Diferencias de género en la mortalidad de personas con diabetes tipo 2: Estudio Asturias 2018 / Gender differences in the mortality of people with type 2 diabetes: Asturias Study 2018

OBJETIVO: Investigar la influencia del sexo en la mortalidad según la presencia o ausencia de diabetes mellitus tipo 2 (DM2) y otros factores de riesgo cardiovascular en la cohorte del Estudio Asturias. MÉTODO: El Estudio Asturias (iniciado en 1998) es un estudio de cohortes observacional, prospectivo, de una muestra representativa de la población asturiana de entre 30 y 75 años. Se dividió la población en grupos según la presencia o ausencia de DM2 y el sexo para valorar el control de los factores de riesgo cardiovascular. Además, conociendo el estatus vital de la cohorte 18 años después del inicio del estudio, se analizaron las diferencias en causas de mortalidad según las categorías anteriores. RESULTADOS: En 1998 iniciaron el estudio 1034 personas, de las cuales 561 eran mujeres (54,25%) y 473 eran hombres (45,75%). Padecían diabetes 131 (12,66%; 75 varones y 56 mujeres). Las mujeres con DM2 presentaron una hazard ratio (HR) para mortalidad total de 1,64 (intervalo de confianza del 95% [IC95%]: 0,97-2,77), y los hombres de 1,63 (IC95%: 1,07-2,50); para mortalidad cardiovascular, la HR fue de 3,06 (IC95%: 1,44-6,47) en las mujeres y de 1,49 (IC95%: 0,64-3,46) en los hombres. La tasa de mortalidad para las personas con DM2 en ambos sexos fue más alta que para las personas sin DM2. CONCLUSIONES: Las mujeres con DM2 tienen un riesgo de fallecer por causas cardiovasculares tres veces mayor que las mujeres sin DM2. Deberían implementarse estrategias de tratamiento en las mujeres con esta condición

OBJECTIVE: To investigate the influence of gender on mortality according to the presence or absence of type 2 diabetes mellitus (DM2) and other cardiovascular risk factors in the Asturias Study cohort. METHOD: The Asturias Study (started in 1998) is an observational, prospective cohort study of a representative sample of a population of Asturias aged 30-75 years. The population was divided into groups according to the presence or absence of DM2 and according to gender to assess control of cardiovascular risk factors. In addition, aware of the vital status of the cohort 18 years after the beginning of the study, we analyzed differences in causes of mortality according to the previous categories. RESULTS: In 1998, 1034 people started the study, 561 women (54.25%) and 473 men (45.75%). Of these, 131 (12.66%) had diabetes (75 men and 56 women). The women with T2D presented a hazard ratio (HR) for total mortality of 1.64 (95% confidence interval [95%CI]: .97-2.77), which was 1.63 (95%CI: 1.07-2.50) for the men and, for cardiovascular mortality, 3.06 (95%CI: 1.44-6.47) for the females, versus 1.49 (95%CI: 0.64-3.46) for the males. The mortality rate for people with T2D of both sexes was higher than for people without T2D. CONCLUSIONS: Women with T2D have a risk more than three times higher than women without diabetes of dying from cardiovascular causes. We should implement treatment strategies in women with this condition

[Gender differences in the mortality of people with type 2 diabetes: Asturias Study 2018]. / Diferencias de género en la mortalidad de personas con diabetes tipo 2: Estudio Asturias 2018.

OBJECTIVE: To investigate the influence of gender on mortality according to the presence or absence of type 2 diabetes mellitus (DM2) and other cardiovascular risk factors in the Asturias Study cohort. METHOD: The Asturias Study (started in 1998) is an observational, prospective cohort study of a representative sample of a population of Asturias aged 30-75 years. The population was divided into groups according to the presence or absence of DM2 and according to gender to assess control of cardiovascular risk factors. In addition, aware of the vital status of the cohort 18 years after the beginning of the study, we analyzed differences in causes of mortality according to the previous categories. RESULTS: In 1998, 1034 people started the study, 561 women (54.25%) and 473 men (45.75%). Of these, 131 (12.66%) had diabetes (75 men and 56 women). The women with T2D presented a hazard ratio (HR) for total mortality of 1.64 (95% confidence interval [95%CI]: .97-2.77), which was 1.63 (95%CI: 1.07-2.50) for the men and, for cardiovascular mortality, 3.06 (95%CI: 1.44-6.47) for the females, versus 1.49 (95%CI: 0.64-3.46) for the males. The mortality rate for people with T2D of both sexes was higher than for people without T2D. CONCLUSIONS: Women with T2D have a risk more than three times higher than women without diabetes of dying from cardiovascular causes. We should implement treatment strategies in women with this condition.

Estimación de grasa corporal según ecuación CUN-BAE e IMC y riesgo de mortalidad por sexos en la cohorte del Estudio Asturias / Estimation of body fat mass using the CUN-BAE index and mortality risk by sex in the Asturias Study cohort

Introducción y objetivos: Conocemos que el exceso de grasa corporal (GC) se asocia con factores de riesgo cardiovascular, algunos tipos de cáncer y otras causas principales de muerte. Se ha definido un nuevo método antropométrico: el índice CUN-BAE (Clínica Universidad de Navarra-Estimador de Adiposidad Corporal), que se basa en el IMC, el sexo y la edad. Hemos utilizado IMC y CUN-BAE para evaluar su contribución en la asociación con mortalidad en la cohorte del Estudio Asturias. Material y métodos: El Estudio Asturias se trata de un estudio de cohortes que incluyó a 1.034 individuos de 30-75 años de edad que participaron en la primera fase del estudio (1998-1999), realizando encuesta, exploración física y sobrecarga oral de glucosa. Se registraron los fallecimientos en la cohorte tras 18 años de seguimiento. Resultados: 204 personas fallecieron: 93 mujeres y 111 varones (16,6% de las mujeres y 23,5% de los varones). Valores basales tanto de IMC como de %GC determinantes de obesidad (> 30 kg/m2 para IMC; > 25% en hombres y > 35% en mujeres para CUN-BAE) fueron mayoritarios en los datos de individuos fallecidos. Tras ajuste por DM2, HTA, ECV y tabaco, el riesgo de mortalidad por todas las causas y cardiovascular es significativamente mayor según se incrementa el CUN-BAE, sobre todo en mujeres. Conclusiones: La ecuación CUN-BAE es una herramienta útil en mujeres para detectar las que van a presentar un mayor riesgo de mortalidad, independientemente de factores de riesgo

Introduction and objectives: In epidemiological studies, excess body fat (BF) has been associated with cardiometabolic risk factors, some types of cancer, and other causes of death. A new anthropometric method has been defined: The CUN-BAE index (University of Navarra Clinic-Body Fat Estimator), which is based on BMI, sex, and age. BMI and CUN-BAE index were used to assess their contribution to mortality risk from any cause in the Asturias Study cohort. Material and methods: The Asturias study is a cohort study including 1.034 individuals aged 30-75 years who participated in the first study phase (1998-1999). The study included a clinical survey, physical examination, and an oral glucose tolerance test. Vital status was determined in the cohort after 18years of follow-up. Results: Two hundred and four subjects died: 93 females and 111 males (16.6% and 23.5% respectively men). Baseline values of both BMI and %BF suggesting obesity (BMI > 30 kg/m2 and CUN-BAE > 25% in males and >35% in females) were found in most subjects. After adjusting for T2DM, HBP, CVD, and tobacco, the risk of all-cause and cardiovascular mortality was significantly higher as CUN-BAE increased, especially in females. Conclusions: The CUN-BAE equation is a useful tool, especially in females, to detect those who will have a greater risk of mortality, regardless of cardiovascular risk factors

Estimation of body fat mass using the CUN-BAE index and mortality risk by sex in the Asturias Study cohort. / Estimación de grasa corporal según ecuación CUN-BAE e IMC y riesgo de mortalidad por sexos en la cohorte del Estudio Asturias.

INTRODUCTION AND OBJECTIVES: In epidemiological studies, excess body fat (BF) has been associated with cardiometabolic risk factors, some types of cancer, and other causes of death. A new anthropometric method has been defined: The CUN-BAE index (University of Navarra Clinic-Body Fat Estimator), which is based on BMI, sex, and age. BMI and CUN-BAE index were used to assess their contribution to mortality risk from any cause in the Asturias Study cohort. MATERIAL AND METHODS: The Asturias study is a cohort study including 1.034 individuals aged 30-75years who participated in the first study phase (1998-1999). The study included a clinical survey, physical examination, and an oral glucose tolerance test. Vital status was determined in the cohort after 18years of follow-up. RESULTS: Two hundred and four subjects died: 93 females and 111 males (16.6% and 23.5% respectively men). Baseline values of both BMI and %BF suggesting obesity (BMI>30kg/m2 and CUN-BAE >25% in males and >35% in females) were found in most subjects. After adjusting for T2DM, HBP, CVD, and tobacco, the risk of all-cause and cardiovascular mortality was significantly higher as CUN-BAE increased, especially in females. CONCLUSIONS: The CUN-BAE equation is a useful tool, especially in females, to detect those who will have a greater risk of mortality, regardless of cardiovascular risk factors.

[Intragastric injection of botulinum toxin. A real alternative for obesity treatment? A systematic review]. / Inyección intragástrica de toxina botulínica mediante endoscopia, ¿una alternativa para el tratamiento de la obesidad? Una revisión sistemática.

BACKGROUND: Obesity is a prevalent disease in our environment, which comorbidities suppose a great challenge to public health. Intragastric injection of botulinum toxin has been used as treatment for obesity, both in humans and animals. It acts by inhibiting gastric emptying and inducing early satiety, consequently reducing intake and finally achieving weight loss. MATERIALS AND METHODS: A bibliographic search in PubMed, Scopus and EMBASE databases between 2000 and 2016 was carried out. Articles regarding the physiological basis of the treatment with intragastric injection of botulinum toxin in human were included, as well as interventional studies, randomised or not. RESULTS: A total of 105 articles were found and 10 were chosen according to our inclusion criteria. Of those, only 4 were randomised and 8 lasted between 8 and 24 weeks. In four of the studies, one randomised, a statistically significant weight loss was found which varied between 3.5 and 11.8 kg. Most of the studies found slowing of gastric emptying. None of them notified any significant side-effects. CONCLUSION: Intragastric injection of botulinum toxin could be useful and safe in the treatment of obesity but better designed, placebo-controlled, long term and with an adequate sample size studies are needed.

Inyección intragástrica de toxina botulínica mediante endoscopia, ¿una alternativa para el tratamiento de la obesidad? Una revisión sistemática / Intragastric injection of botulinum toxin. A real alternative for obesity treatment? A systematic review

Introducción: la obesidad es una patología de elevada prevalencia en nuestro medio, cuyas comorbilidades asociadas representan un gran reto para la salud pública global. La inyección de toxina botulínica intragástrica en animales y humanos se ha empleado como tratamiento para la obesidad. Su efecto incluiría el retraso del vaciamiento gástrico y la inducción de saciedad temprana, con la consiguiente disminución de la ingesta y la pérdida de peso. Materiales y métodos: se realizó una búsqueda bibliográfica en las bases de datos PubMed, Scopus y EMBASE, para el periodo comprendido entre 2000 y 2016. Se incluyeron los artículos que trataron las bases del tratamiento con toxina botulínica intragástrica en humanos, así como los diferentes estudios de intervención, aleatorizados o no. Resultados: se encontraron un total de 105 artículos y, utilizando los criterios de inclusión, se seleccionaron 10. De ellos, solo cuatro fueron aleatorizados y ocho duraron entre 8 y 24 semanas. En cuatro de los estudios, uno de ellos aleatorizado, se encontró una pérdida de peso significativa, que varió entre los 3,5 y los 11,8 kg. La mayor parte de los estudios halló un enlentecimiento del vaciado gástrico. Ningún estudio comunicó efectos secundarios de relevancia. Conclusión: la inyección de toxina botulínica intragástrica podría ser eficaz y segura en el tratamiento de la obesidad, pero son necesarios estudios bien diseñados, controlados con placebo, de largo seguimiento y adecuado tamaño muestral (AU)

Background: Obesity is a prevalent disease in our environment, which comorbidities suppose a great challenge to public health. Intragastric injection of botulinum toxin has been used as treatment for obesity, both in humans and animals. It acts by inhibiting gastric emptying and inducing early satiety, consequently reducing intake and finally achieving weight loss. Materials and methods: A bibliographic search in PubMed, Scopus and EMBASE databases between 2000 and 2016 was carried out. Articles regarding the physiological basis of the treatment with intragastric injection of botulinum toxin in human were included, as well as interventional studies, randomised or not. Results: A total of 105 articles were found and 10 were chosen according to our inclusion criteria. Of those, only 4 were randomised and 8 lasted between 8 and 24 weeks. In four of the studies, one randomised, a statistically significant weight loss was found which varied between 3.5 and 11.8 kg. Most of the studies found slowing of gastric emptying. None of them notified any significant side-effects. Conclusion: Intragastric injection of botulinum toxin could be useful and safe in the treatment of obesity but better designed, placebo-controlled, long term and with an adequate sample size studies are needed (AU)