Serum Lipid and Adiponectin Improvements after a Mediterranean Dietary Pattern in Non-G-Allele Carriers of the Variant rs3774261.

BACKGROUND: The role of adiponectin (ADIPOQ) polymorphisms in weight loss and serum lipid changes following different dietary interventions remain unclear. The Mediterranean dietary pattern has been associated with improved cardiovascular risk factors in different studies. OBJECTIVE: Our aim was to analyze the effects of a hypocaloric diet with a Mediterranean dietary pattern on the metabolic response and adiposity parameters, taking into account the 712 G/A rs3774261 polymorphisms in ADIPOQ. DESIGN: A population of 135 obese patients was enrolled. Anthropometric and serum parameters (lipid profile, insulin, homeostasis model assessment for insulin resistance [HOMA-IR], glucose, C-reactive protein [CRP], adiponectin, resistin, and leptin levels) were measured before and after the dietary intervention (12 weeks). All of the patients were genotyped for the rs3774261 polymorphism. RESULTS: The genotype distribution of this population was 36 patients with AA (26.7%), 68 patients with AG (50.4%), and 31 patients with GG (22.9%). After the dietary intervention and in both genotypes, BMI, weight, fat mass, systolic blood pressure, waist circumference, glucose, insulin, HOMA-IR, and leptin levels all decreased. After the dietary intervention with secondary weight loss and in non-G-allele carriers (AA vs. AG+GG), total cholesterol (Δ = -15.7 ± 3.9 vs. -4.9 ± 2.9 mg/dL; p = 0.02), LDL cholesterol (Δ = -15.3 ± 3.8 vs. -1.7 ± 1.9 mg/dL; p = 0.01), triglyceride levels (Δ = -23.4 ± 5.6 vs. 2.3 ± 2.3 mg/dL; p = 0.01), and CRP (Δ = -1.1 ± 0.1 vs. -0.4 ± 0.2 mg/dL; p = 0.01) decreased. Adiponectin levels (Δ = 7.2 ± 2.1 vs. -0.4 ± 0.3 ng/dL; p = 0.02) increased. Notably, G-allele carriers did not show this improvement. CONCLUSION: Non-G-allele carriers of the ADIPOQ variant (rs3774261) showed significant improvement in serum levels of adiponectin, lipid profiles, and CRP in response to a hypocaloric diet with a Mediterranean dietary pattern.

Effects of a high-protein/low carbohydrate versus a standard hypocaloric diet on adipocytokine levels and insulin resistance in obese patients along 9 months.

OBJECTIVE: Recent dietary trials and observational studies have focused on the effects of diet on health outcomes such as improvement in levels of surrogate biomarkers. The aim of our study was to examine the changes in weight, adipocytokines levels and insulin resistance after a high-protein/low carbohydrate hypocaloric diet vs. a standard hypocaloric diet during an intervention of 9 months. SUBJECTS AND METHODS: 331 obese subjects were randomly allocated to one of two diets for a period of 9 months. Diet HP (n=168) (high-protein hypocaloric diet) consisted in a diet of 1050 cal/day, 33% of carbohydrates, 33% of fats and 34% of proteins. Diet S (n=163) (standard protein hypocaloric diet) consisted in a diet of 1093 cal/day, 53% carbohydrates, 27%fats, and 20% proteins. RESULTS: With the diets HP and S, BMI, weight, fat mass, waist circumference, waist-to-hip ratio, systolic blood pressure, total cholesterol, LDL-cholesterol, insulin and HOMA decreased. The decrease at 9 months of (BMI: -2.6±1.3kg/m(2) vs. -2.1±1.2kg/m(2):p<0.05), weight (-8.4±4.2kg vs. -5.0±4.1kg: p<0.05), fat mass (-5.1±4.1kg vs. -3.4±4.2kg: p<0.05), systolic blood pressure (-5.1±7.1mmHg vs. -3.1±2.1mmHg: p<0.05), (insulin levels -4.0±4.8 UI/L vs. -2.2±2.4 UI/L; p<0.05) and HOMA (-0.8±1.0 units vs. -0.3±1.0 units; p<0.05) was higher in diet HP than Diet S. With both diets, leptin levels decreased. CONCLUSION: A high-protein/low carbohydrate hypocaloric diet shows a higher weight loss, insulin and HOMA-R decreased after 9 months than a standard hypocaloric diet. The improvement in adipokine levels was similar with both diets.

Relation of the rs6923761 gene variant in glucagon-like peptide 1 receptor to metabolic syndrome in obese subjects.

BACKGROUND: The role of glucagon-like peptide 1 (GLP-1) variants in metabolic syndrome (MS) and its components remains unclear in obese subjects. OBJECTIVE: The aim of our study was to evaluate the relationship of rs6923761 with MS and its components in obese subjects. DESIGN: A population of 1,122 obese subjects was analyzed in a cross-sectional survey. To estimate the prevalence of MS, we considered the definitions of the Adult Treatment Panel III. RESULTS: Five hundred and forty-eight patients (48.8%) had the GG genotype (wild-type group), whereas 487 patients (43.4%) had the GA genotype and 87 patients (7.8%) the AA genotype. The mean age was 48.9 ± 12.8 years. The prevalence of MS was 47.4% (532 patients), and 52.6% of patients had no MS (n = 590). The odds ratio of MS for the wild-type versus the mutant genotype was 1.02, with a 95% confidence interval of 0.88-1.12. Body mass index, weight, fat mass, waist circumference, and waist to hip ratio were lower in the mutant than in the wild-type group in patients with and without MS. CONCLUSION: The GLP-1 receptor variant rs6923761 was found to be associated with decreased weight and anthropometric parameters in A allele carriers with and without MS. MS or its components were not associated with this polymorphism in obese adults.

[Roles of rs 6923761 gene variant in glucagon-like peptide 1 receptor on weight, cardiovascular risk factor and serum adipokine levels in morbid obese patients]. / Papel del polimorfismo rs 6923761 del receptor glucagon-like peptide 1 receptor sobre el peso, riesgo cardiovascular y niveles de adipocitoquinas en pacientes con obesidad mórbida.

BACKGROUND: Studies of the GLP-1 receptor have been directed at identifying polymorphisms in the GLP-1 receptor gene that may be a contributing factor in the pathogenesis of diabetes mellitus and cardiovascular risk factors. Nevertheless, the role of GLP-1 variants on body weight, cardiovascular risk factors and adipokines remains unclear in obese patients. OBJECTIVE: Our aim was to analyze the effects of rs6923761 GLP-1 receptor polymorphism on body weight, cardiovascular risk factors and serum adipokine levels in morbid obese patients. DESIGN: A sample of 175 morbid obese patients was enrolled in a prospective way. Basal fasting glucose, c-reactive protein (CRP), insulin, insulin resistance (HOMA), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides concentration and adipokines were measured. Weights, body mass index, waist circumference, fat mass by bioimpedance and blood pressure measures were measured. RESULTS: 87 patients (49,7%) had genotype GG and 88 (50,3%) had; GA (71 patients, 40,6%) or AA (17 patients, 9,7%) (second group). In the group with GG genotype, levels of glucose (4,4 ± 2,3 mg/dl, p < 0,05), tryglicerides (6,8 ± 4,3 mg/dl , p < 0,05), insulin (4,5 ± 2,3 UI/l , p < 0,05) and HOMA (1,5 ± 0,9 units, p < 0,05) were higher than mutant group. No differences were detected in other parameters. CONCLUSION: Data from our study revealed an association with metabolic parameters and rs6923761. Levels of triglycerides, insulin and HOMA were higher in subjects with A alelle than non A allele subjects.

Antecedentes: Los estudios de receptor de GLP-1 se han dirigido a la identificación de polimorfismos en el gen receptor de GLP- 1 que pueden ser un factor que contribuye en la patogénesis de la diabetes mellitus y factores de riesgo cardiovascular. Sin embargo, el papel de las variantes del receptor de GLP-1 variantes en el peso corporal, factores de riesgo cardiovasculares y adipocitoquinas sigue estando poco estudiado en pacientes con obesidad morbida. Objetivo: Nuestro objetivo fue analizar los efectos del polimorfismo del receptor de GLP-1 rs6923761 sobre el peso corporal, factores de riesgo cardiovascular y los niveles de adipocitoquinas séricas en pacientes con obesidad mórbida. Diseño: Se estudió una muestra de 175 obesos mórbidos. La glucosa en ayunas, proteína C reactiva (PCR), insulina, resistencia a la insulina ( HOMA), colesterol total, LDL- colesterol, HDL- colesterol, triglicéridos y la concentración de adipoquinas se midieron. También se determinaron el peso, índice de masa corporal, circunferencia de la cintura, masa grasa a través de bioimpedancia y la presión arterial. Resultados: Un total de 87 obesos (49,7%) tenían el genotipo GG y 88 (50,3%) de los sujetos del estudio tenían los siguientes genotipos; GA (71 obesos, el 40,6%) o AA (17 sujetos del estudio, el 9,7%) ( segundo grupo) . En el grupo con genotipo GG, los niveles de glucosa (4,4 ± 2,3 mg/dl, p < 0,05), triglicéridos (6,8 ± 4,3 mg/dl , p < 0,05), insulina (4,5 ± 2,3 UI/l , p < 0,05) y HOMA (1,5 ± 0,9 unidades, p < 0,05 ) fueron mayores que en el grupo mutante. No se detectaron diferencias en el resto de parámetros analizados Conclusión: Existe una asociación entre los parámetros metabólicos y el alelo mutante (A) del polimorfismo rs6923761 del receptor de GLP- 1 en pacientes con obesidad mórbida. Los niveles de triglicéridos, insulina y resistencia a la insulina son más elevados en los sujetos portadores del alelo A.

Papel del polimorfismo RS 6923761 del receptor glucagon-like peptide 1 receptor sobre el peso, riesgo cardiovascular y niveles de adipocitoquinas en pacientes con obesidad mórbida / Role of RS 6923761 gene variant in glucagon-like peptide 1 receptor on weight, cardiovascular risk factor and serum adipokine levels in morbid obese patients

Antecedentes: Los estudios de receptor de GLP-1 se han dirigido a la identificación de polimorfismos en el gen receptor de GLP- 1 que pueden ser un factor que contribuye en la patogénesis de la diabetes mellitus y factores de riesgo cardiovascular. Sin embargo, el papel de las variantes del receptor de GLP-1 variantes en el peso corporal, factores de riesgo cardiovasculares y adipocitoquinas sigue estando poco estudiado en pacientes con obesidad morbida. Objetivo: Nuestro objetivo fue analizar los efectos del polimorfismo del receptor de GLP-1 rs6923761 sobre el peso corporal, factores de riesgo cardiovascular y los niveles de adipocitoquinas séricas en pacientes con obesidad mórbida. Diseño: Se estudió una muestra de 175 obesos mórbidos. La glucosa en ayunas, proteína C reactiva (PCR), insulina, resistencia a la insulina ( HOMA), colesterol total, LDL- colesterol, HDL- colesterol, triglicéridos y la concentración de adipoquinas se midieron. También se determinaron el peso, índice de masa corporal, circunferencia de la cintura, masa grasa a través de bioimpedancia y la presión arterial. Resultados: Un total de 87 obesos (49,7%) tenían el genotipo GG y 88 (50,3%) de los sujetos del estudio tenían los siguientes genotipos; GA (71 obesos, el 40,6%) o AA (17 sujetos del estudio, el 9,7%) (segundo grupo) . En el grupo con genotipo GG, los niveles de glucosa (4,4 ± 2,3 mg/dl, p < 0,05), triglicéridos (6,8 ± 4,3 mg/dl , p < 0,05), insulina (4,5 ± 2,3 UI/l , p < 0,05) y HOMA (1,5 ± 0,9 unidades, p < 0,05 ) fueron mayores que en el grupo mutante. No se detectaron diferencias en el resto de parámetros analizados Conclusión: Existe una asociación entre los parámetros metabólicos y el alelo mutante (A) del polimorfismo rs6923761 del receptor de GLP- 1 en pacientes con obesidad mórbida. Los niveles de triglicéridos, insulina y resistencia a la insulina son más elevados en los sujetos portadores del alelo A (AU)

Background: Studies of the GLP-1 receptor have been directed at identifying polymorphisms in the GLP-1 receptor gene that may be a contributing factor in the pathogenesis of diabetes mellitus and cardiovascular risk factors. Nevertheless, the role of GLP-1 variants on body weight, cardiovascular risk factors and adipokines remains unclear in obese patients. Objective: Our aim was to analyze the effects of rs6923761 GLP-1 receptor polymorphism on body weight, cardiovascular risk factors and serum adipokine levels in morbid obese patients. Design: A sample of 175 morbid obese patients was enrolled in a prospective way. Basal fasting glucose, c-reactive protein (CRP), insulin, insulin resistance (HOMA), total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides concentration and adipokines were measured. Weights, body mass index, waist circumference, fat mass by bioimpedance and blood pressure measures were measured. Results: 87 patients (49,7%) had genotype GG and 88 (50,3%) had; GA (71 patients, 40,6%) or AA (17 patients, 9,7%) (second group). In the group with GG genotype, levels of glucose (4,4 ± 2,3 mg/dl, p < 0,05), tryglicerides (6,8 ± 4,3 mg/dl , p < 0,05), insulin (4,5 ± 2,3 UI/l , p < 0,05) and HOMA (1,5 ± 0,9 units, p < 0,05) were higher than mutant group. No differences were detected in other parameters. Conclusion: Data from our study revealed an association with metabolic parameters and rs6923761. Levels of triglycerides, insulin and HOMA were higher in subjects with A alelle than non A allele subjects (AU)

[Antibiotic prescribing to the paediatric population of Castilla y León in the last decade: trends, seasonal fluctuations and geographical differences]. / Prescripción de antibióticos a la población pediátrica de Castilla y León en la última década: tendencias, fluctuaciones estacionales y diferencias geográficas.

INTRODUCTION: The development of antibiotic resistance is a danger to the health of the population, especially for children,due to low antimicrobial arsenal available to them. MATERIAL AND METHODS: We performed a retrospective observational study referred to the prescriptions of systemic antibiotic in the paediatric population of Castilla y León in the years 2001 to 2010. RESULTS: The total use of antibiotics outside hospitals is around to 20.7 DID (defined daily dose per 1,000 inhabitants per day). There are two different phases: the first from 2001 to 2007 where there is an increase of consumption, with a peak of 25 DID in 2003, following a phase of decline, with a minimum of 18 DID in 2010. Broad-spectrum penicillins are the most used. We also observe changes in prescription trends. It has a clear seasonal prescription profile related to acute respiratory infections (ARI) of winter, stands in February. The use of antibiotics varies substantially between different Health Areas. CONCLUSIONS: We observed a decrease in antibiotic prescription to children in the last three years. Changes in the prescription profile for amoxicillin and at the expense of greater spectrum antibacterial antibiotics indicate a better match to therapeutic guidelines in recent years. The variability found in different Health Areas suggests the need for improvement in the rational use of antibiotic, at least to some.

Prescripción de antibióticos a la población pediátrica de Castilla y León en la última década: tendencias, fluctuaciones estacionales y diferencias geográficas / Antibiotic prescribing to the paediatric population of Castilla y León in the last decade: trends, seasonal fluctuations and geographical differences

Introducción. El desarrollo de resistencias a antibióticos es un hecho peligroso para la salud de la población, especialmente la infantil, debido al escaso arsenal antimicrobiano disponible para ellos. Material y métodos. Se realiza un estudio observacional retrospectivo referido a las dispensaciones de antibióticos de uso sistémico a la población pediátrica de la Comunidad Autónoma de Castilla y León mediante receta durante los años 2001 a 2010. Resultados. El uso total de antibióticos en el ámbito extrahospitalario está en torno a 20,7 DHD (dosis diaria definida por 1.000 habitantes y día). Se diferencian dos fases: la primera desde el 2001 hasta el 2007 donde se produce un aumento de consumo, con un pico de 25 DHD en el 2003. A continuación una fase de descenso, con un mínimo de 18 DHD en el 2010. Las penicilinas de amplio espectro son el grupo más usado. Además observamos cambios en las tendencias de prescripción. Se mantiene un claro perfil de prescripción estacional relacionado con las infecciones respiratorias agudas (IRAs) del invierno, destaca febrero. La utilización de antibióticos varía sustancialmente entre las distintas Áreas de Salud. Conclusiones. Se observa un descenso en la prescripción de antibióticos a la población infantil en los últimos tres años. Los cambios en el perfil de prescripción a favor de la amoxicilina y en detrimento de antibióticos de mayor espectro antibacteriano indican una mayor adecuación a las guías terapéuticas en los ultimos años. La variabilidad encontrada en las distintas Áreas de Salud sugiere la necesidad de mejora en el uso racional del antibiotico, al menos en alguna(AU)

Introduction. The development of antibiotic resistance is a danger to the health of the population, especially for children, due to low antimicrobial arsenal available to them. Material and methods. We performed a retrospective observational study referred to the prescriptions of systemic antibiotic in the paediatric population of Castilla y León in the years 2001 to 2010. Results. The total use of antibiotics outside hospitals is around to 20.7 DID (defined daily dose per 1,000 inhabitants per day). There are two different phases: the first from 2001 to 2007 where there is an increase of consumption, with a peak of 25 DID in 2003, following a phase of decline, with a minimum of 18 DID in 2010. Broad-spectrum penicillins are the most used. We also observe changes in prescription trends. It has a clear seasonal prescription profile related to acute respiratory infections (ARI) of winter, stands in February. The use of antibiotics varies substantially between different Health Areas. Conclusions. We observed a decrease in antibiotic prescription to children in the last three years. Changes in the prescription profile for amoxicillin and at the expense of greater spectrum antibacterial antibiotics indicate a better match to therapeutic guidelines in recent years. The variability found in different Health Areas suggests the need for improvement in the rational use of antibiotic, at least to some(AU)

Host and environmental factors influencing respiratory secretion of pro-wheezing biomarkers in preterm children.

Cytokines are actively secreted by the respiratory mucosa of preterm children and participate in the pathogenesis of wheezing. This study aimed to identify the factors that could potentially influence respiratory secretion of cytokines in these children. A nasopharyngeal aspirate (NPA) was collected from 77 preterm children 1 yr after birth. NPAs from 14 healthy, 1-yr-old term children were collected in parallel. 27 cytokines were measured in the NPAs using a multiplex assay. Multivariate stepwise regression analysis with Bonferroni correction evidenced that the variable [daycare attendance] was associated with higher levels of [monocyte chemoattractant protein-1 (MCP-1), IL-6, vascular endothelial growth factor (VEGF), IL-1ß, IL-10, tumor necrosis factor (TNF)-α]; [male sex] with higher levels of (MCP-1, VEGF, and IL-1ß); [smokers at home] was associated with higher levels of MCP-1 (p < 0.0013). In turn, [prophylaxis with palivizumab] was associated with lower levels of (IL-6, IL-7) (p < 0.0013). All these mediators participate in the pathogenesis of asthma and recurrent wheezing. Preterm children secreted higher levels of chemokines (interferon-gamma inducible protein-10, macrophage inflammatory protein-1α, Eotaxin, MCP-1), growth factors (platelet-derived growth factor-bb, VEGF, fibroblast growth factor-basic, granulocyte macrophage colony-stimulating factor), Th1 (IL12, interferon-γ), Th2 (IL-9, IL-13), Th17 (IL-6, IL-17) cytokines, and immunomodulatory mediators (IL1RA and granulocyte colony-stimulating factor) than term children. In conclusion, we have identified for the first time a group of individual and environmental factors influencing respiratory secretion of cytokines in preterm children at the long term after birth. To know these factors could help to prevent the instauration of conditions linked to the appearance of chronic respiratory diseases such as wheezing or asthma.

Influence of population structure on the consumption of systemic antibiotics.

The high level of consumption of systemic antibiotics in our country prompted a study of factors affecting the geographical variations in this consumption. Several parameters explain the uneven distribution of consumption: (a) the epidemiology of the infections, (b) population-dependent factors and (c) factors dependent on the prescribing doctor. The aim of this study was to study population-dependent parameters (type of population and age). A retrospective longitudinal study was made from antibiotic consumption data provided by International Marketing Services (IMS) between 1 January 1996 and 31 December 2000. The consumption indicator used was the number of defined daily doses per 1000 inhabitants per day (DID). Global consumption in regions under study varied by 5.7 DID: Medina del Campo (25.9 DID), Valladolid city (23.4 DID), Laguna de Duero (22.6 DID), Northern Region (22.4 DID), Southern Region (21.4 DID) and lastly Central Region (20.2 DID). The specific consumption per area showed a greater consumption of amoxicillin in the three urban areas, amoxicillin-clavulanic acid and the main macrolides in Medina del Campo, quinolones antibiotics in the Northern Region and tetracyclines and sulphonamides in Valladolid City. Significant area-dependent global consumption differences were observed with the most marked in urban areas. The differences were more marked when studying the geographical distribution of consumption of the commonly used antibiotics.