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1.
Cardiovasc Diabetol ; 23(1): 98, 2024 Mar 16.
Artículo en Inglés | MEDLINE | ID: mdl-38493287

RESUMEN

BACKGROUND: Telomere Length (TL), a marker of cellular aging, holds promise as a biomarker to elucidate the molecular mechanism of diabetes. This study aimed to investigate whether shorter telomeres are associated with a higher risk of type 2 diabetes mellitus (T2DM) incidence in patients with coronary heart disease; and to determine whether the most suitable dietary patterns, particularly a Mediterranean diet or a low-fat diet, can mitigate the development of diabetes in these patients after a follow-up period of five years. METHODS: The CORonary Diet Intervention with Olive oil and cardiovascular PREVention study (CORDIOPREV study) was a single-centre, randomised clinical trial done at the Reina Sofia University Hospital in Córdoba, Spain. Patients with established coronary heart disease (aged 20-75 years) were randomly assigned in a 1:1 ratio by the Andalusian School of Public Health to receive two healthy diets. Clinical investigators were masked to treatment assignment; participants were not. Quantitative-PCR was used to assess TL measurements. FINDINGS: 1002 patients (59.5 ± 8.7 years and 82.5% men) were enrolled into Mediterranean diet (n = 502) or a low-fat diet (n = 500) groups. In this analysis, we included all 462 patients who did not have T2DM at baseline. Among them, 107 patients developed T2DM after a median of 60 months. Cox regression analyses showed that patients at risk of short telomeres (TL < percentile 20th) are more likely to experience T2DM than those at no risk of short telomeres (HR 1.65, p-value 0.023). In terms of diet, patients at high risk of short telomeres had a higher risk of T2DM incidence after consuming a low-fat diet compared to patients at no risk of short telomeres (HR 2.43, 95CI% 1.26 to 4.69, p-value 0.008), while no differences were observed in the Mediterranean diet group. CONCLUSION: Patients with shorter TL presented a higher risk of developing T2DM. This association could be mitigated with a specific dietary pattern, in our case a Mediterranean diet, to prevent T2DM in patients with coronary heart disease. TRIAL REGISTRATION: Clinicaltrials.gov number NCT00924937.


Asunto(s)
Enfermedades Cardiovasculares , Enfermedad Coronaria , Diabetes Mellitus Tipo 2 , Dieta Mediterránea , Femenino , Humanos , Masculino , Biomarcadores , Enfermedades Cardiovasculares/epidemiología , Enfermedad Coronaria/diagnóstico , Enfermedad Coronaria/epidemiología , Enfermedad Coronaria/genética , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/genética , Telómero , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano
2.
Nutrients ; 16(8)2024 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-38674939

RESUMEN

The incidence of type 2 diabetes mellitus (T2DM) is growing in Western countries. Nutritional interventions that promote high-quality dietary patterns could help reverse this trend. We aimed to evaluate whether changes in Nutrient-Rich Food Index 9.3 (NRF9.3) were related to the risk of developing T2DM in patients with coronary heart disease (CHD). The study was carried out in the context of two healthy dietary interventions (a Mediterranean and a low-fat diet). For this purpose, we evaluated all the patients in the CORDIOPREV study without T2DM at baseline. Data were obtained during the first 5 years of dietary intervention. The score was calculated using the Food Frequency Questionnaires at baseline and after 1 year of intervention. After 5 years of follow-up, 106 patients developed T2DM (incident-T2DM), while 316 subjects did not (non-T2DM). Total NRF9.3 score and changes during the first year of intervention were compared between incident-T2DM and non-T2DM. Incident-T2DM showed less improvement in NRF9.3 than non-T2DM (p = 0.010). In the multi-adjusted Cox proportional hazard study, patients with greater improvement in NRF9.3 had over 50% less risk of developing T2DM compared with the lowest tertile (HR 2.10, 95%, CI = 1.12-3.56). In conclusion, improved diet quality in terms of nutrient density after the dietary intervention was associated with a lower risk of T2DM in patients with CHD.


Asunto(s)
Enfermedad Coronaria , Diabetes Mellitus Tipo 2 , Dieta Mediterránea , Humanos , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Masculino , Femenino , Enfermedad Coronaria/epidemiología , Enfermedad Coronaria/etiología , Persona de Mediana Edad , Factores de Riesgo , Anciano , Dieta con Restricción de Grasas , Incidencia , Dieta , Modelos de Riesgos Proporcionales , Dieta Saludable
3.
Diabetes Metab ; 50(1): 101503, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38097011

RESUMEN

AIM: Advanced glycation end products (AGEs) play a role in kidney disease in type 2 diabetes mellitus (T2DM). However, there have been no prior controlled clinical trials examining the effects of specific diets on AGE metabolism and their impact on kidney function. Our aim was to assess whether modulating AGE metabolism resulting in reduced AGEs levels, after consumption of two healthy diets, could delay kidney function decline in patients with T2DM and coronary heart disease (CHD). METHODS: T2DM patients (540 out of 1002 patients from the CORDIOPREV study), with estimated glomerular filtration rate (eGFR) ≥ 30 ml/min/1.73 m2, were classified based on their baseline kidney function: normal eGFR (≥ 90 ml/min/1.73 m2), mildly decreased eGFR (60- < 90 ml/min/1.73 m2) and moderately decreased eGFR (<60 ml/min/1.73 m2). Serum AGE levels, methylglyoxal (MG) and N-carboximethyllysine (CML), and gene expression related to AGE metabolism (AGER1, RAGE, and GloxI mRNA) were measured before and after 5-years of dietary intervention (a Mediterranean diet or a low-fat diet). RESULTS: Mediterranean diet produced a lower declined of eGFR compared to the low-fat diet only in patients with mildly decreased eGFR (P = 0.035). Moreover, Mediterranean diet was able to decrease MG levels and increase GloxI expression in normal and mildly decreased eGFR patients (all P < 0.05). One standard deviation increment of MG levels after dietary intervention resulted in a 6.8-fold (95 % CI 0.039;0.554) higher probability of eGFR decline. CONCLUSION: Our study showed that lowering circulating AGE levels, specifically MG, after following a Mediterranean diet, might be linked to the preservation of kidney function, evidenced by a decreased decline of eGFR in T2DM patients with CHD. Patients with mildly decreased eGFR could potentially benefit more from AGE reduction in maintaining kidney function.


Asunto(s)
Enfermedad Coronaria , Diabetes Mellitus Tipo 2 , Dieta Mediterránea , Humanos , Preescolar , Piruvaldehído , Riñón
4.
Biol Sex Differ ; 15(1): 7, 2024 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-38243297

RESUMEN

BACKGROUND: Cardiovascular diseases (CVD), including coronary heart disease (CHD), display a higher prevalence in men than women. This study aims to evaluate the variations in the intestinal microbiota between men and women afflicted with CHD and delineate these against a non-CVD control group for each sex. METHODS: Our research was conducted in the framework of the CORDIOPREV study, a clinical trial which involved 837 men and 165 women with CHD. We contrasted our findings with a reference group of 375 individuals (270 men, 105 women) without CVD. The intestinal microbiota was examined through 16S metagenomics on the Illumina MiSeq platform and the data processed with Quiime2 software. RESULTS: Our results showed a sex-specific variation (beta diversity) in the intestinal microbiota, while alpha-biodiversity remained consistent across both sexes. Linear discriminant analysis effect size (LEfSe) analysis revealed sex-centric alterations in the intestinal microbiota linked to CVD. Moreover, using random forest (RF) methodology, we identified seven bacterial taxa-g_UBA1819 (Ruminococcaceae), g_Bilophila, g_Subdoligranulum, g_Phascolarctobacterium, f_Barnesiellaceae, g_Ruminococcus, and an unknown genus from the Ruminococcaceae family (Ruminococcaceae incertae sedis)-as key discriminators between men and women diagnosed with CHD. The same taxa also emerged as critical discriminators between CHD-afflicted and non-CVD individuals, when analyzed separately by sex. CONCLUSION: Our findings suggest a sex-specific dysbiosis in the intestinal microbiota linked to CHD, potentially contributing to the sex disparity observed in CVD incidence. Trial registration Clinical Trials.gov.Identifier NCT00924937.


The frequency with which cardiovascular diseases occur differs in men and women as it appears with greater frequency in men. Moreover, it has been known for years that the community of bacteria living in our intestine, also known as the gut microbiota, influences the development of these diseases. Indeed, nowadays it known the influence of the intestinal microbiota in the development of atherosclerosis, the pathological process which is responsible for the three main causes of cardiovascular diseases: coronary heart disease, cerebrovascular disease and peripheral arterial disease. This study shows the differences in the community of bacteria living in the gut of men and those living in the gut of women, so that these differences could explain, at least in part, the differences in the frequency with which cardiovascular diseases appear between men and women. Our results suggest that the dysbiosis of the intestinal microbiota associated with CHD seems to be partially sex-specific, which may influence the sexual dimorphism in its incidence. Moreover, the identification of the mechanisms responsible for sexual dimorphism in the incidence of metabolic and cardiovascular disease is of particular importance when developing effective strategies and therapies aimed at reducing their incidence and recurrence. Indeed, the strategies and therapies used to treat the dysbiosis of the gut microbiota should be sex-specific.


Asunto(s)
Enfermedades Cardiovasculares , Microbioma Gastrointestinal , Masculino , Humanos , Femenino , Enfermedades Cardiovasculares/epidemiología , Caracteres Sexuales , Bacterias , Incidencia
5.
Clin Investig Arterioscler ; 36(4): 243-266, 2024.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38599943

RESUMEN

The irruption of lipoprotein(a) (Lp(a)) in the study of cardiovascular risk factors is perhaps, together with the discovery and use of proprotein convertase subtilisin/kexin type 9 (iPCSK9) inhibitor drugs, the greatest novelty in the field for decades. Lp(a) concentration (especially very high levels) has an undeniable association with certain cardiovascular complications, such as atherosclerotic vascular disease (AVD) and aortic stenosis. However, there are several current limitations to both establishing epidemiological associations and specific pharmacological treatment. Firstly, the measurement of Lp(a) is highly dependent on the test used, mainly because of the characteristics of the molecule. Secondly, Lp(a) concentration is more than 80% genetically determined, so that, unlike other cardiovascular risk factors, it cannot be regulated by lifestyle changes. Finally, although there are many promising clinical trials with specific drugs to reduce Lp(a), currently only iPCSK9 (limited for use because of its cost) significantly reduces Lp(a). However, and in line with other scientific societies, the SEA considers that, with the aim of increasing knowledge about the contribution of Lp(a) to cardiovascular risk, it is relevant to produce a document containing the current status of the subject, recommendations for the control of global cardiovascular risk in people with elevated Lp(a) and recommendations on the therapeutic approach to patients with elevated Lp(a).


Asunto(s)
Enfermedades Cardiovasculares , Factores de Riesgo de Enfermedad Cardiaca , Lipoproteína(a) , Humanos , Lipoproteína(a)/sangre , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/etiología , Inhibidores de PCSK9 , España , Aterosclerosis , Consenso , Arteriosclerosis
6.
Antioxidants (Basel) ; 13(1)2024 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-38275650

RESUMEN

In order to evaluate whether telomere maintenance is associated with type 2 diabetes remission, newly diagnosed type 2 diabetes patients without glucose-lowering treatment (183 out of 1002) from the CORDIOPREV study (NCT00924937) were randomized to consume a Mediterranean or low-fat diet. Patients were classified as Responders, those who reverted from type 2 diabetes during the 5 years of dietary intervention (n = 69), and Non-Responders, who did not achieve diabetes remission by the end of the follow-up period (n = 104). We found no differences in diabetes remission between the two diets, and we determined telomere length (TL) by measuring qPCR, telomerase activity using the TRAP assay, and direct redox balance based on the ratio of reduced glutathione (GSH) to oxidized glutathione (GSSH) via colorimetric assay. Responders exhibited higher baseline TL in comparison with Non-Responders (p = 0.040), and a higher TL at baseline significantly predicted a higher probability of type 2 diabetes remission (OR 2.13; 95% CI, 1.03 to 4.41). After the dietary intervention, Non-Responders showed significant telomere shortening (-0.19, 95% CI -0.32 to 0.57; p = 0.005). Telomere shortening was significantly pronounced in type 2 diabetes patients with a worse profile of insulin resistance and/or beta-cell functionality: high hepatic insulin resistance fasting, a high disposition index (-0.35; 95% CI, -0.54 to -0.16; p < 0.001), and a low disposition index (-0.25; 95% CI, -0.47 to -0.01; p = 0.037). In addition, changes in TL were correlated to the GSH/GSSG ratio. Responders also showed increased telomerase activity compared with baseline (p = 0.048), from 0.16 (95% CI, 0.08 to 0.23) to 0.28 (95% CI, 0.15 to 0.40), with a more marked increase after the dietary intervention compared with Non-Responders (+0.07; 95% CI, -0.06-0.20; p = 0.049). To conclude, telomere maintenance may play a key role in the molecular mechanisms underlying type 2 diabetes remission in newly diagnosed patients. However, further larger-scale prospective studies are necessary to corroborate our findings.

7.
Nutr Diabetes ; 14(1): 27, 2024 05 16.
Artículo en Inglés | MEDLINE | ID: mdl-38755195

RESUMEN

BACKGROUND: Type 2 diabetes mellitus (T2DM) is recognized an independent risk factor for chronic kidney disease (CKD). The precise contribution and differential response to treatment strategies to reduce kidney dysfunction, depending on whether obesity is present alongside T2DM or not, remain to be fully clarified. Our objective was to improve our understanding of how obesity contributes to kidney function in patients with T2DM and coronary heart disease (CHD), who are highly predisposed to CKD, to assign the most effective dietary approach to preserve kidney function. METHODS: 1002 patients with CHD and estimated glomerular filtration rate (eGFR)≥30 ml/min/1.73m2, were randomized to consume a Mediterranean diet (35% fat, 22% MUFA, < 50% carbohydrates) or a low-fat diet (28% fat, 12% MUFA, > 55% carbohydrates). Patients were classified into four groups according to the presence of T2DM and/or obesity at baseline: Non-Obesity/Non-T2DM, Obesity/Non-T2DM, Non-Obesity/T2DM and Obesity/T2DM. We evaluated kidney function using serum creatinine-based estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (uACR) before and after 5-years of dietary intervention. RESULTS: Patients with Obesity/T2DM had the lowest baseline eGFR and the highest baseline uACR compared to non-diabetics (p < 0.05). After dietary intervention, the Mediterranean diet induced a lower eGFR decline in patients with Obesity/T2DM, compared to a low-fat diet but not in the other groups (p = 0.014). The Mediterranean diet, but not the low-fat diet, also reduced uACR only in patients with Obesity/T2DM (p = 0.024). CONCLUSIONS: Obesity provided an additive effect to T2DM resulting in a more pronounced decline in kidney function compared to T2DM alone when compared to non-diabetics. In patients with concomitant presence of T2DM and obesity, with more metabolic complications, consumption of a Mediterranean diet seemed more beneficial than a low-fat diet in terms of preserving kidney function. These findings provide valuable insights for tailoring personalized lifestyle modifications in secondary prevention of cardiovascular disease. TRIAL REGISTRATION: URL, http://www.cordioprev.es/index.php/en . CLINICALTRIALS: gov number, NCT00924937.


Asunto(s)
Enfermedad Coronaria , Diabetes Mellitus Tipo 2 , Dieta Mediterránea , Tasa de Filtración Glomerular , Riñón , Obesidad , Insuficiencia Renal Crónica , Humanos , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/complicaciones , Obesidad/dietoterapia , Obesidad/complicaciones , Masculino , Femenino , Persona de Mediana Edad , Enfermedad Coronaria/dietoterapia , Insuficiencia Renal Crónica/dietoterapia , Insuficiencia Renal Crónica/fisiopatología , Anciano , Riñón/fisiopatología , Dieta con Restricción de Grasas , Creatinina/sangre
8.
Clin Investig Arterioscler ; 36(3): 133-194, 2024.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38490888

RESUMEN

One of the objectives of the Spanish Society of Arteriosclerosis is to contribute to the knowledge, prevention and treatment of vascular diseases, which are the leading cause of death in Spain and entail a high degree of disability and health expenditure. Atherosclerosis is a multifactorial disease and its prevention requires a global approach that takes into account the associated risk factors. This document summarises the current evidence and includes recommendations for patients with established vascular disease or at high vascular risk: it reviews the symptoms and signs to evaluate, the laboratory and imaging procedures to request routinely or in special situations, and includes the estimation of vascular risk, diagnostic criteria for entities that are vascular risk factors, and general and specific recommendations for their treatment. Finally, it presents aspects that are not usually referenced in the literature, such as the organisation of a vascular risk consultation.


Asunto(s)
Aterosclerosis , Enfermedades Vasculares , Humanos , Enfermedades Vasculares/prevención & control , Enfermedades Vasculares/diagnóstico , España , Aterosclerosis/prevención & control , Aterosclerosis/diagnóstico , Salud Global , Factores de Riesgo , Factores de Riesgo de Enfermedad Cardiaca , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/etiología , Sociedades Médicas/normas
9.
Sci Total Environ ; 928: 172610, 2024 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-38642762

RESUMEN

OBJECTIVE: To estimate the environmental impact of a dietary intervention based on an energy-reduced Mediterranean diet (MedDiet) after one year of follow-up. METHODS: Baseline and 1-year follow-up data were used for 5800 participants aged 55-75 years with metabolic syndrome in the PREDIMED-Plus study. Food intake was estimated through a validated semiquantitative food consumption frequency questionnaire, and adherence to the MedDiet was estimated through the Diet Score. Using the EAT-Lancet Commission tables we assessed the influence of dietary intake on environmental impact (through five indicators: greenhouse gas emissions (GHG), land use, energy used, acidification and potential eutrophication). Using multivariable linear regression models, the association between the intervention and changes in each of the environmental factors was assessed. Mediation analyses were carried out to estimate to what extent changes in each of 2 components of the intervention, namely adherence to the MedDiet and caloric reduction, were responsible for the observed reductions in environmental impact. RESULTS: We observed a significant reduction in the intervention group compared to the control group in acidification levels (-13.3 vs. -9.9 g SO2-eq), eutrophication (-5.4 vs. -4.0 g PO4-eq) and land use (-2.7 vs. -1.8 m2). Adherence to the MedDiet partially mediated the association between intervention and reduction of acidification by 15 %, eutrophication by 10 % and land use by 10 %. Caloric reduction partially mediated the association with the same factors by 55 %, 51 % and 38 % respectively. In addition, adherence to the MedDiet fully mediated the association between intervention and reduction in GHG emissions by 56 % and energy use by 53 %. CONCLUSIONS: A nutritional intervention based on consumption of an energy-reduced MedDiet for one year was associated with an improvement in different environmental quality parameters.


Asunto(s)
Dieta Mediterránea , Persona de Mediana Edad , Humanos , Anciano , Masculino , Femenino , Ambiente , Gases de Efecto Invernadero/análisis , Eutrofización , Síndrome Metabólico/prevención & control
10.
Environ Int ; 186: 108565, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38574403

RESUMEN

BACKGROUND: Endocrine disruptors (EDs) have emerged as potential contributors to the development of type-2 diabetes. Perfluorooctane sulfonate (PFOS), is one of these EDs linked with chronic diseases and gathered attention due to its widespread in food. OBJECTIVE: To assess at baseline and after 1-year of follow-up associations between estimated dietary intake (DI) of PFOS, and glucose homeostasis parameters and body-mass-index (BMI) in a senior population of 4600 non-diabetic participants from the PREDIMED-plus study. METHODS: Multivariable linear regression models were conducted to assess associations between baseline PFOS-DI at lower bound (LB) and upper bound (UB) established by the EFSA, glucose homeostasis parameters and BMI. RESULTS: Compared to those in the lowest tertile, participants in the highest tertile of baseline PFOS-DI in LB and UB showed higher levels of HbA1c [ß-coefficient(CI)] [0.01 %(0.002 to 0.026), and [0.06 mg/dL(0.026 to 0.087), both p-trend ≤ 0.001], and fasting plasma glucose in the LB PFOS-DI [1.05 mg/dL(0.050 to 2.046),p-trend = 0.022]. Prospectively, a positive association between LB of PFOS-DI and BMI [0.06 kg/m2(0.014 to 0.106) per 1-SD increment of energy-adjusted PFOS-DI was shown. Participants in the top tertile showed an increase in HOMA-IR [0.06(0.016 to 0.097), p-trend = 0.005] compared to participants in the reference tertile after 1-year of follow-up. DISCUSSION: This is the first study to explore the association between DI of PFOS and glucose homeostasis. In this study, a high baseline DI of PFOS was associated with a higher levels of fasting plasma glucose and HbA1c and with an increase in HOMA-IR and BMI after 1-year of follow-up.


Asunto(s)
Ácidos Alcanesulfónicos , Glucemia , Fluorocarburos , Homeostasis , Ácidos Alcanesulfónicos/sangre , Humanos , Fluorocarburos/sangre , Masculino , Femenino , Anciano , Glucemia/análisis , Persona de Mediana Edad , Índice de Masa Corporal , Diabetes Mellitus Tipo 2 , Disruptores Endocrinos , Dieta/estadística & datos numéricos , Anciano de 80 o más Años , Estudios Prospectivos , Contaminantes Ambientales/sangre
11.
Nutrients ; 16(13)2024 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-38999747

RESUMEN

BACKGROUND: The COVID-19 lockdown represented an immense impact on human health, which was characterized by lifestyle and dietary changes, social distancing and isolation at home. Some evidence suggests that these consequences mainly affected women and altered relevant ongoing clinical trials. The aim of this study was to evaluate the status and changes in diet, physical activity (PA), sleep and self-reported health status (SRH) as perceived by older adult men and women with metabolic syndrome during the COVID-19 lockdown. METHODS: We analyzed data from 4681 Spanish adults with metabolic syndrome. We carried out a telephone survey during May and June 2020 to collect information on demographics, dietary habits, PA, sleep, SRH and anthropometric data. RESULTS: The mean age of participants was 64.9 years at recruitment, and 52% of participants were men. Most participants (64.1%) perceived a decrease in their PA during confinement. Regarding gender-specific differences, a higher proportion of women than men perceived a decrease in their PA (67.5% vs. 61.1%), Mediterranean diet adherence (20.9% vs. 16.8%), sleep hours (30.3% vs. 19.1%), sleep quality (31.6% vs. 18.2%) and SRH (25.9% vs. 11.9%) (all p < 0.001). CONCLUSIONS: The COVID-19 lockdown affected women more negatively, particularly their self-reported diet, PA, sleep and health status.


Asunto(s)
COVID-19 , Ejercicio Físico , Estado de Salud , Estilo de Vida , Síndrome Metabólico , Autoinforme , Humanos , Masculino , Femenino , COVID-19/epidemiología , COVID-19/prevención & control , Persona de Mediana Edad , Anciano , España/epidemiología , Síndrome Metabólico/epidemiología , Factores Sexuales , Factores de Riesgo Cardiometabólico , SARS-CoV-2 , Cuarentena , Dieta Mediterránea/estadística & datos numéricos , Sueño , Dieta
12.
Aging Dis ; 2024 Jul 21.
Artículo en Inglés | MEDLINE | ID: mdl-39122449

RESUMEN

Cognitive decline has been reported as a short-term sequela in patients hospitalized for coronavirus disease-19 (COVID-19). Whether COVID-19 is associated with late cognitive impairment in older free-living individuals with high cardiovascular risk, a group at greater risk of cognitive decline, is unknown. We determined this association of COVID-19 through a longitudinal evaluation of post-COVID-19 cognitive performance and impairment as post hoc analysis in 5,179 older adults (48% female) with mean (SD) age 68.5 (5.0) years, body mass index 31.7 (3.7) kg/m2, harboring ≥ 3 criteria for metabolic syndrome (e.g., hypertension, hyperlipidemia, hyperglycemia etc.) enrolled in PREDIMED-Plus trial. Pre- and post-COVID-19 cognitive performance was ascertained from scheduled assessments conducted using a battery of neuropsychological tests, including 5 domains: Global Cognitive Function, General Cognitive Function, Execution Function, Verbal Fluency and Attention domains, which were standardized for the cohort. Cognitive impairment was defined as the bottom 10 percentile of the sample. Multivariable linear and logistic regression models assessed the association of COVID-19 with cognitive decline and impairment, respectively. After a mean 50-week follow-up, no significant associations were observed between COVID-19 status and post-COVID-19 scores of all tapped neuropsychological domains, except Global Cognitive Function (GCF). When fully adjusted, COVID-19 was marginally associated with higher (better) post-pandemic GCF score (ßadj (95% CI): 0.06 (0.00, 0.13) p=.05). However, the odds for post-COVID-19 cognitive impairment in GCF domain were not associated with the disease (ORadj (95% CI): 0.90 (0.53, 1.51) p=.68). In the PREDIMED-Plus cohort, COVID-19 status and cognitive impairment determined 50 weeks post-infection showed no association in older adults at high cardiovascular risk. This suggests that cognitive changes observed shortly after COVID-19 revert over time. However, cautious interpretation is warranted as these data were obtained within the framework of a clinical trial encouraging a healthy lifestyle.

14.
Clín. investig. arterioscler. (Ed. impr.) ; 34(1): 10-18, ene.-feb. 2022. tab, ilus
Artículo en Español | IBECS (España) | ID: ibc-203136

RESUMEN

OBJETIVO: Durante los años 2019 y 2020 se realizaró una serie de reuniones en todo el territorio nacional dirigidas a explicar la metodología y los criterios de elaboración de las recomendaciones sobre la utilización de iPCSK9 publicadas por la Sociedad Española de Arteriosclerosis. Al final de cada una de las reuniones se realizó una encuesta entre los médicos participantes dirigida a describir los requerimientos de prescripción de estos fármacos en las diferentes regiones españolas. METODOLOGÍA: El Proyecto Efecto Mariposa fue desarrollado por un comité científico experto en lipídos. Tras la elaboración de todos los materiales necesarios para llevar a cabo el proyecto, se efectuó una reunión de formadores, impartida por los coordinadores del proyecto, a un total de 17 expertos. Posteriormente, se realizaron 16 talleres regionales con la asistencia de 169 médicos implicados en el manejo de la hipercolesterolemia, los cuales respondieron una encuesta donde se planteaban diferentes cuestiones acerca del uso de los iPCSK9 en su práctica clínica. CONCLUSIÓN: Los resultados demuestran importantes diferencias en el tratamiento con iPCSK9 en el contexto de la práctica clínica habitual en España. El análisis de estos resultados permitirá plantear en el futuro actuaciones orientadas a la equidad del acceso a los iPCSK9 a nivel nacional, con el objetivo principal de maximizar su beneficio potencial de acuerdo con el perfil del paciente.


AIMS: During 2019 and 2020 a series of meetings over the country were carried out, with the aim of explaining the methodology and criteria for the ellaboration of the recommendations on the use of iPCSK9, published by the Spanish Society of Atherosclerosis (SEA in Spanish). At the end of the meetings, a survey was conducted among the participants, in order to describe the prescription requirements of these drugs in the Spanish regions. METHODOLOGY: Butterfly Project was developed by a scientific Committee of experts in lipids. After the ellaboration of the materials for the project, a train the trainers program was carried out, imparted by 17 experts who were the Project coordinators. Later, 16 regional workshops were performed, with the attendance of 169 medical doctors involved in the management of hipercolesterolemia. The attendants responded the survey, where they were asked different questions on the use of iPCSK9 on their clinical practice. RESULTS: A high heterogeneity among centers regarding the requirements and difficulties for iPCSK9 prescription was revealed. Twenty one per cent of responders indicated to have low difficulties to prescribe iPCSK9 in their hospitals, whereas 78% found moderate or high difficulties. The difficulties came from burocracy- administrative aspects (18%), restrictions in the indication (41%) and both (38%). In general, the obstacles did not depend on the hospital level, neither the speciality, or the presence of lipid units, although the existance of lipid units was associated with a higher number of patients treated with iPCSK9. The factors which were associated with higher difficulty in the prescription were: the presence of an approval committee in the hospitals, the frequency in the revision of the treatment by hospital pharmacy, the temporal cadence of the prescription, the profile of patients seen and the criteria followed by the specialists for the prescription.


Asunto(s)
Humanos , Adulto , Ciencias de la Salud , Anticolesterolemiantes/uso terapéutico , Aterosclerosis/tratamiento farmacológico , España , Proproteína Convertasa 9/uso terapéutico
15.
Clín. investig. arterioscler. (Ed. impr.) ; 31(3): 128-139, mayo-jun. 2019. graf, tab
Artículo en Español | IBECS (España) | ID: ibc-182707

RESUMEN

Un grupo de expertos convocado por la Sociedad Española de Arteriosclerosis (SEA) se ha encargado de actualizar el documento de la SEA sobre las indicaciones de los inhibidores de PCSK9 (iPCSK9) en la práctica clínica publicadas en 2016. Esta actualización es necesaria porque en el periodo transcurrido hasta la actualidad se han publicado los resultados de los ensayos clínicos realizados a gran escala con iPCSK9 que demuestran que, además de su alta potencia para disminuir el colesterol aterogénico, disminuyen el riesgo de presentar episodios de enfermedad cardiovascular aterosclerótica en los pacientes con enfermedad tanto estable como reciente, y con un alto grado de seguridad. La presente actualización aporta las recomendaciones y el nivel de evidencia para la prescripción de los iPCSK9 en los pacientes con hipercolesterolemia familiar homo y heterocigota, con enfermedad cardiovascular aterosclerótica y en prevención primaria en los pacientes de muy alto riesgo cardiovascular. Dichas recomendaciones se han establecido teniendo en cuenta la concentración de c-LDL, la situación clínica del paciente, los condicionantes de riesgo adicionales y la relación coste-efectividad de su utilización


A group of experts convened by the Spanish Society of Arteriosclerosis (SEA) has been in charge of updating the SEA document on the indications of PCSK9 inhibitors (PCSK9i) in clinical practice that was published in 2016. This update is justified by the fact that the data from clinical trials carried out on a large scale with PCSK9i have shown that in addition to their high potency to lower atherogenic cholesterol, they reduce the risk of atherosclerotic cardiovascular disease, both in patients with stable disease, and with recent disease, and with a high degree of security. This update provides the recommendations and level of evidence for the prescription of iPCSK9 in patients with homozygous and heterozygous familial hypercholesterolemia, with atherosclerotic cardiovascular disease, and in primary prevention in patients with very high cardiovascular risk. These recommendations have been established taking into account the concentration of LDL-C, the clinical situation of the patient, the additional risk factors and the cost-effectiveness of their use


Asunto(s)
Humanos , Proproteína Convertasa 9/uso terapéutico , Sociedades Médicas/normas , Prevención Secundaria , Hiperlipoproteinemia Tipo II/tratamiento farmacológico , Enfermedades Cardiovasculares/tratamiento farmacológico , Enfermedades Cardiovasculares/prevención & control , Lipoproteínas LDL/efectos de los fármacos , España , Estados Unidos , Europa (Continente)
16.
Rev. esp. cardiol. (Ed. impr.) ; 72(11): 925-934, nov. 2019. tab, graf
Artículo en Español | IBECS (España) | ID: ibc-190744

RESUMEN

Introducción y objetivos: Los beneficios cardiovasculares de la dieta mediterránea se han evaluado bajo supuestos de ingesta total de energía ad libitum (sin restricción de energía). En el presente trabajo se estudia basalmente la cohorte de un gran ensayo en marcha denominado PREDIMED-Plus y la asociación entre la adherencia a la dieta mediterránea hipocalórica según la escala de 17 puntos (MedDiet) de este ensayo con la prevalencia inicial de factores de riesgo cardiovascular (FRCV). Métodos: Evaluación transversal de los participantes de PREDIMED-Plus (6.874 adultos mayores con sobrepeso/obesidad y síndrome metabólico). Se evaluó a los participantes para determinar la prevalencia de 4 FRCV (hipertensión, obesidad, diabetes, dislipemia). Se estimaron diferencias de medias y razones de prevalencia para FRCV individuales y agrupados con modelos multivariables. Resultados: Una mejor adhesión al patrón MedDiet se asoció significativamente con niveles más bajos de triglicéridos, índice de masa corporal y perímetro abdominal. Comparado con una baja adhesión (≤ 7 puntos en el score de 17 puntos), una mejor adhesión a la MedDiet (11-17 puntos) mostró asociaciones inversas con hipertensión (razón de prevalencia=0,97; IC95%, 0,94-1,00) y obesidad (razón de prevalencia=0,96; IC95% 0,92-1,00), pero se observaron asociaciones positivas con diabetes (razón de prevalencia=1,19; IC95% 1,07-1,32). Comparado con el tercil más bajo de adhesión, las mujeres en el tercil superior mostraron un riesgo menor para la agrupación de 3 o más FRCV (razón de prevalencia=0,91; IC95% 0,83-0,98). Conclusiones: Entre participantes con alto riesgo cardiovascular, la mejor adhesión a MedDiet se asoció a mejores perfiles lipídicos y medidas de adiposidad, y entre las mujeres mostró asociaciones inversas significativas con la agregación de FRCV


Introduction and objectives: The cardiovascular benefits of the Mediterranean diet have usually been assessed under assumptions of ad libitum total energy intake (ie, no energy restriction). In the recently launched PREDIMED-Plus, we conducted exploratory analyses to study the baseline associations between adherence to an energy-restricted Mediterranean diet (MedDiet) and the prevalence of cardiovascular risk factors (CVRF). Methods: Cross-sectional assessment of all PREDIMED-Plus participants (6874 older adults with overweight/obesity and metabolic syndrome) at baseline. The participants were assessed by their usual primary care physicians to ascertain the prevalence of 4 CVRF (hypertension, obesity, diabetes, and dyslipidemia). A 17-point PREDIMED-Plus score was used to measure adherence to the MedDiet. Multivariable models were fitted to estimate differences in means and prevalence ratios for individual and clustered CVRF. Results: Better adherence to a MedDiet pattern was significantly associated with lower average triglyceride levels, body mass index, and waist circumference. Compared with low adherence (≤ 7 points in the 17-point score), better adherence to the MedDiet (11-17 points) showed inverse associations with hypertension (prevalence ratio=0.97; 95%CI, 0.94-1.00) and obesity (prevalence ratio=0.96; 95%CI, 0.92-1.00), but positive associations with diabetes (prevalence ratio=1.19; 95%CI, 1.07-1.32). Compared with the lowest third of adherence, women in the upper third showed a significantly lower prevalence of the clustering of 3 or more CVRF (prevalence ratio=0.91; 95%CI, 0.83-0.98). Conclusions: Among participants at high cardiovascular risk, better adherence to a MedDiet showed significant inverse associations with CVRF among women, and improved lipid profiles and adiposity measures


Asunto(s)
Humanos , Dieta Mediterránea/estadística & datos numéricos , Manejo de la Obesidad/métodos , Obesidad/epidemiología , Enfermedades Cardiovasculares/epidemiología , Sobrepeso/epidemiología , Cumplimiento y Adherencia al Tratamiento/estadística & datos numéricos , Obesidad/complicaciones , Enfermedades Cardiovasculares/prevención & control , Factores de Riesgo , Diabetes Mellitus Tipo 2/epidemiología , Hiperlipidemias/epidemiología , España/epidemiología , Sobrepeso/complicaciones , Satisfacción del Paciente/estadística & datos numéricos
17.
Clín. investig. arterioscler. (Ed. impr.) ; 35(3): 105-114, May-Jun. 2023. tab, graf
Artículo en Español | IBECS (España) | ID: ibc-221775

RESUMEN

Background: Advanced glycation end products (AGEs) are pro-oxidant and cytotoxic compounds involved in the progression of chronic diseases as cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). The total body burden of AGEs also depend of those consume through the diet. Our aim was to analyze whether the reduction of AGE levels, after the consumption of two-healthy diets were associated with a greater decrease of intima-media thickness of both common carotid arteries (IMT-CC) in patients with T2DM and coronary heart disease (CHD). Methods: 540 CHD patients with T2DM, at baseline, from the CORDIOPREV study, were divided into two groups: (1) Responders, patients whose IMT-CC was reduced or not changed after dietary intervention and (2) Non-responders, patients whose IMT-CC was increased after dietary intervention. A total of 423 completed baseline and the 5-year follow-up carotid ultrasounds were analyzed in this study.Results: Our data showed that Responders, despite had a higher baseline IMT-CC and serum methylglyoxal (MG) levels than Non-responders, showed a reduction of serum levels of this glycotoxin after dietary intervention. Conversely, in patients whose IMT-CC was increased after dietary intervention (Non-responders), serum MG levels were increased. Moreover, an increase of circulating level of AGEs (and in particular, MG), after dietary intervention, could be considered a risk factor for the progression of atherosclerosis in patients with T2DM and CHD. Conclusion: These results support the importance of identifying underlying mechanisms in the context of secondary prevention of CVD that would provide therapeutic targets to reduce the high risk of cardiovascular events of these patients.(AU)


Antecedentes: Los productos finales de glicación avanzada (AGE) son compuestos prooxidantes y citotóxicos involucrados en la progresión de enfermedades crónicas, como las enfermedades cardiovasculares (ECV) y la diabetes mellitus tipo 2 (DMT2). La carga corporal total de AGE también depende de aquellos que se consumen a través de la dieta. Nuestro objetivo fue analizar si la reducción de los niveles de AGE, tras el consumo de dos dietas cardiosaludables, se asociaba con una mayor disminución del grosor íntima-media de ambas arterias carótidas comunes (GIM-CC) en pacientes con DMT2 y enfermedad coronaria establecida (EC). Métodos: Un total de 540 pacientes con EC y DMT2, al inicio del estudio CORDIOPREV, se dividieron en dos grupos: 1) respondedores, pacientes cuyo GIM-CC disminuyó o no se modificó tras la intervención dietética, y 2) no respondedores, pacientes cuyo GIM-CC aumentó tras la intervención dietética. En este estudio se incluyeron, finalmente, un total de 423 pacientes, aquellos que completaron el estudio de ecografía carotídea tanto en el basal como a los 5 años de intervención dietética. Resultados: Nuestros resultados mostraron que los respondedores, a pesar de tener un GIM-CC y niveles séricos de metilglioxal (MG) más elevados que los no respondedores, mostraron una reducción de los niveles séricos de esta glicotoxina tras la intervención dietética. Por el contrario, en los pacientes cuyo IMT-CC aumentó tras la intervención dietética (no respondedores), los niveles séricos de MG aumentaron. Un aumento de los niveles circulantes de AGE (y en particular de MG) tras la intervención dietética podría considerarse un factor de riesgo para la progresión de la aterosclerosis en pacientes con DMT2 y CE. Conclusión: Estos resultados apoyan la importancia de identificar los mecanismos subyacentes en el contexto de la prevención secundaria de la ECV que proporcionarían dianas y estrategias terapéuticas para reducir el alto riesgo de eventos...(AU)


Asunto(s)
Humanos , Masculino , Femenino , Diabetes Mellitus Tipo 2 , Productos Finales de Glicación Avanzada , Grosor Intima-Media Carotídeo , Enfermedades Cardiovasculares , Enfermedad Coronaria , Dieta , Arteriosclerosis , Investigación , Factores de Riesgo , Técnicas de Laboratorio Clínico
18.
Gastroenterol. hepatol. (Ed. impr.) ; 41(5): 328-349, mayo 2018. tab, graf
Artículo en Español | IBECS (España) | ID: ibc-180611

RESUMEN

La enfermedad hepática grasa no alcohólica (EHGNA) es la causa más frecuente de hepatopatía crónica en nuestro medio y se prevé un incremento de su incidencia en los próximos años asociada al incremento de la obesidad y el síndrome metabólico. Esta guía de práctica clínica propone recomendaciones sobre el diagnóstico y en especial marcadores no invasivos, así como en el manejo y seguimiento de esta enfermedad. La intervención dietética basada en la dieta mediterránea y el cambio del estilo de vida constituyen el pilar del tratamiento de la EHGNA, pero aún falta por elucidar si la composición de la dieta puede influir en la mejoría de la enfermedad más allá de la pérdida de peso. El tratamiento con fármacos debe restringirse a los pacientes con esteatohepatitis y fibrosis significativa que no consiguen resolución de la esteatohepatitis después de una intervención con dieta y ejercicio físico durante un año. Nuevos fármacos aún en fases iniciales de desarrollo han demostrado ser superiores a placebo. Por último, el impacto de la EHGNA en la indicación de trasplante hepático, la viabilidad del injerto y la recidiva de EHGNA de novo tras el trasplante, así como el incrementado riesgo cardiovascular determinan todo el proceso peritrasplante hepático. Esta guía de práctica clínica se ha elaborado tras la I Reunión de Consenso sobre EHGNA con un panel de experto nacionales e internaciones en Sevilla y tienen como objetivo proponer recomendaciones basadas en la evidencia científica disponible para el manejo de estos pacientes


Non-alcoholic fatty liver disease (NAFLD) is the main cause of liver diseases in Spain and the incidence is raising due to the outbreak of type 2 diabetes and obesity. This CPG suggests recommendation about diagnosis, mainly non-invasive biomarkers, and clinical management of this entity. Life-style modifications to achieve weight loss is the main target in the management of NAFLD. Low caloric Mediterranean diet and 200 minutes/week of aerobic exercise are encouraged. In non-responders patients with morbid obesity, bariatric surgery or metabolic endoscopy could be indicated. Pharmacological therapy is indicated in patients with NASH and fibrosis and non-responders to weight loss measures. NAFLD could influence liver transplantation, as a growing indication, the impact of steatosis in the graft viability, de novo NAFLD rate after OLT and a raised cardiovascular risk that modify the management of this entity. The current CPG was the result of the First Spanish NAFLD meeting in Seville


Asunto(s)
Humanos , Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Enfermedad del Hígado Graso no Alcohólico/terapia , Guías de Práctica Clínica como Asunto
19.
Nutr. hosp ; 34(6): 1455-1462, nov.-dic. 2017. graf, tab
Artículo en Español | IBECS (España) | ID: ibc-168988

RESUMEN

Actualmente la industria alimentaria ha generado interés en edulcorantes no nutritivos, por ejemplo la estevia y en componentes especiales como la L-carnitina, utilizados en formulaciones de suplementos nutricionales para el control glicémico específicos para diabéticos. El presente estudio evaluó el efecto de la estevia y la L-carnitina sobre el índice glicémico (IG) y la carga glicémica (CG) de un suplemento nutricional en 19 sujetos sanos (9 hombres y 10 mujeres), quienes completaron aleatoriamente 3 pruebas de consumo, 1 para el suplemento y 1 para cada producto de referencia: solución glucosada (SG) y pan blanco (PB), obteniendo muestras de sangre a los tiempos 0, 15, 30, 45, 60, 90 y 120 min; para medición de glicemias, e insulina basal y postprandial. El área de incremento bajo la curva de glucosa (IAUC) fue menor para el suplemento 11.778,73 que para los productos de referencia (SG) 13.724,06; (PB) 13.153,56 α = p 0,005. El IG = (62) y la CG = (16) resultaron intermedios y más bajos que el del pan blanco IG = (69) y la CG = (18), sin diferencias en la insulina postprandial. Esto demuestra que este suplemento nutricional formulado con estevia y L-carnitina es capaz de prolongar la respuesta glicémica sin aumentar los requerimientos insulínicos en sujetos sanos. Se requieren estudios específicos en diabéticos para validar si el impacto glicémico es menor que el producto patrón. La presencia de otros nutrientes en la fórmula, influyentes en estos indicadores, no permite inferir que los resultados se deban únicamente al tipo de endulzante utilizado y a la L-carnitina (AU)


Currently the food industry has generated interest in non-nutritive sweeteners, for example Stevia and in special components such as L-carnitine, used in formulations of nutritional supplements for glycemic control specific for diabetics. The present study evaluated the effect of stevia and L-carnitine on the glycemic index (GI) and glycemic load (CG) of a nutritional supplement in 19 healthy subjects (9 men and 10 women), who randomly completed 3 consumption tests, 1 for the supplement and 1 for each reference product: Glucose solution (SG) and white bread (PB), obtaining blood samples at the 0, 15, 30, 45, 60, 90 and 120 min times; for measurement of blood glucose, basal and postprandial insulin. The increase area under the glucose curve (IAUC) was lower for supplement 11,778.73 than for reference products (SG) 13,724.06; (PB) 13,153.56 α = p 0.005. IG = (62) and CG = (16) were intermediate and lower than white bread IG = (69) and CG = (18), with no difference in postprandial insulin. This demonstrates that this nutritional supplement formulated with stevia and L-carnitine is able to prolong the glycemic response without increasing the insulin requirements in healthy subjects. Specific studies are required in diabetics to validate whether the glycemic impact is lower than the standard product. The presence of other nutrients in the formula, influential in these indicators, does not allow to infer that the results are due only to the type of sweetener used and the L-carnitine (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Índice Glucémico , Glucemia , Suplementos Dietéticos , Carnitina/uso terapéutico , Edulcorantes/metabolismo , Método Doble Ciego , Estado Nutricional/fisiología , Índice de Masa Corporal , Antropometría/métodos , 28599
20.
Nutr. hosp ; 34(3): 532-539, mayo-jun. 2017. graf, tab
Artículo en Español | IBECS (España) | ID: ibc-164106

RESUMEN

Objetivo: el objetivo de este estudio fue comparar el índice glicémico (IG), la carga glicémica (CG) y la insulina posprandial de dos fórmulas isoglucídicas con distintos edulcorantes y fibra en adultos sanos y diabéticos tipo 2 (DM2). Metodología: en este estudio aleatorizado, cruzado y doble ciego, once sujetos sanos y seis diabéticos consumieron dos fórmulas en cuatro ocasiones (Glucerna SR® Laboratorios Abbott C.A [FG] y Enterex Diabetic®, Victus, C.A [FE], edulcoradas con fructosa y sucralosa respectivamente, con distintas fuentes de fibra), además de solución glucosada (SG) en una ocasión. Se obtuvieron muestras de sangre en ambos grupos a los tiempos 0, 15, 30, 45, 60, 90 y 120 minutos; en los diabéticos se adicionó el minuto 150 y 180 para medición de glicemias e insulina basal/posprandial de dos y tres horas. Resultados: el área de incremento bajo la curva de glucosa (IAUC) fue menor para las fórmulas que para SG. En sanos fue de 12.857 ± 422 para FE y 11.601 ± 272 para FG (p < 0,014). En diabéticos resultó más disminuida para FG (28.656 ± 123) comparada con FE (29.855 ± 496) (p < 0,01). El IG resultó 58,07 ± 8,4 y 60,7 ± 2 para FG y FE respectivamente en controles, y 65,16 ± 0,2 y 68,06 ± 1 en diabéticos, sin diferencias; igualmente en la insulina posprandial. Conclusiones: el IG y la CG de ambas fórmulas resultaron en un valor intermedio en los dos grupos, con perfil glicémico inferior al de SG. No se observaron diferencias en el comportamiento insulínico, evidenciando que la velocidad de absorción de los carbohidratos de estas fórmulas es prolongada, con impacto glicémico menor que el producto patrón, lo que sugiere que es aceptable su indicación en el diabético (AU)


Objective: The aim of this study is to compare the glycemic index (GI) and glycemic load (GL) of two formulas with the same glucose content with different sweeteners and dietary fi ber for diabetics in healthy adults and in patients with type-2 diabetes (DM2). Methodology: In this randomized, double-blind crossover research, eleven healthy people and six with DM2 consumed two enteral formulas, Glucerna SR®, Laboratorios Abbott C.A. (GF) and Enterex Diabetic®, Victus C.A. (EF), sweetened with fructose y sucralose, with 1.2 and 1.3 g/100 ml of fiber source respectively (four times). Additionally, they consumed glucose solution once, obtaining blood samples at 0, 15, 30, 45, 60, 90 and 120 min for controls; in the diabetics, minutes 150 and 180 were added for measuring blood glucose, basal and postprandial insulin after two and three hours. Results: The incremental area under the curve (IAUC) was lower for the formulas rather than for SG. In the healthy controls was 12,857 ± 422 for EF and 11,601 ± 272 for GF (p < 0.014). In diabetics, this curve reduced for GF (28,656 ± 123) compared to EF (29,855 ± 496) (p < 0.01). The IG resulted in 58.07 ± 8.4 and 60.7 ± 2 for GF and EF, respectively, in the controls, and 65.16 ± 0.2 and 68.06 ± 1 in diabetics, without significant differences, as well as in post-prandial insulin. Conclusions: The GI and the GL of the two formulas resulted in an intermediate value in both groups, with a glycemic profile inferior to SG. No significant differences were observed regarding insulin behavior, showing that the absorption rate of carbohydrates in these formulas is slower, with a lower glycemic impact than the pattern product; thus, making its indication acceptable for the diabetic patient (AU)


Asunto(s)
Humanos , Adulto , Índice Glucémico/fisiología , Carga Glucémica/fisiología , Hiperglucemia/dietoterapia , Edulcorantes/uso terapéutico , Edulcorantes Nutritivos , Fibras de la Dieta , Hiperglucemia/diagnóstico , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/dietoterapia , Voluntarios Sanos , Método Doble Ciego , Alimentos Formulados , Glucemia/análisis , Índice de Masa Corporal
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