Síntomas depresivos en una muestra de mujeres con hipotiroidismo subclínico y su relación con los cloratos del agua del grifo / Depressive symptoms in a sample of women with subclinical hypothyroidism and their relationship to chlorates in tap water

Introducción: en el hipotiroidismo subclínico pueden aparecer síntomas depresivos y su presencia suele facilitar la instauración de un tratamiento de reemplazo; sin embargo, estudios recientes no han encontrado una asociación entre ambos. Por otra parte, la función tiroidea puede verse afectada por disruptores endocrinos y, algunos de ellos, como los cloratos, pueden encontrarse en el agua que bebemos. Objetivos: conocer si el tipo de consumo de agua puede influir en la aparición de síntomas depresivos en pacientes con hipotiroidismo subclínico. Métodos: participaron 96 mujeres con hipotiroidismo subclínico, sin tratamiento tiroideo, de un área de salud de España. Estudiamos, entre otras variables, la presencia de síntomas depresivos, el tipo de consumo de agua (grifo/embotellada o manantial) y el nivel de cloratos en el agua del grifo. Resultados: el 41,7 % (40) de las mujeres presentaban síntomas depresivos y estos se relacionaban con el consumo de agua del grifo (p = 0,001), resultando este un predictor confiable (OR: 27,79; p = 0,007). El nivel de cloratos en el agua del grifo era de 250 µg/L, valor situado en el límite máximo permitido por la ley. Conclusiones: en mujeres con hipotiroidismo subclínico, la exposición crónica a cloratos en el agua, en niveles autorizados por la ley, podría favorecer la inhibición del transporte de yodo y la aparición de síntomas depresivos. Sería interesante comprobar esta hipótesis, así como su posible efecto sobre otros perfiles poblacionales.(AU)

Introduction: depressive symptoms may develop in subclinical hypothyroidism and their presence usually facilitates recognition and the establishment of replacement treatment; however, recent studies have found no association between the two. Besides, thyroid function can be affected by endocrine disruptors and some of them, such as chlorates, can be found in the water we drink. Objectives: to know if the type of water consumed may influence the development of depressive symptoms in patients with subclinical hypothyroidism. Methods: 96 women with subclinical hypothyroidism, without thyroid treatment, were enrolled. We studied, among other variables, the presence of depressive symptoms, type of water consumption (tap, bottled or spring) and the level of chlorates in the tap water. Results: 41.7 % (40) of women presented depressive symptoms and these were related to the consumption of tap water (p = 0.001), resulting in a reliable predictor (OR, 27.79; p = 0.007). Chlorate level in the tap water was 250 μg/L, a value within the maximum limit allowed by law. Conclusions: chronic exposure to chlorates in water, in women with subclinical hypo-thyroidism, at levels authorized by law, could favor the inhibition of iodine transport and the appearance of depressive symptoms. It would be interesting to test this hypothesis as well as its possible effect on other population profiles.(AU)

[Depressive symptoms in a sample of women with subclinical hypothyroidism and their relationship to chlorates in tap water]. / Síntomas depresivos en una muestra de mujeres con hipotiroidismo subclínico y su relación con los cloratos del agua del grifo.

Introduction: Introduction: depressive symptoms may develop in subclinical hypothyroidism and their presence usually facilitates recognition and the establishment of replacement treatment; however, recent studies have found no association between the two. Besides, thyroid function can be affected by endocrine disruptors and some of them, such as chlorates, can be found in the water we drink. Objectives: to know if the type of water consumed may influence the development of depressive symptoms in patients with subclinical hypothyroidism. Methods: 96 women with subclinical hypothyroidism, without thyroid treatment, were enrolled. We studied, among other variables, the presence of depressive symptoms, type of water consumption (tap, bottled or spring) and the level of chlorates in the tap water. Results: 41.7 % (40) of women presented depressive symptoms and these were related to the consumption of tap water (p = 0.001), resulting in a reliable predictor (OR, 27.79; p = 0.007). Chlorate level in the tap water was 250 µg/L, a value within the maximum limit allowed by law. Conclusions: chronic exposure to chlorates in water, in women with subclinical hypothyroidism, at levels authorized by law, could favor the inhibition of iodine transport and the appearance of depressive symptoms. It would be interesting to test this hypothesis as well as its possible effect on other population profiles.

Introducción: Introducción: en el hipotiroidismo subclínico pueden aparecer síntomas depresivos y su presencia suele facilitar la instauración de un tratamiento de reemplazo; sin embargo, estudios recientes no han encontrado una asociación entre ambos. Por otra parte, la función tiroidea puede verse afectada por disruptores endocrinos y, algunos de ellos, como los cloratos, pueden encontrarse en el agua que bebemos. Objetivos: conocer si el tipo de consumo de agua puede influir en la aparición de síntomas depresivos en pacientes con hipotiroidismo subclínico. Métodos: participaron 96 mujeres con hipotiroidismo subclínico, sin tratamiento tiroideo, de un área de salud de España. Estudiamos, entre otras variables, la presencia de síntomas depresivos, el tipo de consumo de agua (grifo/embotellada o manantial) y el nivel de cloratos en el agua del grifo. Resultados: el 41,7 % (40) de las mujeres presentaban síntomas depresivos y estos se relacionaban con el consumo de agua del grifo (p = 0,001), resultando este un predictor confiable (OR: 27,79; p = 0,007). El nivel de cloratos en el agua del grifo era de 250 µg/L, valor situado en el límite máximo permitido por la ley. Conclusiones: en mujeres con hipotiroidismo subclínico, la exposición crónica a cloratos en el agua, en niveles autorizados por la ley, podría favorecer la inhibición del transporte de yodo y la aparición de síntomas depresivos. Sería interesante comprobar esta hipótesis, así como su posible efecto sobre otros perfiles poblacionales.

Neonatal outcomes after water birth: A retrospective cohort study.

OBJECTIVE: To compare neonatal outcomes between water births, births with immersion only during labour, and births in which immersion was never used. METHODS: A retrospective cohort study was performed including mother-baby dyads attended between 2009 and 2019 at the Hospital do Salnés regional hospital (Pontevedra, Spain). These women were categorised into 3 groups: water birth; immersion only during dilation; and women who never used immersion. Several sociodemographic-obstetric variables were studied and the main outcome was the admission of the neonate to the intensive care unit (NICU). Permission was obtained from the responsible provincial ethics committee. Descriptive statistics were used and between-group comparisons were performed using variance for continuous variables and chi-square for categorical variables. Multivariate analysis was performed with backward stepwise logistic regression and incidence risk ratios with 95%CI were calculated for each independent variable. Data were analysed using IBM SPSS® statistical software. RESULTS: A total of 1191 cases were included. 404 births without immersions; 397 immersions only during the first stage of labor; and 390 waterbirths were included. No differences were found in the need to transfer new-borns to a NICU (p = .735). In the waterbirth cohort, neonatal resuscitation (p < .001, OR: 0,1), as well as respiratory distress (p = .005, OR: 0,2) or neonatal problems during admission (p < .001, OR: 0,2), were lower. In the immersion only during labor cohort, less neonatal resuscitation (p = .003; OR: 0,4) and respiratory distress (p = .019; OR: 0,4) were found. The probability of not breastfeeding upon discharge was higher for the land birth cohort (p < .001, OR: 0,4). CONCLUSIONS: The results of this study indicated that water birth did not influence the need for NICU admission, but was associated with fewer adverse neonatal outcomes, such as resuscitation, respiratory distress, or problems during admission.

Efectos de la ingesta de lácteos enriquecidos de forma natural con selenio y omega-3 en una muestra de mujeres posmenopáusicas con síndrome metabólico: un ensayo clínico aleatorizado, triple ciego y controlado con placebo / Effects of the intake of dairy products naturally enriched with selenium and omega-3 polyunsaturated fatty acids in a sample of postmenopausal women with metabolic syndrome: a randomized, triple-blind, placebo-controlled clinical trial

Introducción: el síndrome metabólico de las mujeres posmenopáusicas puede mejorar con una alimentación saludable. Objetivos: evaluar si una intervención alimentaria con productos lácteos enriquecidos en selenio y ácidos grasos poliinsaturados omega-3 aumenta los niveles de selenio y mejora los factores de riesgo cardiovascular en las mujeres posmenopáusicas con síndrome metabólico. Material y métodos: ensayo clínico aleatorizado, triple ciego y controlado, realizado en atención primaria. Captación: abril 2018, 46 mujeres posmenopáusicas con síndrome metabólico consumidoras habituales de lácteos. Aleatorización: 23 en el grupo de control y 23 en el grupo experimental. Intervención: consumo durante 3 meses de lácteos enriquecidos naturalmente con selenio y ácidos grasos poliinsaturados omega-3 (leche, yogur y queso fresco). Controles: consumo de lácteos convencionales. Variable principal: selenio en plasma; secundarias: criterios del síndrome metabólico. Número de registro 2018/256, Comité de Ética Galicia. Resultados: finalizaron 23 mujeres en el grupo de control y 21 en el grupo de intervención. Aumentó el selenio en el grupo de intervención (7,2 µg/L, IC del 95 %: 3,7/10,8) frente al grupo de control (-4,5 µg/L, IC del 95 %: -8/-1) (p < 0,001) y disminuyó el colesterol unido a lipoproteínas de muy baja densidad (-2,3 mg/dl, IC del 95 %: -5,6/1) respecto al grupo de control (1,9 mg/dl, IC del 95 %: -0,7/4,5) (p = 0,043). Las mujeres del grupo experimental mejoraron respecto a su medición basal en perímetro de cintura (p = 0,010), índice de masa corporal (p = 0,047) y colesterol unido a lipoproteínas de alta densidad (p < 0,001). Conclusiones: una intervención con lácteos enriquecidos naturalmente con selenio y omega-3 en mujeres posmenopáusicas con síndrome metabólico puede mejorar los niveles de selenio en plasma y de colesterol unido a lipoproteínas de muy baja densidad. (AU)

Introduction: metabolic syndrome in postmenopausal women can improve with a healthy diet. Objectives: to evaluate whether a dietary intervention with dairy products naturally enriched with selenium and omega-3 polyunsaturated fatty acids increases selenium plasma levels and improves cardiovascular risk factors in postmenopausal women with metabolic syndrome. Material and methods: a randomized, triple-blind, controlled clinical trial carried out in GP surgeries. Recruitment: April 2018, 46 postmenopausal women with metabolic syndrome who were frequent dairy consumers. Randomization: 23 in control group and 23 in experimental group. Intervention: consumption of dairy products naturally enriched with selenium and omega-3 polyunsaturated fatty acids (milk, yogurt, fresh cheese) for three months. Controls took conventional dairy. Primary endpoint: plasma selenium levels; secondary endpoints: metabolic syndrome criteria. Registration number 2018/256, Galicia Ethics Committee. Results: in all, 23 women in the control group and 21 in the intervention group completed the trial. Selenium increased in the intervention group (7.2 µg/L, 95 % CI, 3.7/10.8) compared to the control group (-4.5 µg/L, 95 % CI, -8/-1) (p < 0.001) and very low-density lipoprotein cholesterol decreased (-2.3 mg/dL, 95 % CI, -5.6/1) compared to the control group (1.9 mg/dL, 95 % CI, -0.7/4.5) (p = 0.043). Waist circumference (p = 0.010), body mass index (p = 0.047) and high-density lipoprotein cholesterol (p < 0.001) in the experimental group improved in comparison to baseline measurements. Conclusions: an intervention with dairy products naturally enriched with selenium and omega-3 in a sample of postmenopausal women with metabolic syndrome can improve plasma selenium levels and very low-density lipoprotein cholesterol. (AU)

[Effects of the intake of dairy products naturally enriched with selenium and omega-3 polyunsaturated fatty acids in a sample of postmenopausal women with metabolic syndrome: a randomized, triple-blind, placebo-controlled clinical trial]. / Efectos de la ingesta de lácteos enriquecidos de forma natural con selenio y omega-3 en una muestra de mujeres posmenopáusicas con síndrome metabólico: un ensayo clínico aleatorizado, triple ciego y controlado con placebo.

INTRODUCTION: Introduction: metabolic syndrome in postmenopausal women can improve with a healthy diet. Objectives: to evaluate whether a dietary intervention with dairy products naturally enriched with selenium and omega-3 polyunsaturated fatty acids increases selenium plasma levels and improves cardiovascular risk factors in postmenopausal women with metabolic syndrome. Material and methods: a randomized, triple-blind, controlled clinical trial carried out in GP surgeries. Recruitment: April 2018, 46 postmenopausal women with metabolic syndrome who were frequent dairy consumers. Randomization: 23 in control group and 23 in experimental group. Intervention: consumption of dairy products naturally enriched with selenium and omega-3 polyunsaturated fatty acids (milk, yogurt, fresh cheese) for three months. Controls took conventional dairy. Primary endpoint: plasma selenium levels; secondary endpoints: metabolic syndrome criteria. Registration number 2018/256, Galicia Ethics Committee. Results: in all, 23 women in the control group and 21 in the intervention group completed the trial. Selenium increased in the intervention group (7.2 µg/L, 95 % CI, 3.7/10.8) compared to the control group (-4.5 µg/L, 95 % CI, -8/-1) (p < 0.001) and very low-density lipoprotein cholesterol decreased (-2.3 mg/dL, 95 % CI, -5.6/1) compared to the control group (1.9 mg/dL, 95 % CI, -0.7/4.5) (p = 0.043). Waist circumference (p = 0.010), body mass index (p = 0.047) and high-density lipoprotein cholesterol (p < 0.001) in the experimental group improved in comparison to baseline measurements. Conclusions: an intervention with dairy products naturally enriched with selenium and omega-3 in a sample of postmenopausal women with metabolic syndrome can improve plasma selenium levels and very low-density lipoprotein cholesterol.

INTRODUCCIÓN: Introducción: el síndrome metabólico de las mujeres posmenopáusicas puede mejorar con una alimentación saludable. Objetivos: evaluar si una intervención alimentaria con productos lácteos enriquecidos en selenio y ácidos grasos poliinsaturados omega-3 aumenta los niveles de selenio y mejora los factores de riesgo cardiovascular en las mujeres posmenopáusicas con síndrome metabólico. Material y métodos: ensayo clínico aleatorizado, triple ciego y controlado, realizado en atención primaria. Captación: abril 2018, 46 mujeres posmenopáusicas con síndrome metabólico consumidoras habituales de lácteos. Aleatorización: 23 en el grupo de control y 23 en el grupo experimental. Intervención: consumo durante 3 meses de lácteos enriquecidos naturalmente con selenio y ácidos grasos poliinsaturados omega-3 (leche, yogur y queso fresco). Controles: consumo de lácteos convencionales. Variable principal: selenio en plasma; secundarias: criterios del síndrome metabólico. Número de registro 2018/256, Comité de Ética Galicia. Resultados: finalizaron 23 mujeres en el grupo de control y 21 en el grupo de intervención. Aumentó el selenio en el grupo de intervención (7,2 µg/L, IC del 95 %: 3,7/10,8) frente al grupo de control (-4,5 µg/L, IC del 95 %: -8/-1) (p < 0,001) y disminuyó el colesterol unido a lipoproteínas de muy baja densidad (-2,3 mg/dl, IC del 95 %: -5,6/1) respecto al grupo de control (1,9 mg/dl, IC del 95 %: -0,7/4,5) (p = 0,043). Las mujeres del grupo experimental mejoraron respecto a su medición basal en perímetro de cintura (p = 0,010), índice de masa corporal (p = 0,047) y colesterol unido a lipoproteínas de alta densidad (p < 0,001). Conclusiones: una intervención con lácteos enriquecidos naturalmente con selenio y omega-3 en mujeres posmenopáusicas con síndrome metabólico puede mejorar los niveles de selenio en plasma y de colesterol unido a lipoproteínas de muy baja densidad.

Efficacy of baths with mineral-medicinal water in patients with fibromyalgia: a randomized clinical trial.

The layout of this study, designed as a randomized crossover clinical trial, is to evaluate the efficacy of an intervention with mineral-medicinal water from As Burgas (Ourense) in patients suffering from fibromyalgia. This sample was randomly divided into two groups: group A and group B. In phase 1, group A had 14 baths in thermal water for a month and standard pharmacological treatment; group B, standard pharmacological treatment. Washout period is 3 months. In phase 2, group A had standard treatment and group B had 14 baths in thermal water for a month plus standard treatment. The Fibromyalgia Impact Questionnaire (FIQ) was used; this grades the impact of the illness from 1 (minimum) to 10 (maximum), which was measured in both phases. Twenty-five patients were included in each group and the study was concluded with 20 patients in group A and 20 in group B. The intervention group obtained, once the baths finished, a mean score of 60.3 (± 11.8) and the control group of 70.8 (± 13.0) (p < 0.001). Three months later, the intervention group presented a mean score of 64.4 (± 10.6) and the control group of 5.0 (± 11.3) (p < 0.001). We can therefore conclude that the simple baths with mineral-medicinal water from As Burgas can make an improvement on the impact caused by fibromyalgia.

Evolution of quality of life and health-related behaviors among Spanish university students.

At the beginning of their academic studies (testing phase), the quality of life and certain health-related behaviors were evaluated. Four years later (retest phase), they were reevaluated. Between the two evaluation periods, a health promotion (HP) program was applied. The battery of instruments included measures: health-related quality of life (HRQOL), alcoholic and nicotine dependence, eating habits, physical activity, and sexual behaviors. It also included a number of sociodemographic data. The results show that, in general, the students reported adequate levels of HRQOL, and there were no important differences between the two evaluation moments. Regarding dietary behavior, no significant changes were detected in the pattern of adherence to the Mediterranean diet, which remained at an average level of adequacy. On the contrary, significant decreases were detected in relation to alcohol and tobacco dependence as well as significant increases in physical activity levels. Lastly, with regard to sexual behavior, although certain aspects of improvement were perceived, there is a need to increase awareness of the systematic use of condoms. In conclusion, this study provides relevant information that will serve as a starting point for monitoring changes in health behaviors and for the design and implementation of HP actions directed at university students.

Intervención educativa sobre parámetros cardiovasculares en mujeres perimenopáusicas con un factor de riesgo cardiovascular. Ensayo clínico aleatorizado / Educational intervention on cardiovascular parameters in perimenopausal women with a cardiovascular risk factor. Randomised clinical trial

Fundamento y objetivo: Ensayo clínico aleatorizado realizado en 2 centros de salud urbanos de España. Evaluar si una intervención educativa en mujeres en edad perimenopáusica con hipertensión, diabetes mellitus y/o dislipidemia podría conseguir cambios significativos en la reducción de parámetros bioquímicos y hemodinámicos de riesgo. Pacientes y métodos: Participaron 320 mujeres con edades comprendidas entre los 45 y 60 años y diagnosticadas de hipertensión, diabetes mellitus y/o dislipidemia. Fueron asignadas de forma aleatoria a grupo experimental (n=160) y a grupo control (n=160). El grupo intervención recibió 3 sesiones educativas y el grupo control recibió un folleto informativo enviado por correo postal. Fueron evaluadas variables hemodinámicas y bioquímicas al inicio del estudio y un año después en ambos grupos. Resultados: Las mujeres del grupo intervención mostraron, de forma significativa, una disminución de las lipoproteínas de baja densidad (p=0,034) (-5,89±29,8; IC 95%: -13,1/0,27) y un aumento de las lipoproteínas de alta densidad (p=0,013) (2,71±10,6; IC 95%: -1,36/6,20), así como mejoras en la presión arterial sistólica (p=0,016) (-2,16±11,8; IC 95%: -4,4/0,01) y la frecuencia cardíaca (p=0,003) (-1,46±10,3; IC 95%: -3,34/0,42) en comparación con las mujeres del grupo control. Estas últimas aumentaron significativamente los niveles de glucosa (p=0,04) (4,84±15,5; IC 95%: -0,75/31,3) y gamma-glutamiltransferasa (p=0,031) (3,61±14,7; IC 95%: 0,87/6,36) en comparación con las del grupo experimental. Conclusiones: Una intervención educativa puede ser un método eficaz para reducir los parámetros asociados a un aumento de probabilidad de sufrir una enfermedad cardiovascular en mujeres en edad perimenopáusica con hipertensión, diabetes mellitus y/o dislipidemia (AU)

Background and objective: Randomised clinical trial performed in two urban health centres in Spain. To evaluate if educational intervention in women of perimenopausal age with hypertension, diabetes mellitus and/or dyslipidaemia could achieve significant changes in the reduction of biochemical and haemodynamic risk parameters. Patients and methods: The study included 320 women aged between 45 and 60 years old who were diagnosed with hypertension, diabetes mellitus and/or dyslipidaemia. They were randomly assigned to the experimental group (n=160) and the control group (n=160). The intervention group received three educational sessions and the control group received an informative leaflet sent by mail. Haemodynamic and biochemical variables were evaluated at baseline and one year later in both groups. Results: Women in the intervention group showed a decrease in low density lipoprotein (P=.034), (-5.89±29.8; 95% CI: -13.1/0.27) and an increase in high density lipoprotein (P=.013), (2.71±10.6; 95% CI: -1.36/6.20), as well as improvements in systolic blood pressure (P=.016), (-2.16±11.8; 95% CI: -4.4/0.01) and frequency (P=.003), (-1.46±10.3; 95% CI: -3.34/0.42) compared to women in the control group. Women in the control group significantly increased glucose (P=.04), (4.84±15.5; 95% CI: -0.75/31.3) and gamma-glutamyltranspeptidase (P=.031), (3.61±14.7; 95% CI: 0.87/6.36) levels more than those in the experimental group. Conclusions: An educational intervention can be an effective method of reducing the parameters associated with an increased likelihood of cardiovascular disease in women at perimenopausal age with hypertension, diabetes mellitus and/or dyslipidaemia (AU)

Educational intervention on cardiovascular parameters in perimenopausal women with a cardiovascular risk factor. Randomised clinical trial. / Intervención educativa sobre parámetros cardiovasculares en mujeres perimenopáusicas con un factor de riesgo cardiovascular. Ensayo clínico aleatorizado.

BACKGROUND AND OBJECTIVE: Randomised clinical trial performed in two urban health centres in Spain. To evaluate if educational intervention in women of perimenopausal age with hypertension, diabetes mellitus and/or dyslipidaemia could achieve significant changes in the reduction of biochemical and haemodynamic risk parameters. PATIENTS AND METHODS: The study included 320 women aged between 45 and 60 years old who were diagnosed with hypertension, diabetes mellitus and/or dyslipidaemia. They were randomly assigned to the experimental group (n=160) and the control group (n=160). The intervention group received three educational sessions and the control group received an informative leaflet sent by mail. Haemodynamic and biochemical variables were evaluated at baseline and one year later in both groups. RESULTS: Women in the intervention group showed a decrease in low density lipoprotein (P=.034), (-5.89±29.8; 95% CI: -13.1/0.27) and an increase in high density lipoprotein (P=.013), (2.71±10.6; 95% CI: -1.36/6.20), as well as improvements in systolic blood pressure (P=.016), (-2.16±11.8; 95% CI: -4.4/0.01) and frequency (P=.003), (-1.46±10.3; 95% CI: -3.34/0.42) compared to women in the control group. Women in the control group significantly increased glucose (P=.04), (4.84±15.5; 95% CI: -0.75/31.3) and gamma-glutamyltranspeptidase (P=.031), (3.61±14.7; 95% CI: 0.87/6.36) levels more than those in the experimental group. CONCLUSIONS: An educational intervention can be an effective method of reducing the parameters associated with an increased likelihood of cardiovascular disease in women at perimenopausal age with hypertension, diabetes mellitus and/or dyslipidaemia.

Síndrome metabólico y grasa visceral en mujeres con un factor de riesgo cardiovascular / Metabolic syndrome and visceral fat in women with cardiovascular risk factor

Introducción: las enfermedades cardiovasculares son la primera causa de muerte en las mujeres tras la menopausia, ya que después de esta etapa se producen profundos cambios metabólicos y hormonales que favorecen el desarrollo de síndrome metabólico. Un aumento en el porcentaje de la grasa visceral puede estar relacionado con la aparición de dicho síndrome. Objetivo: establecer la relación entre la grasa visceral y los parámetros del síndrome metabólico y determinar el punto de corte óptimo para las variables relacionadas con la obesidad, en mujeres con un factor de riesgo cardiovascular. Método: estudio descriptivo transversal realizado en dos centros de salud urbanos de España. Fueron evaluadas 320 mujeres de edades comprendidas entre 45 y 60 años con hipertensión, diabetes mellitus y/o dislipemia. Se estudiaron edad, actividad estrogénica, grasa visceral y grasa corporal medida a través de un dispositivo de bioimpedancia, índice de masa corporal, perímetro abdominal, presión arterial sistólica y diastólica, triglicéridos, lipoproteínas de alta densidad, glucosa y presencia o no de síndrome metabólico. Resultados: las mujeres menopáusicas presentaban mayor cantidad de grasa visceral (p = 0,011). Se observó una correlación significativa entre la grasa visceral y todos los parámetros definitorios del síndrome metabólico (p < 0,05). El punto de corte óptimo para las variables relacionadas con la obesidad fue: grasa visceral (8 kg), perímetro abdominal (93,5 cm), índice de masa corporal (26,9 kg/m2) y grasa corporal total (24,3 kg). Conclusiones: mostraron mayor cantidad de grasa visceral las mujeres menopáusicas. Se observa una asociación entre la grasa visceral y los parámetros que definen el síndrome metabólico. Sería recomendable realizar un estudio más complejo que estudiase la utilidad de la grasa visceral como posible parámetro de cribado en el síndrome metabólico (AU)

Introduction: Cardiovascular diseases are the leading cause of death in women after menopause, since after this stage there are profound metabolic and hormonal changes which favor the development of metabolic syndrome. An increase in the percentage of visceral fat may be related to the onset of this syndrome. Objective: To establish the relationship between visceral fat and parameters of the metabolic syndrome and to determine the optimal cut-off point for the variables related to obesity in women with a cardiovascular risk factor. Method: Cross-sectional descriptive study carried out in two urban health centers in Spain. We evaluated 320 women aged 45 to 60 years with hypertension, diabetes mellitus and/or dyslipidemia. Age, estrogenic activity, visceral fat and body fat measured through a bioimpedance device, body mass index, abdominal perimeter, systolic and diastolic blood pressure, triglycerides, high density lipoprotein, glucose and the presence or absence of syndrome metabolic were considered. Results: There is a significant correlation between visceral fat and all metabolic syndrome defining parameters (p < 0.05). The optimum cut-offs for obesity-related variables were visceral fat (8 kg), abdominal perimeter (93.5 cm), body mass index (26.9 kg/m2) and total body fat (24.3 kg). Conclusions: Menopausal women showed more visceral fat. An association between visceral fat and the parameters that define the metabolic syndrome is observed. It would be advisable to perform a more complex research to study the utility of visceral fat as a possible screening parameter in the metabolic syndrome (AU)

Ensayo clínico con intervención educativa en mujeres perimenopáusicas con un factor de riesgo cardiovascular / Clinical trial with educational intervention in perimenopausal women with cardiovascular risk factor

Objetivo: Evaluar si una intervención educativa en mujeres en edad perimenopáusica con diabetes mellitus, hipertensión o dislipidemia podría mejorar aspectos relacionados con la calidad de vida o el ejercicio físico. Métodos: Ensayo clínico aleatorizado. Variables: actividad física, calidad de vida y peso en mujeres de 45-60 años de edad (n = 320) en el momento 0 y 12 meses después de la intervención. Grupo de intervención: tres talleres interactivos sobre prevención de enfermedad cardiovascular. Grupo control: información por correo. Resultados: El grupo de intervención obtuvo mejores puntuaciones en el componente mental de la calidad de vida 1 año después (p <0,05) y mostró un aumento significativo de la actividad física (p <0,01). Las mujeres del grupo de intervención mantuvieron su peso, mientras que las del grupo control lo aumentaron (p <0,01). Conclusiones: Una sencilla intervención educativa en mujeres perimenopáusicas con un factor de riesgo cardiovascular mejora aspectos relacionados con la calidad de vida y con hábitos saludables como la actividad física (AU)

Objective: To assess whether an educational intervention in women in perimenopausal age with diabetes mellitus, hypertension and/or dyslipidemia could improve aspects of quality of life and exercise. Methods: A randomized clinical trial. Variables: physical activity, quality of life and weight in women aged 45-60 years (n = 320) at time 0 and 12 months after surgery. intervention group (IG): 3 interactive workshops on cardiovascular disease prevention and control group (CG): information by mail. Results: The IG obtained better scores on the mental component of quality of life one year later (p < 0.05) and showed a significant increase in physical activity (p < 0.01). GI women maintained their weight while in CG women it increased (p < 0.01). Conclusions: A simple educational intervention in premenopausal women with a cardiovascular risk factor improves aspects of quality of life and of healthy habits such as physical activity (AU)

[Clinical trial with educational intervention in perimenopausal women with cardiovascular risk factor]. / Ensayo clínico con intervención educativa en mujeres perimenopáusicas con un factor de riesgo cardiovascular.

OBJECTIVE: To assess whether an educational intervention in women in perimenopausal age with diabetes mellitus, hypertension and/or dyslipidemia could improve aspects of quality of life and exercise. METHODS: A randomized clinical trial. VARIABLES: physical activity, quality of life and weight in women aged 45-60 years (n = 320) at time 0 and 12 months after surgery. intervention group (IG): 3 interactive workshops on cardiovascular disease prevention and control group (CG): information by mail. RESULTS: The IG obtained better scores on the mental component of quality of life one year later (p < 0.05) and showed a significant increase in physical activity (p < 0.01). GI women maintained their weight while in CG women it increased (p < 0.01). CONCLUSIONS: A simple educational intervention in premenopausal women with a cardiovascular risk factor improves aspects of quality of life and of healthy habits such as physical activity.

Beneficios de una intervención educativa en la dieta y en el perfil antropométrico de mujeres con un factor de riesgo cardiovascular / Benefits of an educational intervention on diet and anthropometric profile of women with one cardiovascular risk factor

Fundamento y objetivo: Evaluar si una intervención educativa en mujeres perimenopáusicas con hipertensión, diabetes mellitus y/o dislipidemia sería capaz de mejorar la adherencia a un patrón de dieta mediterráneo y conseguir cambios en parámetros antropométricos. Pacientes: Ensayo clínico aleatorizado de grupos paralelos: 320 mujeres (45-60 años) de 2 servicios de atención primaria urbanos. Variables a estudio: perímetro abdominal y de cadera, índice de masa corporal (IMC), grasa corporal total, visceral y de tronco (medidas con bioimpedancia) y adherencia a dieta mediterránea (cuestionario MEDAS-14). Grupo intervención: 3 talleres interactivos sobre prevención de enfermedad cardiovascular, y grupo control: información por correo. Resultados: Concluyeron el estudio 230 mujeres (113 en el grupo control y 117 en el grupo intervención). Un año después, las diferencias entre grupos fueron significativas en todos los parámetros. En la comparación intragrupos, las mujeres del grupo intervención mantuvieron el IMC y mejoraron la adherencia a la dieta mediterránea. El grupo control aumentó el IMC, el perímetro abdominal y de cadera y los parámetros de grasa (corporal total, visceral y tronco). Conclusiones: Una sencilla intervención educativa en mujeres perimenopáusicas con riesgo cardiovascular puede mejorar sus hábitos saludables (AU)

Background and objective: To assess whether an educational intervention in perimenopausal women with hypertension, diabetes mellitus and/or dyslipidaemia would improve adherence to a Mediterranean diet pattern and achieve changes in anthropometric parameters. Patients: Randomized clinical trial of parallel groups: 320 women (45-60 years) in 2 urban primary care services. Variables studied: hip and waist circumference, body mass index (BMI), total, visceral and trunk fat (bioimpedance measures) and adherence to Mediterranean diet (MEDAS-14 questionnaire). Intervention group: 3 interactive workshops on prevention of cardiovascular disease, and control group: information by post. Results: Two hundred and thirty women completed the study (113 control group and 117 intervention group). The differences between groups were significant in all parameters one year later. In the intragroup comparison, the intervention group maintained their BMI and improved adherence to the Mediterranean diet. The control group increased their BMI, abdominal and hip circumference and fat parameters (total, visceral and trunk fat). Conclusions: A simple educational intervention in perimenopausal women with cardiovascular risk can improve their healthy habits (AU)

[Benefits of an educational intervention on diet and anthropometric profile of women with one cardiovascular risk factor]. / Beneficios de una intervención educativa en la dieta y en el perfil antropométrico de mujeres con un factor de riesgo cardiovascular.

BACKGROUND AND OBJECTIVE: To assess whether an educational intervention in perimenopausal women with hypertension, diabetes mellitus and/or dyslipidaemia would improve adherence to a Mediterranean diet pattern and achieve changes in anthropometric parameters. PATIENTS: Randomized clinical trial of parallel groups: 320 women (45-60 years) in 2 urban primary care services. VARIABLES STUDIED: hip and waist circumference, body mass index (BMI), total, visceral and trunk fat (bioimpedance measures) and adherence to Mediterranean diet (MEDAS-14 questionnaire). Intervention group: 3 interactive workshops on prevention of cardiovascular disease, and control group: information by post. RESULTS: Two hundred and thirty women completed the study (113 control group and 117 intervention group). The differences between groups were significant in all parameters one year later. In the intragroup comparison, the intervention group maintained their BMI and improved adherence to the Mediterranean diet. The control group increased their BMI, abdominal and hip circumference and fat parameters (total, visceral and trunk fat). CONCLUSIONS: A simple educational intervention in perimenopausal women with cardiovascular risk can improve their healthy habits.

Intervención educativa para la prevención de osteoporosis en un servicio de Atención Primaria rural / Educational intervention for the prevention of osteoporosis in a rural Primary Healthcare service

Fundamento y objetivo: Determinar si una intervención educativa en mujeres perimenopáusicas rurales consigue cambios cuantificables en comportamientos de riesgo relacionados con la osteoporosis. Material y métodos: Ensayo clínico aleatorizado de grupos paralelos: 216 mujeres (45-54 años) de un servicio de Atención Primaria rural. Se recogieron preintervención y postintervención: índice de masa corporal (IMC), densitometría y analítica (calcio [Ca], parathormona [PTH]). Grupo intervención (n1 = 110): 2 talleres interactivos sobre prevención de osteoporosis. Grupo control (n2 = 106): información por correo.Resultados: Tras la intervención educativa, el grupo intervención mantuvo su IMC, aumentó su densidad mineral ósea (DMO) (p < 0,001) y disminuyó los niveles de Ca (p ≤ 0,048) y PTH (p < 0,001). El grupo control aumentó su IMC (p < 0,001) y su DMO (p ≤0,048), mantuvo sus niveles de Ca y disminuyó los de PTH (p = 0,01). Conclusiones: La mejoría de parámetros objetivos relacionados con la osteoporosis indica la validez de la educación sanitaria como medida preventiva en este grupo de mujeres. Sería interesante analizar la repercusión de esta mejoría a largo plazo en términos de reducir la incidencia de osteoporosis y de fracturas (AU)

Background and objective: The aim of this study is to determine whether an educational intervention in perimenopausal women in rural environments achieves significant changes in risk behaviors related to osteoporosis. Material and methods: Randomized clinical trials of parallel groups: 216 women (45-54 years old) of a rural Primary Healthcare service. Pre- and post- intervention were covered: body mass index (BMI), densitometry and blood test (calcium [Ca], parathormone [PTH]). Intervention group (n1 = 110): 2 interactive workshops on the prevention of osteoporosis. Control group (n2 = 106): information by post. Results: After the educational intervention, the intervention group maintained its BMI, increased its bone mineral density (BMD) (P < .001) and decreased the Ca (P ≤ .048) and PTH (P < .001) levels. The control group increased its BMI (P < .001) and its BMD (P ≤ .048), maintained its Ca levels and decreased the PTH values (P = .01).Conclusions: The improvement in the objective parameters related to osteoporosis indicates the importance of health education as a preventive measure in this group of women. It would be interesting to analyze the repercussions of this improvement on a long-term basis in terms of reducing the incidence of osteoporosis and fractures (AU)

[Educational intervention for the prevention of osteoporosis in a rural primary healthcare service]. / Intervención educativa para la prevención de osteoporosis en un servicio de Atención Primaria rural.

BACKGROUND AND OBJECTIVE: The aim of this study is to determine whether an educational intervention in perimenopausal women in rural environments achieves significant changes in risk behaviors related to osteoporosis. MATERIAL AND METHODS: Randomized clinical trials of parallel groups: 216 women (45-54 years old) of a rural Primary Healthcare service. Pre- and post- intervention were covered: body mass index (BMI), densitometry and blood test (calcium [Ca], parathormone [PTH]). Intervention group (n1=110): 2 interactive workshops on the prevention of osteoporosis. Control group (n2=106): information by post. RESULTS: After the educational intervention, the intervention group maintained its BMI, increased its bone mineral density (BMD) (P<.001) and decreased the Ca (P ≤.048) and PTH (P<.001) levels. The control group increased its BMI (P<.001) and its BMD (P ≤.048), maintained its Ca levels and decreased the PTH values (P=.01). CONCLUSIONS: The improvement in the objective parameters related to osteoporosis indicates the importance of health education as a preventive measure in this group of women. It would be interesting to analyze the repercussions of this improvement on a long-term basis in terms of reducing the incidence of osteoporosis and fractures.