Thyroid hormone disorder and the heart: The role of cardiolipin in calcium handling.

NEW FINDINGS: What is the central question of this study? Do alterations in thyroid status affect haemodynamic parameters and echocardiographic measurements in the rat postnatal heart, and calcium handling, contractility, relaxation and cardiolipin content in isolated rat cardiomyocytes? What is the main finding and its importance? An imbalance in phospholipids of the mitochondrial membrane such as cardiolipin is related to defects in mitochondrial function. T3 -dependent cardiolipin signals contribute to the maintenance of mitochondrial homeostasis and involve Ca2+ handling, this pathway being more important in hypothyroidism. ABSTRACT: The objective of this study was to evaluate whether alterations in thyroid status affect (1) haemodynamic parameters and echocardiographic measurements in the rat postnatal heart, and (2) calcium handling, contractility, relaxation and cardiolipin content in isolated rat cardiomyocytes. Sprague-Dawley rats aged 2 months treated with T3 (hyperthyroid, 20 µg/100 g body weight) or 0.02% methimazole (hypothyroid, w/v) for 28 days. Heart function was evaluated by echocardiography. Measurements of mean arterial pressure (MAP), heart rate, Ca2+ transients, cardiomyocyte shortening, number of spontaneous contractions per minute and cardiolipin (CL) content were performed. Thyroid disorders were associated with changes in pacemaker activity without modifications of MAP. Thyroid disorder induced changes in left ventricular diameter which were correlated with modifications of cardiac contractility (altered cell shortening and sarcoplasmic reticulum Ca2+ content). Endocrine disorders altered cardiomyocyte relaxation (reduction in the time to 50% re-lengthening and the time to 50% Ca2+ decay). Thyroid disorder increased the number of spontaneous contractions per minute (an index of pro-arrhythmogenic behaviour). CL content was increased only in hypothyroid rats. Changes in CL content, CL composition and CL-protein interaction in mitochondria from hypothyroid animals are responsible for alterations of contractile and relaxation cardiac function. This mechanism may be not be involved in T3 -treated rats. Maintenance of euthyroidism is of crucial importance to preserve cardiac performance. An imbalance in relation to phospholipids of the mitochondrial membrane such as CL is related to defects in mitochondrial function. T3 -dependent CL signals contribute to the maintenance of mitochondrial homeostasis and involve Ca2+ handling, this pathway being more important in hypothyroidism.

Modifiable risk factors associated with prediabetes in men and women: a cross-sectional analysis of the cohort study in primary health care on the evolution of patients with prediabetes (PREDAPS-Study).

BACKGROUND: Prediabetes is a high-risk state for diabetes development, but little is known about the factors associated with this state. The aim of the study was to identify modifiable risk factors associated with the presence of prediabetes in men and women. METHODS: Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS-Study) is a prospective study on a cohort of 1184 subjects with prediabetes and another cohort of 838 subjects without glucose metabolism disorders. It is being conducted by 125 general practitioners in Spain. Data for this analysis were collected during the baseline stage in 2012. The modifiable risk factors included were: smoking habit, alcohol consumption, low physical activity, inadequate diet, hypertension, dyslipidemia, and obesity. To assess independent association between each factor and prediabetes, odds ratios (ORs) were estimated using logistic regression models. RESULTS: Abdominal obesity, low plasma levels of high-density lipoprotein cholesterol (HDL-cholesterol), and hypertension were independently associated with the presence of prediabetes in both men and women. After adjusting for all factors, the respective ORs (95% Confidence Intervals) were 1.98 (1.41-2.79), 1.88 (1.23-2.88) and 1.86 (1.39-2.51) for men, and 1.89 (1.36-2.62), 1.58 (1.12-2.23) and 1.44 (1.07-1.92) for women. Also, general obesity was a risk factor in both sexes but did not reach statistical significance among men, after adjusting for all factors. Risky alcohol consumption was a risk factor for prediabetes in men, OR 1.49 (1.00-2.24). CONCLUSIONS: Obesity, low HDL-cholesterol levels, and hypertension were modifiable risk factors independently related to the presence of prediabetes in both sexes. The magnitudes of the associations were stronger for men than women. Abdominal obesity in both men and women displayed the strongest association with prediabetes. The findings suggest that there are some differences between men and women, which should be taken into account when implementing specific recommendations to prevent or delay the onset of diabetes in adult population.

Internal Validation of the ASFV MONODOSE dtec-qPCR Kit for African Swine Fever Virus Detection under the UNE-EN ISO/IEC 17025:2005 Criteria.

African swine fever virus is considered an emerging virus that causes African swine fever, a disease characterised by high mortality and elevated transmission rates and that, as it is for most other viral diseases, cannot be treated with specific drugs. Effective and reliable detection of the virus is relevant to prevent uncontrolled contagion among boar populations and to reduce economic losses. Moreover, animal health laboratories are demanding standardisation, optimisation and quality assurance of the available diagnostic assays. In the present study, the ASFV MONODOSE dtec-qPCR kit was validated following the UNE-EN ISO/IEC 17025:2005 guidelines. Analytical validation terms include in silico and in vitro specificity, sensitivity, efficiency and reliability (repeatability/reproducibility). Diagnostic validation of the method was assessed through the analysis of a total of 181 porcine samples originating from six different matrix types doped with African swine fever virus DNA received from the European reference laboratory for African Swine Fever (INIA-CISA, Madrid, Spain): whole blood, blood serum, kidney, heart, liver and tonsil. Results agreed with those obtained from a reference detection method also based on real-time PCR, endorsed by WOAH, but the ASFV MONODOSE dtec-qPCR kit incorporates some technical innovations and improvements which may benefit end-users. This kit, available worldwide with full analytical and diagnostic validation, can recognise all known ASFV genotypes and brings additional benefits to the current qPCR technology.

Chronic renal disease in spain: prevalence and related factors in persons with diabetes mellitus older than 64 years. / Enfermedad renal crónica en España: prevalencia y factores relacionados en personas con diabetes mellitus mayores de 64 años.

INTRODUCTION: Type 2 diabetes mellitus and chronic kidney disease (CKD) are conditions which have a high prevalence in individuals ≥ 65 years of age and represent a major public health problem. OBJECTIVES: To determine the prevalence of CKD, its categories and its relationship with various demographic and clinical factors in elderly patients with type 2 diabetes mellitus in Spain. METHODS: Observational, cross-sectional, multicenter, Spanish epidemiological study. Patients with known type 2 diabetes mellitus, age ≥ 65 years of age treated in Primary Care were included. We collected demographic, anthropometric and analytical variables from the previous 12 months, including the albumin-to-creatinine ratio and estimated glomerular filtration rate to evaluate renal function. RESULTS: The prevalence of CKD was 37.2% (95% CI, 34.1-40.3%), renal failure was 29.7% (95% CI, 26.8-32.6%) and increased albuminuria was 20.6% (95% CI, 17.3-23.9%), moderately increased albuminuria was 17.8% (95% CI, 14.7-20.9%) and severely increased albuminuria was 2.8% (95% CI, 1.4-4.2%). In turn, the prevalence of CKD categories were: G1 1.3% (95% CI, 0.6-2%), G2 6.2% (95% CI, 4.6-7.8%), G3a 17.2% (95% CI, 14.8-19.6%), G3b 9.8% (95% CI, 7.9-11.7%), G4 2% (95% CI, 1.1-2.9%) and G5 0.7% (95% CI, 0.2-1.2%). In the multivariate analysis, after adjusting for the remaining variables, CKD was associated with elderly age (OR 5.13, 95% CI, 3.15-8.35), high comorbidity (OR 3.36. 95% CI, 2.2-5.12) and presence of antihypertensive treatment (OR 2.43. 95% CI, 1.48-4.02). CONCLUSIONS: CKD is frequent in the diabetic population ≥ 65 years of age and is associated with elderly age, high comorbidity and with treated hypertension. No relationship has been found with gender and time in years since onset of diabetes.

[Predictive capacity of the diagnostic criteria of metabolic syndrome on the insulin-resistance and the coronary risk]. / Capacidad predictiva de los criterios diagnósticos del síndrome metabólico sobre la resistencia a la insulina y el riesgo coronario.

BACKGROUND AND OBJECTIVE: Since at present several diagnostic criteria of the metabolic syndrome (MS) exist, the objective of the study is to verify the utility of the criteria of the International Diabetes Federation (IDF) to diagnose the MS, their agreement with other previous definitions and the insulin resistance (IR). It also studies its relation with the coronary risk (CR). SUBJECTS AND METHOD: Design of a cross-sectional descriptive study in the scope of the primary care of Yecla (Murcia). We studied 317 selected people from a stratified random sampling (age and sex) of 424 from a population of 18,059 with sanitary card and aged > or = 30 years. Socio-demographic, anthropometric and analytical (lipids, microalbuminuria, hemoglobin A1c and insulinemia) variables were registered. Criteria from the World Health Organization (WHO), Third Report of National Cholesterol Education Program (NCEP-III), European Group for the Study of Insuline Resistance (EGIR) and IDF were used to diagnose the MS. We defined IR when index HOMA > or = 3.8. The agreement between definitions of MS was determined by the kappa statistic. The CR was quantified according to Anderson (1991) method. RESULTS: The prevalence of the MS was: WHO, 35.3% (95% confidence interval [CI], 29.8-40.8); NCEP, 20.2% (95% CI, 15.6-24.8); EGIR, 24% (95% CI, 19.1-28.9), and IDF, 28.9% (95% CI, 23.8-34). The prevalence of IR was 27.7% (95% CI, 22.6-32.8). The agreement between the most clinical criteria (NCEP, IDF) and the biochemists (WHO, EGIR, HOMA) was lower (kappa < 0.50). A 58.2% (WHO), 66.1% (NCEP), 50% (EGIR) and 57% (IDF) of subjects with MS presented a CR greater than 20%. CONCLUSIONS: A high prevalence of the MS in Yecla exists, with a good agreement between the most clinical definitions of the syndrome (NCEP and IDF), that are associated with greater CR.

Glycaemic control of elderly patients with type 2 diabetes mellitus in Spain (2015) and its relationship with functional capacity and comorbidity. The Escadiane study. / Control glucémico de los pacientes ancianos con diabetes mellitus tipo 2 en España (2015) y su relación con la capacidad funcional y la comorbilidad. Estudio Escadiane.

OBJECTIVES: To understand the state of glycaemic control of elderly patients with type 2 diabetes mellitus in Spain and its relationship with functional capacity and comorbidity. METHODS: Cross-sectional, observational, multicentre national study on patients with diabetes mellitus aged 65 years or older. The study analysed demographic and anthropometric variables, cardiovascular risk factors, clinical and laboratory data, associated comorbidity and treatments. We analysed the functional capacity using the Barthel index and the comorbidity with Charlson index. RESULTS: The study included 939 patients with a mean age of 76.4±6.7 years. The mean glycated haemoglobin (HbA1c) level was 7.0%±1.2%, and the mean basal blood glucose level was 137±39.6mg/dL. The HbA1c level showed statistically significant differences depending on the degree of disability. In the patients who were totally, severely, moderately or slightly dependent or who were independent, the mean HbA1c levels were 7.0%, 7.9%, 7.4% and 7.0%, respectively (P<.028). HbA1c levels were 7.3%, 7.1% and 6.9% in the patients with very high, high and medium comorbidity, respectively (P<.001). CONCLUSIONS: Mean HbA1c levels in elderly patients with type 2 diabetes analysed in Spain are below those recommended by the main clinical practice guidelines. The levels are higher in patients who have more functional disability and a higher level of comorbidity.

Cardiometabolic Risk Profiles in Patients With Impaired Fasting Glucose and/or Hemoglobin A1c 5.7% to 6.4%: Evidence for a Gradient According to Diagnostic Criteria: The PREDAPS Study.

It has been suggested that the early detection of individuals with prediabetes can help prevent cardiovascular diseases. The purpose of the current study was to examine the cardiometabolic risk profile in patients with prediabetes according to fasting plasma glucose (FPG) and/or hemoglobin A1c (HbA1c) criteria.Cross-sectional analysis from the 2022 patients in the Cohort study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS Study) was developed. Four glycemic status groups were defined based on American Diabetes Association criteria. Information about cardiovascular risk factors-body mass index, waist circumference, blood pressure, cholesterol, triglycerides, uric acid, gamma-glutamyltransferase, glomerular filtration-and metabolic syndrome components were analyzed. Mean values of clinical and biochemical characteristics and frequencies of metabolic syndrome were estimated adjusting by age, sex, educational level, and family history of diabetes.A linear trend (P < 0.001) was observed in most of the cardiovascular risk factors and in all components of metabolic syndrome. Normoglycemic individuals had the best values, individuals with both criteria of prediabetes had the worst, and individuals with only one-HbA1c or FPG-criterion had an intermediate position. Metabolic syndrome was present in 15.0% (95% confidence interval: 12.6-17.4), 59.5% (54.0-64.9), 62.0% (56.0-68.0), and 76.2% (72.8-79.6) of individuals classified in normoglycemia, isolated HbA1c, isolated FPG, and both criteria groups, respectively.In conclusion, individuals with prediabetes, especially those with both criteria, have worse cardiometabolic risk profile than normoglycemic individuals. These results suggest the need to use both criteria in the clinical practice to identify those individuals with the highest cardiovascular risk, in order to offer them special attention with intensive lifestyle intervention programs.

[Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS): basis and methodology].

The PREDAPS study aims to determine the risk of developing diabetes and the risk of vascular complications in patients with prediabetes and identify factors associated with those risks. It is a prospective observational study of a cohort of 1184 subjects with prediabetes and another cohort of 838 subjects with no alterations in glucose metabolism. The data at baseline were obtained from patients attending primary care centers in Spain throughout 2012. Subjects with prediabetes were classified into three groups: those who had only altered the fasting blood glucose levels -between 100 and 125mg/dl-, those who had only altered the HbA1c level -between 5.7 and 6.4% - and those who had altered both parameters. Information on sociodemographic characteristics, personal and family history, lifestyle and drug therapy was obtained from medical records and the interview with the doctor in the consultation. It was also performed a physical examination to determine weight, height, waist circumference and blood pressure were performed and blood and urine analysis. The PREDAPS study may help to reduce uncertainty in individual prevention strategies in subjects with prediabetes. Annual monitoring of patients recruited for five years will enable to know the risk of developing diabetes type 2 and the risk of macro-and microvascular complications in the three groups of subjects with prediabetes and determine the factors associated with those risks.

[Prevalence of metabolic syndrome in the adult population of Yecla (Murcia). Degree of agreement between three definitions of it]. / Prevalencia del síndrome metabólico en la población adulta de Yecla (Murcia). Grado de acuerdo entre tres definiciones.

OBJECTIVES: To determine the prevalence of metabolic syndrome (MS), its components and insulin resistance (IR) in the adult population of Yecla. To study the variability between 3 definitions of the syndrome and IR. To identify the variables that predict the presence of IR and to verify the diagnostic validity of several strategies for predicting it. DESIGN: Descriptive, cross-sectional study. SETTING: Primary care, Yecla (Murcia), Spain. PARTICIPANTS: We studied 317 persons (292 with analysis) out of 424 selected by stratified (age and sex) random sampling from 18,059 people > or = 30 years old and possessing a health card. MAIN MEASUREMENTS: We used WHO-98, NCEP III, and EGIR criteria for diagnosing MS, and WHO-99 for defining DM2, impaired basal glucose and impaired glucose tolerance. The following variables were collected: social, demographic and personal details, plasma lipid, glycosylated haemoglobin, microalbuminuria, and insulin levels. IR was defined by the HOMA method at > or = 3.8 or as the highest quartile of basal insulinemia in normoglycaemic persons. RESULTS: MS prevalence was NCEP 20.2% (95% CI, 15.6-24.8), WHO 35.3% (95% CI, 29.8-40.8), EGIR 24% (95% CI, 19.1-28.9), and IR was 27.7% (95% CI, 22.6-32.8). The sensitivity and specificity of NCEP, WHO, and EGIR criteria for detecting IR were (46% and 90%), (78% and 81%), and (73% and 95%), respectively. Insulin resistance was associated significantly with age, basal glycaemia, triglycerides, and waist circumference. CONCLUSIONS: Metabolic syndrome is common in Yecla (more so in men). There is disagreement between several diagnostic criteria for the syndrome, with NCEP criteria less sensitive in determining IR. A generally accepted definition is needed.

[Analysis of disturbances in carbohydrate metabolism in the adult population of Yecla (Murcia, Spain)]. / Análisis de las alteraciones del metabolismo hidrocarbonado en la población adulta de Yecla (Murcia).

OBJECTIVE: To determine the prevalence of impaired fasting glucose (IFG or GBA), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM2) in the adult population of Yecla. RESEARCH, DESIGN, AND METHODS: We performed a population-based cross-sectional study (on Primary Care Field) with stratified and random sampling (393) from 17 500 residents in Yecla with sanitary card and aged > or =30 years. We studied 286 subjects (107 declining to participate) and 261 of them (125 men and 136 women) underwent an oral glucose tolerance test (OGTT). MAIN MEASUREMENTS: World Health Organization (WHO-99) and American Diabetes Association (ADA-97) criteria were used for diagnosis of unknown DM2, GBA and IGT. Socio-demographic and anthropometric variables were measured. Plasma lipid, glycosylated haemoglobin (HbA1C), microalbuminuria and insulin levels also were measured. Insulin resistance was evaluated by the HOMA method. RESULTS: According ADA-97 criteria the prevalence of DM2 and GBA was 2.65 (CI+/-1.95) and 4.3% (+/-2.5) respectively. Underwent an OGTT, the age-adjusted prevalence of DM2, IGT and GBA (using the Spanish population of July 02) was 6.7 (95%CI, 3,7-9,7); 13.2 (95%CI, 9.1-17.3) and 0.2% (95%CI, 0-1.8) respectively. The known DM2 was 5,9% (95%CI, 3.8-8) and the global prevalence of DM2 was 12.6% (95%CI, 9.6-15.6). The diabetes was associated with overweight, overage and higher insulin, HbA1C and insulin resistance levels. CONCLUSIONS: There is a high prevalence of DM2 in Yecla (known/unknown 0.87/1). The ADA97 criteria only detected 53% of the unknown DM2. The 78% of normoglycemics subjects had overweight or upper-body fat distribution and diabetics people had higher BMI (Body Mass Index), Hypertension, insulinemia, HbA1C and insulin resistance levels than normoglycemics and IGT subjects.