Socioeconomic Inequalities in Metabolic Syndrome by Age and Gender in a Spanish Working Population.

Lower socio-economic status (SES) is significantly associated with metabolic syndrome (MS) prevalence, possibly affecting women more than men, although evidence in Spain is still limited. The present cross-sectional study analyzed the association between MS and SES by age and gender among 42,146 working adults living in the Balearic Islands (Spain). Prevalence was higher in men (9.4% by ATP-III; 12.3% by IDF) than women (3.8% by ATP-III; 5.7% by IDF) and in the lower social class (7.9% by ATP-III; 10.7% by IDF) than the higher (4.1% by ATP-III; 5.9% by IDF). The SES gradient in MS prevalence was larger in women (PR 95% CI: 3.38, 2.50-4.58 by ATP-III; 3.06, 2.43-3.86 by IDF) than in men (1.23, 1.06-1.41 by ATP-III; 1.15, 1.03-1.30 by IDF) and was already evident from early adulthood, reaching the highest ratio at the late stages of middle adulthood (4.34, 1.11-16.98). Among men, it was significant during the late stages of early adulthood only (1.80, 1.19-2.73). Lower SES influenced MS prevalence in both genders, however, women seemed more affected than men. From a public health perspective, SES could be strongly associated with the burden of MS; in an effort to reduce its prevalence, public health policies should focus on gender differences in socio-economic inequality and consider women with low socio-economic resources as a priority.

A comparison between multiple regression models and CUN-BAE equation to predict body fat in adults.

BACKGROUND: Because the accurate measure of body fat (BF) is difficult, several prediction equations have been proposed. The aim of this study was to compare different multiple regression models to predict BF, including the recently reported CUN-BAE equation. METHODS: Multi regression models using body mass index (BMI) and body adiposity index (BAI) as predictors of BF will be compared. These models will be also compared with the CUN-BAE equation. For all the analysis a sample including all the participants and another one including only the overweight and obese subjects will be considered. The BF reference measure was made using Bioelectrical Impedance Analysis. RESULTS: The simplest models including only BMI or BAI as independent variables showed that BAI is a better predictor of BF. However, adding the variable sex to both models made BMI a better predictor than the BAI. For both the whole group of participants and the group of overweight and obese participants, using simple models (BMI, age and sex as variables) allowed obtaining similar correlations with BF as when the more complex CUN-BAE was used (ρ = 0:87 vs. ρ = 0:86 for the whole sample and ρ = 0:88 vs. ρ = 0:89 for overweight and obese subjects, being the second value the one for CUN-BAE). CONCLUSIONS: There are simpler models than CUN-BAE equation that fits BF as well as CUN-BAE does. Therefore, it could be considered that CUN-BAE overfits. Using a simple linear regression model, the BAI, as the only variable, predicts BF better than BMI. However, when the sex variable is introduced, BMI becomes the indicator of choice to predict BF.

Desigualdades socioeconómicas y diferencias según sexo y edad en los factores de riesgo cardiovascular / Socioeconomic inequalities and age and gender differences in cardiovascular risk factors

Objetivo: Describir los factores de riesgo cardiovascular en población trabajadora de las Islas Baleares y analizar si las diferencias por clase social varían en función de la edad y el sexo. Métodos: Estudio transversal con una muestra de trabajadores/as activos/as de 20-65 años de edad de las Islas Baleares, incluidos en el estudio durante su revisión laboral periódica del año 2011. Se recogieron las siguientes variables: ocupación, clase social, edad, sexo, talla, peso, tabaquismo, presión arterial, perfil lipídico y glucosa. Se calculó el riesgo cardiovascular según dos ecuaciones (Framingham y REGICOR). Resultados: Se observaron diferencias por clase social en la mayoría de los factores de riesgo cardiovascular. Estas diferencias presentaron un patrón diferencial por grupo de edad y sexo. Las diferencias por clase social para la obesidad en las mujeres aumentaron con la edad, mientras que en los hombres disminuyeron. La hipertensión arterial presentó más diferencias por clase social entre las mujeres que entre los hombres, y en ambos sexos estas diferencias aumentaron con la edad. El perfil lipídico en las mujeres mostró diferencias importantes por clase social, que se acentuaron con la edad, en especial en el caso de bajos valores de colesterol HDL. Conclusiones: Las desigualdades por clase social en los factores riesgo cardiovascular fueron mayores entre las mujeres que entre los hombres. Algunos factores de riesgo cardiovascular, como el tabaquismo y la obesidad, presentan desigualdades importantes en etapas muy tempranas de la vida (AU)

Objective: To describe the cardiovascular risk factors in a working population in the Balearic Islands and to examine whether differences by social class vary according to age and gender. Methods: A cross-sectional study was carried out in a sample of active workers aged 20-65 years in the Balearic Islands. The participants were included in the study during their annual work health assessment in 2011. The following variables were collected: occupation, social class, age, gender, height, weight, smoking, blood pressure, lipid profile, and glucose levels. Cardiovascular risk was calculated using two different equations (Framingham and REGICOR). Results: Differences by social class were observed for most cardiovascular risk factors. The pattern of these differences differed depending on age group and gender. Differences in obesity by social class increased with age in women but decreased in men. More differences in hypertension by social class were found among women than among men, with differences increasing with age in both genders. Significant differences by social class were found among women in lipid profile, and these differences increased with age, mainly for low levels of high-density lipoprotein-cholesterol. Conclusions: Inequalities in cardiovascular risk factors by social class were higher among women than among men. Some cardiovascular risk factors such as smoking and obesity showed significant inequalities from a very early age (AU)

[Socioeconomic inequalities and age and gender differences in cardiovascular risk factors]. / Desigualdades socioeconómicas y diferencias según sexo y edad en los factores de riesgo cardiovascular.

OBJECTIVE: To describe the cardiovascular risk factors in a working population in the Balearic Islands and to examine whether differences by social class vary according to age and gender. METHODS: A cross-sectional study was carried out in a sample of active workers aged 20-65 years in the Balearic Islands. The participants were included in the study during their annual work health assessment in 2011. The following variables were collected: occupation, social class, age, gender, height, weight, smoking, blood pressure, lipid profile, and glucose levels. Cardiovascular risk was calculated using two different equations (Framingham and REGICOR). RESULTS: Differences by social class were observed for most cardiovascular risk factors. The pattern of these differences differed depending on age group and gender. Differences in obesity by social class increased with age in women but decreased in men. More differences in hypertension by social class were found among women than among men, with differences increasing with age in both genders. Significant differences by social class were found among women in lipid profile, and these differences increased with age, mainly for low levels of high-density lipoprotein-cholesterol. CONCLUSIONS: Inequalities in cardiovascular risk factors by social class were higher among women than among men. Some cardiovascular risk factors such as smoking and obesity showed significant inequalities from a very early age.

Effectiveness of the Heart Age tool for improving modifiable cardiovascular risk factors in a Southern European population: a randomized trial.

AIMS: To test whether communicating cardiovascular diseases (CVD) risk using a novel risk assessment tool (Heart Age) will be able to motivate a population to adopt healthier lifestyles and improve CVD risk profile over the use of a traditional percentage-based tool. METHODS: A single-blind randomized intervention study was carried out in a Caucasian population. A total of 3153 subjects were randomly allocated to one of three study groups: control (conventional medical advice was given to the subjects), Framingham REGICOR (10-year percentage risk score, calibrated to Spanish population was given to the subjects), or Heart Age group (Heart Age tool was administered to the subjects). Anthropometrical and metabolic parameters were measured and lifestyle habits were recorded at recruitment and 12-months post intervention. RESULTS: Both the Framingham REGICOR and the Heart Age intervention groups demonstrated significant decreases in their risk scores at post intervention compared to the control group, with the improvement being of a greater magnitude in the Heart Age group. No differences per gender were observed in the Heart Age group. CONCLUSIONS: Informing patients about their CVD risk expressed as the new Heart Age tool results in a reduction in their CVD risk higher than the one observed when the Framingham REGICOR risk score was used.

Prevalence of premorbid metabolic syndrome in Spanish adult workers using IDF and ATPIII diagnostic criteria: relationship with cardiovascular risk factors.

BACKGROUND: Metabolic Syndrome (MetS) is a complex disorder defined as a cluster of interconnected risk factors such as hypertension, dyslipidemia, obesity and high blood glucose levels. Premorbid metabolic syndrome (PMetS) is defined by excluding patients with previously diagnosed cardiovascular disease or diabetes mellitus from those suffering MetS. We aimed to determine the prevalence of PMetS in a working population, and to analyse the relationship between the diagnostic criteria of the International Diabetes Federation (IDF) and of the National Cholesterol Education Program Adult Treatment Panel III (ATPIII). The relationship between the presence of PMetS and cardiovascular risk factors was also analysed. RESEARCH METHODOLOGY/FINDINGS: A cross-sectional study was conducted in 24,529 male and 18,736 female Spanish (white western European) adult workers (20-65 years) randomly selected during their work health periodic examinations. Anthropometrics, blood pressure and serum parameters were measured. The presence of MetS and PMetS was ascertained using ATPIII and IDF criteria. Cardiovascular risk was determined using the Framingham-REGICOR equation. The results showed MetS had an adjusted global prevalence of 12.39% using ATPIII criteria and 16.46% using IDF criteria. The prevalence of PMetS was slightly lower (11.21% using ATPIII criteria and 14.72% using IDF criteria). Prevalence in males was always higher than in females. Participants with PMetS displayed higher values of BMI, waist circumference, blood pressure, glucose and triglycerides, and lower HDL-cholesterol levels. Logistic regression models reported lower PMetS risk for females, non-obese subjects, non-smokers and younger participants. Cardiovascular risk determined with Framingham-REGICOR was higher in participants with PMetS. CONCLUSIONS: PMetS could be a reliable tool for the early identification of apparently healthy individuals who have a significant risk for developing cardiovascular events and type 2 diabetes.

Neurotoxicidad y Trabajo. Revisión Bibliográfica y bibliométrica / Neurotoxicology and Occupation. Bibliographic and bibliometric review

Se consideran neurotóxicas las sustancias que inhiben o alteran gravemente las funciones del sistema nervioso. Se entiende por neurotoxicidad la capacidad de estas sustancias para inducir efectos adversos en el sistema nervioso central, los nervios periféricos y órganos de los sentidos. La preocupación por los efectos neurotoxicológicos asociados a exposición a sustancias en el ámbito laboral no es reciente y ha dado lugar a investigaciones en diferentes líneas de trabajo. Resulta clave la investigación sobre las sustancias neurotóxicas y su relación con el ámbito laboral, que permita alcanzar un mejor conocimiento de los factores de riesgo implicados, efectos producidos, dosis/respuesta requerida y actitudes preventivas, todo ello desarrollado desde el mundo de la empresa y por especialistas en Medicina del Trabajo, con la colaboración de otras especialidades técnicas o médicas implicadas. Interesa por ello conocer en qué punto está la investigación en esta materia y qué lugar ocupa nuestra especialidad en ella

Neurotoxic substances are considered those that inhibit or severely alter the functions of the nervous system and neurotoxicity means the ability to induce adverse effects on the central nervous system, peripheral nerves and organs. Concern about the effects associated neurotoxicological exposure to substances in the workplace is not new and has led to investigations in different lines of work. But surely plays a key place the research of neurotoxic substances and their relation to the workplace to enable a better understanding of the risk factors involved, effects, dose / response and preventive attitudes, all of it develop from the world of labour work and specialists in Occupational Medicine, in collaboration with other specialties involved required. Therefore it is interesting to know to what extent the research is in this area and which place has our speciality in it

Body adiposity index and cardiovascular health risk factors in Caucasians: a comparison with the body mass index and others.

BACKGROUND: Several studies have shown a relation between the adipose tissue accumulation and a higher risk for developing metabolic and cardiovascular diseases. Thus, body fat content and, mainly, the fat distribution or adiposity could be considered as important indicators of health risk. In spite of presenting several limitations, BMI is the most widely used and accepted index for classifying overweight and obesity. The aim of the study was to evaluate the correlations between Body Adiposity Index (BAI), BMI and other adiposity indexes such as WC, WHR and WHtR with cardiovascular and metabolic risk factors. Furthermore, the behavior of BAI and BMI regarding the ability to discriminate overweight or obese individuals was also analyzed. RESEARCH METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study was conducted in Spanish Caucasian adult workers. Participants in the study (29.214 men and 21.040 women, aged 20-68 years) were systematically selected during their work health periodic examinations. BAI, BMI, WHR, WHtR, body weight, hip and waist circumference (WC) as well as systolic and diastolic blood pressure were measured. Serum levels of high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG) and glucose were also determined. Results of the study indicated that BAI was less correlated with cardiovascular risk factors and metabolic risk factors than other adiposity indexes (BMI, WC and WHtR). The best correlations were found for WHtR. In addition, the BAI presented lower discriminatory capacity than BMI for diagnosing metabolic syndrome (MS) using both IDF and ATP III criteria. A different behavior of the BAI in men and women when considering the ability to discriminate overweight or obese individuals was also observed. CONCLUSIONS: The adiposity indexes that include the waist circumference (WHtR and WC) may be better candidates than BAI and BMI to evaluate metabolic and cardiovascular risk in both clinical practice and research.

Protective effect of myo-inositol hexaphosphate (phytate) on bone mass loss in postmenopausal women.

INTRODUCTION: The objective of this paper was to evaluate the relationship between urinary concentrations of InsP6, bone mass loss and risk fracture in postmenopausal women. MATERIALS AND METHODS: A total of 157 postmenopausal women were included in the study: 70 had low (≤0.76 µM), 42 intermediate (0.76-1.42 µM) and 45 high (≥1.42 µM) urinary phytate concentrations. Densitometry values for neck were measured at enrollment and after 12 months (lumbar spine and femoral neck), and 10-year risk fracture was calculated using the tool FRAX(®). RESULTS: Individuals with low InsP6 levels had significantly greater bone mass loss in the lumbar spine (3.08 ± 0.65 % vs. 0.43 ± 0.55 %) than did those with high phytate levels. Moreover, a significantly greater percentage of women with low than with high InsP6 levels showed more than 2 % of bone mass loss in the lumbar spine (55.6 vs. 20.7 %). The 10-year fracture probability was also significantly higher in the low-phytate group compared to the high-phytate group, both in hip (0.37 ± 0.06 % vs 0.18 ± 0.04 %) and major osteoporotic fracture (2.45 ± 0.24 % vs 1.83 ± 0.11 %). DISCUSSION: It can be concluded that high urinary phytate concentrations are correlated with reduced bone mass loss in lumbar spine over 12 months and with reduced 10-year probability of hip and major osteoporotic fracture, indicating that increased phytate consumption can prevent development of osteoporosis.

Influencia del consumo de fitato sobre la masa ósea en mujeres posmenopáusicas de Mallorca / The influence of consumption of phytate on the bone mass in posmenopausal women of Mallorca

Fundamento. La osteoporosis supone un gran problema de salud para la población, especialmente para el colectivo de mujeres posmenopáusicas, siendo por ello importante que se establezcan políticas preventivas que hagan disminuir su prevalencia. El objetivo de este estudio es valorar la influencia que tiene el consumo de fitato en los niveles de densidad mineral ósea. Población y método. Se calcula la masa ósea en mujeres posmenopáusicas empleando DEXA de calcáneo (C), columna lumbar (CL) y cuello de fémur (CF) y se relacionan estos valores con el consumo de fitato determinado mediante encuesta alimentaria. Resultados. En las tres localizaciones se observan mayores valores de T-score en las mujeres que consumen fitato en cantidades adecuadas frente a las que no lo consumen (C: 0,1 frente a −0,5; CL: −1,2 y −2,5, y CF: −0,2 y −1,2). También aumenta el T-score a medida que lo hace la cantidad de fitato consumida, hasta un máximo de 2 veces a la semana (C: −0,7 en no consumidores, −0,2 en consumidores de fitato de una vez por semana y 0,2 en los que consumen 2 veces por semana; CL −2,8, −1,7 y −1,1, respectivamente, y finalmente CF: −1,3, −0,6 y −0,1, respectivamente). Conclusiones. Los resultados obtenidos parecen indicar que el consumo regular de fitato puede tener un papel importante en la prevención del déficit de masa ósea en mujeres posmenopáusicas (AU)

Basis. Osteoporosis is a serious health problem in the population, mainly for postmenopausal women. Therefore, it is important to develop programs to decrease prevalence. The main objective of this study is to determine the influence of phytate consumption on bone mineral density. Patients and method. The bone mineral density was evaluated in postmenopausal women by means of dual X-ray double energy absorptiometry for calcaneous (C), lumbar spine (LS) and femoral neck (FN). The results obtained were related to the consumption of phytate by means of a dietary questionnaire. Results. In the three different areas (C, LS, FN) we observed significantly higher values of T-score in women that consumed adequate amounts of phytate as opposed to those that did not, (C 0.1 vs. −0.5, LS −1.2 and −2.5 and FN −0.2 and −1.2). There is also an increase in the T-score as more phytate is consumed, up to a maximum of two times a week (C −0.7 in non consumers, −0.2 in those that consume phytate once a week and 0.2 in those that consume phytate twice a week; LS −2.8, −1.7 and 1.1 and finally, CF −1.3, −0.6 and −0.1). Conclusion. The results obtained seem to indicate that the adequate consumption of phytate may play an important role in the prevention of bone mineral density loss in postmenopausal women (AU)

[The influence of consumption of phytate on the bone mass in posmenopausal women of Mallorca]. / Influencia del consumo de fitato sobre la masa ósea en mujeres posmenopáusicas de Mallorca.

BASIS: Osteoporosis is a serious health problem in the population, mainly for postmenopausal women. Therefore, it is important to develop programs to decrease prevalence. The main objective of this study is to determine the influence of phytate consumption on bone mineral density. PATIENTS AND METHOD: The bone mineral density was evaluated in postmenopausal women by means of dual X-ray double energy absorptiometry for calcaneous (C), lumbar spine (LS) and femoral neck (FN). The results obtained were related to the consumption of phytate by means of a dietary questionnaire. RESULTS: In the three different areas (C, LS, FN) we observed significantly higher values of T-score in women that consumed adequate amounts of phytate as opposed to those that did not, (C 0.1 vs. -0.5, LS -1.2 and -2.5 and FN -0.2 and -1.2). There is also an increase in the T-score as more phytate is consumed, up to a maximum of two times a week (C -0.7 in non consumers, -0.2 in those that consume phytate once a week and 0.2 in those that consume phytate twice a week; LS -2.8, -1.7 and 1.1 and finally, CF -1.3, -0.6 and -0.1). CONCLUSION: The results obtained seem to indicate that the adequate consumption of phytate may play an important role in the prevention of bone mineral density loss in postmenopausal women.

Effect of tetracalcium dimagnesium phytate on bone characteristics in ovariectomized rats.

The aim was to evaluate the influence of dietary Ca-Mg-phytate consumption on the bone characteristics of ovariectomized rats, an animal model for postmenopausal osteoporosis. Twenty ovariectomized female Wistar rats were randomly assigned to two groups fed, respectively, with a non-phytate diet (AIN-76A) or the same diet enriched with 1% phytate (as the calcium magnesium salt, phytin). After 12 weeks of feeding the rats were sacrificed, and both femoral bones and L4 vertebra were removed from each rat. Bone mass, length, width, volume, and mineral density were measured, and the phosphorus, calcium, magnesium, and zinc contents of bones were determined. Deoxypyridinoline (a bone resorption marker) was measured in urine, and osteocalcin (a bone formation marker) was measured in serum. The calcium and phosphorus contents and bone mineral density were significantly higher in both femoral bones and L4 vertebra for phytate-treated rats in comparison to rats in the non-phytate group. Deoxypyridinoline was significantly increased in rats in the non-phytate treatment group. Ca-Mg-phytate consumption reduces bone mineral density loss due to estrogen deficiency. Thus, phytate exhibits effects similar to those of bisphosphonates on bone resorption and may be of use in the primary prevention of osteoporosis if larger studies in humans confirm these findings.

Phytate levels and bone parameters: a retrospective pilot clinical trial.

This study evaluated the relationship between phytate urinary levels and bone characteristics in a large population of postmenopausal women. The study population consisted of 180 postmenopausal women who participated in a descriptive cross-sectional study. A urine sample was collected from each subject to determine phytate levels and the volunteers were divided into two groups according to phytate urinary concentration (i.e., low and high levels). Bone mineral density was determined in the lumbar spine and femoral neck of groups with low and high phytate urinary levels. Urinary levels of phytate were linked to dietary phytate consumption. Hence, bone mineral density values were significantly higher in the lumbar spines and femoral necks of women who consumed high levels of phytate than in women with low urinary phytate concentrations. Higher urinary levels of phytate correlated with higher bone mineral density in the lumbar spine and femoral necks of postmenopausal women. This finding demonstrates the potential use of phytate in the treatment of bone related diseases, as it uses a mechanism of action similar to some bisphosphonates.