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BACKGROUND: Longitudinal data assessing the impact of Iodine deficiency on mortality are scarce. We aimed to study the association between the state of iodine nutrition and the risk of total and cause-specific mortality in a representative sample of the Spanish adult population.; METHODS: We performed a longitudinal observational study to estimate mortality risk according to urinary iodine (UI) concentrations using a sample of 4370 subjects >18 years representative of the Spanish adult population participating in the nation-wide study Di@bet.es (2008-2010). We used Cox regression to assess the association between UI at the start of the study (

Objective: To analyze the reference range of thyroid-stimulating hormone (TSH) in different BMI categories and its impact on the classification of hypothyroidism. Methods: The study included 3,928 individuals free of thyroid disease (without previous thyroid disease, no interfering medications, TSH < 10 mu UI/mL and thyroid peroxidase antibodies [TPO Abs] < 50 IU/mL) who participated in a national, cross-sectional, population-based study and were representative of the adult population of Spain. Data gathered included clinical and demographic characteristics, physical examination, and blood and urine sampling. TSH, free thyroxine, free triiodothyronine, and TPO Ab were analyzed by electrochemiluminescence (E170, Roche Diagnostics, Basel, Switzerland). Results: The reference range (p2.5-97.5) for TSH was estimated as 0.6 to 4.8 mu UI/mL in the underweight category (BMI= 40). By using the reference criteria for the normal-weight population, the prevalence of high TSH levels increased threefold in the morbid obesity category (P < 0.01). Conclusions: Persons with morbid obesity might be inappropriately classified if the standard ranges of normality of TSH for the normal-weight population are applied to them.

Background: Abdominal obesity (AO) is a common modifiable risk factor for certain non-communicable diseases associated with enhanced oxidative stress (OS). The objective of this work was to investigate whether the interaction between antioxidant vitamin intake and OS-related polymorphisms modulates gene-associated anthropometry in a Spanish population. Methods: A total of 246 subjects with AO, and 492 age and gender matched non-AO subjects were included in the study. Anthropometric, biochemical, and OS parameters, and antioxidant dietary intake data were assessed using validated procedures. DNA from white blood cells was isolated and the genotype of seven polymorphisms from genes involved in OS (pro-oxidant and antioxidant) were analyzed using the SNPlex system. The effects of the c.-793T > C polymorphism on promoter activity and thus thioredoxin (TXN) activity were examined using reporter assays. Results: The AO group had higher 8-Oxo-2'-deoxyguanosine levels and took in less vitamin A and vitamin E compared to the non-AO group. Logistic regression analysis revealed that the rs2301241 polymorphism in TXN and rs740603 in catechol-O-methyltransferase (COMT) were associated with waist circumference (WC) and AO. Moreover, these polymorphisms were more strongly associated with variations in WC in subjects with low vitamin E intakes. A promoter assay revealed that the T to C conversion at c.-793 (rs2301241) induced a more than two fold increase in reporter gene expression. Conclusions: WC is associated both with dietary vitamin E intake and genetic variants of TXN and COMT suggesting that existence of a complex nutrigenetic pathway that involves regulation of AO.

Caso clínico Gastric cancer is a frequent cause of cancer-related mortality in the world. Surgery is the only potentially curative therapy, although the adverse effects of surgery are common and considerable. Common variable immunodeficiency is in many cases cause of gastrointestinal system problems such as chronic diarrhea caused by infestation with giardia lamblia, nodular lymphoid hiperplasia ad loss of villi leading frequently to malapsortion and malnutrition. Nutritional deficiencies due to malapsorption (postgastrectomy and secondary to loss of villi, giardiasis and common variable inmunodeficiency) are common. We present the case of a patient with gastric cancer who underwent a gastrectomy with common variable hipogammaglobulinemia and chronic infestation by giardia lamblia, with serious diarrhea resistant to treatment and malabsorption. Yes El adenocarcinoma gástrico es una de las causas más frecuentes de mortalidad en el mundo, siendo la cirugía el único tratamiento potencialmente curativo, aunque los efectos adversos digestivos y nutricionales son frecuentes y abundantes. La hipogammaglobulinemia variable común es causa de frecuentes manifestaciones digestivas, derivándose las más importantes en diarrea crónica causada por giardiasis, hiperplasia nodular linfoide o atrofia vellosa, siendo frecuente la malabsorción y la desnutrición. Los déficits nutricionales secundarios a la malabsorción (postgastrectomía y asociada a la atrofia vellosa y la giardiasis por hipogammaglobulinemia variable común) son asimismo frecuentes. Presentamos el caso de un paciente gastrectomizado por adenocarcinoma gástrico y con hipogammaglobulinemia variable común e infestación crónica por giardiasis que presenta una importante diarrea crónica refractaria a tratamiento y malabsorción.

10.1111/eci.12002

Se ha estudiado la flora y vegetación de dos de los afloramientos perido¬títicos del sur de la Península Ibérica, que incluyen la Sierra de Alpujata (71 Km2) y La Robla (7 Km2) en la provincia de Málaga. La flora serpentinícola muestra características diferentes del resto de la flora que vive sobre suelos zonales, debido a las limitaciones causadas por la composición de los suelos serpentínicos. Los resultados muestran una presencia elevada de serpentinófitos (18 de un total de 27) de los cuales 13 son ser¬pentinófitos estrictos aunque ninguno es exclusivo de las sierras estudiadas. En cuanto a la vegetación, casi todas las asociaciones y comunidades son endémicas de sustratos serpentínicos. Se describe una subasociación nueva y se reivindican, invierten y corrigen nombres de sintaxones. El paisaje vegetal está dominado por matorrales edafoxerófilos (Staehelino-Ulicion baetici), formaciones climácicas de pinos (Pinus pinaster) y coscojas (Quercus coccifera) (Pino-Juniperion phoeniceae), comunidades edafohigrófilas de sau¬cedas (Salicion pedicellatae) y juncales (Molinio-Holoschoenion). La Sierra de Alpujata es el tercer afloramiento del sur de la Península en cuanto a riqueza en vegetación ser¬pentinícola, por detrás solo de Sierra Bermeja y Sierra de las Nieves peridotítica (Sierra Parda). La presencia de especies endémicas y protegidas junto a sus hábitats incluidos en la Directiva 92/43CEE hacen de la Sierra de Alpujata una candidata a ser declarada como LIC (Lugar de Inetrés Comunitario). Este trabajo podría ser de gran valor para el seguimiento de la restauración y regeneración de la Sierra de Alpujata tras el incendio sufrido en el verano de 2012. Iberian serpentine flora and vegetation: Alpujata and La Robla mountains (Malaga, Spain). The flora and vegetation of two peridotite outcrops in the south of the Iberian Peninsula have been studied: Sierra de Alpujata (71 Km2) and La Robla (7 Km2) in the province of Malaga. Serpentine flora and vegetation show different characteris¬tics from the rest of the flora that lives on zonal soils, due to the limitations caused by the serpentine soil composition. The results show a high presence of serpentinophytes (18 out of 27) of which 13 are obligate serpentinophytes although none is exclusive from the studied outcrops. In terms of vegetation, almost all associations and com¬munities are endemic to serpentine substrates. A new subassociation is described and some syntaxa names are claimed, reversed or corrected. The landscape is dominated by xerophytic shrublands (Staehelino-Ulicion baetici), climax communities of pine (Pinus pinaster) and shrub oaks (Quercus coccifera) (Pino-Juniperion phoeniceae) and ripar¬ian forests (Salicion pedicellatae) mixed with higrophytic grasslands on wet soils and streams (Molinio-Holoschoenion). Sierra de Alpujata is the third outcrop of the south of the Iberian Peninsula regarding serpentine vegetation richness, after Sierra Bermeja and Sierra de las Nieves (peridotites of Sierra Parda). The presence of endemic and protected species together with their habitats included in the 92/43/EU Directive may drive Sierra de Alpujata to be a candidate to obtain the declaration of SCI (Site of Comunitarian Interest). This work could be of great value to monitor the restoration and regeneration of Sierra de Alpujata after the fire in the summer of 2012.