High levels of fasting glucose and glycosylated hemoglobin values are associated with hyperfiltration in a Spanish prediabetes cohort. The PREDAPS Study.

AIM: This study aimed to investigate whether different levels of fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) in prediabetes are associated with hyperfiltration. METHODS: A prospective cohort of 2,022 individuals aged 30-74 years took part in the PREDAPS Study. One cohort of 1,184 participants with prediabetes and another cohort of 838 participants with normal FPG and normal HbA1c were followed for 5 years. Hyperfiltration was defined as an estimated glomerular filtration rate (eGFR) above the age- and gender-specific 95th percentile for healthy control participants, while hypofiltration was defined as an eGFR below the 5th percentile. The prevalence of hyperfiltration was compared for different levels of prediabetes: level 1 of prediabetes: FPG <100 mg/dL plus HbA1c 5.7-6.0% or FPG 100-109 mg/dL plus HbA1c < 5.7%; level 2 of prediabetes: FPG <100 mg/dL plus HbA1c 6.1-6.4% or FPG 100-109 mg/dL plus HbA1c 5.7-6.0% or FPG 110-125 mg/dL plus HbA1c <5.7% and level 3 of prediabetes: FPG 100-109 mg/dL plus HbA1c 6.1-6.4% or FPG 110-125 mg/dL plus HbA1c 5.7-6.4%. RESULTS: The participants with hyperfiltration were significantly younger, had a higher percentage of active smokers, and lower levels of hemoglobin and less use of ACEIs or ARBs. Only level 3 prediabetes based on FPG 100-109 mg/dL plus HbA1c 6.1-6.4% or FPG 110-125 mg/dL plus HbA1c 5.7-6.4% had a significantly higher odds ratio (OR) of hyperfiltration (OR 1.69 (1.05-2.74); P < 0.001) compared with no prediabetes (FPG < 100 mg/dL and HbA1c < 5.7%) after adjustment for different factors. The odds ratios for different levels of HbA1c alone in prediabetes increased progressively, but not significantly. CONCLUSIONS: Level 3 of prediabetes based on FPG 100-109 mg/dL plus HbA1c 6.1-6.4% or FPG 110-125 mg/dL plus HbA1c 5.7-6.4% had a significantly higher OR of hyperfiltration compared with participants without prediabetes.

Profile of patients with fibromyalgia being treated in primary care centers in Terrassa, a city in northeastern Spain. / Perfil de pacientes con fibromialgia que acuden a los centros de atención primaria en Terrassa.

OBJECTIVE: To perform an extensive clinical and epidemiological characterization of our fibromyalgia patients. PATIENTS, MATERIAL, AND METHOD: Two-year observational study in 3 primary care centers in Terrassa, Spain. We recruited a sample of 235 individuals diagnosed with fibromyalgia being treated in primary care or rheumatology clinics who, when offered inclusion in a multidisciplinary program, agreed to provide the initial data we requested. The main measures were sociodemographic data, unhealthy habits and physical activity, comorbidities, treatment for fibromyalgia, Fibromyalgia Impact Questionnaire (FIQ), Hospital Anxiety and Depression Scale (HADS), and a family functioning scale (family APGAR). MAIN RESULTS: In all, 97.8% were women and the average age was 54.6 years. Most of the patients had a primary school education and the majority was on sick leave. Ninety-four percent had associated comorbidity and only 3% were not taking any medication for their disease. Many were taking drugs with no proven efficacy in fibromyalgia. The majority had intermediate scores on the FIQ, the HADS showed that 63% and 53% had an anxious and/or probable depressive disorder, respectively, and, according to the family APGAR score, 62% received proper family support. CONCLUSIONS: In agreement with the literature, the major findings in our fibromyalgia patients were a marked predominance of women, a high incidence of comorbidities-mainly psychiatric disorders-a moderate impact of the disease and widespread use of drugs with no demonstrated efficacy.

Prevalencia de enfermedad renal crónica en pacientes con diabetes tipo 2 mediante determinación del filtrado glomerular y su relación con el riesgo cardiovascular / Prevalence of chronic renal insufficiency in diabetic type 2 diabetes patients based on the estimated glomerular filtration rate and relation with cardiovascular risk

Fundamento y objetivo: Los objetivos de este estudio fueron: determinar la prevalencia de la enfermedad renal crónica (ERC) en pacientes con diabetes mellitus tipo 2 (DM2) mediante la estimación del filtrado glomerular (FGe); comprobar los factores asociados a ERC; y en que medida el filtrado glomerular se relaciona con un riesgo aumentado de enfermedad cardiovascular (ECV). Pacientes y método: Estudio observacional retrospectivo transversal. Revisión de una muestra representativa de 500 historias clínicas seleccionada aleatoriamente del listado de 2.950 pacientes con DM2 de nuestra área. Se registraron datos sociodemográaficos, comorbilidades, factores de riesgo cardiovascular, tratamientos farmacológicos y datos analíticos. La ERC se definió como FGe < 60 ml/min/ 1,72m2 y se clasificó en estadios según la K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease. Resultados: El 51,6% eran mujeres y la media de edad era de 66,2 años. Se observó una prevalencia de ERC del 23,2%, con 108 casos (21,6%) en stadio 3 y 8 (1,6%) en estadio 4, sin ningún paciente en estadio 5. Un 70,4% eran hipertensos, un 67% tenían dislipidemia, el 17,6% eran fumadores y el 19% tenían antecedente de ECV (46% de ellos, cardiopatía isquémica). La presencia de ERC se relacionó con más edad, sexo femenino, creatinina plasmática elevada, presencia de microabuminuria y antecedentes de tabaquismoactivo, HTA, dislipidemia y ECV. Al analizar los datos según las categorías de ERC, desaparecía la relación significativa con el tabaquismo. En el análisis multivariado existía relación positiva con edad, sexo femenino, dislipidemia y cardiopatía isquémica. Conclusión: En este estudio se confirma la elevada prevalencia de ERC en pacientes con DM2 y su relación con la presencia de enfermedad cardiovascular (AU)

Background and objective: The aim of this study was: to estimate the prevalence of chronic renal insufficiency (CRI) in diabetic type 2 (DM2) patients treated in Primary Care based on the estimated glomerular filtration rate (GFe); to determine associated factors with CRI, and to evaluate the relationship of GF rate and risk of cardiovascular disease. Patients and methods: This was a descriptive cross-sectional study. We included 500 medical histories randomly selected in a total of 2,950 DM2 patients. We registered sociodemographic data, comorbidities, cardiovascular risk factors and laboratory data. CRI definition was based on GFe rate and classified according to the K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease. Results: The prevalence of CRI was 23.2%. There were 51.6% females and the mean age was 66.2 years; 70,4% had hypertension and 67% dyslipidemia. The presence of CRI was related with older age, females, smoking habit, plasma creatinine value, microalbuminuria, and history of hypert nsion, dyslipidemia and cardiovascular disease. After analysing the data according to the category of GF rate, only the significant relationship with smoking habit disappeared. Multivariate statistic analysis supports a relation with older age, female gender, dyslipidemia and heart disease. Conclusions: We confirm a high prevalence of CRI in DM2 patients and their relationship with the presence of cardiovascular disease (AU)

[Prevalence of chronic renal insufficiency in diabetic type 2 diabetes patients based on the estimated glomerular filtration rate and relation with cardiovascular risk]. / Prevalencia de enfermedad renal crónica en pacientes con diabetes tipo 2 mediante determinación del filtrado glomerular y su relación con el riesgo cardiovascular.

BACKGROUND AND OBJECTIVE: The aim of this study was: to estimate the prevalence of chronic renal insufficiency (CRI) in diabetic type 2 (DM2) patients treated in Primary Care based on the estimated glomerular filtration rate (GFe); to determine associated factors with CRI, and to evaluate the relationship of GF rate and risk of cardiovascular disease. PATIENTS AND METHODS: This was a descriptive cross-sectional study. We included 500 medical histories randomly selected in a total of 2,950 DM2 patients. We registered sociodemographic data, comorbidities, cardiovascular risk factors and laboratory data. CRI definition was based on GFe rate and classified according to the K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease. RESULTS: The prevalence of CRI was 23.2%. There were 51.6% females and the mean age was 66.2 years; 70,4% had hypertension and 67% dyslipidemia. The presence of CRI was related with older age, females, smoking habit, plasma creatinine value, microalbuminuria, and history of hypertension, dyslipidemia and cardiovascular disease. After analysing the data according to the category of GF rate, only the significant relationship with smoking habit disappeared. Multivariate statistic analysis supports a relation with older age, female gender, dyslipidemia and heart disease. CONCLUSIONS: We confirm a high prevalence of CRI in DM2 patients and their relationship with the presence of cardiovascular disease.