve months of follow-up in a cohort of MetS patients. 2. To analyze the influence of weight loss, Mediterranean diet adherence and physical activity on MetS parameters, CVR and serum ucOC levels in the study population. 3. To determine bone quality though densitometry and TBS and to analyze its association with ucOC serum levels and cardiovascular risk (CVR) parameters in a sample of women from the cohort and to evaluate the influence that weight loss, diet quality and physical exercise practice can have on bone health in those women. Conclusion: The present study confirms that weight loss, Mediterranean diet adherence and physical activity are associated with CVR reduction and MetS determinants improvement and moreover MetS reversion. The measurement of circulating ucOC could be a useful tool to identify increased cardiovascular and T2D risk in MetS patients without T2D. The measurement of circulating ucOC levels could become a strategy to identify MetS patients at high risk in order to establish preventive and therapeutic approaches. In addition, lower serum levels of ucOC could contribute to T2D development. These findings break new ground for new research lines to evaluate the role of ucOC as a biomarker and as a potential therapeutic target, as well as the usefulness of CV-ZS in clinical practice in future longitudinal studies. Tesis Univ. Granada.

Osteoglycin (OGN) could be a biomarker of mild kidney function impairment in type 2 diabetes (T2D). Our study aimed to determine the association between serum OGN and impaired kidney function risk in T2D patients and to analyze its potential role as an estimator of kidney disturbances in this population. This cross-sectional study included 147 T2D patients (65 ± 8 years, 58.5% males), and 75 healthy controls (63 ± 10 years, 36% males). Circulating OGN levels were determined by ELISA. Linear regression modeling was performed to determine the variables influencing circulating OGN, and an ROC curve was plotted to assess the usefulness of OGN as an estimator of diabetic kidney disease risk. Circulating OGN was significantly increased in T2D patients compared to controls (18.41 (14.45–23.27) ng/mL vs. 8.74 (7.03–12.35) ng/mL; p < 0.001). We found a progressive increase in serum OGN according to the severity of kidney impairment in T2D patients (normal kidney function: 16.14 (12.13–20.48) ng/mL; mildly impaired kidney function: 19.15 (15.78–25.90) ng/mL; moderate impaired kidney function: 21.80 (15.06–29.22) ng/mL; p = 0.006). Circulating OGN was an independent estimator of mildly impaired kidney function risk in T2D patients. We suggest that serum OGN could act as an albuminuria-independent biomarker of incipient kidney dysfunction in T2D patients., Junta de Andalucía grants (PI-0207-2016 and PI0268-2019), Instituto de Salud Carlos III grants (PI18-00803 and PI18-01235), European Regional Development Fund (FEDER), Instituto de Salud Carlos III (FI19/00118; CD20/00022)

La presente tesis doctoral pretende dar respuesta a los siguientes objetivos: 1. Analizar la evolución de los factores determinantes del síndrome metabólico y la DM2, el RCV así como los valores séricos de OCi al inicio del estudio, a los seis y a los doce meses de seguimiento. 2. Analizar la relación entre los factores determinantes del SM y la DM2 y el RCV y los niveles séricos de OCi según la pérdida de peso, la adherencia a la dieta mediterránea y el nivel de actividad física en la población de estudio. 3. Determinar la influencia de la dieta mediterránea y la práctica de ejercicio sobre los parámetros óseos determinados por Absorciometría dual de rayos X (DXA) y la puntuación de Trabecular bone score (TBS) en un subgrupo de mujeres de la cohorte y analizar su relación con los niveles de OCi y los parámetros del RCV. Conclusiones: Este estudio confirma la relación entre la adherencia a la dieta mediterránea y el ejercicio físico con la reducción del riesgo cardiovascular y la mejora del perfil cardiometabólico, lo cual contribuye a la reversión del síndrome metabólico. La determinación de los niveles de OCi podría convertirse en una herramienta útil para una correcta estratificación de la población con SM en cuanto a RCV, especialmente en aquellos sujetos libres de DM2. Además podría representar una estrategia preventiva para caracterizar aquellos sujetos a mayor riesgo y poder establecer las intervenciones oportunas. La OCi se postula además como estimador del riesgo de desarrollar DM2 en la población con SM. Estos hallazgos abren nuevas líneas de investigación dirigidas a evaluar el rol que desempeña esta proteína ósea como biomarcador cardiovascular y como intervención terapéutica. Así mismo el uso de un score cardiovascular global y homogéneo como el CV-ZS podría ser una herramienta muy útil en la práctica clínica y en futuros estudios longitudinales., This doctoral thesis aims were: 1. To analyze the evolution of the cardiometabolic profile, CVR and serum ucOC levels at baseline and after six and twelve months of follow-up in a cohort of MetS patients. 2. To analyze the influence of weight loss, Mediterranean diet adherence and physical activity on MetS parameters, CVR and serum ucOC levels in the study population. 3. To determine bone quality though densitometry and TBS and to analyze its association with ucOC serum levels and cardiovascular risk (CVR) parameters in a sample of women from the cohort and to evaluate the influence that weight loss, diet quality and physical exercise practice can have on bone health in those women. Conclusion: The present study confirms that weight loss, Mediterranean diet adherence and physical activity are associated with CVR reduction and MetS determinants improvement and moreover MetS reversion. The measurement of circulating ucOC could be a useful tool to identify increased cardiovascular and T2D risk in MetS patients without T2D. The measurement of circulating ucOC levels could become a strategy to identify MetS patients at high risk in order to establish preventive and therapeutic approaches. In addition, lower serum levels of ucOC could contribute to T2D development. These findings break new ground for new research lines to evaluate the role of ucOC as a biomarker and as a potential therapeutic target, as well as the usefulness of CV-ZS in clinical practice in future longitudinal studies., Tesis Univ. Granada.

Additional file 1: Table S1. Associations of total inactive time with adiposity indicators and cardio-metabolic risk factors (with further adjustment for light physical activity, instead of moderate-to-vigorous physical activity). Table S2. Associations of total inactive time with adiposity indicators and cardio-metabolic risk factors (with further adjustment for light physical activity, instead of moderate-to-vigorous physical activity and waist circumference as an indicator of adiposity). Table S3. Prevalence ratio of metabolic syndrome parameters according to tertiles of sedentary time (with further adjustment for light physical activity, instead of moderate-to-vigorous physical activity). Table S4. Isotemporal substitution of inactive time (30 min/day) with sleep time and physical activity on cardio-metabolic risk.