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INTRODUCTION: This study explores the under-investigated area of obesity-related discrimination and stigmatization across different countries, specifically comparing Spain (Europe) and Egypt (Middle East). METHODS: We conducted a cross-sectional observational study involving 2,090 participants from both countries. Participants completed three well-validated questionnaires to assess their attitudes towards obesity, experiences of weight-related stigma, and internalization of weight bias: Antifat Attitudes Scale (AFA), Stigmatizing Situations Inventory (SSI), and Weight Bias Internalization Scale (WBIS). Participants were categorized into four groups based on BMI and history bariatric surgery. RESULTS: Egyptian participants [BMI = 30.2±6.7 kg/m2 (range: 18.5 to 69.0 kg/m2)] showed significantly higher aversion towards obesity, as indicated by higher AFA score, compared to their Spanish counterparts [BMI = 35.4±10.1 kg/m2 (18.5 to 71,9 kg/m2)]. In contrast, Spanish participants reported higher levels of weight bias internalization with increasing BMI, while in Egypt, this association was negative. The association of bariatric surgery on stigma reduction also differed between the countries. Multivariate analysis revealed that residing in Egypt was an independent risk factor for higher scores in AFA and WBIS (Odds Ratio 8.20 [95% confidence interval: 6.78 to 9.62], p<0.001 and OR 6.28 [95% CI: 4.78 to 7.78], p<0.001; respectively). In contrast, Spaniards experienced more stigmatizing situations than Egyptians [OR -2.54 (95% CI: 6.78 to 9.62), p<0.001]. CONCLUSION: Our study underscore the complex and diverse nature of obesity-related attitudes across cultures. Understanding these cultural differences is crucial for developing effective, culturally sensitive strategies to tackle weight stigma. This research opens avenues for further studies and interventions tailored to cultural contexts.
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AIM: To evaluate the impact of aldosterone excess on renal function in individuals with primary aldosteronism and to compare its evolution after surgery or mineralocorticoid receptor antagonist (MRA) treatment. METHODS: A multicentre, retrospective cohort study of primary aldosteronism patients in follow-up in 36 Spanish tertiary hospitals, who underwent specific treatment for primary aldosteronism (MRA or adrenalectomy). RESULTS: A total of 789 patients with primary aldosteronism were included, with a median age of 57.5âyears and 41.8% being women. At primary aldosteronism diagnosis, the prevalence of chronic kidney disease (CKD) was 10.7% (nâ=â84), with 75% of cases classified as state 3a (nâ=â63). Primary aldosteronism patients with CKD had a longer duration of hypertension, a higher prevalence of type 2 diabetes, dyslipidaemia, cardiovascular events, hypokalaemia, and albuminuria. Unilateral adrenalectomy was performed in 41.8% of cases (nâ=â330), and 459 patients were treated with MRA. After a median follow-up of 30.7âmonths (range 13.3-68.4), there was a significant decline in the estimated glomerular filtration rate (eGFR) in operated patients and those receiving MRA. During follow-up, 24.4% of patients with CKD at the time of primary aldosteronism diagnosis had normalized renal function, and 39% of those with albuminuria had albuminuria remission. There were no differences in renal function or albuminuria regression between the two therapy groups. However, development of albuminuria was less common in operated than in medically treated patients (0 vs. 6.0%, Pâ=â0.009). CONCLUSION: CKD affects around 10% of the patients with primary aldosteronism, with a higher risk in individuals with long-term hypertension, type 2 diabetes, dyslipidaemia, cardiovascular events, hypokalaemia, and albuminuria. At short-term, both MRA and surgical treatment lead to a reduction of renal function, but adrenalectomy led to higher renal protection.
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El aumento en la prevalencia de diabetes tipo 2 y la expansión a nivel mundial de los estados de sobrepeso y obesidad están intrínsecamente vinculados, de forma que el porcentaje de diabetes atribuible al aumento de peso llega a ser superior al 80% en muchos países. En 2015 se publica un Documento de Consenso español de SEMI, SED, redGDPS, SEC, SEEDO, SEEN, SEMERGEN y SEMFYC que aborda esta doble condición de acuerdo con las mejores evidencias. Desde las afirmaciones de dicho consenso proponemos cinco recomendaciones para la práctica clínica consensuadas por los Grupos de trabajo de SENDIMAD, SOMAMFYC, SEMG Madrid y RedGDPS, con el fi n de establecer un diagnóstico de precisión y el tratamiento más adecuado: 1. En todo paciente con diabetes y obesidad debe abordarse, tanto al inicio como en el seguimiento, además del cálculo del índice de masa corporal (IMC), el porcentaje de grasa corporal y la valoración de la composición corporal. 2. La aproximación al grado y distribución de la grasa corporal requiere incluir la medición y registro del perímetro de cintura de estos pacientes. 3. La valoración integral del paciente con diabetes tipo 2-obesidad exige la evaluación del grado de actividad física y/o caracterizar la condición de sedentarismo. 4. La prescripción de cambios del estilo de vida debe ser incorporada a la educación terapéutica (plan dietético y de actividad física individualizado, flexible, autónomo y sostenible). 5. El abordaje farmacológico en el tratamiento de la diabetes-obesidad implica la elección de fármacos antidiabéticos que faciliten la pérdida de grasa
The increase in the prevalence of type 2 diabetes and the worldwide expansion of overweight and obesity are intrinsically linked. The percentage of diabetes attributable to weight gain amounts to more than 80% in many countries. This relationship is addressed in a Spanish Consensus Document from SEMI, SED, redGDPS, SEC, SEEDO, SEEN, SEMERGEN and SEMFYC published in 2015 and which gathers best available evidences. Based on the statements of this consensus document, we propose five recommendations for clinical practice to establish a diagnosis of precision and the most appropriate treatment for joint diabetes and obesity. These recommendations have been agreed by the SENDIMAD, SOMAMFYC, SEMG Madrid and RedGDPS Working Groups: 1. For every patient with diabetes and obesity, in addition to the calculation of the body mass index, the percentage of body fat and the approximation to the assessment of body composition should be evaluated throughout the whole process (both at the beginning and follow up). 2. The approximation to the degree and distribution of body fat requires the measurement and recording of the waist circumference of these patients. 3. The integrated assessment of the patient with type 2 diabetes-obesity requires the evaluation of the degree of physical activity and/or characterization of the sedentary condition. 4. The prescription of lifestyle changes should be incorporated into therapeutic education (individualized, fl exible, autonomous and sustainable diet and physical activity plan. 5. The pharmacological approach in the treatment of type 2 diabetes-obesity implies the choice of anti-diabetic drugs that facilitate the loss of fat
Subject(s)
Humans , Diabetes Complications/therapy , Diabetes Mellitus/therapy , Obesity/therapy , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/therapy , Evidence-Based Medicine , Health Education , Obesity/complications , SpainABSTRACT
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Subject(s)
Humans , Female , Middle Aged , Pseudohypoparathyroidism/diagnosis , Pseudohypoparathyroidism/etiology , Delayed Diagnosis/adverse effects , Diagnosis, DifferentialABSTRACT
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Subject(s)
Carotenoids , Bariatric Surgery/adverse effects , Dietary Supplements/adverse effects , Postoperative Complications , Vitamin A/adverse effectsABSTRACT
No disponible